Saturday, June 21, 2008

Pro-Life Drugstores: A Trend for the Future?

By Randy Hendrickson

According to the Washington Post ( “Pro-Life Drugstores Market Beliefs” June 16, 2008), no methods of birth control will be sold in DMC Pharmacy, based in Chantilly, Virginia. This faith-based pharmacy will open in August, however, no birth control pills, morning after pills, condoms, or any other forms of contraception will be available, even with a prescription. This may be the beginning of a new trend in pharmacies that are refusing to sell products that the health care providers (pharmacists in this case) find morally objectionable. “[S]uch methods can cause what amounts to an abortion, and contraceptives promote promiscuity, divorce, the spread of sexually transmitted diseases and other societal woes…. This allows a pharmacist who does not wish to be involved in stopping a human life in any way to practice in a way that feels comfortable.” Some pro-life pharmacies do not sell contraception products only, whereas others also refuse to sell tobacco, pornography, rolling papers, or other commodities that are deemed morally questionable. The patient has the option of going elsewhere to another pharmacy if she does not share this philosophy.

In traditional pharmacy practice, the legal and moral obligations have always involved ensuring that the proper medication ordered by the prescriber is properly delivered to the patient. Physicians, not pharmacists, hold the ultimate responsibility in making sure that the final treatment outcome is achieved. However, according to the American Association of Colleges of Pharmacy’s Commission to Implement Change in Pharmaceutical Care, the definition of ‘pharmaceutical care’ now focuses on “the pharmacists’ attitudes, behaviors, commitments, concerns, ethics, functions, knowledge, responsibilities, and skills on the provision of drug therapy with the goal of achieving definite outcomes towards the improvement of the quality of life for the patient.” How does provision of contraceptive products fit into this view of pharmaceutical care?

Bioethicists have mixed feelings about this issue. Some hold that the needs of the patients should come before the beliefs of the health care professional.

Nancy Berlinger of the Hastings Center for Bioethics Research, claims that “if you are a health care professional, you are bound by professional obligations,” and you can’t refuse to do what is required by the profession.
R. Alto Charo, a University of Wisconsin bioethicist, also fears that pro-life pharmacies may proliferate in the future, especially in rural areas, “creating a separate universe of pharmacies that puts women at a disadvantage.”

Others have differing views:

Loren E. Lomasky, a bioethicist at University of Virginia, states that finding a niche market based on ethical beliefs and “product differentiation expressive of differing values is a very good thing for a free, pluralistic society."
Similarly, Pharmacists for Life International, which is dedicated to the pro-life philosophy, supports the pharmacist’s right to refuse to fill prescriptions for birth control products.

Several other issues are also at stake. Many pro-life pharmacies do not have signs indicating that they will not dispense contraceptives. As a result, women who need the morning after pill may be wasting valuable time finding a pharmacy that will fill her prescription. This would also be a major concern for rape victims. There have also been reports of pharmacists who not only refuse to fill the prescription, but also refuse to return the prescription to the patient so that she could have it filled at another pharmacy. This, however, is extreme, but it has been reported.

A few states, including New Jersey, California, Illinois, and Washington, have laws that require pharmacies to fill all prescriptions for contraception products OR help women find other means to fill their prescriptions, such as recommending other available pharmacies. The state of Virginia, however, has no such restrictions and no intentions to adopt any such prohibitions.

Because of the societal issues that are constantly evolving, the ethics of pharmacy (and medicine in general) has changed tremendously over the past few years, and these changes make the need for an ethical framework more vital today than it has been in the past. Health care providers need to be cognizant of both the expanding ethical responsibilities as practitioners, but also the traditional moral obligations to patients. Hopefully a balance can be achieved that will benefit all involved.

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