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lethe
Pharmicist Deny's Access to birth control based on personal Beliefs

QUOTE
The Missouri bill is one of more than a dozen filed across the country in the past few years that seek to protect pharmacists who object to the increasingly popular form of emergency contraception. Critics of the measures fear that they could keep rape victims from getting the drugs quickly enough to prevent pregnancy.

National debate on the issue has intensified in recent weeks after three pharmacists in Texas lost their jobs for refusing to dispense the drugs. Just this week, another pharmacist came under fire in Wisconsin for blocking a woman's effort to refill her birth control prescription.

Sen. John Cauthorn, R-Mexico, told members of a Senate committee Wednesday that his legislation is designed to protect those pharmacists with enough "semblance of character to protect the right of the unborn."


Wow. Wow. Wow.

Pharmacists denying people medication based on their personal beliefs!!! WHY ARE YOU A PHARMACIST?
My blood boils when I see this stuff.

Question for debate:
Should Pharmacists be protected under law for refusing to give out medications based on their personal beliefs?
Should pharmacists ever be allowed to deny someone medications based on their personal beliefs?
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amf
As a pro-fetus-killer, I'd normally be expected to agree with you.

But I don't. Not at all.

A pharmacy is a business. There's no law that requires a business to carry every product in a particular market. Do you see Coke AND Pepsi at McDonalds? Nope. No reason to force a pharmacist to keep every drug on hand either.

Let's take it a little further and say that the pharmacist DOES carry the drug but refuses to do business with someone for any reason. Is that wrong? Nope again. Businesses make that choice all the time. If a customer is not someone I want to do business with, I kindly direct them to my competitor and go about my business.

Long-term, it's probably not the best of moves for the pharmacist. If he gets to be known as being picky about what he carries -- no Viagra, for example -- people will gravitate elsewhere. That's the way our economy works.

Now why our federal govenment feels the need to create yet another law about this is beyond me. hmmm.gif
lethe
Ah... yes... but there is a major difference between McDonalds and the pharmacy.

Let's suppose, on the basis of religious belief that an employee of a pharmacy denied a customer access to his anti-psychotics, or his heart medication, or his AIDS medication. You see, people can die as a direct result of pharmacies giving or not giving medication to people. It didn't happen in this case. And some of these pharmacists might argue that in some cases Plan B birth control might cause the "death" of an unimplanted embryo, but pharmacists should not be making those decisions for other people.

*edited for grammar
amf
QUOTE(lethe @ May 7 2004, 03:06 PM)
Ah... yes... but there is a major difference between coke, pepsi and the pharmacy.

Let's suppose, on the basis of religious belief that an employee of a pharmacy denied a customer access to his anti-pyschotics, or his heart medication, or his AIDS medication.  You see, people can die as a direct result of pharmacies giving or not giving medication to people.  It didn't happen in this case.  And some of these pharmacists might argue that in some cases Plan B birth control might cause the "death" of an unimplanted embryo, but pharmacists should not be interferring in the health of a third person.

Again: what if the pharmacy is out of stock on those medicines? Same outcome. If the pharmacist tells you up front that they don't carry a particular brand of medicine, what right does anyone -- you, me, or the government -- have to force them to?

There's no difference except on the slippery slope you want to travel. Perhaps I have a genetic NEED for Pepsi instead of Coke and I go into McDonalds and... oops! I'm writhing on the floor... dying because I can't get my Pepsi.

Please. huh.gif
Cube Jockey
QUOTE(amf @ May 7 2004, 11:58 AM)
Let's take it a little further and say that the pharmacist DOES carry the drug but refuses to do business with someone for any reason.  Is that wrong?  Nope again.  Businesses make that choice all the time.  If a customer is not someone I want to do business with, I kindly direct them to my competitor and go about my business.

I can see your point amf but I disagree.

If a pharmacy decided it wasn't going to carry a particular brand of medication or type of medication that would be one thing.

However, if a pharmacy carries a medication and has it in stock that is completely another thing. The job of a pharmacist, the only job, is to examine the medications you are taking and make sure that none of them will interact with each other negatively. They are also to explain the risks, etc of any medication. No where in their job description does it state that they should make moral judgement calls about medication.
Government Mule
Well no matter how much I disagree, some medical professionals still pledge the classic version of the Hippocate Oath in which is stated:

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."

http://www.pbs.org/wgbh/nova/doctors/oath_classical.html

Fortunately, many new professionals are taking a more current version of the oath, which the "abortive remedy" comment has been removed.

http://www.pbs.org/wgbh/nova/doctors/oath_modern.html

But I feel that a woman, or man for that matter has a choice in what doctor he or she uses. One should get to know their doctor, and visit a doctor that has similar values as oneself. There are many doctors out there, and I am sure that everyone can find one that they agree with concerning the issues of our time.
Mrs. Pigpen
A pharmacy is a business, and they are free to make a product available or not. The government should not interfere with this. By contrast, a pharmacist works for that business (unless he/she owns it, in which case they need not sell the product), or at a hospital. I don't believe that a pharmacist should be free to deny to fill medical a prescription, if such a denial violates the policy of the hospital or store, and expect to keep their job.

Edited to add:
QUOTE
amf:There's no difference except on the slippery slope you want to travel. Perhaps I have a genetic NEED for Pepsi instead of Coke and I go into McDonalds and... oops! I'm writhing on the floor... dying because I can't get my Pepsi.

What if the counterperson wouldn't give you a pepsi, because he has a personal issue with the product, even though the store sells it? Should this be okay with the owners and management? huh.gif
Azure-Citizen
Like amf, I too would like to state my position on abortion up-front since it might impact on whether or not a reader would feel I am biased. Personally, I am pro-choice with regards to the first two trimesters of pregnancy, and pro-life in the last trimester (with exceptions for grave health risks). My views fall pretty much in line with what Sagan had to say on the issue in a chapter of his last book, Billions and Billions, entitled "Abortion: Is it Possible to be both Pro-life and Pro-Choice?" For anyone interested, you can read the full text here.

Should Pharmacists be protected under law for refusing to give out medications based on their personal beliefs?

I don't think a law is necessary (more below).

Should pharmacists ever be allowed to deny someone medications based on their personal beliefs?

My thoughts go something like this:

1. If a pharmacist refuses to fill a prescription for a drug that the pharmacist sincerely believes is an immoral drug, and the business for which the pharmacist works is willing to allow this (because perhaps they have the same beliefs that the drug is immoral), then yes, they can not be prohibited from refusing to prescribe that medication. They should not be compelled to violate their own beliefs.

2. If a pharmacist refuses to fill a prescription for a drug that the pharmacist sincerely believes is an immoral drug, and the business for which the pharmacist works is not willing to allow this, then that pharmacist needs to quit their job, and either find a new profession or go work for an employer who agrees with him or her. Its nice that they have strong convictions but if the business chooses to sell that drug, its not up to them (nor should it be!)

Any pharmacists working in government capacities (at government health clinics, or at hospitals on military installations, for example) should be required to agree (as a condition of continued employment) that they will not deny anyone medications based on personal morality. This is really just a form of scenario #2 above, with its basis in the notion that these are not commercial businesses, but taxpayer funded entities and part of government. The pharmacists in question can always seek employment in the private sector instead.

We can not compel private businesses to sell prescription drugs that they do not want to sell based on their beliefs. I am sympathetic to the argument that in some rural communities, some people might find it hard to buy the drugs they need if there is only one pharmacy in town and the business in question chooses not to carry the drugs. I'm not quite sure what to do about that problem. Perhaps the local county health service could manage to stock a small supply of the drugs in question so that they are available to anyone stuck in such a scenario. Perhaps there are other solutions. But if a business does not want to sell a drug based on their beliefs, we can't make them without violating other people's rights.
Lesly
A pharmacy isn't required to carry every item under the sun by law, but their employees are required to fill prescriptions. Eckerd is one such chain that carries this drug.

This bill just begs for FDA OTC approval. That is, if Mark McClellan feels like it.

A few pointers.

Date rape or emergency contraceptives work by either a) changing the ovum so that sperm can't penetrate, or b) sperm penetrate the ovum but the newly formed zygote cannot implant itself in the uterus. If a woman takes the drug after the zygote implants itself in the uterus, nothing happens. At this point if she wants to avoid a clinical abortion she has to take the abortion pill, RU-486. RU-486 poses a greater health risk than the date rape drug, which is basically a higher hormonal dose of the pill. The medical profession doesn't call it a pregnancy until the zygote is in the uterus.

The difference between a and b depends on how soon the woman takes the drug. Pro-lifers have a problem with b) since life begins at conception for them and interfering with the development of the newly formed "child" at any stage amounts to murder. This is also why they discourage the pill. It has a small chance of "aborting" a zygote by making the uterine lining too hostile for implantation. The fact that you can prevent implantation is inconsequential to Pro-Lifers. I've browsed their websites on abortion and have come across the attitude that birth control is responsible for the the country's social ills, so it's not surprising that any "barrier" method would be frowned upon as a matter of course.

The bill is not about forcing pharmacies to carry x-item, amf; it's about giving employees the green light to trump business practices with dogma. If you don't want to "encourage" a 16 year-old to engage in premarital sex by filling out a birth control prescription, get a new degree. If Orthodox Catholics are able to work at convenient stores that sell condoms I imagine these pharmacists can put their personal beliefs aside for eight hours as as well or find a new job.
deerjerkydave
Should a free and private pharmacy be allowed to choose what products to supply in their store? Yes. To me this should be a given in our mostly free market economy. Passing a law seems silly to me as such freedom should be viewed as the norm.

QUOTE(lethe @ May 7 2004, 12:06 PM)
Ah... yes... but there is a major difference between McDonalds and the pharmacy.

Let's suppose, on the basis of religious belief that an employee of a pharmacy denied a customer access to his anti-psychotics, or his heart medication, or his AIDS medication.  You see, people can die as a direct result of pharmacies giving or not giving medication to people.  It didn't happen in this case.  And some of these pharmacists might argue that in some cases Plan B birth control might cause the "death" of an unimplanted embryo, but pharmacists should not be making those decisions for other people.

People who are dependant on medication know where they can go to get it.
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amf
QUOTE(Mrs. Pigpen @ May 7 2004, 03:46 PM)
QUOTE
amf:There's no difference except on the slippery slope you want to travel. Perhaps I have a genetic NEED for Pepsi instead of Coke and I go into McDonalds and... oops! I'm writhing on the floor... dying because I can't get my Pepsi.

What if the counterperson wouldn't give you a pepsi, because he has a personal issue with the product, even though the store sells it? Should this be okay with the owners and management? huh.gif

I went back and re-read the article now that I had time to actually pay attention to what it was saying. blush.gif

In the scenario I imagined in my earlier postings, the pharmicist owned the pharmacy and should be allowed to do as they please, because it's their business.

However, the article is clear: states are creating laws to protect pharmacists -- EMPLOYED BY A PHARMACY THEY DON'T OWN -- who don't dispense certain medicines because of their own beliefs. These pharmacists deserve to be fired for not following their employers' policies.

I see the "law of unintended consequences" about to happen. I'd pull a "Benton, Oregon" in one of these states -- find a Pharmacist willing to refuse to sell ALL drugs -- and see what happens when the lawsuits start to fly.
Lesly
QUOTE
I went back and re-read the article now that I had time to actually pay attention to what it was saying.
-- amf


S'okay. flowers.gif

QUOTE
However, the article is clear: states are creating laws to protect pharmacists -- EMPLOYED BY A PHARMACY THEY DON'T OWN -- who don't dispense certain medicines because of their own beliefs. These pharmacists deserve to be fired for not following their employers' policies.
-- amf


I'm going to assume legislatures in favor of such bills use the religious freedom approach. I think it's so sad that so much time, energy, and money is dedicated to control what happens in women's wombs and when. It's reaching the point where if Roe is struck down the pro-life movement will target the birth control industry next. And then we'll be no better than China.
Victoria Silverwolf
QUOTE(deerjerkydave @ May 7 2004, 04:04 PM)

People who are dependant on medication know where they can go to get it.

Just as a side issue, I could not disagree with this statement more. For very common medications, or for patients located in major areas of population, this may be true. But what about uncommon or very expensive medications, which may not be profitable for pharmacies to stock? What about patients located in rural areas of low population, where the one drug store within a reasonable distance may carry only the most common medications? There are ways to approach this problem that do not involve requiring private businesses to carry medications (the Public Health Service, for example) but it certainly must be recognized as a problem.

Back to the issue at hand. Here is a long and well-researched article by pharmacy students about this topic:

R. Ph. Right To Refuse

In a nutshell, this issue is still very much up in the air. There are no clear legal guidelines as to when a pharmacist may refuse to fill a prescription on ethical grounds. (There are very clear guidelines that allow pharmacists to refuse to fill prescriptions based on professional judgement of the appropriateness of therapy. Such guidelines generally require the pharmacist to contact the prescriber in such a situation. This policy offers me a clue as to how to approach the problem.)

In my opinion, I would grant a pharmacist the right to refuse to fill a prescription on ethical grounds if and only if the pharmacist is able to refer the patient to another source for the medication, within a reasonable distance and within a reasonable time. Although I would have no ethical problem with dispensing a morning-after pill, or with dispensing RU-486, I can certainly understand that another pharmacist would have such a problem.

A related problem that worries me is what to do for a patient who lives in a very conservative area, where such medications are unlikely to be found at all. (Chattanooga, where I work, is said by some to be the largest city in the United States without a place to obtain a legal abortion. In such an environment, I would not be surprised at all if no pharmacy in town carried such medications.) This problem might best be served by some sort of public health program.
Bill55AZ
Question for debate:
Should Pharmacists be protected under law for refusing to give out medications based on their personal beliefs?
Should pharmacists ever be allowed to deny someone medications based on their personal beliefs?

No, and no. The pharmacist must fill prescriptions based on the Doctor's prescription, so he has no say in the matter. He is a technician following orders. If he doesn't like doing so, he should find another profession.
Whatever the source of his/her beliefs, there is no right to deny another's rights.
Looms
This law is dumbest thing I've seen in a very, very long time.

It basically states that one cannot be fired for refusing to do their job. But only as long as it's a pharmacist. Why?

Is the pharmacy supposed to hire another person to provide just that one type of medication? Or calmly lose business due to an idiot who took the job, refuses to do it to their specifications, doesn't quit (why?), and that they cannot fire?

What if it's a doctor who is a Jehova's Witness, and he refuses to perform any blood transfusions, is that fine too?

Furthermore, let's say a woman request ECP and is denied, and later she dies giving birth, isn't the pharmacist somewhat a fault, in a moral sense, if not the legal? This is all about morality, anyway, is it not?
Azure-Citizen
QUOTE(Lesly @ May 7 2004, 03:04 PM)
This bill just begs for FDA OTC approval.

I agree, it sounds to me like FDA OTC approval of ECP is the key to fixing this problem for everyone. Women will be able to get the medication without a prescription and pharmacists won't be involved. Presumably, making the drugs OTC will also make them far more abundant in the supply chain.

Unfortunately, from what I'm reading so far, it seems like the approval issue has been dragging on for some time now with political complications (for those members who have been following these events for the last few years, I'm sure I'm not telling you anything new). The lastest article I found was dated May 4th, 2004, at this location.
lethe
QUOTE
It basically states that one cannot be fired for refusing to do their job. But only as long as it's a pharmacist. Why?
...
Furthermore, let's say a woman request ECP and is denied, and later she dies giving birth, isn't the pharmacist somewhat a fault, in a moral sense, if not the legal? This is all about morality, anyway, is it not?


Well Said!!!!


On over the counter birth control...
sadly, just today the FDA killed Bar laboratories request for offering plan B over the counter.
It was a decision transparently political in nature according to the SacBee, in which the FDA decided to reject the approval AGAINST the 23-4 (for/against) recommendations of the independent scientific advisors.
Conspiracy me has little doubt that the white house is behind this.

Pharmacies that choose not to carry drugs, fine. I personally believe that pharmacies should not be privately run, because IF a pharmacy chooses not to carry a drug.... it's not as if the patient has the option of calling the manufacturer and ordering small quantities, now is there? There is no system for a patient to direct order from the manufacturer. I'm not saying that currently there are major problems with the free market system, I'm just pointing out that there are some serious edges and cracks showing (or this debate wouldn't be taking place).
slim
If pharmacists don't have to sell drugs that their employer wishes to offer, then they need to find another employer that agrees with their beliefs or start their own damn company.

I don't allow my employees to decide what they will and will not do during the course of their work, that decision is made by the owner and our management team. If the employee doesn't like the way we conduct business, then they need to talk to us about it, bring their concerns to us. If we don't change policy, and they don't like it, then they need to move on to somewhere else.

And what makes a pharmacist unique to be granted protection for insubordination while others standing up for their beliefs can be fired? What if the checkout person refuses to ring up these drugs, even after the pharmacist has given them out? Why wouldn't he/she be protected? I try to not play the slippery-slope argument, but this one reeks of the first step in a game of political chess. And of course, from there you can insert your occupation and item of choice : Fast food worker won't sell burgers, movie theater employee won't sell tickets to rated R films, etc. etc. The same logic that extends protection to pharmacists can be easily extended to any number of professions and products without much thought or effort. None of these people deserve protection. They work for someone else. They chose to take the job, and are obligated to perform as the company wishes, as long as they are not asked to do anything illegal.
Terra
QUOTE(Government Mule @ May 7 2004, 03:33 PM)
Well no matter how much I disagree, some medical professionals still pledge the classic version of the Hippocate Oath in which is stated:

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."

http://www.pbs.org/wgbh/nova/doctors/oath_classical.html

If they were swearing to the true Hippocratic Oath, they wouldn't be anywhere near modern biomedicine. After all, they'd be breaking almost every modern bioethical standard we have.

Terra
Lesly
QUOTE
Sadly, just today the FDA killed Bar laboratories request for offering plan B over the counter.


Do you have a link, lethe?

QUOTE
What if it's a doctor who is a Jehova's Witness, and he refuses to perform any blood transfusions, is that fine too?
-- Looms


I'm not sure how it would work out with the Jehova's Witness doctor, but doctors, by law, aren't required to prescribe drugs nor perform procedures that run contrary to their religious/ethical standards. I don't have a problem with this as long as your insurance provider has a list of doctors long enough to cover most needs within the vicinity. Pharmacists have been the exception. They don't order a patient to do anything. They fill out prescriptions.

QUOTE
Furthermore, let's say a woman request ECP and is denied, and later she dies giving birth, isn't the pharmacist somewhat a fault, in a moral sense, if not the legal? This is all about morality, anyway, is it not?
-- Looms


That brings up an interesting point. Let's use example #1 in Victoria's link:

QUOTE
Mary Joe is an 18-year-old college student at UNM. She presents a prescription for four Ovral® tablets. The instructions are to take two immediately and two in twelve hours. Ovral® contains ethinyl estradiol and norgestrel and is used as a contraceptive when taken one tablet per day.

When taken in the manner prescribed to Mary Joe it is intended as a morning-after-pill - emergency post-coital contraception, to inhibit or delay ovulation or to prohibit implantation of a fertilized egg within 72 hours of intercourse.

The only pharmacist on duty, Phil, has strong pro-life beliefs. Firm in his beliefs, Phil refuses to dispense the prescription believing that the prescription is being used as an abortifacient. Mary Joe explains that she needs to have the prescription filled soon, because it is very close to 72 hours since intercourse.

She begins crying and pleads with Phil to fill the prescriptions and explains that she can not have the prescription filled at another pharmacy because this is the only one that allows her to charge, and her financial aid has not come in yet. Phil advises Mary Joe that she should seek counseling and shares his religious belief with her. Mary Joe explains that she was walking home from her volunteer job at the children's hospital when she was attacked and raped.

Mary Joe leaves the pharmacy very upset, without the prescription. Later she calls the pharmacy, explains the situation to the pharmacy manager, and demands that Phil be fired. Does Phil have a right to refuse to dispense the drug? What duty does Phil have to Mary Joe? What are the implications to the patient, the employer, coworkers, the profession, and society? What can be done to minimize the effects of this volatile issue?


Let's say Mary Joe's window is up for taking Plan B. A few days later she takes RU-486 at another pharmacy and dies. Her family wants to sue the first pharmacy for refusing to fill out the Plan B prescription. Does the Missouri bill also extend protection to the first pharmacy in this case? Can Phil be fired? Who foots the litigation bill?

QUOTE
When Julee Lacey, a married mother of two, tried to get her birth control pill prescription refilled at a CVS near her home in suburban Dallas, the pharmacist refused.

"She began to tell me that she personally does not believe in birth control, and that therefore she would not fill my prescription," said Lacey, who attends church regularly and is a former teacher of the year.

Lacey's situation could happen with increasing frequency, since many conservatives are seeking laws that would protect pharmacists' jobs if they refuse to fill any prescription they oppose on religious or moral grounds.

"Pharmacists should not be forced to do anything," said Karen Brauer, president of Pharmacists for Life International. "Pharmacists should be practicing pharmacy for the purpose and benefit of enhancing human health and human life."

...

The Food and Drug Administration and American College of Obstetrics and Gynecology have defined pregnancy as beginning at the moment a fertilized egg is implanted in the uterine wall. But many conservatives believe pregnancy — and therefore life — begins at the moment of fertilization, up to a week before implantation. Since the pill, the so-called morning-after pill, and other hormonal contraceptives can take effect after fertilization, they see these medications as ending human life.
-- ABCNEWS.com


I order my BCPs from Immediate Pharmaceutical Services. Instead of filling prescriptions at a local store I get a three month supply for the price of 2 through the mail. I respect individual beliefs but I don't want Karen Brauer to head IPS. My personal beliefs, the one that counts in this case, is the one that should be indulged. mad.gif
lethe
SacBee
SacBee2

QUOTE
The FDA's move will "have a negative impact on the public health," said Dr. Alastair Wood of Vanderbilt University, one of the FDA advisers who voted 23-4 in December to back the nonprescription switch.

in sacbee2
Artemise
Talk about kowtowing to special interest groups!

I have to go with Slim on this. An employee is there to do a job and if they have ethical problems with the job than they should go elsewhere.

A pharmacist who doesnt believe that birth control should be distributed (to others) is an archaic and uninformed individual in todays age anyway. Perhaps they'd like to foot the bills! Protecting their rights of refusal (of birth control) by law shows how ridiculous weve become in this newly 'evangelical' take over. These people should be forcibly shown reruns of Nova on world populations until they get it, instead of protecting their ignorance.

That said, if a pharmacy owner has these beliefs, then I suppose in a free market they should have the right to refusal and employ as many with the same beliefs as so desired...maybe...but I really think they should be regulated to give medications unless there is suspected harm to the individual taking them, because:

What worries me most is Victorias mention of ultra-conservative small towns or rural areas where there may only be one pharmacy. Mail order usually needs a credit card, thereby marginalysing the poor. Disastrous.

Lets say, in these regions, where surely many married women with growing families and pre-menopausal women are on birth control (perhaps at 45-50 y/o) as well as young sexually active women who would be FORCED to take the risks of unwanted pregnancies because some wackjob with a dogma thinks and knows by law he/she can dictate their lives? Its absurd! What if Joe Shmoe in Backwoods USA has a particular belief that all women should be baby makers? (Utah?), or perhaps has only one particular client to impose his/her belief on for personal reasons? Perhaps he doesnt 'like' her current partner? Humans are wierd, this is open for abuse.

Someone should be protecting the populations right to get the medicines prescribed by their doctor, not protecting a technicians right of refusal based on personal beliefs. Pharmacists I believe are technicians, not doctors.

A pregnancy might endanger the life of the woman..does the pharmacist know this? NO. Because they are not doctors, they work in a distribution industry, not in the 'diagnose and treat' part of it.

I study Naturopathy and the guidlines and laws for nutritionists and naturopaths are very clear, that we must never assume the role of doctors in diagnosis and treatment, but may only 'suggest' that certain treatments have 'been known to' help with certain problems. The law is 'never diagnose' or even suggest such unless you are a doctor of medicine.

It has been suggested here that with a law of this type we will need to set up centers where women can get birth control without pharmacies, at a huge cost to the general population in excess beaurocracy, again reduced population areas are at high risk.

We have all kinds of groups trying to teach India, China and Africa to voluntarily control their populations, and take birth control measures yet in the US, proposing to protect pharmacists right to control distribution of birth control based on personal beliefs? This has to be one of the most backwards and anti-democratic laws I have ever heard to occur here in recent history, not even imagining the consequences and lawsuits involved eventually.
Terra
QUOTE
I'm not sure how it would work out with the Jehova's Witness doctor, but doctors, by law, aren't required to prescribe drugs nor perform procedures that run contrary to their religious/ethical standards. I don't have a problem with this as long as your insurance provider has a list of doctors long enough to cover most needs within the vicinity. Pharmacists have been the exception. They don't order a patient to do anything. They fill out prescriptions.


This only applies to physicians in certain fields. My friends at CHOP (Children's Hopsital of Philadelphia) have severe ethical problems with spending $5 million on certain preemies, but they're not allowed to withhold treatment. Nurses are almost never given this kind of discretion; even though administrators occsionally try to accommodate religious objections, I've known a few devoutly pro-life nursers who were forced to assist on third-trimester abortions.

IOW, mostly the doctors involved with the more controversial aspects of reproductive rights who have this right.

Terra
slim
Pharmacists should not have the right to dictate morality to other people. It's not their job. Their job is to fill prescriptions that have been ordered by doctors. I have serious issues with even a private pharmacy deciding which prescriptions to fill based on their personal views. The pharmacist does not know the circumstances surrounding a person's need for a drug, they only know that a doctor has prescribed it. What if the drug in question is needed to stop a pregnancy caused by rape? What if the drug in question is needed because the woman has been told that carrying a child to term could kill her? A pharmacist would not know these things, and frankly it is none of his/her business. Such discussions have taken place with the doctor and a decision was made by the patient and the doctor that this is the correct road to go down. Since the drugs are perfectly legal, and it is the pharmacist's duty to fill legal prescriptions, I fail to see why the religious viewpoint of the pharmacist carries any weight in the matter.

And a valid argument is made for those that live in small communities where there may be only one pharmacist. What do those people do? Buy a money order, send away for the pills, and wait 10 to 14 days? Not an option, needless to say.


QUOTE
I agree, it sounds to me like FDA OTC approval of ECP is the key to fixing this problem for everyone. Women will be able to get the medication without a prescription and pharmacists won't be involved. Presumably, making the drugs OTC will also make them far more abundant in the supply chain.


I don't think it would be that simple. Nothing would stop the same groups from trying to get cashiers or store managers the same protections they are trying to get for pharmacists at this moment. Granted, there are a lot more clerks and managers, so you would be more likely to find one to sell the drug, but I'm sure many people would still be affected by such legislation.


I am pro-life in my own life, but I do not think it is my place to dictate morality to the masses. For that reason, I am pro-choice, and do not feel the need to belittle others or stand in their way if they make that difficult decision to terminate a pregnancy.
loreng59
I agree with Slim. The Pharmacists have an important job to do. If they can not do that job because of their own moral code, then they are the ones to go elsewhere. Not the person attempting to get the medicines their doctors proscribed for them.

I do not believe that anybody has the right to impose their moral beliefs on anybody else.

Can't do the job then find something that you can do
Ardent Muse
QUOTE(Government Mule @ May 7 2004, 12:33 PM)
Well no matter how much I disagree, some medical professionals still pledge the classic version of the Hippocate Oath in which is stated:

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."

http://www.pbs.org/wgbh/nova/doctors/oath_classical.html

Fortunately, many new professionals are taking a more current version of the oath, which the "abortive remedy" comment has been removed.

http://www.pbs.org/wgbh/nova/doctors/oath_modern.html

But I feel that a woman, or man for that matter has a choice in what doctor he or she uses.  One should get to know their doctor, and visit a doctor that has similar values as oneself.  There are many doctors out there, and I am sure that everyone can find one that they agree with concerning the issues of our time.

Wow... I wasn't aware of that version of the hypocratic oath including the "abortive remedy clause". I was originally going to answer this pole question by saying that if any particular drug is available to be distributed, the pharmacist should dispense it simply because it's his job to do so, despite his personal feelings. But now that I see this hypocratic version (i.e. "the protection of life" - which would indicate the unborn fetus), it really does beg the question whether or not the pharmacist is obligated to dispense such a pharmaceutical.

It makes you wonder then, too, if pharmacists are expected to dispense it despite their persoanl feelings, does that put the burden of responsibility to protect the unborn child solely on the man and woman who created the fetus? If not, should doctors in general then have an obligation to not perform abortion and withhold all forms of pharmaceutically induced abortion based on the hypocratic oath? How much legal and moral merit does the hypocratic oath really hold, or is it simply an optional commitment for the physician?

Wow...good question. I'm not really sure how to answer it given my uncertainty of the level of legal obligation in the oath. mellow.gif
Victoria Silverwolf
Dealing with the side issue of the Hippocratic Oath:

Classical Version

Modern Version (1964)

The classical version is clearly out of date in some ways. It forbids physicians from making use of the knife, for example, and creates an entirely separate category of practice for the surgeon. The modern one is less specific in many ways, but looks like a good moral code. The oath has no legal significance.

Here is a discussion of the relevance of the Oath:

The Hippocratic Oath Today

Back to the main issue:

I'm seeing two lines of thought here with which I cannot be in complete agreement. First of all, there seems to be an assumption that an employee must do whatever an employer wants, as long as it is not illegal. Otherwise, out on the street you go. Surely there is some room for individual conscience?

Secondly, pharmacists are not always required to fill prescriptions as ordered by the doctor. In fact, we are required (generally by regulations set by the individual State Boards of Pharmacy) to refuse to fill prescriptions which are not in the best interest of patients. The majority of such professional decisions do not involve moral issues, but rather such problems as drug interactions. Moral issues are not as obvious, but I would like to leave some leeway for them. Although I would have no problem at all with dispensing a "morning after" pill, I have to respect those who would. I would hope that others would respect my right to refuse to dispense (for example) fertility pills to parents who already have several children. (If they have no other way to obtain the medications, I might have to bite my tongue and dispense it; but I would prefer to refer them to others.)

I believe a pharmacist has a right to refuse to dispense a medication on moral grounds; I also believe it is possible to greatly abuse that right.
Ardent Muse
Hi Victoria.

I thought that since a doctor prescribes a medication or drug, that the pharmacist's job was to simply fill the prescription. But given what you've said, wouldn't/shouldn't doctors have the same moral guidelines NOT to prescribe a given medication/prescription just as the pharmacist has moral guidelines not to dispense them? Can one legally and morally override the other? How does the law deal with that?
Victoria Silverwolf
QUOTE(Ardent Muse @ May 19 2004, 06:51 AM)
Hi Victoria.

I thought that since a doctor prescribes a medication or drug, that the pharmacist's job was to simply fill the prescription.  But given what you've said, wouldn't/shouldn't doctors have the same moral guidelines NOT to prescribe a given medication/prescription just as the pharmacist has moral guidelines not to dispense them? Can one legally and morally override the other?  How does the law deal with that?

Well, a physician is never required to prescribe anything (although all health care facilities are required to provide emergency treatment when needed.) If a patient is harmed because of lack of treatment, that could lead to a lawsuit. What happens if a pro-life MD refuses to administer emergency contraception to a woman on moral grounds? A very messy legal case, I think. Is the situation truly an emergency? I'm sure some would say yes, and others no. Is a woman harmed because of "wrongful birth"? It's possible to argue so.

If a physician orders something and a pharmacist refuses to fill it, and they cannot come to any agreement, what happens? A lot of angry conversation between the two of them, I think. If it came down to a lawsuit, it would have to be determined who acted in the best interest of the patient.

There are few clear rules, and I don't think there can be.
Lesly
QUOTE
Although I would have no problem at all with dispensing a "morning after" pill, I have to respect those who would. I would hope that others would respect my right to refuse to dispense (for example) fertility pills to parents who already have several children.
-- Victoria


I can't support that. Unless there's a medical reason why a woman should not have more children population control is not up to the pharmacist. If I defend one form of autonomy (abortion) I have to defend a couple's right to pursue a little league of their own even while I disagree with their decision.
Paladin Elspeth
Back in the 1960's in my home town, there was a pharmacist who, according to my father, "got religion." The rumor was that the man poked pin holes into condoms because he no longer believed birth control was right. ermm.gif

If a pharmacist has convictions against certain drugs for certain people, it's best that he own his/her own store and send the clients to other pharmacies where their prescriptions will be filled. If the pharmacist in question works for Rite Aid, Walgreen's or another chain pharmacy, that person's job will likely be in jeopardy if management gets wind of it.

Pharmacists have freedom of choice. I think it is important to stand up for one's convictions, as long as the person is up front and civil about it. But there is always the possibility of a lawsuit if a client ends up injured in some way because of the pharmacist's refusal, based on his convictions, to fill a prescription and the client's inability to get that prescription elsewhere.
slim
QUOTE
I would like to leave some leeway for them. Although I would have no problem at all with dispensing a "morning after" pill, I have to respect those who would. I would hope that others would respect my right to refuse to dispense (for example) fertility pills to parents who already have several children. (If they have no other way to obtain the medications, I might have to bite my tongue and dispense it; but I would prefer to refer them to others.)


This is the can of worms that is opened by allowing pharmacists the right to decide on moral grounds who gets medications and who doesn't. Why does another individual have the right to decide whether a family has the right to have more, or less, children? Without knowing anything about a situation other than the quick glimpse of them at a pharmacy, decisions would be made that greatly impact their lives. A pharmacy may be a private business, but it is a public service; one that has great bearing upon the quality (and quantity) of life of the those that use it.

QUOTE
I'm seeing two lines of thought here with which I cannot be in complete agreement. First of all, there seems to be an assumption that an employee must do whatever an employer wants, as long as it is not illegal. Otherwise, out on the street you go. Surely there is some room for individual conscience?


Why? If you take a position with a company, you have agreed to offer the products and services the company offers. You agree to do so in the manner the company dictates. They agree to pay you for doing so. If you disagree with something being offered or the manner in which it is offered, talk to them about it, voice your concerns and perhaps it will change. If not, you must either accept the companies policy or move on. As an employee, you have a legal obligation to perform tasks in accordance with your employees guidelines and up to their standards, the room for individual conscience is prior to entering into the working relationship. At that time, you can ask all the questions you want about their practices and decide if they hold the same values as you. Then make a decision on whether you agree or not and whether you want to take the job or not. It should come as no surprise to someone applying to work at a pharmacy that they might have to sell legal drugs at some point...
nebraska29
QUOTE(lethe @ May 7 2004, 01:49 PM)
Question for debate:
Should Pharmacists be protected under law for refusing to give out medications based on their personal beliefs?
Should pharmacists ever be allowed to deny someone medications based on their personal beliefs?

If the pharmacist is running his/her own shop, why not? If they are filling prescriptions at Wal-Mart however, then they should be systematically fired and told to find a new job. A person may not agree with the morning after pill or birth control, but simply filling out a prescription is not going to doom them to hell. They are just filling out a prescription that will send someone else to a bad place. The pharmacist should just think of it that way and move on.
Cube Jockey
A new wrinkle to this story from Time.com.

QUOTE
Neil Noesen, a relief pharmacist at the Kmart in Menomonie, Wis., was the only person on duty one day in 2002 when a woman came in to refill her prescription for the contraceptive Loestrin FE. According to a complaint filed by the Wisconsin department of regulation and licensing, Noesen refused because of his religious opposition to birth control. He also declined to transfer the prescription to a nearby pharmacy and refused once again when the woman returned to the store with police. The prescription was filled several days later by the managing pharmacist. But Noesen was accused of unprofessional conduct and will face an administrative law judge on June 22. Antiabortion groups are urging Wisconsin officials not to punish Noesen.


QUOTE
The American Pharmacists Association says pharmacists should be allowed to refuse to fill a prescription. If they do, however, it ought to be filled by someone else or transferred to another pharmacy, the group has said. Laws are vague on the subject. But two states, South Dakota and Arkansas, have passed laws that explicitly protect pharmacists who refuse to fill birth-control prescriptions on moral or religious grounds. Similar legislation has been introduced in 13 other states.


That last part is pretty frightening in my opinion.
DaffyGrl
First, let me start by saying I am really really REALLY glad I am nearing the end of my “fertility”. I can hardly believe what’s going on in this puritanical country of ours. huh.gif

Should Pharmacists be protected under law for refusing to give out medications based on their personal beliefs?
A great big, fat, unequivocal NO. Why in the world would someone with rigid religious beliefs get into pharmacology in the first place? There are so many controversial drugs out there that would offend their delicate sensibilities. Are we going to let pharmacists cherry-pick which medications they’re willing to dispense? Puh-leeze. If every employee who had a beef due to his “religious beliefs” with his employer about something the company manufactures or sells and was protected by some goofy law like this, it would wreak havoc on employers – not to mention the legal system! Issues like that should be cleared up right at the get-go; before that person accepts a position.

Should pharmacists ever be allowed to deny someone medications based on their personal beliefs?
Again, a great big, fat, unequivocal NO. . If they aren’t the owner of the shop, then either serve the customer or quit. If they do own the shop, then they wouldn’t carry the drug anyway, and should post something to that effect so the public doesn’t have to deal with their …..stuff.
Artemise
QUOTE
Antiabortion groups are urging Wisconsin officials not to punish Noesen.


Now aint that just logic. The woman wants birth control, not an abortion, but she might need an abortion if she doesnt get it.

What about HIV medicines? Maybe some of these religious freaks think people with HIV should just die for their sins, where does this STOP?

QUOTE
Surely there is some room for individual conscience?


In your own home. This IS America after all.

QUOTE
Although I would have no problem at all with dispensing a "morning after" pill, I have to respect those who would. I would hope that others would respect my right to refuse to dispense (for example) fertility pills to parents who already have several children.


WHAT? Victoria, I cannot believe this. Its not the job of a counter clerk to decide who should or who should not have children or based on personal beliefs. Who is playing God here? Thats ridiculous in my opinion. The doctor and the patient decides, and unless you are a doctor there is no right to make diagnostic decisions on someone elses life and choices if it is not life threatening to the person with the script.
Are you saying you would not fill a fertilty script because YOU think a family has too many children? Thats just insane. How is MY life to be decided by some half baked counter clerk with some bizzarro views swaying one way or another?

Oh no. I think we are going to need some industry regulation, and you bet, if you have personal views on medications and who should get or not get them, then get out of the business or get fired.

I happen to think coca cola, chips and steaks are really bad for people, is my job protected if I refuse sale? Not in our lifetime. If pharmascists want to play GOD then they had better become priests and nuns.
lethe
At least Alabama is doing something about it...

QUOTE
AgapePress) - A controversy appears to be brewing in Alabama over a situation involving employees at state medical clinics who, for religious and moral reason, refused to distribute emergency contraception commonly known as the "morning-after pill." At least two of those who refused claim they were left with no alternative but to resign their positions.

Late last week, the Christian Coalition of Alabama (CCA) reported it had been contacted by "at least a half-dozen" employees of the Alabama Department of Public Health (ADPH) who claimed they were forced to distribute the pills or face disciplinary action. Two of those women -- one a nursing supervisor with 13 years of state employment, and the other a nurse -- told CCA they felt they had no options except to obey the mandate or resign.
<Snip>


Thought I'd give you all an update. At least Alabama is being reasonable when it comes to the distribution of drugs.
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