[politics] Pharmacist morals and patient rights

[holzman_tweed]

There's alot of talk these days about whether or not Pharmacists should be permitted to choose not to fill perscribed medicines if they have a moral objection of some sort to the drugs used.

The American Pharmacist's Association has a code of ethics which I quote in part here:

I. A pharmacist respects the covenantal relationship between the patient and pharmacist.

Considering the patient-pharmacist relationship as a covenant means that a pharmacist has moral obligations in response to the gift of trust received from society. In return for this gift, a pharmacist promises to help individuals achieve optimum benefit from their medications, to be committed to their welfare, and to maintain their trust.

II. A pharmacist promotes the good of every patient in a caring, compassionate, and confidential manner.

A pharmacist places concern for the well-being of the patient at the center of professional practice. In doing so, a pharmacist considers needs stated by the patient as well as those defined by health science. A pharmacist is dedicated to protecting the dignity of the patient. With a caring attitude and a compassionate spirit, a pharmacist focuses on serving the patient in a private and confidential manner.

III. A pharmacist respects the autonomy and dignity of each patient.

A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable. In all cases, a pharmacist respects personal and cultural differences among patients.

[Emphasis original]

I do not see how placing one's moral judgements above a doctor's medical judgements or a patient's autonomy complies with any of these three (of eight) rules.

I don't know if this code of ethics is binding in the way that Doctors' or Lawyers' respective professional codes of ethics are, but I respectfully submit that someone who has a moral prohibition (as opposed to a medical or legal one) against filling any perscription a patient presents is not in a position to become or remain a pharmacist.

I don't single out pharmacists here -- people with moral prohibitions against maintaining patient or client confidence are not in a position to become or remain doctors or lawyers, either. People who want to indulge a habit of breaking into computer systems illegally are not in a position to become or remain CISSPs.

Comments

[docstrange.livejournal.com]

Hear, hear.

That said, I will (with only a little irony) disagree with your very last statement, considering some of the CISSPs I have met (you, of course, excluded).

[culfinriel.livejournal.com]

"I don't know if this code of ethics is binding in the way that Doctors' or Lawyers' respective professional codes of ethics are, "

Um, speaking as one of the damned (ok, doctor in training), you'd like to think they were binding, and they should be, but I've got a real good view from the cheap seats and the people who are ethical are ethical because that's the way they are. They would be ethical if they were municipal sewer workers. They'd be ethical if they were an anarcho-syndicalist commune that took it in turns to act as a sort of executive officer for the
week. I can tell you right now that every person who makes it through medical training is not up to the highest of ethical standards, nor do they find any meaning in oaths, be they Hippocrates', Maimonides' or others. They do, however, have excellent test scores.

[holzman.livejournal.com]

Here's a quick view of where I get my view, cheap seats and orchestra.

When I say that those rules are binding, I'm not talking about the ethical quality of the people in question. I mean that people who get caught violating them occasionally lose their licence. Some people adhere to those ethics because they're ethical, but some people adhere to them because they don't want to lose their license.

[culfinriel.livejournal.com]

I shall peruse the link further and you clearly are fortunate to have one of the ethical ones as a reference. I suspect you also may have access to better seats at the moment ;)

[aliza250.livejournal.com]

But what if the pharmacist truly and honestly believes that unmarried women are better off not having access to the Pill, for example?

Also, in some circumstances pharmacists are required to second-guess the prescribing doctor - for example, if a patient is seeing multiple doctors, a pharmacist may be the only one in a position to head off potential adverse drug interactions.

[holzman.livejournal.com]

But what if the pharmacist truly and honestly believes that unmarried women are better off not having access to the Pill, for example?

It doesn't matter. That is not a pharmacist's decision to make, and is counter to the ethics of the profession. If the pharmacist believes it so strongly that they feel they cannot participate in giving unmarried women access to the Pill, their only ethical recourse is to exit the profession.

Also, in some circumstances pharmacists are required to second-guess the prescribing doctor - for example, if a patient is seeing multiple doctors, a pharmacist may be the only one in a position to head off potential adverse drug interactions.

I believe I addressed this in making a distinction between moral objections and medical or legal ones. A pharmacist is withing their rights pointing out an adverse drug interaction between the Pill and another medication. That doesn't let the pharmacist off the hook about the Pill though -- they are expected to suggest an alternative to the Pill that wouldn't cause an interaction.