As a nation, the United States of America contains a diverse population with different, and often times opposing, view points on subjects. One of those populations of people is health care professionals. We are by no means a harmonious group, and often times we disagree on therapies, guidelines, and diagnosis of patients. Our opinions are based off of multiple factors including morality and ethics. Recently the exercise of personal morality in the work place has come under attack in the pharmaceutical world, specifically in relation to a pharmacist’s right to refuse to dispense a medication.
Over the past years, this protection has grown to collect pharmacists under its wings. The need for this protection rose with the increasing use of emergency contraceptives, specifically when the “morning-after pill” (Plan B) was given non-prescription status and was made available for the public at large. There have been pharmacists who have moral issues with the use of medications which prevent implantation of the egg (fertilized or unfertilized) into the lining of the uterus, thereby causing expulsion of the egg from the body.
Medical professionals enter the field for many reasons, but at the center is a desire to help patients and improve a person’s quality life. However, every health professional has personal morals, ethics, and biases that will come into play in their practice. It is impossible for any person to effectively perform at their job without have a central belief driving them. The issue of refusing to dispense a medication is especially important to a Christian pharmacist looking at going into practice. Although not every Christian pharmacist is opposed to dispensing emergency contraception and normal contraceptives, our profession needs the same protection, as doctors, by law to have the freedom to choose.
Some may argue that there is nothing wrong with dispensing a medication such as Plan B, because it will not terminate a pregnancy by attacking the egg (fertilized or not) but I see no difference. Every medication taken with the intent to abort a fertilized female egg is unmoral and no pharmacist should be forced to dispense a drug that is being used for an unethical procedure. I believe that we should be given the same right as a medical doctor, and be given the option to practice our profession based on the morals that are the very essence of who we are.
There has been some effort taken to resolve this issue. Two major pharmaceutical organizations, APhA and ASHP, have released statement stating their view and opinion of the ability of a pharmacist to refuse to dispense a medication. Both of these national organizations support a pharmacist’s right to refuse to dispense a medication they believe to be unethical, based on their moral or religious beliefs, as long as the patient can gain access to the necessary medication within the appropriate time period.
Many states are of like mind, and have taken the initiative to establish regulations and laws about a pharmacist’s ability to refuse to dispense a medication. South Dakota was the first state to adopt a conscience clause, in 1998, other states soon followed suit. California has established that pharmacists are only allowed to refuse to dispense if they have their managers approval and the patient is able to access the medication within an appropriate time period. The majority of states that have passed legislation give a pharmacist the ability to refuse to dispense based on morals or religious beliefs, without facing legal repercussions.
As of February of 2011, these states include Florida, Georgia, Colorado, Idaho, Maine, Mississippi, Tennessee, and Washington. However, Illinois currently has an emergency clause that requires pharmacists to dispense contraception regardless of moral or ethical beliefs. Following suit, the state of New Jersey has established a clause that prohibits a pharmacist from refusing to dispense on a moral, ethical or religious basis. In addition some cities and businesses are addressing this issue before it becomes a problem. For example, Austin, Texas, has established a law that requires pharmacies that are enrolled in the cities medical assistance program to fill all legal prescriptions or give a patient access to the medication.
This issue is not going to go away as long as there people in the world with differing view points. As time progresses and religious freedom continues to be restricted, pharmacists will rely on the conscience clauses being established now for job security when they practice based on their moral or religious beliefs. I believe it is imperative for every state and company to establish a policy or law relating to a pharmacist specifically.
If we leave the regulations as they are now, there could very possibly by multiple law suits against pharmacists across the country for exercising their religious beliefs in practice. By working with our national organizations and state legislatures, we may be able to come to a conclusion and establish guidelines for pharmacists so that we are not vulnerable and forced to act against our principles.
Thoughts? Comment below!