Purpose: With an evolving role in patient care, pharmacists face increasingly complex ethical dilemmas in clinical decision-making. Yet, pharmacy-specific guidelines and education regarding best practices in ethical decision-making are limited. This knowledge gap may increase outside factors influence on pharmacists’ responses to ethical dilemmas. Thus, there is a need to characterize influences and processes whereby hospital pharmacists currently make ethical decisions.

Methods: Descriptive study conducted through anonymous, web-based survey evaluating responses of hospital pharmacists to clinical case scenarios involving ethical concepts: autonomy, nonmaleficence, justice, and confidentiality. The survey was distributed to pharmacists throughout seven states collected demographic and education information, and presented clinical case scenarios and queries regarding factors on which the response to the scenario was based. Factors ranked on a Likert scale. Results analyzed using descriptive statistics.

Results: Sixty-two responses collected from September 2019 to February 2020; 44 included in the final analysis. Participants primarily based in Utah, working decentralized acute care in hospitals with over 500 beds. Variance existed in which factors influenced survey participant responses to each clinical scenario. Four (code of ethics, legal obligations/laws, education/personal experience, personal values) of six influencing factors analyzed had the greatest weight on ethical decision-making.

Conclusion: Variability was found across pharmacists’ clinical responses to ethical dilemmas. This variance may influence patient care. Study results reinforce that pharmacists display clinical judgment skills and that moral reasoning is guided by ethical tenants. Opportunities for further education were identified to help refine and develop these skills as the paradigm of practice and changing roles in pharmacy continue to progress.