Pharmacists have “duty of care” to women patients


While Australian pharmacists have a right to refuse supply of medicines based on personal beliefs, representatives emphasise the importance of facilitating supply elsewhere

Several commenters have responded to an AJP article covering conscientious objection and religious guidance in the pharmacy with widely varying opinions.

Some said that religion has no place in the pharmacy, while others said they value their right to refuse supply based on personal beliefs.

“How can it be conscientious to deny something that they feel is correct for them, just because you have a religious belief?” wrote Jarrod McMaugh. “Therapeutic grounds are the only reason to ‘object’ to treatment.”

However another responded saying, “Religious and conscientious objections are not mutually opposed.”

“For example I object to supplying the IUD and RU-486 because of my religious view that all human life is sacred from the moment of conception (when sperm and ovum unite) and these devices terminate human life – the former before implantation and the latter after the event … Both of these items harm the most vulnerable patients – the unborn human person, as well as causing harm to the woman. On the latter point the list of problems with IUDs is extensive.”

And Willy the Chemist wrote, “It is political correctness and a form of reverse discrimination of people of certain beliefs, e.g. in the case of Catholics healthcare professionals who object to supplying an abortifacient.”

Dr Safeera Hussainy, a pharmacist and pharmacy practice researcher at Monash University in Melbourne, says it’s important to clarify that emergency contraception is not an abortifacient.

“Evidence shows emergency contraception tablets are not abortifacients, they do not harm an existing pregnancy that has been established – it’s a myth,” she told the AJP today.

“There are various types of IUDs, and the copper IUD can be used as emergency contraception as well, which is great. They are actually a really safe method of contraception as well. They can work hormonally as well as inhibit sperm movement. And again, they are definitely not abortifacients.”

Dr Hussainy says pharmacists should be seen as public health advocates, and the number one goal is to educate pharmacists and rectify any misinformation surrounding contraceptives.

“Even with education, if they’re still not happy [to supply EC] because of religious beliefs, for example, their duty is to facilitate supply by referring the woman to another pharmacy,” she says.

“Emergency contraceptives are also time-sensitive so they need to send them to the nearest pharmacy or sexual health clinic. They can also get a fellow pharmacist to dispense it if that works for them, providing it is in stock.”

One AJP commenter asked, “How can you facilitate that which you are not willing to do yourself? We need to start defining what a right is.”

“Couldn’t agree more,” replied another. “This logic must apply in all areas where our consciences and knowledge tell us that supplying something could cause hurt or harm to that person, even if they don’t agree with our judgement. My right to not supply must never be lost.”

However, PSA guidelines on provision of emergency contraception align with Dr Hussainy’s assertion that pharmacists have a duty of care.

“In the event that an out of stock situation or moral belief of a pharmacist leads to the nonsupply of a product or service, the pharmacist must accept responsibility for ensuring continuity of care – that is, timely access to the required medicine or service,” says the PSA in its official guidance on the provision of pharmacist-only medicine Levonorgestrel.

“This may involve the use of initiative to identify another reasonably available source for the required medicine or service, particularly in rural or remote areas or in other situations where access to alternate service providers may be limited.”

Dr Hussainy also points pharmacists towards the International Consortium for Emergency Contraception for “evidence-based information to dispel myths”.

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5 Comments

  1. Daniel Roitman
    21/03/2017

    We can simply cannot have 21st Century medical practices dictated by the capricious scribblings of 4000 year old desert dwellers. Religion and medicine should never overlap, our duty is first and foremost to our patients and our community. Dr Hussainy said it perfectly above and I strongly encourage all religious-based pharmacists to take heed of her words. Ultimately, you are free to practice whichever belief structure you choose, though the moment you put on the white lab coat your loyalty must be to objective evidence.

    • Ron Batagol
      21/03/2017

      Well written Daniel!! Couldn’t agree more!!

      • Willy the chemist
        22/03/2017

        I think that this is exactly the type of black-and-white thinking that is inflexible, judgemental but masquerading as liberal and open minded.

        Everyone must be allowed to act within his or her own conscience. It is a basic human right. Whether you are a healthcare professional or “white lab coat”wearer does not mean you are lesser human being.

        Ethics is almost never black or white. It is often the very people who appears “liberal” or “progressive” that they disparages of different point of view. It is a form of bigotry and intolerance.

        For example in the case of apotemnophilia. If a patient seeks amputation of a healthy limb, would you also say that the physician must perform the surgery?

        Lastly, don’t confuse loyalty with “objective evidence”. Tell me what is objective evidence here? The termination of a viable pregnancy (in the absence of a medical contraindication in the pregnancy)?

        Please don’t confuse loyalty with conscience. Don’t confuse objectivity or evidence with being judgemental.

        • Dianna Donnelly
          27/03/2017

          “I’d help you feel better, but the medicine you need is against my personal beliefs”.

          Ya… go get another job then. Period.

  2. Dianna Donnelly
    27/03/2017

    What is right is personal rights and freedoms. If a Jehovah’s Witness became a pharmacist, imagine all of the life-saving meds they would refuse to sell! Would you condone that?

    Get out of the line of business if you can’t allow your patrons to make their own personal decisions!!

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