C
cattyfan
Guest
I would ask that people read this carefully before responding. There is an analogy toward the end that I think is especially pertinent.
Prescription for Trouble
What if your doctor says you need a medication, but your pharmacist refuses to provide it? This situation is being discussed across the country—Does a pharmacist have the right to decide what should be dispensed to a patient?
Before I delve into this topic, let me clarify my own beliefs. Some people have misconstrued my viewpoint as being tantamount to tacit approval of a catalog of transgressions. I’ll be blunt: I don’t approve of promiscuity, fornication, adultery, abortion, or homosexuality. I have family members and friends near and dear to me who have participated in one or more of these immoral behaviors. By some people’s definitions of sin I’ve probably occasionally behaved questionably as well. I understand perfectly the idea of not doing something because it is contrary to values. I want everyone to be clear: I am not supporting the violation God’s Word in any fashion.
That being said, I don’t accept the notion the pharmacist should have veto power for my prescribed medications.
Illinois Governor Rod Blagojevich recently signed an order prohibiting pharmacists from refusing to fill prescriptions. Already two pharmacists have filed suit to overturn the order and they’ve requested a preliminary injunction allowing them, until the legal case is settled, to turn away prescriptions they deem ‘contrary to their morals and religious beliefs.”
The issue most often cited in the news media, or should I say the medication mentioned most often, is emergency contraception, sometimes called the ‘morning-after pill’ and frequently confused with RU486. Emergency contraception is chemically not the same thing, and there is considerable grey area as to where it falls in the realm of preventing conception versus causing a miscarriage.
If RU486, which is used for abortions, was the sole concern, I might be inclined to side with the pharmacists. I would even be open for debate on emergency contraception. The problem is there are other prescriptions going unfilled, but those aren’t being as widely recounted. It’s easier to profile the dispute as another pro-life quarrel. It’s better copy and allows the liberals to squawk about women’s rights, and if the left-wingers win the fight, no other medications will be in dispute. But by severely limiting the scope, the crux of the disagreement has been lost.
The debate about allowing pharmacists to follow their individual conscience isn’t, or at least shouldn’t be, about “reproductive rights.” It’s about privacy. It’s about the right of the patient to follow the medical advice and treatment prescribed by their physician.
In the last few years, virtually everyone has been asked to review and sign a document detailing the HEPA laws. They are the rules requiring medical personnel and related entities to maintain patient secrecy. Records can’t be sent to insurance companies without permission…pharmaceutical companies can’t purchase patient lists for mass propaganda mailings…in theory, a nurse can’t stand in earshot of the waiting room discussing a patient’s lab results. It isn’t a perfect system, but it’s improving.
I remember signing the HEPA form before picking up medications at Walgreen’s years ago, so I know the pharmacy is supposed to adhere to these rules as well. I also know they sometimes fail, as the pharmacy technician at the counter has been known to say quite clearly, “Your name? Your address? And Mrs. Eddy, do you have any questions today about your prescription for (fill in the blank)?” That’s not exactly guarding Mrs. Jones and Mr. Smith from learning my business. As I said, it isn’t a perfect system.
However, the HEPA laws in part reinforce my argument that pharmacists have no right to overrule my doctor’s assigned treatment. It was bad enough when the snotty little nurse working in the North Carolina insurance company office who had never laid eyes on me or my medical file tried to tell me that she had a more thorough knowledge of what I needed than did my doctor. (By the way, she lost that fight.) I shouldn’t have to defend my medical therapy to the pharmacist. I understand pharmacists have extensive education, but they are not doctors and they are not privy to a patient’s complete medical or personal history.
It’s not just RU486 that is causing the controversy. Some pharmacists are refusing to dispense ‘birth control pills’ and AIDS medications. Many of these pharmacists claim dispensing these meds “violates their beliefs.” Here’s where things start to get slippery.
Some objections are based on the pharmacist being pro-life while other opposition is to the patient’s lifestyle. There is a flaw in both protestations.
Let’s first examine a refusal based on being pro-life. ‘The Pill’ is a misnomer. So-called birth control pills are not always prescribed solely for preventing conception. The medication is comprised of hormones and is given out for a variety of reasons including, but not limited to, hormonal imbalance, excessive or dangerous monthly bleeding, and irregular or painful periods. The patient may not even be sexually active, and the medication in question is vital to her health. Should a patient who is holding a prescription for ‘birth control’ have to discuss with the pharmacist her “feminine difficulties” before getting the prescription necessary to alleviate her medical infirmities?
The second objection is lifestyle. The woman holding the prescription for birth control would now be asked to defend why she is using something to keep her from getting pregnant. Is she married or single? Why doesn’t she want children? Would pregnancy be a health risk for her? How big of a risk? These topics are not something a complete stranger has any reason to know.
Let’s turn the birth control conundrum on its ear: will a woman taking fertility drugs have to endure an inquisition about being able to afford multiple children if they should result? If there is more than one baby, is she likely to abort one for the “safety” of the other? Is she married…single…how did she become infertile?
What about the person with over-the-counter contraceptive creams and condoms? Should they be quizzed about how and with whom those items will be used?
Similar objections to lifestyle are being employed by several pharmacists to defend their choice to not dispensing AIDS treatments to patients. The patients are homosexual and the pharmacists don’t support that. What they are saying, essentially, is gays deserve suffering and death because they are sinners. Last I checked, we were all sinners. How does refusing these people treatment bring them to Christ before they die?
Theoretically, a patient could be expected to explain to the pharmacist how they contracted HIV to make sure the cause meets with the pharmacist’s approval. Will the pharmacist refuse to treat the needle-sharing addict, or even the child born to an infected mother because they inherited ramifications of their mother’s particular sin? Will the pharmacist then be asking everyone with herpes (even “cold sores”) to tell exactly how they were infected? Fornicators and adulterers are out of luck getting their medications, but those infected through casual contact or lying partners form a line over here—You can have your prescription after filling out this brief questionnaire.
If a pharmacist can refuse to fill a prescription based on their point of view, the door is opened for a host of controversial decisions. Perhaps the patient with emphysema shouldn’t be treated. Smoking a pack a day really makes the ailment the patient’s fault, no different than the consequence of catching an STD that someone indulging in promiscuity faces. A patient with high cholesterol could be denied their drug. Their abhorrent eating habits caused the problem, and the pharmacist may believe it’s wrong to consume certain foods. Since the patient chose the unhealthy lifestyle, they should suffer the negative results.
Unfortunately the pharmacists who have already been documented as objectors for varying reasons have proven I’m not being an alarmist. These professionals have defied the dictum of The American Pharmacists Association which states the following:
“Serving our patients and helping them make the best use of their medication is our priority, which is why our organizations support the two part policy stressing the need to assure patient access to legally prescribed, clinically appropriate therapy in a timely manner when a pharmacist steps away from working with a prescription based on personal beliefs. Pharmacists must not use their position to berate, belittle or lecture their patients—our organizations oppose such action.”
The guidelines go on to say a pharmacist who declines to dispense medication due to personal beliefs is required to refer the patient to an accessible facility that will fill the prescription. The pharmacists who have refused to distribute medications in most cases have not done this, thereby blocking access, and in some cases (such as with the prescriptions for AIDS patients) causing harm, all in the name of their values.
The pharmacist who arbitrarily decides who receives physician-prescribed treatment and who doesn’t not only thumbs their nose at their own association, they are abdicating their responsibility and role in the health system. Additionally, I would question if they are acting in accordance to God’s will or their own.
Think of it this way: a pharmacist who refuses to dispense medications normally sold through the pharmacy which employs them would be like someone getting a job as a check-out person at the grocery store and then refusing to scan the chicken and beef because they are a vegetarian. They knew going in the store had a meat department, but they won’t handle the products because consuming animals is against their beliefs.
I’m not advocating these apothecaries abandon their morals. I would suggest they seek a more appropriate venue in which to practice. For example, a pharmacy in a conservative Christian hospital would allow them to follow their heart without infringing on the patients’ rights. But they need to make sure the patients who seek treatment are immediately aware of the position of the personnel in the facility.
There are times when finding a pharmacy reflective of the pharmacist’s beliefs may be difficult. But it’s no more of a strain than demanding a patient to seek another pharmacy. Not every town has a Walgreen’s every six blocks.
Until an equitable solution is reached there need to be precautions taken so the patients receive the care deemed necessary by their physicians, and not have it second-guessed by someone who isn’t, and shouldn’t be, completely informed about the rationale behind the treatment. It’s called doctor/patient confidentiality for a reason.
—Berta Collins Eddy
Almost Normal Publications 2005
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