Disclaimer: The purpose of this discussion is really to focus on
a pharmacist's right to refuse the filling of a prescription based on
their moral or ethical beliefs. It is NOT about what constitutes an abortion and whether abortion should be legal. I will not hesitate to reject comments that I feel are straying into this area.
Take a look at these articles from NEJM and Obstet Gynecol.
While the main topic surrounds one or two scenarios in particular,
what are some other instances or medications where conscientious
objection becomes controversial?
Mentors, what guidance can you give the students as they begin to form their professional opinion of a difficult subject?
What opinions do the pharmacy organizations have on this subject?
What states have laws addressing a pharmacist's right to refuse?
What are your thoughts? I'm sure that we'll have some good discussion of this topic.
49 comments:
I think as medical professionals our opinions and beliefs shouldn't be thrown into the mix. Medicine is a science and not tied to any kind of emotionally driven system. Should we be able to deny diabetic medicine to an overweight patient who smokes? Technically, they are "abusing" the medication since they are not willing to make any kind of lifestyle change. I really think we have to be careful when throwing our opinions and feelings into the mix because it's not really our place to tell a patient they should or shouldn't do something. When asked for counseling we can give our professional opinions based on interactions etc, but not what they should do in their everyday life.
"Pharmacists are not automatons completing tasks; they are integral members of the health care team. Thus, it seems inappropriate and condescending to question a pharmacist’s right to exercise personal judgment in refusing to fill certain prescriptions." This statement from The Limits of Conscientious Objection article pretty much sums up how I feel about this area of debate. A Pharmacist is indeed a professional. We go through 4 years of graduate school, many of us do residencies, and then pass a licensing exam JUST LIKE PHYSICIANS DO. If a physician has the right to tell a patient they do not think they need medication for whatever ails them, then we should also have the right to refuse to fill a prescription we think may be unnecessary, or even abusive.
Avoiding the controversial debate of emergency contraceptives and even birth controls, I would say that "conscientious objection" pops up most with prescriptions written for narcotics, specifically opioids. I have seen people come up to the pharmacy counter and hand me a prescription for 180 oxycodone/acetominophen. After checking to see if we even had that many, I asked my pharmacist if he would be okay with filling that much. While the women who handed me the prescription looked pretty "rough" and acted like she was already slightly sedated, my pharmacist filled it anyway, saying "You don't know what she might be going through. She could be terminally ill." This opened my eyes as to what assumptions we make without even noticing. This "right" we have should be exercised with extreme caution.
I have my own (very strong) opinions regarding a pharmacist's refusal to sell certain items. However, as a matter of policy, I know that if I wish to make my own decisions, I have to let others make their own decisions. This is the curse of a free society, but one that must be suffered if freedom is worth perpetuating.
-Craig Douglas
This issue is broader than contraceptives. Regardless of your stance on issues such as abortion, it is important to keep in mind that as a pharmacist, we should try to separate our moral opinions from our practices and stay professional. The pharmacist is does not always know the patient’s reasoning for using medication, and it could be for an issue other than what the medication is typically used for where the implication of refusing to fill the prescription could affect the patient’s health. Although I believe we shouldn’t completely abandon personal opinion, we should keep in mind that the overall goal is to think professionally to best serve the patient.
I think that denying people medication is outrageous, no matter what the medication is or what a pharmacists views on it are. Law making is not the job of pharmacist rather it is the job of government officials. Therefore a pharmacist, I do not feel, has any right to deny medication to a patient because it their right and their personal choice to take it. If there is a question on the dosing then a pharmacist can contact a physician, but I feel denying a patient medication infringes on a patient's right to access to it and is essentially stepping outside of the role of being a pharmacist.
-Nick Scaturo
This issue of conscientious objection is a very heated and controversial topic. In my opinion, as medical professionals, we should have the right to refuse to fill a prescription if it conflicts with our morals or beliefs, or if we feel it is not in the best interest of the patient. However, we should never, under any circumstances, harass or belittle the patient. As we learned in critical thinking, the first rule/step to critical thinking is to suspend judgement. We do not know why the patient has been prescribed a certain medication (as with the 14 year old girl in the second article) and even if we did, we should never judge or belittle a patient. If it is against your moral or religious conviction not to prescribe a particular medication you should politely tell them that you are unable to fill the prescription, but will provide them with someone who can. I do not believe a pharmacist should have to go against their morals; however, I do not think this should effect the patient ultimately getting their medication or leave them feeling embarrassed or berated.
In the pharmacies where I have worked, I have heard every pharmacist that worked there say “I have the right to refuse filling this medication.” In fact, I’ve seen signs posted in the pharmacy that is clearly visible stating that exact fact. I do believe that the pharmacist has a right to refuse the fill of a script. However, I think they should use their best judgment when doing so. Seeing a prescription and automatically refusing to fill it is not good practice. Our first point in critical thinking is to suspend judgment. Taking the time to figure out why a patient might need a particular medication or a situation they’re experiencing is important before jumping to a conclusion. Like mentioned in the article about a 14 year old female who had bleeding trouble and was prescribed birth control. The pharmacist automatically assumed it was to prevent pregnancy and a form of abortion. He insulted this patient and mother without evening knowing the situation. Therefore, I think it’s extremely important to figure out the situation if a certain prescription does bother a pharmacist. Now granted, upon examination, if a prescription truly isn’t legitimate (it’s tampered with), suspicion of addiction (no insurance, comes in with a crowd, etc), or you truly don’t believe in dispensing that drug, then that should be the pharmacist’s call because in the end it’s their license.
-Aaron Shaver
I personally feel that as a professional your individual feelings should not factor into deciding what is best for the patient. I feel that if a patient comes to the pharmacy to pick up their medications the pharmacist can counsel the patient on the side effects or warnings but does not have the right to refrain from giving them the prescription if it against their religion, such as birth controls or plan B. I feel like by going into the medical field you have to put aside your beliefs and do what is best for the patient.
Lora Steffner
I think denying medication is up to the pharmacist, but it should only be exercised if dispensing or selling the medication puts a patient's life or health at risk. If dispensing Plan B could potentially cause dangerous side effects for the woman buying it, I think the pharmacist should be able to refuse. However, if the pharmacist is denying the patient this medication due to his or her beliefs about abortion, I don't really think that is the pharmacist's call. Another example is selling syringes to people without having an insulin (or other injectable medication) prescription on file. Even if the customer is using the syringes for illegal drugs which are potentially very dangerous, the pharmacist has no way of knowing if that is actually why the customer is buying them. I think everyone probably has their opinions about taking certain medications, but I really don't think it's the pharmacist's right to decide what is right and what is wrong.
I completely agree with Morgan’s post about “exercising extreme caution” when refusing to fill a medication. It is unprofessional to read into a patient’s situation, and it reflects poorly on the individual who constantly relies on assumptions to make decisions. We are not the police; however, we do have a responsibility to take great care when dispensing prescriptions.
I think the freedom to refuse filling a prescription should exist, but I do not think it should be used to prevent patients from purchasing certain medications. For example, the NEJM mentioned refusing to fill drugs for a HIV positive patient or an unmarried man who has a script for Sildenafil. I don’t think there is room or time for judgments to be made in the pharmacy, and the article states that pharmacists “have an obligation to serve patients without judgment.”
I agree with the following statement from the first article: “Professionals are expected to exercise special skill and care to place the interests of their clients above their own immediate interests.” In my opinion, the pharmacist’s main goal should be to improve a patient’s drug therapy. Lots of times this goal will interfere with the pharmacist’s moral and ethical values, like the pharmacist who refused to dispense the emergency contraceptive. In cases like this, the pharmacist needs to set aside their personal opinion for a while and focus on the patient.
As medical professionals, we have a right to do what we believe is in the best interest of the patient, not what is in the best interest of our personal beliefs. If a patient comes into our pharmacy for help, especially if they have a prescription from their doctor, we as pharmacists have no right to intervene. It is a patient's decision, with her doctor's guidance what she chooses to do and regardless of our personal religious beliefs, we need to act professionally and do our job. The pharmacy is not the place to get on your soap box about your personal beliefs. It is a place to help the patient.
Sherry Robles
Like many have said, I believe that a Pharmacist has a job to dispense medication, but also to ensure patient safety at all times. The only time I believe a Pharmacist should refuse to dispense, is if there is a possibility of imminent danger to the patient.
Every person has their own set of morals, but when at work, as a medical professional, these beliefs or morals should be put aside.
There are many things personally I think are not right in the world, but as a pharmacist, it is my duty to serve and be a patient advocate, not a preacher!
Elizabeth Patrick
As practicing professionals in the field of pharmacy, I believe we as pharmacists should have the right to refuse a patient medication. The fact that we are professionals does not change the fact that we have the freedom to practice and uphold our own morals and beliefs. However, I do believe that pharmacists should do the very best they can for any and every patient. If it is in the best interest of a patient to receive a medication, that medication should be given to the patient. If opposition arises, a pharmacist should be able to refuse the release of medication to a patient. However, that pharmacist can direct the patient to another professional who may deem the medication acceptable or necessary. I do not think it is healthy or moral for any pharmacist/professional to go against their religious morals or beliefs. When a pharmacist does go against their own ethics and standards, I feel that it strips away a part of who that pharmacist really is. In my opinion, we cannot practice and remain true to our individuality if we are going against our own beliefs. Instead, redirect a patient to someone who can help them without feeling remorse or guilt because of it. I would also like to add that regardless what the pharmacists beliefs are, every patient should be treated with care and respect. No patient should ever feel mistreated.
Kaila Sims
ok so this is a very controversial topic. Whether I agree with this or not the tone in the second article is disrespectful to the profession of pharmacy. The way they said that we have customers and not patients. They just simply did not giving us the respect that our profession deserves. It could be that they just don't understand our side our things.
As far as this topic goes. I don't think you can just seperate your beliefs from your work. For me personally, my beliefs make up the core of who I am. They are the foundation for my values. If you ask me to seperate them I wouldn't even know how to because they are an integral part of who I am. Therefore, as for this issue I feel that they should have the right not to fill it if they don't want to. However, again people should utilize caution when making judgements or choices and they should consider their patients as well. I just don't think it is right to say that they have to do something they just don't believe in.
I believe that pharmacists should have the right to refuse filling a medication in only in extreme situations where the patient could potentially be at a severe health risk. In this case, I think it is the pharmacist's responsibility to contact the doctor but ultimately letting the physician make the change. I think that when working in a profession such as pharmacy, your own morals and values should stay separate from work and should not intervene. What you think is right or wrong might not be in the best interest of the patient and this is what you ultimately work to do. I agree with the statement in the article, Refusals by Pharmacists to Dispense Emergency Contraception, that states, "...pharmacists do not exercise full autonomous control and authority over their area of expertise." Patients go to the pharmacy to have a prescription filled that was previously discussed between the patient and physician. Physicians still maintain the care of the patient, the care is not transferred to the pharmacist. If the pharmacist is questioning any part of the RX, they should contact the prescriber and obtain clarification. In retail settings, pharmacists do not see medical histories, perform physical exams, or interpret any lab results. In cases like this, they are not in a position to refuse a medication simply because they do not think it is right.
"I will consider the welfare of humanity and relief of human suffering my primary concerns.
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." These are the opening lines of the oath of pharmacy. If pharmacists are to refuse dispensing products because of their own moral beliefs, they may be violating their own oath. If our job is to better serve humankind, it may be better to leave personal objections at the door.
Off the topic, but the second article (the Wall/Brown article) was unbelievably offensive (and this is coming from someone who wasn't that upset about the pharmacist scope of practice article from earlier). Dr. Wall and Brown say that we suffer from "incomplete professionalization" and then say we have more in common with corporate managers, retailers, and the business community than a traditional "learned" professional. Then they base the entire crux of their argument on a hypothetical case, with a hypothetical "Mrs. Jones," who got poor care from a hypothetical pharmacist! And they have the gall to call us unprofessional? Making up a fake story to prove their made up point is the definition of unprofessional. And it's also unbelievably lazy writing.
~Chris Pavero
I believe that the topic of conscientious objection although is heated, should not be. I believe as healthcare professionals, pharmacists are there to serve and better the patient in the most effective way. Once in the workplace, the individuals' own beliefs should be left at the door and not by any means be inflicted on the patient. If a patient comes in to the pharmacy with a prescription that can cause harm or safety issues to the patient, the pharmacist should make the patient aware of these risks and let the patient make the decision of whether or not they want it filled or want to take the medication. However, if it does not directly relate to patient counseling, the pharmacist should keep recommendations to him or herself. The patient is the first priority of the pharmacist and situations should be handled as so without judgement. The pharmacist should also refrain from belittling the patient on their decisions and/or life choices because it is the job of the pharmacist to make the patient better, not make them feel worse. I don't believe a pharmacist should have the right to deny a prescription to a patient no matter the situation, however if there are safety issues I believe the patient should be counseled and advised but the decision should still be their own. As for over the counter medications such as Plan B, I still believe 100% it is the choice of the patient.
I think that we need to maintain a professional attitude when it comes to our jobs as pharmacist. Our job is to help with the well being of patients. If that includes something we may not necessarily agree with, then so be it. I've always been the type to leave the personal life out of the work life. A high school teacher said to me one time "work while you work, and play while you play, but don't mix the two." And I have not, nor do I plan on changing that once I graduate.
Rich Wall
As other folks have stated, the tone of the Obstet Gynecol article was extremely off-putting; it portrayed pharmacists as ignorant, incapable, and uninformed. Really a terrible piece of writing. At the same time, there can be a benefit to seeing the other side of an issue, even if it is an extreme one. On the issue at hand, I don't believe that anyone can operate in a moral vacuum, even in a professional setting. As pharmacists, it will be our goal to provide to highest standard of care to each of our patients, but its hard to govern how we make those provisions. I was amused with the examples of not providing AIDS medications to questionable patients or insulin to obese people because those because those scenarios would require reckless judgement of a patient. And if we have learned anything from Lorne and Critical Thinking it is that we, as professionals, are expected to suspend judgement. Though those examples are a little far-fetched, they are not outside the realm of possibility, depending on the character of the individual. And it become harder and harder to draw the line between conscientious objection and spiteful refusal, as soon as we start to mettle with it. I have worked with pharmacists before who have not dispensed certain medications, and others who have refused to fill certain prescriptions based on the current circumstances. I would say that pharmacists should still retain the right to not fill certain prescriptions, most often in cases of patient detriment or known fraudulence. As for birth control specifically, I feel like it should be treated like any other medication. That is, in accordance with law, if the pharmacist is unable or unwilling to fill the prescription, they need to provide the patient with an alternate means of filling it. You can't just leave a patient hanging out to dry, especially in circumstances where they are unable to fend for themselves. I hope that in my professional studies, I am able to gain a working knowledge to base my opinions off of in the future, as I develop as a professional.
Jesse R Alvarado
I personally do not think it is necessary to give pharmacists the ability to refuse the filling of a prescription based off of moral or ethical beliefs. Pharmacists should only be rejecting the filing of a prescription for medically relevant reasons. The duty of a pharmacist is to reject a prescription if they note that the prescription has potential to be dangerous to the patient, according to medical reasons of scientific backing (i.e. drug interactions, allergies, etc.). A medical professional needs to uphold the standards and ultimate missions of health care and quality of patient care. He or she needs to recognize their own personal bias and have the ability to leave judgment at home.
Although North Carolina’s law allows pharmacists the right to refuse a prescription based off of moral or ethical beliefs, they do require that the pharmacist provides alternative sources for the patient. Though this law appears to be a very democratic way to accommodate all beliefs, it does raise a few issues. If a pharmacist feels strongly enough to refuse the dispensing of a specific drug (in some cases, at the expense of their own business), how can we be sure that the refusing pharmacists are fulfilling their responsibility of providing the patient with another option? If the pharmacist is allowed to express their negative opinion on Plan B, for example, the patient may feel undue judgment. Patients should never have reason to fear the judgment of medical professionals; they should that they are in a safe environment, free to express their concerns and to discuss matters of their health without being wary of any possible breaches of confidentiality and privacy.
My job as a pharmacist is not to push my feelings or beliefs on someone else. Just as i expect others to not push theirs on me. I am not here to judge or make decisions that will affect the lives of my patients or customers (as I should call them based on the second article, which is laughable) just because I don't agree with their choices. What if I didn't believe that ADHD existed? That those were just bad kids, with bad parents (I do believe that it is a certified condition, I'm not trying to offend anyone here). Should I refuse to fill the prescribed medication order? No. That is not my job. My job is to ensure the safety and accuracy of the order and communicate any issues, i.e. side effects or dosage information among other things, that the patient may encounter. I am not God, nor do I play one behind the counter.
-Zach Robinson
In every area of life we must choose whether or not to speak our opinions and act according to our own individual beliefs. How and when we decide to do this varies. Personally, I do not believe that just because I step into a professional positional I should abandon my morals and values. These are the very values and morals that have gotten me this far in life. That does not mean I let them control and overtake a situation. In order to exhibit professionalism you must expend the best judgment possible. I wouldn't feel comfortable compromising my values or beliefs, it takes applying them to each individual situation and not making assumptions. We are required to make medical judgments based on what we find to be best for our patient's therefore we must form an educated opinion/idea about what to do. If, as one article suggested, I serve the community and view them as customers than I wouldn't care about their well-being or what they are doing, what they are putting in their body, why they are taking something. The clerk at the cash register doesn't question the customers they check out as to why they are buying something. Just the differences in wording makes me feel more responsible for their well being which in turn makes me care for what they are doing or getting. So yes, including your own personal values when deciding whether to fill a medication is a tricky scenario, but sometimes we need to follow our gut, ask questions, and do what we think is best. We will go through plenty of schooling to get into a pharmacy, we have to trust ourselves to decipher black, white, and grey areas in all questionable situations. For me to feel secure in what I do, knowing I'm doing it to the best of my ability and upholding certain standards I will need to hold onto my moral values and beliefs because they have shaped me and drive me in every choice/decision I make.
The 1st Amendment of the US Constitution should not be limited when we put on our white coats at work. My freedoms to speak my mind and to conduct myself however I so desire are absolutely guaranteed by the highest law in the land. If I choose not to sell a customer a certain item, that choice is protected by the 1st Amendment. So is my freedom of speech when I express my opinion to that customer. No work contract can negate this fact so long as my actions do not harm others.
The topic of Conscientious Objection is not a matter of opinions or feelings, it is a matter of legality. And it is absolutely protected by law.
I think as pharmacists we should have the right to refuse any prescription or sale in the pharmacy. When we are working in the pharmacy I feel it is our responsibilities to not only keep the patients’ health and safety in mind, but also the staff working in the pharmacy. At the pharmacy where I work we do not sell needles to patients who do not have prescriptions that would require them. When the new location first opened, we did sell needles to anyone who came into the pharmacy and asked. It started out one or two “questionable” patients each day asking for needles. Before long we averaged 10 to 15 needle customers each day who were not buying prescriptions and other items in the store. Many times we would find empty packages from where they would come in and shop lift. People were soliciting the parking lot after closing hours and customers were complaining about used needles. I know it’s not right to judge people based on their appearance. Abusers are going to abuse weather we sell them the needle or they use a dirty one. I just know that once we started asking for proof for needle sales, the sketchy traffic slowed down. It made me feel especially uncomfortable late at night when only a few employees would be working in the store and the patient asking for needles was obviously impaired.
I personally believe that as a pharmacist, I should be able to reserve the right to deny filling a prescription. I understand the point made by my fellow classmates when they say that they do not want to mix their emotions and/or beliefs into their professional career. Enabling the pharmacist to deny filling a prescription is in no way synonymous to pushing your beliefs on someone. In fact, I believe that pharmacists should never “push” their beliefs on their patients in anyway. I also believe that they should never have to forfeit what they believe in for any reason. Having said this, it is very important for pharmacists not to jump to conclusions regardless of what they believe in. As a few of my classmates have previously stated in this blog, young girls might be prescribed birth control for other indications than preventing pregnancy. Also, a person who comes in regularly to get their narcotics filled might really be terminally ill and they are not just abusing meds. In conclusion, I strongly believe that pharmacists should be able to deny the filling of a prescription as long as they remember to suspend judgment and not jump to conclusions about any patient.
-David Williams
I think pharmacists should have the right refuse to fill a prescription, only if the refusal is due to potential health risks or medical harm to the patient, and not because of moral or ethical beliefs. I think part of the job description of a pharmacist includes having an open mind and setting aside personal beliefs and opinions. Patients expect and deserve impartial care from all members of the healthcare profession, otherwise they might not seek treatment or recommendations out of fear of embarrassment.
Refusing to fill a prescription or sell a particular medication due to moral reasons may completely prevent the patient access to that drug. As the NEJM article mentioned, a patient may live in a rural area, that only has one local pharmacy. In that situation, the patient would not have any other ways to fill their prescription. Also, from my experience in retail pharmacy, there have been patients that rode the bus to the pharmacy, and had just enough change in their pockets to pay for their medicine and the return bus ride home. So if a pharmacist refused to fill that patient's Rx, they could not afford to travel to another pharmacy to obtain their medication. Ultimately, the patient's health or medical condition could be compromised if a pharmacist objects to filling a medication prescribed by a physician or selling a product that a patient has the right to purchase.
I think that if it goes against the morals of a pharmacist to fill a certain prescription then they should have every right to object. On the other hand I do not believe that a pharmacist should object to filling a prescription if they only find moral conflict with one of its indications. He/she should not assume that the patient is using it for the one indication that they find morally wrong. If there was a medication that the pharmacist objected to all of its indications, as is the case with plan b in a lot of examples, I believe it is totally appropriate for a pharmacist to object to filling that prescriptions. No ones morals in any profession should be compromised under any circumstances.
-Emily Heubel
Becoming a pharmacist does not give you the power to deny a person healthcare. You are the one they come to for help, be it pain medications, birth control, or the Plan B pill. You are welcome to have your own opinions, and your morals, but you should not force people to abide by your morals because you put on a white coat. You do not know what their situation is, and you have to believe the best in people. You have to put yourself second, and consider the overall well-being of your patients first. THE PATIENT MUST ALWAYS COME FIRST. You have to realize isn't sacrificing your morals or beliefs, it is helping the patient to the best of your abilities.
I believe the right to refuse a prescription is a practice that needs to be regulated more. The controversy over the Plan B medication is basically a belief controversy. Plan B is not a prescription medication for consumers over 17 years old. A pharmacist would be refusing to sell (or ring the person up) the medication, not refusing to fill a prescription. I think everyone is entitled to their beliefs. But, I believe professionals should be just that - professional. They need to set aside their beliefs and offer the best advice they can when dealing with OTC medications and prescription medications.
This is a very controversial topic in pharmacy. In my opinion, pharmacists should have the right to refuse to fill a prescription if it goes against the pharmacist's morals or religion. During our professional oath, it states that we will uphold our ethics and values. Even though I feel the pharmacist has the right to refuse to fill a prescription, I believe a pharmacist has the obligation to find someone who can help the patient. *Note that I do not think the pharmacist should try to embarrass the patient or try to force values onto the patient.
-Curtis Austin
I believe the right to refuse a sale because of a pharmacist's beliefs should be upheld and respected. Along with this, I also believe that the pharmacist should handle the situation in a professional manner. They should not let their beliefs and personal morals interfere with treatment of the patient. Even though they do not agree with their choice (Plan B) they should still suspend their judgement and advise them on where they would be able to purchase the medication. Pharmacists have an obligation to dispense medication, treat patients, and ensure medication safety. But pharmacists are still people, and should not be asked to compromise their conscious or go against their own beliefs.
I believe that as pharmacists, it is our job to serve the public and not let our moral opinions stand in the way of that job. As a pharmacist and a professional in the medical field, our expertise is on medication. It is not our job to say who can and cannot receive a drug. We may have our own opinions on some controversial topics but they are to be left to ourselves. I believe that the only reason a pharmacist should deny a patient a medication is because it is not in the best interest of the patient on a medical standpoint. Either there is some sort of abuse involved, or the medication is not right for the patient; whatever the reason, it should not by any means be based on a moral opinion. We should not judge any of our customers/patients, and denying a medication based on an opinion is the result of judgment.
I like the fact that The New England journal of medicine (NEJM) provided supporting reasons for both the rights of patients and the Pharmacist as far as filling or selling emergency contraceptive is concerned. I also read The American Pharmacists Association (APhA) policy and found that it supports the rights of pharmacists to refuse to dispense emergency contraception such as Plan B, but recommends that the objecting pharmacist "step away" rather than "in the way" of such a transaction which means that Pharmacist should be allowed to exercise their freedom of moral values. If selling emergency contraceptives to anyone hurts their conscience, I think they should be permitted to do what is right for their conscience. However APhA makes it clear that the pharmacist should not prevent the patient from getting help from another source. I also add that the patient must not be maltreated in any way as well.
Now the question is if no one is available to help the patient, what can be done? That is what makes it a tough choice. If the patient is deprived then professionally, the Pharmacist has not met that goals. Have we thought about it that someone might commit suicide because of an unwanted pregnancy? So I personally think that although any Pharmacist has every right to refuse or dispense emergency contraception to a patient, he or she also has the professional responsibility to find alternative means for that patient to get what she needs. Also if a Pharmacist does not want to sell Plan B because of "high moral values", then where are those values if they treat their fellow human being so rudely and unjustly? Just like the patient who had to go and sit in her car and cry, this is really out of place but unfortunately it is out there so I hope that all the upcoming Pharmacists will remember this and treat all human beings professionally. Let us have empathy for the people that we serve, that is our profession.
- Vida Ohene Agyeman
I feel as if the pharmacist has the right to refuse to sell anything he or she wants to a patient. There is nothing written about what pharmacists have an obligation to dispense and is solely based on their beliefs. If someone comes in and asks for something that such as Plan B and you don't want to sell it to him if you do not want to. If it is against your beliefs you can tell them that they will be able to purchase it at another pharmacy where the pharmacist will be more than happy to dispense it to him.
I believe that this all comes down to professional judgment, which is a vital part in any career. While it is important to not be too judgmental in the field of pharmacy, sometimes we must rely on instincts to make the proper decision. We are geared to focus on patient safety and should be allowed to make decisions that we feel are best for a patient. If this means refusing a sale because you feel it is not right, then I do not see a problem with it. After all, it is our own careers on the line and we want to do everything in our power to maintain good practice.
I can understand how many people might be in favor of "conscientious objection," due to their beliefs, morals, or just personal objections to taking part in supplying patients with certain drugs. I, however disagree with that view, because I feel that becoming a pharmacist is a choice, and in making that choice, we have to decide to commit to supplying all patients with the drugs they are prescribed, according to what is stated by law. I feel that as a professional, it is our duty to put our personal opinions/feelings aside, and treat patient equally to the full extent of our governing laws and regulations, and that includes supplying them with drugs for valid prescriptions.
-Evan Palmieri
As medical professionals we should try our best to hide our own opinions or atleast control them. We have to think about the patient's well being first. By refusing to dispense a patient a medication we may be interferring with their well being. I understand that we should have this right but we need to make sure that when we decide to act on it, it is for the right reasons. For example, we may have to refuse the sell of narcotics to some individuals that we feel are drug seekers. But, whenever we feel that we are going to refuse to dispense a medication to a patient, we should first suspend judgement. Suspend judgement and then critically think about the patients' point of view.
As medical professionals practicing pharmacy, I believe first and foremost that it is our responsibility to put the needs of the patient first, even if that means refusing to fill a prescription if we feel that it is in our best medical judgement. If we do choose not to fill a certain prescription, this should be the exception and not the rule and should only be done after a lot of careful thought. We should also be careful to not unfairly judge the patient's personal circumstances, whatever they might be. Thought it may seem disrespectful to a patient to not fill a prescription, I know from experience that forged prescriptions do make their way to the pharmacy from time to time. Filling these prescriptions then becomes a federal offense, putting the pharmacist's license in jeaopardy. Again, no matter what the situation, we should always use our best professional and impartial judgement, and always look out for the needs of the patient.
While I feel that we should never judge or be disrespectful to a patient, I do believe that there are exceptions when it is in the best interest of the patient to respectfully refuse to fill their prescription. This does not mean that the patient should be belittled in any way. However, I don't see refusing to fill a prescription as being unfair or disrespectful to a patient, as long as the refusal is done in the absolute best interest of the patient. I don't think that prescriptions for emergency contraceptives should be refused, but it must be kept in mind that there are false prescriptions that do make their way to the pharmacy, especially false prescriptions for scheduled drugs. Filling a false prescription may not only hurt the patient, but it puts the pharmacist's license in jeapordy as it is a federal offense. While I don't believe that pharmacists should obstruct the filling/sale of emergency contraceptives, there are cases where it is in the best professional judgement of the pharmacist to refuse to fill.
As health care professionals we should never restrict a patient’s access to medication. This includes emergency contraception. If we as pharmacists intend to be recognized as health care providers and be respected by other health care professionals we need to check our morals at the door. We can advise patients, but it is ultimately their choice to use a medication. We do not have a right to force our beliefs onto someone else. I had a similar experience in my own life. I worked in a laboratory that used aborted fetal livers to obtain a certain type of stem cell for HIV research. Even though I did not agree with the use, I as a professional performed my duties. Many other professionals do not get to pick and choose in their respective fields. Think about public defenders representing a murderer and actually getting them acquitted for it. How about medical doctors that are affiliated with hospitals that are now being forced by law to comply with providing women with all the proper health care. We live in a world that everyone has the ability to be offended by something, but we professionals we need to provide our service to our patients because they also have a say in their healthcare.
I believe that as a professional, a pharmacist should set aside their personal beliefs when filling prescriptions. This topic of conscientious objection is a hot topic in the field of pharmacy. This issue arises most commonly with emergency contraceptives. Many people have very strong beliefs against emergency contraceptives. I believe that if you are a pharmacist and have strong beliefs against emergency contraceptives and will not dispense emergency contraceptives, you must attempt to find an alternative route for the patient. One alternative route can be contacting a near by pharmacy that will dispense the specific medication. With this idea in mind, it is very important to keep in mind that you are a PROFESSIONAL. When refusing to dispense a medication its very important to handle the situation in a professional way. I actually worked at a pharmacy back in Michigan at which the pharmacist would not actually sell emergency contraceptives (Plan B) but was ok with a technician taking care of the transaction. In this case I’m ok with dispensing emergency contraception. The only time I ever refused the sale was when an older gentleman came in wanting four boxes of Plan B. Due to the suspicion of not knowing what this gentleman was actually using these for I refused to sell it. There were many things that crossed my mind, such as, is this person selling them to underage children or not.
Pharmacists should have the right to refuse to fill. If you take our rights and our beliefs out of our profession, how are we different than the InstyMed machine or other computers that dispense medications? We are becoming pharmacists to use our professional judgment and our knowledge to develop with the doctor what is the best therapeutic outcome for the patient.
-Jessica Osteen
I personally think the pharmacist has no right to refuse to fill a prescription. The pharmacist can’t just assume why the patients are asking the specific medicines based on his personal feel or beliefs. Our job, as pharmacists, is to provide patients the best service by offering them the correct medicine not by rejecting their needs. Therefore, if the pharmacist think there are better choices for patients’ better health, he or she must council patients by informing them the side effects of the medicine and the possible harmful situations that can be caused by the medicine.
We have every right -- especially as medical professionals -- to act in accordance to what we believe is in the best interest of our patients, BUT not to the extent of our personal beliefs. Patients who approach our pharmacies deserve to exercise their right to choose or not choose [or deem/not deem] what is appropriate for themselves, whether or not said action agrees with whatever our personal belief and take on the matter may be. There should be no intervention UNLESS for the sole purpose of addressing a medically relevant concern. Should our patients inquire about further issues, we should -- at all costs -- aid them in making informed decisions based on our professional insight... not personal opinion.
-James Agtuca
This is a hot topic because it is easy to see both sides. With that said, I think we are entering pharmacy as professionals of healthcare and the patients are our first concern. Denying a patient a medication because of the pharmacist’s feelings or beliefs would in turn be denying the patient of their feelings or beliefs. I think that the right of refusal should pertain to the specific healthcare of the patient without regards to personal choices or morals. A pharmacist’s job does require the ability to refuse to fill a prescription if it is clear that this is the incorrect treatment for the patient.
I feel that a Pharmacist's feeling should be considered. If their religious beliefs are against the effects of a certain drug, I don't feel that they should be forced to go against their beliefs. That is infringement on their religious beliefs upheld by this countries basic standards. I don't think that someone should be a jerk and judge a person for their decision (especially when they aren't sure what reason a patient or physician has for requesting that drug), but personally, I feel like it could be detrimental to the psychological health of the pharmacist if they felt that they were a part of aiding another in something they didn't think was right. This might sound dramatic, but depending on how into their beliefs they are, being forced to go against their beliefs could lead to self incrimination and depression. Thus I feel that having the choice is the better option.
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