Druggist Refuse to Give Out Pill

[Averett]

Link

Tue Nov 9, 6:54 AM ET Politics - USATODAY.com

By Charisse Jones, USA TODAY

For a year, Julee Lacey stopped in a CVS pharmacy near her home in a Fort Worth suburb to get refills of her birth-control pills. Then one day last March, the pharmacist refused to fill Lacey's prescription because she did not believe in birth control.

"I was shocked," says Lacey, 33, who was not able to get her prescription until the next day and missed taking one of her pills. "Their job is not to regulate what people take or do. It's just to fill the prescription that was ordered by my physician."


Some pharmacists, however, disagree and refuse on moral grounds to fill prescriptions for contraceptives. And states from Rhode Island to Washington have proposed laws that would protect such decisions.


Mississippi enacted a sweeping statute that went into effect in July that allows health care providers, including pharmacists, to not participate in procedures that go against their conscience. South Dakota and Arkansas already had laws that protect a pharmacist's right to refuse to dispense medicines. Ten other states considered similar bills this year.


The American Pharmacists Association, with 50,000 members, has a policy that says druggists can refuse to fill prescriptions if they object on moral grounds, but they must make arrangements so a patient can still get the pills. Yet some pharmacists have refused to hand the prescription to another druggist to fill.


In Madison, Wis., a pharmacist faces possible disciplinary action by the state pharmacy board for refusing to transfer a woman's prescription for birth-control pills to another druggist or to give the slip back to her. He would not refill it because of his religious views.


Some advocates for women's reproductive rights are worried that such actions by pharmacists and legislatures are gaining momentum.


The U.S. House of Representatives passed a provision in September that would block federal funds from local, state and federal authorities if they make health care workers perform, pay for or make referrals for abortions.


"We have always understood that the battles about abortion were just the tip of a larger ideological iceberg, and that it's really birth control that they're after also," says Gloria Feldt, president of Planned Parenthood (news - web sites) Federation of America.


"The explosion in the number of legislative initiatives and the number of individuals who are just saying, 'We're not going to fill that prescription for you because we don't believe in it' is astonishing," she said.


Pharmacists have moved to the front of the debate because of such drugs as the "morning-after" pill, which is emergency contraception that can prevent fertilization if taken within 120 hours of unprotected intercourse.


While some pharmacists cite religious reasons for opposing birth control, others believe life begins with fertilization and see hormonal contraceptives, and the morning-after pill in particular, as capable of causing an abortion.


"I refuse to dispense a drug with a significant mechanism to stop human life," says Karen Brauer, president of the 1,500-member Pharmacists for Life International. Brauer was fired in 1996 after she refused to refill a prescription for birth-control pills at a Kmart in the Cincinnati suburb of Delhi Township.


Lacey, of North Richland Hills, Texas, filed a complaint with the Texas Board of Pharmacy after her prescription was refused in March. In February, another Texas pharmacist at an Eckerd drug store in Denton wouldn't give contraceptives to a woman who was said to be a rape victim.


In the Madison case, pharmacist Neil Noesen, 30, after refusing to refill a birth-control prescription, did not transfer it to another pharmacist or return it to the woman. She was able to get her prescription refilled two days later at the same pharmacy, but she missed a pill because of the delay.


She filed a complaint after the incident occurred in the summer of 2002 in Menomonie, Wis. Christopher Klein, spokesman for Wisconsin's Department of Regulation and Licensing, says the issue is that Noesen didn't transfer or return the prescription. A hearing was held in October. The most severe punishment would be revoking Noesen's pharmacist license, but Klein says that is unlikely.


Susan Winckler, spokeswoman and staff counsel for the American Pharmacists Association, says it is rare that pharmacists refuse to fill a prescription for moral reasons. She says it is even less common for a pharmacist to refuse to provide a referral.


"The reality is every one of those instances is one too many," Winckler says. "Our policy supports stepping away but not obstructing."

In the 1970s, because of abortion and sterilization, some states adopted refusal clauses to allow certain health care professionals to opt out of providing those services. The issue re-emerged in the 1990s, says Adam Sonfield of the Alan Guttmacher Institute, which researches reproductive issues.

Sonfield says medical workers, insurers and employers increasingly want the right to refuse certain services because of medical developments, such as the "morning-after" pill, embryonic stem-cell research and assisted suicide.

"The more health care items you have that people feel are controversial, some people are going to object and want to opt out of being a part of that," he says.

In Wisconsin, a petition drive is underway to revive a proposed law that would protect pharmacists who refuse to prescribe drugs they believe could cause an abortion or be used for assisted suicide.

"It just recognizes that pharmacists should not be forced to choose between their consciences and their livelihoods," says Matt Sande of Pro-Life Wisconsin. "They should not be compelled to become parties to abortion."

God. I don't even know what to say. This makes me sick. What makes it their right to refuse any woman her medication because of MORAL standings??? Fucking hell. So will these same druggists refuse to sell a man a box of condoms?

Unreal.

[ShaniFaye]

Im at a loss for words over this

[tecoyah]

Loss of liscence....six months working at an orphanage......seems a good sentance to me.

[Averett]

What if a 72 year old man comes in for his heart medication. Can the druggist say "Sorry sir, but I believe if you take this medication you are furthering your life, and if you have a bad heart, well then apparently God wants you to die. It's against my morals to do something that is against God's will"

GRRRRR!

[Cynthetiq]

She filed a complaint after the incident occurred in the summer of 2002 in Menomonie, Wis. Christopher Klein, spokesman for Wisconsin's Department of Regulation and Licensing, says the issue is that Noesen didn't transfer or return the prescription. A hearing was held in October. The most severe punishment would be revoking Noesen's pharmacist license, but Klein says that is unlikely.

Susan Winckler, spokeswoman and staff counsel for the American Pharmacists Association, says it is rare that pharmacists refuse to fill a prescription for moral reasons. She says it is even less common for a pharmacist to refuse to provide a referral.

Before everyone gets all up in arms about this...

I ask, is this an isolated incident? If not, how many times does it happen?

Think of the total women out there and how many people there are filling prescriptions etc. and if it's just this one incident or even a handfull it's not indicative of a trend. It just happens to be a situation that has happened.

I'm even beginning to think that it's alarmist propaganda as it happened in 2002 and we're just hearing about it now right after an close election.

[Averett]

If it happens just once, it's a problem.

[irseg]

Originally Posted by Cynthetiq

Before everyone gets all up in arms about this...

I ask, is this an isolated incident? If not, how many times does it happen?

Enough to make a state law about it, apparently.

This really pisses me off. Pharmacists are not there to be judges, philosophers, theologians, or moral crusaders. Their sole legitimate purpose is to make you sit around for an hour waiting for them to dump some pills into an orange bottle. If they have moral problems with dispensing certain types of pills for a legitimate prescription, then they need to find another line of work.

[Cynthetiq]

Originally Posted by Averett

If it happens just once, it's a problem.

sure, agreed, but IMO not any more different of a problem than someone robs and murders.

I ask the questions because if it's so important, then why did this come to light in after the 2004 election and not at all in 2003? Why suddenly this surfaces?

[MikeyChalupa]

If you are a pharmacist that has a moral objection to handing out birth control pills, then I think it's time to look for another job. Here are customers actively trying to do what so many other groups are reiterating over and over, practice safe sex and responsible sex, and the pharmacists just don't want to get with the program. The woman in the story was 33, not like she was 16 or something.

-Mikey

[f6twister]

Originally Posted by Cynthetiq

sure, agreed, but IMO not any more different of a problem than someone robs and murders.

I ask the questions because if it's so important, then why did this come to light in after the 2004 election and not at all in 2003? Why suddenly this surfaces?

This didn't just show up. These incidents have been happening for a few years now. I never been a person who thought that a person has any right to force their views and beliefs onto others and this is about as bad as it gets. If they don't want to do their job and prescribe the medication as prescribed by a licensed doctor, then they should find a job that doesn't conflict with their morals. These morons should know that birth control pills are prescribed for other medical issues besides preventing birth. Instead of a law protecting them, there should be a law which prevents them from refusing to fill a doctors order, especially since they have no idea why the drug was prescribed. They only know what, how much and how often to use it...not the symptoms behind the reason.

[SecretMethod70]

Individual pharmacists, yes, they should adhere to their employer's guidelines. If a private company chooses to not distribute certain drugs, however, that is within their right. And, really, if the private company wants to have an official stance that it is the discretion of the pharmacist, that is within their ability as well. Nowhere does it say access to birth control is one of our unalienable rights and I'd rather be getting things from someone who can service me with a good conscience than force someone to do something which is against their conscience. I believe it is wrong to force moral standards on someone on EITHER side of the debate.

[tropple]

Hmmm.. he won't return the presrciption slip? Sounds like robbery to me. Call the cops.

Then have some friends come by and do some after-work asskicking.

[SecretMethod70]

Originally Posted by tropple

Hmmm.. he won't return the presrciption slip? Sounds like robbery to me. Call the cops.

Then have some friends come by and do some after-work asskicking.

Yes, not returning the prescription slip, no matter if the company has a policy of not filling the prescription or not, is in fact theft.

[Stompy]

Some women NEED it to regulate hormones for certain things (my girlfiend, for example).

If she misses a day, it's not a problem.

But still, that doesn't matter. If an old man misses his heart medication for one day, it won't be a problem, but I don't think he really wants to test it.

I'd LOVE to get a pharmacist that pulls this shit. They'll be in for quite a surprise

[water_boy1999]

Unbelievable. I seriously doubt this is an isolated event with the "1,500-member Pharmacists for Life International" working in the medical field. Yeah, people are entitled to their own beliefs, but this is just a little overboard. Serve up some pills or find a job where your skewed views won't conflict with your work.

[denim]

Originally Posted by tecoyah

Loss of liscence....six months working at an orphanage......seems a good sentance to me.

Nice. That's good for a first offense. Second offense should be loss of license and blacklisting.

It's bad enough that these people obstruct others lives. If they insist on getting more offensive like this, I easily see a civil war erupting over it. And since they're not willing to make any move to take life, I suspect I know who will win.

[denim]

Originally Posted by irseg

If they have moral problems with dispensing certain types of pills for a legitimate prescription, then they need to find another line of work.

Well put, sir.

[KinkyKiwi]

i agree with waterboy...seriously...your job is to fill prescriptions..if your "moral" issues get in the way then go work at a church or anyplace where its acceptable to behave that way. i've had druggests give me long moral lectures when i went to pick up my birth control pills but none so far have tried to stop me or have refused to give them to me. as to refusing to give the morning after pill...thats just wrong and selfish.

[fckm]

I don't think that there should be state laws condoning this type of behavior. I think it should be up to the particular store. If a pharmacist wants to deny someone their medication, then the customer can complain and have the pharmacist fired. If the store wants to have a policy that allows pharmacists to refuse, that's should be ok. However, it should be illegal for the pharmacist to refuse to hand back the perscription. Taking the perscription slip is just asinine.

[Drider_it]

ever roll a ball down a hill.. or better yet toss a rock down a hill and it starts a rock slide it gains momentum and all hell breaks loose. political correct.. that was a fad. yet you still see it everywhere and in a ironic greater number.

lets see ban birth control, of all forms. we as a society have two choices. no sex.. (yeah right) or there will be a huge increase in the family .. oh good plan there.

lets see whats next .. *snaps fingers* the terminally ill ... they are gonna die anyways lets just help them along. my inner well being couldnt handle knowing thier pain. Oh your a christian. you cant come into my store im a jew. or vice versa.

ive always said it.. give the people too much rope and they will hang themselves

[gcbrowni]

I believe their national organization has guidelines for these types of things. They don't have to fill a perscription but are supposed to direct the customer/patient to someone who will.

[lurkette]

This is fucking ridiculous. If they have a potential moral conflict with part of their job, they should not be allowed to work as a pharmacist. If a doctor refused to treat a black person because he was a white supremacist, or an illegal immigrant because he was here illegally, he'd sure as hell be in deep shit. When dealing with peoples' health, you should have a moral obligation to keep your religious and political opinions to yourself or go find a different calling. Like as a missionary. Or maybe that crazy guy preaching on the corner.

Hell in a handbasket, I tell you.
*goes hunting for the Canadian immigration web site*

[KMA-628]

Like Secret said earlier in this thread, if it is an private store, then can sell/not sell whatever they please. There is no law that says every drug prescribed must be dispensed.

This is a free-market people. If they don't want to sell it, they don't have to. If you don't want to buy it, then don't buy it.

It's not like she couldn't go to another pharmacy.

/goes looking for the Candian immigration web site if the laws in this country change and tell me (or anyone else) what I can or can't sell in a store that I (or anyone else) owns.

//go to a jewish/muslim meat store and ask for non-kosher meat. They won't sell it for religious reasons--should they be forced to as well?

///freedom means freedom, to sell something or to not sell something. We are in a competitve marketplace, one person sells it one person doesn't--so what?

[CinnamonGirl]

(bitter sarcasm) Well, sure, if everyone else can decide who we're allowed to marry, why can't they decide whether or not we can use birth control? (/bitter sarcasm)

Honestly, I'm not surprised. A little pissed off, yes, surprised, no.

[filtherton]

Originally Posted by KMA-628

Like Secret said earlier in this thread, if it is an private store, then can sell/not sell whatever they please. There is no law that says every drug prescribed must be dispensed.

This is a free-market people. If they don't want to sell it, they don't have to. If you don't want to buy it, then don't buy it.

It's not like she couldn't go to another pharmacy.

/goes looking for the Candian immigration web site if the laws in this country change and tell me (or anyone else) what I can or can't sell in a store that I (or anyone else) owns.

//go to a jewish/muslim meat store and ask for non-kosher meat. They won't sell it for religious reasons--should they be forced to as well?

///freedom means freedom, to sell something or to not sell something. We are in a competitve marketplace, one person sells it one person doesn't--so what?

This isn't a product that they aren't selling because they don't stock it. This is a product that they've been selling this woman for a year. Then, one day, a morally superior pharmacist decides that he is too moral to do her job. This isn't a free market issue. This is a "don't get hired for a job if you are morally opposed to doing your job" issue.

[KMA-628]

so what?

So you are in favor of denying him his right to sell or not sell a product?

One person's freedoms taken away for another person's freedoms?

it is very simple, don't bitch about it, go to another store.

[vermin]

I don't think it would be out of line to require a store or individual pharmacist to post a sign stating what drugs they morally object to and will not dispense. Then everyone in the community who disagrees with this moral stance can shop someplace else (where they do sell birth control pills, presumably) and the offensive store can either lose sales and possibly go out of business or change their policy. Or if a majority of the people in that community agree with this policy, then the other store goes out of business. Democracy in action.

[greytone]

OK, it is time for me to step into it. I am a physician an I have no moral problem with contraception. However, I have absolutely no doubt as a biologist and as a physician that an embryo and later a fetus is maintaing homeostasis and is undergoing cellular reproduction. I am also convinced that at no point will it change species. The point is, leaving religion out of the thought process, but objectively looking at professional ethic, taking any action to avoid pregnancy after conception is not something I am willing to do as a physician. More importantly, no one can force me to.

When oral contraceptives where introduced they worked by preventing ovulation. In other words, they did allow for conception to occur. Over the years, the hormone dosages have been cut the least effective dose. This is important to reduce the risk of side effects. Eventually we came to realize that even though these doses were preventing pregancy, they were not preventing ovulation. Ovulation frequently does occur, but the homonal effects of the newer pills causes changes in the endometrium that does not allow for implantation. While I understand that many of you will disagree with me (and I respect that) this leads me to conclude that precsribing oral contraceptives is the moral equivalence of performing an abortion. There are many nuances that are worthy of discussion but are not relevent to this thread.

I now refuse to write scripts for the Pill. I know that there are other reasons to take it, but because I don't write for it most of the time, I don't keep up with all the changes. These women benefit from seeing ther gynecologists anyway, so just refer them anyway. I have never made a women feel uncomfortable about using the Pill and I only explain why I don't if a patient really pushes the issue.

I may loose patients because of this. I don't think that has had any real effect, but it is possible. I also understand that, as an employee, the organization that owns my practice could choose to terminate me for this.

I came to this conclusion after I spent eleven years in training and had several years of experience in practice. I work hard and I think I am an above average primary care physician. My patients seem to think I am providing a valuable service for them. Do some of you really believe that the government should make it illegal for me to continue in my current practice and find another career?

For the record, I think CVS should force this pharmacist to fill the prescription. She is not in a position to know the reasons the patient is taking it. That is between the doctor and the patient. CVS carries the drug. If the pharmacist owns her own pharmacy and is willing to take the financial hit of not carrying a given drug or class of drugs, she should be free to do so. But it is clear that CVS has not made that choice, and the pharmacist should follow company policy.

[SecretMethod70]

The company is free to fire the pharmacist if they so please. If they don't want to, the pharmacist is free to perform his or her duties in a manner he or she deems appropriate, and the customer is free to go to a different company for their prescriptions. I don't understand what's hard to understand here: there is no "right to buy things" or "right to force people to do things they don't morally agree with." And, no, they shouldn't choose another job - that's like saying a cardiologist shouldn't be a doctor because he's morally opposed to abortion. (Interestingly enough, they're actually working on that as I understand some medical schools force med students to perform abortions.) The fact is, there are plenty of reasons to be a pharmacist, even when one is opposed to certain drugs.

I don't want other people forcing their morals on me and I certainly won't work to force other people to go against their morals because I don't agree with them.

[iccky]

Originally Posted by KMA-628

so what?

So you are in favor of denying him his right to sell or not sell a product?

One person's freedoms taken away for another person's freedoms?

it is very simple, don't bitch about it, go to another store.

I agree that at least theoretically a pharmacist shouldn't have to dispense a pill that is against his or her moral judgment. The problem is those cases where the woman doesn't have another option. I can easily imagine places in rural America, where the fundies are strong and pharmacies are few and far between where a pharmacist refusing to hand over the pill would mean having to drive 40 or 50 miles to get a prescription filled. Let's say you're a teenager and mom and dad don't know about the pill. Probably you're just not going to get it filled, and probably you're gonna get pregnant.

I remember a similar situation somewhere in Texas where they couldn't find a contractor who would pour the cement for a Planned Parenthood clinic that would be the only abortion clinic for a couple hundred miles. Certainly, the contractor has a right to not support an activity he/she considers murder, but if everyone refuses a woman's right is essentially nullified.

Seriously though, saying a pharmacist should find a new job because he or she doesn't want to give out birth control pills is ridiculous. I don't imagine filling birth control prescriptions is a large part of a pharmacist’s job, or that that many people get into the profession because of a zeal for birth control. If your mechanic won't fix your Pinto because he thinks it’s a POS car, you don't expect him to give up the trade entirely. I say this as a person who is very happy his girlfriend is on the pill and who would take one himself if they made a male version of it.

(Interestingly enough, they're actually working on that as I understand some medical schools force med students to perform abortions.)

To turn the tables on you, if a med school belives that a woman's right to choose is important, and that it is essential that there be doctors available to perform this procedure, isn't it their right to require students to learn it? Can't the students simply go to another med school if they don't like it? (I haven't heard of any med schools doing this, but I'm sure that there are many med schools that do not require it, in fact I bet there are many that don't even teach it anymore).

[SecretMethod70]

Originally Posted by iccky

To turn the tables on you, if a med school belives that a woman's right to choose is important, and that it is essential that there be doctors available to perform this procedure, isn't it their right to require students to learn it? Can't the students simply go to another med school if they don't like it? (I haven't heard of any med schools doing this, but I'm sure that there are many med schools that do not require it, in fact I bet there are many that don't even teach it anymore).

heh, I didn't say it wasn't within their right (provided they are a private institution), just that they are doing it. However, if it is a public institution (for example, University of Illinois at Chicago Medical School) then such a practice would be unacceptable as it is forcing a morality on a person.

[ariekitten]

my opinion is kinda harsh, but i think anyone who fucking takes on a job filling out prescriptions should just STFU and do their damn job. people who've got moral objections to certain drugs should either stop bitching or choose a different job. it's their JOB, they get PAID to take the slip from the customer, read it, get the drugs into the bottle, take the money, hand the bottle to the customer. it shouldn't have to be so complicated....

i cannot believe that someone would deny service because of their morals. what if a restaurant owner refused service because i came in and wanted food and i have an eyebrow piercing? or what if a black man came into an insurance agency and they said "sorry, we don't believe it's morally right for black people to have insurance." it's their FUCKING JOB. get over yourselves people.

[Stiltzkin]

I'm studying to be a pharmacist, and I promise I won't be like this! That is all.

[VitaminH]

I could literally type for an hour on this subject, but I am not about too. Allow me to give a student pharmacist's perspective (almost there to the full thing...).

First of all, druggist is a dated term, we're Pharmacists dammit

I, as a student pharmacist think any of my own personal morals and such go straight out the window when I am at work, and would definitely fill an Rx for 'the pill'. However, allow me to play the devils advocate here...

The number one rule of medicine I believe is to "do no harm" to the patient. Take now, for example a script written by a doctor that would obviosuly kill a person to the pharmacist, should the pharmacist fill that prescirption? According to many of you, it's all between the patient and doc and none of our buisness so we should. So it gets filled the patient takes it and dies, and now it's my ass as well. It's not always so clear cut.

Now, honestly I don't know about not giving the prescription back being theft or not. What if we get a script that's very blatently falsified? It's our job to confiscate the Rx immediatly and refuse to fill. Is that then theft?

Another situation. What if we have a known dirty doctor who is writing scripts for controlled substances for addicts? Is that a doctor patient relationship? I can tell you right now that if we didn't intervene in that, once again it's goodbye liscense and it's my ass going down with the rest.

Many of you have stated that the pharmacist doesn't know why she is taking this medication so she should not have refused to fill it. Well, we don't know that. The pharmacist may very well have asked. I noticed the lady who didn't get her birth control said it wasn't our job to regulate what people take. I'm going to disagree with that as well. The final prescribing is done by a physician generally yes, however pharmacists are constantly consulted on medications. It happens more in a hospital setting, but I can tell you at the pharmacy I work at, nurses and doctors constantly call me and consult with myself or a full pharmacist at the store to aid in a patient's drug therapies. With the ridiculous number of drugs out on the market now it is near impossible for Physicians to keep up, and in some medical schools that I know of, out of their 4 years (8 semesters), med students get a mere 1 semester of pharmacy. THis is all hearsay to me, so take it as you will. However, pharmacists are becoming an integral part of treatment and we're not just some guy behined the counter taking the pills out of the big bottle and putting them into the little bottle.

I reiterate once again, that I feel what this pharmacist did was wrong, but it's an extremely complicated world out there in this stuff, and it's hard to always be able to make the right decesion every time. This is why they make us get doctorates now.

So please, don't go to your local Walgreens and punch the pharmacist in the face. Feel free to burn down the Walgreens though, that company is bad for our profession

[VitaminH]

Originally Posted by ariekitten

it's their JOB, they get PAID to take the slip from the customer, read it, get the drugs into the bottle, take the money, hand the bottle to the customer. it shouldn't have to be so complicated....

Our Job is considerably more than that. And the job is EXTREMELY complicated.

[irateplatypus]

rather than type out a lengthy redundant response... just put me in the same column as secretmethod.

[DelayedReaction]

There's a difference between holding on to a prescription that is suspect, and refusing to return a perfectly valid one because of moral reasons. I respect the job that a pharmacist has, and respect their work in preventing unhealthy results, but I have to disagree with refusing to administer medicine on purely moral grounds.

[VitaminH]

Originally Posted by DelayedReaction

There's a difference between holding on to a prescription that is suspect, and refusing to return a perfectly valid one because of moral reasons. I respect the job that a pharmacist has, and respect their work in preventing unhealthy results, but I have to disagree with refusing to administer medicine on purely moral grounds.

I completely agree with you. Allow me once again to restate my position: I think what this pharmacist did was stupdi and wrong, and my own person morals do not come into play when I am working. I am concerned only their the patient's health and not their religious salvation.

[Stompy]

If you think this is bad, just wait until legislation is passed that will make it more difficult, if not impossible, for unmarried women to even get a perscription for it.

The proposed solution: abstinence.

[Fohur2]

Originally Posted by Stompy

The proposed solution: abstinence.

Oh my,good laugh.