Pharmacists have consistently ranked among the most highly respected professionals in the country. According to a Gallup poll, Americans consider pharmacists highly ethical, above medical doctors, police officers and clergy.
That lofty position may soon change. Despite the trust they have long enjoyed, pharmacists are now raising questions of conscience that could polarize the profession and the public they serve.
Over the last few years some pharmacists have refused to dispense morning-after pills. These are prescribed in cases of rape or incest as well as contraceptive failure.
The hormones provide effective emergency contraception if taken within a few days of unprotected intercourse. Morning-after pills work by keeping a fertilized egg from implanting in the uterus, so abortion opponents object on the grounds that a fertilized egg is a human life.
Now some pharmacists are refusing to fill other prescriptions as well on religious grounds. Women with prescriptions for ordinary birth control pills have been turned away empty-handed.
This has created a firestorm of controversy. State legislatures are getting
into the act, some with bills to protect the pharmacists’ right of refusal. Others are preparing counter legislation that would require pharmacists to fill every legitimate prescription.
All the talk of ethics in the pharmacy has opened the door to other potential conflicts. For example, imagine a young woman who has been prescribed birth control pills, not for contraception, but to treat painful menstrual cramps or severe acne. Does the pharmacist have a right to grill her about her sex life before dispensing the pills?
What about a man who has a prescription for Viagra or some other erectile dysfunction drug? Should a pharmacist demand that he present a marriage license?
Other potential ethical conflicts could take this issue to extremes. Many people don’t approve of stimulant medication for attention deficit disorder. Others, especially Scientologists, object to psychiatric drugs such as antidepressants. Should such a pharmacist be allowed to turn away a patient with a prescription for Prozac on the grounds that it violates his religious principles?
Pain poses other ethical dilemmas. Powerful narcotic medications like OxyContin or Vicodin can be abused. But people in agony from severe back pain or cancer need the relief such drugs provide.
Should a pharmacist be allowed to turn down a legitimate prescription from a physician just because she has doubts about a patient? We heard from one reader about such a case: “We have a close friend who was injured in a car accident and is now disabled. She is in constant pain. When she moved to a new small town, the pharmacist was unwilling to fill her prescriptions for pain medicine. Our friend now has to drive over 100 miles to get the medications she needs to function.”
Pharmacists have historically had the right to refuse to fill prescriptions. But they risk alienating many customers if they allow their religious or moral convictions to affect their professional responsibility.