Pharmacists’ moral acumen
2006-04-24
One of the more interesting and underrepresented facts about many women’s health providers — places that are routinely targeted because they provide low- or no-cost birth control for women, as well as access to abortions — is that they often offer other health services, such as flu shots and general health exams.
Sometimes, antibiotics are prescribed.
Most of these clinics don’t have on-site pharmacies, so it is up to the patient to go elsewhere to have the prescription filled.
Or, as was the case with a patient from the Cedar Rivers Clinic, which has facilities in Renton, Tacoma and Yakima, Wash., the prescription is called into a pharmacy for pickup.
Unfortunately, in May 2005, a pharmacist at the Swedish Medical Center outpatient pharmacy took it upon him or herself to decide it was morally unacceptable to receive antibiotics from a clinic that provides access to birth control and abortion, and refused to fill the prescription.
That’s right. A pharmacy refused to fill a prescription based on who prescribed it.
“Well maybe,” you try to rationalize to yourself, “the pharmacist believed that it was an abortion-related complication and they felt complicit?” Ignoring the logic behind that, which basically says that someone deserves an infection, let’s move to another example.
At a Safeway in Yakima, Wash., a pharmacist refused to fill pregnancy-related vitamins for a pregnant woman who was receiving healthcare from Cedar River Clinic. This is a woman who was making an active effort to have a healthy pregnancy.
The Safeway pharmacist reportedly repeatedly quizzed the woman why she needed the pills (seems obvious to you and me, eh?), and then launched into why she was going there.
There.
As if the woman should be castigated for receiving healthcare for her pregnancy.
My friends know that I often play devil’s advocate for pharmacists who decline filling Plan B or chemical abortificant prescriptions on moral grounds.
My reasoning for this is that in some ways you can argue that the filling of these prescriptions does directly force the pharmacist to participate in the providing of a service they morally oppose — what they view, rightly or otherwise, to be abortions.
We do not force doctors to perform abortions on women who want them, and I think it’s reasonable to extend this logic to pharmacists.
But these pharmacy moral-police are overstepping their boundaries when they begin denying prescriptions based on who writes them.
If a pharmacist decides he or she has the moral acumen to decide if someone should or should not have access to antibiotics, what’s next?
Denying someone their AIDS cocktail?
Refusing to fill someone’s prescription for methadone, since maybe they’re lying about having chronic pain and they’re really a heroin user in recovery?
Maybe these morally righteous pharmacists will determine that you shouldn’t have access to any “Class II drugs,” or that you’ll need to provide documentation of your illness before they release the prescription to you.
The potential nightmares can be spun out for a while.
Thankfully, the Washington State Pharmacy Board realizes the potential for abuse, while also recognizing the right of the pharmacist to conscientiously object to some prescriptions, such as Plan B.
Late last week, the board released its first draft of a new rule outlining a pharmacist’s right to refuse prescriptions.
While the exact wording of the rule remains uncertain as it undergoes further revision, so far the indications have been pretty clear: Pharmacists have the right to a conscientious clause only so long as there is another pharmacist on site or closely nearby who can fill the contested prescription.
Which is how it should be. Pharmacists dispense medicine, they don’t practice it.
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