Politics and Religion

Pharmacists refusing to fill prescriptions
The Moose 26 Reviews 7192 reads
posted
1 / 19

Story about some pharmacists who refuse to fill prescriptions for birth control pills, etc. on moral grounds.....

This is absolutely reprehensible....These pharmacists are in no position to play God.....They should change careers if they don't want to fill these prescriptions....I mean, what's next.....You'll have ER physicans refusing to treat people on moral grounds....

Druggists refuse to give out pill
By Charisse Jones, USA TODAY
For a year, Julee Lacey stopped in a CVS pharmacy near her home in a Fort Worth suburb to get refills of her birth-control pills. Then one day last March, the pharmacist refused to fill Lacey's prescription because she did not believe in birth control.

"I was shocked," says Lacey, 33, who was not able to get her prescription until the next day and missed taking one of her pills. "Their job is not to regulate what people take or do. It's just to fill the prescription that was ordered by my physician."

Some pharmacists, however, disagree and refuse on moral grounds to fill prescriptions for contraceptives. And states from Rhode Island to Washington have proposed laws that would protect such decisions.

Mississippi enacted a sweeping statute that went into effect in July that allows health care providers, including pharmacists, to not participate in procedures that go against their conscience. South Dakota and Arkansas already had laws that protect a pharmacist's right to refuse to dispense medicines. Ten other states considered similar bills this year.

The American Pharmacists Association, with 50,000 members, has a policy that says druggists can refuse to fill prescriptions if they object on moral grounds, but they must make arrangements so a patient can still get the pills. Yet some pharmacists have refused to hand the prescription to another druggist to fill.

In Madison, Wis., a pharmacist faces possible disciplinary action by the state pharmacy board for refusing to transfer a woman's prescription for birth-control pills to another druggist or to give the slip back to her. He would not refill it because of his religious views.

Some advocates for women's reproductive rights are worried that such actions by pharmacists and legislatures are gaining momentum.

The U.S. House of Representatives passed a provision in September that would block federal funds from local, state and federal authorities if they make health care workers perform, pay for or make referrals for abortions.

"We have always understood that the battles about abortion were just the tip of a larger ideological iceberg, and that it's really birth control that they're after also," says Gloria Feldt, president of Planned Parenthood Federation of America.

"The explosion in the number of legislative initiatives and the number of individuals who are just saying, 'We're not going to fill that prescription for you because we don't believe in it' is astonishing," she said.

Pharmacists have moved to the front of the debate because of such drugs as the "morning-after" pill, which is emergency contraception that can prevent fertilization if taken within 120 hours of unprotected intercourse.

While some pharmacists cite religious reasons for opposing birth control, others believe life begins with fertilization and see hormonal contraceptives, and the morning-after pill in particular, as capable of causing an abortion.

"I refuse to dispense a drug with a significant mechanism to stop human life," says Karen Brauer, president of the 1,500-member Pharmacists for Life International. Brauer was fired in 1996 after she refused to refill a prescription for birth-control pills at a Kmart in the Cincinnati suburb of Delhi Township.

Lacey, of North Richland Hills, Texas, filed a complaint with the Texas Board of Pharmacy after her prescription was refused in March. In February, another Texas pharmacist at an Eckerd drug store in Denton wouldn't give contraceptives to a woman who was said to be a rape victim.

In the Madison case, pharmacist Neil Noesen, 30, after refusing to refill a birth-control prescription, did not transfer it to another pharmacist or return it to the woman. She was able to get her prescription refilled two days later at the same pharmacy, but she missed a pill because of the delay.

She filed a complaint after the incident occurred in the summer of 2002 in Menomonie, Wis. Christopher Klein, spokesman for Wisconsin's Department of Regulation and Licensing, says the issue is that Noesen didn't transfer or return the prescription. A hearing was held in October. The most severe punishment would be revoking Noesen's pharmacist license, but Klein says that is unlikely.

Susan Winckler, spokeswoman and staff counsel for the American Pharmacists Association, says it is rare that pharmacists refuse to fill a prescription for moral reasons. She says it is even less common for a pharmacist to refuse to provide a referral.

"The reality is every one of those instances is one too many," Winckler says. "Our policy supports stepping away but not obstructing."

In the 1970s, because of abortion and sterilization, some states adopted refusal clauses to allow certain health care professionals to opt out of providing those services. The issue re-emerged in the 1990s, says Adam Sonfield of the Alan Guttmacher Institute, which researches reproductive issues.

Sonfield says medical workers, insurers and employers increasingly want the right to refuse certain services because of medical developments, such as the "morning-after" pill, embryonic stem-cell research and assisted suicide.

"The more health care items you have that people feel are controversial, some people are going to object and want to opt out of being a part of that," he says.

In Wisconsin, a petition drive is underway to revive a proposed law that would protect pharmacists who refuse to prescribe drugs they believe could cause an abortion or be used for assisted suicide.

"It just recognizes that pharmacists should not be forced to choose between their consciences and their livelihoods," says Matt Sande of Pro-Life Wisconsin. "They should not be compelled to become parties to abortion."




-- Modified on 11/15/2004 5:01:18 PM

Number 6 124 Reviews 6271 reads
posted
2 / 19
zinaval 7 Reviews 8239 reads
posted
3 / 19

What would happen to a telephone operator who refused to give out evangelical church numbers on moral grounds?  Or, who during a contentious political campaign, refused to give out numbers to the republican party?  That would be a rather defective telephone operator, I would say.  For the most part, that work is not as critical as the work of a pharmacist.    

I don't consider this to be a "moral" stand.  Underhandedly losing somebody's prescription is neither brave nor honorable; it  is simply harassment, and not aimed at a higher authority, but aimed at someone beneath him, depending on him.

This pharmacist needs to find a new job on moral grounds.  Giving out birth control is nothing new, and he knew very well during training that he would be doing it.  If he objected since then, then it's time to get another career.  That's called moral fortitude.    

If we make moral stands too easy, and they are no longer moral stands, they become state sanctioned mob actions.  Then we will have fascism.  

/Zin  



-- Modified on 11/16/2004 4:07:45 AM

-- Modified on 11/16/2004 4:19:33 AM

zinaval 7 Reviews 5223 reads
posted
4 / 19


I'll tell Eckerds that I'm never buying from them as long as they have a sleazebag on their payroll who has done this.  I'll send them my pharmacy bills over the year to show them the share they will never have.  

I'm going to tell Walgreens that if I ever hear something like that doing this and keeping their jobs, they are going to lose my current business.

/Zin

HarryLime 10 Reviews 7289 reads
posted
5 / 19

There is an earlier thread about this.  Note also that some states in the Red have pending legislation (in some states, existing laws) protecting pharmacists who take these "moral" positions.  

Screw them.  Women who face this kind of discrimination might turn the states a little more Blue in the next election.  Sometimes people have to get slapped up the side of the head before they figure out where their interests lie.  

Harry

upstater 6367 reads
posted
6 / 19

I dont have a dog in this fight but let me take the other side for a minute.

First let me just say the business has to make sure they have coverage and employees who will deliver the customer service required to fill the perscriptions. This issue is no different than observant jews/ muslims/ add your religion here,  who need special days off. Forcing a worker to betray a belief they hold is wrong. As long as the business knows up front they should be able to deal with it.

Its like when they ( left wing activists)try to force catholic hospitals to preform abortions,or hand out birth control to its employees.Its totaly against their beliefs and teachings. Why should they have to accept your condemnation for being observant?
Dont you(lefties) celebrate when people stand up for draft dodging and other acts of civil disobediance?

TheAnswer 51 Reviews 5553 reads
posted
7 / 19

I think its a stupid and senseless thing these pharmacies are doing but completely within their rights in a free society.  As an individual and a business, I have the freedom to believe and act upon anything I want as long as it doesn't impinge upon others for break any laws.  These pharmacies are no different than Walmart not selling CD with explicit lyrics or Blockbuster not selling porn.  They are taking a moral stand against something they think is wrong.  The government shouldn't and won't tell these guys to sell a product they don't want to sell.  THINK ABOUT IT!

Yes, I feel bad for the consumers who have to go elsewhere to get their prescriptions filled, but that's hardly a burning platform to violate the rights of the businesses.  I sincerely hope that these places lose a shitload of business because of this stupid stance, but that's entirely up to the marketplace, not regulators.  And while I also feel bad for those in one-pharmacy towns, there is mail order Rx which is actually cheaper and easier for chronic (e.g., no emergency, continuous) refills like birth control.

To me, the only thing borderline egegious in this case is that the pharmacists won't give the Rx back to the patient, but that's a minor issue: any good physician will just reissue the script or, better yet, send it electronically to another pharmacy.

I don't like the religious right nor do you.  Just remember that by regulating their behavior you're doing exactly what you despise.  You guys gotta see the light on this one.

zinaval 7 Reviews 5350 reads
posted
8 / 19

Those are being put on the books.  Some states want to protect this form of disobedience, thus making it easier to take.  Where is your conservative outrage against this?  Is that substantially different than the Jim Crow laws, protecting businesses that took a "moral stance" against "Negros" mixing with whites like equals?  

I'VE THOUGHT ABOUT IT!!!

What happened was not the policy of a chain, like Walmart, where a product just isn't offered, and it's pretty much an open policy that it isn't offered.  And at least they don't play personally mean practical jokes on you as well: ie, offer you empty Eminem cases for sale at a great discount.  What's happening here are actions by  individuals, not only in a breech of trust with a patient, but a breech of trust with his employer.  Fine, they made their stand.  Fire them.  Have them work in something morally safe.  I won't argue with the egregious case, except to say it will not continue to be the rare egregious case now.    

Calling a doctor back and having him reissue the script may be minor, (although I find doctors hard to get a hold of) unless the next pharmacy has somebody who does the same, or worse, issue placeboes instead as a "morally acceptable" substitute.  

I can take a moral stand as well.  I declare war on a pharmacist who does this, and to the store that doesn't fire him, and on the board that doesn't suspend his license.  Period.  

BTW, I will never shop at a WalMart for the reasons you cited.  I am at war with them.

I did ask, what about the operator who doesn't give out numbers to organizations that he/she objects to?  That would be contemptible.

/Zin






-- Modified on 11/16/2004 9:47:35 AM

The Moose 26 Reviews 6323 reads
posted
9 / 19

While it's true Walmart doesn't have to sell explicit CD's & Blockbuster doesn't have to carry porn, one can argue that a pharmacist not filling a prescription COULD be a life & death matter...It's an apples to oranges comparison....

If a pharmacist doesn't want to fill a prescription for birth control pills, etc. would that be any differnt if he or she would refuse to fill prescription for Niaspan (which lowers LDL cholesterol & raise HDL, or good cholesterol)....They could say "I refuse to fill prescription for Niaspan because people should be able to control cholesterol w/diet & excercise & Niaspan is the easy way out"......Where will it end??

Just like an ER physician has to treat all patients who come in, IMHO, a pharmacist is obligated to fill all prescription (which come from a MD's order) whether they want to or not.....



-- Modified on 11/16/2004 10:30:09 AM

bribite 20 Reviews 9537 reads
posted
10 / 19

Individuals who have such strong personal held positions, should seek other employment, or be made to by their employers.  It should be noted that the states that passed laws protecting the conscience of Pharmacists were passed mainly for the "Abortion Pill", RU486, not intending to cover other birth control medications.  I would support the right of pharmacists to refuse on the issue of RU486, and I know you most likely disagree.  

I would not, however, support legislation on this issue, let the market take care of it.  Those who attempt to impose personal moral beliefs will lose business and it will be a windfall for those to don't.

It might interest you that a substantial amount of MD's serving in the military have refused to do all abortion procedures.  Their right to refuse has been upheld by JAG!

TheAnswer 51 Reviews 6956 reads
posted
11 / 19

OK, good points.  I think you're a wise man to boycott Walmart and think it would be great if you boycotted these pharmacies too.  That's what civil disobedience is all about.  Its this kind of behavior that will marginalize these guys.  In a perfect world, pro choice patients never use these guys but the pro-lifers love them.  Everyone wins, right?

You also rightly argue that if the pharmacist does this against the will of their employer, then they should be fired.  I wholeheartedly agree.

Regarding your 411 operator, I feel that as long as the 411 company discloses this, that is fine.  My hopsital has a physician referral line that only lists their physicians - isn't that the same thing (albeit for economic, not moral reasons).

Here's what I take issue with:

The Eminem CD analogy is bogus.  None of these pharamacists are passing placebos to patients according to the article.  If so, they should be thrown in jail.  I agree.  But, if they are just refusing to fill the script, much different issue.

The Jim Crow law anology is similarly weak.  The most common JC laws mandated that businesses keep whites and blacks separate or forbid businesses from serving blacks.  This was a clear and extreme violation of civil rights.  The pharmacists aren't violating anyone's rights.  They're just choosing which products they want to sell.  

I'm a management consultant and my firm doesn't offer certain products we don't believe are ethical but others do.  We lose many clients as a result.  The only difference might be that pharmacists deal with life dependent drugs.  However, you'll notice many smaller pharmacies don't offer full scope of drugs based on economics.  If we follow your argument, we should force them to carry everything possible, right?

TheAnswer 51 Reviews 5837 reads
posted
12 / 19

You're right in that pharmacists offer a life or death drug, but that's a slippery slope in the other direction.  If we are going to legislate their social responsibility, then shouldn't all pharmacies be required to carry all types of esoteric drugs that they would inevitably lose money on?  

Remember too, there are physicians and hospitals who take moral stands on far greater issues than birth controls.  Catholic hospitals don't offer birth control either, nor do their pharmacies sell the pills.  And, hospitals are the sole community provider more frequently than pharmacies.  Should we require Catholic Hospitals to perform abortions?

Let's take something else controversial - bariatric surgery.  Many hopsitals in fact don't perform it because they DO believe diet and exercise are more effective.  Should we require them to perform the surgery?

Remember, ER physicians must treat all patients regardless of ability to pay.  They are not required to treat all patients regardless of condition or treatment.

JBIRDCA 8 Reviews 6271 reads
posted
14 / 19

and you touched on it in another reply.

If a pharmacy (not the paharmacist) has a moral objection to dispensing a product, all they need do is not stock the product. Then the issue is moot because thy do not carry the product.

If the pharmicist is an employee, then he must adhere to the ethical standards and guidelines of the organization he works for.

Like many "morality" issues, there are compelling arguments to both sides of the issue.

The Moose 26 Reviews 6864 reads
posted
15 / 19

"there are physicians and hospitals who take moral stands on far greater issues than birth controls."

Issues like DNR orders, right to die, etc. make birth control seem rather minor.....

Bariatic surgery I think is only done in morbidly obese cases?; & the jury is still out on the overall benefits of this procedure, plus I think there are still alot of insurance issues to, so to answer- hospitals should not be required to perform it.....

HarryLime 10 Reviews 6411 reads
posted
16 / 19

... If you read my earlier posts, you will see I agree with most of what you say.  However, some points should be made.  

Large pharmacies with contracts with health care providers should live up to their contracts.  They should not be able to violate the terms of these contracts (dispense pills that the Doctor ordered for an agreed price) without dealing with the consequences of violating their contracts.  Since the women who were denied service are the agrieved parties, their rights under equity should be protected:  e.g. they should be able to sue the pharmacy's shorts off for any undesired medical outcomes.  Additionally, the law should insure that the contract holder (the state, the company employing the woman), is also liable since they bear some responsibility for offering a plan that they have not implemented.  People who self insure should also be protected -- a pharmacy that accepts a perscription and then does not fill it has almost certainly violated commercial business law in any state.  The rights of injured people in equity have to be protected.

Pharmacies have a right to any personal policies they want.  They have to implement these policies in the context of their legal obligations to their clients.

If you agree, then let the "pharmacists for life" have their way.

Harry

HarryLime 10 Reviews 7194 reads
posted
17 / 19

... It is a wonderful moral / ethical / legal argument about the pharmacys.  However, if the person who has the expectation of service is not served, they can be injured.  

Pharmacies that don't fill perscriptions for common drugs are probably violating their agreements with providers or ignoring existing commercial law.    They, and the other parties to the contracts, are liable for damages in equity.  The government must insure these rights are protected and smooth the process to make any damaged party whole.

This should include, but not be limited to,

- covering increased costs of filling the prescription elsewhere,
- covering any costs associated with driving and taking time off work to take the
  prerscription elsewhere,
- paying for abortions in the case of unwanted pregnancy,
- paying to raise unwanted children,
- paying for any medical complications associated with pregnancy.
...covering lost wages when unwanted children are born (18 years of them),
...

Do you want to play?  The GOP devil "Trial Lawyers" are licking their lips.

TheAnswer 51 Reviews 6892 reads
posted
18 / 19

Pharmacies have no written or implied contract with the ordering physician (they certainly don't stipulate a price).  Pharmacies do have written contracts with insurers or self insured employers but they do not stipulate which drugs the particularly pharmacy carries nor do they obligate the pharmacy to carry anything particular.  "People" don't self insure, its called not having insurance, so there is certainly no implied or written contract with them.

So, in this context, I guess I don't understand agree with your point.

HarryLime 10 Reviews 7071 reads
posted
19 / 19

... HC contracts are with providers and with Large Pharmicys.  

People not covered by HC contracts do have certain protections.  A pharmacy that accepts a prescription is obligated to fill it.  A pharmacy has a problem if it accepts a prescription, and then refuses to fiill the prescription of moral grounds.   The Pharmacy has liability (IMHO, will be tested in courts I'm sure) if it's "moral decision" results in measurable damage to the customer.  The liability will certainly extend beyond the pharmicist to the pharmacy.  

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