"Walgreens pharmacist denies woman miscarriage medication due to his beliefs"

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Can you imagine how much greater this debate could have been if misopristol was a controlled medication and this was an unfilled eRx?

Let’s just pause for a second and think about that...:corny:

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And if you're going to claim to not dispense based on ethical grounds, you should be familiar with those indications and dispense appropriately when it is being used for something that does not fall afoul of your personal sense of ethics. To not do so is incompetence secondary to ignorance

you keep saying ethics, but I think you mean to say morality.

I'm well aware, but given that I'm likely going to practice in a state where dispensing medication is a duty, not a discretionary privilege, I am obviously fine with this.
You are objectively wrong here. It is not a duty at all.
I know you know what Duty means with regard to care.

We don't have it.
 
you keep saying ethics, but I think you mean to say morality.


You are objectively wrong here. It is not a duty at all.
I know you know what Duty means with regard to care.

We don't have it.
Ethics pertain to actions that apply within a specific set of circumstances and are imposed by outside sources. Morals apply to all people at all times and are determined at the individual level. Given that one can only prescribe within the context of being a pharmacist, and their beliefs about abortion are descended from what has been decided by those establishing religious doctrine, it is a sense of religious professional ethics that they believe it is unethical to dispense medication because it allows for the immoral act of abortion.
 
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You may want to watch your wording when you say it's a duty.
Per Washington's law:
(1) Pharmacies have a duty to deliver lawfully prescribed drugs or devices to patients and to distribute drugs and devices approved by the U. S. Food and Drug Administration for restricted distribution by pharmacies, or provide a therapeutically equivalent drug or device in a timely manner consistent with reasonable expectations for filling the prescription
 
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Woah woah woah... pharmacists are prescribing now?
Sorry, I just got done doing a whole class on writing prescriptions so the nomenclature was off because that's how brains tend to work when they're stuck on something. You know what I meant though. Also pharmacists are prescribing in a few states, but that's a whole different issue...
 
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Per Washington's law:
(1) Pharmacies have a duty to deliver lawfully prescribed drugs or devices to patients and to distribute drugs and devices approved by the U. S. Food and Drug Administration for restricted distribution by pharmacies, or provide a therapeutically equivalent drug or device in a timely manner consistent with reasonable expectations for filling the prescription
That seems unwise. Pharmacists are usually the first to catch on to pill mills and the like
 
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Sorry, I just got done doing a whole class on writing prescriptions so the nomenclature was off because that's how brains tend to work when they're stuck on something. You know what I meant though. Also pharmacists are prescribing in a few states, but that's a whole different issue...

Well I think this nomenclature is important...

For prescribers: If they deem it professionally appropriate, prescribe

For dispensers: if they deem it professionally appropriate, dispense

Without a doubt there is a subjectivity to what is and what isn’t professionally appropriate. If the dispenser doesn’t have an authority which enables them to choose not to dispense something when they receive a prescription, what purpose do they really serve?

As much as every type of medical professional wishes there weren’t, there are bad actors, those not paying enough attention at a given time, and situations where egos can get in the way. This shouldn’t happen, but does. If I get an rx with an aggressively high dose that I know beyond a reasonable doubt would be fatal, I call the doc and they say no just dispense what I wrote. I would 10/10 times refuse. If you think I should dispense in that situation, sorry not sorry.
 
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Absolutely, when their beliefs serve no logical or religious function and have the potential for harm should they become precedent
No one should have to aubmit their moral beliefs to others for approval when it comes to abstaining from a transaction....their employer is the only other opinion that matters
 
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Pill Mills scripts aren't usually incorrect or fraudulent
But they fall under their own PMP laws that specifically monitor opioid use and such. It's a totally different area of law that a pharmacist has to be compliant with and outside the purview of the case that was addressed, as the acts concerning the PMP limit opioid prescriptions and dispensing based on various factors. It's a totally separate area of law that has its own subsections and exemptions with regard to the law addressed in the case presented earlier, but without copying and pasting all of the subsections and how they relate to each other, basically pharmacists can refuse to fill above the opioid limits (and can also override if they believe the doses are appropriate). They do still have to fill up to the limit, but can report suspected bad actors.
 
No one should have to aubmit their moral beliefs to others for approval when it comes to abstaining from a transaction....their employer is the only other opinion that matters
I used to agree with you, but I'm back to the belief that when you're a part of a profession, your responsibilities and duties are paramount, and if they conflict with your personal ethical and moral principles, you should not be a member of said profession and the law should ensure that you are removed from it.
 
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I used to agree with you, but I'm back to the belief that when you're a part of a profession, your responsibilities and duties are paramount, and if they conflict with your personal ethical and moral principles, you should not be a member of said profession and the law should ensure that you are removed from it.
The nuremberg defense was dumb back then and it still is......it really is important that people retain legal access to moral restraint

If the market hates their choice enough the work will evaporate but they have a right to the choice
 
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I still don't get why the pharmacist refused to dispense even after the patient told him it was not for elective abortion. If he had doubt, why not call the physician?

He probably looked up "misoprostol indications" on LexiComp and couldn't find anything regarding a dead fetus.
 
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Per Washington's law:
(1) Pharmacies have a duty to deliver lawfully prescribed drugs or devices to patients and to distribute drugs and devices approved by the U. S. Food and Drug Administration for restricted distribution by pharmacies, or provide a therapeutically equivalent drug or device in a timely manner consistent with reasonable expectations for filling the prescription

I'm not talking law, I'm talking you say duty as if we shouldn't use our vast knowledge to determine what is appropriate and when the doctor is prescribing inappropriately, missed a major contraindication, etc.

When you say duty it appears you think we're useless people that only give out medications.

Just trying to help you out that is all. I don't want you to call a pharmacy and say just do your duty.
 
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But they fall under their own PMP laws that specifically monitor opioid use and such. It's a totally different area of law that a pharmacist has to be compliant with and outside the purview of the case that was addressed, as the acts concerning the PMP limit opioid prescriptions and dispensing based on various factors. It's a totally separate area of law that has its own subsections and exemptions with regard to the law addressed in the case presented earlier, but without copying and pasting all of the subsections and how they relate to each other, basically pharmacists can refuse to fill above the opioid limits (and can also override if they believe the doses are appropriate). They do still have to fill up to the limit, but can report suspected bad actors.
If the PMP was that accurate we wouldn't have a problem.

why don't you ask the local pharmacist around here how many of them have called people trying to scan drugs with a normal PMP...
 
I'm not talking law, I'm talking you say duty as if we shouldn't use our vast knowledge to determine what is appropriate and when the doctor is prescribing inappropriately, missed a major contraindication, etc.

When you say duty it appears you think we're useless people that only give out medications.

Just trying to help you out that is all. I don't want you to call a pharmacy and say just do your duty.
I specifically meant in the legal sense. Pharmacists most key role is protecting physicians from their own occasional stupidity, since no one is perfect
 
What is this lady going to do, sue Walgreens because the fetus she wanted to abort died/ended up living? (2 different scenarios, I didn't read the article.)
 
What is this lady going to do, sue Walgreens because the fetus she wanted to abort died/ended up living? (2 different scenarios, I didn't read the article.)

Can't, she just wanted the spotlight.
 
Without a doubt there is a subjectivity to what is and what isn’t professionally appropriate. If the dispenser doesn’t have an authority which enables them to choose not to dispense something when they receive a prescription, what purpose do they really serve?

As much as every type of medical professional wishes there weren’t, there are bad actors, those not paying enough attention at a given time, and situations where egos can get in the way. This shouldn’t happen, but does. If I get an rx with an aggressively high dose that I know beyond a reasonable doubt would be fatal, I call the doc and they say no just dispense what I wrote. I would 10/10 times refuse. If you think I should dispense in that situation, sorry not sorry.

You seem to be confused. The "Duty" clause above for Washington specifically carves out a provision for "reasonable expectations" in regards to filling prescriptions. No state anywhere requires pharmacists to dispense medications that the pharmacist believes will be fatal and I will even go farther and say that all states require pharmacists to NOT dispense medications they believe will be fatal. (Ok there exists a subset of states that I think allow for medically assisted suicide but can we leave those out of the discussion?)
 
The nuremberg defense was dumb back then and it still is......it really is important that people retain legal access to moral restraint

If the market hates their choice enough the work will evaporate but they have a right to the choice

How can anyone be morally restrained from dispensing misoprostol for a miscarriage? Well I guess what I should be asking is how is that behavior consistent with being a pharmacist?
 
How can anyone be morally restrained from dispensing misoprostol for a miscarriage? Well I guess what I should be asking is how is that behavior consistent with being a pharmacist?
Taken at face value i would have dispensed it if I understood the patient presentation right....and I’m the guy who thinks elective abortions should be crimes

But the larger issue is that no profession should take away someone’s moral autonomy to abstain from acts they find objectionable.....if they can find enough customers or an employer willing to put up with they should be legally allowed and their license intact
 
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Taken at face value i would have dispensed it if I understood the patient presentation right....and I’m the guy who thinks elective abortions should be crimes

But the larger issue is that no profession should take away someone’s moral autonomy to abstain from acts they find objectionable.....if they can find enough customers or an employer willing to put up with they should be legally allowed and their license intact

Ah yes, I forgot - the free market will fix everything. ;)
 
Per Washington's law:
(1) Pharmacies have a duty to deliver lawfully prescribed drugs or devices to patients and to distribute drugs and devices approved by the U. S. Food and Drug Administration for restricted distribution by pharmacies, or provide a therapeutically equivalent drug or device in a timely manner consistent with reasonable expectations for filling the prescription

Congrats on being 2% correct. LOL

I'm honestly shocked even 1 state put that into law
 
You seem to be confused. The "Duty" clause above for Washington specifically carves out a provision for "reasonable expectations" in regards to filling prescriptions. No state anywhere requires pharmacists to dispense medications that the pharmacist believes will be fatal and I will even go farther and say that all states require pharmacists to NOT dispense medications they believe will be fatal. (Ok there exists a subset of states that I think allow for medically assisted suicide but can we leave those out of the discussion?)

I’m not confused though... reasonable expectations is tremendously subjective. If I believe there is a significant possibility for birth defects? Kidney failure? Loss of eye sight? Priapism? Where is the line drawn? Theres black box warnings on meds that increase the risk of suicidal thoughts... could I or couldn’t I refuse those because it might lead to the patient killing themselves? What if the patient already had history of attempts? Then is it ok?

These are all rhetorical of course...
 
I’m not confused though... reasonable expectations is tremendously subjective. If I believe there is a significant possibility for birth defects? Kidney failure? Loss of eye sight? Priapism? Where is the line drawn? Theres black box warnings on meds that increase the risk of suicidal thoughts... could I or couldn’t I refuse those because it might lead to the patient killing themselves? What if the patient already had history of attempts? Then is it ok?

These are all rhetorical of course...

Your straw man argument is ridiculous on the face of it. Please show me where any pharmacist anywhere is compelled to dispense a medication they believe to be unsafe for the patient.

That is a totally different and separate issue from deciding it is immoral or against the tenants of your religion to treat a miscarriage. The only thing I can see that they have in common is that both involve the pharmacist refusing to dispense. But one is for safety reasons and the other is for reasons unknown to me.
 
Your straw man argument is ridiculous on the face of it. Please show me where any pharmacist anywhere is compelled to dispense a medication they believe to be unsafe for the patient.

That is a totally different and separate issue from deciding it is immoral or against the tenants of your religion to treat a miscarriage. The only thing I can see that they have in common is that both involve the pharmacist refusing to dispense. But one is for safety reasons and the other is for reasons unknown to me.

So I’d personally have no problems dispensing this first and foremost. However, we are throwing around language like “duty to dispense” I just want to ensure any prescribers out there aren’t misconstrued that there is a mandate to dispense. While it wasn’t the rationale provided for not dispensing, it is a much easier out for many situations. Not that I believe it should always be used but since the language is subjective it can be interpreted as an extremely large gray area. It’s that professionals judgement of risk:reward. Not saying there judgement shouldn’t always be nothing less than perfect, but it is variable.
 
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Per Washington's law:
(1) Pharmacies have a duty to deliver lawfully prescribed drugs or devices to patients and to distribute drugs and devices approved by the U. S. Food and Drug Administration for restricted distribution by pharmacies, or provide a therapeutically equivalent drug or device in a timely manner consistent with reasonable expectations for filling the prescription

Congrats on being 2% correct. LOL

I'm honestly shocked even 1 state put that into law

That changed in 2007, but the wording is actually not quite what you think.

Being licensed in WA and within the controversy (because I am one of the few pharmacists in the federal system who are authorized for DWDA prescriptions), note that the specific wording is "pharmacies", not pharmacists. This has ALWAYS been a point of contention within Washington state, as pharmacists have been before the Board and won on that duty matter getting their pharmacies cited instead. There's actually changes in statute pending to that particular area to specify "pharmacists", but it's being vehemently contested as it may be overriden by Washington's general professional licensing act, which with the exception of the LIPs, has a fairly vague clause about no duty to act. So, what happens when a pharmacist refuses to do their job in WA is that the pharmacy gets sanctioned, not necessarily the pharmacist. But you can bet if a pharmacy is sanctioned over a pharmacist's conduct, that pharmacist is fired and I know that Walgreens doesn't have a problem with firing over that reason.

Also, it's quite well known in WA that the provisions in unfilled prescriptions are not enforced unless egregious (and practically never with respect to controls). The DEA Field Offices for Portland and Seattle have specifically defended pharmacists being overly cautious about refusing to fill or quarantining prescriptions until a lawful determination can be made.

Also, if you're writing for a DWDA script protocol (and by the way, the prescriber has to personally deliver it or mail it and be known to the pharmacy and pharmacist), note that a pharmacy may categorically refuse to fill this. DWDA overrides the Pharmacy Practice Act because the language requires the pharmacy to voluntarily do so. Even for a legal prescription given the right stock, no pharmacy or pharmacist may be compelled to fill that prescription/order.

As a practicing, observant Catholic, I do not see the objection to dispensing outright abortifacients, and I have and will continue to dispense those meds, because it is a medical matter, and I am not the cause (I do believe abortion is a serious and avoidable sin, which is why I make it a point not to give cause for such a consideration). I can face St. Peter with a clean conscience on that matter (although I won't on quite a number of other ones). That said, if a pharmacist does have a religious opposition to filling a prescription like that, there are practice environments like nuclear that they could work in where that pharmacist would never have controversy in choosing what to fill. I don't think a law is necessary in this case to force behavior, practice and job sanction are sufficient.

In this case though, the pharmacist is clearly an idiot, but I do not think he/she is sanctionable as the pharmacist still does not have a duty to fill anything.
 
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Muh stop liking what I don't like
When other people are affecting your ability to live your life it isn't the same as a preference for pineapple on pizza. They don't "like things I don't like," they are seeking to substantially limit the ability of others to do things that have the potential to have a serious impact on their life. That is not so much in relation to this case, but to the SCOTUS stuff going on
 
Putting the word "muh" in front of something isn't an argument. I basically see it as you being unable to reply and conceding that I'm right.
Or to put it in your terms, "muh ability to form coherent thoughts."


I didn't there was an expectation of a coherent, intellectual argument there.
I can only imagine you're mourning in a very public and strange way.
When other people are affecting your ability to live your life it isn't the same as a preference for pineapple on pizza. They don't "like things I don't like," they are seeking to substantially limit the ability of others to do things that have the potential to have a serious impact on their life. That is not so much in relation to this case, but to the SCOTUS stuff going on
You're just describing government and politics in general but putting a twist on it by focusing on one facet of the opposition.
 


I didn't there was an expectation of a coherent, intellectual argument there.
I can only imagine you're mourning in a very public and strange way.

You're just describing government and politics in general but putting a twist on it by focusing on one facet of the opposition.

I'm a centrist, my opposition is whatever side happens to be getting out of control at the moment. I don't trust people to make adequate decisions in the political realm because neither party is my cup of tea. We need a much more "let everyone do whatever they need to do without getting in their way" approach to things. You want guns? Have them. You want abortion meds? Here ya go. I don't like what you like but I don't think I should be stepping in your way to get it. Now, I also think people in professions lose some autonomy as part of their bargain with society, in which we are granted rights and responsibilities, so for the same reason an anti-gun liberal shouldn't open up a firearm shop, a person that is unwilling to provide their patients with prescribed medications that have been deemed medically necessary and appropriate shouldn't be working in a pharmacy.
 
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I'm a centrist, my opposition is whatever side happens to be getting out of control at the moment. I don't trust people to make adequate decisions in the political realm because neither party is my cup of tea. We need a much more "let everyone do whatever they need to do without getting in their way" approach to things. You want guns? Have them. You want abortion meds? Here ya go. I don't like what you like but I don't think I should be stepping in your way to get it. Now, I also think people in professions lose some autonomy as part of their bargain with society, in which we are granted rights and responsibilities, so for the same reason an anti-gun liberal shouldn't open up a firearm shop, a person that is unwilling to provide their patients with prescribed medications that have been deemed medically necessary and appropriate shouldn't be working in a pharmacy.
So since as a family doctor I am trained in early abortions, I should be required to provide that service?
 
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So since as a family doctor I am trained in early abortions, I should be required to provide that service?
It is not a procedure in the standard capacity of your practice. There is functionally no difference between dispensing one pharmaceutical prescription and another, making it a completely different situation
 
It is not a procedure in the standard capacity of your practice. There is functionally no difference between dispensing one pharmaceutical prescription and another, making it a completely different situation
So an OBGYN should be required to, I see now
 
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It is not a procedure in the standard capacity of your practice. There is functionally no difference between dispensing one pharmaceutical prescription and another, making it a completely different situation
I think there should be a REMS for it.

It seems silly to have one for Absorica but not misoprostol.
 
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So an OBGYN should be required to, I see now
You know it's not even close to a similar comparison. The service being offered is filling prescriptions and ensuring they are filled properly. An OB/Gyn's services offered can be anything from cancer care to birthing to abortion services. Not all OB/Gyns provide all services, but all pharmacists in retail chains provide the service of dispensing medication. A nuclear pharmacist shouldn't have to dispemse abortion medication because obviously, their job is specifically nuclear pharmacy and it isn't a part of their normal services. You're smarter than this and you know it's a ridiculous comparison.
 
I think there should be a REMS for it.

It seems silly to have one for Absorica but not misoprostol.
Given that the teratogenicity if Absorica is taken during pregnancy is so high that birth defects are all but assured, a highly undesirable outcome, and that fetal loss is the desired outcome of misoprostol, I can see exactly why a REMS doesn't exist. Misoprostol has had 21 recorded deaths worldwide when used for abortion, compared to 1,500 accidental deaths for Tylenol in the United States alone. Something with that low of a risk profile has no need for any counseling on the part of pharmacists unless the patient requests it.
 
You know it's not even close to a similar comparison. The service being offered is filling prescriptions and ensuring they are filled properly. An OB/Gyn's services offered can be anything from cancer care to birthing to abortion services. Not all OB/Gyns provide all services, but all pharmacists in retail chains provide the service of dispensing medication. A nuclear pharmacist shouldn't have to dispemse abortion medication because obviously, their job is specifically nuclear pharmacy and it isn't a part of their normal services. You're smarter than this and you know it's a ridiculous comparison.
But general OBGYNs pretty much will all do D&Cs for miscarriages. The procedure is identical for early abortions. They're providing a service of removing something from the uterus, the only difference is heart beat v. not heart beat.

Its a perfectly fine comparison for anyone that actually knows anything about the medicine involved.
 
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But general OBGYNs pretty much will all do D&Cs for miscarriages. The procedure is identical for early abortions. They're providing a service of removing something from the uterus, the only difference is heart beat v. not heart beat.

Its a perfectly fine comparison for anyone that actually knows anything about the medicine involved.
Yeah, but pharmacists aren't offering each individual medication as its own service. They offer the general service of dispensing medications. Just like a person that prescribes, say, AEDs for seizures isn't going to prescribe them for bipolar disorder. Indications matter in medicine, pharmacists don't practice medicine.
 
Yeah, but pharmacists aren't offering each individual medication as its own service. They offer the general service of dispensing medications. Just like a person that prescribes, say, AEDs for seizures isn't going to prescribe them for bipolar disorder. Indications matter in medicine, pharmacists don't practice medicine.
Indications absolutely matter in pharmacy, whether or not they practice medicine.
 
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