Wednesday, November 23, 2005

Shut Up and Fill the Prescription

Funky Dung has an excellent post entitled "Shut up and Fill the Prescription" which was written by a good friend of the blog host, a licensed pharmacist and a committed Catholic, who addresses the issue of refusing to dispense oral contraceptives.

Here are some excerpts from that post.

The groups that are pushing for pharmacists like me to "shut up and fill the prescription" argue that no matter what I believe about birth control, the decision occurs between a woman and her physician and I should not push my "morality" into the situation. I should not councel any patient about how this drug works (by the way, when was the last time your doctor told you how any drug works?) so that she can reconsider her decision, I should not warn her that birth control has been linked to an increased risk of breast cancer or can cause life-threatening thromboembolic events (blood clots) including stroke, I should not tell her about other side effects such as peripheral edema (swelling mainly of the ankles), severe nausea, decreased glucose tolerance (which can lead to diabetes), depression, anxiety, etc., and I most certainly should NOT be able to refuse to fill it. To me this is the same as forcing an OB/GYN to perform an abortion.

Why, then, does my profession exist? Why did I spend six years earning a doctorate in order to be told I play no part in the decision of what is appropriate drug therapy? Let me turn the situation around. Let's say a young woman is trying to get pregnant and succeeds but is not yet aware of the pregnancy. Unfortunately, she comes down with pneumonia. When she goes to the doctor, she tells him/her that she is allergic to penicillins. Said doctor prescribes doxycycline, but in haste forgets to ask if she may be pregnant and/or give the simple urine test to confirm such diagnosis. She brings me a prescription which is the right dose, duration and frequency, is perfectly legal, and seems to make sense for her infection. According to the above mentality, I should be required to fill it with no questions asked, since this treatment decision was already finalized between her and her physician. Indeed, I should not even bother mentioning whether the prescription was appropriate or not since it was legal - after all, that's all that counts, right? However, doxycycline is listed as pregnancy category D, meaning that it is known to be harmful to developing fetuses, and her baby is born with severe birth defects, or worse yet, does not survive. When her lawyer is making the list of health professionals to sue for malpractice, my name will be on it and I will have my license suspended if not revoked.

This is great stuff. You can learn more here.

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