Thursday, February 23, 2012

Should a pharmacist's personal views affect my access to controlled substances?

Yesterday, a federal judge in Washington state ruled that the state could not force pharmacies to sell Plan B. Under Washington state law, pharmacies are required to dispense any medication for which there is a community need and to stock a representative assortment of drugs needed by the community. Several pharmacies sued, claiming that being required to stock and dispense Plan B violated their religious freedom because that drug can prevent the implantation of a fertilized egg. The state countered that the law is religiously neutral, applies to all pharmacies and medicines, and promotes a government interest.

I'm certain that this will be appealed and I hope (and trust?) that the outcome must be different at the appellate court level because this can't be right. First, on the medical issue, Plan B is the same drug, just at a higher dose, as regular birth control and the same objection can be made to standard birth control. So this decision leaves open the possibility that pharmacies can decline to dispense birth control. That would be potentially devastating in rural communities where access to pharmacies is already limited. Second, which stems a little from the first, how far are we willing to take this? How many other drugs are we willing to allow individual pharmacists and pharmacies to choose not to dispense?

We as a society have decided to control access to certain substances. We require that doctors write prescriptions for drugs. We don't allow those drugs to be sold just anywhere; only a licensed pharmacist can dispense them. This system doesn't leave room for individual pharmacists to decide they don't like certain drugs. A Christian Scientist pharmacist can't be allowed to refuse to dispense drugs to their customers until those customers give healing through prayer a fair shot.

The judge in this case found that the state must allow exemptions for religous or moral objections. I find that a terrifyingly broad holding. A pharmacist could have a moral objection to pain killers and thus refuse to dispense them? I don't even know the wide scope of drugs that exist to treat all manner of conditions, let alone all the possible moral objections that individual pharmacists could have to certain drugs. As a patient holding a legal prescription, I shouldn't have to worry about my pharmacists moral or religious beliefs. Pharmacists just don't get to decide which of those drugs they'll dispense and which they won't. The FDA approves drugs. Doctors, in consultation with their patients, prescribe them. And those people who have voluntarily taken on the responsibility of dispensing them dispense them, without imposing their own personal religious or moral beliefs.

Plan B is in a unique position in a couple of respects. It doesn't require a prescription, but it can't actually be sold OTC just anywhere. It's in that gray area, like pseudoephedrine is in a lot of states. So it is still limited in terms of where and when it can be sold. It is also unique because it needs to be taken quickly for maximum effectiveness. Combine these factors and it becomes pretty apparent why the state wanted its citizens to be able to trust that they could find this drug at any pharmacy so they wouldn't have to drive all over or arrange transportation to get to the pharmacy in the next town because the one a block away refuses to sell it.

There are just some professions where you don't get to impose your own personal, moral, and/or religious beliefs on other people. Pharmacists, who voluntarily take on the responsibility of standing between people and controlled substances, are in just such a profession. They can have all the moral and religious beliefs they want, but they simply can't bring those personal beliefs into the pharmacy with them. I hope the federal circuit court sees this and overrules this decision.

No comments:

Blog Designed by : NW Designs