Again; Should Pharmacists Be Allowed To Refuse To Dispense Drugs They Object To?

Great Debates
181

[QUOTE=Mince]
Forced? Certainly not. But if the mother’s life is at risk and an immediate abortion is indicated, you’d better have a physician who not only is qualified, but willing.
[/QUOTE]
All OB/Gyns are most likely qualified to do necessary abortions, as they are surgeons. As you may have guessed, I was talking about elective abortions. So…I will rephrase the question, since I don’t think anyone’s life is ever IMMEDIATELY at risk it they don’t obtain Plan B:

What about OB/Gyns? Should they be forced to perform elective abortions? Or is delivering babies out if you don’t want to perform these elective surgeries?

182

[QUOTE=Kalhoun]
And is qualified OB/GYN abortion objector (qualified to perform an abortion) obligated to save the living or the unborn? Or would he let both of them die?
[/QUOTE]
In my opinion (and this is just me), the OB/Gyn abortion objector, when faced with a situation where the life of the mother is at risk, is obligated to treat the situation in whatever manner the mother desires it to be treated in, provided she is given the information needed to make a decision, and capable of making it at that moment. If she is not, then the mother’s life should be considered first. I am not sure what the professional ethics on that are, however.

But that is completely irrelevant to this discussion, as I don’t think there is any life-or-death indication for Plan B.

183

What IS relevant to the discussion, now that I think about it, is whether professionals have to cater to any and all elective treatments that fall under their area of specialty. I don’t see why this would be the case. A plastic surgeon may only be interested in doing reconstructive procedures, and not care to get involved in those that are purely cosmetic, for example. Isn’t that his or her perogative?

184

[QUOTE=Sarahfeena]
Again, you have not given any logical reason for this rule to exist.
[/QUOTE]

Because I have a reasonable expectation that I will be able to fill a prescription properly issued by my doctor at a place that calls itself a “Pharmacy.” That’s what a pharmacust does. He may do other things, like compensate for substandard medical care by “counseling” people who were not able to discuss their prescriptions with a doctor. I don’t see how that has any bearing on their right to not do their jobs.

185

There are a couple of states now that have passed laws requiring pharmacists to dispense according to the prescription, in the absence of a medical reason against. For those who think that a pharmacist has a right not to dispense drugs they don’t approve of, do you consider these laws a violation of the pharmacists’ rights?

186

[QUOTE=saoirse]
Because I have a reasonable expectation that I will be able to fill a prescription properly issued by my doctor at a place that calls itself a “Pharmacy.” That’s what a pharmacust does. He may do other things, like compensate for substandard medical care by “counseling” people who were not able to discuss their prescriptions with a doctor. I don’t see how that has any bearing on their right to not do their jobs.
[/QUOTE]
Who do you think guarantees you this reasonable expectation? Should the government guarantee it? The pharmacy? The pharmacist? Seems to me what you have in a case like this is a problem with the pharmacy, and that you need to talk to them or take your business elsewhere.

187

[QUOTE=jsgoddess]
There are a couple of states now that have passed laws requiring pharmacists to dispense according to the prescription, in the absence of a medical reason against. For those who think that a pharmacist has a right not to dispense drugs they don’t approve of, do you consider these laws a violation of the pharmacists’ rights?
[/QUOTE]
If you are asking me, yes, I do.

188

Thanks to anyone who is backing me up. I don’t post often, but I couldn’t let this one go.

When I mentioned lethal doses, I was referring to the idea that Plan B is lethal to a possible embryo. I could see the argument that it is not ethical to dispense such a med. I don’t agree with it…but I could see the argument. A few pharmacists have the same argument with regard to birth control pills. Very few of those pharmacists got their degrees after 1962, when the first oral contraceptive came out. I wonder what took them so long to speak up.

One more note: Plan B is indeed prescription only for patients under 18 years old.

Not that our hospital even carries it…

Actually, I like the analogy of the OB-GYN doctor being forced to perform an abortion, a legal procedure, if the patient requests it. Obviously this is not a must for any particular doctor. So why should one particular pharmacist be required to sell a patient anything he/she doesn’t approve of? Cigarettes, alcohol, Plan B? If the pharmacist is not standing in the way of the patient getting the requested item elsewhere, I don’t really know how to object to that. Of course, if I owned a pharmacy and an employee of mine refused to sell merchandise of which I approved, I would fire the person without another thought.

189

[QUOTE=Theobroma]
Thanks to anyone who is backing me up. I don’t post often, but I couldn’t let this one go.

When I mentioned lethal doses, I was referring to the idea that Plan B is lethal to a possible embryo. I could see the argument that it is not ethical to dispense such a med. I don’t agree with it…but I could see the argument. A few pharmacists have the same argument with regard to birth control pills. Very few of those pharmacists got their degrees after 1962, when the first oral contraceptive came out. I wonder what took them so long to speak up.

One more note: Plan B is indeed prescription only for patients under 18 years old.

Not that our hospital even carries it…

Actually, I like the analogy of the OB-GYN doctor being forced to perform an abortion, a legal procedure, if the patient requests it. Obviously this is not a must for any particular doctor. So why should one particular pharmacist be required to sell a patient anything he/she doesn’t approve of? Cigarettes, alcohol, Plan B? If the pharmacist is not standing in the way of the patient getting the requested item elsewhere, I don’t really know how to object to that. Of course, if I owned a pharmacy and an employee of mine refused to sell merchandise of which I approved, I would fire the person without another thought.
[/QUOTE]
I agree very much with what you say here. I can’t see any legitimate argument for making it compulsory for a pharmacist to dispense a drug that they have a moral objection to. If we are supposed to have freedom of choice in this country, and the government is not supposed to be the morality police, then that counts for everyone, not just certain people. As far as I’m concerned, these kinds of laws clearly violate the pharmacist’s freedom of conscience.

190

[QUOTE=jsgoddess]
There are a couple of states now that have passed laws requiring pharmacists to dispense according to the prescription, in the absence of a medical reason against. For those who think that a pharmacist has a right not to dispense drugs they don’t approve of, do you consider these laws a violation of the pharmacists’ rights?
[/QUOTE]
Yes, I do. I tend to take a pretty libertarian view of such matters. Anybody who is not actively causing harm to another non-consenting adult ought to be left to his or her own conscience. “Actively” is a key word here. I may believe that an individual has a moral obligation to help someone else, to actively interfere in some manner in the circumstance before him, but I don’t believe I have the right to force him to do so (by and large–like anything else, this is something of an oversimplification). People have the right to be left alone, to make their own moral decisions, so long as those moral decisions don’t actively create harm for someone else.

Let me clarify my position. If you have made the purchase of Plan B and I steal it from you, I have actively interfered with your decision. This is more than simply refusing to help you. That’s the distinction for me. Those who hold otherwise, IMO, must logically admit that they believe some form of, “You must be forced to actively accommodate my right, to abandon your own moral right, whether you want to or not.” I find that a repugnant circumstance.

My not doing what you want me to does not actively create harm. I am not obligated to do something you deem to be “good,” especially not when I disagree. You think you have the right to Plan B? I may disagree with that, but I certainly have the right not to provide it.

191

[QUOTE=Theobroma]
Very few of those pharmacists got their degrees after 1962, when the first oral contraceptive came out. I wonder what took them so long to speak up.
[/QUOTE]

um, sorry. That should read “before 1962.”

192

[QUOTE=Sarahfeena]
Who do you think guarantees you this reasonable expectation? Should the government guarantee it? The pharmacy? The pharmacist? Seems to me what you have in a case like this is a problem with the pharmacy, and that you need to talk to them or take your business elsewhere.
[/QUOTE]

Yes, the government. The government allows pharmacists a concession. They may make demands upon the pharmacist in return.

I’ve read a lot here about how important pharmacists are in detecting drug interactions when prescriptions are written by different doctors (you should inform any doctor who writes you a prescription of any drugs you’re taking. You should write them down before the appointment if necessary, but I understand that some people are unable to keep a doctor’s attention long enough to discuss medication with them). This only works if the pharmacist is the only pharmacy provider to the customer. If the pharmacist is allowed to pick and choose the drugs he’ll dispense, then many of his patients will go to more than one pharmacy. In that case, the pharmacist is not going to be able to find drug interaction issues, since he won’t know about the other prescriptions. So allowing a pharmacist a “conscience clause” serves to degrade the care he provides his patients.

In a large city, finding another pharmacy is often as easy as walking across the street. In small towns, the next pharmacy could be miles away.

193

[QUOTE=saoirse]
Yes, the government. The government allows pharmacists a concession. They may make demands upon the pharmacist in return.

I’ve read a lot here about how important pharmacists are in detecting drug interactions when prescriptions are written by different doctors (you should inform any doctor who writes you a prescription of any drugs you’re taking. You should write them down before the appointment if necessary, but I understand that some people are unable to keep a doctor’s attention long enough to discuss medication with them). This only works if the pharmacist is the only pharmacy provider to the customer. If the pharmacist is allowed to pick and choose the drugs he’ll dispense, then many of his patients will go to more than one pharmacy. In that case, the pharmacist is not going to be able to find drug interaction issues, since he won’t know about the other prescriptions. So allowing a pharmacist a “conscience clause” serves to degrade the care he provides his patients.

In a large city, finding another pharmacy is often as easy as walking across the street. In small towns, the next pharmacy could be miles away.
[/QUOTE]
Two comments on this:

  1. The nature of small-town life should not be a consideration when deciding what rights to confer upon people

  2. Just because the government licenses pharmacists, it does not make them slaves of the state.

194

[QUOTE=Sarahfeena]
Two comments on this:

  1. The nature of small-town life should not be a consideration when deciding what rights to confer upon people

  2. Just because the government licenses pharmacists, it does not make them slaves of the state.
    [/QUOTE]

This isn’t about confering rights on people. Everyone has the right to not sell any pharmaceutical product they do not wish to sell. Even if pharmacists are required to sell a given product, a person can still not be a pharmacist.

The question is whether the state, when it grants a license to perform an otherwise illegal activity, can require that the licensee performs certain acts. That they clearly can do. You don’t think the government should do that, but it is simply incorrect to talk about this in terms of conferring a right not to sell a product.

195

[QUOTE=villa]
This isn’t about confering rights on people. Everyone has the right to not sell any pharmaceutical product they do not wish to sell. Even if pharmacists are required to sell a given product, a person can still not be a pharmacist.

The question is whether the state, when it grants a license to perform an otherwise illegal activity, can require that the licensee performs certain acts. That they clearly can do. You don’t think the government should do that, but it is simply incorrect to talk about this in terms of conferring a right not to sell a product.
[/QUOTE]
Well, yes, they clearly CAN do it, because they do this kind of thing all the time. Doesn’t make it right.

196

This is a regulatory failure. The government has interfered with the free market by forcing citizens to find a state-licensed vendor with a particular moral code to sell them Plan B. As others have pointed out, this is not a big deal in a city, but effectively delists the drug in many small towns.

As I see it, there are two remedies:

  1. Force licensed pharmacists to stock and dispense all drugs as requested unless there are clear contra-indications.

  2. Deregulate Plan B and allow the free market to step in and make it available at convenience stores, etc.

Personally, I think #2 is the way to go. People in some small towns with low demand may still need to stock up when they visit a city, but at least the government won’t be getting in the way.

197

[QUOTE=saoirse]
Yes, the government. The government allows pharmacists a concession. They may make demands upon the pharmacist in return.
[/QUOTE]
Pharmacists are licensed as a process to ensure they’re qualified. They’re not purchasing a franchise from the government. There are no limits I am aware of for the number of pharmacists who can be licensed in a given area, for example.

And, as Sarahfeena points out, just because government oversight is involved doesn’t make every regulation warranted. If there is a compelling argument to regulate a pharmacist’s behavior as covered in this thread, that regulation can be installed without the government granting a license first. Don’t see why that’s relevant here. I would see an argument if the license was necessarily monopolistic in some manner, though.

198

[QUOTE=villa]
The question is whether the state, when it grants a license to perform an otherwise illegal activity, can require that the licensee performs certain acts. That they clearly can do.
[/QUOTE]
Certainly they can. They can install restrictions even in the absence of a license. The question is whether or not the restriction is appropriate.

199

[QUOTE=Sarahfeena]
What IS relevant to the discussion, now that I think about it, is whether professionals have to cater to any and all elective treatments that fall under their area of specialty. I don’t see why this would be the case. A plastic surgeon may only be interested in doing reconstructive procedures, and not care to get involved in those that are purely cosmetic, for example. Isn’t that his or her perogative?
[/QUOTE]

One goes to a pharmacy to buy drugs–prescription & OTC. One assumes that they will be on hand, barring a stocking problem. And, if they are on hand, that they will be sold. (Leaving the pharmacist the right–or obligation–to call the MD if they think there’s a medical problem with a prescription.)

One does not just drop by any OB’s office to terminate a pregnancy. If a woman has made that decision, she damn well knows where to go. Perhaps she was the victim of the pharmacist who was too “moral” to dispense Plan B, so the undifferentiated clump of cells was “protected.” Now, she will abort the resulting fetus.

But that pharmacist & his supporters can bask in their moral superiority.

200

[QUOTE=Bridget Burke]
One goes to a pharmacy to buy drugs–prescription & OTC. One assumes that they will be on hand, barring a stocking problem. And, if they are on hand, that they will be sold. (Leaving the pharmacist the right–or obligation–to call the MD if they think there’s a medical problem with a prescription.)

One does not just drop by any OB’s office to terminate a pregnancy. If a woman has made that decision, she damn well knows where to go. Perhaps she was the victim of the pharmacist who was too “moral” to dispense Plan B, so the undifferentiated clump of cells was “protected.” Now, she will abort the resulting fetus.

But that pharmacist & his supporters can bask in their moral superiority.
[/QUOTE]
From that last comment, I glean two things:

  1. The thing that really bothers people is the idea that some people have a different morality than they do

  2. That some still think that one has to be pro-life (or anti-Plan B, at least) to support the right not to dispense the drug

As far as the first point is concerned, the fact is, we all have different ideas about what is right and what is wrong, and the government has no business, IMO, to decide whose morality is “correct” in the eyes of the government.

In the prior thread on this subject, someone suggested that the pharmacy should have a sign out front saying that they don’t sell Plan B. I think that’s reasonable…then the customer doesn’t even have to stop and inquire, and hopefully will even have known ahead of time that they need to figure out where to get Plan B if they should ever want it (or, even more hopefully, actually procure it before hand).

The second point gets further into what I believe the government’s responsibility is SUPPOSED to be, which is to protect the freedoms of all its people. I have said repeatedly in this thread that, while I do support the rights of the pharmacist, it has nothing to do with agreement that Plan B is morally wrong. I just happen to think there is a higher principle at work here. The government has given women the freedom to exercise their morality in using Plan B. The pharmacist deserves equal protection of freedom to exercise his morality, as well.

meara is right, actually, I think we do have a regulatory problem here. The pharmacist should be cut out as a middleman, and they should allow any store who wants to carry the product. Some will choose not to, for whatever reason, and some will choose to, and the customer will probably end up with a lot more options in terms of places to buy.