The first indication of an ethical issue in development was when the pharmacist explained to Ms. Cross that her prescription changed due to formulary restrictions. The patient is adamant about getting the exact medication prescribed after experiencing diarrhea the last time she took it. Moreover, the pharmacist is limited in what he/she can dispense due to the hospital’s formulary restrictions and may not know why the patient was specifically prescribed Vantin instead of Ceftin. He/she might have seen that the patient was on Ceftin before and assumed it would be an acceptable therapeutic substitution. Thus, interpersonal tension may develop between the pharmacist and Dr. Wells, especially since the original order was changed without any communication
