Gedoogbeleid

Discussing antibiotic pharmacist issues with another antibiotic pharmacist from a different hospital today, we came to the topic of areas where it would be great if ward pharmacists could enforce a particular policy, however (because the issue at stake is complicated, outside the relevant ward pharmacist's confidence zone and above all too time-consuming for their already overstretched clinical time) the policy is not enforced, and so it is in-effect non-existent.

Coincidentally this evening, I stumbled upon a website that talks about the official policy of gedoogbeleid in the Netherlands. 

To quote Vincent Vega "(In Amsterdam, hash is) legal, but is ain't a hundred percent legal".  In fact the use of cannabis is totally illegal in the Netherlands. But the authorities have decided not to enforce this law, instead deciding to officially tolerate use of the drug for various reasons.  Further more everyone else also agrees to tolerate breaches of this law, to the point where it becomes impossible to prosecute for breaches of it. This policy of pragmatism is known as gedoogbeleid, which apparently can be translated as "permissiveness-because-there-are-bigger-fish-to-fry."

This set me thinking about my daily life - things in our daily lives that are technically illegal yet officially authorised, customary and even approved practice.  In community phamacy, and coincidentally sticking with antibiotics, we can now sell chloramphenicol eye drops, which have are POMs, apart from the  P-medicine licence for use in "the treatment of acute bacterial conjunctivitis in adults and children aged 2 years and over".

Yet the official RPSGB guidance suggests that we should supply in viral conjunctivitis - which is to supply a product outside it's P exemptions and thus it reverts to being a POM.  Whilst the reasons for supplying in viral conjunctivitis are perfectly sound and of limited risk to the patient; it does make me wonder about what else we do that is gedoogbeleid.