Abstract
INTRODUCTION: Brazil has one of the largest drug retail markets globally and more than three times the recommended number of pharmacies per inhabitant. In this scenario, pharmacists have ethical dilemmas that lead to poor credibility among the population. Due to the lack of studies that address the view of stakeholders who are essential in delineating the code of conduct in this scenario, they had to be heard so that business imperatives could be better understood. This study aimed to understand the perceptions of drug retail stakeholders regarding the influences, causes, and strategies needed to minimize ethical dilemmas in pharmacy practice. METHODS: Nineteen semi-structured interviews were conducted online, transcribed, and analyzed by content analysis. Word clouds and themes were created, and we compared the opinions reported by the groups of managers and mentors. RESULTS: The results of the perceptions were classified into the following themes: (a) Industry Enticement-main consequence, (b) "Push therapy" and strategies to minimize these dilemmas, (c) Assimilating that selling is not unethical, (d) Compliance, (e) Collective goals, (f) Generating profits through services. The poor diffusion of compliance programs and the fragile autonomy of the pharmacist keep the profession on the "tightrope". Therefore, investing more in services and state actions for patient safety rather than in products could balance this scenario. CONCLUSION: The ethical discourse of stakeholders remains ideological and is not consolidated in pharmacy practice. Accelerating market regulation through compliance and effective state action, as well as monetizing pharmaceutical services, could create a more ethical environment for the sector.