Some WA pharmacists want to continue forcing their morality on customers

[ladyfoxfyre]

@Siege

Yes, there’s an unknown and currently unknowable risk that any of these methods might prevent a fertilized egg from implanting, and I’ve seen websites which argue that these methods should be illegal for that reason.

Actually, that’s what birth control pills are intended to do also. It creates a more hostile environment within the uterus that discourages implantation, should fertilization happen. I think an important thing to point out, which has been pointed out before but doesn’t seem to be sticking, is that Plan B is not an abortifacient. It does not terminate pregnancy. In fact, OB/GYN’s have been prescribing the equivalent in a specialized dosing of preexisting birth control for years now. The only difference is that the pharmacists who have been refusing prescriptions are doing so based on a false idea that it is an abortifacient, which they know pharmacologically to be false. It’s the equivalent to having evidence of evolution and sticking your fingers in your ears singing “La la la la la”. They’ve made up their minds and no amount of science is going to change that.

Carry on.

ETA: Further, Plan B is indeed designed to implantation, as well as fertilization and ovulation.

[VinylTurnip]

To understand the opposition, I think one has to engage in the same sort of magical thinking employed by objectors and their apologists like mswas: that a fertilized egg suddenly and immediately possesses a soul, thoughts and feelings, autonomy and sentience, even before the first cell division occurs. That taking a pill the day after intercourse is morally distinct from taking the same pill the day prior, and so reprehensible that saddling the woman with a potential unwanted pregnancy (and likely, a more complicated abortion later) is the more just decision. That for the woman to intentionally prevent the fertilized egg from attaching is a tragedy akin to murder, while the millions upon millions of cases in which this occurs spontaneously, without women even knowing about it, pass without mention— simply nature taking its course, “God’s plan.”

[Zakalwe]

@mswas

You’re still missing the point. We are not talking about not helping people who have had abortions, or not helping abortion doctors or not helping people who are pro-choice. What we are talking about is NOT HELPING FACILITATE THE ACT. It’s not about the people, it’s about the act.

How about you shut that festering gob until you’ve answered the questions you’ve been asked?

[Alan_Smithee]

Should a family doctor/OB be required to write a prescription for Plan B? It seems that that is likely to be at least as large an obstacle to women receiving the drug as reluctant pharmacists are. At least a woman who gets turned down at the pharmacy knows that she needs Plan B and that she needs to go somewhere else to get it. A woman whose doctor (or hospital) won’t prescribe it might not even know it exists.

[LilShieste]

@Alan Smithee

Should a family doctor/OB be required to write a prescription for Plan B? It seems that that is likely to be at least as large an obstacle to women receiving the drug as reluctant pharmacists are. At least a woman who gets turned down at the pharmacy knows that she needs Plan B and that she needs to go somewhere else to get it. A woman whose doctor (or hospital) won’t prescribe it might not even know it exists.

I think this is a tougher situation to deal with, since doctors use their own judgment as to whether or not a certain drug should be prescribed. They might have legitimate concerns about a drug’s potential side effects on a particular patient, for example.

Once the prescription is written, it should be filled. If a pharmacist has a concern, they can bring it up with the prescribing doctor.
LilShieste

[Alan_Smithee]

@LilShieste

I think this is a tougher situation to deal with, since doctors use their own judgment as to whether or not a certain drug should be prescribed. They might have legitimate concerns about a drug’s potential side effects on a particular patient, for example.

Once the prescription is written, it should be filled. If a pharmacist has a concern, they can bring it up with the prescribing doctor.
LilShieste

Pharmacists use their own judgment as well. If a pharmacist believes a patient is feeding an addiction to a narcotic, I believe the pharmacist is obligated not to fill it, regardless of what the doctor says. I don’t know whether pharmacists have a similar ability to override a doctor for medical reasons, but it would neither surprise nor alarm me. If a pharmacist’s professional judgment isn’t to be trusted, why is a doctor’s, especially when the doctor can cause far more harm for doing precisely the same thing for the same reason? OTOH, if doctors are to be given the leeway to exercise their personal moral judgment as well as their medical judgment, I don’t see why it should be such a crisis if a state allows a pharmacist to do the same.

I suspect it all comes down to cultural associations that cause us to see doctors as trusted authorities and pharmacists as state-licensed shopkeepers.

[drachillix]

@Alan Smithee

I suspect it all comes down to cultural associations that cause us to see doctors as trusted authorities and pharmacists as state-licensed shopkeepers.

Well in some respects, yes they are. I worked in the biz, and I know there is far more to being a Pharm than just knowing what pills to put in what bottle. Between compounding, storage requirements, understanding drug interactions across thousands of medications and contraindications for various meds in various medical conditions is a HUGE job. I expect the pharmacist to know drugs much better than the MD does, its part of his/her job to look for medication interaction problems that the doc may not be aware of. In addition, most docs go to school almost twice as long as a pharmacist does (PharmD’s get to about 75% as much)

However, like it or not, I can go to any one of dozens of pharmacies in my town and get the same pills, in the same time frame, in the same style of little plastic bottles, along with the same advice with regards to side effects.

The doc has already had an opportunity to discuss why this patient feels this is a proper course of action, if patient and doc agree, and the pharmacist has no medical reason not to dispense that medication, who the fuck is he to tell the doctor and the patient no.

[drachillix]

@mswas

You’re still missing the point. We are not talking about not helping people who have had abortions, or not helping abortion doctors or not helping people who are pro-choice. What we are talking about is NOT HELPING FACILITATE THE ACT. It’s not about the people, it’s about the act.

So you going to answer my question? Who gets to say what religion we now have to bow to. Will you welcome pharmacists who refuse you blood products like rogam or medication period? Or will you happily watch your child suffer while respecting the pharmcists religious beliefs. Praise God :rolleyes:

[thirdwarning]

@Zabali_Clawbane

Sure you can, it happens all the time in the ER. Black people have helped rabid KKK types, and saved their lives, Jews also have helped anti-Semites, women have nursed mysoginists, women have nursed rapists, parents have performed life saving procedures on dying pedophiles, you name it, people set their feelings aside to help the patient on a daily basis. ETA: And I might add that those situations would also touch on a person’s religious leanings, and their creed as well.

None of which has any bearing on the discussion at hand. All of those decisions were likely made for moral as well as ethical reasons, to save life regardless of one’s opinion of the person. I really wish mswas had stayed out of this thread, because all she’s doing is throwing in red herrings all over the place (and totally stupid and offensive ones at that). The pharmacist’s decision has nothing to do with his opinion of what his customer might have been doing, it has only to do with what he will do (or not). This isn’t about pharmacists refusing to dispense because they disapprove of the customer’s actions or morals. It’s about refusing to do something that violates their own morals.

So all the comments about insulin, or HIV medicine, or even antibiotics, are way off the mark, really bad analogies. Those are all about making judgements based on what the customer is doing or has done. The Plan B discussion isn’t. If you can demonstrate to me that any pharmacist has refused Plan B to an unmarried customer or one who didn’t take other precautions, while dispensing it without problem to married ones or those who meet his criteria for morality, then I’ll admit I’m wrong, but until then the statement stands.

And the antibiotic situation that keeps being referred to? Not quite relevant, and you can’t tell me that there isn’t at least one extremist nut in pretty much every profession.

[Zabali_Clawbane]

@thirdwarning

<snip>This isn’t about pharmacists refusing to dispense because they disapprove of the customer’s actions or morals. It’s about refusing to do something that violates their own morals.

Yes, they are refusing to fill legally written prescriptions, thereby holding another person’s reproductive rights hostage, in essence saying they have a right to cause others to follow their morals by their refusal. (ETA: At least in some areas it turns out this way, because of the remoteness and time senstive nature. Enough areas that legislation has been proposed due to it.)

@thirdwarning

And the antibiotic situation that keeps being referred to? Not quite relevant, and you can’t tell me that there isn’t at least one extremist nut in pretty much every profession.

It is pertinent, because the pharmacist used the “moral objection” card with antibiotics due to the origin of the prescription. Some of those who are refusing to fill Plan B presriptions and birth control prescriptions will probably follow suit if the legislation isn’t tightened to prohibit that.

@thirdwarning

So all the comments about insulin, or HIV medicine, or even antibiotics, are way off the mark, really bad analogies. Those are all about making judgements based on what the customer is doing or has done. The Plan B discussion isn’t. If you can demonstrate to me that any pharmacist has refused Plan B to an unmarried customer or one who didn’t take other precautions, while dispensing it without problem to married ones or those who meet his criteria for morality, then I’ll admit I’m wrong, but until then the statement stands.

Which is it, the situation with the antibiotics is, or isn’t pertinent? :dubious: Also, there have been cases in which pharmacists refused to fill birth control prescriptions because the woman was un-married. Plan B is a form of birth control, it does not cause abortions.

[Shodan]

@Fear Itself

They weren’t convicted under their military code. Does it surprise you to learn that an army is judged more harshly by their enemies? So it is entirely accurate to say soldiers cannot disobey lawful orders just because they have personal moral objections.

This is a non sequiteur. It would be entirely accurate to say that soldiers should disobey lawful orders, because their moral objections should supercede.

But I have no doubt that an army is judged more harshly by its enemies. Just as I have no doubt that these pharmacists are going to be judged more harshly by the pro-abortion side than the anti-. The idea of the Nuremburg trials was that there was a higher moral imperative than following a lawful order, which should have led the soldiers to disobey.

Regards,
Shodan

[Zakalwe]

@Shodan

The idea of the Nuremburg trials was that there was a higher moral imperative than following a lawful order, which should have led the soldiers to disobey.

Except that in response to that, we have aligned our law to that of Nuremberg effectively saying that what is moral is also ethical (or legal). The problem with the current situation vis-a-vis pharmicists (as has been noted numerous times already in this thread) is that the moral/ethical/legal issues are disconnected and pharmacists are asking to allow their own personal morals to override the ethical/legal issues. And they (well he) have asked to do this after agreeing otherwise for many years.

[drachillix]

@thirdwarning

None of which has any bearing on the discussion at hand. All of those decisions were likely made for moral as well as ethical reasons, to save life regardless of one’s opinion of the person. I really wish mswas had stayed out of this thread, because all she’s doing is throwing in red herrings all over the place (and totally stupid and offensive ones at that). The pharmacist’s decision has nothing to do with his opinion of what his customer might have been doing, it has only to do with what he will do (or not). This isn’t about pharmacists refusing to dispense because they disapprove of the customer’s actions or morals. It’s about refusing to do something that violates their own morals.

I feel that mswas has contributed greatly to this thread because she shares the same moral/ethical disconnect as the pharmacists in question. That being the silly concept that there can be no moral behavior without religion and that morality/ethics/religion are all one and the same. Using the word morals as some kinda of convenient substitution for the word religion because that could uncork legal intervention.

[Jodi]

@Liberal

Jodi, I really do think your argument would be more coherent if it weren’t so coy.

I do not give the single smallest shit what you think of my opinion. You can certainly attack it’s merits if you feel their are grounds, but I will disregard your opinion regarding its coherency and coyness, since IMHO I am consistently far more coherent and less coy than you.

Your premises compel you to conclude that a central authority (or committee of authorities) ought to determine what pharmacists must do irrespective of what their employers may think.

Incorrect. My premises do not “compel” me to conclude anything with regard to a central authority. The fact is, pharmacists dispense medications without making moral judgments, just as firefighters put out fires without consideration of whose house it is, and doctors save lives without regard to who is dying. There are any number of professions where it is implicit that the professional provide the service – DO THEIR JOB – without feeling it is appropriate or even allowed to sit in moral judgment of the people requiring their services. This has nothing to do with any regulatory agency; it is the nature of the job that ALL pharmacists are expected to do.

You posited that a pharmacist ought to dispense whatever he is told to by a doctor, tempered by the exercize of his own medical judgment.

She should only be employing her own judgment to the extent of making sure the medication is appropriate to the patient (i.e., no adverse drug interactions). Even then, her concerns should be conveyed back to the doctor; the ultimate decision as to whether the drug is dispensed should not be hers. And her moral judgment as to the drug and/or the patient should never enter into it.

There is no way to make that happen universally without the coercion of a central authority.

Sez you. The general understanding of what pharmacists do supports this position, regardless of whether pharmacists are licensed or not. Though as to that, I have no problem requiring pharmacists to be licensed, and if universal expectations regarding the profession are clarified by regulation, I have absolutely no problem with that. None of this requires me to go down the road of your half-baked libertarian “coercion” bullshit.

If that isn’t the argument you wish to make, then you should modify your premises.

I’ll decide the argument I make, and I’ll decide when to modify it. If you have trouble understanding it, I will clarify, but if you feel another argument needs to be made then make it yourself.

Then why was she arguing with me? I told her that she should frame her position as advocating central planning. I may not know pharmaceuticals, but I know political philosophy. Coercion by The State is the very essence of authoritarianism.

I’m arguing with you because you are misrepresenting my position, which aggravates me, and you are advising me on how my argument can be “improved,” which pisses me off. You want me to join you in framing every single discussion in terms of your own pet philosophy, and I unequivocally refuse to do so. I am not required to respond to, much less embrace, such over-generalized horse shit as “coercion by the state is the very essence of authoritarianism,” as if we regulate pharmacists on Monday and the jack-booted fascist troops march in on Tuesday.

Make your own arguments, to the extent you can, but leave me out of them.

[Alan_Smithee]

@drachillix

@Alan Smithee

I suspect it all comes down to cultural associations that cause us to see doctors as trusted authorities and pharmacists as state-licensed shopkeepers.

Well in some respects, yes they are. I worked in the biz, and I know there is far more to being a Pharm than just knowing what pills to put in what bottle. Between compounding, storage requirements, understanding drug interactions across thousands of medications and contraindications for various meds in various medical conditions is a HUGE job. I expect the pharmacist to know drugs much better than the MD does, its part of his/her job to look for medication interaction problems that the doc may not be aware of. In addition, most docs go to school almost twice as long as a pharmacist does (PharmD’s get to about 75% as much)

However, like it or not, I can go to any one of dozens of pharmacies in my town and get the same pills, in the same time frame, in the same style of little plastic bottles, along with the same advice with regards to side effects.

The doc has already had an opportunity to discuss why this patient feels this is a proper course of action, if patient and doc agree, and the pharmacist has no medical reason not to dispense that medication, who the fuck is he to tell the doctor and the patient no.

I think there is a clear conflict of rights here: the right of the client to receive medical care (a right I support, but that frankly isn’t legally recognized in almost any case) and the right of the pharmacist to practice his profession without violating his religious beliefs. I don’t think there is an obvious answer, and I have no problem in principle with different communities choosing to resolve the issue differently (as the states have done).

Of course, if the issue arises in my state or on the national level, I will have to use my own judgment of whose rights are more severely infringed in this conflict to decide where to place my political support. What you have just told me (and everyone else has implied through their silence) is that the infringement of the women’s right isn’t that significant. After all, doctors’ power to deny prescriptions is potentially a much greater infringement of that right, but it isn’t worth making a fuss over because pharmacists are an easier and more tempting target. Lashing out at an easy and tempting target without seeking to address greater and more basic sources of conflict is recreational outrage in its purest form. Which is fine, have at it, but don’t expect my vote as a result.

@drachillix

I feel that mswas has contributed greatly to this thread because she shares the same moral/ethical disconnect as the pharmacists in question. That being the silly concept that there can be no moral behavior without religion and that morality/ethics/religion are all one and the same. Using the word morals as some kinda of convenient substitution for the word religion because that could uncork legal intervention.

Actually, the religion aspect strengthens the pharmacists’ case rather than weakens it. There is no legal requirement to accommodate a worker’s moral beliefs. There is a legal requirement to accommodate a worker’s religious beliefs, if such accommodation is “reasonable.” It can certainly be argued (and I would agree) that the pharmacists are demanding accommodation that goes beyond what is reasonable, but such an argument is required only because the issue is religious in nature.

There is no universal legal requirement that service providers not allow their own religious beliefs to limit or effect what services they perform or who they provide services to. Licensing requirements and other legislation may impose such a requirement, but this raises constitutional issues.

[Shodan]

@Zakalwe

Except that in response to that, we have aligned our law to that of Nuremberg effectively saying that what is moral is also ethical (or legal).

100%, in every instance? I rather doubt that, and I am sure the pharmacists would also disagree. I am sure you could come up with instances where our law is not in accordance with what you believe is moral and/or ethical. Gay marriage, perhaps. Would you agree that civil disobedience in support of gay marriage is illicit?

In any case, this is more or less begging the question. The question is whether or not the pharmacists should be allowed to exercise what our law (in the form of Roe v. Wade) has said is their right.

If I understand the moral vs. ethical distinction correctly, morals are personal and ethics are public. Well and good - the ethic established by Roe v. Wade is that it is not ethical to impose one person’s morals on another. Entirely correctly, therefore, the pharmacists are asking that the unethical practice of imposing someone else’s morals on them be ended.

And they (well he) have asked to do this after agreeing otherwise for many years.

I don’t think that’s the case either. I doubt the pharmacists in the suit were dispensing Plan B for many years, and have now abruptly stopped.

Regards,
Shodan

[WhyNot]

@Alan Smithee

Should a family doctor/OB be required to write a prescription for Plan B?

Morally, you mean? Yes, morally a family doctor (or any doctor) should articulate and be prepared to facilitate every medical plan of action that is medically acceptable and commonly used to treat the condition in question.

Yes, I know most doctors don’t do that, they just hand you a scrip for the most common treatment/their first impulse/whatever the drug rep was pushing this morning, and I think that’s abhorrent, and I don’t tolerate it in my doctors. If they give me a scrip for Albuterol, I ask them about other treatment options for pediatric bronchiolitis, and I don’t leave the office until we’ve discussed other options. Whether or not I decide to use the Albuterol is my choice, but I won’t make it without being informed of other choices, their benefits and drawbacks, and together with my doctor make the best choice for me. My doctor is there as a reference tool, not an authority figure.

So yes, morally, I think doctors should write a scrip for a legal, safe drug that is not medically contraindicated, after communicating options and agreeing on a course of action with the patient.

Legally? Ethically? License-ally? I don’t know, and I’m too worn out to look up more regulations.

[Fear_Itself]

@Shodan

This is a non sequiteur. It would be entirely accurate to say that soldiers should disobey lawful orders, because their moral objections should supercede.

Your Nuremberg gambit is a red herring. The fact remains that US soldiers may not disregard a lawful order based on their personal morals.

[Zakalwe]

@Shodan

100%, in every instance? I rather doubt that, and I am sure the pharmacists would also disagree.

Okay, sorry for that confusion. I was speaking to our analogy of the Armed Forces. In those case, we have aligned societal morals, ethics, and the law. I promptly noted that it didn’t apply here. In fact, it’s one of the few cases I can think of where we have done so.

The question is whether or not the pharmacists should be allowed to exercise what our law (in the form of Roe v. Wade) has said is their right.

How does Roe v. Wade apply? These women aren’t seeking an abortion as defined in the laws of any state.

Get it through your head. Plan B is not an abortifacient and taking it doesn’t constitute an abortion. Now, you want to try again?

I doubt the pharmacists in the suit were dispensing Plan B for many years, and have now abruptly stopped.

The exception they are asking for is to be allowed to refuse medication based on personal morals. It doesn’t have to be specific to Plan B, they’ve never had this right (in WA) with regard to any medicine before, now they do.

[stretch]

@Alan Smithee

Pharmacists use their own judgment as well. If a pharmacist believes a patient is feeding an addiction to a narcotic, I believe the pharmacist is obligated not to fill it, regardless of what the doctor says. I don’t know whether pharmacists have a similar ability to override a doctor for medical reasons, but it would neither surprise nor alarm me. If a pharmacist’s professional judgment isn’t to be trusted, why is a doctor’s, especially when the doctor can cause far more harm for doing precisely the same thing for the same reason? OTOH, if doctors are to be given the leeway to exercise their personal moral judgment as well as their medical judgment, I don’t see why it should be such a crisis if a state allows a pharmacist to do the same.

I suspect it all comes down to cultural associations that cause us to see doctors as trusted authorities and pharmacists as state-licensed shopkeepers.

bolding mine

Actually, I expect the pharmacist to fill this prescription anyway, if the doctor orders it. I’m fine with the pharmacist contacting the doctor and discussing the issue, but it is not for the pharmacist to decide if someone is feeding an addiction or treating an actual medical complaint. Mr.stretch takes Percodan everyday for pain control. This is prescribed by a licensed MD and the pharmacist needs to fill the scrip whether s/he thinks my husband is an addict or not. Not for them to decide not to fill a med that my husband needs because they can’t see what’s wrong with him or because they think he takes too many meds. (Not that I have this problem–we have an excellent pharmacist.)

I have a problem with doctor’s exercising their morals judgements instead of treating patients as well, but I didn’t start this thread to discuss that issue. I will say that our physcians’ office wrote a letter to the editor of our local paper making it pretty clear that they are against abortion. I brought this issue up with the doctors to assure that they still provide information on birth control and abortion to patients, because I have a daughter who goes to this office and does not need another child. I was assured that although the doctors personnally believe that abortion is wrong they do still inform patients of this choice. If they had indicated that they don’t provide that info, I would have found a different office to go to.