Conscience Schmoncience! Who cares what you believe?

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PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Again, unless the pharmacists are physically restraining these women or calling all surrounding pharmacists and putting them on some kind of 'do not dispense' list, they are not being stopped, their liberties are not affected.

*** I can only guess you are a city dweller.

Specializes in FNP, ONP.

It doesn't matter what Plan B is, or what it does (but FTR, it is not an abortifactant) that is not the point. The point is, pharmacists who refuse to dispense a lawfully prescribed drug are overstepping their bounds and should be fired and lose their license. They are not educated or licensed to assess or prescribe, they have no status or authority to make a decision about what a patient should or should not be taking. Their job is to count out the pills, put them in the cup, take the money, counsel the patient. That's it. They are not empowered to make decisions. If they wanted to make decisions about patient care, they should have become a provider. The end.

Specializes in FNP, ONP.
Lots of interesting opinions on this thread. I am a Christian, and this is how the "Plan B" issue looks to many of us: According to our beliefs, all forms of abortion are murder. Therefore, dispensing a medication that will either kill the embryo outright, or prevent implantation ( thus killing the embryo indirectly) is, to us, aiding someone else to commit murder. The aiding of murder makes us just as morally guilty as the one committing the act.

Now any of you are certainly free to disagree with this point of view. I am simply setting forth the reasoning behind some religious objections to giving or dispensing this drug. There is a great deal of difference between dispensing a drug you believe is inadvisable (such as an early childhood vaccine) and dispensing a drug that you believe will make you an accessory to murder.

This is why many strongly religious people object so vehemently to the idea of requiring a pharmacist to dispense "Plan B" against his or her conscience. Again, you may agree or disagree with this position. I hope I have given you the chance to understand, at least a little bit, why someone else might feel this way.

Plan B is no more committing murder than not pulling the trigger on a gun is murder.

uRNmyway, ASN, RN

1,080 Posts

Specializes in Med-Surg.
*** I can only guess you are a city dweller.

Yes, I am currently a city-dweller. However I grew up in the country and do know what it is like. And I still say that unless the women are being physically restrained from seeking out another pharmacist, they still have the ability to seek Plan B from someone who doesn't feel it is against their beliefs.

And for what it matters, I am completely pro-choice. I have used Plan B myself. But my pro-choice beliefs are more global. I believe that so long as what you do doesn't HARM someone else, we have no right to tell you how to behave. And telling a woman that this particular pharmacist will not dispense Plan B, well that is not causing harm. I am sure it can upset her, it can certainly be an inconvenience if she has to go elsewhere. But it doesn't HARM her.

Now, take away the livelihood of a pharmacist for this ONE medication? How many people does that harm? What if this is a really good pharmacist? What if he is supporting a wife and a couple of kids? Who are we to take away his source of income for choosing not to dispense something that is firmly against his religious beliefs, especially when we bend over backwards to accommodate everyone else's beliefs?

uRNmyway, ASN, RN

1,080 Posts

Specializes in Med-Surg.
*** Given the large number of RN jobs that would never require her to administer blood products I would tell he she was in the wrong profession. I ertainly would tell her she is in the wrong nursing specialty. Is she has a religoud believe that prevents her form administering blood products then she needs to NOT seek a position where that would be a normal expected part of her daily practice, like ICU nursing. I would no problem firing her for refusing to preform her job.

Sure, this nurse could go work in an area that is less likely to involve blood products. But on the off chance that say, her psychiatric patient needs a transfusion, then what? Can she just ask a colleague to administer for her, or is she in the 'wrong profession'?

*** Yes she should have to live with the concequences of her choices. If she chose to work in a unit that required blood administration, and deliberatly ignored all the other RN jobs where it would not be an issue I would tell her to suck it up or hit the road.

But see, that's the thing. If this one pharmacist doesn't feel right dispensing this medication among the THOUSANDS of other medications he gives, he should just 'hit the road'? Regardless of the service he is providing to other patients, with other medications? If this person really wants to be a pharmacist, they should reconsider because of this ONE medication?

*** Of course! If a nurse doesn't wish to provide pericare then they should not choose to work in an area where that is a normal and expected part of their job. The should have personal responsibiliety for their actions and choices.

I agree with you on this, but only because pericare is a LOT more common that dispensing Plan B. Well, if not, I think the neighborhood probably has much more underlying issues requiring either police involvement if rape, or education if rampant promiscuity with no protection.

*** From my perspective it is Christians treating everyone else like "poop".

Really, tell me how? Christians (and remember, agnostic here, so I'm not personalizing, I am relaying observations) are ALWAYS getting told how ignorant, backwards, wrong they are. Their values are always trampled on. They do fight back, like most people would, when they feel their right to freedom of religion are infringed. Now, do I believe that Christians have a right to determine for everyone else that abortion is wrong, that gay marriage is wrong, whatever? No, of course not. In my mind, if it does no harm, whatever floats your boat, I couldn't care less. I don't think ANYONE should have the right to tell others how to behave, whether it is based on religious beliefs or the LACK of them.

uRNmyway, ASN, RN

1,080 Posts

Specializes in Med-Surg.
It doesn't matter what Plan B is, or what it does (but FTR, it is not an abortifactant) that is not the point. The point is, pharmacists who refuse to dispense a lawfully prescribed drug are overstepping their bounds and should be fired and lose their license. They are not educated or licensed to assess or prescribe, they have no status or authority to make a decision about what a patient should or should not be taking. Their job is to count out the pills, put them in the cup, take the money, counsel the patient. That's it. They are not empowered to make decisions. If they wanted to make decisions about patient care, they should have become a provider. The end.

BlueDevil, I don't know what your background is, but I find this so insulting to pharmacists. First, this description of them makes them sound like no more than a med-tech with a 6 week crash course rounding a LTC or something. Where I am from, pharmacists are educated on pharmacology, pathophysiology, etc. They do much more than just count pills and read off an information pamphlet.

Did you ever work bedside? Did you ever have a doctor tell you to do something you knew was wrong? Did you ever refuse *gasp* to do what a doctor told you to do? I have. I was told to administer IV heparin to a patient with new MI. I refused because the MI was from prolonged anemia, after internal bleeding of unknown etiology, multiple transfusions. There was no way I would give heparin when we still didn't know what the source of bleeding was. Should I have just gone to med school then? As a nurse, am I not supposed to do my OWN thinking sometimes? Or should I just be some brainless drone, pass pills, change dressings, turn and position, rinse, repeat.

Specializes in FNP, ONP.

I am aware that pharmacists are extremely well educated. Their educational background does not change the fact that they are not licensed to assess a patient and prescribe treatment. Their opinion of the patient and the patient's prescriptions is therefore moot, excepting obvious issues regarding safety. They cannot change the prescription and do not have the autonomy to determine not to dispense a prescription simply because they don't like it, and don't think the patient ought to be taking it.

John, the friendly corner pharmacist doesn't get to say "Hey Susie Q, I think Doctor Jones was wrong to prescribe this antibiotic for that sinus infection, since evidence demonstrates most sinus infections are viral. This prescription is really very inappropriate. I've decided not to give it to you. Drink lots of fluids and take some mucinex, it's on aisle 5. See Dr Jones again next week if you aren't better."

Well, truth be told, John could be right in that case and Dr Jones might have given Susie Q the prescription just to shut her up and get her out of the office. But the law says John doesn't get to make that call. Not about an antibiotic, and not about Plan B. Sorry John.

If pharmacists want to make those decisions, they have to earn prescriptive authority, and that's all there is to it. Until then, they dispense what is prescribed so long as it is not contraindicated due to preexisting condition or drug-drug interaction, etc. There is no room for their personal feelings about the merits or applications of a drug to enter into the equation. They advise providers, but they do not make the final decisions. They do not hold the authority to make decisions that might affect patient outcomes; only the patient and provider can make those decisions together. Advise, not decide.

And that is why they cannot be permitted to decide not to dispense plan B. That decision affects outcomes, and pharmacists simply do not have the right to do that.

Specializes in Pediatrics, Emergency, Trauma.

Again, unless the pharmacists are physically restraining these women or calling all surrounding pharmacists and putting them on some kind of 'do not dispense' list, they are not being stopped, their liberties are not affected.

How about the situations where there is lack of access to healthcare? Those areas DO exist...

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Really, tell me how?

*** In this case the pharmacist can be in a position to impose his beliefs in others by refusing to dispense. I think in many or most areas a woman would havbe other options to get around one who refuses to dispence the Plan B, bit in some areas, like where I live refusal to dispence by one pharmacy means thge woman simply can not get it.

Christians (and remember, agnostic here, so I'm not personalizing, I am relaying observations) are ALWAYS getting told how ignorant, backwards, wrong they are.

*** Well I don't say that about them. I have never heard Christians being told that. It's something beyond my experience.

Their values are always trampled on.

*** Pfffffffttt!! Not! Their values are impossed on all in our society. I resent it.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Yes, I am currently a city-dweller. However I grew up in the country and do know what it is like. And I still say that unless the women are being physically restrained from seeking out another pharmacist, they still have the ability to seek Plan B from someone who doesn't feel it is against their beliefs.

*** If a woman only has one option for a pharmacy and that pharmacy chooses not to dispence she is out of options. I disagree.

I believe that so long as what you do doesn't HARM someone else, we have no right to tell you how to behave. And telling a woman that this particular pharmacist will not dispense Plan B, well that is not causing harm.

*** Your views on abortion don't really matter since this discussion has nothing to do with abortion. If there is only one pharmacist and he refuses he is harming her.

Now, take away the livelihood of a pharmacist for this ONE medication?

*** In my opinion people who choose not to do their job can and should be fired.

What if this is a really good pharmacist?

*** A pharmacist who refuses to do his job isn't a good pharmacist. If he doesn't want to dispence plan B he should choose to work in a job where it isn't an expectation. There are plenty of them out there.

if he is supporting a wife and a couple of kids? Who are we to take away his source of income for choosing not to dispense something that is firmly against his religious beliefs,

*** Each of us must consider the effect of our individual choices on our family. If he chooses not to do his job and is fired then he only has himself to blame. He should make choices that are the best for his family. If that means he has to work as an ICU or oncology pharmacist so he isn't in a position to impose his personal values on others then that is what he should do.

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