Should pharmacists be able to choose?

[PrincessFiona]

From Bill Maher:

And finally, New Rule: Pharmacists have to fill prescriptions.

As our audience seems to already know, more and more American pharmacists are refusing to fill prescriptions for birth control because of their personal moral objections. Hey, you know what would really teach us a lesson? If you took off your pretend doctor jacket and got another job.

Or maybe I'm wrong. Maybe cutting off the pill doesn't even go far enough. Yeah, it's high time activist drugstores stopped coddling sluts on every aisle. Let's not sell any more makeup either. A good woman doesn't paint herself. And no more deodorant. You should smell bad. Keep the boys from getting ideas. And no suntan lotion. I've seen what happens at the MTV Beach House, you whore. You want to avoid melanoma, buy a veil.

Why is this country becoming Utah?!...

Now, of course, I know the other side is saying, yes, but this is a moral issue. Yeah, but the problem is, not everyone gets their morals from the same book. You go by the book that says slavery is okay but sex is wrong until after marriage...

In conclusion, let me say to all the activist pharmacists out there,.... Fellas, a pharmacist is not a law-giver, not even a doctor. In the medical pecking order, you rank somewhere in between a chiropractor and a tree surgeon.

You don't answer to a law above the laws of men. You work for Sav-On. The doctors are the ones who make medical decisions because they went to medical school, whereas you were transferred from the counter where people drop off film

What do you guys think?

kris

[houseelf]

Wow...While I agree with the author's opinion that some pharmacist activism exceeds an acceptable level, he doesn't need to besmerch the entire field of pharmacists. This completely undercuts the validity of his opinion.

Sorry for the sidetracked response!

Kelly

[Meenah]

I agree with you Kelly. I think it is absurd for a Pharmacist to choose what he or she wants to fill, but I wouldn't want to acuse all of them.

Can't we just shoot the ones we don't like!!
Luanne

[migirl]

I also agree with the central point of his argument in that pharmacists should fill prescriptions regardless of their views, but his overly snarky attitude toward the profession was really unnecessary.

[PrincessFiona]

Wow...While I agree with the author's opinion that some pharmacist activism exceeds an acceptable level, he doesn't need to besmerch the entire field of pharmacists. This completely undercuts the validity of his opinion.

Sorry for the sidetracked response!

Kelly

:> I love Bill Maher! :>

Me too!

And snarky is his schtick.

[Sheherezade]

A bit too snarky??

Personally, I agree that pharmacists need to fill prescriptions or leave the job. Still, I also think that if that is the case, they shouldn't be libel if a doc gives a faulty prescription and they fill it. With all the drug interaction info and computerization at the pharmacies these days, I can only assume that they do have liability if something bad happens after they sell a drug even if it was the doctor's prescription. Does anybody know? It needs to be decided if pharmacies are simply dispenseries or if they have to put thought into the drugs they give out. I know in DH's hospitals, the pharmacies have more and more "policies" that the the docs have to work around. That would suggest that the pharmacists aren't just tools of the doc. If that is the case, they probably do get a legal say in what they dispense-- and fall a bit higher up than "tree surgeons".

Ahhh....I love Bill Maher.

I disagree with him on this one. I do think it is ok for a pharmacist to choose not to fill a birth control pill prescription. I don't agree with the pharmcists on this *at all*, but if the pharmacy has appropriate mechanisms in place to ensure that the patient still gets the prescription -- as many of the big pharmacy chains do -- I think it is ok. I do not think it is ok for the pharmcist to lecture the patient as to why but rather that they recuse themselves from that case. I suppose there could be a situation of a small pharmacist-owned pharmacy that has a policy of not filling BCP prescriptions. In that case, as a customer, I would take all of my business elsewhere.

I think this would be a similar situation to an ob/gyn refusing to perform abortions or....trying to think of something a little less controversial....a pediatrician or ob/gyn refusing to do a circumcision (on moral grounds).

[Rapunzel]

Well, the quote in the op is insulting to be sure (what was up with the Utah comment btw?).

Pharmacists are businesspeople. Period. They have to receive a certain level of training to enter their trade, but it's a business. In this country we are allowed the freedom to follow our ethical principles when we run our own business (within bounds - ie we have to follow laws such as the Civil Rights Act, etc).

A pharmacist that works for himself has every right to refuse certain business based upon his ethical/moral principles. If we lived in a totalitarian state it would be otherwise, of course. There is no "right" to have your prescription filled at a particular business. And, additionally, pharmacists may refuse to fill prescriptions as their perogative based upon their medical knowledge (for example you will find people go to several different doctors and get conflicting prescriptions with dangerous interactions - pharmacists must catch these problems and may refuse to fill due to this).

If a person has their prescription refused at a pharmacy that person can take their business elsewhere. A pharmacist that refuses to fill certain types of prescriptions runs the risk of hurting his business due to loss of customers over this issue. It's his perogative. And, it's the nature of capitalism.

Now, if a pharmacist works for a major pharmacy corporation (such as, say, Walgreens) and refusing to fill certain prescriptions runs counter to company policy then that pharmacist can do one of two things: quit his job (based on his ethical principles) OR attempt to change the company's policy.

What gets me over this issue is how violently emotional people (especially in the media) get over what is a simple matter of business and the right people have to conduct their businesses on their ethical principles. Obstetricians do not HAVE to perform voluntary (ie non-medically necessary) abortions based upon their ethical standards. Plastic surgeons don't HAVE to perform elective cosmetic procedures. Why? Because these individuals are, ultimately, business people who can run their businesses according to their ethical standards within the law.

Personally, I think the whole thing is silly. And, Bill Maher doesn't seem to have a good grasp of the subject.

Jennifer

[PrincessFiona]

OK...so Bill Maher might not have been the right messenger, but it DID get tons of responses right away :> I still love Bill Maher because he is...hysterical. But this is taken out of context. He can also really laugh at himself.

But ole Billy boy aside.....

I believe that personal 'moral' beliefs don't belong in medical decisions. If you aren't going to be willing to fill a Rx then you shouldn't be a pharmacist. This might be a little bit of black/white thinking on my part, but I think we have to draw a line somewhere. What if the pharmacist feels morally against homosexuals and doesn't want to fill their hiv Rx or how about a scientologist dr who would refuse blood transfusions for patients based on moral grounds. How about the pediatrician who refuses to perform circumcisions based on moral grounds...or what about the ped that insists on circs even if the family is against it...on 'moral grounds'. I think it is a slippery slope.

[migirl]

I believe that personal 'moral' beliefs don't belong in medical decisions.

Along these lines, this made me think of an attending at DH's program who is a very devout Catholic. He refuses to perform vasectomies based on his religious beliefs, so these patients simply get referred elsewhere for this procedure. I guess I'm not sure how I feel about this, I mean should this man be forced to perform a procedure that he apparently finds immoral and objectionable? I don't know, it's a tricky area.

I think it is presumptuous and judgemental for a pharmacist to refuse to fill a prescription for emergency contraception when they have no information about that patient's case. Was it a case of incest? Rape? A condom that broke during intercourse between a husband and wife? Frankly, it should not matter to the pharmacist but to the physician and the patient; the sanctity of the doctor patient relationship has to be preserved in my opinon.

I agree completely that it is presumptuous and judgemental and meddling -- however, I think that it would be worse to legislate that someone must do something they are morally opposed to. I also think it would be wrong to force an urologist to do a vasectomy, an ob/gyn to do an abortion, or a pediatrician to do a circumcision, or any other type of provider to do a procedure or or service they are morally opposed to. If that is the case, though, those providers should not keep their patients from getting that done just as a pharmacist should not keep a patient from getting emergency contraception or BCP.

[Sheherezade]

I think a real problem exists in very few communities. When these stories first hit, there were reports of this pharmacy in Texas that refused service. The big sticking point was that the nearest alternative pharmacy was 60 odd miles away. Thus, the pharmacist's moral choice or business decision affected the care that was available to the local community. I think in most locations, there is a choice of pharmacy so any one person's decisions do not necessarily result in the unavailability of BC or RU-486. If all the local pharmacies made the same decision, you could argue that it was a "community standard". However, if there is only one pharmacy in a 60 mile radius the argument gets more complex. I suppose the climate would be ripe for a new pharmacy!! Am I mistaken to think that this is a new arm of the abortion wars -- over RU-486 prescriptions -- or is this strictly about birth control?

Fine, don't fill the prescription, but leave your opinon behind the counter, I don't care to hear it.

I agree. I thought there was talk about legislation on this and I thought that went too far. I sort of wonder though, if a pharmacist is that opposed to BCP if pharmacy is the best career for them -- I'd imagine that pharmacies dispense quite a lot of them.

[SuzySunshine]

I agree with Nellie when she relates it to the vasectomy, how is that different from an abortion? As a doctor you can choose the field you would like to go into and the likely hood of someone, say a neurosurgeon, ever having to perform an abortion is next to none. A pharmacist who chooses retail, chooses retail but should he get to choose what prescriptions he fills?

I think it is an interesting topic and I agree with the comment that if you are a privately owned pharmacy you should be able to turn away any customer like any other retail store can choose to do.

I'm sure the debate could go on forever and its only elevated by talking heads, like Maher.