Sunday, January 13, 2008

Should Pharmacists be Allowed to Refuse Service?

Suppose your child has done his homework for the day and has completed his chores, so you allow him to traipse off to the store with some of his allowance to purchase a sweet treat.

Upon arrival at the store, the kid picks out his candy and heads to the counter. There, the clerk tells the youngster that candy is bad for his teeth. So the clerk refuses to sell the candy to the child because of his moral compunction to help kids prevent tooth decay.

This scenario is hypothetical and I don’t know of any instance where it has occurred, but if it did occur the parents and their kid would have every right to complain to the store management about the intransigence and gall of the clerk. It’s not about tooth decay; it’s about a stranger’s right to restrict otherwise legal activity by another because of a distaste for that activity himself.

Take another example. What would you think of a clerk in a bookstore that refused to sell someone a copy of the bible because the clerk is an atheist and is made uneasy by the idea of disseminating religious mythology? Or what about another clerk who refuses to sell a book promoting atheism because he or she is a religious fundamentalist?

Shouldn’t all the clerks in the examples above either lose their jobs or be severely reprimanded? Even if you agree that children shouldn’t be allowed to buy candy or that religion is bad or that the bible should be distributed widely, you probably do not agree with the methods used by the clerks in the scenarios I outlined, right?

After all, they have jobs to do. If part of that job is so repulsive to them that they can’t bring themselves to perform it, they should quit and seek new employment.

Wouldn’t the same hold true for, say, pharmacists? What if a pharmacist refuses to fill a prescription for birth control pills because the pharmacist disagrees with the morality of using contraceptive pills or other birth control measures?

Well, the last scenario has happened, and is still happening, all across the country. It may not happen daily or it may not happen at a large number of pharmacies, but it happens regularly enough.

News stories are easy to find that describe how women bearing emergency prescriptions for contraceptives have been refused service by a pharmacist who doesn’t believe in birth control or the morning after pill.

Now, the Indiana General Assembly is considering a bill that would give pharmacists the legal right to refuse to fill any prescription for emergency morning-after contraception, and for other similar medications that are legally prescribed. If it passes, Indiana would join with only four other states that have such a law on the books.

Seven states explicitly prohibit pharmacists from refusing to fill a prescription. Seven other states have laws that prohibit pharmacists from obstructing patient access to medication. And the other states, including Indiana, have laws that implicitly require pharmacists to fill all prescriptions. Only Arkansas, Louisiana, Georgia, and South Dakota currently have laws that allow a pharmacist to refuse to fill a prescription that goes against his conscience.

Indiana should not become one of those states. It would be a giant step backward in health care. It would allow a third party to interfere with the relationship between a doctor and his or her patient. And it would be exactly like a bookseller refusing to sell the bible because of the bookseller’s distaste for religion.

Regardless of how anyone personally feels about birth control or the morning after pill, if a person has chosen to be a pharmacist by profession, that person should be compelled to fill all prescriptions. If doing so is repugnant to them on moral grounds, they should find new employment.

1 comment:

NC Pharmacist said...

After having first hand experience with this sad situation,I feel like it is in the best interest of the patient and the pharmacist to sometimes not fill a prescription. Even after calling the doctor. A patient came into my pharmacy a few years ago who weighed 68 pounds and her doctor was still writing her prescriptions for diet pills. The woman was 35 years old and could hardly stand up because she was so weak. I politely told her I didn't feel comfortable filling her prescription. She said she understood, but came back to the pharmacy after I was off duty and the other pharmacist filled it. I got a call from the woman's parents telling me she was in a local hospital and would I come sit and talk to them. I did but unfortunately the woman DIED about 2& 1/2 hours later. That experience has really stuck with me throughout my career so I am very careful of what I fill and not fill.Sure, some patients may get ticked off about it, but I would rather go with my gut feeling rather than have another experience like that. I'll never forget it as long as I live!