When People Fail

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Handout photo of Lance Armstrong speaking with Oprah Winfrey in AustinI am personally struggling with two pieces of information today.  The first is that Lance Armstrong has come clean with Oprah about his doping scandal.  I had hoped that it was all fabricated by those who were jealous, but alas he is guilty.  I cannot even understand why the leagues (baseball, biking etc...) don't realize that the cost of winning is at ALL costs.  Why not just make these substances all legal and do away with that aspect of what we are capable of doing on our own.  This is 2013.  I would say at this point most sports has seen their very best without enhancement.  What is left?  Enhancement. I know that seems bizarre for a pharmacist to say publicly that doping for sports should be made legal, but that is what I am saying.  As long as it stays illegal, the coaches and trainers and others involved in making the best of the best will go at all lengths to find substances that are not yet known or tested and continue to dope.  It is inevitable.

The other piece of information that I am struggling with today is that a former classmate in pharmacy school (who I will call Ed for his own privacy) has made a deal in pleading guilty in a case that I have had a hard time understanding.

You see, Ed was the type of student in our class who was a man of character.  He was one of the good guys.  I believe he was already married and was in the pharmacy fraternity that was more studious and less partying.  You can imagine that I was in the partying one and you would imagine right.  Ed has a large family now; he has small children and a wife that need him.

Ed has had some legal trouble in which there was some sort of federal charge brought against him for distributing controlled substance (Oxycontin) from his pharmacy.  I don't know how this whole thing began, but apparently it began fairly innocent enough with perhaps one bad decision or perhaps another part of the story that I do not know.  Maybe it was driven by needing money.  Perhaps it was driven by a bad decision further snowballing into extortion by some drug addicted criminals.

Either way, Ed is going to likely go to prison for around five years or so, and my heart breaks for him.

I know that it is easy for many to condemn a man like Lance Armstrong for doping but the bigger offense being the lies he told over the years and nastiness that ensued.  He threatened, sued and was a bully for the most part.  He "beat" cancer of the brain metastasized from testicular cancer, and he founded Livestrong.  There was good to the fame and notoriety even if he came by it by cheating.  Does the means justify the end?  Sometimes?

Fifteen years ago I would have looked at both men making bad decisions and would have spewed my opinion, and it would have been quite judgmental.  I tend to not do that as much because the situation is much more complicated the older I get.  You see, people fail.  People are human - even the most trusted professional, the pharmacist.  The moment that I believe that I am infallible of filling will be the moment where I am the most vulnerable.  We must always strive to do our best.  Do not compromise even for a moment the integrity and good name you have.  It is all you have in the way of public opinion, and in the case of Ed, I was a little saddened to read that he has struck a deal with the government about pleading guilty to one count and going to prison.  He will be sentenced right before this summer, and I dread it for him and his sweet wife and children.

I do hope for a silver lining for Lance Armstrong somehow.  I hope that he is able to look back at his life and see his own shortcomings and how they shaped him into something even better.  Yes, he made a mistake and turned that mistake into a snowball of lies and more denials that took years for him to admit, but there are good things that he has done.

My friend made a mistake and is going to pay the consequence for it by missing five years of his children's lives.  Both of them still are men I can admire for good things in the past and I hope even better things in the future.  Somehow.

 

 

Morality and Ethics in the Pharmacy

Should a pharmacist be allowed to exercise their own beliefs and ethics while at work?  This question is part of a big debate in our country in regards to abortion vs. a woman’s right to choose and how it could pertain to a pharmacists’ right to not dispense a medication, specifically the morning after pill.

It is ironic that the same liberal and feminist groups have defended other people in their choice to exercise their own beliefs.  A soldier has been backed by these same groups when they have not wanted to go to war.  The man or woman smoking marijuana to ease pain, although illegal in most states, has been backed by the same.  However, exercising your own beliefs or morals about abortion and the debate of when life begins ends when it comes to the morning after pill.  These groups want to make it mandatory that all pharmacists must dispense Plan B when requested regardless.

On the other hand, a female wanting to exercise her right to choose could be met with resistance from a pharmacist whose morals including viewing life beginning at conception.  There is no clear winner on either side.

By law, a pharmacist can refuse to fill a prescription for any reason they see fit.  Should that reason include their own morals?  Why do you believe yes or no in this debate?

Hospice Care

When I'm entering/reviewing orders for someone with terminal cancer and the last "D/C to hospice" order.  A lump will come up in my throat and then I start thinking about life.  What will I die of?  Will someone enter my last orders someday?  Will I die of a terminal cancer or something else?  I know I shouldn't think about it, but the last few decades of life have passed rather briefly.  Will the rest of life be the same?  Quick and so fast you don't take the time to enjoy it? Anyway, that's what those orders do to me... and then I have to clear my thinking and my mind and get back to work.

I just wonder sometimes if others are affected by it in the same way.

One of the most profound rotations in my last year of pharmacy school was with a hospice nurse.  To this day I still remember each and every patient we visited at various stages of dying.  The man whose terminal wife was hours if not a day from death but yet he seemed so stoic and in denial.  That one was the worst.  They had this gorgeous custom home with all the fine details and obviously had planned retirement together in this space.

Life had other plans.

 

NAPLEX is Suspended

Prof. accused of sharing licensure exam questionsQuality of University not in doubt KRISTEN COULTER

Issue date: 8/30/07 Section: News

Shirley Zhang, a graduate student from China studying biochemical sciences, walks past the Pharmacy Building located on South Campus.

A University pharmacy professor is a defendant in a federal court case, in which he is accused of collecting and disseminating pharmacy test questions to students, according to court documents obtained by The Red & Black.

The National Association of Boards of Pharmacy filed the case Aug. 3 against the Board of Regents and Flynn Warren Jr., citing copyright infringement, misappropriation of trade secrets and breach of contract, according to the documents.

NABP has investigated Warren twice for these allegations.

The North American Pharmacist Licensure Examination and Georgia Multistate Pharmacy Jurisprudence Examination are tests required to obtain a license to practice pharmacy. The NAPLEX is used by all 50 states’ boards of pharmacy, and the MPJE “combines federal and state specific law items to serve as the state law examination in 46 participating jurisdictions,” according to a NABP news release.

At an Aug. 23 meeting, the executive committee of NABP decided to suspend all administrations of the NAPLEX and the Georgia MPJE beginning Aug. 25 and will not administer the test nationwide.

NABF said in the news release it has not decided when to reinstate the test.

“I cannot comment on this, given the current investigation,” said University Provost Arnett Mace Wednesday afternoon.

Warren, who was reached at his home Wednesday evening, also refused to comment.

The College of Pharmacy referred calls to Tom Jackson, the associate vice president for public affairs. Jackson wrote Wednesday in an e-mail, “parties have been ordered by the court not to comment on the matter while it is in litigation.”

While he would not comment on the investigation, George Francisco, associate dean of the College of Pharmacy, said Warren has taught the board review course at the University “for several years.” Francisco said the class lasts three days and is available to both University pharmacy students and students at other institutions.

Warren is accused of copyright infringement because NABP owns the copyrights on the exam questions. Court papers say he asked students to memorize NAPLEX test questions and share them with him. He collected the tests’ contents and created a review packet.

Warren is faced with these accusations because he was never “granted a license … to copy, sell, distribute, prepare derivative works from, or otherwise offered to transfer the ownership of the copyrights of the NABP Examination Questions, to which NABP has exclusive rights,” the court papers read.

Warren is accused of misappropriation of trade secrets because: “the NABP Examination Questions are original lists of questions containing technical information used for evaluating the competency of a candidate in the field of pharmacy,” and the questions “derive economic and evaluative value from not being generally known and not being readily ascertainable by proper means,” according to the documents.

The breach of contract charge stems from a 1995 settlement agreement, in which Warren and the University said they will “cease and desist for profit or otherwise from all past, present and future copying, transcribing or other infringing use of NABP copyrighted materials, including but not limited to patient profiles, sample questions, or other copyrighted information.”

Francisco said he was unaware of the 1995 settlement, and the pharmacy school was not monitoring Warren’s classes.

Last year, the BOR offered to pay $40 million for an addition to the College of Pharmacy.

Professors at other schools exposed exam study guide

According to a biography on the University’s Web site, Warren has been a pharmacy faculty member since 1985. Before his July 1 retirement, he was a clinical professor and the college’s assistant dean for student affairs.

Though he retired last month, Warren still is teaching elective classes for the pharmacy school, Francisco said.

This case arose after Warren offered an annual exam review course at Samford University.

Alan Ray Spies, an assistant pharmacy professor at Samford, said in an affidavit that he learned Warren was giving NAPLEX questions to students. Spies said he first found out this information in May 2007.

“Specifically, I learned that Mr. Warren’s course materials include, among others, a series of questions, some 2,700 in number, that appear to be very similar, if not verbatim, to questions asked on the NAPLEX,” Spies said in the affidavit.

Spies said he talked with some of his students about Warren’s course in the affidavit.

“It soon became apparent to me that individuals who had just taken the exam were sending Mr. Warren questions which he in turn was forwarding to students who had not yet taken the NAPLEX.”

Spies said he sent the information he found in an e-mail to Steven Pray, a pharmacy professor at Southwestern Oklahoma State University.

In his affidavit, Pray discussed his view of the importance of exam security for the NAPLEX.

“The knowledge base required to become a competent pharmacist is vast, taught via hundreds of hours of lectures, laboratories, and practical experiences,” Pray said.

In the affidavit, Pray also discussed his thoughts about the extensive consequences for the exam if the questions have been compromised.

“A loss of hundreds or thousands of items, as it appears, has occurred through the activities of Mr. Warren, will force NABP to endure a loss of millions of dollars and will necessitate a radical overhauling of the examination pool,” he said. “If this is required, the nation’s pharmacy graduates cannot be licensed until a new, uncompromised NAPLEX can be created.”

As he further researched the issue, Pray said in the affidavit that he found an online forum where students discussed Warren’s course.

“This Web site also discussed an individual named ‘Flynn,’ who offered a review course and notes on passing the NAPLEX,” Pray said in the document. “One correspondent on the Web site suggested that prospective examinees review the comments sent to ‘Flynn’ by other students, and another provided his address at the University of Georgia.”

Pray declined Wednesday to speak for attribution about the case with The Red & Black.

Professionals feared news would ‘impair confidence’

According to court documents, Pray sent the information to Carmen Catizone, executive director of NBAP.

In his affidavit, Catizone said Kerri Hochgesang, a lawyer for NABP, bought Warren’s course materials on July 31. In her affidavit, she stated, “a true and correct copy of my payment receipt from the ‘UGA Pharmacy Cont ED, Pharmacy Building’ for the course materials” was given to her for $100.

According to Catizone, the materials contained at least three PDF files. On the NAPLEX REVIEW 2007 disc included in the materials, the files were labeled “NAPLEX MATERIAL PART 2, 2006 INFO FOR NAPLEX, and NAPLEX SAMPLE TEST W ANSWERS.”

Catizone reported his analysis of this material “revealed at least 633 ’sample’ questions contained in Warren’s ‘review course’ and/or were made available by Mr. Warren to candidates who gave him their e-mail addresses.”

He also discussed his concerns about the value of the test if the allegations against Warren are true.

“The extent of the forgoing breach in the confidentiality of NAPLEX exam questions calls into serious question the integrity of the exam,” Catizone said in the affidavit.

Efforts to reach Catizone Wednesday were unsuccessful.

According to an Aug. 6 NABP news release, “United States’ Marshals seized materials and computers from the University of Georgia College of Pharmacy and the offices and home of Flynn Warren, Jr.”

“NABP is disappointed and appalled that the

public trust and health were victimized, the security of the NAPLEX and MPJE breached, and the integrity of the licensure process compromised,” Catizone said in the news release.

On Aug. 3, NABP motioned to file the case under seal, citing potential public panic as a result of the case.

“If the facts of this case are covered in the media or are otherwise publicly available, there is a significant chance that the confidence of the general public in pharmacists and the dispensation of pharmaceuticals will be impaired,” NABP stated in the document.

“This case involved copyright infringement and misappropriation of trade secrets in highly confidential testing materials used in the licensure of pharmacists in many jurisdictions, and reproduction of the testing materials is required in order for Plaintiff to prove its case. Making this information publicly available will further compromise the licensure of pharmacists.”

Warren filed a motion to stay Aug. 21, citing a lack of subject matter jurisdiction.

On Aug. 27, the court “provided the parties with a limited opportunity to conduct discovery related solely to the jurisdiction issue,” according to court documents.

The court also stated, “there have been no final factual determinations by the court and no findings of liability on behalf of any defendant. Furthermore, the court has made no findings that would question the quality of education provided by the University of Georgia College of Pharmacy.”

- Alexis Garrobo, Juanita Cousins and Brian Hughes contributed to this report.