It's not always about being funny.

Drugs

Last night we had a pretty passionate talk about pharmacists and what rights they have to hide behind shields of morality or religious convictions when refusing to dispense legal medication. If you’re interested, you can download the show or subscribe to the podcast on iTunes.

And while I clearly won the discussion, an hour didn’t really feel like enough time to talk about all of the issues, so I thought I’d bring the topic over to the blog to discuss in more detail. I’m interested in everyone’s opinion on this subject:

Should a pharmacist be allowed to refuse to dispense a prescription or over the counter medication to a patient for moral or religious reasons?

If you say yes, should there be any restrictions or conditions on that right? Are there any medications that should always be dispensed regardless (Insulin, heart medication)? Why should they be allowed?

If you say no, what should the penalty be? Why should a pharmacist be forced to serve someone when in other retail environments, the business can refuse service to anyone?

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93 Replies to “Drugs”

  1. Amanda

    I feel that pharmacists, like doctors, and really like all people, should help other people in any way they can. Withholding medication is a self-centered act, because you’re promoting your beliefs instead of thinking about what’s best for the patient.

  2. Danalyn

    First, the distinction needs to be made between the pharmacy (as a company) and the pharmacist (as an individual).

    For many reasons, pharmacies can choose to not stock certain drugs or if they run out of supplies, it is fine if they refer people to other pharmacies.

    However…the line needs to be drawn when pharmacists, as individuals, choose NOT to fill a prescription simply for their own personal beliefs.

    If a situation occurs where they think fraud or substance abuse is in play, they can either choose to deny the prescription or fill it and report it to the authorities.

    However, moral or religious beliefs of the INDIVIDUAL pharmacist is grounds for termination, in my opinion. They are hired to do a job, and if it is not the pharmacy’s policy to stock or not stock certain drugs, they have no right to refuse to fill the damn prescription.

  3. Dave2

    In all honesty, I feel that in order to call yourself a “pharmacy” you should be required to stock and dispense ANY medication that might be prescribed by a doctor. Obviously, if you are in a small or remote area and serving a limited population, it would be a financial hardship to do this… in which case, you should only be required to stock ALL medications which are needed for use in an immediate time frame… but also be required to order non-time-sensitive medications whenever they receive a prescription for it (no questions asked).

    Yet, I don’t know that this way of thinking is in any way enforceable by law. Pharmacies are just businesses in the end, and businesses get to decide what they carry. Fortunately, online pharmacies and FedEx make a lot of this moot. If your pharmacy doesn’t carry a drug you need, switch to another source… if enough people do this, they’ll either start carrying the drugs people want or go out of business.

  4. B.E. Earl

    Didn’t get a chance to listen to the show.

    Did anyone mention our current President’s plan to push for legislation in this arena?

    Bush and his band of merry men/women want to propose a new rule at the Department of Health and Human Services that will affect any health care service that receives any federal funding. (Basically, all of them.) They will have to certify, in writing, that none of their employees will be forced to participate in any procedure that they find morally objectionable.

    This will allow health care providers to refuse to participate in medical procedures that goes against their religious beliefs. Among other things.

    Like I said…I don’t know if it came up or if it was relevant to your conversation. But yeah…the current guy in office is still hard at work. Saving us.

  5. Little Miss Sunshine State

    I used to be a pharmacy tech. I was allowed to fill prescriptions under the supervision of a pharmacist.

    I don’t think a pharmacist should be allowed to decide which medications a person should be allowed to receive, unless he personally owns the pharmacy (there are still a few that aren’t owned by a corporation)

    Most of the drugs that pharmacists are refusing to fill are things like birth control and the “morning-after pill”. If they refuse those orders from the doctor, they are also practicing sex discrimination, because these drugs are only marketed to women.

    When I worked for C^S, I had to fill prescriptions for Viagra for a customer who was using them as part of illegal activities that involved minors. We suspected, but it was over a year before he was arrested. I filled narcotics for drug addicts…until their “Candy Man” doctor got arrested for his illegal activities.

    We would only refuse if they were trying to fill a prescription too early and the insurance company would deny.
    It’s not the place of the pharmacist to pass judgment on the customers.He is hired by the pharmacy to fill prescriptions.
    If he thinks his job is in conflict with his personal beliefs, he needs to find a new job.

    Off my soapbox now.

  6. Faiqa

    Let’s not forget that while religious reasons are fairly containerized, “moral reasons” can become exceedingly problematic.

    For example, what if a group of pharmacists in a city decided that they wanted to promote abstinence only prevention in their small town and thus stopped dispensing birth control all together? Or, even worse, they refuse to dispense medications for AIDS and other STDs because they believe that the people who contracted them are being punished by God for their evil actions? These are not so much religious reasons as they are generally “moral” points.

    One might argue that people wanting medications could go to another city, but I submit that the people refusing them medications are acting as OBSTACLES to their getting proper treatment. And we cannot discount the deep intentions behind the creation of these obstacles: to discourage people from obtaining them, at all.

    At this point, their statement is less of a religious one and more of a political one as it has been imposed upon people who live outside of their faith.

    Which brings me to another ludicrous example, some people’s religion is politics. What if they allowed their politics to inform how they dispensed medications? Like, say, “I’ll only give the morning after pill to demographic A rather than B because I don’t want A to add to the population.” He’s an idiot, right? Now just substitute something about Jesus, Moses or Muhammad in there. Still sounds like an idiot, right?

    I know these examples sound far fetched, but laws should be based upon preventing worst case scenarios, particularly when the issue of civil rights or potential discrimination comes into play.

    One need only take a look at the financial crises occurring on Wall Street to understand why government regulation, though not popular in the American psyche, is critical in maintaining a well balanced and fair nation.
    :dance:

  7. Honeybell

    A privately owned pharmacy should be able to sell or not sell, whatever they choose, like any other business. An individual pharmacist however, should not have the right to refuse to dispense any medication.

    Straight from the Pharmacist Code of Ethics: A pharmacist respects the autonomy and dignity of each patient. A pharmacist avoids discriminatory practices, behavior or work conditions that impair professional judgment, and actions that compromise dedication to the best interests of patients.

    To me that says the individual Pharmacist ethically does not have the right to refuse their services. Now for pharmacists that refuse to dispense insulin or blood products . . . why the fuck they became pharmacists in the first place is beyond me. A pharmacist that refuses to dispense birth control or the “morning after pill” shouldn’t be putting themselves in a position to do so. Not all pharmacists have to work in the public sector.

  8. Cap

    I mostly agree with Honeybell. However, I will add that dispensing the morning after pill is not a life and death situation and therefore refusing to fill the prescription is the pharmacist’s right. Doctors are allowed to refuse to perform abortions – and 95% of them do not do that procedure. It’s an elective all around. The patient elects to have it or not, the doctor elects to do it or not, and the pharmacists elect to dispense the pill or not. The end.

  9. Blondefabulous

    The mom and pop pharmacies may have a voice in what they dispense, but the chain pharmacies probably don’t. Like I commented last night, the pharmacist is selling something and most businesses reserve the right to not serve someone if they don’t want to. That’s why I said just go somewhere else. Fuck ’em if they don’t want to sell me my pills. I’ll just go find someone who will and a faceless corporation that has hundreds of locations and no moral compass will do just fine!

  10. kapgar

    Katie works in a pharmacy and she and I both feel a pharmacist should not be able to refuse to fill a prescription. Pharmacists, by refusing to do so, are passing judgment on the actions of a fellow human or “playing god.” I don’t care about your politics. You are in the health care field and have taken an oath to serve people. In all cases, the only thing a pharmacist has is a prescription slip. They do not have the patient’s medical records to make fully realized and educated judgments. For example, women can take birth control pills and prenatal vitamins for hormone regulation and not for the standard, accepted reasons. There are multiple uses for almost any prescription in existence and without the proper information, the pharmacist can be doing more harm than good by refusing to fill it.

    For the record, this is not like your normal retail environment where you can refuse service. So long as the patient/customer is not being beligerent and an overall asshole, service should not be refused.

    If a pharmacist says no, their license should be revoked by the state.

  11. RW

    The rights in conflict are that both buyer and seller are expressing their opinion by their choices to agree with or disagree with a medication and everything use of that medication would imply. More simplified, if I had a tavern and someone wanted a beer I didn’t have and – furthermore – didn’t have because I thought it was terrible beer, I shouldn’t be required to have it in case somebody asked for it. If you get a prescription and your pharmacy doesn’t carry it because of their opinion get another pharmacy or go online… or get help from the doctor to help you find where you get it.

    I think with the advance of available sources for things the question is fairly moot by now and not as hot button as it once was. But as much as I’d rather like to get any drug my doctor thinks I need, I also want to be sure you have a right to remain an idiot. Metaphorically.

  12. Crystal

    Current Pharm tech here.

    This comes up now and then in my pharmacy. I’ve poked through some of the company documentation regarding this, and my company’s stance on it is that a RPh has an issue with dispensing a script because of their personal beliefs, they are required to find someone who will, be it another RPh in that store or in the vicinity.

    Personally, I’m of the belief that you took a job to *do* the job, not to take out your beliefs on some random stranger. You’re not behind that counter to judge someone based off a slip of paper, you’re there as a healthcare professional and to help someone who needs help. We don’t know a person’s circumstances, just that they need help, and by refusing them help because of your belief system you’re just being a douche.

    For the record, it’s not just the pharmacists who discriminate based on beliefs, the techs do it as well. Check out some of the pharm-tech communities where they discuss selling syringes without a RX for them and see how many people won’t sell them if they think the customer is a junky (which is part of the main reason that some states allow OTC syringes – to halt the spread of disease among IV drug users). And I trained with several techs who wouldn’t dispense Plan-B.

  13. Sue

    Freedom of Religion is also a freedom FROM religion. When one in the medical profession refuses to treat a patient based on their beliefs, they are, in effect, forcing the patient to adhere to that doctrine. That is wrong. If you can’t treat or administer to all, get a new line of work.

    Inversely, that is religious discrimination. Meaning, to refuse to treat somebody based on your beliefs, you are also proving that they have different beliefs and that you are discriminating against them for religious reasons. Catch my drift?

    Here is an case that exemplifies how the discrimination can be reversed, only in this case the patients were lesbians.

    http://transadvocate.com/autumnsandeen/archives/category/religion

  14. Miss Anne Derstood

    Others have said it here much better than I can at 9:00 in the morning before my level of coffee and cigarettes has reached the desired height.

    However, I agree wholeheartedly with whomever has said that it’s way uncool for a pharmacist to refuse to dispense drugs because of religious or moral belief. :deadhorse:

  15. suze

    If I go to my pharamcy, I expect them to be able to fill my prescription, in a reasonable amount of time, without comment or judgement, no matter what medication my doctor has determined I need. Be that from something as benign as my thyroid hormone replacement (all natural, has to be special ordered, but my pharmacy does that) or something as controversal as the morning after pill. No one knows the situation behind the prescription aside from the doctor and the patient. Whatever the prescription, the doctor and patient have decided this is the right course of treatment for them. The pharmacist’s job is to fill that prescription – their individual moral or religious beliefs should not affect that. Just like a therapist or (in my opinion) any other medical professional, they should be neutral. If they can’t do their job, they should do something else. Don’t want to perform abortions? Fine, go into a different field of medicine. Don’t want to give out birth control because you think it is akin to abortion? Fine, don’t be a pharmacist. Easier said than done, I know, we’re all human, but I don’t think anyone should have the right to force their personal beliefs upon another when it comes to personal medical or bodily decisions.

  16. Sue

    I need to add that contraceptives are not always prescribed for birth control reasons only. I had to use them years before I ever had sex to regulate hormone levels in my body to prevent ovarian cysts from enlarging and/or forming. They are often prescribed for this purpose alone.

  17. NYCWD

    I really have nothing new to add that hasn’t already been said.

    -A pharmacist who owns his own pharmacy does not necessarily have to stock drugs he finds objectionable

    -A pharmacist working for someone else has a responsibility to dispense what the owner/pharmacy stocks

    This actually reminds me of a case out in the mid-west (Arizona, maybe?) where a wedding photographer declined to photograph a “commitment” ceremony between two women because of the photographer’s religious beliefs. There was, of course, a lawsuit and the photographer was found guilty of discrimination.

    Therefore, if a pharmacy does not stock a certain medication so they therefore can’t dispense it, can it be construed as discrimination?

    The pharmaceutical companies would love that.

  18. RW

    When Suze says “I don’t think anyone should have the right to force their personal beliefs upon another when it comes to personal medical or bodily decisions” what she means is unless it’s her forcing her opinion on someone, which is what she does when she demands a pharmacy give her something it doesn’t want to. It’s just as easy to say go to another pharmacy as it is to say “don’t be a pharmacist”, and a lot less intrusive.

  19. Poppy

    My point to Dawg last night was that someone could become a pharmacist with every intention of helping every and anyone, but suddenly a medication is introduced to the market that goes against that person’s beliefs. The morning after pill is a good example of something that could finally bring a pharmacist to their belief system crossroads.

    I don’t have answers. I’m mulling it over.

  20. Poppy

    (Becky, I don’t disagree with you, but) could we please be in the pharmacist’s shoes for one minute? What if in the very near future we start allowing prescriptions for euthanasia? It’s against A LOT of people’s belief systems to commit suicide. And let’s pretend we’ve gone through the debate of “is euthanasia suicide” and concluded that it is. Then what?

    Pharmacists are humans. I can understand circumstances under which it would be a very hard decision.

  21. hello haha narf

    poppy, i appreciate what you are saying, but i stand by my comment.

    a pharmacist doesn’t stand over a comatose patient and shove meds down their throats or into their veins. they simply fill what someone else prescribes without knowing the medical rational (such as the birth control pills to prevent cysts example above). it is not their job to know the background, but to know who drugs interact with each other and to dish them out exactly as a doc tells them to. that is their job. that’s it.

    when i worked at the bank and had to ask little old ladies if they wanted a credit card, i quit because i didn’t believe in it and went into a related business that didn’t require that type of selling from me.

    i don’t like gambling so i don’t work in a casino.

    don’t see what the big deal is…granted i missed the show last night, but this just doesn’t seem like a big deal to me.

  22. Honeybell

    Just an aside re euthanasia:

    @Poppy-people don’t talk about it, but we ARE dispensing meds for euthanasia in the hospital ALL THE TIME. It comes down to the amount of medicated needed to relieve pain is a lethal overdose, the nurse, the patient, the family, the doctor, and the pharmacist all know it. Who gets to decide when that patient gets the meds and when they shouldn’t? It should be between the physician and the patient-not the middle man.

  23. Sheila (Charm School Reject)

    While I understand the need for pharmacies to be able to readily supply the general population with medications that are necessary and vital to their health, I think that it SHOULD be up to a pharmacists if they want to fill a prescription or not for things that are not necessary. Insulin, yes. Plan B, no.

    People keep mentioning that “civil rights shouldn’t be infringed upon” – well, why should MY civil rights be infringed upon to ensure that YOURS are not? I realize that civil rights and equality for all people is a big deal but at the same time I think that people are focusing too much on civil rights and legal wording. Everyone is so damned busy focusing on “civil rights” and “being offended” that they forget to look at the other side. Just because you choose to believe in something (like abortion) doesn’t make me a douche just because I don’t believe in it and I shouldn’t have to compromise my beliefs and morals simply to acquiesce to yours.

    This kind of goes hand in hand with the curriculum in schools – a teacher, regardless of their religious beliefs, is required to teach evolution as the only “theory” to the existence of humans and the world in general. If you try and even present creationism as an alternative “theory”, you will lose your job. If, as a high school studen who doesn’t believe in evolution, you choose to write a paper supporting creationism instead, you will fail your paper. I know this because it happened to me – not because the teacher wanted to fail me but because the curriculum demanded it. Apparantly, I was “forcing” my religion onto the lone teacher who read my paper.

    If you “need” the morning after pill, go to Planned Parenthood.

    So – considering the fact that MY civil rights are being infringed upon at every freakin’ turn, I couldn’t really give a shit about your civil rights.

  24. RW

    Forcing a pharmacy to dispense what it has a moral concern about is wrong. May as well do away with Conscientious Objector status during times of a national draft and say “I’m sorry you’re a Quaker but you get in uniform NOW.” There are reasons for exceptions and they are based on an individual’s right to have their own moral standard.

    The patient has a right to whatever medical help is available and the pharmacy has a right to not dispense things it has a moral concern about. The question here is the balance of rights. When we say a pharmacy MUST dispense everything regardless of any moral concern we cross a line into impinging one moral standard over another just as in the reverse.

    No one’s rights ought to ever trump another’s, just as your right to do something doesn’t stop my right to disagree with you. the answer is to allow people to follow their personal moral conscience, and order the damn stuff online.

  25. Jay

    I really don’t think a pharmacist should be allowed to put his/her moral views ahead of filling a prescription. There are lots of things that people in lots of jobs do that they find morally objectionable, but they have to do them and have no legal recourse if they get fired. I found it morally objectionable to lay people off from their jobs on Dec 1st three straight years at a former job. (Merry Christmas you’re fired hope you kids understand!) So why should pharmacists have this protection just because it’s about SEX! Morality and right and wrong covers a lot of things other than sex.

  26. Willie G

    Anytime religion or politics enters the conversation people get their panties in a bunch and strike out and demean those who hold different points of view from their own. Any issue, whether medical care, pharmacy care, abortion, whatever quickly becomes emotionally charged when the religion card is played because we feel either excluded by our differing beliefs, or remonstrated by those with opposing beliefs. But for me, the issue at hand is fundamentally a constitutional one. The US constitution guarantees us the right to the religion of our choice and the expression of that religion. The constitution does not allow for our religious expression to impact the inalienable rights of others to life, liberty or the pursuit of happiness. This has been upheld by the supreme court, such as in the case of fundamentalist parents denying medical care to a minor child. The courts have ruled that the parents are liable for the life and health of that child if in the course of their religious expression they withhold life-saving medical or pharmacuetical care. However, this is not the case of what we are discussing here. If my religious beliefs preclude me from prescribing or dispensing a particular drug then I am within my constitutional rights to refuse to prescribe or dispense it. If I work for someone other than myself, such as a corporation, then my religious position may require me to sacrifice my employment with that company if they do not hold the same point of view. If I work for myself, the constitution protects my right to not perform any action that would violate the tennants of my particular religion.

    If you hold no religious convictions, or different religious convictions than mine, and you choose to make use of a drug that violates my religious point of view, that is your choice, but you must find a different source for that drug. You must go to a different pharmacy. It is not the responsibility of the pharmacist to dispense a drug just because a doctor prescribed it. The pharmacist, or anyone for that matter is responsible for their own actions. If they choose to be guided by religious beliefs, then our constitution protects them and gives them the right to make those choices.

    I think the last thing we want to get involved in is to allow our government to tell us how we can or cannot express our religious values and beliefs. We don’t want anyone forcing their religion on us, we certainly don’t want the government making laws that mandate how we can or cannot express our beliefs or lack of beliefs.

    I personally want the government out of my life and affairs as much as possible. Especially when it comes to my personal convictions and how I express those convictions.

  27. hello haha narf

    could someone clarify (because i sorta think it matters)…are we talking pharmacists as individuals or pharmacies as corporations?

    yes there are situations were there might be an owner who is also the lone pharmacist, but there are many more places that employ more than one actual certified and licensed pharmacist.

  28. Miss Britt

    @hello –

    The conversation as *I* saw it last night was about business owners.

    If an EMPLOYEE is unable to fulfill thier EMPLOYER’S policy – that is an issue that should be taken up between them.

    However, there is a push for legislation apparently that would revoke a pharmacists license if they refuse to dispense a prescribed medication.

    A pharmacy is a retail business.

    They have a right to determine how that business is run as much as Wal*Mart does.

    Should we start going after convenience stores if they don’t sell condoms, too?

  29. B.E. Earl

    @RW and others
    Not exactly sure what you mean here. Of course a pharmacist has the right to NOT carry certain medication at their pharmacy. That should be a given. It’s a business and they should be allowed to run it however they deem fit.

    But I thought the original question was if a medication is prescribed AND the pharmacist carries the medication, does he/she have the right of refusal based upon moral/religious reasons. Based upon the specific patient/case.

    Then again, I guess if they had objections then they wouldn’t carry the product in the first place. Or maybe they would…I dunno. I’m confused.

  30. Poppy

    Hola, I definitely understand. I would never be cut out for this line of work…

    Honeybell, I was thinking of that when I wrote the example, because I do know it happens, I was just imagining a time in the near future when a drug company actually markets something specifically for the task, via TV commercials and full-page ads in magazines. There’s somehow a big difference between a hushed order to overdose a patient on a med that typically makes someone sleepy or feel less pain and a drug that is specifically marketed to kill you.

  31. Sue

    Bottom line, a patient has a right to receive medical treatment. If that treatment is a prescription, they have a right to get that prescription. This isn’t a civil right, it’s an actual LAW. What if EVERY pharmacist had ‘religious objections’ to a particular drug? How would the patient receive his law-bound right to treatment?

    Here’s a thought… what if a hospital pharmacist refused to give the precriptions (antibiotics, drugs that treat venereal disease, and/or emergency contraceptives) to a rape victim because his religion views being raped is a crime? Should she be forced to find ‘alternative’ means, even if she’s not a muslim?

  32. hello haha narf

    britt, then adam’s post is misleading. he used pharmacist and you are saying pharmacy. i think this is a massive difference in regards to this conversation. i don’t shop at wal-mart because i don’t like how they run their business. if a pharmacy doesn’t carry what i want i could go somewhere else. but if the store has it and one person won’t give it to me, i am so going over the counter after that fucker. hehe

  33. RW

    Earl I’m basically responding all along to the idea – as was said up above – that “If I go to my pharamcy(sic), I expect them to be able to fill my prescription, in a reasonable amount of time, without comment or judgement(sic), no matter what medication my doctor has determined I need” which in the context of the moral dilemma in question is impinging one moral set over another.

    I’d try to have everything in my pharmacy if I had one because my moral code informs me that I want your money and really don’t give a rat’s ass about your morals or perceived lack of them. But yeah, if a pharmacy doesn’t want to dispense it they probably wouldn’t or shouldn’t even have it.

    To speak to another issue though I don’t, however, see a difference in what we should think about this subject as to whether or not the pharmacy is independent or a corporation.

  34. Avitable

    To clarify, I’m talking about a pharmacist who works for a pharmacy. Pharmacists who own their own little pharmacy make up less than 1% of the pharmacists in the country, so I’m talking about a pharmacist at a normal pharmacy.

  35. Willie G

    @Adam: Then that totally changes the discussion. If the Pharmacist cannot comply with his/her employers requirements because of religious convictions, then he/she should not dispense the drug, walk out the door and go work somewhere else.

  36. NYCWD

    @ Miss Britt- Actually, that legislation is targeting pharmacies that accept MediCaid and MediCare insurance money (which is most pharmacies) so that they will give what is actually prescribed by the doctor as opposed to a cheaper generic brand.

    Its after there was fallout from the MediCare prescription plan where patients were not receiving what they were actually prescribed so the pharmacies made more money. There is similar legislation regarding hospitals, clinics, and ambulances.

  37. Miss Britt

    In which case what we’re discussing is employer/employee relations – which is a completely different topic than what people are discussing here throwing around the word “rights” and “morals”.

    Does a pharmacist who works for Walgreens have a right to refuse to dispense medication they don’t agree with?

    Sure. And the employer has the right to fire them if that goes against their published policy or have SOMEONE ELSE THERE who can distribute the medication.

    But the individual still has that right.

    @hello – you also have the right to be pissed off about it. People aren’t required to act in a way that won’t piss off or inconvenience someone else.

    We have, as I said last night, a right to be assholes in this country. As long as it doesn’t do you immediate harm.

    The answer here is simple – go to another pharmacy and/or pharmacists. You ALWAYS, in this country, have a CHOICE about which business you will choose to give your money to.

  38. Miss Britt

    And anyone who questions whether or not a pharmacy is a business because they are distributing medication?

    Please come pay my $118 bill for my monthly prescription.

    Maybe I should find someone I can bitch to about that not being fair and demand they give me my pills whether I pay for them or not.

  39. Avitable

    I’m not talking about employee/employer relations at all. I’m talking about the pharmacist’s right, regardless of whether or not they own the business.

    If a pharmacist refuses to dispense medication, which is his or her job, they should lose their license.

    If they get fired/go out of business/whatever, that’s fine. But there should be repercussions beyond that.

  40. martymankins

    So many commenters here posted what I would already say, but both Amanda and Kapgar posted my position on this topic exactly.

    A pharmacist should NEVER refuse to fill a prescription. And government shouldn’t be passing some rule of law, enforced by the Health and Human Services (thanks, former Utah governor Mike Leavitt) to protect their conscience or moral position and passing judgment to those seeking a prescription for any reason.

  41. Sybil Law

    As usual, I have a real hard time deciding here. I mean, if the pharmacist actually owns the pharmacy, then they should be allowed to decide what they sell – period. That goes for condoms, Playboy magazines, and Snickers candy bars. If they don’t want to sell or dispense that stuff, then they shouldn’t have to.
    However, if a pharmacist works for a chain pharmacy, or they are not the actual owner, I think they should shut up and do their job. If they disagree with the companys’ policies on any of the medications they dispense, they should find another job.
    I had no clue how widespread this problem was until last night. It’s really crazy! Apparently, some Christian Scientist/s who work for Target can refuse to sell you the morning after pill. If Target fires them, they get sued. If they don’t serve you that pill right then (but they will later, when the CS is gone), you could sue them.
    Fucking lawsuits are ruining this country!
    Anyway, so both sides have valid points. However, I do wonder why anyone with a moral objection to certain pills would bother to become a pharmacist in the first place.

  42. Willie G

    “If a pharmacist refuses to dispense medication, which is his or her job, they should lose their license.”

    “there should be repercussions…”

    WHAT?? A Pharmacist is licensed to ensure they know how to handle and dispense potentially lethal substances, not so they can be some kind of pharmacological vending machine. They didn’t trade in their intellect and conscience for a crisp framed license. And Repurcutions??? WTF?? You want to punish people for standing on their principles. So, because I have a job and a license I have to be some mindless automaton or suffer punative consequences? Welcome to the Gulag for fuck’s sake..

  43. RW

    I wasn’t going to go to the “Gulag” thing first but yeah, what Willie said.

    The implication, Adam, is that you would have no qualms about impinging your beliefs on someone but would quickly piss and moan about the perception that someone has tried that on you.

    There’s an H word for that, and it kind of suggests a moral superiority no one actually has.

    For the record I wouldn’t have a problem dispensing anything from morning-after pills to the devices for doctor-assisted suicide. Condoms, birth control pills, whatever. You want it I’ll get it. But I’m talking about the nexus point where differing views overlap.

  44. Poppy

    @RW… and then they order it or pick up the phone and find another pharmacy that has it in stock, is my experience.

    Everyone has a breaking point. There is something that EVERYONE wouldn’t dispense if put in a circumstance, trust me. Maybe it’s a product containing kittens, or maybe a product manufactured by a terrorist organization, or maybe a product that has killed your family member…

    This issue just isn’t clear cut for me.

  45. Miss Britt

    “For the record I wouldn’t have a problem dispensing anything from morning-after pills to the devices for doctor-assisted suicide. Condoms, birth control pills, whatever. You want it I’ll get it. But I’m talking about the nexus point where differing views overlap.”

    Ditto.

    And exactly.

  46. RW

    Poppy it’s just as easy as that for the customer. If I go to a pharmacy and they say they don’t sell what I need for the sake of their beliefs I go my merry way and find a pharmacy that does. And if I can’t find one I call the doctor’s office and ask where i should get it since he said I should get it. It’s not a big deal, really. I think where this conversation starts to go wrong is in the assumed moral imperative of people who somehow feel that their moral imprint ought to be the law.

    The question is framed in the OP “Should a pharmacist be allowed to refuse to dispense a prescription or over the counter medication to a patient for moral or religious reasons?”

    But the question might also be – Should a government be allowed to require someone dispense a prescription or over the counter medication to a patient despite their moral or religious reasons?” I say no, because to do otherwise opens up a whole basket of unintended circumstances that impinge on more things than just pharmacies.

  47. RW

    Poppy it’s just as easy as that for the customer. If I go to a pharmacy and they say they don’t sell what I need for the sake of their beliefs I go my merry way and find a pharmacy that does. And if I can’t find one I call the doctor’s office and ask where i should get it since he said I should get it. It’s not a big deal, really. I think where this conversation starts to go wrong is in the assumed moral imperative of people who somehow feel that their moral imprint ought to be the law.

    The question is framed in the OP “Should a pharmacist be allowed to refuse to dispense a prescription or over the counter medication to a patient for moral or religious reasons?”

    But the question might also be – “Should a government be allowed to require someone dispense a prescription or over the counter medication to a patient despite that person’s moral or religious beliefs?” I say no, because to do otherwise opens up a whole basket of unintended circumstances that impinge on more things than just pharmacies.

  48. NYCWD

    @RW and @WillieG

    So basically, using your argument, as an EMT, if I am a pacifist and do not believe in violence, I can refuse to do CPR on someone because it WILL break their ribs and is actually a very violent action on the body… nothing can be done to me because it is against my moral beliefs?

    While I can see some personal benefit to that, overall that’s truly ass.

  49. Avitable

    I’m going to write more later, but RW and Willie, I’m not talking about the government. I’m talking about the board that gives a license to pharmacists and regulates them. They, not the government, should require that a pharmacist in the role of dispensing medicine should have to dispense all available medicine or lose their license.

    And, RW, pharmacists are already required by law to keep a certain amount of many different medications in stock at all times.

  50. Miss Britt

    @WD – not dispensing a pill that is obviously NOT urgent (or it would have been given to you at a doctor’s office/hospital) and CAN be gotten elsewhere is not the same as watching someone die from lack of oxygen.

    Adam – who the fuck do you think these magical licensing boards are??

    It is the LAW that you have to have a license to practice. Maybe I’m confused. Who makes the laws again?

  51. RW

    “They, not the government, should require that a pharmacist in the role of dispensing medicine should have to dispense all available medicine or lose their license.”

    To do this – in the context of this specific issue – without exception made for personal beliefs, is draconian and callous.

  52. NYCWD

    @RW unfortunately we already missed this year’s Burning Man… but I’m always down for a winter version.

    @ Miss Britt- Actually it is the same… its your non-emergent perception of the role a pharmacist plays in the medical care of a patient that is not allowing you to see the need for regulation and the requirement that they fulfill their job description.

    I think its important to keep something in mind: The Pharmacist is trained to prepare and distribute Federally approved narcotics as ordered by a Doctor/PA. They’re job is to get the script right, not the effects of the script on the patient. They have not taken a medical history, performed an exam, or for that matter rarely even speaks with the patient for more than a minute. Their job is outlined before they take their classes and receive their license/degrees. If they have a problem doing their job, dispensing medication, then they should become something else.

    Like a crossing guard.

  53. Miss Britt

    The non-emergent nature is much more than a perception, it’s a reality – as is evident by the fact that pharmacies aren’t required to be open 24 hours, 7 days a week.

    The fact that some choose to be is a result of a BUSINESS decision.

  54. Avitable

    A pharmacist’s job is to dispense legal medication. If he or she cannot do that job, that pharmacist should lose their license to practice. Why is this the way that I feel? There are several reasons:

    1. Imposing your own morality or religious belief on a customer is infringing upon the customer’s belief. Providing birth control medication or Plan B to a customer does not mean that pharmacist supports birth control or Plan B. The pharmacist isn’t being forced to take the medication or do anything other than provide it to the customer who has a legal right to it. This situation is different from a Quaker being conscripted into an army – in that situation, the Quaker is being forced to pick up arms against someone else.

    However, by allowing the pharmacist to impose his or her beliefs on the customer, our society is currently forcing the customer to subscribe to someone else’s beliefs.

    2. The pharmacist does not have the requisite relationship with the customer nor the knowledge to make this decision. A physician writes a prescription for his or her patient based on a confidential relationship and diagnosis. There are reasons that someone might have a prescription for birth control that have nothing to do with contraception and do not conflict with the pharmacist’s morals or religious beliefs. Therefore, allowing the pharmacist to refrain simply based on the type of medication and his or her rash assumption is inappropriate.

    3. Pharmacists can already refuse to dispense medicine for legitimate reasons. If they think that it’s being used for an illegal purpose or if they think the physician miswrote the dosage, a pharmacist can refuse to fill a prescription. These are the only reasons that a legal prescription should not be dispensed.

    4. There is a very slippery slope that we can go down if pharmacists are allowed to refuse to prescribe medicine for moral or religious reasons. Consider a Christian Scientist who becomes a pharmacist – he or she would consider most, if not all, medication to be unacceptable. Should this pharmacist keep their license?

    What if a pharmacist decides not to dispense any medication to help with the symptoms of HIV because they feel that the gay lifestyle is inappropriate, even if the recipient may or may not be gay?

    What if a pharmacist decides that children get overdiagnosed with ADD and they are morally opposed to Ritalin?

    What if a pharmacist decides that, as a Scientologist, they should reserve medication for other Scientologists and will not dispense certain medications needed to sustain life, to people who are Oppressive People under Scientology?

    Once you start to allow pharmacists to insert their own subjective morality into their job, they can and will infringe on the right of the customer and can seriously and irreparably harm someone by limiting access to necessary, legal medication.

    Whether each state needs to pass legislation requiring that pharmacists do their job, or if the licensing boards for each state need to make moral and religious refusal grounds for losing their license, some type of action needs to be taken to ensure that my need and your need and his need and her need for legal medication is not inhibited in any way by someone who wants to impose their own values on me.

  55. RW

    Logical fallacy trumps non-emergent perception every time and a straw man is a straw man regardless of who is using the argument.

    The point is the implied requirement of a pharmacist to do something that is against their beliefs. As a Quaker myself, and therefore a pacifist, I would break six ribs if it meant I would be saving someone’s life. But it is instructive to remember that we Quakers are also exempt from any military draft. We are exempt from the military draft and we don’t have to raise our hands and swear an oath on the Bible when questioned in a court of law. The law has made an exception for our personal beliefs even though it may appear to some that we are either traitors in times of national peril or being deceitful under cross-examination.

    The precedent is to allow for the personal beliefs of a freeborn individual in the context of the situation, the law, and their moral compass. So why do we stop that process for a pharmacist? In my mind – and if strawman arguments are ok here – then I’d say it’s because it is mostly centered around the issue of birth control and abortion, and these are the real issue underlying this discussion.

    But since I think a strawman argument is specious I won’t use one.

  56. NYCWD

    The precedent is to allow for the personal beliefs of a freeborn individual in the context of the situation, the law, and their moral compass.

    Then why do we put Muslim men on trial after they save their family’s honor by killing their adulteress daughters?

  57. RW

    Counter arguments to the numbered points

    1. Likewise, Adam, a customer that demands a pharmacist provide a medication or device that that pharmacist may personally deem as wrong is an equal case of infringement. The pharmacist is not STOPPING anybody from doing anything. The customer need only go online or find another pharmacy or call the doctor and ask where to go; and in a civil, more non-litigious society the refused customer need only have the class to accept that not everyone believes as they do and go find one. Hopefully mine, where I will sell them anything they want.

    2. There are people who believe that any form of contraception is immoral. It is equally inappropriate assumptions, stemming from point 1, on the part of the customer that force an absolute on the pharmacist where no absolute is being forced on the customer.

    3. Law is based on an agreed-upon morality. In many cases individuals are even more scrupulous in their personal behavior than the law requires of them. It is their choice. Why is there no provision for a pharmacist who may feel that birth control is something being abused?

    4. If any of the examples in your #4 came to be the law of the land that would be imposing a moral view onto others. But so long as other pharmacies exist without those religious and/or quasi-religious convictions mentioned in your point, nothing is actually being imposed on anyone.

  58. Sybil Law

    I hate to jump into the middle of all this, but Adam – I already stated up there that there’s a Target who stands behind their Christian Scientologist/ pharmacist who doesn’t want to dispense the morning after pill. (I’d find the link again but I’m in a hurry!) They’ll fill it – just not when that particular pharmacist is around.
    This issue could equally trample on a LOT of people’s rights all around. Apparently, it already does.
    There’s a link on my blog to The Angry Pharmacist. The latest entries have been pretty much general gripings, but if you read older entries, their point of view can be really interesting.

  59. RW

    Then why do we put Muslim men on trial after they save their family’s honor by killing their adulteress daughters?

    There is a law against willful murder. I agree with it. But someone here wants to make a law saying a pharmacist must dispense medications they have a moral problem with. i would be against that.

    Unless you are saying we should not allow for the personal beliefs of a freeborn individual in the context of the situation, the law, and their moral compass?

  60. Willie G

    @Adam: “I’m talking about the board that gives a license to pharmacists and regulates them. They, not the government, should require that a pharmacist in the role of dispensing medicine should have to dispense all available medicine or lose their license.”

    As I said above, the licensing board validates and ensures that a pharmacist has the knowledge and skill necessary to handle controlled substances in a safe and legal manner, and will perform his/her job ethically and according to the laws governing the drug industry. The licensing board is not a moral or religious pit bull put in place to guard some mandated standard. The Pharmacist can make their own judgement calls when faced with what they perceive as a personal moral conflict. Making a moral/religious based decision not to dispense a drug is not the same thing as not being adequately skilled to follow the laws governing the industry.

  61. Avitable

    RW, I’m just glad that this isn’t your forum, where I’d only have one chance to respond.

    1. You did not address my point at all. A pharmacist is not violating his religious/moral beliefs by filling a prescription – he is not being forced to take that medicine or even to administer it to someone else. And the pharmacist need only to have the class to accept that maybe they should go work in research or not be a pharmacist anymore.

    2. If it’s not being used for contraception, then it’s not contraception.

    3. Birth control is not a controlled substance. Something like Oxycotin is.

    4. That’s the point of a slippery slope. By allowing pharmacists to get away with it now, these are all very likely scenarios.

    Sybil, oh, I know that these situations do happen, although it’s interesting that the Christian scientist will dispense other medication – what a hypocrite he is! I’m just talking about what should be happening.

  62. Honeybell

    Britt, by that rationale, a hospital pharmacist (that is open 24 hours) could refuse to dispense certain blood products based upon religious beliefs. And who gets to decide what’s life threating? It goes beyond just Plan B. If a pharmacist has the right to refuse to provide that doctor ordered treatment (based on morality, NOT availability) then who gets to pick and choose which medication they can refuse? Pharmacists are often in a position to be the gateway to emergent life saving drugs.

  63. RW

    Thank you faiqa.
    —————–
    Adam that was the old political blog rules, now I just tell people to go die in a fire.

    1. Dispensing a medication used to accomplish something you are morally opposed to can be seen as a matter of conscience. Forcing someone to do something that may go against their conscience is impinging your moral code on someone else. They have no recourse, but you can go get your IUD somewhere else. I know you use them a lot. :poke:

    2. My point is apropos to #1. You are enforcing an absolute on the pharmacist, but the pharmacist is not enforcing an absolute on the customer.

    3. Which misses my point about some folks being more stringent in their personal behavior than even the law requires.

    4. The scenarios may be likely, and according to Sybil may already be. But until they are absolute in every pharmacy in the land you have no complaint.

  64. NYCWD

    There is a law against willful murder. I agree with it. But someone here wants to make a law saying a pharmacist must dispense medications they have a moral problem with. i would be against that.

    If you are going to make the exception for the man who’s morals dictate that he not fulfill his duty, then you need to make the exception for the man who’s morals dictate that he fulfill his duty. Otherwise you’re saying you are okay with double standards based on which moral compass is being followed.

    THAT seems callous.

  65. RW

    If you are going to make the exception for the man who’s morals dictate that he not fulfill his duty, then you need to make the exception for the man who’s morals dictate that he fulfill his duty. Otherwise you’re saying you are okay with double standards based on which moral compass is being followed.

    By your logic, then, we should not allow personal conscience into our thinking when making laws?

    I think societies have a right to make their laws as they see fit. if the majority of people want to impinge on the beliefs of a pharmacist then there it is. I’d be against it.

    But I didn’t realize you were actually for honor killings.

  66. Willie G

    @NYCWD: “If you are going to make the exception for the man who’s morals dictate that he not fulfill his duty, then you need to make the exception for the man who’s morals dictate that he fulfill his duty.”

    This is such a Straw-Man fallacy it’s not even funny. You are in essence saying that if I allow for a religious / moral based decision to not dispense a drug that I must also allow for cultural based murder of a human being.

    I don’t think we are even debating the correctness of the Pharmacists belief system, but rather the right to base his decisions on that belief system. Their is no pharmacy monopoly in this country. You can get your drugs through a different avenue. As RW said, bring him the perscription, he’ll take your money and give you anything you want. However, the murder of an innocent indivdual based on religious beliefs most definitely infringes on the rights of the person being murdered. She has no other options. She can’t go down the street and buy another life.

    The two arguments are not connected and do not follow to the same logical conclusion. This strawman, as all, should go up in smoke.

    I mean that in the nicest of ways of course.

  67. Miss Britt

    Dawg – the difference to me is clear and a large part of what I based my argument on last night.

    YOUR rights only stretch to the point that they begin to infringe on mine.

    And let me be clear that there is a difference between a right and a desire or expectation.

    We have a RIGHT to life, liberty (including religious liberty) and the PURSUIT of happiness – basically.

    Honor killings interfere with my right to life.

    Refusing service such as this does not interfere with your right because it is readily available other places.

    Convenience, as I said last night, is not a right.

  68. Coal Miner's Granddaughter

    Honestly? I haven’t thought about this probably because all I ever get from the pharmacist is birth control, amoxicillin (sp?), and some kind of trippy cough syrup that can knock my shit out for two solid weeks. I lost Christmas, 2000 on that stuff.

    What I have to say on this is that if your 16-month-old is taking two days of prednisone for the croup (helps with his breathing) and develops red blotches due to said medication (common side-effect), can I tell my worrisome, drive-me-fucking-crazy MIL to go drive off a cliff when she insists I take him to the ER due to said red blotches?

    Thanks.

  69. NYCWD

    @ RW- Almost exactly my point… we should not allow the influence of questionable morality when making laws. I also think we should not allow the influence of religious beliefs when making laws. Both have had influence on this nation and its laws.

    @ Willie G- At no time did I say anything about religious beliefs or cultural beliefs. I am speaking on the aspect of morality, which I admit can be influenced by both the cultural and religious aspects of one’s life and vice versa. I also am not arguing about Pharmacists in particular because I believe the argument is bigger than that. I believe it is about personal morality vs. societal/employment duty, and by arguing, as I believe you are, that your morality should come before duty then that opens an entire other issue because the moral values of one group may not be the same as those of the other. I am not making a “straw man’s” argument in the slightest… in fact if anything I am the one raising the bar above the scope of the role of the Pharmacist… who’s job description still has not changed.

    @ Miss Britt- Yes, I understand your argument and I heard your argument from the show last night. Of course, there was plenty of frustration in not having a flux capacitor so I could call in live, but that aside please think of this:

    The convenience of being able to sit at the front of the bus is in fact a right. The convenience of being able to go to a school is a right. The convenience of eating in a restaurant with other patrons is a right. The convenience of being able to legally marry the person you love SHOULD be a right, but we aren’t quite there yet because morality is against it. The convenience of being able to get a prescription from a location where there is a licensed and certified person SHOULD also be a right, especially when that convenience is available at any other time.

    If those conveniences aren’t rights… then that is discrimination.

  70. RW

    Well Dawg, finally, we make distinctions because distinctions need to be made. A does not equal B and B does not equal C. Honor killings are not the same thing as pharmacists and medicine; they are completely different things. They need to have a distinction made between them and the balance of your argument wants to blur that distinction. I recommend you check my link on logical fallacies. There are degrees and differences and distinctions; and you can’t extrapolate something to its most heinous end and negate the whole principle. Please read what I suggested.

  71. Willie G

    @NYCWD: IMHO you are clearly trying to make us all slaves to our chosen professions. Whereas I say that you must be true to yourself. If I were a Pharmacist I would perform those duties as licensed to perform in the shadow of my values and principles whether they are governed by a specific religion or not. If I find a drug to be morally objectionable then I would not sell it regardless of how much you personally were inconvenienced. I would not feel obligated to push my values on you in any way, I would simply tell you that you would have to go to a different Pharmacy. I say that as a result of this stance you may think me a poor Pharmacist, but I would sleep at night knowing that I am a strong man.

  72. NYCWD

    RW, I never said A equaled B and B equaled C. I’m saying A equals A and therefore it should be treated like A… otherwise as your argument suggests the value of an individual’s morality is not greater than an individual’s duty because morality varies. Duty, on the other hand, is constant and equal and across the board.

    Or at least it should be.

    I did in fact read what you suggested… but to be honest I don’t believe that to be the case here.

  73. NYCWD

    @WillieG- Sorry for the delay, we must have been commenting at the same time.

    That’s quite a contradiction you have there… because it’s pretty hard to be made a slave when it is a profession that you have chosen. No one is holding a gun to your head to make you a pharmacist. They’re holding a paycheck.

    When your chosen profession is in the service industry and directly deals with the well being of a life, then absolutely you need to be held accountable for your failure to fulfill your duty.

    By not providing me a service that is offered by your employer, and still accepting the money they pay you although you have denied me the service is discriminatory. I also don’t think quality or time of sleep determines the strength of a man’s morals.

    The strong man would find a new job.

  74. Trukindog

    Other than suspicion of illegal activity NO they should not be allowed to refuse to perform the sevice they are hired to do for any other reason, if they have a moral or religious problem with some of the products they are expected to provide to the customer THEIR IN THE WRONG LINE OF WORK.

  75. baseballmom

    Just chiming in…I’m late to the party, as usual. My dad was a pharmacist, and owned his own pharmacy until the ‘big boy’ chain stores pushed him out of business. He was famous for running his business the way he wanted, and if people didn’t like it, they could go somewhere else. That said, a pharmacist should have to distribute what is written on a prescription, regardless of their personal feelings, as long as it’s legal. They are there to do a job, bottom line. You could also insert the scenario of a pharmacist refusing to distribute a certain drug because they were paid by the drug companies to only distribute their brand. Moral? NO, but it could happen. Who is to say that a pharmacist is REALLY doing it for moral or religious purposes? Maybe they’re being paid off, and lying about it! Who knows…

  76. Eric

    Pharmacists are like bartenders, and no one would ever say that a bartender shouldn’t be able to withhold serving alcohol.

    When the legality of a certian prescription or the demeanor of the client indicate that the person is an illicit user, then they should and do have the absolute right to reefuse service and that’s perfect.

    About religious views? Call it what it is, the context is the morning after pill only, right? Because retin-A and hydrocodone aren’t particularly religiously impacting drugs.

    Anyways. Who cares anyways? Find a different pharmacy.

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