Looks like Walgreen's has improved their policy regarding refusal ..

[Maat]

to fill prescriptions for birth control pills:

http://www.mndaily.com/articles/2005/07/27/64850

"A recent victory for the organization was when Walgreens amended its Pharmacist Refusal Clause. This clause stated that if a pharmacist refuses to fill a prescription, usually birth control or emergency contraceptives, on the basis of his or her “moral beliefs,” the customer was sent to another store to get her prescription filled. The amended policy places this burden back on Walgreens, making the company deliver the prescription from another store to the store the customer is at, or the customer’s house, in a timely manner. This insures that women are able to receive their prescription without undue burden or distress. Actions such as NOW’s campaign and others provide some light in the dark, uphill battle for the preservation of women’s reproductive rights."

Another DUer brought the article up in the context of the bill they are trying to pass, or have passed, in Wisconsin.

[ugarte]

1. Thank God for NOW

Gotta love those strong women.

[Maat]

3. Yep.

Peace,

[kestrel91316]

12. We proudly call ourselves FEMINISTS nt

[SeanQuinn]

2. Well done. I like that, but prefer CVS' plan.

We'll give you the birth control pills. Period.

[Maat]

4. I do like the CVS plan.

Unfortunately, there is not one around us.

[Ilsa]

5. My God, with college rape as bad as it is,

can you imagine not having wmergency birth control available? Or RU486 if the first one fails?

[Ian David]

6. While I oppose any attempt to refuse birth control, here is an idea:

Anyone working at a 24-hour pharmacy MUST fill ALL prescriptions-- period.

Not just during late hours. Always. If they don't like it, they can get a job at a pharmacy that isn't open 24-hours.

Meanwhile, states should refuse to license pharmacists (or even pharmacies) that discriminate.

Also, here's another idea:

Refuse to sell ANYTHING to people on Sundays if they are wearing a cross.

[SeanQuinn]

8. I disagree Ian.

I'm a church-going Catholic and proud supporter of birth control.Religion doesn't define everything.

[Ian David]

9. I know. I'm not trying to really make any assumptions about individuals...

I apologize if you think I've insulted you.

The target of the protest wouldn't be individual christians... but would instead be intended to trigger the outrage of christian organizations.

If someone like you walked in on a Sunday and I refused to sell you something, it would be unfortunate that I'd piss you off.

However, having you go to Agape Press and get the story circulated far and wide would be the actual goal.

To make the point, "Hey, what if someone did it to YOU..."

Does that sound better, or is it still a bad idea?

[SeanQuinn]

13. Sounds better, but a note for the future

Instead of cross, a "Moral Majority" or "Focus on the Family" pin. That is less of a general statement and I'd not get on your case. ;)

[Ian David]

14. I don't think I've ever seen one of those. Have any pictures? n/t

[SeanQuinn]

15. If they exist..I have no idea. I don't think they do.

But I know a "Support Family Values" pin exists..oy.

[MockSwede]

16. 24 hours or nothing.

This is NOT about discrimination.

No pharmacist can be forced to practice against his moral or ethical choices, just like nurses and physicians are not forced to participate in abortions and euthanasia, etc. Not by the board of pharmacy not by the employer not by the public.

IF a pharmacist refuses to fill such a prescription as being discussed, he/she must return prescription or transfer prescription to pharmacist who will fill. It is UNprofessional to do otherwise and is grounds for sanction by the board of pharmacy. This is what has happened in each of the three cases I know of where pharmacist overtly OBSTRUCTED prescription versus caused reasonable delay due to redirection/transfer.

Inconvenience does not trump morals, which is why pharmacists presenting to a board of pharmacy for state licensure not only have to have the educational requirements but also 'good moral character' and 'honorable reputation', just like nurses and physician before their respective boards.

Please check article BELOW by David Work, Executive Director of the NC Board of Pharmacy, on page 13 of the July 25, 2005, issue of DRUG TOPICS.

I hope this provides some more background from inside the profession.

ARTICLE HERE:

In February of 2004, the North Carolina Board of Pharmacy received a consumer complaint about a pharmacist who declined to dispense a prescription for Preven—a product used for emergency contraception (EC)—based on his religious beliefs. The board initiated an investigation; however, the complaint was later withdrawn. Much publicity has focused on this kind of conduct. As a result, the North Carolina pharmacy board adopted the following policy during its meeting in April.

Conscience concerns in pharmacist decisions A pharmacist should function by serving the individual, community, and societal needs, while respecting the autonomy and dignity of each patient. The best practice by a pharmacist is to promote the good for every patient in a caring, compassionate, and confidential manner. Pharmacists should discuss and resolve any questions about emergency contraception prior to employment. Compassionate care and conscientious objection are not mutually exclusive.

A pharmacist has the right to avoid being complicit in behavior that is inconsistent with his or her morals or ethics. It is unacceptable, however, for pharmacists to impose their moral or ethical beliefs on the patients they serve. Pharmacists who object to providing a medication for a patient on this basis alone, therefore, should take proactive measures so as not to obstruct a patient's right to obtain such medication.

The board notes that although pharmacists have a right to avoid moral or ethical conflict, they do not have a right to obstruct otherwise legitimate prescription dispensing or delivery solely on the basis of conscientious objection.

Board of pharmacy staff interprets this policy to mean that if a pharmacist refuses to fill a prescription for emergency contraception, then that pharmacist has an obligation to get the patient and the prescription to a pharmacist who will dispense that prescription in a timely manner.

In the widespread media coverage of this issue, the terms contraception and abortion have been not been properly defined. So, first, we need to settle on a standard definition of terms. Conception occurs and pregnancy begins when a fertilized egg attaches to the wall of a woman's uterus. Preventing the fertilization or attachment is standard contraception accepted by nearly everyone.

Recent research indicates that some products suppress ovulation when the chance of conception is highest or obstruct penetration of the egg by sperm. In the normal life of a sexually active female, there are many instances when a fertilized egg fails to attach to the uterine wall and is expelled as part of the menstrual cycle. Dislodging and expelling the fertilized egg from the uterine wall is abortion. By definition, contraception is not abortion.

EC acts by preventing a fertilized egg from attaching to the uterine wall. Missed birth control pills or rape can produce an urgent need for EC. Time is of the essence in this situation because the drug should be administered within 72 hours of intercourse to be effective.

Consuming a large dose of a standard oral contraceptive can also prevent attachment. The only drug used in contemporary medical practice that causes an abortion is RU-486 (mifepristone, Danco Laboratories). Federal rules require this product to be provided only by a physician, and R.Ph.s do not dispense it.

A pregnancy could result if a pharmacist declines to dispense EC and fails to refer the patient to another source. This pharmacist could have liability exposure for the tort of "wrongful conception," which is recognized in many states.

In one published case from Michigan, an R.Ph. negligently dispensed the wrong drug instead of an oral contraceptive, and the patient became pregnant. Damages could include medical expenses, pain and suffering, emotional distress, and so on, but not the cost of raising the child. If the pregnant patient decides to have an abortion, it is possible the R.Ph. could also be liable for that expense. If the pharmacist intentionally refuses to dispense the Rx, and that is found to be willful and wanton misconduct, then punitive damages may be possible. This is a straightforward malpractice case in which an R.Ph. has a duty established by the pharmacy board or by expert testimony and fails or refuses to comply with that duty. And damages are a direct result of that conduct.

Pharmacists need to check the law in their individual state for concepts such as "wrongful conception" and "wrongful life" or similar torts.


(Doubled the cut and paste.)


http://www.drugtopics.com/drugtopics/article/articleDetail.jsp?id=171440

[iverglas]

17. hey -- you're right!

No pharmacist can be forced to practice against his moral or ethical choices ...

"He" is PERFECTLY FREE TO STOP PRACTISING PHARMACY any time "he" likes.

Ain't freedom a wonderful thing?

If a restaurant owner doesn't want to serve people of colour, s/he is perfectly free to close the restaurant.

If a property owner doesn't want to rent to Jews, s/he is perfectly free to sell the building.

If an employer doesn't want to hire women, s/he is perfectly free to hire no one at all.


IF a pharmacist refuses to fill such a prescription as being discussed, he/she must return prescription or transfer prescription to pharmacist who will fill.

And a restaurateur who refuses to serve people of colour may direct customers to the lunch counter down the street; a property owner who refuses to rent to Jews may direct them to the apartment building on the other side of town; an employer who refuses to hire women may offer them advice on how to start up a baby-sitting business.

Recent research indicates that some products suppress ovulation when the chance of conception is highest or obstruct penetration of the egg by sperm. In the normal life of a sexually active female, there are many instances when a fertilized egg fails to attach to the uterine wall and is expelled as part of the menstrual cycle. Dislodging and expelling the fertilized egg from the uterine wall is abortion. By definition, contraception is not abortion.

EC acts by preventing a fertilized egg from attaching to the uterine wall. Missed birth control pills or rape can produce an urgent need for EC. Time is of the essence in this situation because the drug should be administered within 72 hours of intercourse to be effective.

EC is INTENDED TO ACT, and DOES ACT, by preventing ovulation.

There are THEORIES that EC acts by preventing implantation, *IF* it fails to prevent ovulation (e.g. if ovulation has already occurred).

I have yet to see facts that CONFIRM these theories -- that demonstrate that this DOES happen and HAS happened.

And even if the theories were confirmed -- so what? The INTENDED effect of the medication dispensed is to prevent ovulation. The reason for which the medication was prescribed, and the reason for which the pharmacist is dispensing it, is to prevent ovulation.

If pharmacists are going to start worrying about the possibility of a medication preventing implantation of a fertilized ovum in a woman's uterus, we're looking down a long and very slippery slope. And the pharmacists aren't even starting at the top of it. There are scads of medications that can act as "abortifacients" AFTER implantation -- i.e. after the actual commencement of a true pregnancy.

If these pharmacists' delicate sensibilities are offended by the THEORETICAL possibility that a drug they dispense will prevent implantation of a fertilized ovum in a woman's uterus, how can they possibly not be concerned about drugs that may actually cause abortion, or cause harm to a fetus?

http://www.druginfonet.com/pi_mfr/ppi/merck/zocor/zocor.htm

Women who are or may become pregnant: Pregnant women should not take ZOCOR because it may harm the fetus. Women of childbearing age should not take ZOCOR unless it is highly unlikely that they will become pregnant. If a woman does become pregnant while on ZOCOR, she should stop taking the drug and talk to her doctor at once.

A pharmacist will properly advise a female client of child-bearing age of this risk. But the pharmacist's job is then done; s/he does NOT administer a pregnancy test to the woman in order to decide whether it would offend his/her sensibilities to dispense the drug to her.

A pharmacist being asked to dispense EC has no more idea whether the woman to whom it is dispensed has a fertilized ovum in her body than s/he has whether the woman to whom Zocor is dispensed is pregnant or might become pregnant while taking it.

These vicious hypocrites are claiming to be entitled to refuse to dispense a legal, prescribed medication based on nothing more than a hypothetical effect of the medication -- in a scenario that will NEVER materialize in the case of a woman for whom the drug prevents ovulation, or in whose body no ovum that is released is fertilized.

Compassionate care and conscientious objection are not mutually exclusive.

They most definitely ARE mutually exclusive when the pharmacist's "conscientious objection" is used as an excuse to DENY the service that the pharmacist is permitted by society to provide.

This IS about discrimination, purely and simply.

[Ian David]

7. Do any of them refuse to sell cigarettes on moral grounds?

Wouldn't it be fun to watch someone come into a 24-hour pharmacy at 3 AM and send them into hysterics when they can't get their cigarettes?

hee hee...

[noamnety]

10. We need someone to do that

No joke.

We need someone willing to get a part-time job at Walgreens, and refuse to sell cigarettes, someone willing to get themselves fired for it in a publicity stunt.

[Ian David]

11. Agreed! My wife would kill me if *I* did it though

We need someone retired who isn't really looking for a job.

[iverglas]

18. in Canada ...

Pharmacies are not permitted to sell cigarettes; haven't been for quite a few years.

(Actually, I'm not sure about other provinces, but the practice was banned in Ontario in 1994.)

http://epe.lac-bac.gc.ca/100/201/300/cdn_medical_association/cmaj/vol-154/0230e.htm

Canadian Medical Association Journal 1996; 154: 230-232

How have pharmacists reacted to the ban on the sale of cigarettes in drugstores? A court challenge by a small group did not succeed, and since then, says Leroy Fevang, executive director of the Canadian Pharmaceutical Association (CPA), "it's almost a nonissue." The CPA, which fought long to persuade its members to stop selling tobacco, welcomes Ontario's legislation.

Jim Dunsdon, registrar of the Ontario College of Pharmacists, personally believes the sale of tobacco "is incompatible with the role of the pharmacist." Generally Ontario pharmacists are complying with the act, he says, although a few are circumventing the law by subdividing their store or setting up separate kiosks. Apparently this is legal; the law says that cigarettes may not be sold in pharmacies, not that pharmacists may not sell cigarettes. Dunsdon is not happy with this situation, but says it's not his job to impose his principles on others.

Selling cigarettes is not a matter wtihin a pharmacist's professional job description; it's a personal, business activity. The fact that pharmacists own and operate businesses that involve much more than dispensing medications creates conflicts like this -- as one pharmacist pointed out, he also sells chocolate bars, which are "bad for" people; that's a bit of an overstatement. In this case, the line has been drawn to exclude the sale of things that are rather undeniably "bad for" people.

[Shallah Kali]

25. Or what of Viagra, Cialis, etc. unless for use by married man for procreat

? Or what of a Christian Scientist pharmacist who refuses to sell ALL medications? Or Scientologist who refuses psychatric meds? What happens when a Christian Identity or related group memeber doesn't want to provide medications to non-white, non-christians? How much grief would the pharmacist get for any of these?

[Isntapundit]

27. Better yet...

Get a Mormon to take a job in a Starbucks and refuse to serve Coffee.}(

[HockeyMom]

19. It's spreading to other medications,

such as mood stabilizers and pain medication. If they can get away with birth control pills based on their "conscience", what other medications will their RELIGION not let them dispense?

[TheDebbieDee]

20. "What other medications will their RELIGION.....

not let them dispense?"

Exactly, Hockeymom. Where is the line drawn?

[MountainLaurel]

21. Excellent point

Especially in light of recent events, such as the parents convicted of negligence because their baby died of an easily-treated infection because their sect required prayer and prohibited medical intervention. What if that father or mother was a pharmacist? Would they refuse to fill any prescription?

And how about psychiatric medications: I was taught in a more mainstream fundamentalist church (no faith healing, snake handling, speaking in tongues) that mental illness does not exist, and psychology is a secular exemplar of man's selfish nature. Would the pharmacists from that church refuse to fill a prescription for Ativan or Effexor?

Another big problem could be treatment of STDs like gonorrhea or AIDS. Fred Phelps isn't the only one who says AIDS is a gift from Gawd to kill the homosexual menace: You'll hear that shit in many mainstream churches on Sunday morning. Will those pharmacists feel emboldened enough to refuse to fill prescriptions for AIDS patients? What about methadone for recovering addicts?

That loud noise you heard was the sound of thousands of cans of worms being opened by these religious conscience laws.

:scared:

[iverglas]

22. yup

And as I noted in my other post, the particular problem of a medication being "abortifacient" extends far beyond contraceptives. Many common and important medications can harm fetuses (which I have to assume these righteous pharmacists would be very concerned about) or interrupt pregnancies.

Would the pharmacists from that church refuse to fill a prescription for Ativan or Effexor?

And here's where the real point about "freedom" comes in, as it relates to the pharmacists themselves.

We may not prohibit, say, Scientologists from becoming pharmacists. That would be intolerable discrimination.

We simply do not have to tolerate anyone practising a profession, or carrying on a business that is subject to public regulation, in whatever manner s/he chooses to do it, for whatever reason s/he may have, where it is done contrary to the public's / the client's interests, for reasons having nothing to do with those interests.

*If* someone chooses to practise a profession or carry on a business in such a way as to interfere in other individuals' ability to do things that we consider it important that people be able to do -- e.g. rent housing, purchase goods at retail, secure employment, obtain the professional services that they need in what they regard as their best interests -- *then* we may, if they persist, impose sanctions on them.

It's beyond me how anyone could agree that property owners should be prohibited from refusing to rent to Jews, or employers should be prohibited from refusing to hire women, or restaurateurs should be prohibited from refusing to serve people of colour ... and yet approve of permitting pharmacists to refuse to serve women who have a need that only a pharmacist may meet.

Pharmacists practice in the public interest and the client's interest, first and foremost, and it is up to the public and the client, not pharmacists, except in matters within pharmacists' professional and not personal judgment, to decide what that is.

Any pharmacist who does not accept and abide by that simple and fundamental ethical/professional requirement simply does not meet the requirements for practising pharmacy.

[MountainLaurel]

23. Amen, sister

From iverglas:

It's beyond me how anyone could agree that property owners should be prohibited from refusing to rent to Jews, or employers should be prohibited from refusing to hire women, or restaurateurs should be prohibited from refusing to serve people of colour ... and yet approve of permitting pharmacists to refuse to serve women who have a need that only a pharmacist may meet.

Pharmacists practice in the public interest and the client's interest, first and foremost, and it is up to the public and the client, not pharmacists, except in matters within pharmacists' professional and not personal judgment, to decide what that is.

Any pharmacist who does not accept and abide by that simple and fundamental ethical/professional requirement simply does not meet the requirements for practising pharmacy.

[Baltimore]

24. Illinois

In Illinois Governor Rod Blagojevich has made it against the law to refuse a woman her birth control pills.

[Shallah Kali]

26. Petition to get other pharms do to the same:

http://www.thepetitionsite.com/takeaction/792375278

In my state not only can they refuse to give BC and EC but *any* medication that they feel is 'inappropriate'. Check if your state has a similar law:
http://www.naral.org/yourstate/whodecides/states/



Maine - my state:
http://www.naral.org/yourstate/whodecides/states/maine/issue.cfm?issueid=2628

PHARMACIST REFUSAL CLAUSE


Maine allows pharmacists to refuse to fill or refill prescriptions.


To whom does the refusal clause apply? Pharmacists.


What does the refusal clause allow? Pharmacists or persons acting at the direction of pharmacists may refuse to fill or refill any prescription if unsatisfied about the legitimacy or appropriateness of any prescription presented, the validity of photographic identification, or the identity of any patient presenting a prescription or any person acting on behalf of the patient.


Does the law require the refusing individual or entity to notify the persons affected? No.


Are there circumstances under which a refusal clause may not be exercised? No.


Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for prescription services? No.


Does the law provide a mechanism for women to otherwise obtain specific reproductive health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.