We are indeed all familiar with the battle that has been raging in our profession regarding pharmacists refusing to dispense drugs for abortion. Recently, our brethren at the American Medical Association (AMA) have joined in the fray by approving a new policy to encourage States to allow physicians to dispense medications when there is no pharmacist nearby (within a 30-mile radius) willing to do so. The AMA asserts large numbers of pharmacists are refusing to fill prescriptions for contraceptives and abortifacients. Some pharmacists, according to AMA delegates, are also refusing to dispense psychotropic and pain medications.
In addition, the policy-making body alleges pharmacists are refusing to return unfilled prescriptions to patients, thus preventing them from taking the prescriptions elsewhere, and they are “lecturing” patients about the drugs. While these accusations may sound extreme, I have no doubt there is at least a “grain” of truth therein. While I do not believe we have a right to confiscate legally written prescriptions, I do believe we have an obligation to counsel patients regarding the medications they are or are about to take. This is our professional duty and it is imputed upon us, so to speak, through our taking of the pharmacist’s oath. As it may have been a few years since we studied the oath, I have included it below and have specifically related it to the issue of dispensing abortifacients further below.
Oath of a Pharmacist:
At this time, I vow to devote my professional life to the service of all humankind through the profession of pharmacy. I will consider the welfare of humanity and relief of human suffering my primary concerns. I will apply my knowledge, experience, and skills to the best of my ability to assure optimal drug therapy outcomes for the patients I serve. I will keep abreast of developments and maintain professional competency in my profession of pharmacy. I will embrace and advocate change in the profession of pharmacy that improves patient care. I take these vows voluntarily with the full realization of responsibility with which I am entrusted by the public.
The recent issues addressed by the AMA, particularly those related to our refusal to fill prescriptions specifically designed to end a human life, go to the very heart of the pro-life moral position. As Christians, we view the beginning of life as the moment of conception. It is that miracle moment, which science cannot completely describe, where God fashions a human soul with a divine purpose.
Jeremiah 1:5 illustrates the beauty of God’s authorship of mankind as God speaks of His Sovereign purposes. Luke 1:41-44 shows that the purposes of God begin prior to birth as John’s first act as the forerunner of Jesus was to leap in his mother’s womb when the as-yet unborn Lord approached. God indeed has a purpose for all from even before the time of conception. Thus, we look at our oath in perhaps a different light than others. Our view is a biblical worldview. Consider our oath sentence by sentence:
1. “At this time, I vow to devote my professional life to the service of all humankind through the profession of pharmacy.”
All humankind includes those who are not yet born because life begins at conception. As a pharmacist I must consider an unborn baby as a patient.
2. “I will consider the welfare of humanity and relief of human suffering my primary concerns.”
Ending a human life does not consider his/her welfare and actually increases human suffering as many who have undergone abortions suffer physically and emotionally for years. (See Johnson T. Christianity and Pharmacy 2005;8 (l):21-22). Additionally, there is blessing in suffering, though that is yet another topic…see Romans 8:28-39.
3. “I will apply my knowledge, experience, and skills to the best of my ability to assure optimal drug therapy outcomes for the patients I serve.”
Ending his/her life is not and “optimal drug therapy outcome” for my patient.
4. “I will keep abreast of developments and maintain professional competency in my profession of pharmacy.”
Not all developments in medicine or pharmacy are positive according to a biblical worldview. God allows discovery through general revelation, yet how we apply that discovery determines its usefulness. There is no room for pragmatism in a biblical worldview.
5. “I will embrace and advocate change in the profession of pharmacy that improves patient care.
Is this not the mission of Christian Pharmacists Fellowship International (CPFI)? What could improve patient care more than their coming to a personal relationship with Jesus Christ?
6. “I take these vows voluntarily with the full realization of responsibility with which I am entrusted by the public.”
Yes, our profession’s view from the public eye is important. However, I am infinitely more concerned about serving my Lord. He is my first concern, followed by my wife, children, other family members… and somewhere down that list is the public’s view of my profession. As such, I will adhere to His Word and the principles contained therein to guide all of my earthly relationships, including my professional conduct.
As a resident of the State of Illinois (though a pharmacist in Missouri), I was deeply concerned over a recent decision by our State’s Governor, Rod Blagojevich-D, to force pharmacists to dispense emergency contraception, specifically, Plan B. In response to complaints by two women in Chicago who had been denied prescriptions for Plan B, Blagojevich signed an executive order ordering pharmacies and pharmacists to make the medication available. The rationale was if a pharmacy carried traditional oral contraceptives for preventing pregnancy, that pharmacy must carry all the agents in that category, including drugs not intended for prevention of pregnancy, but for abortion.
Likewise, in a pharmacy carrying those medications, the pharmacist must dispense any medication in the category, including Plan B, “without delay”. Herein, we have a situation where the government has:
1. Singled out a particular medical profession, pharmacy,
2. Eliminated its member’s ability choose what their pharmacies will stock, and
3. Eliminated a pharmacist’s ability refuse to fill a prescription based on moral convictions.
In response, Luke Vander Bleek, a Roman Catholic pharmacist in Northwestern Illinois, has filed suit challenging the order on the basis that it violates Illinois’ “conscience” law. The conscience law gives health care practitioners the ability to refuse to perform certain procedures based on their moral objections. Vander Block asserts the conscience law gives him the right to refuse to carry or dispense Plan B.
This is an important test case for our profession as well as the entire nation because Illinois’ conscience law is quite strong. The case is likely to be lengthy and may be subject to numerous appeals due its potentially broad reaching implications. We plan to carry a detailed interview with Vander Bleek in an upcoming issue of the Journal.
More immediately, we all need to remain vigilant and rooted in our convictions. Prior to joining my current organization, I made it clear to both the district and pharmacy managers that I would not dispense Plan B. Just this week, I was involved in an emotionally charged discussion with another pharmacist and a pharmacy studentboth of whom know that I am a Christian. They invoked the pharmacist’s oath as a reason for me to dispense Plan B, which we do not even carry. I argued that the oath is intended to protect human life, not end it, and that since life begins at conception, I could not, in good conscience, dispense the medication. The pharmacist asked me if I would adopt the child whose life I would not end. I responded that if I could prevent the death of a child by my own hand, I would certainly adopt the child. Interestingly, he had nothing more to say.
Note: At the CPFI annual meeting, the Board of Directors approved a Conscience Clause that can be found on the CPFI website under “About us” and “Beliefs” at the bottom of the web page (www.cpfi.org).