Prescription Morality

My friend John R. sent me his thoughts on an interesting trend seen in many parts of the country. Some pharmacists are refusing to give people their prescriptions if those prescriptions conflict with their arbitrary moral beliefs. Some might say it's tantamout to refusing medical care if you don't like something about the patient. It's a tactic that an enlightened society should find disgusting and dangerous. In his comments presented here in their entirety, John says that the Law -- so often the bulwark against the frightened bleatings of the irrational -- could set things right here:

-------------------------------

This is a situation that has received a little attention in the news lately, but not nearly enough, in my humble opinion. Recently, in the Northeast, as well as other parts of the country, pharmacists have refused to fill prescriptions for routine contraceptives, such as birth-control pills, citing moral objections, forcing patients to return later or go store to store, and in some instances, missing doses because of the delay.

This is an unacceptable situation. These alarming cases highlight the need for a federal law to ensure patients get their prescriptions filled in a timely manner. It is unfortunate that such a law would be necessary, but apparently it is.

Of course, pharmacists, like other professionals, are human beings with opinions, values and religious beliefs. But a firefighter cannot refuse to douse a burning home because he or she objects to a family situation or lifestyle, such as a gay couple or an interracial couple. Nor can a pharmacist substitute his or her judgment for that of a physician or a customer -- and they should not be in the business of creating undue hardships for patients who have limited opportunities, because of the number of pharmacies or access to transportation in an area, to get their prescriptions filled.

Furthermore, customers should not have to go into a drugstore worrying about being subjected to another individual's moral judgment, no matter what they are purchasing, as long as that item is legal. Whether or not you approve of birth control in general, from condoms to the pill, or the morning-after pill specifically, the fact of the matter is: They are legal.

Certainly, pharmacists serve a valuable role in determining whether a patient's prescriptions conflict with or counteract each other, but they should not be in the position of determining whether medication is morally "right" -- or, to take this reasoning to the not-unforeseeable extreme, whether certain segments of society are worthy of receiving medication at all. It is up to a physician and a patient to determine the best course of action for that particular individual. Period.

The American Pharmacists Association says pharmacists should not be required to fill certain prescriptions if they have personal objections. However, the organization says, they should ensure that there are alternatives in place, such as referring the patient to another pharmacist on duty.

That is the goal of the federal Access to Legal Pharmaceuticals Act, which was introduced in the U.S. House and Senate in April. The legislation would recognize the right of pharmacists to hold personal religious beliefs, but would make sure that does not impede a patient's access to legal prescriptions, including contraception.

The bill, introduced by U.S. Rep. Carolyn Maloney, D-N.Y., and Sen. Frank Lautenberg, D-N.J., would allow an individual pharmacist to refuse to dispense contraception, but require the pharmacy to ensure that someone else there fills the prescription in a timely manner. The bill would make sure that a patient's prescription is filled without delay or harassment, regardless of the religious or moral beliefs of a specific pharmacist. Since the proposed legislation does nothing to resolve the issue in a small pharmacy with only one pharmacist on duty, owners of those shops should be prepared to lose regular customers if their pharmacists are allowed to dictate morality in dispensing prescriptions.

Personally, I think this bill, while not ideal (in that it does not force pharmacists to provide medication regardless of their personal moral beliefs, which would be a similar standard under which physicians operate), is the best middle ground for which we can hope in the philopolitical atmosphere of our current national debate. While a compromise solution, it remains a solution nonetheless, and should be supported.

And as a final warning to pharmacists out there -- speaking in my capacity as an attorney, and in particular a tort litigator, I would be very cautious in counseling clients that they were free to refuse to dispense medication based on moral or religious grounds, merely because a professional association allows that behavior. In our current highly litigious culture, creative tort theory is ever evolving, and I would not want to be in a courtroom for a case of first impression where a woman brings suit against a pharmacist for monetary damages as the result of an unwanted pregnancy caused by that pharmacist's refusal to dispense the morning-after pill on a timely basis. Too far-fetched you say? You would be surprised...