I often enjoy the "JP At Large" columns in Drug Topics. However, I strongly object to the author's assertion, in "A wart on our nose", that a pharmacist's refusal to dispense prescriptions (e.g., emergency contraception) for religious or moral reasons is "blatantly unprofessional conduct."

I recognize that differences of opinion exist with respect to abortion and when it is that life begins. The pharmacists whom Mr. Plagakis has criticized believe that life begins when an egg and sperm unite (fertilization), and that interference with implantation of a fertilized egg (one of the actions of hormonal contraceptives) terminates life (i.e., abortion). Can there be any reason that is more important in declining to do something than a belief that taking such an action would contribute to the termination of a human life?

This belief should be respected even if there is disagreement regarding abortion and the point at which life begins.

I swore I wouldn't waste any more of my time on the issue of our right not to fill emergency contraceptives, but I have you to blame for getting me angry again. Personally, I don't have a problem filling these Rxs and want to share my thoughts with you.

One of our California senators authored a bill that would require us to fill "all valid prescriptions without unnecessary delay or interference." She said that "access to pharmaceuticals should depend on medical judgment, not personal ideology." The bill says that if the item is not in stock, the pharmacy must order it, or, if the customer prefers, transfer it to another pharmacy or give the Rx back.

I wrote to the senator and asked her to answer the following questions for me:

To my amazement, I received a reply. It was a form letter, addressed to "Dear Friend." It thanked me for sharing my thoughts with her and said, "Should I have the opportunity to consider legislation on this or similar issues, I will keep your views in mind." That sure made me proud to be represented by her.

Legislators, insurance companies, and HMOs target the weakest link in the healthcare delivery system-us. We are too fragmented to have a strong single voice. Someone said, "If you get crumbs thrown at you, remember someone has a loaf of bread." We have a lot of crumbs surrounding that wart on our noses.

Harry H. Ambrunn, R.Ph.
Seventeen Fifty Medical Center Pharmacy Inc.
Burlingame, Calif.

Tit for tat

This is the conversation between a pharmacist and the CEO of a major airline who stops at the pharmacy to pick up a refill:

Pharmacist: How may I help you?

CEO: I'm here to pick up my prescription refill.

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