Friday, July 27, 2007

Pharmacists Sue State Because State Tells Them To Do Their Damn Job

*Apologies in advance for the poor copyediting and generally rambling nature of this post.

Yes, this is about emergency contraception:

Pharmacists have sued Washington state over a new regulation that requires the sale of emergency contraception, also known as the "morning-after pill."

In a lawsuit filed in federal court here, a pharmacy owner and two pharmacists say the rule that took effect Thursday coerces them into "choosing between their livelihoods and their deeply held religious and moral beliefs."

The state ruled earlier this year that druggists who believe emergency contraceptives are tantamount to abortion can't stand in the way of a patient's right to the drugs.


I hold a pretty strong opinion on this one: The pharmacists in question need to have their licenses to practice removed. Now. If pharmacists want to retain control of their profession, there needs to be some attempt at self-policing to prevent shit like this. Otherwise, I suspect we're going to see political activists put pressure on state and federal legislative bodies to craft stricter rules for pharmacists around dispensing medications, which will have the effect of taking medical decisions out of the hands of medical professionals. That, I suspect, is not something most pharmacists want to see, especially when the recent advent of the PhD in Pharmacy and the greater role pharmacists are playing in patient care.

Given that EC is just a really strong dose of birth control pills, I'm curious to know if the pharmacists in question are opposed to birth control as well. It's possible - they are Roman Catholic, according to the story - but if they, I think it would come as a shock to many people who consider birth control a pretty uncontroversial thing.

At the bottom of the story was another bit that caught my eye:

Pharmacists are also forbidden to destroy prescriptions or harass patients, rules that were prompted by complaints from Washingtonians, chairwoman Rebecca Hille said.


I'd be curious to see the exact number and nature of complaints....though I will say that again, this is a case where the fact that a state regulatory body felt the need to intervene is something I consider a net loss for pharmacists. This is something that I think should be handled at the level of the pharmacists themselves, be it their professional association or whatever. It's still in their best interests - as it is with most professions - to be able to self-regulate. The argument that these issues fall outside the purview of pharmacists since they are "ethical" or "moral" issues doesn't hold water for me; however you classify them they involve pharmacists, patients, state or federal oversight, and the public's view of pharmacists as trustworthy dispensers of medicine. And it only takes a few well-publicized cases to freak people out.


...it should be noted that the state regulation in question doesn't force every pharmacist to dispense medication they are opposed to, just that someone in the pharmacy fill the prescription during the same visit. This strikes me as a very reasonable request that allows for personal beliefs to be respected without those beliefs spilling over onto others. However, if the reason the three people in question is upset is that they're not being allowed to fuck with their patients, then forget them. And I do think that's what is happening, based on this part of the new rules:

Pharmacies also are required to order new supplies of a drug if a patient asks for something that is not in stock.


This new regulation is only objectionable if the personal beliefs in question include not allowing women access to EC.

Oops.

This, for the record, is why I'd like to see professional pharmacists do a better job of making clear what responsibilities are expected of pharmacists, and making decisions based on medical advice and not kooky personal beliefs is one of them.

In all fairness, given how much more knowledge your average Doctor of Pharmacy has about drugs and drug interactions than your average Medical Doctor, I can see a case in which the pharmacist has a better idea of what drug is appropriate to prescribe than an MD. In such a case, it would make sense to allow the pharmacist to override or change the doctor's prescription, yes? The problem is that crap like this lawsuit undermines public trust in pharmacists to make those changes with the interest of the patient in mind (leading to increased regulation by the state), which obviously has a negative effect on their ability to do their job.

Thanks to David for the hour of coffee-fueled & heated conversation in a car at 7 a.m. that helped me develop this position.

Via Feministe.

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