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AMA rules on pharmacist conscience
clauses
Increasing numbers of pharmacists
invoke
personal values when they decline to fill certain
prescriptions;
AMA responds with a statement accommodating both
pharmacists’ and
patients’ rights.
On Monday, June 20, the American
Medical Association’s
House of Delegates voted to adopt a resolution regarding
pharmacist
conscience clauses, which had been introduced in the
House of
Delegates during their 2005 Annual Meeting in Chicago.
The resolution is an attempt to address the concern
some physicians
have regarding pharmacists objecting to dispensing
prescription
medications for moral or religious reasons—using
what’s
often referred to as a “pharmacist’s
conscience clause.” While
the number of times these clauses have been invoked by
pharmacists
is unknown, it is thought that occurrences are isolated
and relatively
rare. Regardless of the numbers, the level of media
attention
has created what appears to be a controversial
trend.
APhA has had a policy supporting a pharmacist’s
conscience
clause since 1998, around the time when Oregon enacted
its physician
assisted suicide law. APhA’s two-part policy
supports the
ability of the pharmacist to step away from
participating in
activity to which they have personal
objections—but not
step in the way. The Association supports the
pharmacist’s
right to choose not to fill a prescription based on
moral or
ethical values. But recognizing the pharmacist’s
important
role in the health care system, APhA supports the
establishment
of systems to ensure that the patient’s health
care needs
are served.
Reportedly, physicians advocating for the passage of
the new
AMA policy were concerned about pharmacists abusing
these conscience
clauses and obstructing patient care. The AMA’s
resolution, “Preserving
Patients’ Ability To Have Legally Valid
Prescriptions Filled,” states:
RESOLVED, That our
American Medical Association
reaffirm our policies supporting responsibility to the
patient
as paramount
in all situations and the principle of access to
medical care
for all people (Reaffirm HOD Policy); and be it
further.
RESOLVED, That our AMA support
legislation that requires individual
pharmacists or pharmacy chains to fill legally valid
prescriptions
or to provide immediate referral to an appropriate
alternative
dispensing pharmacy without interference (New HOD
Policy);
and be it further.
RESOLVED, That our AMA work with
state medical societies to
support legislation to protect patients’ ability
to have
legally valid prescriptions filled (Directive to Take
Action);
and be
it further.
RESOLVED, That our AMA enter into
discussions with relevant
associations (including but not limited to the
American Hospital
Association,
American Pharmacists Association, American Society of
Health
System Pharmacists, National Association of Chain Drug
Stores,
and National Community Pharmacists Association) to
guarantee
that, if an individual pharmacist exercises a
conscientious
refusal to dispense a legal prescription, a
patient’s
right to obtain legal prescriptions will be protected
by immediate
referral
to an appropriate dispensing pharmacy (Directive to
Take Action).
RESOLVED, That our AMA, in the
absence of all other remedies,
work with state medical societies to adopt state
legislation
that will allow physicians to dispense medication to
their own
patients when there is no pharmacist within a thirty
mile radius
who is able and willing to dispense that medication.
(Directive
to Take Action).
The
resolution makes one point clear. Despite the alarming
headlines, pharmacists and physicians agree:
Patients should
receive their
medications without harassment and interference.
Essential to APhA’s policy is establishing
systems to
ensure patient access before the prescription ever
reaches the
pharmacist. Well-constructed systems are seamless, and
often
the patient is unaware of the pharmacist’s action.
On this
point, we agree with the AMA and welcome dialogue that
will ensure
this continued recognition of the need to serve patients
and
recognize the individual beliefs of pharmacists and
physicians.
Just as physicians are not required to provide all
medical services,
pharmacists should not be required to provide all
pharmacy services.
It is unfortunate that the conversation between the AMA
and
APhA did not take place before their House of Delegates
action.
Physicians and pharmacists collaborate every day to
improve medication
use and advance patient care—including navigating
issues
of conscience. APhA looks forward to working with the
AMA on
this issue, much as our individual members are working
together
with physicians today.
Web links
Related resources on
www.pharmacist.com
Contact the writer: Bob Reynolds
(breynolds@aphanet.org), Pharmacy
Today
Posted June 27, 2005, 2:50 pm EDT
| Increasing numbers of pharmacists invoke personal values when they decline to fill certain prescriptions; AMA responds with a statement accommodating both pharmacists’ and patients’ rights. |
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