April 13, 2006

Antibiotics - the next threat to America's moral fiber

So let's say (for the sake of argument) we agree that pharmacists are people, too, and they shouldn't be forced to act in ways they believe to be immoral by, say, dispensing emergency contraception. They'd be, like, conscientious objectors or something, right?

So let's say there's a pharmacist who objects to filling a prescription for antibiotics. Still a moral issue, right? They can refrain from doing this if they feel it's immoral, can't they?

But surely, you might be saying to your screen right now, but surely, M.E., no pharmacist could object to antibiotics!

And there, sweet Reader, is where you would be wrong.

The Stranger of Seattle reports on an assortment of pharmacists who refused to fill prescriptions for things other than RU-486, also on moral grounds. The refusals are now the subject of a complaint filed with the Washington State Department of Health by Cedar River Clinics, a women's health center with several branches in Washington state.

The complaint includes one incident at the Swedish Medical Center outpatient pharmacy in Seattle. According to the complaint, someone at the Swedish pharmacy said she was "morally unable" to fill a Cedar River patient's prescription for abortion-related antibiotics. Cedar River's complaint quotes its Renton clinic manager's May 17, 2005, e-mail account: "Today, one of our clients asked us to call in her prescription... to Swedish outpatient pharmacy. [We] called the prescription in... and spoke with an efficient staff person who took down the prescription. A few minutes later, this pharmacy person called us back and told us she had found out who we were and she morally was unable to fill the prescription."
I'm figuring that the prescription itself didn't say "abortion-related antibiotics." I've never had a prescription with my diagnosis written alongside the name of the drug. (Although some things, like Diflucan, are pretty easy to read into.) The pharmacist decided that the antibiotics were "abortion-related" after discovering that the prescriber was a clinic which - among other services - offered abortions. In fact, antibiotics are also used to treat things like urinary tract infections, which increase the risk of miscarriage, low birthweight, stillbirth, infant respiratory infections, and mental retardation.

Perhaps even more incredible was the complaint against the pharmacist who refused to provide a woman with vitamins on the grounds that a Cedar River patient must no longer be pregnant and thus wouldn't need them.
... a pharmacist at a Safeway reportedly refused to fill a Cedar River patient's prescription for pregnancy-related vitamins. The pharmacist reportedly asked the customer why she had gone to Cedar River Clinics and then told the patient she "didn't need them if she wasn't pregnant."

I'm sorry, is folic acid a moral issue, too, these days?

Bitch, Ph.D. points out that these cases - pharmacists refusing to provide things like antibiotics under so-called "conscience clauses" - used to be the stuff of allegedly paranoid hypotheticals. Yep, not so hypothetical anymore.

In addition to the general repugnance of allowing pharmacists' moral beliefs to interfere with reproductive (and, I guess, anti-reproductive) health care - a subject most feminist-minded folks have already discussed - I guess I'm just reeling at the stupidity of assuming which of a multitude of conditions a given drug is being prescribed to treat, and denying patients access to drugs that have legitimate uses other than reproductive health.

So, your vote, dear Reader! What is the next "morally problematic" prescription? The Pill is an obvious choice, but don't stop there! Aromasin (a breast-cancer drug) can cause complications if taken by pregnant women; Celebrex, while primarily used for arthritis pain, is also used to treat severe menstrual cramps, which as we all know to be the Curse of Eve, and how dare women try to escape that? Best not dispense it to any female, just in case she's not actually using it for arthritis.

And, of course, we all know the moral problems with prescribing Aldactone (a diuretic used to treat complications of congestive heart failure), Delatestryl (for male hypogonadism, which can increase risks of male osteoporosis, among other things), and Climara (used to treat side effects of menopause, including - again - osteoporosis) - they're all used in hormone therapy for trans people, too. And we can't be having that, now can we?

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