Spurred by recent changes in medicine and public policy, an increasing number of pharmacists are debating whether they should have the right to refuse to dispense medications they morally oppose.
One of the major concerns is whether druggists should be allowed to reject prescriptions they believe will induce abortion -- a situation that leaves their beliefs and their jobs on a collision course. The sometimes heated debate has preoccupied many pharmacists' associations across the country.
"They're entitled to their own moral standards," said Stephen Brandt, head of the Garden State Pharmacy Owners in Rochelle Park, New Jersey, whose organization has taken no official position. "They can't just throw the prescription in the garbage, but they shouldn't be forced to fill it either."
Although a handful of pharmacists raised these questions years ago, the discussion intensified last year after Somerville-based Gynetics Inc. announced it would market a packet of pills that could act in an abortifacient manner.
Many pro-life supporters view the drug combination as an abortion-inducer, because it may prevent implantation of a fertilized egg. Pro-life pharmacists said the availability of the drug effectively forces them to participate in what they view as an immoral act.
The conflict is likely to escalate in the coming year if the FDA approves the dangerous French abortion pill RU-486 and if other states follow Oregon's decision to legalize prescriptions for physician-assisted suicide.
Some pharmacists in Florida, Indiana, Washington, and California have been reprimanded or fired for refusing to dispense drugs they feel can be abortifacient.
Last July, at the behest of the American Pharmaceutical Association, the New Jersey Pharmacists Association passed a resolution urging the Board of Pharmacy to recognize "the individual pharmacist's right to exercise conscientious refusal" while urging the establishment of a system that would ensure patients' access to legally prescribed therapy. (In other words, it would have pharmacists refer the patient to someone who would provide the drug.
So far, the board has taken no action on the measure.
The resolution has its share of opponents from both sides of the abortion issue. Abortion advocates oppose pro-life conscience clauses that would protect pro-life pharmacists from being forced to disseminate abortifacient drugs.
Pro-life supporters, however, say the association's resolution does not go far enough. By requiring the pharmacist to refer patients to another druggist who will dispense the prescription, the resolution effectively presses objecting pharmacists to aid the very act they oppose.
'Our position is, pharmacists who oppose abortion shouldn't be forced to make a referral to kill," said John Tomicki, head of the League of American Families, a lobbying group in Pennsylvania and New Jersey. "Doctors have a right to refuse to perform an abortion. Why shouldn't pharmacists have the same right?"
Tomicki's group is drafting legislation that would give New Jersey pharmacists the right to refuse prescriptions they oppose on religious or moral grounds, and would give other health care professionals the right to refuse an order to stop providing sustenance to terminally ill patients. The bill would also give them the right to refuse to refer the patient to another provider.
Tomicki says the bill will be introduced next month. He insists he has legislators who will sponsor it, though he won't identify them.
Last year, to the dismay of abortion advocates, lawmakers in South Dakota enacted a bill that shields pharmacists from being sued or fired for refusing to dispense drugs used for abortion, suicide, or euthanasia.
Pharmacies are left wondering how to dodge the cross-fire. On the one side, Kmart officials have said they will not tolerate pharmacists who refuse to dispense legally prescribed drugs. Kmart has gone so far as to fire one pharmacist who indicated a refusal to fill certain prescriptions. However, Wal-Mart -- one of the largest pharmaceutical retailers in the country -- announced last month it would stop selling Preven, the contraceptive kit many pharmacists see as abortifacient.
"At this time, Wal-Mart has made a business decision not to sell Preven," said the statement from Wal-Mart, which has 2,428 pharmacies nationwide. "However, in the interest of serving and meeting the needs of our customers, our pharmacy will refer any requests for this particular drug to a pharmacy that does carry it."
Company representatives refuse to say whether the "business" decision was based on pressure by pro-life supporters, who have threatened to boycott any company associated with RU-486, which is not yet on the market.
Wal-Mart spokeswoman Jessica Moser did say, however, "I know of no other prescription in the history of Wal-Mart that the company has refused to sell."
Source: Thursday, April 29, 1999 , Bergen (NJ) Record
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