Dr. Andy

Reflections on medicine and biology among other things

Monday, March 28, 2005


That is how I'd describe pharmacists who refuse to fill prescriptions that don't conform to their personal moral beliefs, at least those that don't make alternative arrangements.
Some pharmacists across the country are refusing to fill prescriptions for birth control and morning-after pills, saying that dispensing the medications violates their personal moral or religious beliefs.
Maybe they should consider a new line of work.

When I was a fellow, I used to moonlight covering a pediatric practice and one Saturday I got a call from a teenager (I don't remember the exact age, but it was at least 18) asking for the morning after pill since a condom had broken. As a supporter of this form of contraception (and it is contraception) I called it in, warning her to be more
careful in the future. I thought about what I'd do if I was opposed, but decided I'd really have to give up this moonlighting shift (or make alternative arrangements) since there was no particular reason patients should have to be inconvenienced by my personal religious beliefs. I feel the same way about other health care workers

If a doctor is personally opposed to abortion, he or she has no duty to perform them, but then he or she needs to find a job that doesn't require performing them. He or she can't very well take a job at Planned Parenthood and then object to doing his/her job. And if you take care of women in a specialty where they might become pregant, you have to be willing to refer to someone who will perform abortions.

I don't see it as being any different for pharmacists. If they won't fill prescriptions for OCPs they should start special pharmacies which clearly state which medicines they will and won't fill. If enough fundamentalist wackos want to go to those pharmacies, fine for them, but the average person deserves to have their prescriptions filled in any pharmacy that doesn't clearly and publically proclaim that there are certain prescriptions they won't fill.

I have little patience with the idea of "transferring" the prescription either. If it is a big pharmacy and they always make sure to work with another pharmacist who will fill those prescriptions that is no big deal, but I don't see why customers should have to schlepp all over town because somebody doesn't want to do his or her job.

This quote, I can hardly even comment on:
Brauer, of Pharmacists for Life, defends the right of pharmacists not only to decline to fill prescriptions themselves but also to refuse to refer customers elsewhere or transfer prescriptions.

"That's like saying, 'I don't kill people myself but let me tell you about the guy down the street who does.' What's that saying? 'I will not off your husband, but I know a buddy who will?' It's the same thing," said Brauer, who now works at hospital pharmacy.
Comparing morning after contraception, must less OCPs (Oral contraceptive pills is medical argot for birth control pills) to murder is way, way over-the-top. Morning after contraception probably works primarily by preventing implantation of the fertilized ovum (aka embryo) in the uterus. Guess what? The majority of fertilized embryos don't implant anyway. I haven't seen a lot of "funerals" for embryos that didn't implant or much medical research devoted to decreasing all these tragic deaths (ed: be careful what you wish for).


At 9:22 AM, Anonymous jb said...

Does this get generalized to all forms of commerce? Does a kosher butcher have to sell pork chops? Does a grocer who believes drinking alcohol is wrong/immoral/stupid have to sell Budweiser? Does a priest have to marry a couple who have been shacking up for the past year? Does a bookshop owner with strong leftist beliefs have to sell Ann Coulter's books?

An employed person (physician, pharmacist, store clerk, clergy) is required to fulfil the requirement imposed by the employer, or she can find another job. One of the advantages of self employment is that you get to make those decisions for yourself, subject only to legal requirements and whatever you voluntarliy contract yourself to do (this might include calling in morning-after Rxs, but maybe not). This principle may be modified by emergent circumstances, but a busted rubber is a prime example of the concept that "your poor planning does not define my emergency."

At 4:44 PM, Blogger Dr. Andy said...

To the extent that a pharmacist chooses to work in a job where dispensing objectionable medicines is not required (say a NICU or nursing home) I have zero problem with it. Doctors have no obligation to enter a field where they need to prescribe contraception (morning after or otherwise).

But these are pharmacists who take jobs at regular pharmacies which do, routinely, dispense these medicines. If they choose not to take those jobs, that is their business, but if so they shouldn't take jobs requiring this in the first place


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