When a pharmacist turns a woman away

[Lexington2012]

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There's a firestorm going on right now about this situation:

http://www.msnbc.com/msnbc/when-pharmacist-turns-woman-away

A pharmacist refused to fill a misprostol script for a woman and a lot of people are angry about it. The comments from readers are pretty crazy. Thoughts?

 

[GatorPharm]

I think religious objections are BS. Don't become a pharmacist if you aren't willing to fill prescriptions for every type of drug.

 

[Dr Wario]

I think religious objections are BS. Don't become a pharmacist if you aren't willing to fill prescriptions for every type of drug.

I understand the sentiment, but you may want to rephrase what you just wrote so that you don't sound completely stupid.

 

[meister]

No actually he is right. Some pharmacists just have a chip on their shoulders.

Don't ask what it's for, throw the pills in the bottle and move on.

 

[BenJammin]

No actually he is right. Some pharmacists just have a chip on their shoulders.

Don't ask what it's for, throw the pills in the bottle and move on.

Not only no but HELL no. Pharmacy is a licensed profession. I'm fine with your mentality as long as you abolish the state board of pharmacy in the same breath.

By the way, I grabbed this little gem from the link in the original post

America's healthcare should be nationalized and ALL private pharmacies put out of business . We don't need domestic terrorists deciding women's medical issues and / or coming between any patient & their doctor.

That's quite a tactic coming from the left. Liberals who impose their point of view on you are progressive and understanding while conservatives are domestic terrorists. You have freedom of choice in this country! If Dr Smith has horrible bedside manner, fire him and go see Dr Johnson. If Walmart is giving you crap about the medications you take, transfer your medications to another pharmacy. Such whiny babies!

 

[BenJammin]

I think religious objections are BS. Don't become a pharmacist if you aren't willing to fill prescriptions for every type of drug.

Funny how no one says this about physicians who refuse to perform abortions.

 

[Digsbe]

Practitioner ethics should be respected and protected. Patient's have the right to access healthcare, not to force the hand of healthcare practitioners as if their are entitled to whatever they ask for so long as it's legal.

Your license, your practice, your name on the script as the dispensing pharmacist who used their license to approve of the med and your liability. Conscience clauses are necessary to protect the rights of practitioners. Now, to be completely ignorant of indications and not approve of a medication for a miscarriage is professional negligence and ignorance. That I have problems with.

 

[Dalteparin]

Practitioner ethics should be respected and protected. Patient's have the right to access healthcare, not to force the hand of healthcare practitioners as if their are entitled to whatever they ask for so long as it's legal.

Your license, your practice, your name on the script as the dispensing pharmacist who used their license to approve of the med and your liability. Conscience clauses are necessary to protect the rights of practitioners. Now, to be completely ignorant of indications and not approve of a medication for a miscarriage is professional negligence and ignorance. That I have problems with.

I agree. If you can't think of a reason why a person needs a drug, the correct course of action is to call the physician and ask them, not to throw up your hands and do nothing. If the the drug was actually for an abortion, the pharmacist had called the MD to verify that and then refused to fill it, (s)he'd have a case. Refusing to fill without getting all the facts is just plain lazy.

 

[WVUPharm2007]

There were 3 other pharmacies like 3 minutes down the street. The pharmacist refused, the physician called it in to another pharmacy. The patient then went and confronted the pharmacist. In instances where another pharmacist is easily available it is pretty extreme to expect a pharmacist to act in a manner contrary to their personal ethics. Just have the patient go elsewhere. No harm, no foul.

 

[Sparda29]

I agree. If you can't think of a reason why a person needs a drug, the correct course of action is to call the physician and ask them, not to throw up your hands and do nothing. If the the drug was actually for an abortion, the pharmacist had called the MD to verify that and then refused to fill it, (s)he'd have a case. Refusing to fill without getting all the facts is just plain lazy.

Why is it an issue of it was for an abortion?

 

[Vain Brother]

No actually he is right. Some pharmacists just have a chip on their shoulders.

Don't ask what it's for, throw the pills in the bottle and move on.

i mean this is nonsensical. physicians make mistakes. it's the job of pharmacists to understand this stuff. speaking as a pharmacist and future physician here.

(i don't see why the OP couldn't have just posted this in the thread we were talking about these exact issues earlier this week, but) my thoughts on the matter have been expressed before. a pharmacist's job is to determine the medical appropriateness of the therapy.

 

[PharmNerdMatt]

Why is it an issue of it was for an abortion?

We literally just talked about this in another thread. So, I am going to make an assumption and leave this... :troll:

 

[Lexington2012]

I missed the earlier discussion. Do you have a link?

 

[Sparda29]

We literally just talked about this in another thread. So, I am going to make an assumption and leave this... :troll:

And which thread was that?

 

[eagles22]

Funny how no one says this about physicians who refuse to perform abortions.

This is an apples to narwhals comparison. Abortions aren't within the scope of care of every physician. Those that want to do it are trained and offer the services. Those that don't want to, don't get trained and would be committing malpractice if they offered those services.

As far as I know, it is within every community pharmacists training and scope of practice to dispense abortion drugs. If I'm wrong, please correct me.

 

[Digsbe]

This is an apples to narwhals comparison. Abortions aren't within the scope of care of every physician. Those that want to do it are trained and offer the services. Those that don't want to, don't get trained and would be committing malpractice if they offered those services.

As far as I know, it is within every community pharmacists training and scope of practice to dispense abortion drugs. If I'm wrong, please correct me.

So there is no such thing as pro-life OB/GYN's who don't provide elective abortions but provide all other services within their scope? In school we learned about abortifacients, how to safely dispense them and their other indications and if for another indication to make sure the person taking it is not pregnant (due to miscarriage), but just because it's within someone's scope or they learned how to do something shouldn't mean they are obligated to do that. Should all primary care physicians who learned pain management in residency have to provide pain management services?

 

[eagles22]

So there is no such thing as pro-life OB/GYN's who don't provide elective abortions but provide all other services within their scope? In school we learned about abortifacients, how to safely dispense them and their other indications and if for another indication to make sure the person taking it may not be pregnant, but just because it's within someone's scope or they learned how to do something shouldn't mean they are obligated to do that. Should all primary care physicians who learned pain management in residency have to provide pain management services?

People practice within a narrowed scope of every specialty. Does every orthopod replace knees, shoulders, hips, and do hand surgery? No, of course not. Do all obgyns do gynological-onc surgery? No again. You're trying to argue that all procedures that fall within a single specialty should be performed by a physician boarded in that specialty. Unfortunately, that's not the case and specialists narrow their scope much further down than just "Family medicine" or "gynecology".

But do answer your questions, yes a PCP who is well trained should offer pain management within his scope (i.e. NSAIDS, APAP, occasional narcotics), and to my knowledge most do. Should he be doing epidural steroids? No out of his scope.

As far as I know, community pharmacy does not specialize into just dispensing heart medications or just dispensing gyne meds, but things may have changed since I was in pharmacy.

 

[Digsbe]

My comment was in response to when you said "This is an apples to narwhals comparison. Abortions aren't within the scope of care of every physician. Those that want to do it are trained and offer the services. Those that don't want to, don't get trained and would be committing malpractice if they offered those services. "

Don't most OB/GYN's learn how to provide an abortion? What if someone was trained in it due to a mandatory residency rotation but doesn't want to do them? I know specialists narrow areas, but they are still trained broadly to some degree.

I would disagree with you though. I know some physicians who won't prescribe opioids for pain even though they manage it with other drugs. They don't like dealing with the DEA and the risks of prescribing scheduled meds and in my area there is a high amount of prescription drug abuse. They know how to use them, monitor patients on them and prescribe them but they don't nor should they be forced to. For insomnia I know other practitioners that won't go beyond trazodone or vistaril, but they know how to use Zolpidem, Lunesta and other meds. I also support their right to practice in such a way.

My whole argument is that just because you may have been trained or know how to do something that doesn't mean you have to incorporate that into your practice, in much the same way I think it's totally acceptable for pharmacists to not stock or dispense abortion meds even though they may know how to and learned about them. It should be within the law to have conscience clauses that afford freedom to practitioners to not provide services they feel are unethical. They can't stop patients from going elsewhere preserving their right to access, but conversely patients shouldn't have the right to force the hand of practitioners in various areas requiring them to give them something the practitioner feels is wrong/immoral/unethical. It's their license. I think giving patients absolute control over your license, and part of your life (your ethics) to force your hand to provide a service you feel may be morally or ethically wrong is in itself a rights violation. The rights of practitioners should be respected. Patient's rights should extend to accessing care, not to forcing caregivers to provide it against their will.

 

[eagles22]

My comment was in response to when you said "This is an apples to narwhals comparison. Abortions aren't within the scope of care of every physician. Those that want to do it are trained and offer the services. Those that don't want to, don't get trained and would be committing malpractice if they offered those services. "

Don't most OB/GYN's learn how to provide an abortion? What if someone was trained in it due to a mandatory residency rotation but doesn't want to do them? I know specialists narrow areas, but they are still trained broadly to some degree.

I would disagree with you though. I know some physicians who won't prescribe opioids for pain even though they manage it with other drugs. They don't like dealing with the DEA and the risks of prescribing scheduled meds and in my area there is a high amount of prescription drug abuse. They know how to use them, monitor patients on them and prescribe them but they don't nor should they be forced to. For insomnia I know other practitioners that won't go beyond trazodone or vistaril, but they know how to use Zolpidem, Lunesta and other meds. I also support their right to practice in such a way.

My whole argument is that just because you may have been trained or know how to do something that doesn't mean you have to incorporate that into your practice, in much the same way I think it's totally acceptable for pharmacists to not stock or dispense abortion meds even though they may know how to and learned about them. It should be within the law to have conscience clauses that afford freedom to practitioners to not provide services they feel are unethical. They can't stop patients from going elsewhere preserving their right to access, but conversely patients shouldn't have the right to force the hand of practitioners in various areas requiring them to give them something the practitioner feels is wrong/immoral/unethical. It's their license. I think giving patients absolute control over your license, and part of your life (your ethics) to force your hand to provide a service you feel may be morally or ethically wrong is in itself a rights violation. The rights of practitioners should be respected. Patient's rights should extend to accessing care, not to forcing caregivers to provide it against their will.

Not all obgyn residents are trained in doing abortions. It is not a required skill to become boarded.

The thing is, you're describing physicians who are treating the complaint albeit in different ways. They aren't just saying "nope, nope, nope". They are treating these patient's appropriately in their evaluation. They are doing pain/sleep/etc medicine within their scope of practice. Pain doesn't require narcotics. Insomnia doesn't require Lunesta. Doctors are given the latitude to treat the way they see is the best given clinical history, exam, labs, etc.

Pharmacists do not practice in that way. They aren't given an rx saying "we need to treat HTN. You choose the therapy". Pharmacy practice entails receiving an rx for a specific drug and then examining it for authenticity, therepeutic appropriateness, and interactions. When a pharmacist denies a fill, they aren't practicing any sort of pharmacy. They are leaving the patient out to dry. It is reasonable to expect a pharmacist to fill all legit rxes without any issues. The analog of the physician is for a patient to go to the PCP with a common complaint which is reasonable for him to be expected to treat and being met with the response of "nope, don't treat that, sorry".

 

[Vain Brother]

My comment was in response to when you said "This is an apples to narwhals comparison. Abortions aren't within the scope of care of every physician. Those that want to do it are trained and offer the services. Those that don't want to, don't get trained and would be committing malpractice if they offered those services. "

Don't most OB/GYN's learn how to provide an abortion? What if someone was trained in it due to a mandatory residency rotation but doesn't want to do them? I know specialists narrow areas, but they are still trained broadly to some degree.

I would disagree with you though. I know some physicians who won't prescribe opioids for pain even though they manage it with other drugs. They don't like dealing with the DEA and the risks of prescribing scheduled meds and in my area there is a high amount of prescription drug abuse. They know how to use them, monitor patients on them and prescribe them but they don't nor should they be forced to. For insomnia I know other practitioners that won't go beyond trazodone or vistaril, but they know how to use Zolpidem, Lunesta and other meds. I also support their right to practice in such a way.

My whole argument is that just because you may have been trained or know how to do something that doesn't mean you have to incorporate that into your practice, in much the same way I think it's totally acceptable for pharmacists to not stock or dispense abortion meds even though they may know how to and learned about them. It should be within the law to have conscience clauses that afford freedom to practitioners to not provide services they feel are unethical. They can't stop patients from going elsewhere preserving their right to access, but conversely patients shouldn't have the right to force the hand of practitioners in various areas requiring them to give them something the practitioner feels is wrong/immoral/unethical. It's their license. I think giving patients absolute control over your license, and part of your life (your ethics) to force your hand to provide a service you feel may be morally or ethically wrong is in itself a rights violation. The rights of practitioners should be respected. Patient's rights should extend to accessing care, not to forcing caregivers to provide it against their will.

there's a difference between an ethical objection and a moral objection. as a licensed pharmacist, i am expected to uphold the law and the ethical standards of my profession. having a pharmacy license does not necessarily confer the moral right to refuse service for personal reasons. some states (like georgia, in this story) may specifically cover this, in which case such a refusal is within the ethical boundaries of practice in that state, but simply having "a pharmacy license" is not license to practice according to one's whims

 

[Vain Brother]

And which thread was that?

probably the thread that's been at the top of this board all week with the words "declining" and "abortion meds" in the title

 

[GatorPharm]

I understand the sentiment, but you may want to rephrase what you just wrote so that you don't sound completely stupid.

How does it sound stupid? I didn't say a pharmacist should fill every prescription written, but being unwilling to fill a specific type of drug for a valid use is acting as a barrier to patient care, and it's unnecessary. They can get it filled somewhere else, but if that's going to happen, then why not just fill it yourself? If your religion conflicts with part of the responsibilities of your profession, you should find a different profession.

 

[Digsbe]

Not every pro-life person believes such on the grounds of religion. Regardless of how things are practiced, I think for issues like human life and death should have conscience clauses able to protect practitioners that wish to not participate in that. Sure abortion may be legal, but I don't believe under any circumstance that any practitioner be forced to provide or accommodate an elective abortion. Similarly the same exemptions should exist for refusing lethal injections. Your ethics are part of who you are, and I believe professionals should have the human right to refuse to do things that gravely violate their conscience. Patient's should have such strong of "rights" that they can force you to do something you believe is wrong, especially when it comes to the gravity of contributing to killing a human life. I don't see the massive harm in handing back a script when the patient can take it somewhere else reasonably or for a pharmacy to just not stock those kinds of medications. I think greater harm may be done to the practitioner who, in their conscience, just actively participated in and approved of the killing of a human life.

 

[SClENCE]

Heaven forbid that a women be inconvenienced and have to drive to another pharmacy. Apparently her 20 minutes of time are far more valuable to any moral/ethical/religious beliefs of the pharmacist and his/her license. Actually her rights are more important than life itself when you think about it.

 

[SClENCE]

How does it sound stupid? I didn't say a pharmacist should fill every prescription written, but being unwilling to fill a specific type of drug for a valid use is acting as a barrier to patient care, and it's unnecessary. They can get it filled somewhere else, but if that's going to happen, then why not just fill it yourself? If your religion conflicts with part of the responsibilities of your profession, you should find a different profession.

A boob job is a 100% valid medical procedure. Should a doctor who doesn't want to do you boobs get fired for acting as barrier to patient care? Absolutely not, because he isn't acting as a barrier to patient care seeing as boob jobs has NOTHING to do with patient care. Same thing with contraceptives. Plan b, birth control, and abortion meds have nothing to do with patient care. The patient has no medical condition, and the medication is not improving the health of the patient. Obviously birth controls can be used for reasons other than contraception and some abortions are in fact necessary to ensure the health of the patient, but I'm not referring to these cases. I don't see how it is the responsibility of the pharmacist to dispense medications that have nothing to do with patient care when patient care is their objective.

Apparently the right of a women to have an abortion and not be inconvenienced to drive 20 minutes to another pharmacy is more important than what any pharmacist says. I don't see how people can say that a pharmacist should be FORCED by law to sell something that in no way has anything to do with the patients well being. Being able to have sex with no babies is not a human right that you inherit... it is something you pay for and nobody should be obligated to provide this.

All this being said, I personally would fill any and all of these prescriptions. I just find it very scary when people say that the pharmacist should be forced to fill them by law. That is 100% ridiculous.

 

[Sparda29]

Heaven forbid that a women be inconvenienced and have to drive to another pharmacy. Apparently her 20 minutes of time are far more valuable to any moral/ethical/religious beliefs of the pharmacist and his/her license. Actually her rights are more important than life itself when you think about it.

As a health care professional, your religious beliefs should mean absolutely nothing.

 

[zelman]

Not every pro-life person believes such on the grounds of religion. Regardless of how things are practiced, I think for issues like human life and death should have conscience clauses able to protect practitioners that wish to not participate in that. Sure abortion may be legal, but I don't believe under any circumstance that any practitioner be forced to provide or accommodate an elective abortion. Similarly the same exemptions should exist for refusing lethal injections. Your ethics are part of who you are, and I believe professionals should have the human right to refuse to do things that gravely violate their conscience. Patient's should have such strong of "rights" that they can force you to do something you believe is wrong, especially when it comes to the gravity of contributing to killing a human life. I don't see the massive harm in handing back a script when the patient can take it somewhere else reasonably or for a pharmacy to just not stock those kinds of medications. I think greater harm may be done to the practitioner who, in their conscience, just actively participated in and approved of the killing of a human life.

This is a valid concept. However, in this case I don't know if there was a determination that this was for an elective abortion. From my understanding, we have nothing more than an attempt to phone in a medication order for a drug that is FDA approved as a gastroprotectant. Then a number of assumptions were likely made.

So, unless there was a consultation regarding the level of risk in this pregnancy (and sexual history involving rape and/or incest, depending on your personal abortion criteria), it suggests an interesting question of where the line can be drawn. And does it apply only to health care professionals? Suppose a gas station attendant notices that your GPS is headed toward an abortion clinic. Is it just to refuse them fuel or repairs? If you're the crossing guard working near a clinic, is it just to refuse to help a slightly pregnant-looking person cross the road toward that clinic?

I dunno. I don't really care. I'll fill most anything. Just thought it led to some novel questions.

 

[Old Timer]

A boob job is a 100% valid medical procedure. Should a doctor who doesn't want to do you boobs get fired for acting as barrier to patient care? Absolutely not, because he isn't acting as a barrier to patient care seeing as boob jobs has NOTHING to do with patient care. Same thing with contraceptives. Plan b, birth control, and abortion meds have nothing to do with patient care. The patient has no medical condition, and the medication is not improving the health of the patient. Obviously birth controls can be used for reasons other than contraception and some abortions are in fact necessary to ensure the health of the patient, but I'm not referring to these cases. I don't see how it is the responsibility of the pharmacist to dispense medications that have nothing to do with patient care when patient care is their objective.

Apparently the right of a women to have an abortion and not be inconvenienced to drive 20 minutes to another pharmacy is more important than what any pharmacist says. I don't see how people can say that a pharmacist should be FORCED by law to sell something that in no way has anything to do with the patients well being. Being able to have sex with no babies is not a human right that you inherit... it is something you pay for and nobody should be obligated to provide this.

All this being said, I personally would fill any and all of these prescriptions. I just find it very scary when people say that the pharmacist should be forced to fill them by law. That is 100% ridiculous.

You are 100% wrong and 1000000% full of S**t. On any level you are a jerk. It's not your body, you don't have medical records, you have no idea what's going on with the patient. These decisions are made between the doctor and the patient. Unless there is some medical reason to refuse to fill a prescription, you fill the fu**in thing or get the f out of the profession.

Barrier to care: It is a barrier and you have no right to make a barrier. I don't care if the nearest competitor is 10 feet away or 10,000 miles away. It's not your right to come between the doctor and the patient. You don't get to make judgements about any legal procedure ordered by a licensed physician unless there is harm to the patient involved. Have you ever had a miscarriage? Has your spouse or any other close relative? It's a pretty devastating experience. Now your doctor tells you that your options are a surgical procedure or a chemical procedure. Not wanting to have surgery you get the prescription and are told by some a-hole pharmacist to move along and you have no need for it and you think the pharmacist acted legally, ethically and humanely when in fact he did nothing of the kind.

Birth Control, Plan B and abortion meds: Many people take birth control for cycle regulation. Many people cannot get pregnant (think Accutane ) and unless you know for sure, STFU and fill the prescription. You don't know anything about the patient. You see the prescription and make an assumption you have no business making.

Yes, the right of a woman (despite the Republican right) to get an abortion is a right and you have no business interfering with it. You should be forced to fill them by law and without interrogating the patient. Your editorial view of their health status is meaningless and intrusive.

As for the OP, Walmart is either 1000000000000% lying or their pharmacist should be sued for malpractice. A simple literature search will find this drug is safe and effective for the purpose intended in this case despite the fact the manufacturer did not apply for a labeling change. The drug does not read the label to decide what it does to the patient. Do you refuse to fill Hydralzine for CHF patients as it is only indicated for hypertension. Would you have refused to fill propranolol prescriptions for hypertension when it was only approved for angina? Their fig leaf excuse is a cover up.

By your way of thinking a little town in bumstumble Alabama could have no pharmacies that would fill this and a patient would have to potentially have a surgical procedure with all of the risks involved to satisfy your desire to control her body based on what you deem is a medical need?

This pharmacist has no ethics or humanity and neither does anyone who supports this position

 

[radio frequency]

Refusing to fill in this situation and not referring the patient to a different pharmacist who would fill the medication is ethically wrong and also just bad patient care. These stories really hurt pharmacy as a whole.

 

[meister]

It is ethically wrong but makes certain annoying pharmacists feel oh so good I bet.

 

[Dalteparin]

Why is it an issue of it was for an abortion?

According to what's been posted, in Georgia it's legal for a pharmacist to refuse to dispense abortion meds. So if the med was for abortion, and if the pharmacist had called to verify that and then objected based on conscience, that would be OK in the state where this occurred.

 

[Sparda29]

According to what's been posted, in Georgia it's legal for a pharmacist to refuse to dispense abortion meds. So if the med was for abortion, and if the pharmacist had called to verify that and then objected based on conscience, that would be OK in the state where this occurred.

Sounds like a ****ed up state.

I'd have dispensed it even if I knew it was for abortion and abortion was illegal in that state.

I've dispensed and verified orders knowing full well it was for euthanasia/physician-assisted suicide.

 

[ExpressMaiL]

I love America.

 

[Guilded_Age]

My religion requires that I never dispense any medication- I believe all meds interfere with God's grand plan. I just clock in and read a magazine all day. My manager likes me though because I always make sure to say "Be Well!" to every customer I turn away.

 

[DAW2]

Let's not forget what's really important. That pharmacist lost a sale doing that. Now that's effed up

 

[cjb56]

You are 100% wrong and 1000000% full of S**t. On any level you are a jerk. It's not your body, you don't have medical records, you have no idea what's going on with the patient. These decisions are made between the doctor and the patient. Unless there is some medical reason to refuse to fill a prescription, you fill the fu**in thing or get the f out of the profession.

Barrier to care: It is a barrier and you have no right to make a barrier. I don't care if the nearest competitor is 10 feet away or 10,000 miles away. It's not your right to come between the doctor and the patient. You don't get to make judgements about any legal procedure ordered by a licensed physician unless there is harm to the patient involved. Have you ever had a miscarriage? Has your spouse or any other close relative? It's a pretty devastating experience. Now your doctor tells you that your options are a surgical procedure or a chemical procedure. Not wanting to have surgery you get the prescription and are told by some a-hole pharmacist to move along and you have no need for it and you think the pharmacist acted legally, ethically and humanely when in fact he did nothing of the kind.

Birth Control, Plan B and abortion meds: Many people take birth control for cycle regulation. Many people cannot get pregnant (think Accutane ) and unless you know for sure, STFU and fill the prescription. You don't know anything about the patient. You see the prescription and make an assumption you have no business making.

Yes, the right of a woman (despite the Republican right) to get an abortion is a right and you have no business interfering with it. You should be forced to fill them by law and without interrogating the patient. Your editorial view of their health status is meaningless and intrusive.

As for the OP, Walmart is either 1000000000000% lying or their pharmacist should be sued for malpractice. A simple literature search will find this drug is safe and effective for the purpose intended in this case despite the fact the manufacturer did not apply for a labeling change. The drug does not read the label to decide what it does to the patient. Do you refuse to fill Hydralzine for CHF patients as it is only indicated for hypertension. Would you have refused to fill propranolol prescriptions for hypertension when it was only approved for angina? Their fig leaf excuse is a cover up.

By your way of thinking a little town in bumstumble Alabama could have no pharmacies that would fill this and a patient would have to potentially have a surgical procedure with all of the risks involved to satisfy your desire to control her body based on what you deem is a medical need?

This pharmacist has no ethics or humanity and neither does anyone who supports this position

I've always enjoyed your posts, as you typically have a great deal of wisdom to share about the profession. I've learned a few valuable things from reading your posts that helped me be a better pharmacist, so thanks for that.

As far as the passages in your post that I quoted and bolded, you are ranting behind a political point of view just the same as someone ranting from a religious point of view. Abortion terminates a human life, no matter if it is legal in a particular state and no matter your stance on the issue. Same with euthanasia and assisted suicide. If a pharmacist doesn't feel ethically okay with dispensing a drug that is meant to directly terminate a human life they should not be compelled to do so. I'm certain there are nurses and physicians who would not feel compelled to participate in abortion procedures, euthanasia or assisted suicide. It should be no surprise that some pharmacists hold those views, as well.

 

[Old Timer]

Thank you for your kind words. But alas, I must totally disagree with you

As far as the passages in your post that I quoted and bolded, you are ranting behind a political point of view just the same as someone ranting from a religious point of view.

It doesn't matter what my point of view is. My obligation is to the patient in front of me. It is not my job to make her conform to my values and beliefs. Is the prescription legal, in the normal course of the prescriber's practice and will not harm the patient? If the answer to these questions is yes, you must fill the prescription or turn in your spatula. To hide behind the defense of it's an off label indication is cowardice in the extreme as I will bet everything I own against everything you oen he does not deny Hydralazine to patient's in heart failure even though that is also an off label indication.

Have you ever had a miscarriage. Before my first child was born, my wife had a miscarriage. She had to go to the hospital and undergo a surgical procedure as the chemical option in this case was not available. It is a heart wrenching experience that does not have to be made worse by a jerk off pharmacist who is totally lacking in empathy and compassion and wants to be in the position to judge another human being and maybe potentially force her to have surgery.

Abortion terminates a human life, no matter if it is legal in a particular state and no matter your stance on the issue.

Well no, it doesn't. This is your view religious or otherwise. I am a deeply religious person and the status of the fetus in my religion is it is NOT a human life. If there is a miscarriage you don't get a death certificate. You don't have a funeral. There is no recording of a life at the time of conception. To force me to conform to your view of things is wrong. I would never force you or anyone else to have an abortion. There is a clear difference here. This is not about abortion at all. What we have here is a holy roller so worried about abortion he would deny safe treatment to his patient

Same with euthanasia and assisted suicide. If a pharmacist doesn't feel ethically okay with dispensing a drug that is meant to directly terminate a human life they should not be compelled to do so. I'm certain there are nurses and physicians who would not feel compelled to participate in abortion procedures, euthanasia or assisted suicide. It should be no surprise that some pharmacists hold those views, as well.

Here you have a leg to stand on as this is a human life and taking of the human life, while it may reduce suffering is still taking a human life. The case in question here is not that. This is a vase about a cowardly jerk off pharmacist making life difficult for a woman who is under immense strain and in emotional turmoil and he is lacking in the balls to tell the truth and is hiding behind the defense of an off label indication.

 

[PharmNerdMatt]

Well no, it doesn't. This is your view religious or otherwise. I am a deeply religious person and the status of the fetus in my religion is it is NOT a human life. If there is a miscarriage you don't get a death certificate. You don't have a funeral. There is no recording of a life at the time of conception. To force me to conform to your view of things is wrong. I would never force you or anyone else to have an abortion. There is a clear difference here. This is not about abortion at all. What we have here is a holy roller so worried about abortion he would deny safe treatment to his patient

While I disagree with the pharmacist in the above example (this isn't really a case of abortion). I also find some irony in the bolded statement, even though I agree with it. If a pharmacist believes that a fetus is an individual life with value, then under "do no harm" they have a reason to both ethically and morally refuse to participate in abortion by supplying those medications. So, why do you think that someone has the right to force that pharmacist to conform to their view that a fetus is not an individual life with value? You apply to this principle to only the woman in front of you while others apply this to all life, "will this Rx harm any human life?" This is so very similar to the argument about physician assisted suicide. However, in that case one might believe that someone could decide to take their own life and be fine with that, but not be okay with the termination of an innocent life.

The biggest problem in this whole argument is that we still don't agree on what constitutes an individual life. We will probably never agree.

I want to bring up physicians and abortions again. People keep saying that all OB/GYNs are not trained to perform abortions, but I don't really think this is the case anymore. You can now be taught to perform an abortion (medically, through mifepristone and misoprostol) without ever actually doing it. So, I still don't understand why a physician who has the knowledge and ability to prescribe these meds is allowed to refuse on moral and ethical grounds but a pharmacist is not.

 

[HelpfulPharmer1]

QUOTE="Old Timer, post: 16400364, member: 150642"
Have you ever had a miscarriage.
Yes.

Before my first child was born, my wife had a miscarriage. She had to go to the hospital and undergo a surgical procedure as the chemical option in this case was not available.
Same here.

It is a heart wrenching experience that does not have to be made worse by a ******** pharmacist who is **** lacking in empathy and compassion and wants to be in the position to judge another human being and maybe potentially force her to have surgery.
Agree...

 

[SClENCE]

You are 100% wrong and 1000000% full of S**t. On any level you are a jerk. It's not your body, you don't have medical records, you have no idea what's going on with the patient. These decisions are made between the doctor and the patient. Unless there is some medical reason to refuse to fill a prescription, you fill the fu**in thing or get the f out of the profession.

Barrier to care: It is a barrier and you have no right to make a barrier. I don't care if the nearest competitor is 10 feet away or 10,000 miles away. It's not your right to come between the doctor and the patient. You don't get to make judgements about any legal procedure ordered by a licensed physician unless there is harm to the patient involved. Have you ever had a miscarriage? Has your spouse or any other close relative? It's a pretty devastating experience. Now your doctor tells you that your options are a surgical procedure or a chemical procedure. Not wanting to have surgery you get the prescription and are told by some a-hole pharmacist to move along and you have no need for it and you think the pharmacist acted legally, ethically and humanely when in fact he did nothing of the kind.

Birth Control, Plan B and abortion meds: Many people take birth control for cycle regulation. Many people cannot get pregnant (think Accutane ) and unless you know for sure, STFU and fill the prescription. You don't know anything about the patient. You see the prescription and make an assumption you have no business making.

Yes, the right of a woman (despite the Republican right) to get an abortion is a right and you have no business interfering with it. You should be forced to fill them by law and without interrogating the patient. Your editorial view of their health status is meaningless and intrusive.

As for the OP, Walmart is either 1000000000000% lying or their pharmacist should be sued for malpractice. A simple literature search will find this drug is safe and effective for the purpose intended in this case despite the fact the manufacturer did not apply for a labeling change. The drug does not read the label to decide what it does to the patient. Do you refuse to fill Hydralzine for CHF patients as it is only indicated for hypertension. Would you have refused to fill propranolol prescriptions for hypertension when it was only approved for angina? Their fig leaf excuse is a cover up.

By your way of thinking a little town in bumstumble Alabama could have no pharmacies that would fill this and a patient would have to potentially have a surgical procedure with all of the risks involved to satisfy your desire to control her body based on what you deem is a medical need?

This pharmacist has no ethics or humanity and neither does anyone who supports this position

I stated in my post that I was referring to cases where birth control is used solely for contraception. Not only that, but I also directly stated that I would fill all and any of these. You only make yourself stupid when you start arguing against points that were never made.

That being said, I completely disagree with the notion that it's a women right to have an abortion and healthcare providers must comply. This line of thinking is quite scary... forcing a provider to use their license to end an unwanted life. Completely contradicts their purpose weather they have a religious objection or not. Again, I am obviously referring to cases in which the baby is simply unwanted. Thought I'd clarify before you wrote another novel about a hypothetical situation in which an abortion is necessary for the mother to live.

In the end though this whole discussion comes down to one simple question:

Is the apparent right of a woman to have sex and not get pregnant greater than the religious freedoms of the pharmacist?

It's really that simple. You can go on all day about miscarriages and rape and so on but guess what? No pharmacist is going to object to filling a medication in these cases because the medication is not being used in a way that conflicts with their beliefs, weather they are against abortion/birth control or not. So the story about your wife that attempts to use emotion to draw support is really irrelevant to the discussion... because nobody here is talking about these situations except you.

Liberals like you are the single most expensive commodity that this country has. You truly disgust me.

 

[Rouelle]

Well no, it doesn't. This is your view religious or otherwise. I am a deeply religious person and the status of the fetus in my religion is it is NOT a human life. If there is a miscarriage you don't get a death certificate. You don't have a funeral. There is no recording of a life at the time of conception. To force me to conform to your view of things is wrong. I would never force you or anyone else to have an abortion. There is a clear difference here. This is not about abortion at all. What we have here is a holy roller so worried about abortion he would deny safe treatment to his patient

I'm certainly not going to try to insert my own political and/or religious views. However, philosophically I would like suggest that existence (or non-existence) of life is independent of governmental certification/recognition.

 

[SClENCE]

I'm certainly not going to try to insert my own political and/or religious views. However, philosophically I would like suggest that existence (or non-existence) of life is independent of governmental certification/recognition.

You would think that this is obvious but once again Old Timer holds nothing back in the spewing of his/her ignorance.

 

[BenJammin]

I don't know how anyone can take Old Timer seriously until he admits that he wants to be the one to answer the question "Is a fetus considered to be a human life?".

 

[Old Timer]

You would think that this is obvious but once again Old Timer holds nothing back in the spewing of his/her ignorance.

Says who. There is a scientific consensus that a fetus is a human being at the time of conception? That is supported by what scientific group? Show me. This is a religious and philosophical question that human beings will never resolve. To say it is cut and dried and I alone am one side and all of science is on the other side is false. I am not spewing ignorance. I am spewing nuance, something you apparently do not understand at all.

If you don't want to be involved in this, that's ok with me. But when you take an oath as a health care provider, you provide care to the patient in front of you and you do not judge them. If you can't comply with that, go into accounting. My religion does not believe life begins at conception. So if a female of my faith in consultation with her doctor and her clergy person feels this is best option for her health, it is not up to you and your beliefs to prevent her from getting the care she needs.

I really don't want this to be about abortion. This is a hot button topic that never ends well.

This case is about when it is and is not appropriate to dispense a medication to a woman who preferred to have a pharmaceutical treatment rather than a surgical treatment after a miscarriage. It is not up to the pharmacist to deny this patient the medication in this case.

 

[SClENCE]

Says who. There is a scientific consensus that a fetus is a human being at the time of conception? That is supported by what scientific group? Show me. This is a religious and philosophical question that human beings will never resolve. To say it is cut and dried and I alone am one side and all of science is on the other side is false. I am not spewing ignorance. I am spewing nuance, something you apparently do not understand at all.

If you don't want to be involved in this, that's ok with me. But when you take an oath as a health care provider, you provide care to the patient in front of you and you do not judge them. If you can't comply with that, go into accounting. My religion does not believe life begins at conception. So if a female of my faith in consultation with her doctor and her clergy person feels this is best option for her health, it is not up to you and your beliefs to prevent her from getting the care she needs.

I really don't want this to be about abortion. This is a hot button topic that never ends well.

This case is about when it is and is not appropriate to dispense a medication to a woman who preferred to have a pharmaceutical treatment rather than a surgical treatment after a miscarriage. It is not up to the pharmacist to deny this patient the medication in this case.

Again you are talking about miscarriages. Read my above post for the love of God. Weather it is a life or not is completely irrelevant... however to imply that it is not a life simply because there is no death certificate is the ignorance that I am referring to.

 

[Old Timer]

That being said, I completely disagree with the notion that it's a women right to have an abortion and healthcare providers must comply. This line of thinking is quite scary... forcing a provider to use their license to end an unwanted life. Completely contradicts their purpose weather they have a religious objection or not. Again, I am obviously referring to cases in which the baby is simply unwanted. Thought I'd clarify before you wrote another novel about a hypothetical situation in which an abortion is necessary for the mother to live.

So you get to be in the mind and chart of any patient and decide the baby is unwanted? The height of arrogance. Do you want me to agree there are too many abortions in this world. That would be obvious to anyone. But again that is not what this thread is about.

In the end though this whole discussion comes down to one simple question:

Is the apparent right of a woman to have sex and not get pregnant greater than the religious freedoms of the pharmacist?

No. your logic is flawed. This is about your duty as a pharmacist. You are free to practice your religion just not at the expense of the health of the patient in front of you.

It's really that simple. You can go on all day about miscarriages and rape and so on but guess what? No pharmacist is going to object to filling a medication in these cases because the medication is not being used in a way that conflicts with their beliefs, weather they are against abortion/birth control or not. So the story about your wife that attempts to use emotion to draw support is really irrelevant to the discussion... because nobody here is talking about these situations except you.

This indicates that you are wrong. It is my view the pharmacist did just that and the corporate justification after the fact was an attempt to avoid having the religious freedom argument as that would not be good for the employer. Since in this case it was not about abortion or birth control and the patient was refused anyway. As for using my wife as an example. It's how you make arguments in a discussion with examples, just like you did above with hypothetical unwanted baby. You gave an example, a very good example for not letting people have abortions wherever and whenever they want, but an example none the less. But that does not make my example less valid. In fact it makes my point perfectly. My wife had to have a surgical procedure. There is always a risk when having a surgical procedure. If there was an option given to me to have a pharmaceutical treatment and it was denied, I would be pissed and rightly so.

Liberals like you are the single most expensive commodity that this country has. You truly disgust me.

I'm shocked and amazed. I really don't care if you agree with me or not. Just make your arguments and follow them to their logical conclusion. If you believe human life begins at conception and a human being is a person with same rights as any other person then any abortion would be murder. How can you justify murdering one human being for the sake of another?

 

[Old Timer]

Now I will take this discussion down the rabbit hole. I want to be clear. A fetus is alive. The question is, is it a human being? At what stage is it a human being? If you are a religious person, at least a western religious person, when does a person acquire a soul. That of course is the clear difference here. We have no issue with euthanasia for our pets, for while they are alive, they are not human beings nor do they have a soul. For atheists, these points are moot and it's a question of ethics. Flesh out your arguments and prove to me at the time of conception the zygote is a human being.

 

[Digsbe]

I think it's dangerous to define human life based on how the government recognizes it. After all, Africans, Jews, racial/religious minorities and others have legally not been recognize as "people" or given unequal human rights by governments throughout history and such things today are recognized as atrocities, although completely legal back in those ages. There are also some laws that protect fetal life and have enhanced charges if a pregnant woman is murdered, not to mention lawsuits if malpractice occurs leading to a miscarriage or preventable deformity. Although that's beside the point. My main belief is that issues regarding abortion, lethal injection, physician assisted suicide and other ethics should fall within the realm of conscience clauses as the practitioners should have some sense of human rights to not be forced to do unnecessary treatments that violate their conscience as a person. I don't think the fact that something is legal means you should be forced to provide it. I think patients should have the right to access and not demand or be entitled to care (assuming non-lifesaving care and non ER related care).

 

[SClENCE]

I think it's dangerous to define human life based on how the government recognizes it. After all, Africans, Jews, racial/religious minorities and others have legally not been recognize as "people" or given unequal human rights by governments throughout history and such things today are recognized as atrocities, although completely legal back in those ages. There are also some laws that protect fetal life and have enhanced charges if a pregnant woman is murdered, not to mention lawsuits if malpractice occurs leading to a miscarriage or preventable deformity. Although that's beside the point. My main belief is that issues regarding abortion, lethal injection, physician assisted suicide and other ethics should fall within the realm of conscience clauses as the practitioners should have some sense of human rights to not be forced to do unnecessary treatments that violate their conscience as a person. I don't think the fact that something is legal means you should be forced to provide it. I think patients should have the right to access and not demand or be entitled to care (assuming non-lifesaving care and non ER related care).

This is the exact point I'v been trying to make. The problem is people believe that a patient is in fact entitled to any and every sort of care regardless of medical necessity to to say otherwise is to act as a barrier to patient care.

 

[SClENCE]

So you get to be in the mind and chart of any patient and decide the baby is unwanted? The height of arrogance. Do you want me to agree there are too many abortions in this world. That would be obvious to anyone. But again that is not what this thread is about.

Well first of all I don't know many pharmacist who preform abortions. It's the doctor. And I'm pretty sure the doctor would be aware of the reason for the abortion...

No. your logic is flawed. This is about your duty as a pharmacist. You are free to practice your religion just not at the expense of the health of the patient in front of you.

If the abortion is simply because the baby is unwanted or if birth controls are solely being used to prevent pregnancy then I do not see how the health of the patient is suffering. I'v already made it clear that there are the situations that I am referring to.

This indicates that you are wrong. It is my view the pharmacist did just that and the corporate justification after the fact was an attempt to avoid having the religious freedom argument as that would not be good for the employer. Since in this case it was not about abortion or birth control and the patient was refused anyway. As for using my wife as an example. It's how you make arguments in a discussion with examples, just like you did above with hypothetical unwanted baby. You gave an example, a very good example for not letting people have abortions wherever and whenever they want, but an example none the less. But that does not make my example less valid. In fact it makes my point perfectly. My wife had to have a surgical procedure. There is always a risk when having a surgical procedure. If there was an option given to me to have a pharmaceutical treatment and it was denied, I would be pissed and rightly so.

In this case the pharmacist likely assumed that the medication was for contraception and blindly refused the patient. We both agree that this is out of line, however the pharmacist did not deny the patient knowing the circumstances thus my statement remains true.

I'm shocked and amazed. I really don't care if you agree with me or not. Just make your arguments and follow them to their logical conclusion. If you believe human life begins at conception and a human being is a person with same rights as any other person then any abortion would be murder. How can you justify murdering one human being for the sake of another?

I personally don't believe this... however somebody that does obviously wouldn't be putting themselves in this type of practice so again the statement is completly irrelevant