Pharmacist Beliefs and Consumer Rights Clash Again

By George Anderson

Last week, a woman in Rhode Island went to a CVS pharmacy to have a prescription filled for the emergency contraceptive known as Plan B, aka the “morning after pill.”

The pharmacist behind the counter informed the woman that she would either have to return to the store later when another pharmacist was on duty or go to another drugstore to
have her prescription filled. The pharmacist would not fill the prescription based on moral grounds.

CVS has a policy to deal with such an eventuality. According to an Associated Press report, it allows pharmacists to personally fill a prescription but requires the pharmacist
to help the consumer find another source “without delay.”

As incidents such as the one in Rhode Island continue to happen, state governments and businesses that fill prescriptions are looking for answers to the dilemma.

Walgreens, as is the case with CVS, allows pharmacists to refuse to fill a prescription on moral grounds but also requires that the pharmacist assist the consumer in finding
an alternative source. The exception for Walgreen is in Illinois, where all pharmacists are required to fill prescriptions regardless of their beliefs. In Illinois, pharmacies
that sell contraceptives are required to fill prescriptions without delay.

The Jean Coutu Group, which owns Eckerd and Brooks, does not give pharmacists the option of refusing to fill prescriptions. Company policy requires pharmacists to fill all prescriptions
as a normal term of employment.

Moderator’s Comment: What is the answer to the continuing controversy over a consumer’s right to purchase legally prescribed pharmaceuticals and a pharmacist’s
decision to refuse based on moral grounds?

– George Anderson – Moderator

BrainTrust

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Richard Layman
Richard Layman
18 years ago

If a licensed establishment refuses to dispense a legal product, then they should lose their license. The employee, who holds a license separately granted by the state, should lose their license to practice as a pharmacist.

Similarly, if a bar serves an alcoholic beverage to an underage person, there are various sanctions for the server and for the establishment.

The pharmacist and CVS should be fined at the very minimum.

Ron Margulis
Ron Margulis
18 years ago

The answer is full disclosure — if a pharmacy or pharmacist refuses to dispense a certain drug on moral grounds, that information should be clearly visible to everyone potentially presenting a prescription for the drug. The market will work out everything else.

Peter Fader
Peter Fader
18 years ago

Should an employee at an apparel store be allowed to refuse to sell someone a particular shirt because they find it ugly or offensive? Of course not! By agreeing to work for that employer, you have no say over the merchandise they sell. If you don’t like something they sell, don’t work there. Period. End of story.

neil bourjaily
neil bourjaily
18 years ago

As an employee of a company, it is my responsibility to execute the policies of that company to the best of my abilities. The pharmacist has every right to pursue his personal beliefs at a company whose policies better match those beliefs. A private business is not a democracy.

Mark Lilien
Mark Lilien
18 years ago

The pharmacist is a representative of the employer. If the employer is selling convenience, personal care, confidentiality, and service quality, the employer should have the right to require its staff to fill all prescriptions without delay.

If the employer feels that the staff’s moral code is more important than the customers’ desires, then that’s the employer’s decision.

Of course, the employer may experience tremendous controversy as a result of taking either position. This is a no-win situation.

Years ago, I read about ad agencies in NY that allowed their staff to refuse work from tobacco companies. For some people, this might be a comparable situation.

Rick Moss
Rick Moss
18 years ago

JIMRALEIGH… thank you for writing in to present the opposing view. I agree the commentary was too one-sided. However, I have to take issue with your proposition that “the inconvenience the woman experienced at the pharmacy would in no way come close to the personal anguish the pharmacist would suffer should he be required to fill the prescription and thus facilitate the possible termination of life.” The woman is the one facing the life-altering decision, not the pharmacist. Perhaps being turned away by the pharmacist will intimidate her to the point that she’ll fail to seek the drug elsewhere. Maybe she’s uneducated and will become confused about her options. Without getting into the entire pro-choice/pro-life debate, if we’re supposed to be protecting pluralism, isn’t our first responsibility to the rights of the many consumers that enter the store, vs. those of a single pharmacist?

Ralph Hanson
Ralph Hanson
18 years ago

Wasn’t there a case a few months back where the pharmacist not only refused to fill the prescription, but also refused to return the prescription form to the customer so she could, in fact, take it to another pharmacy? Moreover, I believe it was a weekend in a rural area where it was unlikely she could get a doctor to replace the prescription within the 24 hour period needed to be most effective. I don’t remember the final outcome from the litigation that ensued.

Karen Kingsley
Karen Kingsley
18 years ago

This situation just makes me nuts.

In my opinion, it is akin to refusing service to someone of a different color or ethnicity, a different religion, whatever. To refuse service in a public place based on one’s personal convictions is inappropriate. If one’s own beliefs are that important, choose another profession or practice it in a private institution that supports it, e.g., a Catholic Hospital, where consumers might reasonably expect it.

Richard Alleger
Richard Alleger
18 years ago

The pharmacist should be fired. He or she is not there to pass judgment on anyone’s prescribed needs…medical or otherwise, unless asked. Should the chain or pharmacy decide not to carry particular drugs, then the pharmacist has a way around his moral dilemma. In this case, the chain or independent pharmacist needs to inform the employees of the protocol.

Tom Zatina
Tom Zatina
18 years ago

Find another pharmacy.

Dave Wendland
Dave Wendland
18 years ago

This discussion topic continues to be a perplexing one.

If a pharmacy elects not to carry a particular product line, that is their prerogative. However, that being said, it needs to be clearly posted and stated so those patrons of that pharmacy understand its position in the market. This may drive loyal patients to alternative pharmacies – but they should not be forced to carry a product if they don’t agree with it. Keep in mind, for a chain or multi-store opportunity, this should be a corporate policy, not a one-off decision based on a particular pharmacist’s viewpoint. Will some pharmacists disagree with this policy? You betcha. Should they find a different place of employment? Perhaps. Otherwise they should accept the corporate policy … my guess is there are other items in that store that they disagree with selling (perhaps a risqué magazine, etc.).

I’ve spent enough time on this topic – not sure there will ever be one solution that will appease all.

James Raleigh
James Raleigh
18 years ago

The issue that is at stake here is the preservation of personal moral conviction. It is not a matter of retail preferences, nor is it a restriction of trade issue based on civil rights criteria. To try and draw those parallels on either side is unseemly at best.

The comments posted here point to the very flaw in the logic that is being used; one is not allowed to live by their personal code of ethics, and be protected in the workplace, if it conflicts with some other person’s desires. The inconvenience the woman experienced at the pharmacy would in no way come close to the personal anguish the pharmacist would suffer should he be required to fill the prescription and thus facilitate the possible termination of life.

Like it or not folks, if we embraced the philosophy of pluralism in its traditional sense, this would not even be an issue. The consumer would seek another outlet that would accommodate her wishes, and the pharmacist would not need to worry about compromising his or her ethics for the sake of convenience.

Bernice Hurst
Bernice Hurst
18 years ago

Perhaps the early part of the commentary was one-sided because so many people feel strongly on that side of the argument. No one – I assume – is censoring anyone who disagrees. As I understand it, the medication under discussion is time critical so it isn’t just a matter of inconveniencing a woman who has to find an alternative pharmacist. If pharmacists feel so strongly about filling such a prescription, how can they work in a place that sells condoms? Or other contraceptives? If they object to things of this nature, they are in the wrong job.

James Raleigh
James Raleigh
18 years ago

Rick Moss – I think you may have misinterpreted my meaning of the term pluralism. In the current vernacular, it refers primarily to the tolerance of a multiplicity of worldviews. In that regard, it is not one pharmacist vs. many consumers; that was never the crux of the argument. Rather, it is the conflict of one worldview versus another. In a pluralistic society, which we supposedly have, both worldviews must be respected and allowed to flourish. Therefore, it would be as devastating to the pharmacist in providing for what he or she views as a life-ending abortifacient, as it would be for the woman who was making what amounts to, at most, a life altering decision. Thus, according to the tenets of pluralism, we must respect and make allowances for both viewpoints.

Ms. Hurst – Irrespective of how the media might portray these drugs, the jury is still very much out on whether they are a contraceptive, which prevents conception, or an abortifacient, which causes a physiological response which prohibits uterine attachment, thus facilitating spontaneous abortion. That may be a hair-splitting distinction to some, however, to others it is very clear. This is certainly an emotional topic, and that is why both sides must be given. From that point, the case should then be decided on the logical and intellectual merits of what benefits the society, as well as protects the individual.

Bernice Hurst
Bernice Hurst
18 years ago

JIMRALEIGH – I respect your viewpoint and those of others who disapprove of contraception and abortion. The point under discussion is whether someone who is committed to employment which includes dispensing legally permitted medication, recommended in a specific instance by a woman’s physician (leaving aside, for the moment, the separate discussion of whether that medication can or should become available OTC) is entitled to prevent her from receiving that medication. My view is no, it is not up to the pharmacist to make a judgement on the issue but to do his/her job as agreed when accepting employment.

Sid Raisch
Sid Raisch
18 years ago

With all the litigation over corporate fraud lately, doesn’t this fit in the same category? Morality is morality. We want people to be honest when that honesty fits our own definition of morality, but not when it doesn’t? I agree that companies should be able to set their own policies for what they sell as well as when and how they sell it with the marketplace determining how they feel about that. Either way. Period. Some of you want all pharmacies to require dispensing the drug as a condition of employment. Others feel the pharmacy cannot choose what they sell, but should be legislated to sell anything someone else chooses. What if…our country is overtaken somehow and the new government requires pharmacies to distribute drugs for suicide purposes on demand?

James Raleigh
James Raleigh
18 years ago

Ms. Hurst – I don’t believe I ever came out and made a statement as to what side of the issue I am on. I have merely sought to clarify the issues. Given that fact, it would not be proper to make the inference you have made above. If you will read my posts, you will see they deal with the right of conscience, not the inflammatory peripheral issues.

There are multiple points to this article that should be examined. It is not only an issue of an employee’s responsibility to perform their duties based on company policy. The issue which I am saying must be examined, especially in the light of pluralism, is the company’s responsibility to codify its stance on actions which might violate a person’s right to conscience.

In the absence of clear guidelines, which is what has caused this debate, there must be a reasonable accommodation made for the employee, akin to current civil rights legislation. Or else, the policy of the company must be made clearer. As I am sure you can see, this is not an issue over the products themselves, rather, it is an attempt to ensure that expectations are managed properly for both employees and the consumer. Under agency, both parties must be considered without prejudice.