Idaho pharmacy board is OK with pharmacist who was OK with woman bleeding to death

reply to post by Busymind

And, in my opinion; if a pharmacist is uncomfortable filling certain prescriptions -be it an abortifacient or a pain reliever or a steroid or an antibiotic- then that pharmacist should quit and get a job that does not cause moral conflict.

But what if the pharmacist has an eerie feeling about a prescription but fills it anyway and the autopsy reveals it was an overdose because of over-prescription?

Or, what about a prescription they expect to be fake (that is what got Jeb Bush's daughters in hot water in Florida. An alert pharmacist spotted the faked prescription).

What about drug interaction? The pharmacist sees that a doctor might have made a mistake, are they not bound to dig deeper before handing over a potentially lethal combination?

What about a questionable person picking up the prescription? They have the right information, but they seem a little shady. Should the pharmacist hand over a narcotic or a potential poison to someone different than the patient, just because they seem to have the right permission?

I think we want our pharmacists being proactive and alert. I know I want my pharmacist being proactive and alert!

Originally posted by JayTee
I think the Idaho Board of Pharmacy did the right thing by not pursuing any action against the pharmacist. Not only that, it was also a hit at Planned Parenthood, which has it's roots in eugenics. People shouldn't be forced or coerced to do anything, especially if it goes against their conscience. Not only that, there's a pharmacy in every Wal Mart and grocery store. They aren't hard to come by.

So If I feel that I have a an objection to you because you are say a member of a terrorist organization like Operation Rescue I should refuse to fill your nirtoglycerine perscription?

Yes there are many options and I dont know the particulars of this case but not many are open 24 hours and perhaps that was the case in this instance.

Also, NOT liking someone is part and parcel of being in the medical field. You either check your prejudices, bigotry, religious zealotry, etc at the door, of you should not practice IMHO. Or in the case of this guy perhaps he should set up shop outside Fred Phelps merry bunch so he can be around people who wont offend his tender sensabilites

Originally posted by getreadyalready
I think we want our pharmacists being proactive and alert. I know I want my pharmacist being proactive and alert!

But do you want him or her passing moral judgement over what you are getting? All of the thing you mention is well within the scope of a medical professional, but refusing to treat a patient because of a moral or religious objection is simply wrong.

Is it any different than refusing to fill out a script for an HIV patient because he or she was a homosexual?
Is it any different than refusing to fill out a script for a patient with Tay-Sachs disease because he or she is Jewish?

Where is the line?

Originally posted by AnneeI would really love to see proof of that law.

Here is the some of the case law for a pharmacist dispensing a drug following a doctors order but potentially harmful to the patient given their medical history.

As I read it seems that usually the pharmacist will be held liable if they fail to inform the patient of possible interactions or to dispense the medication if they know of a counter-indicating condition in the patient.

PHARMACIST'S DUTY TO WARN

III.The Duty to Warn On The Part Of Pharmacists

A.Common Law Tradition

A court will almost always hold liable a pharmacist who makes an error in dispensing the prescription drug. Considered a mechanistic task, filling a prescription is given no latitude for error.[20] Slightly more restless is the doctrine governing the plight of a pharmacist who correctly fills a prescription, but does not warn the patient of potential side effects of the drug.

The general thrust of the case law finds a pharmacist without a substantial duty to warn the patient of drug side effects. Some courts, however, have held pharmacist to a higher standard. For example, the court in Hand v. Krakowski[21] found negligent a pharmacist who correctly filled a prescription for a psychotropic drug, but dispensed it to an alcoholic patient. The court held that the pharmacist had actual knowledge of the customer's alcoholism and knew or should have known that the prescribed drug and alcohol are contraindicated.[22] Since he nevertheless continued to refill the prescription for six years, the court held the pharmacist liable for his actions. Though this case seems to suggest a duty to warn principle on the part of pharmacists, its relatively narrow factual scenario precludes any significant precedential effect. It is rare for a pharmacist to have such clear and personal knowledge concerning a customer. Moreover, in such situations, where there is virtually no added cost of acquiring information of a potential hazard, a duty to warn the patients seems to be a well-founded moral obligation; no legal prod is necessary.

In Rift v. Morgan Pharmacy, the pharmacist also filled the prescription as written by the physician but this time failed to inform the customer or the physician of an obvious error in the prescription itself.[23] While the physician's order instructed the patient to administer one suppository every four hours to ease a headache, the patient went unwarned that no more than two suppositories should be used per headache and no more than five used in a single week. Ignorant of these hazards, the patient misused the drug and sustained permanent nerve damage. In support of a "safety net of overlapping responsibilities" where each member of the health care team is, in part, "his brother's keeper,"[24] the court held the pharmacist liable for his failure to correct the obvious error in the prescription. Here again, however, the pharmacist's duty to warn rests on a narrow factual scenario in which the physician's prescription was clearly erroneous in light of a toxicity well known among pharmacists.

At most, Hand and Rift establish an extremely limited duty to warn for pharmacists. Far more representative of the courts' position is the recent Washington State Supreme Court ruling in McKee v. American Home Products Corp.[25] There the court refused to attach liability to a pharmacist who had accurately filled a prescription but had not warned the patient of the potential side effects associated with extended use of the prescription drug. In a lengthy discussion of the issue, the court confirmed that under the learned intermediary doctrine the duty to warn falls only on the shoulders of the physician; the pharmacist bears no responsibility to convey to the patient nonjudgmental information regarding potential hazards of drug use. Consistent with Hand and Rift, the court held that "the pharmacist still has a duty to accurately fill a prescription...and to be alert for clear errors or mistakes in the prescription." A pharmacist, however, "does not...have a duty to...warn customers of the hazardous side effects associated with a drug."[26] The McKee court crystallized the position of many other state courts and reaffirmed the general common law principle -- pharmacists do not have a broad duty to warn their customers of the potential dangers of prescription drug use.[27]

reply to post by FredT


The "where is the line" is the problem.

Somewhere there is a line between a "moral objection" and a "gut feeling." I don't want the pharmacists discouraged from trusting their gut feeling, but I also don't want life-saving medications withheld on strictly moral grounds.

This could become eugenics or hate crimes or any other number of pitfalls. But it could also tie the hands of the pharmacist and cause fatal errors to happen.

I totally agree that a pharmacist should not be working in that field if they have a problem dispensing birth control or HIV medications. If their religious beliefs interfere with their duties, then they should pick another career.

I think the OP is one of those cases that rides the line. I don't know the mindset of the pharmacist, but perhaps they were afraid this was a backroom abortion? Or perhaps they thought there was a problem with the abortion that would require medical attention and not just a pill. Or perhaps they truly had a moral objection to all abortions. I would agree with them in the first two mindsets, but not in the third. This case is the perfect example of "where is the line?"

I'll throw in a little potato-tastic input, since I am currently stuck in this hellhole of a state (Originally from NorCal so I am an impartial observer of the wildlife here.)

First of all, let's all remember that the concept of 'United States' allows for individual laws based on the state's needs and desires, not the federal's. Idaho is a very religious state (what did someone say on page one? 'Mississippi of the NW? YES), and as such laws like this are 'feel-good' and resonate with the voters .
Let this be a reminder: Research states before you move there (take it from me!!!!).

I see that like so much legislature here in ID, the end result of this is a steaming pile of vague and contradictory poop. How in the hell can a pharmacist object post-op unless the patient comes out and says "I had an elective abortion, now treat me"?
We get so used to the pharmacist rushing around and slinging pills, we forget that they are Doctors of Pharmacy...and not just 'a doctor', but YOUR doctor. He is liable for his scope of care, the same as your OB/GYN might be. While the scope of what they do does involve understanding your medical history, it doesn't involve the motivations behind it! Without understanding the motivations (in a post-op scenario) there can be no informed moral objection, only a knee-jerk reaction unbecoming of a member of the medical community.

If I had to draft a moral objection law like this thing, I would be sure to define the scope of objection to pre-procedure medications. The author of this law failed horribly...Preventing situations such as this should have been foremost in his mind as he wrote it.

Whatever happened to "First, do no harm"?

Originally posted by Annee

Originally posted by Kailassa

Originally posted by Annee
That is ridiculous. Pharmacists need to be required to fulfill any prescription written by a patients doctor. They are not in the position to refuse on personal belief.

I don't know what the law(s) on this are in America, but in Australia the pharmacist does a 4 year university course and can be prosecuted for correctly filling a harmful prescription.

Thank you for your post.
I would really love to see proof of that law.

Obligations

1.2 A pharmacist must not purchase, sell or supply any medicinal product where there is reason to doubt its safety, quality or efficacy or where there is clear, new evidence that demonstrates or places doubt on previously established product safety or where a product may impose a hazard to the patient's health or condition.

This is self regulation, the Pharmaceutical Society of Australia Code of Professional Conduct.
Britain has one that's virtually identical.

I can promise you, if any of the chemists in the three cases I mentioned had supplied me with the prescribed drugs and I experienced side effects, I would have been in a position to sue.

Originally posted by Annee
In my experience - - - the pharmacist explains the medicine prescribed - - then require customer to sign that they understand. OR - - the customer (patient) can refuse explanation and is required to sign that they were offered explanation and declined.
In no way is it the responsibility of the pharmacist to make the decision whether you should have the medication or not.
It makes no sense for the pharmacist to override what a doctor prescribes.

Some doctors are idiots. The doctor who prescribed me lithium and thyroxine together is referred to by staff at the local hospital as "Twitty Witty".
What would the point be of a pharmacist having four years uni study in the field if he then had to obediently fill out prescriptions for drugs that could injure or kill the patient?

It's a basic principle in society that if you are in a position to prevent harm coming to a person you have a responsibility to do so.


Of course none of this is relevant to the case of a pharmacist refusing to supply a drug which he has reason to believe is vital to the patient's health or survival. I have no sympathy with such twisted, irresponsible hatefulness.

Originally posted by JayTee
I think the Idaho Board of Pharmacy did the right thing by not pursuing any action against the pharmacist.

She caused a woman to bleed to death.

Not only that, it was also a hit at Planned Parenthood, which has it's roots in eugenics.

And knowingly causing the death of someone who you feel is "unworthy" isn't, so long as you eat your cracker and jiggle your beads, right?

Well congratulations, you can mark your little political scorecard with the uterine blood of a dead woman. Aren't you #ing proud of yourself? Talk about being a ghoul.

People shouldn't be forced or coerced to do anything, especially if it goes against their conscience

Don't get a job dispensing medicine if you have a moral objection against dispensing medicine. I'm starting to wonder if people - like this pharmacist, and like yourself - aren't pursuing these positions expressly for the purpose of laughing at and finding joy in the misery and death of people they dislike.

Not only that, there's a pharmacy in every Wal Mart and grocery store. They aren't hard to come by.

Gosh, my vagina is gushing blood. I think I'll shop around!

You're either pointing out my lack of clarity, or you didn't read the first part of my post. So, for clarity: If a pharmacist is *MORALLY* uncomfortable filling a prescription then that pharmacist should quit and get a job that does not cause moral conflict. In my opinion.
And in answer to your questions, I expect my pharmacists to be proactive and alert and to fill the prescriptions I bring them AND to inform me of potential interaction problems. Often times a pharmacist will catch potential problems that a physician does not catch. It's part of their training. I do not want a pharmacist who is going to refuse to dispense my personal medication based on their assumption that I am doing something they find morally objectionable.

Originally posted by getreadyalready
reply to post by Busymind

 

And, in my opinion; if a pharmacist is uncomfortable filling certain prescriptions -be it an abortifacient or a pain reliever or a steroid or an antibiotic- then that pharmacist should quit and get a job that does not cause moral conflict.

But what if the pharmacist has an eerie feeling about a prescription but fills it anyway and the autopsy reveals it was an overdose because of over-prescription?

Or, what about a prescription they expect to be fake (that is what got Jeb Bush's daughters in hot water in Florida. An alert pharmacist spotted the faked prescription).

What about drug interaction? The pharmacist sees that a doctor might have made a mistake, are they not bound to dig deeper before handing over a potentially lethal combination?

What about a questionable person picking up the prescription? They have the right information, but they seem a little shady. Should the pharmacist hand over a narcotic or a potential poison to someone different than the patient, just because they seem to have the right permission?

I think we want our pharmacists being proactive and alert. I know I want my pharmacist being proactive and alert!