Posted by: Matthew Wright7 FEB 2013
The conscience clause that allows pharmacists to refuse to supply emergency hormonal contraception (EHC) is under fire — again. It is a topic that refuses to go away.
Authors of a perspective piece published in the Journal of Medical Ethics argue that pharmacists should either go ahead and supply the EHC to someone who is eligible to receive it or refuse to help that person entirely. And that means refusing to refer to an alternative supplier and facing up to any regulatory consequences that might follow.
They call for rules to be applied universally across the profession.
The authors from the pharmacy schools at University of Hertfordshire and the Royal College of Surgeons, Ireland, liken exercising the conscience clause to refusing supply of 200 paracetamol tablets to a suicidal customer but suggesting he or she might go around to all the nearby newsagents collecting boxes of 16. In essence, they suggest that there is no ethical distinction between supply and referral for supply.
It is a tough stance they take. And I draw attention to the example above not because it is necessarily a fair comparison.
Nevertheless, the authors of the paper make a compelling case: that there should not be a two-tiered profession that allows professionals to opt out when they feel uncomfortable or their personal beliefs are threatened.
But it is not a simple argument. Should a person have to separate professionalism from personal beliefs? (You do not stop being a Christian, Muslim or Scientologist, for argument’s sake, when you walk into the dispensary.) On the other hand, suggesting that an EHC objector should offer no help whatsoever might be a step too far.
And what does the General Pharmaceutical Council say? Its chief executive Duncan Rudkin commented: “Individual pharmacists have a professional responsibility to ensure that their own beliefs do not impact adversely on patients. This includes making sure that if they are unable to provide a particular service for any reason, including their religious or moral beliefs, they must inform those responsible for organising services in advance, so that they can make arrangements for patients to receive the medicines or other services that they need.”
We heard last year that the GPhC would be considering whether or not amendments to the conscience clause are needed as part of a wider review of standards for ethics, conduct and performance in 2013–14. If the argument for amending or removing the conscience clause is sound, will the GPhC be brave enough to do so?