Monday, June 06, 2005

Pharmacists as Conscientious Objectors: What Next?

Some pharmacists are getting selective about the medications they are willing to dispense on moral grounds. Sounds like these pharmacists are putting themselves ahead of the patient.

What if doctors were conscientious objectors? "Sorry I can't treat that. I don't believe in it." Or... "I think you were dumb to get it." Or... "I'd rather treat something interesting or profitable. Got anything else?"

What if grocers became conscientious objectors? "Sorry, no more tuna here at Foods4U. Tuna's got mercury. I don't want to get sued later for selling something that might give you too much mercury. You want your heavy metals? Shop at Wally World."

What if a contractor became a conscientious objector? "Well, used to be I'd build any style you wanted, but really, I think modern ranch is dumb, and Tudor's dumb, too, so if you want Colonial or Victorian, I'm your man. Otherwise, Ted's your guy. Ted does Tudor."

What if an ER nurse became a conscientious objector? "This guy stoned? No deadheads on my shift.... This guy drunk when he did it? I don't work on winos.... OK girl, how'd you get pregnant? You married? You got a name for the father? You got an OK from your priest?"

Well, well, from these examples we can see that not all jobs are the same. Indeed, most freelancers and sole proprietors are selective in the jobs they'll take. Sometimes, just their style dictates who their clients will be. Some pick and choose.

Some professionals can afford to pick and choose, and some do their best for us by being specialists. Even some of the doctors we see are specialists. But that is different from the role of pharmacist, who, as the dispenser of our meds is supposed to be on our side, following, with care, a doctor's order.

Women especially - beware. Women over 17 should have the right to control their bodies and pregnancies. Some people - unfortunately, far too many people from politics to prescriptions are sexist, even if they're hiding behind a regressive moralism. These people are out to curtail your rights. They are fighting freedom for women.

It doesn't seem to me that building my house or selling me insurance or even serving me a meal is a moral imperative. But it does seem that when it comes to police protection, fire protection, other public services, the legal system, and the "health care system" that we should all have equal and full access to the best we can get - and get whatever it is we need to pursue life, liberty and at least a decent existence, if not overwhelming happiness and eternal well-being. The cure is not guaranteed, but at least access to the best care and medicine ought to be guaranteed. (Maybe this is yet another reason to move health care from private for profit profession to public service - just don't let the government pick and choose the way some doctors and pharmacists are!)

Perhaps those pharmacists who object to some meds, even a few, should find a different profession. And don't they realize that dispensing a medication does not in any way condone a disease or condition? These self-centered "objectors" are missing the point and turning yet another facet of our culture into a self-righteous travesty. And if we'd like to say that these are people of superior conscience, living up to their own principles, let's remember that, unlike "conscientious objector" citizens who, once drafted, refuse to arm themselves or kill, pharmacists trained for years, knowing full well that they would likely be called upon to dispense new and heretofore unknown medicines, perhaps even for heretofore unknown illnesses and conditions. That's the adventure of being a pharmacist, which my grandfather was for fifty some odd years, with a lot of changes in that time (roughly 1924 to 1974), so get over it, and brave the new world.

But aren't health care professionals different? Or shouldn't they be? Seems they've take training and oaths to put the needs and even the preferences of the patient above their own desires and beliefs, no matter what. It is that priority for the patient that makes a patient feel they can confide in a doctor or pharmacist and expect privacy and respect - no matter who they go to, without having to shop around and delay a diagnosis and treatment, which may include medication.

Seems this nation is becoming more self-righteous than it has been for some decades, and that sort of self-righteousness seems petty - even if the concerns are branded as "moral." Real morals and honorable ethics would put the patient first. The doctor and pharmacist may feel a bit god-like dispensing the keys to health, but they are still servants and should behave and perform their duties as such.

Higher morals and the best ethics would put the adult, responsible, present patient at the top of the list, not subject to the condemnations or recriminations or mercy of the servant or others not present and/or not responsible. When we put the patient first and foremost, we are honoring their right to be responsible and take responsibility for their own lives.

That is an essential 'scrip' for any freedom that's worth a damn.


At 1/11/2006 1:28 PM, Anonymous Blue Cross of California said...

Great blog I hope we can work to build a better health care system as we are in a major crisis and health insurance is a major aspect to many.


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