Community pharmacies increasingly deliver preventive and health-promotion services while remaining retail organizations that may benefit financially from products or services recommended during the same encounter. This dual position creates an ethical problem that cannot be resolved simply by establishing that a commercial interest exists. The relevant question is whether the financial linkage creates a meaningful risk that professional judgment, presentation of alternatives, or patient-centered recommendation is displaced or distorted. This conceptual article develops a Recommendation-Integrity Framework for evaluating commercially linked preventive advice. The framework distinguishes structural commercial interest from demonstrated influence; formal professional status from practically usable independence; recommendation quality from patient trust; and transparency from stronger responses such as separation, substitution, or abstention. Evidence from community-pharmacy ethics, professionalism, work-system research, conflicts-of-interest scholarship, disclosure experiments, and trust research is used to establish the framework’s normative components without treating cross-professional evidence as pharmacy-specific proof. Recommendation integrity can remain intact when evidence, patient interests, professional control, and credible alternatives govern the advice despite a financial benefit. Stronger ethical responses become warranted as commercial influence becomes more proximate to the recommendation, professional independence weakens, alternatives are obscured, or organizational safeguards cease to be practically effective.
