Digital systems have been developed over the last 40 years to meet the changing needs of pharmacy practice, in particular the pharmacist’s changing role from being solely a supplier of medicines to being a clinical professional, providing patient-focused services. Developing digital technologies and clinical terminologies have enabled digital systems used for pharmacy and medicines to be increasingly interoperable, and these, in turn, enable integration of pharmacy services with other parts of the health service. This chapter provides an overview of these developments. However, large-scale digital systems used across healthcare provider organisations, or indeed healthcare economies, are sociotechnical systems in that their overall systemic impact is not just related to their technical functionality, but to the behaviours of users within the social context of the user environment. Such systems therefore have the potential to manipulate user roles and service delivery and are therefore value-laden. Consequently, they can raise ethical issues. The chapter therefore provides a preliminary discussion of the sociotechnical ethics of large-scale digital systems in the context of digital systems for pharmacy and medicines.