"Pro-life" pharmacies

The BBQ Pit
101

[QUOTE=NinjaChick]
With hormonal contraception, be it the ring or the patch or the pill, I can’t just go out and buy them. Because of the way our healthcare system is set up, I need someone else to dispense that to me. And in my opinion, to put oneself in that position, where there’s a reasonable expectation that you will dispense legitimately prescribed drugs, and then to not do so, is not okay, because there’s no alternative. Yes, I know I could go to another pharmacy, but I think it’s unethical for someone to make a person resort to that.
[/QUOTE]

I’m quite in agreement that licensing boards SHOULD require pharmacies to dispense any legally prescribed prescription they’re asked to, and in cases where such a rule exists and they refuse, their licenses should be taken away.

However, if that’s not the rule, then the correct thing to do, IMHO, is to first make it the rule, and THEN hammer the ones who refuse to live up to their professional obligations.

102

A prescription is not a guaranteed right to a medication. It’s an authorization, indicating that you are legally allowed to possess and use a dangerous drug in accordance with federal and state law. If you present me with a prescription for a drug necessary to sustain your life but you can’t pay for it, I’m under no legal obligation to fill your prescription. The prescription itself does not give you an absolute right to a medication. Instead, it serves as a form of communication between me and your doctor, telling me that legally I’m ok to fill the drug.

So while it isn’t unreasonable to expect a pharmacist to fill a legal prescription for you, it also isn’t unreasonable to expect a pharmacist to not fill something that does not grant you an absolute right if he/she feels it violates her conscience.

Actually, we get paid huge amounts of money to prevent medication errors from occuring, to educate patients regarding their medications, AND to actually dispense medications. Each part is an important part of our jobs and reducing our job to “counting pills into bottles” is as offensive as me reducing a secretary’s job to gabbing on phones and typing things or a ninja’s job to punching and kicking stuff. :wink:

Nope, my job encompasses quite a bit more than just filling your prescription. In my state, I must make sure that the prescription meets ALL state and federal requirements. Further its my responsibility to inquire about your current and past medications, drug allergies, non-drug allergies, and disease states to assess whether or not the drug written for is appropriate for you (and yes, your doctor is supposed to be doing this as well–we use redundency as much as possible in healthcare to prevent medication errors from occuring). I’m also required to offer to counsel you on the drug, it’s uses, risks, benefits, etc. I also counsel and make recommendations on appropriate OTC product selection, and I’m legally allowed to give you certain immunizations. I could probably break it down even further, but I hope you get the idea.

The second sentence does not logically follow the first. If you can go to another pharmacy, you, by definition, HAVE an alternative. You may not like it and it may inconvenience you, but you DO have an alternative.

Legally, it IS the concern of the pharmacist. Were we to dispense it and the patient overdoses, we are legally liable to a degree. Even if nothing negative happens, should the DEA audit us, they can (and would) find a way to hit us with fines.

103

Pharmacists aren’t granted a monopoly. Any physician who wants to can dispense Plan B, and samples from their office. As far as I know, they can even go so far as to set up a pharmacy on site and hire a pharmacist with the agreement that the pharmacist will dispense whatever medication they write for which meets all legal requirements. Licensure is required to determine that we have met minimum standards necessary to practice, nothing more. Further, it can’t really be a monopoly if there’s plenty of interdisciplinary competition (and there is, judging by the number of CVS and Walgreen’s stores popping up every other corner), or at least, so I would think.

Except that I’ve been in a number of arguments with obstinant physicians who wanted us to dispense in situations where there was a very clear danger to a patient if they followed the physician’s desired instructions. Were we to do it your way, I’d still be legally liable for harm caused to a patient. Since dispensing affects my liability (and potentially my ability to hold my license), I’d say it’s only fair I have a say in the matter.

While I don’t necessarily agree with the misogynistic label, I do agree with the moron part. I’m only including this to show that I personally feel the same way y’all do about these pharmacists/pharmacy owners. I think they’re using junk science and faulty reasoning skills to justify their religious oddities. But I can step back from that and acknowledge that they are both legally allowed to do this in most states AND that there are underlying reasons beside their religious objections for approaching “required to dispense” laws very cautiously.

104

Neither does your doctor, if you want to be nitpicky. He/she is making an educated guess when he/she prescribes your initial dose/type of medication and adjusts it according to your response. And with modern pharmacy education, I’m actually equipped to manage your pain regimen nearly as well (and in some cases better than) your physician. And again, if it affects my liability, you bet it’s also up to me to dispense or not.

And as another nitpick, you may very well be able to tolerate 16 regular strength Vicodin per day in terms of its opiate potency, but you also are getting double the maximum dose of Acetaminophen in the process and almost guaranteed destroying your liver (which you won’t see symptoms of until the damage is done–and liver disease is NOT a pleasant way to go). Sometimes the reason we tell you not to do something (like take more than 8 vicodin per day) actually has a good reason for it. :stuck_out_tongue:

Of course, if someone does that (barring certain exceptions), they qualify for the moron label we’ve previously given to these religious nut pharmacists earlier in the thread, in my frank opinion.

They can’t. Nor do I think has anyone said otherwise. Your doctor is free to write you a prescription for Dr Wiggle’s Shimmyandshake elixir if he desires. We’re just under no legal obligation to dispense it. :stuck_out_tongue:

105

[QUOTE=RickJay]
I’m quite in agreement that licensing boards SHOULD require pharmacies to dispense any legally prescribed prescription they’re asked to, and in cases where such a rule exists and they refuse, their licenses should be taken away.
[/quote]

I’m not. Certainly not as you’ve written it, at any rate. Requiring me to dispense ANY legally prescribed prescription could mean that I would be required to dispense 3 different benzodiazepines and phenobarbital to a singular patient as long as each prescription was legal as written. Very bad idea. Requiring me to dispense ANY legally prescribed prescription would require that I give the $1500 lovenox to the patient who couldn’t afford to pay for it. Very bad for the business’ bottom line. Requiring me to dispense a birth control prescription to a woman with known clotting issues, even though legal, could result in the woman’s death if I was not able to do my job. Requiring me to dispense a warfarin prescription, aspirin prescription, clopidogrel prescription all together could result in a patient who hemmorrhages internally. I could go on and on if you’d like.

There’s a great deal more to dispensing than just the legality of the prescription itself.

106

[QUOTE=Revtim]
Satan’s Little Cotton Fingers!
[/QUOTE]

:smiley:

As of my freshman year in college, I was the only under-21 female on my mother’s (Fundamentalist Baptist) side of the family who was allowed to use tampons. My mother learned this at a family reunion/home-school high school graduation – pads were a big topic of conversation that day for the adult female relatives.

107

[QUOTE=JayRx1981]
Pharmacists aren’t granted a monopoly. Any physician who wants to can dispense Plan B, and samples from their office. As far as I know, they can even go so far as to set up a pharmacy on site and hire a pharmacist with the agreement that the pharmacist will dispense whatever medication they write for which meets all legal requirements. Licensure is required to determine that we have met minimum standards necessary to practice, nothing more. Further, it can’t really be a monopoly if there’s plenty of interdisciplinary competition (and there is, judging by the number of CVS and Walgreen’s stores popping up every other corner), or at least, so I would think.

[/QUOTE]

Which is why, to be fair, I said monopoly, or quasi-monopoly, or any form of protection from competition…

In a big city, the effect of licensing on competition is small. The smaller the comunity gets, the more effect it has, as the profitability of competing pharmacies is likely to be lower, and therefore the relative effect of any increased costs through licensing are magnified.

If the government gives you a license to sell something that they prevent other people from selling, accepting the license makes you liable for government restrictions, IMHO, including being required to sell something you might not otherwise want to sell, or not being allowed to sell a product to everyone to whom you might wish to sell it.

108

[QUOTE=Jeep’s Phoenix]
:smiley:

As of my freshman year in college, I was the only under-21 female on my mother’s (Fundamentalist Baptist) side of the family who was allowed to use tampons. My mother learned this at a family reunion/home-school high school graduation – pads were a big topic of conversation that day for the adult female relatives.
[/QUOTE]

Mind explaining the reasoning behind this? I can get women simply not being comfortable using them (hell, my mother used pads until she hit menopause), but how the hell are tampons considered to be sinful?

109

[QUOTE=Jayn_Newell]
Mind explaining the reasoning behind this? I can get women simply not being comfortable using them (hell, my mother used pads until she hit menopause), but how the hell are tampons considered to be sinful?
[/QUOTE]

Because they go…in there. Because in order to use them a woman has to touch herself…you know where. And during…you know when. Her time.

110

[QUOTE=Annie-Xmas]
Because they go…in there. Because in order to use them a woman has to touch herself…you know where. And during…you know when. Her time.
[/QUOTE]

That’s it? Poo. Either the religious nutters aren’t as much fun as they used to be, or I’m jaded by too many stories of doctors not wanting to give out Plan B or BCP.

111

[QUOTE=JayRx1981]
I’m not. Certainly not as you’ve written it, at any rate. Requiring me to dispense ANY legally prescribed prescription could mean that I would be required to dispense 3 different benzodiazepines and phenobarbital to a singular patient as long as each prescription was legal as written. Very bad idea.
[/QUOTE]

If it wasn’t obvious, it wasn’t my intent to suggest a pharmacist should dispense drugs s/he knows will kill or injure the patient. Obviously, if I come in with a scrip for an antibiotic you know I’ll be allergic to, you’re not just going to send me on my merry way with death pills. Similarly, people have to pay for your service.

However, that’s a pharmacist’s job, and I would presume is part of the law and the various regulations that govern the profession. **Moral ** judgments concerning medications are not, and should not be permitted by the licensing bodies.

112

[QUOTE=Jayn_Newell]
Mind explaining the reasoning behind this? I can get women simply not being comfortable using them (hell, my mother used pads until she hit menopause), but how the hell are tampons considered to be sinful?
[/QUOTE]

They steal your precious virginity. People are fucking nuts, especially when it comes to dirty evil vaginas, and I can’t help but wonder if there are pharmacies that won’t stock tampons because of this moronic reasoning. Am curious if the pharmacy in the OP stocks them.

113

[QUOTE=Jayn_Newell]
That’s it? Poo. Either the religious nutters aren’t as much fun as they used to be, or I’m jaded by too many stories of doctors not wanting to give out Plan B or BCP.
[/QUOTE]

Yep…that’s pretty much it. Plus, there’s the long-standing myth that a tampon will “take your virginity”…and some fundamentalists believe that’s the only thing a woman has to offer.

114

[QUOTE=nyctea scandiaca]
Bricker said, “Why shouldn’t a pharmacist have the freedom to refuse to fill prescriptions he doesn’t like?”

Change that to “Why shouldn’t a physician have the freedom to refuse to treat people he doesn’t like?”

Pixilated said, “I’m pretty sure a customer cannot tell a business owner how to do their job if it is against what that business owner wants.”

So I asked, can a business owner put up a sign saying that they will only allow white people or Christian people to shop there? Can a doctor say he will only treat white people or Christian people?

Does anyone know if a doctor is allowed to refuse to treat certain people because he doesn’t like their ethnicity or religion?

I admit they’re not the same exact things, but it’s food for thought.

[/QUOTE]

See, nyctea, we have this thing called a “society.”

I would like to be the one that makes the rules for all of us, because, frankly, I know much better than you what’s best.

Unfortunately, others also make that claim. With no objective way to decide which of us to crown a philosopher-king, we have reached an agreement about how to make rules in this society. We elect leaders.

Now, those leaders have made rules about the very situation you describe. Everywhere in the country, it’s illegal to refuse service to someone based on his race. This national rule reflects our shared agreement to abide by this rule; even if some members of the society aren’t in favor of it, it will be enforced against all.

There’s no such similar national rule for pharmacists. Some states require pharmacists to dispense such products, but most don’t. That’s because we don’t have a national consensus about pharmacy products.

That, then, is the answer to your question. The case of racial discrimnation is illegal; the case of refusal to dispense birth control is not illegal.

OK?

115

I think she’s saying “why isn’t it illegal?” not “it IS illegal”…

116

[QUOTE=Really Not All That Bright]
I think she’s saying “why isn’t it illegal?” not “it IS illegal”…
[/QUOTE]

OK.

Because in this country we have a comfortable majority consensus that racial discrimination should be prohibited by law.

We do not have such a consensus about forcing pharamacists to dispense all products. In short, then: it’s not illegal because not enough people agree with her view.

117

[QUOTE=Bricker]
OK.

Because in this country we have a comfortable majority consensus that racial discrimination should be prohibited by law.

We do not have such a consensus about forcing pharamacists to dispense all products. In short, then: it’s not illegal because not enough people agree with her view.
[/QUOTE]

Interesting theory - but we had legislation prohibiting racial discrimination long before we ever had a consensus on it.

The people of Arkansas would have been most surprised to learn that they had reached a consensus allowing black students to attend white schools in 1957.

118

edit

119

[QUOTE=JayRx1981]

Except that I’ve been in a number of arguments with obstinant physicians who wanted us to dispense in situations where there was a very clear danger to a patient if they followed the physician’s desired instructions. Were we to do it your way, I’d still be legally liable for harm caused to a patient. Since dispensing affects my liability (and potentially my ability to hold my license), I’d say it’s only fair I have a say in the matter.
[/QUOTE]

If you can be held legally liable for doing something like this, then I completely understand why you would consider withholding the medication. But I have a problem with you being stuck with such liability - that, too, I think should belong solely to the prescribing physician.

120

[QUOTE=Really Not All That Bright]
Interesting theory - but we had legislation prohibiting racial discrimination long before we ever had a consensus on it.

The people of Arkansas would have been most surprised to learn that they had reached a consensus allowing black students to attend white schools in 1957.
[/QUOTE]

Yes, but you’re looking at the situation myopically. That was federal law, and while the people of Arkansas may not have been on board, enough people in the rest of the country were. That was precisely why I said:

Our consensus is determined by the laws in force. If the elected leadership does enact laws that flout our national consensus, we can always elect new ones within two years - one-third of the Senate and the whole House are changeable in a mere two years; two-thirds of the Senate and the White House in no more than four.

The people of Arkansas are also part of the United States. The federal constitution addresses racial discrimination and is enforeable in Arkansas.

Nowhere does the federal constitution, or federal law, address recalciotrant pharmacists. nyctea scandiaca hysterically asks why allowing pharmacist choice doesn’t imply racial discrimnation, and that’s the answer.