Declining Abortion Meds soon to be a reality?

[MajorBubblez]

Advertisement - Members don't see this ad

morality police would be pharmacists running around in parking lots slapping pills out of people's hands, a professional exercising their right to a conscience is simply not partaking in the transaction.

There is no professionalism aspect to be discussed here. The only question is if your employer requires it as part of your employment.

I don't disagree with that, I guess I'm looking at this under the assumption that one's contract prioritizes the business over the pharmacist's beliefs, i.e. if they (the store) have the medication and someone has a script for it they sell it to the patient. Are there stipulations in pharmacists contracts regarding these situations?

 

[deleted480308]

I don't disagree with that, I guess I'm looking at this under the assumption that one's contract prioritizes the business over the pharmacist's beliefs, i.e. if they (the store) have the medication and someone has a script for it they sell it to the patient. Are there stipulations in pharmacists contracts regarding these situations?

If I owned the pharmacy? hell yes, you sell whatever I tell you to

I don't know what CVS has in their contracts

 

[PharmNerdMatt]

I just want to interject something in here for thought.

What about this as a freedom of religion argument. If I employ a pharmacist who is Muslim, then I must accommodate his ability to say his prayers everyday. This is an existing constitutionally protected right. No one has to pass an additional law that states that pharmacists must be allowed to pause their day to say their prayers (not that something like that would ever pass most places).

One might be able to make the same argument about the reasons doctors and nurses can't be forced as part of their jobs to perform abortions.

As Illinois' law has never been challenged in federal court, it is unknown if it would pass a test of constitutionality. And you can't say that you shouldn't get into the profession if you don't want to participate. That isn't a question that gets asked when testing laws against the first amendment.

 

[deleted480308]

I just want to interject something in here for thought.

What about this as a freedom of religion argument. If I employ a pharmacist who is Muslim, then I must accommodate his ability to say his prayers everyday. This is an existing constitutionally protected right. No one has to pass an additional law that states that pharmacists must be allowed to pause their day to say their prayers (not that something like that would ever pass most places).

One might be able to make the same argument about the reasons doctors and nurses can't be forced as part of their jobs to perform abortions.

As Illinois' law has never been challenged in federal court, it is unknown if it would pass a test of constitutionality. And you can't say that you shouldn't get into the profession if you don't want to participate. That isn't a question that gets asked when testing laws against the first amendment.

speaking of ideal situations here...you shouldn't have to accommodate anything as an employer. If you want employees wearing a particular uniform, or to not quit working during certain periods, or to sell all of the product you want to sell....you should be able to require all of those as terms of employment.

 

[PharmNerdMatt]

speaking of ideal situations here...you shouldn't have to accommodate anything as an employer. If you want employees wearing a particular uniform, or to not quit working during certain periods, or to sell all of the product you want to sell....you should be able to require all of those as terms of employment.

Except you can't make requirements that would discriminate against a protected group. I cannot make a job requirement that would prevent a faithful muslim from working at my business (unless inherent in the job) because that would be a discriminatory hiring practice. The question for the courts would be; is dispensing certain medications (the theoretical outpatient Rx for mifepristone) inherent in your job? I'm just not sure it is in the same way that contact with pork would be for a butcher at a pork processing company.

 

[deleted480308]

Except you can't make requirements that would discriminate against a protected group. I cannot make a job requirement that would prevent a faithful muslim from working at my business (unless inherent in the job) because that would be a discriminatory hiring practice. The question for the courts would be; is dispensing certain medications (the theoretical outpatient Rx for mifepristone) inherent in your job? I'm just not sure it is in the same way that contact with pork would be for a butcher at a pork processing company.

in my mind, "inherent to the job" is the sole discretion of the person offering the job.

 

[PharmNerdMatt]

in my mind, "inherent to the job" is the sole discretion of the person offering the job.

(From the perspective of the co-owner of a family business)

Except, it isnt. Not according to the courts. The questions our lawyers advise us to ask are: What would they not be able to do? What would THEY give as their reason for not being able to do it? Is that covered under a protected class (religion, gender, disability, etc)? Can you make a reasonable accommodation?

If the answer to the third question is yes, then the answer to the fourth must be no in order to refuse to hire them based on that subject. The problem becomes who decides what is reasonable. Reasonable accommodations can only really be decided in court after you and the potential/former employee disagree on the subject. Further problems are introduced when job restrictions change. At this date, no pharmacy really has to deal with the issue of mifepristone dispensing. Therefore, the question for employers is even more important as it would be more about who to fire instead of who to hire. Wrongful termination lawsuits are probably much scarier to big companies that are refusal of employment ones.

 

[deleted480308]

(From the perspective of the co-owner of a family business)

Except, it isnt. Not according to the courts. The questions our lawyers advise us to ask are: What would they not be able to do? What would THEY give as their reason for not being able to do it? Is that covered under a protected class (religion, gender, disability, etc)? Can you make a reasonable accommodation?

If the answer to the third question is yes, then the answer to the fourth must be no in order to refuse to hire them based on that subject. The problem becomes who decides what is reasonable. Reasonable accommodations can only really be decided in court after you and the potential/former employee disagree on the subject. Further problems are introduced when job restrictions change. At this date, no pharmacy really has to deal with the issue of mifepristone dispensing. Therefore, the question for employers is even more important as it would be more about who to fire instead of who to hire. Wrongful termination lawsuits are probably much scarier to big companies that are refusal of employment ones.

I agree with you assesment...I'm just saying it shouldn't be that way. Protected class accomodations are ridiculously subjective and shouldn't exist

 

[SClENCE]

You said there were no risks. Now youre saying there are risks. Which is it?

Im saying there are risks, that you, on the other side of the Pharmacy counter may or may not be aware of. And frankly, I dont think its any of your darn business. I had a patient roll through whose pregnancy abdominal pain turned into a pancreatic cancer diagnosis, after which careful discussion among many doctors she decided to terminate the pregnancy to start chemo to spend a few more months-years with her 2 year old. So yeah, be grateful you get to be so judgey and not in the drivers seat of THAT decision.

I think you missed the part where I said HEALTHY pregnancy. I didn't know developing cancer was part of a normal, healthy pregnancy. The risks associated with a healthy pregnancy never have been and never will be a reason for an abortion.

A previous poster started that the duty of the pharmacist is the health of the patient, and should therefore fill all abortion meds. My response was that a healthy pregnancy does not compromise the health of a patient, therefore the argument is not valid. Now you are giving me an example of a unhealthy pregnancy, which indicates that you are either illiterate or have missed the point.

That being said, I don't give a damn about what's going on "on the other side of the pharmacy counter" and would therefore fill the meds anyways. My point is that I am no way obligated to end a healthy pregnancy.

 

[touchpause13]

I think you missed the part where I said HEALTHY pregnancy. I didn't know developing cancer was part of a normal, healthy pregnancy. The risks associated with a healthy pregnancy never have been and never will be a reason for an abortion.

A previous poster started that the duty of the pharmacist is the health of the patient, and should therefore fill all abortion meds. My response was that a healthy pregnancy does not compromise the health of a patient, therefore the argument is not valid. Now you are giving me an example of a unhealthy pregnancy, which indicates that you have clearly missed the point.

No you are just showing that you fail to understand why a woman would want an abortion. You have no idea what her reasons are, and she would have already received the prescription so I don't see what right you have to say that getting the abortion isn't the best decision for her health.

 

[SClENCE]

No you are just showing that you fail to understand why a woman would want an abortion. You have no idea what her reasons are, and she would have already received the prescription so I don't see what right you have to say that getting the abortion isn't the best decision for her health.

I have already stated twice that I am referring to healthy pregnancy only, so it doesn't matter what the reasons are because any good reason has already been excluded from my response. Stop spewing ignorance

 

[touchpause13]

I have already stated twice that I am referring to healthy pregnancy only, so it doesn't matter what the reasons are because any good reason has already been excluded from my response. Stop spewing ignorance

There are plenty of good reasons that you just aren't considering - you just have a much more narrow definition than I do.
And again you have NO idea why the patient wants to terminate and it's really none of your business

 

[SClENCE]

There are plenty of good reasons that you just aren't considering - you just have a much more narrow definition than I do.
And again you have NO idea why the patient wants to terminate and it's really none of your business

Many women choose to get an abortion because they cannot afford a child or simply do not want one. This has nothing to do with their health, and are the cases that I am referring to. As pharmacist, my concern is the patient's health. In this case, their health had nothing to do with the decision to abort. Because of this, I am not obligated to dispense. These are healthy pregnancies.

I have stated three times that I am only referring to these cases. How can you not understand this? Is it because you are in osteopathic medicine?

 

[touchpause13]

Many women choose to get an abortion because they cannot afford a child or simply do not want one. This has nothing to do with their health, and are the cases that I am referring to. As pharmacist, my concern is the patient's health. In this case, their health had nothing to do with the decision to abort. Because of this, I am not obligated to dispense. These are healthy pregnancies.

I have stated three times that I am only referring to these cases. How can you not understand this? Is it because you are in osteopathic medicine?

Hahahha
Alright then, going *that* route just shows that you aren't worth my time.

 

[AspiringERMD]

I think you missed the part where I said HEALTHY pregnancy. I didn't know developing cancer was part of a normal, healthy pregnancy. The risks associated with a healthy pregnancy never have been and never will be a reason for an abortion.

A previous poster started that the duty of the pharmacist is the health of the patient, and should therefore fill all abortion meds. My response was that a healthy pregnancy does not compromise the health of a patient, therefore the argument is not valid. Now you are giving me an example of a unhealthy pregnancy, which indicates that you are either illiterate or have missed the point.

That being said, I don't give a damn about what's going on "on the other side of the pharmacy counter" and would therefore fill the meds anyways. My point is that I am no way obligated to end a healthy pregnancy.

Spoken like a man who's never had a baby destroy his vagina or abdomen during delivery. Not to mention persistent urinary problems after birth, etc.

Also, you can't predict pregnancy complications. A healthy pregnancy is only healthy until something suddenly goes wrong. If a woman doesn't want to take the risk that something will, then she shouldn't have to.

 

[SClENCE]

Spoken like a man who's never had a baby destroy his vagina or abdomen during delivery. Not to mention persistent urinary problems after birth, etc.

Also, you can't predict pregnancy complications. A healthy pregnancy is only healthy until something suddenly goes wrong. If a woman doesn't want to take the risk that something will, then she shouldn't have to.

Having an abortion because though there is no evidence of an impending complication you are afraid there may be one? You've got to be kidding!

Lucky for you, I'd fill the medication anyways and even preform the abortion to assure you comfort and peace of mind.

 

[AspiringERMD]

Having an abortion because though there is no evidence of an impending complication you are afraid there may be one? You've got to be kidding!

Lucky for you, I'd fill the medication anyways and even preform the abortion to assure you comfort and peace of mind.

No, I am not kidding. Everything has risks. Patients get to choose what risks they do or do not want to take on for everything of medical consequence. Pregnancy is absolutely not different.

And again, even normal pregnancies will absolutely wreck a woman down there.

 

[PharmNerdMatt]

Hahahha
Alright then, going *that* route just shows that you aren't worth my time.

No, I am not kidding. Everything has risks. Patients get to choose what risks they do or do not want to take on for everything of medical consequence. Pregnancy is absolutely not different.

And again, even normal pregnancies will absolutely wreck a woman down there.

***This is absolutely a "Devil's Advocate" kind of argument. So, please attack the point only, and not me.

Some would say that except in the setting of rape, the woman has already made the decision to accept the potential risks of a healthy pregnancy by being sexually active. All birth control (or should in the case of an Rx) comes with a warning that they are not 100% effective. Those that, through their religion (see freedom of religion argument), see the fetus as an individual life argue that they must consider the health of each patient exposed to the drugs they dispense. Therefore, they refuse to participate in an act that will save someone from non-life threatening consequences if it will destroy the life of another.

Additionally, do the medical students want to argue that an OB/GYN should not be able to refuse to prescribe mifepristone to a woman who wants an abortion simply because it is an unwanted pregnancy?

 

[touchpause13]

***This is absolutely a "Devil's Advocate" kind of argument. So, please attack the point only, and not me.

Some would say that except in the setting of rape, the woman has already made the decision to accept the potential risks of a healthy pregnancy by being sexually active. All birth control (or should in the case of an Rx) comes with a warning that they are not 100% effective. Those that, through their religion (see freedom of religion argument), see the fetus as an individual life argue that they must consider the health of each patient exposed to the drugs they dispense. Therefore, they refuse to participate in an act that will save someone from non-life threatening consequences if it will destroy the life of another.

Additionally, do the medical students want to argue that an OB/GYN should not be able to refuse to prescribe mifepristone to a woman who wants an abortion simply because it is an unwanted pregnancy?

I have no problem with a physician not providing abortion, they still need to provide a referral to someone who will. I don't have a problem with an individual not personally providing, the problem comes when you don't provide it AND you don't give the patient any means to get the drug

 

[PharmNerdMatt]

I have no problem with a physician not providing abortion, they still need to provide a referral to someone who will. I don't have a problem with an individual not personally providing, the problem comes when you don't provide it AND you don't give the patient any means to get the drug

As people have used this argument for pharmacies, what about if you are the only physician in a rural area? At what point does your referral become unreasonable?

 

[SClENCE]

As people have used this argument for pharmacies, what about if you are the only physician in a rural area? At what point does your referral become unreasonable?

The patient can drive a few hours if they want the procedure. You can't force a physician or pharmacist to do something. Nobody is entitled to these services and the condition is obviously not a matter of health. This is obviously with the assumption that the patient is is no danger as a result of the pregnancy and not a rape victim (before 5 people flip out and tell me I have no idea what the patient may be going through again).

As I'v already stated I wouldn't deny a medication of this nature because I'd rather make my employer happy and not deal with the bs. I don't support these abortions but at the same time I could care less about the life decisions that other people make.

 

[touchpause13]

As people have used this argument for pharmacies, what about if you are the only physician in a rural area? At what point does your referral become unreasonable?

I wish I had a good answer to this. I don't know. There is a huge problem with access to abortion care in this country and I don't have a solution

 

[Jibby321]

Procreation for the vast majority needs to stop.

 

[BidingMyTime]

And again, even normal pregnancies will absolutely wreck a woman down there.

OK, this really has nothing to do with the subject, but your statement is quite an overstatement. As someone who has been through 5 pregnancies, I can assure you that normal pregnancies do not "absolutely wreck" a woman down there--sure they can in some cases, but "absolutely" as in always? No. Hyperbole never helps ones argument.

 

[AspiringERMD]

***This is absolutely a "Devil's Advocate" kind of argument. So, please attack the point only, and not me.

Some would say that except in the setting of rape, the woman has already made the decision to accept the potential risks of a healthy pregnancy by being sexually active. All birth control (or should in the case of an Rx) comes with a warning that they are not 100% effective. Those that, through their religion (see freedom of religion argument), see the fetus as an individual life argue that they must consider the health of each patient exposed to the drugs they dispense. Therefore, they refuse to participate in an act that will save someone from non-life threatening consequences if it will destroy the life of another.

Additionally, do the medical students want to argue that an OB/GYN should not be able to refuse to prescribe mifepristone to a woman who wants an abortion simply because it is an unwanted pregnancy?

By that logic, you don't deserve medical treatment if you get into a car crash because you accepted the risks when you chose to drive.

 

[PharmNerdMatt]

By that logic, you don't deserve medical treatment if you get into a car crash because you accepted the risks when you chose to drive.

Fair enough... Care to address the 2nd (freedom of religion) or 3rd part (doctor's freedom) of that post?

 

[deleted480308]

By that logic, you don't deserve medical treatment if you get into a car crash because you accepted the risks when you chose to drive.

No one deserves any one else's services unless that person agrees

 

[AspiringERMD]

OK, this really has nothing to do with the subject, but your statement is quite an overstatement. As someone who has been through 5 pregnancies, I can assure you that normal pregnancies do not "absolutely wreck" a woman down there--sure they can in some cases, but "absolutely" as in always? No. Hyperbole never helps ones argument.

Never? Sounds like hyperbole 😉

You must have been particularly lucky. My understanding is that the majority of people are quite... (ahem) stretched out, at best. Barring needing a C section, of course, which comes with its own damage. Many (perhaps not most) wind up with bladder issues too. And occasional full tears? Yeesh. Anyway, my point was that all of these occur in pregnancies that are not considered complicated, and they cannot be predicted.

 

[AspiringERMD]

No one deserves any one else's services unless that person agrees

My point is that the same rules should apply to accidents of different types, whatever the rule winds up being.

 

[AspiringERMD]

Fair enough... Care to address the 2nd (freedom of religion) or 3rd part (doctor's freedom) of that post?

That's already been pretty well covered in this thread. I was addressing the part of the argument that hadn't really been yet.

 

[deleted480308]

My point is that the same rules should apply to accidents of different types, whatever the rule winds up being.

My reason for thinking pharmacists can refuse has nothing to do with the concept of abortion/birth control/religion. It is as simple as pharmacists are still humans and have the right to determine which activities they don't want to be a part of...

 

[BidingMyTime]

Never? Sounds like hyperbole 😉

touche.

You must have been particularly lucky. My understanding is that the majority of people are quite... (ahem) stretched out, at best. Barring needing a C section, of course, which comes with its own damage. Many (perhaps not most) wind up with bladder issues too. And occasional full tears? Yeesh. Anyway, my point was that all of these occur in pregnancies that are not considered complicated, and they cannot be predicted.

Well, I will clarify that there is a definite recovery period. It wasn't like I felt perfectly normal immediately after giving birth, and recovery can take a few months, even several in some women. I took your term "wreck" to mean permanently, but if you meant women having to deal with issues in the recovery period, I will agree that is true of most women giving birth.
Kegals before and after definitely help.

 

[Digsbe]

I think the thread has gone the way of a debate on abortion and lost track of the initial idea of not imposing servitude upon another. It's quite simple. Patients have the right to access health care services, health care providers should have the right to use their licenses and practice in ways that they find to be ethical and personally provide services in line with who they are as a person. The patient right to access does not equate with a patient privilege to force servitude upon any licensed professional who may be qualified to provide that service. A provider can't remove a patient's right to access legal care, and likewise a patient should not have the right to remove a provider's personal freedoms regarding their ethics and impose forced servitude. A right to access is not an entitlement to be demanded of others and forced out of them.

Say a physician is trained in pain management, but it's their moral or ethical practice to only provide pain management services under a contract with patients. Should a patient be able to make an appointment and force them to provide care without signing a contract because they feel it may limit their choice in pharmacies/pharmacy hopping or accessing other providers? Are they entitled to the pain management service simply because the physician knows how to provide it even though they are not comfortable doing so without contractual guidelines to prevent abuse? How about some cosmetic procedures? There are pictures of the "human Barbies" floating around where these people had serious work done, what if a plastic surgeon feels it is ethically wrong for them to do a surgery like that? Since they know how to should they be forced to do it because the patient asks? Fundamentally it's about the provider's rights to practice in accordance with what they find to be ethical. Choosing not to do so does not remove the patient's right to access that care. The same should be applied to dispensing abortion meds, drugs for lethal injection or other ethical areas impacting pharmacy and other areas of healthcare.

 

[BeLikeBueller]

Reading this thread...

 

[AspiringERMD]

Sorry, I think I assisted in getting the thread off track a bit. Apologies. Carry on with the initial discussion!

 

[WVUPharm2007]

The problem with people arguing over **** like this is that it becomes an ideological struggle rather than an issue where all sides can simply be allowed to come to a compromise that suits all parties. Since about 2003 or so, that's pretty much been the MO of most of the loudmouth asshats in this country. A sort of scorched Earth, no compromise, political ideology as religion sort of stance. And certain issues trigger this sort of response. Its not a discussion or an attempt to make all parties happy, its just a "political argument." This is one of them.

Due to the emergence of a very strong womens' right movement over the last century, many people on the left have become blind to just how ridiculously powerful women have become in many aspects of life. Womens' reproduction has become one of the few "political argument" issues that has somehow become more important than literally everything else. Including life itself. And its pretty easy for me to defend this statement.

Womens' access to reproductive drugs is literally the only type of medication required by law to be given out for free. Let's say there is a kid with a congenital heart defect. He has to go to a specialist. He has to have custom compounded heart medications. The kid needs the stuff to live. Is it free? No, of course not, this is America. That will be the higher copay tier to see that specialist. And those medications? That's $40 each, per month. Women's access to medications that allow them to have worry free sex? Free. Period. By law. Going to the OBGYN? Free. Period. By law. Let's say there is a procedure available that can cure the kid. Is it free? No, of course not, that will be that $3000 deductible. Let's say there is a procedure to make women sterile. Is it free? OF COURSE!!!

Women's access to monthly or permanent birth control (and just women, mind you. Men still have to pay for condoms and vasectomies.) has been made more important than access to life sustaining medications by Federal law. And I'm apparently the only person that has realized how ridiculous this is. The part of me that thinks that the government should just run healthcare entirely likes the fact that at least something is covered...but the part of me that actually gives a damn about humanity is confused and somewhat furious that access to life saving medical goods and services was passed over for effing birth control. Birth control.

And when you think about it, really its all just a handout to the pharmaceutical and medical industries. In many parts of the world, birth control is OTC. Like Plan B. The most LOGICAL thing to do, IMO. By why isn't it here? Money and politics. The Democrats wrote the law in order to please their pharmaceutical and feminist overlords. Dangling free birth control makes both very happy. But it costs the healthcare plans and the country more money in the long run. In China or India, you walk in, get a birth control...I'm guessing maybe like $10, if that...done. In the US, you go to a physician and get a script. That's $80-100 to the health system. You get that generic Yaz. That's another $40 or so AWP plus the dispensing fee. Hundreds of dollars vs hundred of dollars.

Big Pharma loves it because they can charge a bunch of money for a product that should cost about $10. The feminists love it because they see the words "free" and stop there. But its not the most logical way to do things at all. You have to follow the money and the political clout. The current paradigm is wasteful.

But wtf is my point? The most logical thing to do is pretty simple when you just remove your biases. You try to find a way in which both patient and practitioner can be happy.

The obvious answer is to allow the practitioner to refuse to do anything as long as they assist in finding someone who will. In 99.999% of the cases, this is the obvious easy fix. But being the hot button issue it is, people like bringing out the ridiculous 1-in-100,000 case of a kid in the middle of Idaho with one pharmacy within a 6 hour drive. The answer there is pretty simple, too. Make it so people with objections have to identify another practitioner within a reasonable distance from their practice that will handle whatever it is they object to. Sort of like how critical access hospitals get different rules to stick to, perhaps we should have critical access pharmacies that are required to offer more services at government subsidization. That way pharmacists with ethics issues can simply work in a place where said issues won't hinder patient care and patients will have access somewhere reasonably close by. Plus, it would be nice for these rural patients to have more services you see in larger cities like compounding, MTM, etc. It would be a win for everyone.

But this is America. You don't give a **** abut other people and their beliefs...or healthcare...or whatever. We don't come up with healthy compromises. We send letters to Iran that tell them not to negotiate with the president. A pox on both your stupid houses.

 

[touchpause13]

wowwwwwwwww

 

[SClENCE]

Couldn't agree more with WVU. People seem to be of the mindset that it is their human right to have this medication for free and by denying to dispense a pharmacist is "imposing his/her beliefs on the patient."

By forcing a pharmacist to fill, you are also imposing your beliefs on the pharmacist. The argument can just as easily be turned around. And I don't see how having worry free sex is a human right and is the responsibility of the tax payers/insurance company.

Obviously birth controls pills can be used for more than one reason but I'm obviously not talking about these cases. Like I said before, I wouldn't personally deny one but this issue really disgusts me.

 

[Vain Brother]

law =/= ethics =/= morals

ethics, in this sense, refers to a set of principles that govern the practices of a group. pharmacists are health care providers; their professional duty is to provide patients with medications that are safe and effective. birth control pills, EC, etc -- these are therapies that, whatever one's moral objections, are evidence-based and part of appropriate care. i think therefore that it is unethical to refuse to dispense birth control or emergency contraception. as a counter-example, i refuse to sell cigarettes at my pharmacy counter, because i feel it would be unethical for me, as a health-care provider, to do so. the evidence that cigarettes are harmful is ver clear.

all of this, of course refers to ethics, not law. in most places, pharmacists may be free to refuse to dispense these kinds of things. this would be legal, though i would argue it would be unethical

the access issue can be a real thing. i float in rural vermont. once i worked at a store with a sign in front of the pharmacy counter that said "needles will be dispensed only with a prescription" or something along those lines(selling needles OTC is legal in vermont). the only other pharmacy anywhere close, right across the street, had the same policy; in effect the pharmacists in town had colluded to prevent IVDUs access to clean needles. (i disregarded the policy when i covered that store)

 

[touchpause13]

law =/= ethics =/= morals

ethics, in this sense, refers to a set of principles that govern the practices of a group. pharmacists are health care providers; their professional duty is to provide patients with medications that are safe and effective. birth control pills, EC, etc -- these are therapies that, whatever one's moral objections, are evidence-based and part of appropriate care. i think therefore that it is unethical to refuse to dispense birth control or emergency contraception. as a counter-example, i refuse to sell cigarettes at my pharmacy counter, because i feel it would be unethical for me, as a health-care provider, to do so. the evidence that cigarettes are harmful is ver clear.

all of this, of course refers to ethics, not law. in most places, pharmacists may be free to refuse to dispense these kinds of things. this would be legal, though i would argue it would be unethical

the access issue can be a real thing. i float in rural vermont. once i worked at a store with a sign in front of the pharmacy counter that said "needles will be dispensed only with a prescription" or something along those lines(selling needles OTC is legal in vermont). the only other pharmacy anywhere close, right across the street, had the same policy; in effect the pharmacists in town had colluded to prevent IVDUs access to clean needles. (i disregarded the policy when i covered that store)

Wow. That's really messed up. Let's make sure IVDUs are using in the most unsafe way possible! I don't get it, how could a health care provider do that in good conscious?

 

[deleted480308]

Wow. That's really messed up. Let's make sure IVDUs are using in the most unsafe way possible! I don't get it, how could a health care provider do that in good conscious?

It's a different philosophy than yours but still a valid one

 

[touchpause13]

It's a different philosophy than yours but still a valid one

It's a short sighted one.
After learning about all the things that can go wrong with using dirty needles in micro.... I think it's pretty ****ed up to refuse them. I mean, what's the point?

 

[SClENCE]

You would knowingly sell needles for illegal drug use? Are you kidding me?

 

[touchpause13]

You would knowingly sell needles for illegal drug use? Are you kidding me?

Of course I would.
If it was my patient I would give them a script for it if the pharmacy requested them. Bacterial endocarditis is no joke. I would also be doing other things to help them get clean of course, but I'm not about to just knowing let someone use dirty needles if I can do something about it.

 

[touchpause13]

@dpmd works with this population, so I'm sure she could speak more eloquently on this topic than I can.

 

[Vain Brother]

You would knowingly sell needles for illegal drug use? Are you kidding me?

do some reading of the public health literature kiddo, better yet meet someone who's used. plenty of states (like mine) have laws for exactly this purpose!

 

[SClENCE]

Actually in my state there are laws stating is is illegal to sell needles knowing they will use them for this purpose "kiddo"

 

[dpmd]

@dpmd works with this population, so I'm sure she could speak more eloquently on this topic than I can.

I would much rather the drug user has clean needles to use (and instructions that tell them licking the tip before injection is stupid) since it would drastically cut down on the kinds of things i need to treat them for. I am not willing to put my license on the line though so probably wouldn't write them for needles unless i saw a policy that allowed me to do so in my state (or if needlea became otc in my state). I do however advocate for a needle free administrative technique to every injection drug user i take care of without feeling the slightest ethical qualm that i may be participating in their undesirable activity. I don't get to choose if my patients do drugs, but if they tell me they are going to do so i feel trying to make it safer for them is better than leaving them with less safe options (which would be how i would deal with the decision to prescribe an abortifacient or fill the rx if i were against abortion-unlike a surgical abortion, prescribing or filling medication doesn't actually make you involved in the abortion since ultimately you don't know if the patient ends up taking it or not)

 

[touchpause13]

I would much rather the drug user has clean needles to use (and instructions that tell them licking the tip before injection is stupid) since it would drastically cut down on the kinds of things i need to treat them for. I am not willing to put my license on the line though so probably wouldn't write them for needles unless i saw a policy that allowed me to do so in my state (or if needlea became otc in my state). I do however advocate for a needle free administrative technique to every injection drug user i take care of without feeling the slightest ethical qualm that i may be participating in their undesirable activity. I don't get to choose if my patients do drugs, but if they tell me they are going to do so i feel trying to make it safer for them is better than leaving them with less safe options (which would be how i would deal with the decision to prescribe an abortifacient or fill the rx if i were against abortion-unlike a surgical abortion, prescribing or filling medication doesn't actually make you involved in the abortion since ultimately you don't know if the patient ends up taking it or not)

Fair enough.
I mean if it was against the law, no I'm not going to lose my license over it. I think laws forbading it are really sad and short sighted, but I know the health of IV drug users isn't exactly high on most politicians priority list.

 

[WVUPharm2007]

The druggies around me buy them on New Egg.