PHARMACISTS’ OBJECTIONS OVER DISPENSING CONTROVERSIAL MEDICATION GENERATE DEBATE
Title: PHARMACISTS’ OBJECTIONS OVER DISPENSING CONTROVERSIAL MEDICATION GENERATE DEBATE , By: Frederick, James, West, Diane, Drug Store News, 01917587, 4/23/2001, Vol. 23, Issue 6
Section: CATEGORY NEWS
Chain Pharmacy
COLUMBUS, Ohio — Lawmakers in several states are debating job-protection legislation for pharmacists who refuse to dispense certain medications on moral or ethical grounds.
If passed, the new laws could present drug chains with a new set of complications as they seek to sidestep controversies surrounding a handful of medications related to birth control and other healthcare topics that generate strong opinions.
“Conscience” bills are currently under state legislative review in Ohio, Kentucky, Indiana and Kansas and previously have been considered in Michigan, Missouri and Minnesota. Most are variations of a 1998 South Dakota law allowing pharmacists to refuse to fill prescriptions that conflict with their personal religious and moral beliefs.
Cases most widely cited in the conscience-clause debate involve use of “morning-after” emergency contraception pills, or ECPs, which have generated controversy from anti-abortion groups. However, pro-life groups don’t agree when life “begins,” which is central to the ECP debate.
ECPs, which are regular oral contraceptives given at high doses, are thought to work either by preventing fertilization or by preventing a fertilized egg from implanting in the uterus. The current position of the National Right to Life Committee, an antiabortion group, says they “take no position on the prevention of fertilization, i.e., the union of the sperm cell and egg cell.” It is impossible to tell with certainty whether oral contraceptives or ECPs stop a possible pregnancy by interrupting fertilization or uterine implantation.
Viagra restrictions
Viagra (sildenafil citrate) Pfizer’s blockbuster pill for erectile dysfunction, has become a matter of conscience in at least one state. A lengthy, detailed March 7 amendment to the conscience clause being debated in Kentucky (H.B. 106), according to the state legislature’s Web site, may be the first to restrict the use of Viagra to married, heterosexual couples. Under the amendment, pharmacists could require patients to produce a diagnosis of erectile dysfunction “written on the face of the prescription,” and could limit dispensing it to “a husband who is present with his wife at the time of dispensing.”
In addition, Kentucky’s Viagra amendment suggests pharmacists could require the following documentation before dispensing the drug to a patient: “a certified copy of their marriage certificate, a copy of the King James Version of the seventh commandment prohibiting adultery and a profession of allegiance to this prohibition and a valid state photographic identification that corresponds to the husband and wife to whom the medication is to be dispensed.” More information is available at (http://www.lrc.state.ky.us/RECORD/01RS/HB106.htm).
Chain pharmacies thus far have been dealing with such ethical matters on a case-by-case basis. WalMart Stores opted not to dispense the morning-after drug after it was approved for use, in the face of criticism from some groups, though the chain said its decision was based on a lack of consumer demand for the pills. Kmart, meanwhile, is defending itself in a wrongful-termination suit filed by pharmacist Karen Brauer, who refused in 1996 to dispense a birth control drug that she considered tantamount to abortion. The case reportedly will be heard next month. In another case last year, according to published reports, Eckerd Corp. successfully defended itself in a discrimination suit filed by an Orthodox Jewish pharmacist who refused to sell condoms.
Planned Parenthood confirmed that it is monitoring the state legislative moves surrounding pharmacy conscience clauses but are not now involved in lobbying efforts.
State pharmacist groups, such as the Ohio Pharmacist Association, generally support the “pharmacist’s right to conscientious objection to morally, religiously or ethically troubling therapies while protecting the patient’s right to obtain legally and medically indicated treatments for them.”
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By James Frederick and Diane West
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Source: Drug Store News, 4/23/2001, Vol. 23 Issue 6, p21, 2p
