At 06:35 AM 1/18/2008, you wrote:

>Even if the motivation is increasing sales and stock value, if a pharmacy 

>recruits customers by truly providing better service to those with 

>literacy and language challenges, then it's still a good thing. If I have 

>an option to go to a pharmacy that consistently ensures that I understand 

>my medicines, then we all win. They get another customer and I get better 

>service.


This is what I mean by "what is the least dangerous assumption."

This terminology is used more in education.

"In 1984, Anne Donnellan, a respected researcher in special education, 
wrote that "the criterion of least dangerous assumption holds that in the 
absence of conclusive data, educational decisions ought to be based on 
assumptions which, if incorrect, will have the least dangerous effect on 
the likelihood that students will be able to functional independently as 
adults." Furthermore, she concluded "we should assume that poor performance 
is due to instructional inadequacy rather than to student deficits." In 
other words, if a student does not do well, the quality of the instruction 
should be questioned before the student's ability to learn. Thus, for 
Donnellan, the least-dangerous assumption when working with students with 
significant disabilities is to assume that they are competent and able to 
learn, because to do otherwise would result in harm such as fewer 
educational opportunities, inferior literacy instruction, a segregated 
education, and fewer choices as an adult."
From: http://disabilitysolutions.org/newsletters/files/six/6-3.pdf

I know we want to protect people from the complicated, confusing traps that 
exist, especially with Medicare/Medicald. BUT, I also want to promote 
independence and skills related to making informed decisions. Presuming 
that the pharmacy's sole goal is to swindle folks means we do not trust 
that folks are able to learn or use their skills.

This doesn't mean that there are no checks and balances, but it does 
re-frame, "what is the least dangerous assumption"?  Is it that it's all 
about money or is it that  although there is a marketing angle to the 
project, good can come from providing understandable information about 
medications - even in a for-profit world?

If we do not assume competence of the people we care about and that the 
service is useful, then we are limiting the options and isolating people 
with lower literacy skills.

I think the focus should be on looking at the quality of the instruction 
provided....but it sounds like i may be in the minority here.

REmember, if people feel swindled or are swindled and they still don't 
understand their medications, then it is the fault of the program, not the 
consumer. Removing the opportunity from the consumer says we do not believe 
they are capable.

Respectfully,
Joan Medlen, RD, LD

Project Director, Creating Solutions
www.creating-solutions.info
Clinical Advisor, Health Literacy & Communications
Special Olympics Health Promotion
Author, The Down Syndrome Nutrition Handbook
www.downsyndromenutriton.com