Debate: Euthanasia (Pharmacist POV)

[Sparda29]

So you're working at the the pharmacy and one day you recieve a prescription for a really high dose of morphine for a patient that you know is not an addict or has developed tolerance to the medication. You call up the physician and he tells you that the patient doesn't wish to live anymore due to illness and he is going to assist the patient in ending his life.

Do you still fill the prescription?

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[eeyore spice]

I don't think that would be any different from filling large amounts of morphine for a hospice patient. With hospice, the point isn't to kill them directly, but you're not taking any steps to prolong their lives or cure their illness.

If the patient walked in and handed me the script, I'd discuss it more with him/her and the doctor, but if this was for someone in hospice, or just with a terminal illness, I'd be okay with it. I think morphine makes a lot more sense than Kevorkian's KCl approach, and if I had a terminal illness, I'd probably start slamming fentanyl, and if I die, so be it. (No, I would never use fentanyl recreationally under any other circumstances.)

Worst case scenario, the patient goes over to the APAP, buys 10 bottles and eats that. Or uses a gun, or tries some other method that may go horribly wrong. If they're sure of what they want, and I have no reason to think that maybe it's depression that can be treated, I don't want to make them suffer by keeping them alive.

 

[evilolive]

I wouldn't mind opiates as a way of biting the dust. Anyone else perversely consider - if they allow euthanasia in the future - how they'd wanna go?

 

[WVUPharm2007]

how they'd wanna go?

123 y/o...coitus induced MI...with 23 year old supermodel..."You were born in '83? Me too!"

 

[TXPharmDStudent]

So you're working at the the pharmacy and one day you recieve a prescription for a really high dose of morphine for a patient that you know is not an addict or has developed tolerance to the medication. You call up the physician and he tells you that the patient doesn't wish to live anymore due to illness and he is going to assist the patient in ending his life.

Do you still fill the prescription?

Yes. If I don't then they'll just shoot themselves or jump off a bridge.


If they are serious about ending their life, they'll do it no matter what your beliefs or morals are. That's why I always laugh when I hear that a girl threatened to commit suicide over a boy breaking up with them. That's a cry for attention, but not in the case you apparently described.

EDIT: People need to realize that you cannot legislate behavior. Just because you make euthanasia illegal does not mean people will stop trying to kill themselves, same thing with marijuana.

 

[SpirivaSunrise]

Big fat hell no.

Posted via Mobile BlackBerry Device

 

[nafcillin]

yes and I hope another doc and pharmacist would show the same kindness to me if I am in that circumstance.

 

[TXPharmDStudent]

Big fat hell no.

Posted via Mobile BlackBerry Device

I'm really interested in why it's not just a no but a big fat no. Why would you refuse when they're just going to go somewhere else to get it filled? Is it because of your morals?

Reminds me of the pharmacists who refuse to sell insulin syringes to obvious druggies. They're gonna get them anyway and I'd rather them shoot up with clean needles than sharing with an HIV patient.

 

[naseuy]

So you're working at the the pharmacy and one day you recieve a prescription for a really high dose of morphine for a patient that you know is not an addict or has developed tolerance to the medication. You call up the physician and he tells you that the patient doesn't wish to live anymore due to illness and he is going to assist the patient in ending his life.

Do you still fill the prescription?

Depends on the my legal responsibilities. I don't have a moral objection to mercy-killings, but I wouldn't put my ass on the line for it.

 

[Priapism321]

Depends on the my legal responsibilities. I don't have a moral objection to mercy-killings, but I wouldn't put my ass on the line for it.

Morals < Ass.........???

 

[ForcedEntry]

You call up the physician and he tells you that the patient doesn't wish to live anymore due to illness and he is going to assist the patient in ending his life.

Do you still fill the prescription?

The Dr. just informed you he was going to murder a patient. NO, I will not be an accessory and I probably should call the authorities.

 

[rx2010]

Before I dispense the order, I would verify with the patient to make sure he/she wants to no longer live due to their horrible illness. If I was terminally ill and in pain and stuck in a bed 24/7, I would rather die and end my misery than to continue living and putting my family through all the trouble of trying to take care of me and worrying constantly.

 

[naseuy]

Morals < Ass.........???

No, since I do not have a moral objection to it. Even if I did, if the laws require me to do dispense, I will.

 

[Praziquantel86]

Before I dispense the order, I would verify with the patient to make sure he/she wants to no longer live due to their horrible illness. If I was terminally ill and in pain and stuck in a bed 24/7, I would rather die and end my misery than to continue living and putting my family through all the trouble of trying to take care of me and worrying constantly.

So instead of the patient worrying about his family, you'll bankrupt your own and leave them father/motherless because you're in jail after being convicted of manslaughter. Seems reasonable.

 

[ForcedEntry]

No, since I do not have a moral objection to it. Even if I did, if the laws require me to do dispense, I will.

The laws require you to use professional judgment, not dispense just because a doctor wrote it.

 

[naseuy]

The laws require you to use professional judgment, not dispense just because a doctor wrote it.

Professional judgment does not equate to injecting your own beliefs and morals into your practice.

 

[rx2010]

So instead of the patient worrying about his family, you'll bankrupt your own and leave them father/motherless because you're in jail after being convicted of manslaughter. Seems reasonable.

It is not illegal in Oregon, so how can I be put in jail for filling something a physician wrote for at the request of the patient when the state of Oregon allows it?

http://www.oregon.gov/DHS/ph/pas/

Whether you fill the script or not, if the patient really wanted to end their life, they will find another way to do it if you won't fill their script. The patient might resort to something worse such as shooting himself or stabbing himself in the head or heart. Why not let him end his life a less painful way if it's legal?

 

[TXPharmDStudent]

The laws require you to use professional judgment, not dispense just because a doctor wrote it.

Leave your morals at home, I don't want to be forced to subscribe to your religious beliefs.

 

[Aznfarmerboi]

Besides Oregon, anybody who dispenses it is asking for trouble. If you want to get sued and lose your license, go ahead and do it. Oh yeah, I hope you like that pounding in the rear by bubba in jail.

Knowingly helping a patient commit suicide is no different than taking a gun and shooting him. It is murder and your professional degree will not protect you from criminal charges.

Sparda.. do your own ethical homework!

 

[Aznfarmerboi]

Professional judgment does not equate to injecting your own beliefs and morals into your practice.

No it doesnt, but it does require you to follow the law accordingly. Besides physician assisted being illegal, there is also the ethical part of being a professional. Look it up. It is a requirement to you being licensed and why your license can be revoked if you have a DUI.

 

[TXPharmDStudent]

No it doesnt, but it does require you to follow the law accordingly. Besides physician assisted being illegal, there is also the ethical part of being a professional. Look it up. It is a requirement to you being licensed and why your license can be revoked if you have a DUI.

Don't give us that "ethical" and "moral" crap, at one point in our nation we thought slavery was the right thing to do. At one point we thought black people were 3/5ths of a citizen. At one point we thought women didn't deserve the right to vote.

Your ethics and morals mean nothing to me.

 

[naseuy]

No it doesnt, but it does require you to follow the law accordingly. Besides physician assisted being illegal, there is also the ethical part of being a professional. Look it up. It is a requirement to you being licensed and why your license can be revoked if you have a DUI.

Its legal status depends on where you live. For morally gray issues, I think it's best to just go by what the law says, and if you disagree with it, you can try to change it. Breaking them would be a bit...

 

[SpirivaSunrise]

I'm really interested in why it's not just a no but a big fat no. Why would you refuse when they're just going to go somewhere else to get it filled? Is it because of your morals?

Reminds me of the pharmacists who refuse to sell insulin syringes to obvious druggies. They're gonna get them anyway and I'd rather them shoot up with clean needles than sharing with an HIV patient.

How original....selling syringes to addicts as a moral dilemma. Did your Dad come up with that one for you too? Give me a break...

I'll do everything in my professional scope to ensure a terminally ill patient lives out the rest of their life humanely, and in as little pain as possible [Side note: Read up on a drug or two I deal with frequently - Sm-153 Lexidronam and Sr-89 Chloride, and you may actually learn something from this conversation.] But that sure as heck doesn't include an Rx tantamount to a bullet with my initials on it.

I'll justifiably go head to head with another RPh on this issue...but until you have a license hanging on the wall, don't you dare go challenging one about their professional judgment to refuse to dispense a lethal dose of something, and throw around the moral card.

 

[ForcedEntry]

Professional judgment does not equate to injecting your own beliefs and morals into your practice.

It is not illegal in Oregon, so how can I be put in jail for filling something a physician wrote for at the request of the patient when the state of Oregon allows it?

http://www.oregon.gov/DHS/ph/pas/

Whether you fill the script or not, if the patient really wanted to end their life, they will find another way to do it if you won't fill their script. The patient might resort to something worse such as shooting himself or stabbing himself in the head or heart. Why not let him end his life a less painful way if it's legal?

Leave your morals at home, I don't want to be forced to subscribe to your religious beliefs.

It has nothing to do with morals. In the nebulous context Sparda provided you have no idea where this is occurring and the patients wishes are hearsay. It is only legal in one State and I applaud their decision. But you cannot use their example for making blanket decisions in this arena or else you can lose your career and face jail time.

IF this happened in Oregon, you still have a legal obligation to the patient to ensure they've met the requirements for the death with dignity act. Are they a qualified patient? Have they made a written request? What is their diagnosis and prognosis? Has the 15 day waiting period elapsed? Even then, with all of the answers before you, no healthcare provider is required to participate. If the answer to any of them is no, then you could still face jail time.

 

[Sparda29]

First off, this is not for my homework, I had this class last year. I just wanted to inject some life into this forum.

Just to make it more interesting, assume that euthanasia is ILLEGAL in the state you are practicing in.

 

[TXPharmDStudent]

How original....selling syringes to addicts as a moral dilemma.

I'll justifiably go head to head with another RPh on this issue...but until you have a license hanging on the wall, don't you dare go challenging one about their professional judgment to refuse to dispense a lethal dose of something, and throw around the moral card.

How exactly is that a moral dilemma? You really think you can legislate human behavior?

Give me a break, people are going to shoot up, smoke weed, etc. Why don't pharmacists have a duty to at least make sure that they do this stuff with clean needles? Oh right because the DEA says drugs are illegal or the Bible that no one subscribes to says drugs are bad.

There's nothing wrong with not wanting to spread Hepatitis and HIV.

 

[SpirivaSunrise]

How exactly is that a moral dilemma? You really think you can legislate human behavior?

Give me a break, people are going to shoot up, smoke weed, etc. Why don't pharmacists have a duty to at least make sure that they do this stuff with clean needles? Oh right because the DEA says drugs are illegal or the Bible that no one subscribes to says drugs are bad.

There's nothing wrong with not wanting to spread Hepatitis and HIV.

When did I say it was????

You were the one that brought up syringes...I don't see how it's even remotely tied to this topic.

You presumed (incorrectly I might add) that I take issue with dispensing syringes.

 

[Carboxide]

First off, this is not for my homework, I had this class last year. I just wanted to inject some life into this forum.

Just to make it more interesting, assume that euthanasia is ILLEGAL in the state you are practicing in.

That makes it LESS interesting.

If it was illegal, I would:

1). Refuse to dispense
2). Refuse to return the script
3). Report the doctor as violating the law

I would protect my license. End story.

 

[ForcedEntry]

You really think you can legislate human behavior?

You can't possibly be this stupid...no really...you can't

 

[TXPharmDStudent]

You can't possibly be this stupid...no really...you can't

Oh give me a break. Are you going to look me in the eye (well virtual eye) and tell me that if you make something illegal then no one will do it?

Do criminals not obtain guns, druggies not obtain drugs, motorists not speed, and citizens not use profanity in your fantasy world?

 

[ForcedEntry]

Oh give me a break. Are you going to look me in the eye (well virtual eye) and tell me that if you make something illegal then no one will do it?

Do criminals not obtain guns, druggies not obtain drugs, motorists not speed, and citizens not use profanity in your fantasy world?

In your fantasy world do you punch everyone in the face because you get mad? Do you drive drunk without regard? Do you pay your taxes? Do you hand out drugs w/o a prescription?

No, I will not tell you everyone will abide by the laws, but the laws ARE in place to legislate human behavior.

 

[TXPharmDStudent]

In your fantasy world do you punch everyone in the face because you get mad? Do you drive drunk without regard? Do you pay your taxes? Do you hand out drugs w/o a prescription?

No, I will not tell you everyone will abide by the laws, but the laws ARE in place to legislate human behavior.

Murder is not a human behavior, being under the influence is an altered human behavior, are you insane?

Addiction, lust, greed are human behaviors you CANNOT legislate away. There's no two ways about it either.

 

[confettiflyer]

I'll justifiably go head to head with another RPh on this issue...but until you have a license hanging on the wall, don't you dare go challenging one about their professional judgment to refuse to dispense a lethal dose of something, and throw around the moral card.

I've never seen you so riled up before, I lllliiiiike it

Give me a break, people are going to shoot up, smoke weed, etc. Why don't pharmacists have a duty to at least make sure that they do this stuff with clean needles? Oh right because the DEA says drugs are illegal or the Bible that no one subscribes to says drugs are bad.

Exactly why I wouldn't dispense the lethal dose...DEA has the power to arrest you and throw you in jail, the family has the right to file civil suit against you...the only guy who could possibly come to your defense is conveniently dead now.

I'm not about to risk my livelihood because of some misguided sense of moral obligation that is so clearly against the law/standards of care (except Oregon). If you want to be a martyr and dispense in this situation, be my guest.

 

[SpirivaSunrise]

I've never seen you so riled up before, I lllliiiiike it

Haha...oh I get riled up frequently; just try to stay away from SDN on those occasions. Stay out of trouble that way

 

[ForcedEntry]

Murder is not a human behavior, being under the influence is an altered human behavior, are you insane?

Addiction, lust, greed are human behaviors you CANNOT legislate away. There's no two ways about it either.

Yea...you are that stupid

Please define behavior. I'm sure you will choose the most obtuse definition you can find. Then please tell me about all of the laws we DON'T have to address abhorrent behavior.

 

[KUMoose]

@Sparda
If you're looking to make things more interesting you should have it legal in your state, not illegal. Making it illegal removes any moral issues and makes it solely based on self-preservation (i.e. keeping the license).


@Tx
Murder isn't a behavior, rather an action based on other behaviors such as, Greed, Jealousy, Lust, etc. The act of murder is as old as time, and while I'm not one to use the bible as a reference, see Cain and Able. And we, as a society, are perfectly happy legislating behavior, much to my frustration.

 

[ForcedEntry]

@Sparda
@Tx
Murder isn't a behavior, rather an action based on other behaviors such as, Greed, Jealousy, Lust, etc. The act of murder is as old as time, and while I'm not one to use the bible as a reference, see Cain and Able. And we, as a society, are perfectly happy legislating behavior, much to my frustration.

Dangit Moose! You gave him the answer. I was going to see how many times that dog was going to chase his tail before getting dizzy.

 

[KUMoose]

Yea, I realized that after I hit submit and refreshed. Shhhh maybe he won't notice.

 

[Sparda29]

That's the whole issue. Do you think assisting someone with suicide is murder?

 

[litetigre]

I hate those suicide bastards. If you want to die, go f*** youselves. Don't go to doctors or pharmacists and take them down with you unless you need help to get out of it. Since this country has so many lawyers, if I know the drug is for suicide I would just refuse to fill that script and save my sorry ass.

 

[KUMoose]

That's the whole issue. Do you think assisting someone with suicide is murder?

That's not how it's phrased with the conditions you imposed. At that point, i.e. the people of the state, determined it should be illegal, what I believe is mute, in order to keep my conduit to cash (i.e. my license) I couldn't in all conciousness fill it, because at that point I'm not imposing on just my needs and wants, but also those that depend on me.

So to take your question a step further, no, I'm not willing to risk my family's stability to help someone die and hope that a jury sees things my way. There are many ideals I am willing to do that, this just doesn't happen to be one of them.

 

[ForcedEntry]

Hell, I don't think all murders are murders. Some I would consider a public service i.e., Dahmer being beaten to death by a fellow inmate.

 

[litetigre]

That's the whole issue. Do you think assisting someone with suicide is murder?

on an online forum for professionals, I strongly urge you to not ask these types of questions. It will create a heated debate and does not fit the purpose of this forum. If you want to discuss this matter, please post it somewhere else.

 

[Sparda29]

on an online forum for professionals, I strongly urge you to not ask these types of questions. It will create a heated debate and does not fit the purpose of this forum. If you want to discuss this matter, please post it somewhere else.

Professionals shouldn't have heated debates? Asking a question relative to pharmacy doesn't fit the purpose of a pharmacy forum?

I had a professor back at LIU who was a pharmacist who said he filled a prescription for a morphine solution, which the doctor picked up and told him he was going to administer a lethal dose to his cancer patient.

 

[litetigre]

Professionals shouldn't have heated debates? Asking a question relative to pharmacy doesn't fit the purpose of a pharmacy forum?

I had a professor back at LIU who was a pharmacist who said he filled a prescription for a morphine solution, which the doctor picked up and told him he was going to administer a lethal dose to his cancer patient.

well Your intial question "do you fill the prescription?" is related to pharmacy. But to ask question about a definition that has the scope beyond your control is not suitable. This forum is for genuine discussion. Even though your second question does not intend to create a sensation, it touches a very sensitive topic. There are so many factors that affect individual judgements.

 

[TXPharmDStudent]

Yea...you are that stupid

Please define behavior. I'm sure you will choose the most obtuse definition you can find. Then please tell me about all of the laws we DON'T have to address abhorrent behavior.

A behavior is an action based on choice and preference. You choose to be angry at the driver who hit your car because you prefer your car to be in perfect working order and anger is the best way you have of getting over that feeling. Because it's a behavior, it's always voluntary...there is no such thing as an involuntary behavior. You don't just feel angry for no reason, there is always an emotional or biological reasoning behind it.

The difference between the act of murder and the act of doing drugs is that murder is a violation of the principle of being a free human being. You murder and you take freedom. However you don't take away freedom from others when you shoot up or smoke a joint (I'm talking by itself, not while driving a car or flying a plane).

People with your attitude drive me insane, you want to live in this fantasy world where you pass a law and everything disappears. Drugs are illegal yet people still shoot up, speeding is illegal yet I keep getting tickets for it, stealing is illegal yet people still do it. The only difference is that there is no way to ease the killing process (it's like trying to make people less pregnant, you're either pregnant or you're not) but there is a way to ease the drug crisis. If you want to let people spread HIV and Hepatitis then go ahead, you're a human being with free will. But I don't think that a pharmacist should have that mindset that they can be the ones to stop a behavior that's more immoral in their eyes than illegal. We can all agree that murder is more illegal than drugs, especially since no one has ever been put to death for being caught with a joint.

A lot of people find protestors to be abhorrent since they can sometimes use shocking language and posters to demonstrate a point but there are no laws that infringe on that freedom of speech.

 

[KUMoose]

A behavior is an action based on choice and preference. ... Because it's a behavior, it's always voluntary...there is no such thing as an involuntary behavior.

Are you sure about that? I wonder didn't Pavlov and Skinner have some things to say on this topic?

 

[TXPharmDStudent]

Are you sure about that? I wonder didn't Pavlov and Skinner have some things to say on this topic?

Not when it comes to things like drinking alcohol and doing drugs, those are two different things.

 

[ForcedEntry]

A behavior is an action

Very good. We have laws that limit or force actions.

there is no such thing as an involuntary behavior.

The law disagrees with you.

However you don't take away freedom from others when you shoot up

Ugh..when your ass gets addicted and you wind up becoming a leech on society, YES it ****S with MY freedom to NOT pay for your sorry ass.

People with your attitude drive me insane

I don't think you can understand my attitude. It's not what you think.

there is no way to ease the killing process

There are a million ways they can off themselves without putting my pursuit of happiness in jeopardy.

If you want to let people spread HIV and Hepatitis then go ahead, you're a human being with free will.

I never said anything about HIV or Hep, but nice straw man (you may want to look that up too).

But I don't think that a pharmacist should have that mindset that they can be the ones to stop a behavior that's more immoral in their eyes than illegal.

Here is the great part about it...you don't have to have that mindset. Follow the laws. In this case, the one Sparda put forth, the doctor has informed you he is going to engage in an illegal act. Go ahead tough guy...fill it. I triple dog dare you.

A lot of people find protestors to be abhorrent since they can sometimes use shocking language and posters to demonstrate a point but there are no laws that infringe on that freedom of speech.

You can't say whatever you want, whenever you want, where ever you want. how big is that rock you are under?

[YOUTUBE]http://www.youtube.com/watch?v=6bVa6jn4rpE[/YOUTUBE]

[YOUTUBE]http://www.youtube.com/watch?v=t244-zEENSs[/YOUTUBE]

 

[Sparda29]

Very good. We have laws that limit or force actions.



The law disagrees with you.



Ugh..when your ass gets addicted and you wind up becoming a leech on society, YES it ****S with MY freedom to NOT pay for your sorry ass.



I don't think you can understand my attitude. It's not what you think.



There are a million ways they can off themselves without putting my pursuit of happiness in jeopardy.



I never said anything about HIV or Hep, but nice straw man (you may want to look that up too).



Here is the great part about it...you don't have to have that mindset. Follow the laws. In this case, the one Sparda put forth, the doctor has informed you he is going to engage in an illegal act. Go ahead tough guy...fill it. I triple dog dare you.



You can't say whatever you want, whenever you want, where ever you want. how big is that rock you are under?

[YOUTUBE]http://www.youtube.com/watch?v=6bVa6jn4rpE[/YOUTUBE]

[YOUTUBE]http://www.youtube.com/watch?v=t244-zEENSs[/YOUTUBE]

The 2nd video is reason enough to pick up some guns and light up some government buildings.