Gee, thanks. Good thing I went to college to be a freaking robot.
Look, the whole point of having a pharmacist in between the doctor and the patient is to introduce another set of eyes, another mind, another person in the middle to catch mistakes and errors. If we just mindlessly give whatever the doctor orders, we are committing malpractice (if we let a problem through). The law is clear on this. This is “what the industry expects of its pharmacists.” I assure you that I cannot legally play doctor, and I am certainly doing my fucking job.
We had a thread not long ago about this. Somebody was asking why we had pharmacists at all (instead of dispensing robots or machines), and the OP was surprised to hear about pharmacists’ real job and responsibilities. How do we decide what’s in the patient’s best interest? We are supposed to rely on our education and experience, and act in good faith…just like any other health provider. (That doesn’t mean “according to religion,” it means “doing the best that you honestly can.”)
But enough of my self-defense: back to the OP.
If I may ask: the pharmacists who protest are getting press, sure. But aren’t there any doctors who refuse to prescribe Plan B in the first place? Are the patients simply going elsewhere, or what? And how big is this problem? Are there a couple of religious pharmacists getting a lot of airtime, or is this really an issue of wide-scale lack of access to treatment? I ask because I honestly don’t know. I work in a hospital where it isn’t an issue…I barely know any retail pharmacists (the ones who work in drugstores).
In other words, how many women are trying to get Plan B, but really can’t get it because of pharmacists standing in the way? How many request it from a Catholic doctor and are turned down, but don’t call the newspaper? How many try to get Plan B and have no problem? What is the real size of the issue?
Because that’s exactly where the problem is in what the OP’s talking about. In these incidents, the pharmacies stocked Plan B, and it was solely the pharmacists’ moral objections to it that prevented its sale.
Then this issue wouldn’t be discussed.
If a pharmacy decides to not stock a product, that’s fine. It implies they have analyzed the moral and financial ramifications of their decision and still concluded that they will not stock it. That’s fine, that’s an informed and principled conclusion. But if a pharmacy has a product in stock, that implies that they accept the morality of the use of that product. So a pharmacist who doesn’t sell something his pharmacy stocks is acting against the wishes of both his customers and his employers. That’s what makes it so much worse than a pharmacy simply not stocking a product. The obstacle to the product is a person who has no place inserting his moral judgement. Only his professional judgement is welcome and required.
Hopefully they’ll find a pharmacy not staffed by morality police.
Of course. You need to weigh the wisdom of doing so, because a large portion of your sales might be for cigarettes. But you should be under no obligation to stock what you don’t want to.
Of course. But I would question the business sense behind stocking a product neither of you want to sell. As I see it, you either submit to the demand (and keep your morality to yourself), or don’t stock the product.
No one’s saying a pharmacy should stock a product it doesn’t want to. We (or at least I!) am arguing that if a pharmacy has a product, a moral busybody shouldn’t get in the way of the sale of that product.
I’m not saying it does. Acting unethically does not equal not doing everything you could conceivably do in your professional capacity. As it pertains to this case, it means acting outside of your clients’ legitimate wishes or interests.
Like I said above, anything about the a product not being in stock is irrelevant, because in the OP, the product in question was in stock; it was entirely the moral objections of the pharmacist that prevented its sale. Any discussion about whether pharmacies should stock the product, if they should be forced to stock it, what reasons they might have for stocking or not stocking… all totally besides the point.
Also, it’s never been my position that an owner shouldn’t accomodate his employees. Management should make reasonable accomodations for his employees. But the fact that the pharmacists in these scenarios were still put in a position where they still had to sell Plan B suggests they didn’t make their objections known. AFAIK, none of them has ever said, “I told my bosses I didn’t want to sell it, but they didn’t accomodate me.” AFAIK, their objections only surfaced in the form of their refusal to sell it to customers. Which, as I previously said, is pretty chickenshit behavior.
Since Plan B is OTC (unless you’re a minor), there’s no prescription to return.
I agree that it would be wrong of a pharmacy to force a pharmacist to sell a product he disagrees with morally. The pharmacist should either be fired (for not being willing to perform his job) or accomodated somehow. But he shoudn’t be forced. However, let’s not ignore that the pharmacist isn’t completely innocent. By refusing to sell Plan B even though it’s legal and sold by his pharmacy, he too is inflicting his moral code upon people: his employer and his customers.
Requiring all pharmacies to stock products goes against the spirit of free enterprise and is yet another infliction of values. I think the obstacles to abortion in this country are silly, but I can’t support that kind of requirement. I also don’t think any business should have to explain why it doesn’t stock something.
The best way to avoid this problem is for pharmacies to not hire pharmacists with moral objections to abortifacients or other objectionable products.
Theobroma, thanks for contributing. I have felt more comfortable making my arguments having read your posts.
This isn’t 100 percent accurate. I was a Pharmacy Technician in the U.S. Navy for seven years. On many, many occasions I dispensed medications (always non-parenterals) as the lone pharmacy representative. I do realize, however, the military is a different animal. Frankly, I believe the professional freedom given to technicians in the military is due to better training. For instance, the only requirement to be a technician in Illinois is a high school diploma.
I know this has been covered, but I’m jumping on the train. There is no way in hell you could earn a pharmacy degree exclusively on-line, ostensibly at home (B.S. or Pharm. D.). The immediate consideration would be how the hell the student would complete the many required labs throughout the program.
In the realm of pharmacy, the pharmacist is king. M.D.'s maybe…maybe…get a semester of pharmacology. Pharmacists get 4 years plus of specialized training. As a technician (seven months of U.S. Navy pharmacy technician school…for the record), I had to explain to many physicians about the incompatability of intravenous drugs and why they could not mix them. A few even asked for a recommendation on which medication to give a patient. Of course, the pharmacist had to deal with that. So, it is fallacious to presume that the M.D. has complete pharmaceutical authority.
I don’t know why we are discussing this anyway. The quandary of the OP is ethical and/or moral, not legal or educational. Should a pharmacist be allowed to refuse to dispense drugs they object to? Of course. No human should be required, either by law or providence, to dispense anything. Of course, if you take a positon (i.e. Wal-Mart), you should be bound to dispense anything and everything on the formulary. If you own your own pharmacy and decide not to carry a product on moral principle, you are costing yourself money. If you refuse to fill a prescription at a retail pharmacy, you are costing other people money.
If I morally object to the proliferation and use of birth control devices, I might question if I should pursue one of the few careers that would require me to do so.
Yes, and here’s where your argument gets circular once again, when you assert that “doing your job” by definition means filling every prescription a doctor prescribes. That’s not what it means or what your prior cite stated (or what a pharmacist in this very thread told us).
And in this instance there not the same thing you seem to think they are either.
Shouldn’t a pharmacist be aware that Plan B is now an OTC drug?
So really, any woman can walk into the pharmacy and ask for it. They don’t need a prescription unless they’re minors under the age of 18.
The last thing I want is a pharmacist, who doesn’t know me, doesn’t know any of my medical history, and doesn’t know what condition I’ve been prescribed a particular drug for deciding whether I should have it or not.
I no longer bother to tell a pharmacist what drugs I’m allergic to, because they don’t listen to me and I have gotten scrips filled that I am allergic to. Had I known that before I got it filled, I wouldn’t have wasted the money! I would have, if I could’ve read the doctor’s handwriting, but that’s another issue. I’ve had pharmacists refuse to fill a prescription in less than thirty days - a prescription for birth control pills. I had a hell of a time with that one, and ended up transferring the prescription to another pharmacy after complaining to the store manager that their pharmacist was wrong and giving out very bad and potentially dangerous information. You don’t take your 28 birth control pills, wait two days, and then get the next packet.
No, I don’t want pharmacists deciding that I shouldn’t have Plan B, especially since I know they’re out there giving bad and wrong information and refusing to fill birth control prescriptions until two days after the customer has run out of pills.
How does a pharmacist make that decision? Does he look at the patient’s medical records? Does he give an examination? Does he take a detailed history? If I go into a drugstore and ask for Plan B, what would be a valid reason for a pharmacist to refuse to accommodate me? What information, aside from drug interactions or allergies, could possibly put a pharmacist in a better position to determine what is “best” for a patient?
In his mind, that Plan B is murder is a valid reason. It’s not a clinical consideration. The Pharmacist is not deciding that it would endanger the patients well-being. He is making a decision based on morality.
That’s not a medical reason. I’m asking for an instance, other than what I stated above, that would allow a pharmacist’s decision to trump the decision of the doctor and/or patient.
There is no medical reason beyond a sub-therapeutic or super-therapeutic dose or some other contra-indication the doctor has missed. In other words, the pharmacist can’t clinically evaulate the patient and determine his own therapy based on that evaluation. But I think that is irrelevant. I believe the OP is asking if pharmacists should legally be allowed to deny a patient an abortifacient due to his perception that it is a moral transgression, i.e. murder. I don’t think there is any sane pharmacist who would deny a patient such medications based on his own clinical evalutation, given that the script (dosing, sig, etc.) is in proper order.
But he isn’t necessarily going against the wishes of his employer, that’s my point. If he made an arrangement with his employer that he doesn’t have to sell it, then that’s between the two of them, and that’s it.
OK
Right.
I would question that, too, and it’s not necessarily what I would do, but we are talking about rights vs. obligations here.
Even if the boss agrees that they are willing to support that morality? See, what I was trying to say about the stocking was that there are 3 possible scenarios here (regarding moral issues with the drug):
Pharmacy owner has a moral objection to the product, and doesn’t stock it
Pharmacy owner has no moral objection to the product, stocks it, and allows an employee to opt out of selling it if desired
Pharmacy owner has no moral objections to the product, stocks it, and requires all employees to sell it.
IMO, the owner & the pharmacist are well within their rights to approach the situation in any of these three ways…they have NO obligation to the customer to provide it, they only need to decide what the policy is going to be at that store.
I see no issue with ethics here, as long as the customer is told the truth about the drugs availability, and not impeded from getting it someplace else (don’t see how that second part would be relevant, given that it is an OTC drug).
The point is, what is the difference between not stocking & not selling?
I wouldn’t disagree with this, but it’s kind of unclear from the info given exactly what happened between the pharmacist & the pharmacy.
Right, so it would be very difficult to impede the customer from getting Plan B someplace else.
See, I don’t get the “inflicting moral code” thing at all. HE doesn’t want to be party to something he sees as wrong. That’s it. He’s not trying to force anyone to do anything, as long as it doesn’t involve him. JUST like the OB/Gyn that doesn’t do abortions, or the convenience store owner who doesn’t sell cigarettes.
Well, we agree on that, then.
But even that is infringing on the rights of the pharmacies. For one thing, the pharmacy itself could have moral objections (meaning, the owner). For another, what if the best-qualified pharmacist they could get is someone with a moral objection, and it makes the most business sense for the pharmacy to work around it? I don’t think that anyone has the right to tell the pharmacy it can’t do so if it wants to.
He’s not trumping the decision. He is simply not contributing to advancing it because he finds it objectionable. Again, he’s not surreptitiously replacing a prescription with something else, or giving a placebo (which would be trumping the doctor’s decision). He is simply saying if you want this filled, you’ll have to go somewhere else. I assert that a patient’s right to get a prescription does not mean I have to be the one to fill it, not if I object to the prescription, in the same way that a doctor needn’t perform an abortion. I don’t see any reason this isn’t an apt analogy, circular definitions of what a pharmacist must do notwithstanding.
Not Plan B necessarily. But many pharmacists who morally object to dispensing arbotifacients (Plan B) object to dispensing other similar medications that do require a prescription (birth control, for instance).
I agree with you overall, but I don’t necessarily agree with this analogy. A doctor can specialize in cardiology and never have to worry about being requested to perform an abortion. A retail pharmacist cannot specialize in dispensing a certain medication or group of medications. It’s quite different with a clinical pharmacist. He can choose, say, radiology, oncology and chemotherapy specialization and never have to worry about dispensing Plan B. Then, of course, he’s limiting himself to clinical pharmacy. But it’s a self imposed limitation. I think it would be practical for someone who morally objects to birth control to choose a career outside of medicine; but I also don’t think it should be a limiting factor either.
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.
What if the only available doctor is not willing? And, again, how is this different from the pharmacist who won’t be a party to something he finds objectionable?
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?