some questions for pharmacists

You’ve no doubt heard that some pharmacists are refusing to fill birth control and morning-after pill prescriptions based on ethical and religious views. It seems that some state legislatures are now considering whether or not pharmacists can be required to dispense medication if it goes against their beliefs or moral frameworks.

Now, to my mind, pharmacists have no right to choose at will which prescriptions they will or won’t fill. At the very least, it seems to me, they have a moral and ethical obligation to meet the needs of their patients. If you can get a prescription for a drug, then you ought to be able to get that prescription filled at any pharmacy you choose. Allowing pharmacists to elect not to fill a prescription because they don’t believe in its telos seems to me to be a step down a path that we as a society would be better off not taking. Of course that’s all just personal opinion and not based on any knowledge of pharmacists and their trade or of the legal aspects of this, so I am appealing to you pharmacists out there for your opinions and understandings of the issue. But first, a little personal anecdote to illustrate why the implications of this trouble me.

In the Fall of 2003, I was embroiled in one of the more difficult periods of my graduate school career. I was a teaching assistant for the first time and had three seminars that required a slew of papers and an outrageous amount of reading. In short, I was highly stressed and wasn’t getting much sleep. I began to develop a collection of bumps on my left arm and a shooting pain whenever anything came into contact with the skin on the left half of my torso. Come to find out, I had shingles (which, as you may know, is a form of the herpes virus). To treat it, my doctor prescribed Valtrex, which is probably best known from those commercials with the sappy music and people running on the beach proclaiming that genital herpes will not keep them from playing Frisbee with their dog. Now, suppose my pharmacist refused to fill my prescription for Valtrex based on a mistaken belief that I had a sexually transmitted disease, and that I was therefore a promiscuous slut who had casual sex with any person or farm animal I could get my hands on: should I have to drive from pharmacy to pharmacy inquiring as to each pharmacist’s ethical and religious beliefs in order to get my prescription filled?

Republican Congresswoman Marilyn Musgrave says yes. We shouldn’t allow a “matter of convenience” to trump a “matter of conscience”. Perhaps it is only a matter of convenience for those of us who live in communities with a Walgreens and CVS on every corner (although I think it’s a bit more complicated than that). But what of those who live in small towns where there’s only one pharmacy, or in rural areas where one must drive several towns over to get to the only pharmacy in a 100 mile radius? Is it really only a “matter of convenience” for them? And besides, how are we to know which pharmacists will fill which prescriptions? Do I have to drive to every pharmacy around, begging to have my prescription filled? Or will pharmacies be required to post signs outside their businesses: “Doug works Mondays and Thursdays from 8 to 6 and has philosophical reservations about the following medications.”

Of course, I really have no reason to worry about whether or not my prescription needs will be met: this is primarily an issue of women’s rights. Were I a woman, I might have an anecdote like the woman on NPR this morning who was ridiculed and refused treatment by a pharmacist for seeking to have a birth control prescription filled. You can rest assured that a bill requiring pharmacists to fill all prescriptions they are presented with would be passed in a flash if some rogue pharmacist somewhere was refusing to fill an order for Viagra. But that doesn’t mean that we shouldn’t all be concerned about this.

So some questions for pharmacists: are the ethics of filling prescriptions something that is addressed in pharmacy school? Should pharmacists be required to fill all prescriptions that come their way? Do pharmacists take the Hippocratic oath, and if so, how does that factor in? Is there any sort of pharmacist creed or ethics handbook that deals with this sort of stuff?