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March 30, 2005

Why pharmacist malpractice matters

Amy Sullivan writes:

The Washington Post says there is, devoting a frontpage article to the issue on Monday, declaring: "Pharmacists' Rights at Front of New Debate." But let's look closer. "Some pharmacists across the country are refusing to fill prescriptions for birth control..." "The trend has opend a new front in the nation's battle over reproductive rights..." Says Steven Aden of the Christian Legal Society, "More and more pharmacists are becoming aware of their right to conscientiously refuse..." [...]

Hmm. What kind of a sample are we talking about here? Is a trend thousands of pharmacists? Hundreds? Even a few dozen? Halfway through the piece, reporter Rob Stein admits that "no one knows exactly how often [this] is happening" but notes that cases have been reported in ten states.

Never you mind whether this is a real problem or a trumped-up political issue on both sides, though, because, as we are told in melodramatic fashion: "Pharmacists often risk dismissal or other disciplinary action to stand up for their beliefs, while shaken teenage girls and women desperately call their doctors, frequently late at night, after being turned away by sometimes-lecturing men and women in white coats." [Emphasis added.]

This is a political issue, but it's hardly trumped-up. The issue is not how many wingnut pharmacists are currently refusing to supply birth control but rather how many states permit them to do so and how many more jurisdictions may soon give their pharmacists the right to opt out of modern scientific medicine.

Friends of unwanted pregnancy want to give pharmacists a special dispensation to refuse legally prescribed contraception--a practice that directly or indirectly violates all eight articles of the American Pharmacists Association's Code of Ethics for Pharmacists.

The majority of pharmacists are employees of large drugstore chains. Not unreasonably, most drugstores demand that every pharmacist fill every prescription from every licensed prescriber for every paying customer. These chains reserve the right to fire any pharmacist whose "scruples" interfere with the fundamental condition of his employment. (Except, of course, where local laws prohibit them from doing so.)

So-called "pharmacists' rights" groups are demanding impunity for pharmacists who refuse to fill prescriptions. Ortho Tri-Cyclen alone is among the the top 25 most-commonly prescribed branded drugs in America. These rankings don't even reflect the combined popularity of smaller BCP brands and generic BCP. Given that contraception is bread and butter for most pharmacies, any pharmacist who won't fill a BCP prescription is a worthless employee who deserves to be fired. If I were a pharmacy manager it would be one of the first questions I'd ask any potential pharmacist, out of concern for my bottom line, if nothing else. (I don't know of if so-called conscience clauses prevent pharmacy owners from asking job candidates if they intend to do their jobs.)

Pharmacists who won't do their jobs don't deserve special protection. As healthcare professionals, they are responsible for doing what is medically best for each patient--and since staying non-pregnant is medically safer than being pregnant or getting an abortion, a pharmacist has no right to disregard a pregnancy-preventing prescription.

Pharmacists who refuse to honor legitimate prescriptions should be subject not only to job action by their employers but also to malpractice suits for any damages their primitive superstitions might cause their patients. This goes double for pharmacists who are so ignorant as to claim exemption on the groups that emergency contraception is abortion. Any pharmacist who is so unclear on the basic facts of human reproduction is a quack who deserves to lose his license regardless of his prescription-filling predilections.

Update, granted, Pharmacists For Life is a slick and well-funded lobby group who seems to be getting a free ride publicity-wise. [Media Matters]

[However,] a quick glance at the map shows how far this theocratic madness has already spread:


According to Pharmacists for Life, Illinois also has a so-called "conscience clause" for all healthcare professionals and Ohio is currently considering a similar measure.


There's no reason to tolerate pharmacists who refuse to do what they are required to do. There's also no reason to "solve" the problem posed by these pharmacists. But I'll do it: if you're such a pharmacist, quit. If you employ one, fire him. If you discover your pharmacist is one of these logic-challenged people, get another pharmacist. There, "solved."

This is not a real problem. They made it up.

I have been a pharmacist for almost 25 years, and do not understand why, suddenly, pharmacists have decided to take up this issue. Does anyone know who these pharmacists are?????? Are they new grads? I am embarrassed for our profession by their behavior. There are always a few extreme attitudes in any profession, but this has crossed the line of ethics. It seems to me that what will be necessary to stop this insolent behavior by a few activists pharmacists, is for someone to actually become pregnant because of the lack of birth control, and to subsequently sue the individual pharmacist as well as the pharmacy that they work for. There was a classic lawsuit against a Revco pharmacist, years ago, in which a pharmacist refused to refill a birth control prescription for a patient who was out of refills. One would think that the pharmacists was within the law, but the patient became pregnant due to missing several pills, and wound up suing the pharmacist. The patient won the suit and the pharmacist was required to pay a child support payment for that child until it turned 18 years old. Maybe something like that would put a stop to this nonsense that is going on.

Regarding the right to know "why" someone is filling a prescription, legally the pharmacist is supposed to know. When Medicare begins paying for prescriptions in 2006, a diagnosis will be required for each prescription filled, so that isn't really an argument. Most pharmacists care very much about their patients/customers, and want to help them. Knowing what is wrong helps to fulfill their duty to warn. Law in this state requires for pharmacists to obtain disease states and conditions and a personal offer to counsel each new medication. So offering quality pharmaceutial care isn't the issue. The issue it these nuts that are not offering care at all. And, by-the-way, the prescription itself is a legal document and belongs to the patient. It is always the property of the patient's. The pharmacist is required to keep it only if he fills the prescription or if the doctor orders him to do so. So, keeping the hard copy prescription should be challenged in a courtroom. This just isn't right.

Lastly, most retail pharmacists are in the business of selling a product. In these days of competition of mail order pharmacies and Canadian pharmacies, I can't believe that a community pharmacist in our country would behave in this manner and deprive patients of access of medication that the patient and prescriber decided to be their treatment. This is absurd.

With powers like these, i can rule the world.

I went to this website........what a kook! You have got to be kidding? Is this the one that has stirred up all this garbage and triggered the recent headlines? If so, she should be disciplined by her State Board of Pharmacy for unethical behavior. Unbelievable!

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