Pharmacy Archives - Page 5 of 8 - Protection of Conscience Project Library

When to Grant Conscientious Objector Status (Conscientious Objection and Emergency Contraception)

Ronald A Lindsay

Extract
Provided the physician notifies the patient as soon as possible of any limitations on services and promptly assists the patient with referrals to other physicians, physicians should be allowed to refuse to provide some services. However, once the patient and physician have decided on a course of action, they should be able to rely on the cooperation of other healthcare workers. The last thing we need is to complicate our healthcare system even further by allowing pharmacists, nurses, and others to obstruct a person’s healthcare decisions based on their sectarian beliefs.

Lindsay RA. When to Grant Conscientious Objector Status (Conscientious Objection and Emergency Contraception). Am J Bioethcs. 2007 Jun 01 ;7(6):25-26. Available from:

The Pharmacist’s Personal and Professional Integrity (Conscientious Objection and Emergency Contraception)

(Conscientious Objection and Emergency Contraception)

Howard Brody, Susan S Night

Extract
We conclude that, although a “duty to refer” may not describe very well an actual, working policy that effectively balances the duties of personal and professional integrity for the objecting pharmacist, Card’s (2007) mandatory-service policy fails at a basic level to respect the dual dictates of personal and professional integrity. A policy that attempts to maximize the extent to which both duties can be fulfilled might be denounced by Card as a “moderate” policy in the sense that he finds objectionable. Nonetheless, it is ethically the soundest option.

Brody H, Night SS. The Pharmacist’s Personal and Professional Integrity (Conscientious Objection and Emergency Contraception). Am J Bioeth. 2007;7(6):16-17.

Moral Disagreement and Providing Emergency Contraception: A Pluralistic Alternative (Conscientious Objection and Emergency Contraception)

Noam Zohar

Extract
Thus my conclusion is not very far from Card’s, but it rests on very different grounds. A pluralistic framework leads to an expectation that the pharmacist provide EC, even while acknowledging the legitimacy of his view that using it is wrong. The pharmacist should in this kind of case respect and yield to the differing view of the client. Yet in other kinds of situations—such as when what is required is direct action, as distinct from mere assistance—conscientious objection should sometimes be allowed.

Zohar N. Moral Disagreement and Providing Emergency Contraception: A Pluralistic Alternative (Conscientious Objection and Emergency Contraception). Am. J. Bioeth.. 2007;7(6):35-36.

Health care provider refusals to treat, prescribe, refer or inform: Professionalism and conscience

R Alta Charo

Advance: Journal of the ACS Issue Groups

Extract
Conscience is a tricky business. Some interpret its personal beacon as the guide to universal truth and undoubtedly many of the health care providers who refuse to treat or refer or inform their patients do so in the sincere belief that it is in the patients’ own interests, regardless of how those patients might view the matter themselves. But the assumption that one’s own conscience is the conscience of the world is fraught with dangers. As C.S. Lewis wrote, “of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”

Charo RA. Health care provider refusals to treat, prescribe, refer or inform: Professionalism and conscience. Advance J ACS Issue Groups. 2007 Spring 1:119-135.

Pharmacist refusals and third-party interests: a proposed judicial approach to pharmacist conscience clauses

Lora Cicconi

Abstract
The issue of pharmacists refusing to dispense birth control or emergency contraception recently has become a major debate in the battle over reproductive rights. Several states have enacted legislation to protect refusing pharmacists, and many more are considering such laws. I explore these new laws against the backdrop of the existing legal landscape governing the actions of pharmacists, including tort law, Title VII of the Civil Rights Act of 1964, and free exercise jurisprudence. I then consider how courts might interpret refusal clauses upon which pharmacists may rely. I argue that courts should read pharmacist refusal statutes narrowly by limiting the protected act of conscience to the actual refusal to dispense medication, and not extending protection to behavior that could violate the pharmacist’s duty of care to patients. Such an approach will not only minimize the impact of refusals on the interests of patients and employers, but will meld these new statutes with the existing legal framework addressing religious objectors, which has consistently shown concern for third-party rights.

Cicconi L. Pharmacist refusals and third-party interests: a proposed judicial approach to pharmacist conscience clauses. UCLA Law Rev. 2007 Feb;54(3):709-749.

Refusal to Dispense Emergency Contraception in Washington State: An Act of Conscience or Unlawful Sex Discrimination?

Dana E Blackman

Extract
This Article will demonstrate that a pharmacist’s refusal to fill a valid prescription for emergency contraception constitutes sex discrimination and violates the WLAD. Part I explains the nature and function of emergency contraceptive pills (ECPs) as well as their role in basic health care for women and the importance of their accessibility. Part II addresses federal civil rights protections and the failure of these protections to provide relief for women facing refusals. Focusing on the WLAD, Part II also explains how state public accommodation statutes protect women from discrimination in places of public accommodation. It further sets forth the prima facie case of such a claim where a woman is refused access to emergency contraception. Part III presents arguments likely to be submitted by a pharmacist facing litigation under the WLAD. Finally, Part IV illustrates how Washington public policy supports women and the protection of reproductive freedom. The Article concludes with suggestions for judicial interpretation..

Blackman DE. Refusal to Dispense Emergency Contraception in Washington State: An Act of Conscience or Unlawful Sex Discrimination? Michigan Journal of Gender & Law. 2007;14(1):59-97.

Rx for Drugstore Discrimination: Challenging Pharmacy Refusals to Dispense Prescription Contraceptives under State Public Accommodation Laws

Charu A Chandrasekhar

Extract
The problem of refusals to dispense prescription contraceptives in pharmacies is real and urgent. State public accommodations statutes offer an excellent vehicle in many states for challenging these discriminatory practices. State public accommodations lawsuits should ideally be brought solely against the pharmacy, not against the individual pharmacist who refuses to dispense a prescription. Pharmacies are best positioned to make institutional adjustments that ensure the filling of prescription contraceptives while accommodating the views and legal rights of their pharmacist employees. Moreover, a state public accommodations lawsuit will likely have a greater remedial and public relations impact if brought against a pharmacy as opposed to against an individual
pharmacist and will result in broader systemic change.

Chandrasekhar CA. Rx for Drugstore Discrimination: Challenging Pharmacy Refusals to Dispense Prescription Contraceptives under State Public Accommodation Laws. Albany Law Rev. 2006;70:55-115.

(Correspondence) Revisiting Pharmacists’ Refusals to Dispense Emergency Contraception (Author’s Response)

Ralph Baergen, Christopher Owens

Extract
pharmacists are autonomous, moral agents who are accountable for their choices and entitled—within limits— to decide in which activities they will participate. Pharmacists’ professionalism is defended, their responsibilities in the provision of drug therapy are set forth in the context of pharmaceutical care, and these lead to the conclusion that pharmacists’ refusals may be ethically justified. There are important limits on how are being asked to participate in actions they find morally objectionable. Notably, they must ensure that these prescriptions are filled by someone else in a timely manner and must refrain from any abusive or demeaning treatment of patients, as summed up in our Principle of Conscientious Refusal to Dispense.

Baergen R, Owens C. Revisiting Pharmacists’ Refusals to Dispense Emergency Contraception. Obstetrics & Gynecology. 2006;108(5):1277-1282.

Scope Note 46: Pharmacists and Conscientious Objection

Richard M Anderson, Laura Jane Bishop, Martina Darragh, Harriet Hutson Gray, Anita Nolen,Susan Cartier Poland

Extract
The literature and online resources cited below include (1) policy statements and codes by professional organizations; (2) review essays on conscientious objection in health care and articles on the current debate regarding the field of pharmacy; and (3) legal perspectives and cases.

Anderson RM, Bishop LJ, Darragh M, Gray HH, Nolen A, Poland SC. Scope Note 46: Pharmacists and Conscientious Objection. Kennedy Inst Ethics J. 2006;16(4):379-396.

Two Cheers for Conscience Exceptions

Adrienne Asch

Abstract
The pharmacist who wants her integrity and self-conception to be respected must accord respect to the woman whose views about sex, life processes, and parenthood differ from her own by courteously offering her own rationale and a referral.

Asch A. Two Cheers for Conscience Exceptions. Hastings Cent Rep. 2006;November-December):11-12.