A sizeable minority of pharmacists would refuse to dispense drugs used in voluntary assisted dying, an AJP poll shows

Last month, the lower house of Victorian Parliament passed Labor’s controversial Voluntary Assisted Dying bill, which would pave the way to permitting euthanasia under very strict circumstances.

If implemented, the legislation would be one of the most conservative in the world, and include 68 safeguards.

Pharmacists would be part of the process, supplying lethal medicines in a “locked box”. Their participation would be voluntary, and professional organisations have stressed the importance of this.

At this stage it is unsure what those medicines could be, though it has been suggested that a cocktail of drugs put together by specialist compounding pharmacists would be used, rather than drugs used internationally in euthanasia such as Nembutal and Seconal.

We asked readers whether, should such legislation be passed and implemented in their state or territory, they would supply drugs under these circumstances.

Over a third of pharmacists would not dispense these “locked box” drugs, our poll found: 32% (108 readers) simply said they would not provide the medicines, while another 5% (16 readers) said that while they personally supported the legislation, they wouldn’t participate.

Some wanted to know more before making a decision – 22%, or 75 readers – while the most commonly selected option, at 41% (140 readers) was “yes”.

Dr Betty Chaar from the University of Sydney, for whom a key area of interest is ethics in pharmacy, says these results are disappointing.

“Everyone is entitled to their opinion no doubt, but it is our opinions in the context of our professional roles as pharmacists that we are exploring here in depth,” says Dr Chaar.

“Being a professional means you may need to provide services that you might not entirely believe are useful or therapeutic et cetera: for example the harm minimisation policy and provision of needle exchange services or methadone.

“Evidence however, shows that the policy works despite the concerns.”

She says it’s worrying that such a large proportion of AJP readers would not take part in this service, “with no additional comment on providing continuity of care or compassion with the suffering of the patient that is requesting this.

“There is this universally recognised contemporary debate going on, about the right of the healthcare professional to decline a service in balance with respect for patient autonomy.

“It is unresolved in most parts of the world, when it comes to euthanasia, but important to note and important to build tight protocols around such concerns to ensure patient care is enacted.

“It is not an easy subject to navigate, but we will have to if it is legalised in Australia, and we as a profession will need to face the controversies and bring together all these views to develop carefully considered guidelines and standards of practice to enable pharmacists to know what to do in such cases and what to fall back on if they have a conscientious objection to what may be deemed a professional duty.”