Letters: May 2009

May 1, 2009

Pharmacists speak out about the right to refuse to dispense.

Key Points

Wow! There was a great deal of hostility in the letters written about pharmacists who object on moral grounds to the dispensing of Plan B or contraception! Surely, Drug Topics, you got some less-heated responses, or responses supporting the other position. Where are their letters?

The directive of the pharmacist to [leave] and not let the door hit you on the way out was appalling. Are there not morally objectionable parts of many jobs? Should no one do them? Yes, pharmacists do have a duty to serve all patients but no, pharmacists should NOT check their faith at the door.

Debbie Reed, RPh
RICHMOND, VA

David Dworsky, BSPharm, RPh
WEXFORD, PA

I have more baby boomers using [birth control] for HRT, both pre- and post-menopausal, as well as for other problems. Other women use it for endometriosis, regulation, etc. My practice is only concerned with the proper use of the drug, not religious or pro-life objectives. Another common misconception is with regard to the use of the Plan B pill. I am sick of hearing that [religion is] the only reason a pharmacist has to reject giving this. We never hear or respect the pharmacist who follows best practices. I have worked in a clinic where nurse practitioners and physicians prescribe this drug "prn" and it easily becomes a patient's primary means of birth control. If I see a patient falling into this trend, I will cut them off after their last dose and contact the prescriber, letting them know that the patient needs to have an alternative method of birth control.

Kathleen Schilli, PharmD
ONTARIO, CA

In response to "Pharmacies have a duty to serve all patients, and the pharmacists need to check their religious views at the door," pharmacists must have the option to deny service based on "religious views," especially with regard to dispensing abortifacients. One of the ways birth control pills work is by causing abortions, preventing the fertilized egg from attaching to the uterine wall, killing a growing baby. Some of us prefer to let God be the judge.

Gary J. Kassel, RPh
ALMA, WI

I, too, am shocked. I am shocked that some think we should leave our ethics and beliefs outside of the pharmacy. Plenty of pharmacies dispense oral contraceptives, Plan B, and other products that might be objectionable to others. Physicians are free to prescribe or not prescribe these products and no one gets upset. Physicians may or may not choose to perform abortions and, again, no one gets upset. But let one pharmacist decline to sell Plan B because of their moral convictions and it is deemed an outrage. What is an outrage is that we are to be robotic dispensers of whatever medication a customer is seeking.

Ron Bowie, D.P
HASTINGS, NE

Unlike [letter writer John Pattison; Letters, March 2009], I am not shocked by the outcome of the October Instant Poll. As a group, pharmacists have very strong and deliberate moral and ethical character. However, I am disturbed by the angst apparent in the two letters regarding pharmacists' right to refuse to fill prescriptions based on moral objections. As professionals, pharmacists (or nurses, physicians, or any other licensed healthcare practitioners) are not pawns of the government or their employers. We are professionals and, as such, bring a code of ethics and morals to our practice settings. We do not - nor should we be forced - to "check them at the door." Would you want to be forced to participate in an execution by lethal injection if you are opposed to capital punishment?

J. Ray Sprout, RPh
SHINGLEHOUSE, PA

Pharmacy is a profession with multiple opportunities for practitioners of diverse faiths, and yes, even consciences! Pharmacists no more have to check their religion at the door than they would check their personalities, beliefs, or any other facets of what makes them human.

Edward S. King, RPh
ROCKY RIVER, OH

Does every physician have an obligation to perform abortions and prescribe abortifacients and contraceptives, regardless of his/her beliefs? Does every nurse have an obligation to assist in abortions, regardless of his/her beliefs? Does every physician and nurse have an obligation to "serve all patients" if that is what the patient wants, regardless of his/her own feelings? Of course not. But for some reason, [some] pharmacists believe other pharmacists should not have a right to politely refuse to fill a prescription. Funny; refusal used to be common if drug abuse was suspected (a bit of a moral judgement, I would say), but it is unacceptable if pro-life issues are involved.

Mark Schexnayder, PharmD
FARMVILLE, VA

I must assume your magazine is pro-choice, since in March you featured letters only from pharmacists who favor dispensing the morning-after pill. Seems like one from each side would have been fair.

W. Sammy Brown, RPh
FLOWERY BRANCH, GA