Cross-posted from my
home blog.
Pharmacists appear to be trying to carve out a larger and more "relevant" role in the health care system by making a stand regarding the issue of pregnancy prevention. In doing so, they are undermining the patient/doctor relationship. Medical ethics are decided at the level of doctor and patient, not that of patient and pharmacist.
(More on the flip, including my particular predicament)
I have a great relationship with my pharmacists. They have commiserated with me through the endless ear infections that marked the first year of my daughter's life. Like clockwork, two days after picking up any new prescription for my little girl, they'd call and see how she (and I) were doing. I appreciate that, and it is what I expect out of our relationship.
They never questioned why the endless rounds of antibiotics that we tried before finally settling on surgery to correct Anna's problem. I did not expect them to - those decisions were made between her doctors and me, informed by our mutual, complete knowledge of her medical history and our goals for treatment.
My pregnancy gave me two beautiful little girls. Unfortunately, it also left me a problem - I can't get pregnant again. If I do, it is very likely I will die. Because of my medical problems, my husband and I use barrier protection when we have sex. We know it can fail. With this knowledge, we discussed the situation with my OB carefully. We three decided I would use Plan B if the barrier protection ever failed. Thankfully, so far it has not.
I am faced with the nightmare now of having someone putting their judgment between that of myself and my doctor. Placed in a position where they can legally second-guess that medical decision, and delay or hinder my ability to obtain Plan B within its very narrow window of effectiveness. I made this decision with my doctor and my husband, so my little girls will have a mother. Now, someone I have a much more casual relationship with could interfere based on their moral objections.
That someone is my pharmacist. The same one I have had this wonderful relationship with may decide to not fill this one type of prescription, without knowing my full medical history, without having been privy to the discussions with my doctor, or the two weeks I spent in a darkened hospital room, my body slowly failing as we tried to eke out enough time for my daughters to be born safely. Risking my life based on their assumptions about the reasons for my prescription, not having been privy to the decision making process.
The American Pharmacist Association (APhA) argues "pharmacists, like physicians and nurses, should not be required to engage in an activity to which they object." This is a comparison of apples and oranges. When picking a doctor I know in advance if they object to certain medical procedures because they can and do limit their practice so that I know in advance that certain types of care will not be available. There is no equivalent standard for pharmacists, nor should there be. Their role is delivery of the medications prescribed by my doctor. A pharmacist is not entitled to apply moral judgments to medical decisions.
The APhA further claims that the pharmacist who opts out of dispensing certain medicines is "stepping out of the way" but not "stepping in the way" of the patients care. This is once again a spurious argument. Failure to provide services is not only a sin of omission by failing to act in a professional manner; it is a breach of trust for a pharmacist to supersede my doctor's judgment.
Having already had to deal with a failed contraceptive, contacting my doctor and getting a prescription, now I must wonder if I can locate a pharmacist who will fill the prescription. To stand at a counter at the local drugstore and have the pharmacist quietly whisper that I will have to go elsewhere is intolerable. The pharmacist doesn't know, and doesn't need to know, the "why" of why I am here. The APhA claims that by stepping aside I will not be negatively impacted by the pharmacists actions. They are wrong - I am and will be affected. Every hour I spend driving off to another pharmacy is eating away at my window of time. The longer I have to wait to take the drug heightens the chance for implantation and pregnancy, which would then leave me and my family the decision to terminate a potentially viable pregnancy in order to protect my life. Will my pharmacist be able to dispense a solution then?