Pharmacists can continue to refuse to provide medication based on their beliefs

// 25 March 2010

Photo of contraceptive pill packetAmy Clare mentioned the recent case of a Sheffield woman who was refused the contraceptive pill by a religious pharmacist and told to come back the next day when a different pharmacist would be working. Sadly, the new industry regulator, the General Pharmaceutical Council, have said that they will not be removing the ‘conscience clause’ that allows pharmacists to do this from the new code of practice. The pharmacists in question may have to direct customers to a different pharmacist, but that’s it. Their personal beliefs are apparently more important that the customer’s right to healthcare.

This just sickens me. An individual is free to believe what they want, and to apply those beliefs to their own personal choices, but they do not have the right to use their belief to curtail the rights and freedom of others.

The couple of times I’ve had to get the morning after pill has been on a Sunday, when my local GP surgery wasn’t open. Naturally, I’ve wanted to get it as soon as possible, not potentially wait for hours at an NHS walk-in centre, so I’ve gone to a pharmacy and forked out for it (asking the guy to pay his share, which I think is only right. And, yes, I’ve been lucky that I could afford it.) There’s generally a limited range of pharmacies open on a Sunday, and if I had been faced with one of these selfish bigots I may not have had anywhere else to go. I certainly couldn’t have waited for a less selfish pharmacist to come in to work the following day. Getting emergency and regular contraception can be stressful enough, without finding yourself pitted against a pharmacist whose beliefs compromise their ability to do their job.

If you’re not happy to dispense drugs that are legally available in this country, don’t become a pharmacist. It should be a breach of professional conduct to refuse to do so, not a bloody perk of the job.

The GPhC’s consultation on ethics and codes of practice has closed (presumably this announcement is the result of that consultation), but you can feedback here. The BBC says there may be wider consultation on this issue later in the year.

Image by Beppie K, shared under a Creative Commons Licence.

Comments From You

spiralsheep // Posted 25 March 2010 at 12:10 pm

There’s another potential approach to this in addition to lobbying the pharmacists to change their policies. One of the most prized and lucrative jobs in the pharmacy industry is being licenced as an NHS dispensing pharmacy. Why doesn’t the NHS create a requirement that all pharmacists in licensed NHS dispencing pharmacies to agree to dispence any NHS prescribed medication on demand? Possibly extending that requirement, to relieve the “burden” on the NHS ;-) , to also dispensing all those same medications, when they don’t require a prescription? I think the government should act on this issue and, in fact, should have done so years ago when it first arose.

Shea // Posted 25 March 2010 at 12:49 pm

@ spiralsheep – very interesting perspective.

I don’t agree with any health professional “using” conscience as an excuse not to do their job. Whether thats pharmacists and the morning after pill, or doctors and abortion. You shouldn’t be allowed to enter a profession if you are not prepared to fufil all aspects of the job.

Troika21 // Posted 25 March 2010 at 12:52 pm

Previously, I defended the right of some christian B&B owners to refuse a gay couple admission into their business.

And I did so on what I belive are the rights of christians to stick by their convictions. However, it is this point where that line of defence stops.

The provision of medical services is a vital part of society, and no-one get to use that to push their beliefs onto others. This is the point where the ‘conscience clause’ breaks down, rather than becomes useful.

Trying to remain calm // Posted 25 March 2010 at 3:20 pm

Oh this really annoys me. If you are morally against doing an important part of a certain job, you should not do that job.

I feel this way about doctors who refuse to refer women (who probably aren’t having the best time or feeling at their most happy and confident at this point in their lives even before meeting an unsupportive doctor) for an abortion. If you want to be a doctor but are not prepared to support women in this important part of your job, be a bone surgeon or something – you should not be able to become a GP and just refuse to do the parts of your job that you don’t like.

BareNakedLady // Posted 25 March 2010 at 3:51 pm

@Troika21: The provision of medical services is a vital part of society, and no-one get to use that to push their beliefs onto others.

I really can’t see how the two cases are different. Are you saying that it’s okay to discriminate if you’re just in charge of people’s holidays, but not if you do something more important? Where’s the line… if the two men had been doctors staying at the B&B on business, would it be okay for the homophobic B&B owners to discriminate? Or if I wanted to take the morning after pill while staying at their B&B, would it be okay for them to kick me out or would that fall under medical grounds?

Using your own beliefs as an excuse to actively discriminate against someone else’s perfectly legal action is wrong. End of. And if you work in an area where you are required to do something you personally disagree with, either grit your teeth and get on with it, or change jobs.

Claire // Posted 25 March 2010 at 4:46 pm

I see parallels with the registrar in Islington two years ago who lost her job because for religious reasons she refused to conduct civil ceremonies between same sex couples. Pharmacists who won’t perform their whole job can move over and let those who are unemployed and willing to do the whole job do the whole job.

Rachel // Posted 25 March 2010 at 5:47 pm

Hmmm, I’m actually slightly torn to be honest. If the pharmacists were employed directly by the NHS then I would consider it absolutely unacceptable for them to refuse to provide any kind of contraception. The problem is that they are private businesses, so there isn’t really any ‘right’ for you to be able to buy something in their shop, as far as I can see. I’m not sure exactly how their contracts with the NHS to provide services work though, so its not a totally informed opinion.

angercanbepower // Posted 25 March 2010 at 7:09 pm

Rachel: if the state is going to control access to drugs through prescription, rather than directly dispensing them, it’s the responsibility of the state to ensure that they are accessible. Sure, if one pharmacy refuses to hand them over you can go to any other. But how many does it take to refuse before it is reasonable for a citizen to say that the state has not discharged its reponsibility?

Of course this is exactly the type of question that the Department of Health loves answering – it wouldn’t surprise me if there were some sort of national performance indicator linked to the number of pharmacies within a defined local area with guidelines about action to be taken in the case of non-availability of medication, probably index-linked to an arbitrarily calculated by dividing the “social value” of receiving the medication by the the cost of obtaining it.

But (my irritation with the DoH aside) that’s not a road we need to go down here – people face enough obstacles between ill health and recovery without needing the judgment of a pharmacist in there too.

Jeff // Posted 25 March 2010 at 9:35 pm

That’s gotta be illegal. Whether or not the doctors/pharmacists agree with the morals of the drugs being requested is irrelevent. If the pills are legal (whether they should be or not) then they surely have a legal obligation to dispense them?

Mephit // Posted 25 March 2010 at 10:09 pm

And actually it’s not as simple as being able to go to another pharmacy or pharmacist if you’re refused at one: that assumes that there is another you can get to.

In rural areas there doesn’t tend to be much choice. The two outlets nearest to me are run by the same pharmacists, for example, so if they turned awkward it could be a major problem, especially for non-drivers. And even in urban areas, having to go further afield is likely to cause difficulties, particularly for more vulnerable groups.

Melaszka // Posted 26 March 2010 at 12:55 am

The one and only time I have used the morning-after pill, the pharmacist I went to told me I couldn’t get it there (I don’t think he clearly explained it was on conscientious grounds – being naive and never in this situation before, I just thought that normal pharmacies didn’t stock it) and then, despite the fact that there were half a dozen other pharmacies within a mile’s radius of his shop, directed me to an abortion clinic several miles away (presumably in a deliberate attempt to “educate” me that the morning-after pill is “really” abortion).

Oh, and he also spoke to me with utter contempt in his voice and face, although he didn’t actually say anything rude, so I couldn’t make a complaint.

I dearly hope that other people he “served” were less clueless than me and complained about him and he’s since been struck off (or was what he did legal?).

Despite this, I would still feel sorry for pharmacists with religious convictions against the morning-after pill if they had to provide it, especially those already working in the profession, who may have spent many years and a lot of money training for their jobs at a time when they were assured they could avoid this aspect.

But I can see that, even if the pharmacist is polite and professional (as mine wasn’t), being told “I won’t serve you, as it’s against my conscience” can feel like a slap in the face and a form of moral pressure, particularly as you’re normally already feeling frightened and upset to be asking for it in the first place! If they just pretended they’d run out, I wouldn’t mind.

Kate // Posted 26 March 2010 at 11:09 am

This article in CIF has sparked something for me.

http://www.guardian.co.uk/commentisfree/belief/2010/mar/26/pharmacists-

religious-belief

The conscious clause could be invoked theoretically by a Scientologist

objecting to prozac, or a vegetarian objecting to gelatine based pills.

But I doubt there would be any sympathy for these positions and more

importantly I doubt that the powers that be would have felt it

necessary to include a conscious clause if these were the pressing

issues facing pharmacists.

My feeling is that that this is less about protecting individuals’

religious beliefs and more that the Council/society etc are all too

ready to believe that women’s contraception etc is not a medical

essential but something “problematic”, something with “moral

implications”. It’s an embarrassment that sill lingers decades after

we accepted that women have a right to recreational sex and bodily

autonomy. As a society we are ready to marginalise Jehovah’s Witness

for their views on blood donation but at heart too many people are

ready to accept religious “beliefs” that restrict women’s freedom.

Charlotte // Posted 26 March 2010 at 8:15 pm

Aaaargh. This is ridiculous. I had no idea there was conscious clause in the UK. Grr.

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