The Right Pharmacist

Let’s cut right to the chase here:

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.

If I say this is outrageous, it doesn’t even begin to express half of my anger over this. I know it’s a facile question, but where’s it going to end? The fact that such cultish behavior is crawling on its belly in to the mainstream leaves me terrified, angry, and worse, hopeless.

A pharmacist is not a moral arbiter. A pharmacist is not a marriage counselor. A pharmacist is not a doctor. A pharmacist’s job is, I thought, silly me, to dispense medication and make sure the patient recieving that medication is informed about the medical implications of taking that medications. Medical implications. Not social. Not moral.

It’s a testament to the state of my despair that my first thought was, well, okay, if a pharmacist is going to act that way, they should be so labelled. That way, terrified patients won’t suffer humiliation at the hands of an unsympathetic dispensor. But that’s just ridiculous. If I refuse to do my job, I don’t get to work. A pharmacist taking this course of action should be fired. Instead, they’re the standard bearers at the desk at the back of the store. Bathed in the holy light of flourescents, a pharmacist now is given the option to reset your moral compass while handing you your antibiotics.

I swear, we are not just waging a war on terror. We are waging a war on women. God help us. God help our daughters.

18 thoughts on “The Right Pharmacist”

  1. This from the American Pharmacists Association:

    “The APhA absolutely supports patients’ right to access their legally prescribed medications. APhA also supports the pharmacist’s right of conscience. That right of conscience comes with responsibility to assure patient access to the legally prescribed therapy.”

    They go on to say the a pharmacist is within their rights to refuse to dispense the drug and hand over the dispensing of said drug to another pharmacist. Personally, if I had to take birth control I would have a very direct and up front conversation with my pharmacist to find out where he/she stood on this issue. However, I do not believe that a pharmacist should be able to deny the filling of a legal prescription under any circumstance. If one should refuse there should exist a process whereby a patient could complain and that pharmacist would be barred from their position.

    If you have a problem completing all of the requirements of your job, you shouldn’t do it. Otherwise, if you are being paid to fill prescriptions – then just do it.

  2. Right on to what you said, Terry. But do you think we should HAVE to have a conversation with the pharmacist on the issue? We’d have had this conversation with a doctor in a supposedly confidential setting. Yet now, we’re facing being denied a choice by a person who’s making a value judgement about that choice in a very public setting.

    I don’t CARE where my pharmacist stands as long as they don’t inflict their politics on the decisions I’ve made. Okay, maybe I do care, but it’s none of my damn business, just like a woman’s decision to use birth control is none of theirs.

  3. Unfortunately, there is no law requiring pharmacists to fill the prescription regardless of their personal feelings or beliefs. Unless state legislatures pass a law making it illegal for a pharmacist to refuse to fill a legal prescription you are going to have to have that conversation. Lucky for you, living in Seattle, you are less likely to have a pharmacist who objects to birth control.

    I feel for the women who live in rural counties in the Midwest and South. Planned Parenthood locations are few and far between and under constant siege by local parties. I believe that these are the areas where the test case that brings about legislation will end up happening.

    A young woman in her twenties has been raped and is refused the “morning-after” pill, told that it would make her and the pharmacist murderers. She is directed to a pharmacy over an hour away that will fill her legal prescription. Overcome by her confusion and shock, she succumbs to the false guilt and shame inspired by the exchange and kills herself. Her parents sue the pharmacist and drug store chain for contributing to wrongful death.

    How high do you think this would have to go in the courts before someone in a State legislature introduced a law compelling pharmacists to do their job without inflicting their personal beliefs onto their customers? My guess is pretty darn high.

    In the State of Washington there is no requirement for the pharmacist to fill the prescription just a lot of rules about the prescriptions they fill. http://www.leg.wa.gov/WAC/index.cfm?section=246-863-095&fuseaction=section

    Perhaps, we should start a letter campaign or some kind of petition to submit to the State Department of Health requesting a rule change for the Pharmacy Board that requires all licensed pharmacists to fill all legal prescriptions presented within a timely fashion. What do you think?

  4. Brilliant idea. I am always frustrated by not knowing what, exactly, to do. Wouldja draft it? Your articulation is so much better than my stuttering outrage.

    All the women at the dinner table last night were up in arms about this. I can promise you at least four correspondents. Not much, but it’s a start.

  5. I sent an email to the Washington State Department of Health’s “Health Professions Quality Assurance” office:

    “Do pharmacists have the right to refuse to fill a legal prescription for any reason? If yes, what are those reasons? If no, please indicate where this restriction is stated and how it is enforced.” Thank you for your help.

    This is the office that handles complaints about state licensed health care workers and pharmacists are considered part of that tribe. So, let’s see what this group has to say. I will go ahead an put together a draft but first I would like to see what the State’s official position is on this issue.

    There is no point haranguing our State elected officials if policy is already stated and enforced. But that wouldn’t stop me from helping women in other states where there is no legal standard and enforcement.

  6. NARAL has a petition about this: I just got it sent to me from ActForChange. With one click, they’ll forward your letter of complaint to walmart & a half-dozen other large drug stores. It might not make much of a difference, but at least it’s something. Forty-five seconds later, you’ll get an infuriating auto-reply email from walmart explaining that they respect their pharmacists’ “right of conscience.” But if enough of us send this, then maybe walmart will change? I’m an optimist.

  7. My friend A. just sent me email about this which I thought was worth sharing:

    Imagine a guy goes into the pharmacy for Viagra, and the pharmacist is all: “Sir, I’ll need to see your marriage license in order to dispense this.” I doubt it. It’s all about discriminating against women … men are so terrified of women’s sexuality and the power to give birth that they have to control it. Argh.

  8. How nice for Wal-Mart to respect the “right of conscience” for their pharmacists while denying the majority of their employees adequate health care. Unfortunately, IMO, the only kind of consumer pressure that Wal-Mart would understand is the kind that keeps people out of their stores. The states need to compel pharmacists to fulfill their duties or get out of the drug store.

  9. Here is a link to Majikthise that has a map with states that either have laws allowing pharmacists to refuse to dispense meds on “moral” grounds, states that are considering similar measures and 5 states that are considering laws to compel pharmacists to fill any and all legal prescriptions. http://majikthise.typepad.com/majikthise_/2005/03/why_pharmacist_.html

    Still waiting to hear back from WA DOH – but I think we should consider pushing the state legislature to pass a law compelling pharmacists to fill any and all legal prescriptions.

  10. Here is the first response I got back from the DOH:

    Dear Theresa,

    Please refer to WAC 246-863-095 (1f), RCW 69.41.040, and RCW 69.50.308 (3e) (attached). These rules and laws elucidate the pharmacist’s responsibilities when interpreting and filling prescription medications. A pharmacist who receives a prescription that is not issued pursuant to applicable state/federal statutes and regulations must not be filled. A complete listing of pharmacy laws and regulations can be found at http://www.doh.wa.gov/pharmacy. Thank You.

    http://www.leg.wa.gov/RCW/index.cfm?section=69.50.308&fuseaction=section
    http://www.leg.wa.gov/RCW/index.cfm?section=69.41.040&fuseaction=section
    http://www.leg.wa.gov/WAC/index.cfm?section=246-863-095&fuseaction=section

    Sincerely,

    Andrew Mecca, R.Ph.
    Pharmacist Consultant-Board of Pharmacy
    Department of Health
    PO Box 47863
    Olympia, WA 98504-7863
    Voice: (360)236-4831 Fax: (360)586-4359
    Andrew.Mecca@doh.wa.gov

    And here is my response:

    Dear Andrew,

    Thank you for this information, much of which I had already found on your very well executed and informative website. However, I should have asked a much more blunt question:

    In the State of Washington may a pharmacist refuse to fill a legal prescription for oral contraception or RU-486 for personal reasons, i.e. they are morally opposed or they are a member of a church that opposes the use of the drug(s)? I don’t see anything in the statutes that require a pharmacist to fill a legal prescription regardless of their personal, religious beliefs.

    I look forward to the answer to this question and l appreciate your time in assisting me with this matter.

    Best regards,

    Theresa Christiani

    Yeah, yeah, it’s Theresa as in “the little flower.” What can I say, I was raised Catholic!

  12. Well, it looks like we need to get busy in Washington. Here is the answer to my very pointed question:

    Dear Theresa,

    There is nothing in state statute that requires a pharmacist to fill a prescription. A statute that may be of interest to you is RCW 70.47.160. (attached). In the past, the Board of Pharmacy staff have advised pharmacists that have asked this question to refer the patient and/or prescription to a colleague or pharmacy that may provide the service.

    http://www.leg.wa.gov/RCW/index.cfm?section=70.47.160&fuseaction=section

    Sincerely,

    Andrew Mecca, R.Ph.
    Pharmacist Consultant-Board of Pharmacy
    Department of Health
    PO Box 47863
    Olympia, WA 98504-7863
    Voice: (360)236-4831 Fax: (360)586-4359
    Andrew.Mecca@doh.wa.gov

    This is NOT acceptable. If you are unwilling to perform your job, then you should be fired. This refer to a colleague or other pharmacy is not good enough. So, I am going to draft a letter and put it into a new post. Let’s get busy!

  13. Yesterday, Illinois governor Rod Blagojevich took action to address this issue:

    http://seattletimes.nwsource.com/html/health/2002228473_pharm02.html

    The ruling is only good for 150 days, so it will be interesting to see how it plays out long-term.

    I’m not familiar enough with Washington law to know if our governor is authorized to issue a similar ruling. If she is, it’s good to know such a possibility exists, should it be needed.

  14. The NYT had a great editorial on this topic yesterday. A really good read. Ladies, if you want to get something going in WA, let’s talk… I have a few PR braincells to spare for a good cause!

  16. Sorry guys but there ARE OBGYN’s that do not prescribe the morning after pill OR give abortions, and it’s OK for them?????? Every patient has the ability to go to another pharmacy-Your insurance is probably accepted at many other pharmacies in your town. A pharmacist has the right not to participate in something they may not believe in. If I believe an addicted patient is being given RX’s for narcotics by an uncaring or unscrupulus doctor, I CAN AND WILL decline the prescription. I do have the right as a practitioner with a licence I studied for and CONTINUALLY pay for to determine what i will and will not do. If a doctor prescribes a harmful dose I WONT FILL THE PRESCRIPTION. EVEN IF HE TELLS ME TO DO SO. That is my right. I will protect my licence at any cost. Would I dispense the morning after pill? YES I would, oral contraception as well. Even though my religious beliefs prohibit that, my personal beliefs condone it. I just don’t think that because you have a pharmacy, medical or nursing license you HAVE to perform duties you morally just don’t agree with.

  17. You people need to pull you heads out of your asses! I will not fill an rx for the morning after pill. I do not care what the circumstance is! If it is simply because you did not make adequate plans for your birth control issues IN ADVANCE, it’s not my problem. I am a practising Catholic, and I do not condone the murder of innocent lives. My motto in my practice is as follows:

    ” A failure to plan on YOUR part does not constitute an EMERGENCY on MY part!”

    If you were raped, then I guess you better get your ass to the emerg or the police, not to my pharmacy!

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