should pharmacists be able to decide what to dispense?

Parent Cafe
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<p><a href=“http://seattlepi.nwsource.com/local/262603_pharmacists11.html[/url]”>http://seattlepi.nwsource.com/local/262603_pharmacists11.html&lt;/a&gt;
Washington isn’t the only state where pharmacists have refused to dispense prescriptions for birth control pills- morning after pills etc.</p>

<p>It got me to thinking. WHat if a pharmacy refused to dispense say mulitiple prescriptions for medications that could be sold on the street? About medications that were for “sexual fullfillment” to someone that you knew was unmarried… It really seems to be opening up a can of worms in my mind at least about what someone who is licensed by the state to fulfill a job, can decide about what and what not he or she will do under the guise of that position.
Should we maybe have different classifications for pharmacists who have already decided that they will not dispense as written so the pharmacy can make arrangements to have another pharmacist available?</p>

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<p>They should not be allowed to decide. Period. Why be in that profession then?</p>

<p>So, some pharmecists don’t want to provide birth control to even married women</p>

<p>Please note that women will be the most affected</p>

<p>When they get the license, they agree to follow medical advice</p>

<p>And pharmecies already prescribe all kind of stuff that is abused- they sell heartmedication that is used for sexual inhancement, they sell glue that kids sniff</p>

<p>It is interesting that most of the stuff they are not wanting to sell are focused toward women’s needs</p>

<p>Now, there is a bil lthat states a woman’s main doctor can not be her gyn, but must be a general practioner who will decide if the woman should see her obygyn of a checkup</p>

<p>Like women can’t take care of their bodies and know what they need</p>

<p>Its getting damn scary out there</p>

<p>DId you here about the SD representative that voted down abortion? He said was only for a young girl, who was still a virgin, who was sodomized, brutally beaten, raped for hours, that kind of thing, any other kind of rape was okay I guess</p>

<p>scary times</p>

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<p>Seventeen states are currently considering measures that have “pharmacist refusal” or “conscience clauses” in them, according to the National Conference of State Legislatures.
Pharmacy boards in Wyoming, Nevada, North Carolina and Massachusetts have already said pharmacists don’t have such rights.</p>

<p>I agree that in general womens health rights are much more affected than a mans
In particular time is of the essence, and a woman who is raped, and wants to insure that they do not become pregnant- to stop implantation the morning after pill needs to be administered right away. a delay to find a pharmacy that will dispense could cause medical complications</p>

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<p>If they want to judge morality, they should be preachers.</p>

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<p>No one should be forced to do something they find morally repugnant. I thought this was a free country.</p>

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<p>My friend goes to an ob-gyn who refuses to prescribe birth-control pills unless they are required for hormonal imbalances, as it goes against her religious beliefs. I think she should have chosen another medical specialty.
As far as the pharmacist goes, does the head Pharm. decide what meds they even carry? That would be plain ridiculous. How does the pharmacist know what the b.c.pills are for. they could actually be for hormonal problems which lead to diabetes, ovarian cysts etc.</p>

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<p>so what about my suggestion of different levels of qualifications?
I don’t think that someone who goes to a pharmacy to pick up medication prescribed by his or her doctor should be turned away.
They should either have someone else there who will fill the prescription, or let the patient know ahead of time that they will not fill it and give them a referral to someone who will.
If we allow pharmacists to refuse to fill doctors orders merely because they disagree with the usage, where will it stop?
Where does the patients rights come in to be able to recieve fulfillment of their clinicians treatment plans?
I can think of a lot of things pharmacists could have a problem with, from viagra, to methadone, tranquilizers and amphetamines.
But why are the drugs that are being protested, just used by women?</p>

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<p>they could actually be for hormonal problems which lead to diabetes, ovarian cysts etc.</p>

<p>This is true
a friend has a daughter who is developmentally disabled, she is on birthcontrol pills not only so that her mother will know when she is having her period and can monitor it, but so just in case she impulsivly either has sex or was molested, she won’t get pregnant, because that would be a nightmare.</p>

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<p>People make moral decisions every day. Professionals too. Some physicians won’t provide abortions or assisted suicide. Some attorneys won’t defend someone they feel is guilty. Some teachers report suspected child abuse in the home. Pharmacists are people too and have moral and personal standards. </p>

<p>Pharmacists are NOT required to dispense medications even with a legitimate prescription. There are many reasons they may choose not to. If an prospective employer has requirements that go against the law respecting the pharmacist’s professional judgement, the employer should discuss them before hiring. Here is a section from the PA Pharmacy Act deferring to the professional judgement of the pharmacist in dispensing decisions (similar in other states):
<a href=“Pennsylvania Code”>http://www.pacode.com/secure/data/049/chapter27/s27.18.html&lt;/a&gt;&lt;/p&gt;

<p>“(c) A pharmacist may decline to fill or refill a prescription if the pharmacist knows or has reason to know that it is false, fraudulent or unlawful, or that it is tendered by a patient served by a public or private third-party payor who will not reimburse the pharmacist for that prescription. A pharmacist may not knowingly fill or refill a prescription for a controlled substance or nonproprietary drug or device if the pharmacist knows or has reason to know it is for use by a person other than the one for whom the prescription was written, or will be otherwise diverted, abused or misused. In addition, a pharmacist may decline to fill or refill a prescription if, in the pharmacist’s professional judgment exercised in the interest of the safety of the patient, the pharmacist believes the prescription should not be filled or refilled. The pharmacist shall explain the decision to the patient. If necessary the pharmacist shall attempt to discuss the decision with the prescriber.”</p>

<p>You either want a professional to evaluate your medication regimen and to provide assistance and advice, or you want a human vending machine for drugs. If you have health or medication problems, would you like your pharmacist to be your advocate? Or, would you like someone to carelessley sell drugs to you as if he were selling hardware? I think most would prefer the former. If you want the latter, look around for a pharmacist with lower standards…but don’t expect the level of attention and service you would get from an excellent pharmacist. </p>

<p>Here is the Pharmacist’s Oath, required to be taken at graduation (note particularly the part about moral and ethical conduct.)</p>

<p>"At this time,
I vow to devote my professional life
to the service of all humankind through
the profession of Pharmacy.</p>

<p>I will consider the welfare of humanity
and relief of human suffering
my primary concerns.</p>

<p>I will apply my knowledge, experience, and skills
to the best of my ability
to assure optimal drug therapy outcomes
for the patients I serve.</p>

<p>I will keep abreast of developments
and maintain professional competency
in my profession of Pharmacy,</p>

<p>I will maintain the highest principles of moral, ethical, and legal conduct.</p>

<p>I will embrace and advocate change in the profession of Pharmacy that improves patient care.</p>

<p>I take these vows voluntarily
with the full realization
of the responsibility with which I am entrusted by the public"</p>

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<p>thank you for posting.
I understand that I can’t expect pharmacists to dispense something they feel will cause harm to the patient- but that gets into a blurry area it seems. How do they know what it is being prescribed for?
Are there certain doctors which they know are “looser” with the PDR criteria than they should be?
When that doctors name comes up on the pad, are they less likely to give out the meds? How can patients find this out ahead of time?</p>

<p>*People make moral decisions every day. Professionals too. Some physicians won’t provide abortions or assisted suicide. Some attorneys won’t defend someone they feel is guilty. Some teachers report suspected child abuse in the home. Pharmacists are people too and have moral and personal standards. *
A surgical procedure is planned for in advance, you don’t just make an appt with a doctor and expect them to give you an abortion, same with asst suicide, you don’t just go to a dr and have them “write you a prescription for a lethal dose”, not to mention some places it would be illegal.
( same with abortion)
It is actually illegal NOT to report a suspected case of child abuse, but so far I think most places, pharmacists are required to dispense meds as written. ( Arkansas allows pharmacists to refuse , so does MIssissippi and South Dakota)</p>

<p>In addition, a pharmacist may decline to fill or refill a prescription if, in the pharmacist’s professional judgment exercised in the interest of the safety of the patient, the pharmacist believes the prescription should not be filled or refilled.
So this makes it sound like all those pharmacists who refuse to dispense birth control to married or unmarried women are doing so not for safety reasons but for other reasons.Or are they allowed not to give out birthcontrol jsut because they don’t “believe in it”?</p>

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<p>So Barrons, do you find birth control pills immoral, do you find women, in whatever circumstances, who take them immoral? </p>

<p>If my ObGyn didn’t dispense the medication I needed because she thought I was a slut or whatever, I would go to a different Obgyn</p>

<p>Because that is what she is saying… women for tens of thousands of years have done all kinds of things to not get pregnant or to end a pregnancy…</p>

<p>Who is to judge someone elses lifestyle choices of having sex…because that is what this boils down to, women having sex and others judging them for that…and believe it or not the natural method doesn’t always work</p>

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<p>Perhaps pharmacists could be required to prominently post those medications that they refuse to dispense on account of conscience. Then I could decide which pharmacies would no longer enjoy my patronage.</p>

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<p>I’m sorry, lkf, but the law you cited does NOT let the pharmacist fail to dispense birth control based on personal moral beliefs. Unless a pharmacist is fundamentally unethical enough to claim that every BC prescription is fraudulent or that BC is unsafe (and do NOT think for one second that saying BC is unsafe would hold up in any court of law - the FDA and numerous studies have both concluded that birth control is very, very safe). That law gives a pharmacist the right to block what are fraudulent prescriptions, to block combinations of drugs they know to be harmful (i.e. if a doctor mistaking proscribes drugs that will interact in a bad way), and to block filling prescriptions that are clearly fronts for recreational use.</p>

<p>The intent of that law is CLEARLY to guard against fraud, and most of the law is CLEARLY focused on narcotics and potentially recreational drugs. The safety clause cannot reaonsably be applied to BC. That law provides 0 protection for a pharmacist failing to dispense for religious reasons.</p>

<p>LKF, I don’t need or want my pharmacist to do anything other than fill my prescriptions and get out of my way. If I have healthcare questions I’ll go to my doctor.</p>

<p>This whole thing is ridiculous. If your religious beliefs inhibit your ability to do a job in material and important ways, DON’T TAKE THAT JOB. Tell me, you who think that pharmacists have the right not to dispense based on religious beliefs, do you think religious programmers should be allowed to refuse to write code for Grand Theft Auto without being fired? Do you think that religious camera men should be allowed to refuse to shoot R rated movies without facing any consequences?</p>

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<p>Well, good luck with getting you questions answered by your doctor. He may be great, but the reasons most people ask their pharmacist include the lack of availability of the doctor or the fact that many people don’t want to “bother” their doctors with “stupid” questions.</p>

<p>I’m sure if you check around, you will be able to find a human vending machine who will make no judgements, either ethical or pharmaceutical. Since you don’t want any professional advice, you might consider a mail order pharmaceutical service. You are in the minority in refusing advice. </p>

<p>People certainly have the right to refuse to do anything. Employers also have the right to refuse hire or to fire them. </p>

<p>Personally, I don’t know anybody who refuses to fill oral contraceptives. I do know some who will not fill prescriptions to induce abortion (there are two patients there, and it is in the best interest of the fetus to not die). I also know physicians who will not perform abortions. </p>

<p>If this whole thing ever became a big issue, I think employers would stipulate such in the required performance standards. Maybe people should “shop around” for a pharmacist, just as they shop around for a doctor or dentist, utilizing whatever criteria they feel is relevant.</p>

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<p>The doctor and the pharmacist are there for the well being of the patient, not to fulfill some moralistic agenda.</p>

<p>Safety reasons pretty much are limited to drug interactions that the doctor didn’t spot. If a drug is, on it’s own, known to be unsafe, it wouldn’t have been approved by the FDA for dispensal. The job of the pharmacist is not to decide the method of treatment for the patient; that is the job of the doctor and the patient.</p>

<p>Allowing pharms to not dispense bc pills seems reckless to me. Simply because a legitimate supply is no longer available does not in any way reduce the need for the pills. What’s morally applaudable about forcing women to go to the black market for the pills? In areas with very few pharmacies, I can see this becoming an issue. Less so in the cities and suburbs where a hospital and CVS/Longs/Target pharmacies are all close by.</p>

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<p>He may be great, but the reasons most people ask their pharmacist include the lack of availability of the doctor or the fact that many people don’t want to “bother” their doctors with “stupid” questions.
I go to an independent pharmacy and prices are a tad higher than a large chain, but they don’t have the turnover in pharmacists that some places do.
However I dont ask the pharmacists Qs, for one there is a line of people behind me,and two, I don’t have the sort of relationship with the pharmacist even though I have known him for 20 years that would make me comfortable giving him the amount of information he would need to advise me.
I agree that people should shop around for a pharmacy- it would help if in some areas they had a choice of pharmacies to go to, and not just pharmacies that are owned by huge chains who have made the decision at the top to decide not to carry or dispense certain medications.
I did shop around for a pharmacy just by selecting locally owned shop rather than Safeway, even though Safeway is closer.</p>

<p>Perhaps since I don’t have the medical background you do, you could explain to me how a pill that prevents implantation induces abortion.
With a fertilized egg, doesn’t it have to be implanted before there can even be a fetus?
The morning after pill is a birthcontrol pill not an abortfacient. It acts to delay ovulation, prevent fertilization or prevent implantation.
From the FDA The scientific and medical definition of abortion is after implantation [in the wall of the uterus]…These birth control pills are used to prevent pregnancy, not to stop it. This is not abortion."</p>

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<ol>
<li><p>If you find birth control to be morally repungant, don’t be a pharmacist, where you are expected to dispense it every day. There’s a reason that I would not go into many professions, no matter how much money I could make, because I want to sleep at night. Don’t like birth control? It’s a free country - don’t be a pharmacist.</p></li>
<li><p>What sicko equates not being pregnant with drug abuse? </p></li>
<li><p>As someone who took birth control solely for medical reasons - not having sex, but needed to stop ovulating because I had tremendous pain and an ovarian cyst - I find pharmacists who take over for my physician to be morally repungant. So I’m not supposed to get medicine because it has alternative uses that those people don’t like? Most young women that I know take birth control for non-standard purposes: to deal with heavy periods; to deal with severe nausea; to regulate periods; for cysts; and for endometriosis. Any pharmacist that refuses to fill birth control medication is taking over the role of a physician to determine the medical needs of a woman, while lacking accreditation and a MD. It has nothing to do with questioning the value of the prescription or abuse by it; it is a per se refusal to admit that hormones have medicinal value for any woman. Last time I checked, anyone holding themselves out to be a physician without the MD and licensure is subject to some pretty heavy penalties. Let’s bring it on.</p></li>
</ol>

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<p>Since Targets and other chain stores have refused to fill birth control prescriptions ( although at Target, it looks like they were temporary workers and not official Target pharmacists)
I found this website for women who may be concerned that they are at risk for pregnancy
<a href=“http://ec.princeton.edu/[/url]”>http://ec.princeton.edu/&lt;/a&gt;&lt;/p&gt;

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<p>There are so many over-the-counter methods of birth control, including condoms and diaphragms, usually hanging right there at the pharmacist’s window…that it is RIDICULOUS for a pharmacist to morally refuse to supply you the pills.</p>

<p>Anyhow, my pharmacist has me sign a waiver, stating that I do not want his advice, and that absolves him of any responsibility</p>

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<p>Has anyone here actually had personal experience with pharmacists refusing to fill oral contraceptive prescriptions? I will repeat that I have NEVER heard of such an occurrance in more than 25 years of practice. </p>

<p>I am not saying that I agree with refusing to fill Rx’s. I’m only saying that pharmacists have that right, both legally and personally. Employers have the right to fire them. You also have the right to shop elsewhere. If you are hospitalized, you get the pharmacy services whether you want them or not. (If anybody is interested, I dispense them and I personally take them…I’m only making a point.)</p>

<p>I am sorry to hear that everyone has such a poor opinion of their pharmacists. Maybe the students on this board who are struggling with the competitive admissions into pharmacy school should think twice about devoting 6+ years to their education in order to serve people who want no service other than cash register checkout. Luckily, your physicians utilize pharmacy service more than you know.</p>

<p>I’m also glad that the hospital patients and retail customers in my area don’t share your low opinions of the pharmacy profession, but rather avail themselves of the many services their pharmacists offer.</p>