Pharmacy: Morals v Ethics

Several hormonal birth control drugs

“Should healthcare providers be allowed to choose their religious beliefs over the care for their own patients?”

The question plagues Washington, as well as pharmacies found across the country.  In an article published by Pharmacy Times, this issue is further analyzed by pharmacist Jeannette Wick.

The Issue: Some pharmacists (and other healthcare providers), practice religion. This is their Constitutional Right, as found in the Bill of Rights. Some pharmacists believe their religion may prohibit certain medications and therapies– including contraception (birth control), certain medications that contain gelatin (commonly derived from pork), and therapies for transgender patients. However, not every patient follows the same religious practices as their providers. Access to some of these therapies can be life altering for patients and their loved ones. While many activists argue that access to healthcare is a fundamental right, it is missing from the Constitution.

Morally, a pharmacist may choose to either enforce their religious conviction or not. Since religion is a common core value, it helps guide people during their day-to-day lives. Ethically, a pharmacist is obligated to serve all their patients to the best of their ability. As a profession, we must determine the middle ground where pharmacists feel respected but are able to help their patients still. This could look like satellite prescription validation, multiple staffed pharmacists with diverse religions/sects, or even referrals to other nearby providers in extreme cases.

Overall, this article in Pharmacy Times conveys an informational approach to the issue. This works wonderfully for the piece, especially since this topic can be very emotion-evoking for those affected. Personally, I side strongly with the patient. We as pharmacists have a duty to serve our patients, not ourselves. Additionally, my view is self-serving– as an LGBT person, my own access to healthcare is at risk. The fact that I can be turned away from having my blood pressure taken purely due to my status as a queer person is nauseating. Unfortunately regardless of laws, Transgender patients face challenges in their access to care.

Rainbow Rod of Asclepius

This dilemma poses a threat to every pharmacist and every patient who fills prescriptions (and even patients at ambulatory care clinics, and elsewhere who may interact with a pharmacist outside of a community pharmacy). Not only is this an issue of theoretical morals and ethics, but the Trump administration has recently introduced a new “Conscience and Religious Freedom” office, to maintain providers’ religious freedoms/expressions in the workplace. Given the broad applications this could have, it will doubtless be sorted by the courts; however, this still has vast potential consequences for pharmacists and their patients. It is never easy to ask someone to break a core value, but nor is it easy to deny care to a patient in need.

In the meantime, large chain pharmacies and health systems will inevitably choose their own policies for employees to follow. Whether this comes in part from federal/state guidance, remains to be seen, though I’m sure we will have plenty of tweets to update ourselves on any decisions made.

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