Medical Ethics Gone Wild

As an RN – I have come across so many different types of people from so many different walks of life. People of different shapes, sizes and colors – with various different beliefs, morals, value systems, politics and experiences. Some of those people I have fallen in love with. Some of those people I can do without. Some I just hugged – – others I wished never to see again.

Be that as it may, I’m a nurse. My job is to provide care to patients no matter what. Yes, even if they are liberal Democrats – – I STILL overlooked it and provided care. Even during times where I didn’t agree with their decisions for their own healthcare – even when I knew thought they were wrong.

The promiscuous teenager who kept coming back for treatment of STD’s – only to receive yet another lecture about safe sex. The 3 pack a day smoker who kept coming back in for refills of their inhalers – even after the diagnosis of lung cancer. The chronic back pain patient who just wouldn’t stop the weekend football league, no matter how much it hurt. The mothers who wouldn’t treat their kids because they were sure god would take care of it – nature’s way. The hippie chick who thought for sure that herbal vitamins would cure her gangrenous gallbladder.

I treated them all. Advised them all. Even knowing that they were doing things I necessarily did not agree with.

Who am I to judge? It’s not for me to say what is or isn’t right for your life. I can recommend and advise all I want – – but when you come back into my ER for treatment – – I will treat you, and give more advise that I know you will not follow.

Why am I ranting? Because this is wrong on so many levels – I can’t even begin to describe how wrong this is.

Pro-life pharmacists who refuse to fill birth control prescriptions because it, for those pro life radicals – anything that prevents conception is a form of abortion?? Hello?

First of all – and here’s a little Sex. Ed. for ya – – in order for it to be an abortion – – THE SPERM HAS TO MEET THE EGG FIRST! Birth control pills prevent that – – so shedding an unfertilized egg is now, somehow, abortion? How extreme have we become in this quest for the respect of life. I mean, respect life all you want – – but it has to be LIFE first, doesn’t it?

For a pharmacist, or any health care worker for that matter, to impose their religous belifs, moral values or any other convictions on their patients is just wrong. Are people not free to make their own decisions regarding their own healthcare treatment?

Could you imagine going into your local KMart – heading to the pharmacy to fill your birth control prescription, only to have the pharmacist say “I’m sorry, young lady – but it’s against my moral beliefs to fill this for you.” So, then you drive down the street to WalMart . . . Walgreen’s …. Eckert — same story everywhere.

Can I open a local drugstore and refuse to hire a pharmacist based on his moral/religous beliefs? Are we going to require a litmus test for our pharmacists now – as well as our Supreme Court judges?

Time to check all your local town pharmacies to find out where their pharmacy staff stands on the pro-life/pro-choice issue just to be sure you can be a big grown-up and make big grown up decisions regarding your own family planning without the interferrance of your local Walgreens (insert local pharmacy name here).

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41 thoughts on “Medical Ethics Gone Wild”

  1. If I owned a pharmacy and one of my Pharmacists refused a customer because of his moral beliefs, i’d fire him immediately. I don’t care if the American Pharmacists Association gets this passed or what, i’d still fire him.

    It’s my business, i’ll do with it what I want to do with it. I’ll hire who I want, when I want, and i’ll fire anyone who brings their personal beliefs into my work place because really, it would be MY work place. =D

  2. I am simply STUNNED by this. I fail to understand howinhell a pharmacist feels he/she HAS THE RIGHT to tell me what I can or cannot take — as long as I have a prescription from a licensed M.D., FILL THE DAMNED THING AND KEEP YOUR OPINION TO YOURSELF!

    Not to mention the fact that they MAY be putting a patient’s life in danger. Um — who are the pharmacists to be second-guessing an M.D.?

    Damn and blast! This really riled me up! Chris’s title says it all.

    Utterly bloody ridiculous.

  3. It is irresponsible for a Pharmacist to fail to fill a legitimate prescription because of his or her moral beliefs. It is this type of behavior that will put a Democrat back in the White House in 2008.

    If a person comes into the hospital and wants treatment but is refused treatment on the moral grounds of the physician, then we have reached a reverse cultural barbarism.

    I am a long time Right of Center person but this is maddening.

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  5. This Christian agrees with you, Lisa–it’s immoral to refuse to fill somebody’s prescription. Pretty soon somebody will argue that you shouldn’t get your chemotherapy because it’s God’s will that you die of cancer, after all.

    And there are reasons other than rampant promiscuity why some women take birth control pills, after all. It isn’t just piggish and autotheocratic for these pharmacists to do this; it’s bad practice, since generally pharmacists don’t have access to a patient’s diagnosis.

  6. I’m a religious whacko. It’s been 1873 days since my last conversion. (Hi Michael!)

    We all have to make a decision when life begins – some people believe it’s a parasite until birth (see Gen Wesley Clark’s statement in the primaries it’s ok to abort a 9 month old fetus until the day it’s born). Others believe it begins at conception. I suppose some believe it starts before conception. Since we can’t ask the embryos or stick a probe in them that measures the amount of life, it’s going to stay opinion.

    But even I would have trouble understanding the concept that a contraceptive by itself is immoral. I have a lot more trouble with the morning-after pill, but not a contraceptive.

  7. Let me tell you a story about the only vet in a small town of 5o00 people, where the next closest vet is 3 hours away by Boeing 727 at a travel cost of $1500, who refused to fix local cats & dogs for the same reasons.

    Life is stranger than fiction ain’t it?

  8. Ok I’m going to be unpopular, but if I’m a pharmacists who thinks certain things are wrong, I won’t do them. That should be my right and no one should be given the power to force me to do otherwise

    That being said I also will have to face the music when the rational world punishes me for my stupidity and/or religious beliefs.

  9. Then Howard – you are in the wrong job.
    Sometimes I’m really glad I live in the U.K. where this sort of thing just doesn’t happen (perhaps because it’s a significantly more secular country)

  10. OK, then I was wrong…I know there was SOMETHING they wouldn’t sell at WalMart…

    Oh, I remember… the Morning After Pill.

    (A little brain dead today!) 😳

  11. This subject makes me mad as hell!
    I don’t understand what their problem is! If they have such a problem with it…Get another fucking job!:twisted:

  12. To me the real contentious thing is the pharmacist refusing to release the prescription to another pharmacist. If an individual pharmacist wants to refuse to provide the medicine that’s his problem, I’ll just take ALL my prescriptions to an alternate. However if he is going to make a stand, then do it up front, refuse to take the prescription in the first place.

    Tim, oh how I miss the good old NHS! I remember when I went to the hospital and the first thing they did was ask you what was wrong, rather than how are you going to pay for this, and when my medical information was considered more important than my credit score. I was never the greatest fan of the expense of the NHS but it is way way cheaper than the $120 a week that comes out of my paycheck to pay for my medical insurance, not to mention the 4 months without coverage that I had to suffer while between jobs.

  13. It seems to me that perhaps the Pharmacist has chosen the wrong career?

    As Mark Hasty pointed out in his comment, there are other reasons to take BC pills. I take them to attempt to control recurrence of endometriosis. It’s either that or Lupron, which isn’t really an option for me.

    I had to go through major surgery via laparoscopy to remove a whole bunch of crap. It cost my insurance approximately $25,000. And, there is a possibility that at some point in the future I’ll have to do it again, if the endo comes back.

    So, to take BC pills and stave off the return saves a little insurance $$. I already had to get the prescription from my doctor. Why should I have to justify it to the pharmacist? I guess we could all go to Mexico or Canada mail order … but, honestly.

  14. It would seem to me that perhaps that pharmacist is in the wrong profession.

    An alternative for consumers is Canada mail order or a quick trip to Mexico (for CA). But we should have to. We have already received a prescription from a doctor, we shouldn’t have to justify ourselves to the pharmacist, too.

    And, as Mark Hasty pointed out, there ARE other medical conditions that BC pills are prescribed for, not just family planning.

    For me, earlier this year I had major surgery performed via laparoscopy to remove extensive endometriosis, among other things. That surgery cost my insurance company approx. $25,000. I take BC pills to try and prevent recurrence of that painful and debilitating disease. My other option is Lupron, which is not an option for me.

    So, $25k vs. preventative maintenance. Hmm.

  15. The problem, or one of the problems, is that it sets a precedent that can be modeled by others. Perhaps you are traveling in an area wherein the local pharmacist does not like the fact that you are wearing an American Flag pin, or that you are getting medication that extends life because he or she believes in the right to die. We often open up holes that we later walk into ourselves.

    This will not be good.

    Howard – when you are in the profession of caring for others you will be forced to deal with people and problems that you would not normally deal with – it is part of the job. Here’s to hoping you are not a health professional.:grin:

  16. The doctor who thinks rock music is a tool of the devil will not treat your shattered ear drum you suffered at the Metallica concert downtown.

    The store clerk who will not sell you a pack of bubble gum because sugar is evil and will rot your teeth.

    The vegatarian clerk at the meat counter who will only sell you soy burgers.

    I could go on 🙂

  17. While we are on the subject, my insurance keeps refusing to fill prescriptions until I have tried a half dozen cheaper drugs first. First off it’s embarrassing when the pharmacist says “sorry sir, your insurance won’t cover this” Secondly it’s a major pain in the ass to have to go back to the doc and say “hey, won’t this work?” Thirdly pisses me off no end to have to make 20 trips to the Doctor and pharmacist just fill a prescription, and finally (and way more importantly) who the hell is the insurance company to presume they know more about my medical needs than my fricking doctor? did the stupid little prick who answers the phone when I have to call them up spend 7 years of college getting his doctorate? if so why is he answering phones for a living!?!? Can “they” make a medical evaluation of me with out actually meeting me face to face, if so why the hell do I have to keep going to the quack they obviously endorse. Grrrrrr…… Why can’t the insurance company give the Doctor a list of meds they will pay for and at least save me the embarrassment factor.

  18. Lisa -You are more than “Just a Girl” you are also gifted with a wonderful mind.

    I hear you Fred. Healthcare is not an easy subject. Insurance even less so.

  19. Actually, most insurance companies do have a medical advisory board made up of physicians who make decisions on what drugs a person could try first. Drug A is cheaper than Drug B – and they are in the same category of drug – so they recommend trying Drug A first. The guy answering the phone at your insurance company is just repeating that information to you – the phone guy isn’t making the decision, he’s just enforcing the policy set forth by the insurance company based on the decision of their medical advisory board.

    Most insurance companies do give doctors a drug formulary to refer to when prescribing drugs – but it’s the rare physician who pays attention to their patient’s insurance carrier.

  20. Well, you know what though, I would like to think that the doctor prescribed me the medicine, not because it was expensive and he wanted to screw over the insurance company, but because he thought it was the best medicine to treat whatever condition I had. But, having said all that, I would settle for just a little communication between the Doctor, pharmacist and Insurance dude to prescribe me the correct medicine first time. My Doctor does happen to be fairly considerate of my health care woes and has been of great assistance when it has come to billing discrepancies with the insurance company, the re prescribing of drugs to satisfying the insurance company pisses him off as much as it pisses me off, If he had one I’m sure he would use a Drug Formulary, after all it is not in his best interest to continue to have to revisit my files (perhaps if he charged for it I would think otherwise) And please don’t come to the defense of the morons on the insurance phone line, I appreciate they are not doctors, in fact I would be shocked if the graduated 8th grade, and I should not have to explain their policy to them as I have had to do repeatedly over the last 6 month. I also appreciate that this carrier sucks , as I have no where near the problems with my previous insurance, all I know is that things went smoother back home with no insurance companies in the equation.

  21. Hey – I’m not defending anyone – – just answering your query about what makes the guy on the phone qualified to decide what drugs you get/don’t get. Answer is: he isn’t. He’s not the one making the decision either.

    Our healthcare system ain’t perfect by a longshot – – but I think it beats nationalized heathcare where the government is the one pulling the strings.

    Getting back to the topic at hand – I had a guy email me and tell me that preventing pregnancy is preventing life and pregnancy is gods way of populating the earth.

    I responded.

    Using his logic – treating fatal cancer, for example, is preventing death – – so I full expect that he not seek treatment for his ills and woes. gods way, after all.

    I love the argument where god enabled man to create the technology to extend life – – but I suppose it was the devil that enabled man to prevent life? Chemotherapy exists because god allowed it to be created . . . was he absent the day birth control pills were developed?

  22. I still maintain the doctor who examined me has better idea what’s better for me than the doctor who works for the insurance company. As for a national health system, if given the choice, I would have it but it doesn’t bother me that much, what bothers me is the inefficiency of the privately run system, but enough off topic.

    I’d be interested in his response to your follow-up, the guy is an obvious god idiot. Gods way of populating the earth ? That may have been a useful tool of government when infant mortality was at 50%+ but now as we approach plague status it’s just plain irresponsible, look to the mess in China, do we really want to subject ourselves to that just because we are squeamish about preventing or aborting unwanted pregnancies?
    ?

  23. A brilliant analogy Lisa. You are right. People often fail to think through the consequences and repercussions of their thoughts – instead they embrace stupidity.

  24. Checking back in and I guess I got some attention. Cool!
    To put everybody’s mind at ease, I am not a health care professional. I also love birth control and would like it put in the municipal water system of every county in America. I am also far from a bible-thumping Jesus freak.
    That being said, I am uneasy saying a pharmacists must, i.e. force him/her to, do something against their ethics or he should lose a job. I just don’t like force.
    I do, however, work with the public in an advisory capacity and have come across people who are adamant that I do something for them I don’t feel is right. They may want a portfolio that is too aggressive or too much life insurnace, etc. I those cases where I cannot dissuade them I politely disengage and point them to one of my competitors.
    With the interstate highway system, 800 numbers, and the internet most problems can be solved fairly easily.

  25. Umm, Lisa, the BC pills don’t actually prevent conception. They prevent the implantation of a fertilized ovum in the uterus. “Contraceptive” is actually a misnomer, intentional or otherwise.

    That presents a moral problem for those who believe that life begins at conception. In fact, it moves the argument exactly into the same ground whereby Catholic doctors refuse to perform an abortion. There’s not much question of their moral right to so abstain.

    Generally, though, the market will take care of “problems” like this. If a merchant will not/cannot supply a product, the would-be customer takes his/her custom elsewhere. There are other pharmacies, if not in town, then on-line or by an 800 number or fax.

    The pharmacist in question may well go out of business if he doesn’t satify customer demands. But customers don’t have any legal right to cause him to commit a moral “sin”.

  26. Another point on the “Sex Ed” question:

    According to some theologians, a fertilized ovum cannot be considered a “person” because fertilized ova can do things that a person cannot. For instance, a fertilized ovum can be simply re-absorbed by the body, before implantation, thus disappearing. “Persons” don’t do that. Similarly, a fertilized ovum can split in two (or more), creating twins (or more). “Persons” don’t do that.

    I find this a rational argument that, to my mind, permits the use of birth control pills, but I’m not as strict on this point as many others, and clearly not the pharmacist in question.

  27. I see your point, John – – and yet, still – a fertilized ovum is not life, in an of itself – it requires implantation. It’s a very very grey line and fully depends upon a persons view of life.

    I still don’t see it, John – as a nurse, I’m not going to impose my morals upon someone else. I have quite a few patients who practice things that I may consider ethically or morally wrong in their life – – yet, it’s not for me to judge and turn my back to them and refuse them treatment just because I”m sitting high in my moral stance.

    There are other reasons that women take BC pills – as noted above. In my opinion – pharmacists aren’t there to impose their moral beliefs on me – more specifically, I don’t feel I would need to justify my reasons for taking BC pills to a pharmacist by saying something like “Oh, I’m taking this for endo. not for pregnancy prevention” – – that is information they are not entitled to.

    Such pharmacists should go to work filling prescriptions for nursing homes or elderly assisted living facilities where their delicate sensibilities won’t be challenged by such moral decisions.

    Just my two cents. 🙂

  28. Who cares? basically unless you are some warped zealot then the definition of contraception and fertilization is as about as relevant as Clinton’s definition of “is”.

    Fact of the matter is that the churches objection to contraception is due to a prior need to reproduce as much as possible in order to perpetuate the species, or perhaps (to them) more importantly the religion itself. Now that we obviously neither the species or the church are in danger of extinction I think it would behove the church to moderate their stance before we explode into plague proportions. Like so much of what the church stands for it is almost unfathomable to someone looking in from the outside.

  29. Lisa, I think you’ve pegged it: “It’s a very very grey line and fully depends upon a persons view of life.”

    That person’s view of life, though, is what we claim to protect when we say we value individual liberty. We can disagree with that view, think it wrong, stubborn, pig-headed, narrow-minded. But we can’t really deny a person the right to his/her own beliefs. Whether those beliefs are derived from religious upbringing or independently achieved conclusions, they are still beliefs. And beliefs are all equal under the law. Actions is where the matter gets tricky.

    The pharmacist is clearly performing an action in not filling the prescription. It is his belief that to do so would force him into a morally damaging act.

    Would we force a Jew or Muslim to eat pork “because there’s nothing intrinsically wrong” with eating pork? After all, there are thousands of Americans whose livelihoods rest on the production and sale of pork. What about them? The only “damage” a non-pork-eater would realize is to his moral sense of the world.

    There have been many legal cases that revolve around this issue. Can a Sikh be forced to not wear a turban? Can an Orthodox Jew be forced to work on the Sabbath? Can a Wiccan soldier be forced to put up with the lack of Wiccan chaplains in the service? Can a Catholic Church-affiliated hospital refuse to perform abortions?

    Consistently, the law has come down on the side of personal moral authority. The right to hold one’s own moral sense trumps practicality, convenience, common sense.

    I know it’s a hard issue, but without an official theology, the state has a hard time drawing “thou shalt not” lines on behavior based on moral sensibility. We, as a culture, do draw lines on things like murder and theft, but no longer do so for things like adultery or sodomy (mostly). But if a person believes that contraception (or abortion) is murder, then how would you want them to act? Just go with the flow?

    I’d rather people exercise their moral insights, even if I think they’re factually wrong–as in the case of this pharmacist. I’m not religious myself, I think organized religions have serious failings. While I’m happy to think, “Scientology is for nutcases” or “Mennonites are quaint but out of touch,” I’m not ready to ban them.

    I think it would be a far graver moral failure to take away the individual’s right to behave in a manner s/he believed moral.

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