New Rules for Pharmacists

by SUZANNE SCHREINER & r & & r & & lt;span class= & quot;dropcap & quot; & I & lt;/span & n the wake of stiff opposition from Gov. Chris Gregoire, women's advocacy groups and the public at large, the Washington Board of Pharmacy ruled on Aug. 31 that pharmacists' moral objections cannot bar access to a woman seeking emergency contraception. Seattle pharmacist Donna Dockter was the lone dissenter among the seven members of the Board.


"It was a difficult process, but they did the right thing," says Jet Tilley of Planned Parenthood of the Inland Northwest. Tilley also credits the Governor, "a major player in this," because "she encouraged the Board to protect Washingtonians' access to medical care." Despite the political turmoil, Tilley adds, "It's important to remember that the majority of pharmacists want to fill prescriptions and provide health care."


Echoing the position of the Spokane Pharmacy Association, Jim Ruster of Group Health Cooperative called the ruling "disappointing," saying pharmacists should be allowed to object on matters of conscience. He asks, "Why should one group of health care professionals be held to a different standard than others?" Doctors and nurses do not have to provide abortions if they have moral objections, some pharmacists point out. Still, he stresses they must have some sort of personal or professional strategy "to make sure that the patient gets the care even if you feel you can't provide that."


Calling Plan B safe and effective, Spokane County Health Officer Dr. Kim Marie Thorburn says "Allowing pharmacists to refuse presents an unnecessary barrier [to patients]." In response to pharmacists who claim objections of conscience are part of the continuum of professional discretion they have always exercised, such as dangerous drug interactions that doctors may be unaware of, Thorburn says, "They're really talking about a moral argument; they're not applying science. Drug interactions are not a moral issue." And those doctors who refuse to provide abortions, she adds, are ethically bound to ensure that the patient is getting service elsewhere. Whether the objection is to emergency contraception or a patient's possible addiction to pain medication, Thorburn counters that people in medicine and health should be driven by facts. By couching medical issues in moral terms, she says, "They're saying their own personal beliefs should influence their practice."


Steve Pickette, director of pharmacy clinical services at Providence Health, says the controversy about pharmacists' exercise of conscience has missed the point -- particularly in Washington, where pharmacists have worked to improve access to care. For many people, their most direct access to health care may be from a pharmacist, whom they can approach directly in a Walgreens or a Rite Aid with the full expectation of confidentiality and respect.


"The focus," Pickette says, "should be on how much a pharmacist helps" rather than some errant practitioner who is the exception. They are professionals, he says, not automatic dispensers of prescriptions, who should be allowed the same latitude in the exercise of conscience as doctors, so long as it is in line with employers' policies. In any given situation, he adds, "It's a thousand times more likely that a pharmacist is going to be helpful."