Should Pharmacists' Moral Codes Trump Professional Duties?

The Food and Drug Administration is considering an application that would make the morning-after pill available over the counter. Some of the politicking could become moot if the FDA approves it, but for now the controversy is heating up.

Also known as emergency contraception, the morning-after pill is essentially a mega dose of birth control hormones that is effective for up to five days after sexual contact, but is most effective the earlier it is used. It works by preventing female ovulation or the fertilization of an egg by sperm or by interfering with the implantation of a fertilized egg into the uterus.

Abortion opponents believe this is tantamount to preventing human life. Supporters of the morning-after pill say it is simply another form of contraception.

The supporters, such as Planned Parenthood, where the movement to allow pharmacists to reject prescriptions is known as "pharmacist refusal," say the denial or delay of contraceptive medication is an infringement on patient rights.

"The point is that women need to have their birth control when they need it, with no delay," said Karen Pearl, interim president of Planned Parenthood.

Is There An Alternative?

Pharmacists say their expertise in evaluating prescriptions is a necessary part of the medicating process, and the pharmacy industry believes these questions can be answered without a legal mandate to fill prescriptions.

Frank J. Ascione, dean of the University of Michigan's College of Pharmacy, said the hope is that pharmacists with religious or moral concerns will avoid jobs where contraception prescriptions are an issue.

"If they're going to be working in a community pharmacy, they're going to be dispensing oral contraceptives. If they can't administer oral contraceptives for whatever moral reasons, they have every right not to work there," he said.

Winckler of the APhA said pharmacists should have the right to refuse. But the APhA also supports the creation of a system that would ensure patients can access legally prescribed medicine in cases of refusal, such as a referral to another pharmacy.

For customers forced to drive around to various pharmacies, this would be an inconvenience. But Manion said creating an inconvenience is not the same as violating patients' rights.

"They're saying that freedom of religion and access to contraception are both fundamental liberties," Manion said. "If that's true, when two fundamental liberties collide, you don't just throw one out in favor of the other, you balance them. And I'm sure you don't balance them by telling pharmacists: 'You have no rights.' "

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