…albeit minor. The AMA is taking on pharmacists’ “moral objections” to filling doctors’ scripts:
The American Medical Association has decided to use its clout to ensure pharmacists’ moral objections don’t block patients’ access to needed medicine, including emergency contraceptives.
The action during the A-M-A’s meeting today in Chicago was prompted by complaints from several physicians’ groups about the growing number of pharmacists refusing to fill prescriptions for contraceptives they consider a form of abortion.
…and a little bonus for those of you who made it this far: an unusually blunt editorial on mental health from the Carlisle Sentinel:
Our services here in Pennsylvania are being reduced. The much-talked-about moves to integrated community care have been improperly coordinated, funded or advanced for years. What care has been provided usually is for very specific types of cases, but the personnel providing care — many of whom are required to have advanced degrees — have been poorly paid.
We don’t have enough psychiatrists. We have criminalized some of the mentally ill. We have turned them into street people through our oh-so-specific rules and lack of care facilities. We have treated mental illness as if it were an orphan of physical illness when it has become evident chemical balances can be involved.
We have crossed the street to get away from any image of that dirty person pushing a packed cart and talking to him- or herself. We have sneaked out of town to get counseling as if it were a shameful thing. Oh, and we’ve gone round and round on the short and long forms of treatment, thrown up our hands at how to get people to stay on their meds and ignored people seeking help for loved ones because we honestly don’t know what to do.
And then we’ve turned around and said we’re doing better.
Read the whole thing for a fine example of what opinion writing ought to be like.
Christian Scientist Pharmacist sues Albertsons
/snark
Thanks for posting a rare sign of sanity! I needed that, it’s been a bleak time.
Thanks for the lift on the prescription b/c front. Bums me out though about the mental health care issues brought forth since my Uncle was fighting PTSD and ended his life and my husband has some same issues. When meeting with a bereavement counselor and explaining my complicated grieving of my Uncle he advised me to read Catch 22…it is my assignment I guess. I never have read it, just started it last night.
I don’t think the idea of “moral objections” can be dismissed entirely. To push it to an extreme, if you were a pharmacist, would you fill a Viagra prescription for a known child molester? Not the same thing, except refusal would also be based on moral objection. Should the government or civil suits force you to fill that prescription? It’s not entirely a black-and-white issue, but I think it could be resolved without compulsion from police or lawyers.
Talk among yourselves.
but being a child molester is illegal, so the basis for refusal would not just be moral objection, it would be public safety.
Being a woman who uses birth control is not illegal…yet at least.
a convicted and released child molester.
But I suppose it’s too inflammatory an example to speak to the principle.
So what about this: does Walmart or Blockbuster have a right to refuse to sell CDs and videos they find objectionable? They do it, so it’s legal. So why should pharmacists have lesser rights? I’m not siding with them — I think they’re nuts — but do we really want to compel everybody by force of law to go against their so-called consciences? What about conscientious objectors to war? Should they just be prosecuted?
I guess I’ve come round to thinking that this is an area where the market really can work, mostly. If a pharmacy or pharmacy chain decided to refuse to fill ANY prescription on “moral grounds” they’d have to put up large notices in their windows and in their ads to the effect that “We only fill prescriptions we personally approve of.” I think Walgreens and CVS would deal swiftly with any employees who put them in the position of doing that.
That leave’s the one-horse little outfit, who I guess I’d tend to leave alone while they lose their last remaining business to Walmart.
One thing that often isn’t taken into account in this debate is that pharmacy is a profession, which carries obligations. The profession of pharmacy has a monopoly on the distribution of prescription drugs. They thus have a duty to not discriminate against anyone. If a pharmacist can’t live with that, in my opinion they should not be in the profession. I planned a diary on this when I had time, but I’m getting ready to move and that has been consuming a lot of my energy. Please read the editorial below in its entirety – it is well worth it.
An editorial titled The Celestial Fire of Conscience — Refusing to Deliver Medical Care in the New England Journal of Medicine addresses this better than I can.
Largely as artifacts of the abortion wars, at least 45 states have “conscience clauses” on their books — laws that balance a physician’s conscientious objection to performing an abortion with the profession’s obligation to afford all patients nondiscriminatory access to services. In most cases, the provision of a referral satisfies one’s professional obligations. But in recent years, with the abortion debate increasingly at the center of wider discussions about euthanasia, assisted suicide, reproductive technology, and embryonic stem-cell research, nurses and pharmacists have begun demanding not only the same right of refusal, but also — because even a referral, in their view, makes one complicit in the objectionable act — a much broader freedom to avoid facilitating a patient’s choices.
There is even a move to make it legal to abstain from counseling about any medical treatment that the provider finds distasteful, such as emergency contraception for rape victims, or treatments eventually developed from embryonic stem cells.
What differentiates the latest round of battles about conscience clauses from those fought by Gandhi and King is the claim of entitlement to what newspaper columnist Ellen Goodman has called “conscience without consequence.”
And of course, the professionals involved seek to protect only themselves from the consequences of their actions — not their patients. In Wisconsin, a pharmacist refused to fill an emergency-contraception prescription for a rape victim; as a result, she became pregnant and subsequently had to seek an abortion. In another Wisconsin case, a pharmacist who views hormonal contraception as a form of abortion refused not only to fill a prescription for birth-control pills but also to return the prescription or transfer it to another pharmacy. The patient, unable to take her pills on time, spent the next month dependent on less effective contraception. Under Wisconsin’s proposed law, such behavior by a pharmacist would be entirely legal and acceptable. And this trend is not limited to pharmacists and physicians; in Illinois, an emergency medical technician refused to take a woman to an abortion clinic, claiming that her own Christian beliefs prevented her from transporting the patient for an elective abortion.
The author talks about how this trend isn’t just expressions of individual conscience, but part of the culture wars.
The editorial then speaks of the necessity of putting in place a system of referrals to ensure that both patients and providers can follow their own conscience.