Pharmacists Refusing to fill Birth Control

[Yoshindor]

I'm a member of Planned Parenthood and I got this in the mail today.



I'm going to sign the papers and send them back because I personally believe this is bullshit. My little sister is on birth control because she was having very bad periods that sent her to the hospital at least once a month. Ever since she's been on them, she's been fine. Last week she went to get her prescription filled after school, but came home empty handed and the unbelievable story of "they refused to fill it". We all thought she just made it up and went with friends instead, but after reading this, we're speechless.

Think about it, if they start denying birth control to all women, the women who cannot support the baby will become pregnant and end up having an abortion or giving it up to adoption. Adoption centers and Foster homes will become full, and soon will not be able to accept any new clients. Then what? Either both the mother and the baby become homeless, the mother gives the baby away to an unsafe home, or the mother abandons the baby.

Opinions?

Okay I agree it's bologna that pharmascits are denying to fill perscription, they have no right to do this, it's really none of their buisness.

But I personally think some of the people against birth control do have a valid point. They are just going about it in the most wrong of ways. But also handing out birth control pills and condoms to 12 y/o children like candy is not right iether.

In my opinion, I think their point is when does Parental control and responsibility and duty to their children come into play. And things like abstonence and self control.

I agree birth control has it's time and place and that it's definatly not a bad thing. But to me there is something wrong when we are passing out condoms and pills in sex ed. instead of teaching basic things like "if you don't do it you can't get STD's or pregnent". I thinbk abstonece should be taught first and "protection" should be made avalable when needed.

I belive it was one of Clintons Staffers (damned if I know his name) that said something to the effect of "mastebation is the only safe sex" and was shortly after fired then 4 months later the lewenski scandal broke.

Just my opinion but I think if we went about teaching our kids diffrently, the need for birth control would not be as great. I think that is also the point of the people who are opposing it (but going about it in the wrong way).

 

[Kat]

Okay I agree it's bologna that pharmascits are denying to fill perscription, they have no right to do this, it's really none of their buisness.

But I personally think some of the people against birth control do have a valid point. They are just going about it in the most wrong of ways. But also handing out birth control pills and condoms to 12 y/o children like candy is not right iether.

In my opinion, I think their point is when does Parental control and responsibility and duty to their children come into play. And things like abstonence and self control.

I agree birth control has it's time and place and that it's definatly not a bad thing. But to me there is something wrong when we are passing out condoms and pills in sex ed. instead of teaching basic things like "if you don't do it you can't get STD's or pregnent". I thinbk abstonece should be taught first and "protection" should be made avalable when needed.

I belive it was one of Clintons Staffers (damned if I know his name) that said something to the effect of "mastebation is the only safe sex" and was shortly after fired then 4 months later the lewenski scandal broke.

Just my opinion but I think if we went about teaching our kids diffrently, the need for birth control would not be as great. I think that is also the point of the people who are opposing it (but going about it in the wrong way).

I think this is the first thing you've written I can honestly say I wholeheartedly agree with. Nice job!!!

Just to reiterate a tad about my personal situation with my daughter, she had been dating this boy for about a year. I saw those "signs" coming and coming strong. That first love and all that stuff. I knew it was just a matter of time and I wanted her to be protected. We would discuss it, she would swear she wasn't, then she got pregnant with Michael. Btw, she got pregnant the first time they had intercourse. My daughter is a breeding machine. Thank goodness she uses that birth control patch thingy now and has been for the past 3 years.

 

[Firestreak]

You can hand out condoms to 2 year olds for all I care. You can get condoms out of a vending machine in a men's room with quarters.

The point I'm trying to make is that birth control has always been an aspect of being a pharmacist, abortion has not. Doctors are not required to perform abortions, I don't see why pharmacists are required to dispense it in pill form.

Do you think if librarians suddenly had that responsibility thrust upon them it would be right or wrong to fire a librarian upon the refusal to perform abortions?

The question seems to unrealistic and perverse that it has no bearing on the argument, but years ago, there was no morning after pill, and someone strongly pro-life could enter into the field of pharmacy without moral conflicts. There is no one who can make an argument they are against condoms or birth control and never thought they wouldn't run into a conflict becoming a pharmacist. If suicide was declared legal tommorrow would we be having the same debate about pharmacists who didn't want to sell people suicide pills?

The point is for a person who wants the medication, they can get it. For a person who doesn't want to sell it, just leave them be for a few years...

 

[Peregrine]

Take your daughter off the patch if she smokes and your family has a history of strokes, emboli, or heart disease. FDA put a new warning on patches this fall.

Abortions must be specialized in. Anyone who can do them will do them, because they chose to be trained in them. Your doctor most likely *can't* do them. The physician doesn't have to authorize it because that is their right, but they must point the patient to a physician who will. And if they don't authorize it knowing that they're the only one capable of pointing the patient in the right direction for an abortion, they are in malpractice.

Pharmacists, however, must be trained in the disbursement and explanation of taking birth controls. They all know how to do it. They can all do it. That they don't have a similar national standard is quite honestly sad. It is not their place to deny a prescription. It is the physician's. They didn't talk to the patient. They didn't discuss with them the details. They don't know the state or story of the circumstance. It's their job to disburse medication safely and accurately while monitoring potential drug drug interactions and reviewing with patients how to take their medications. They do not have the right to override a physician on anything but drug drug interactions and contraindications.

If they wanted moral weight they should have been physicians. You can state your opinion when asked, but if you denied referral based on moral obligations in medicine you would be destroyed. These pharmacists trying to throw moral weight around because they went 6 years post-secondary school and are part of the medical team should be fired, and their companies forced to nationally comply.

It's a shame that the dominant pharm associations in the country weren't all over this before it ever became an issue. Shame on them for letting Southern Walmart manage healthcare.

Now if they don't carry the drug at all, that's another issue.

 

[Marajade]

Okay I agree it's bologna that pharmascits are denying to fill perscription, they have no right to do this, it's really none of their buisness.

But I personally think some of the people against birth control do have a valid point. They are just going about it in the most wrong of ways. But also handing out birth control pills and condoms to 12 y/o children like candy is not right iether.

In my opinion, I think their point is when does Parental control and responsibility and duty to their children come into play. And things like abstonence and self control.

I agree birth control has it's time and place and that it's definatly not a bad thing. But to me there is something wrong when we are passing out condoms and pills in sex ed. instead of teaching basic things like "if you don't do it you can't get STD's or pregnent". I thinbk abstonece should be taught first and "protection" should be made avalable when needed.

I belive it was one of Clintons Staffers (damned if I know his name) that said something to the effect of "mastebation is the only safe sex" and was shortly after fired then 4 months later the lewenski scandal broke.

Just my opinion but I think if we went about teaching our kids diffrently, the need for birth control would not be as great. I think that is also the point of the people who are opposing it (but going about it in the wrong way).

The problem with teaching abstinance over protection is you vilify it in a way. If you show it as not being a bad thing, teenagers wont feel ashamed buying condoms/Birth controll pills. But if you portray it as "Dont do this, you'll get pregnant and/or STDs" then it'll be almost impossible for teenagers to obtain the protection, because they'll be afraid of what other people would say/do. Not that they wouldnt have sex, but they wouldnt be doing it with protection most of the time. Because lets face it, We Teenagers arent the brightest people, and we're going to do stupid things regardless.

Simply handing out birth controll isnt the solution either. You need to educate teens about the consiquences of thier actions, so they can make informed dscisions about it on thier own, and tell them that what they're doing isnt wrong but it does come with many responsibilities.

 

[Yoshindor]

The problem with teaching abstinance over protection is you vilify it in a way. If you show it as not being a bad thing, teenagers wont feel ashamed buying condoms/Birth controll pills. But if you portray it as "Dont do this, you'll get pregnant and/or STDs" then it'll be almost impossible for teenagers to obtain the protection, because they'll be afraid of what other people would say/do. Not that they wouldnt have sex, but they wouldnt be doing it with protection most of the time. Because lets face it, We Teenagers arent the brightest people, and we're going to do stupid things regardless.

Simply handing out birth controll isnt the solution either. You need to educate teens about the consiquences of thier actions, so they can make informed dscisions about it on thier own, and tell them that what they're doing isnt wrong but it does come with many responsibilities.

I never said say "sex is bad don't do it".

I'm saying teach abstinece and what the consequences of sexual intercourse are. I have no problem with condoms and pills being avalable, but simply passing them out after a sex ed tape and saying be safe does not cut it. Thats like giveing a child a loaded gun in my opinion. Simply because of all the misconseption and rumors about sex that float around all through jr. high and high school. Like you can't get pregnate your first time ect.

Strong in your face fact filled education from all angels is the solution in my opinion. The way they teach kids now days in school about sex is soo cock eyed no wonder kids are haveing sex to find out the truth. You find out more from a 10 minuiet porn video than you do from a week sex ed course at your local school (I know this because I sat in on my daughters).

 

[Firestreak]

Take your daughter off the patch if she smokes and your family has a history of strokes, emboli, or heart disease. FDA put a new warning on patches this fall.

Abortions must be specialized in. Anyone who can do them will do them, because they chose to be trained in them. Your doctor most likely *can't* do them. The physician doesn't have to authorize it because that is their right, but they must point the patient to a physician who will. And if they don't authorize it knowing that they're the only one capable of pointing the patient in the right direction for an abortion, they are in malpractice.

Pharmacists, however, must be trained in the disbursement and explanation of taking birth controls. They all know how to do it. They can all do it. That they don't have a similar national standard is quite honestly sad. It is not their place to deny a prescription. It is the physician's. They didn't talk to the patient. They didn't discuss with them the details. They don't know the state or story of the circumstance. It's their job to disburse medication safely and accurately while monitoring potential drug drug interactions and reviewing with patients how to take their medications. They do not have the right to override a physician on anything but drug drug interactions and contraindications.

If they wanted moral weight they should have been physicians. You can state your opinion when asked, but if you denied referral based on moral obligations in medicine you would be destroyed. These pharmacists trying to throw moral weight around because they went 6 years post-secondary school and are part of the medical team should be fired, and their companies forced to nationally comply.

It's a shame that the dominant pharm associations in the country weren't all over this before it ever became an issue. Shame on them for letting Southern Walmart manage healthcare.

Now if they don't carry the drug at all, that's another issue.

I'm not going to argue medical facts with you because it's not my field and is supposedly yours. I don't know, or where to find out, how long it would actually take a doctor to learn the prodecure to perform a basic abortion, what kind of specialized doctor would most likely know it, the percentages of those who know, the ease to learn it, ext.

I'll just say it's a rather convieniant excuse. Don't want to perform abortions? Don't learn how to do it! I'm not arguing that it's wrong, and I think a doctor with moral objections to abortion shouldn't have to if they are trained in the area or not. The only point being, depending on the actual difficulty of learning the procedure, you can or can't make an argument that protects doctors and not pharmacists. Although there are medical implications, the judgements in question are moral reasons, and if a person spend 7 years in school, 6 years or 0 years everyone has the right to take their own morals into account. Afterall, just as pharmacists have to deal with abortion in pill-form, doctors will most likely have to deal one day with an abortion procedure so basic it'd be impossible to hide behind lack of training.

 

[Peregrine]

Again, all pharmacists are trained and capable of handing out birth control. Not all physicians are trained and capable of performing abortions, nor can you expect them to be. The public's faith in the improvement of medicine is flattering, but let's be realistic. Abortions are a big procedure. You can't get rid of something with a beating heart so easily. The mother's and the fetus' physiology will not allow it to ever be no big deal.

Physicians refer when they can't. They have to. Pharmacists have no such requirement. They don't have to do their job if they don't want to. Physicians, in the end, do. Pharmacy is not there to make medical decisions. They're there to make medical decisions safe. That's what they agreed to when they signed up to be a pharmacist and not a physician. They can't prescribe, so why should they have any right to deny prescription? If they refuse to carry the prescription that's their business, but in the end they have no right to deny prescription. Unfortunately it'll take someone killing themselves and pissed off family to force Southern Pharmacy to get back in their place.

If you're a physician and a teen comes in wanting an abortion and you disagree, you can advise her until you're blue in the face. It's considered bad practice but not malpractice. You can refuse to do the abortion. You can even refuse to refer her to an abortion clinic. But if you do nothing at all--just send her out against her wishes to be pregnant and deliver the baby--and she finds out that you're malpracticing, you're sued. Would you likely be sued? No. Would she likely have the baby if you sent her out with non-intent to refer in a small town where you were the only one capable of getting an abortion rolling? Quite possibly. Is it still malpractice? Yes. It would be easier to catch a malpracticing pharmacy because let's be honest--the job is simple, cut, and dry. Love pharmacists to death, but they know the drugs. That's what they're paid to do. That's the only thing they're paid to do.

There is no such standard in the pharmacy business. It's state-determined whether or not a pharmacy has to fill a prescription when given. Again, shame on the pharmacy associations in the US.

Best advice is to go to your local hospital or talk to the doctor who prescribed. The hospital most likely has a pharmacy and the doctor can tell you their preferred pharmacy that cooperates with all prescriptions. And if WalMart refuses to fill a prescription they ordered on non-medical terms, that physician will be furious. If I had given a birth control prescription to a 15 year-old we would have already talked at length about risks of sexual behavior at such a young age and all that jazz already. I'd be taking a trip to WalMart if I found out that prescription was denied. If she gets pregnant on account of WalMart when I knew she was never going to be convinced to not have sex, their ass is lit. She could get depressed and kill herself. Her husband or father could beat her. She could try nonmedical abortion. She may be medically unable to carry to term. She may have been raped by her boyfriend. She might have severe PMS. She could have bad acne. She might have had ovarectomy. Irregular period. Anemia due to period bleeding. All these things we would have discussed and the pharmacist would have been utterly clueless.

The pharmacist has such a limited window into the healthcare of each patient, that they have no business doing anything but telling patients how to take the drugs already prescribed. That is hard enough to do correctly. If this happened to one of my patients I'd be down in that phamacy asking why the **** they denied my patient RU486 but sold her the Tylenol that almost killed her the night they decided that they had a moral obligation to stand up for what they believe in, which is apparently not the life of my patients. All very loudly of course so everyone can hear. Even if it wasn't true, they would never know. But it sure would look mighty bad for them.

 

[Firestreak]

Your rant is well thought out and I agree with your logic and general way of thinking. But unfortunately you may be wrong in this specific case as what I understand the product in question, Preven, is not prescribed but simply an over the counter drug.

As well, it is always advertised as Emergency Contraception, which is a deceptive name. Furthermore, Walmart doesn't refuse to fill subscriptions. They refuse to stock the item. So if you run down to Walmart shouting at the clerk you may come off as a bit of a lunatic.

Here's a useful source, doc. http://www.morningafterpill.org/shumard.htm

 

[Peregrine]

Oh it's preven? That's very odd, because Preven is just a typical birth control pill. It mimics estrogen. Typical prescription that any pharmacy should have, or should have the equivalent to. Mifepristone is a progesterone blocker-the so-called day after pill. AKA RU486. It antagonizes progesterone. Two very very different drugs. Both prescribed.

I highly doubt WalMart would not carry Preven or the generic of Preven. If they really did deny it as a prescription, it's because someone did their homework. A secondary effect of Preven is to decrease implantation, which makes it sound like a pregnancy terminator. The pharmacist must have been looking for a fight if they selectively chose to not carry Preven, because you don't prescribe it for that reason. You prescribe it to prevent ovulation just like any other drug in this class.

 

[Firestreak]

This appears to be a semantics argument...

http://www.afterabortion.org/PAR/V6/n4/birthcontrol.htm

If you want to see the information I'm getting this off of. Fascinating, in a horrible kind of way.

 

[Peregrine]

Nevermind, I looked the brand name up. We're not emphasizing brand namage yet. I know the drugs in preven, not the marketing BS they get packaged in yet. I guess that's a special kit marketed as an implant blocker. The two drugs in preven are the same as in patches and pills and every other contraceptive. It's probably just marketed differently.

They don't have to carry preven if they don't want to if it's not marketed as a typical birth control pill. The doctor who prescribed it should have known that it wasn't going to be filled locally. Originally looking it up, it looked like a typical contraceptive. But blame marketing if WalMart won't carry it. There's nothing in that kit that Kat's daughter doesn't have in her system right now.

 

[Firestreak]

Come on now, the point isn't if the chemical is foreign or not to the woman's body. There are even trace amounts of Arsenic in the human body. The point is what is it supposedly does, which if used specifically as a "morning after" pill kills a fertilized egg, and that it's an over the counter drug.

 

[Peregrine]

Denying preven is one thing. The doctor might just as well have been the one loading the gun if he sent a 15 year-old to a Winn-Dixie in Mississippi with a Preven prescription. Or he could have known that no one filled preven prescriptions within a 2-hour drive of his office and was trying to "fulfill his moral obligation" as well. Or more likely, a Lawyer for planned parenthood got ahold of a shady doc and got himself a client with a preven prescription to milk. That brand name is a loaded gun, and responsibility falls on the physician to get that type of prescription filled if they prescribed it. I'm sure planned parenthood would like you to think that pharms should have to carry this stuff, but they don't have to. You can't tell a smalltown pharmacy they have to carry a morning after pill. You can't tell a WalMart chain to carry a socially controversial drug.

The real sticking point that people have legit argument against is when pharmacies give birth control pil regimens to some women and not to others, solely based on the pharmacists' moral judgment. That is not safe. They aren't trained to make those types of medical decisions. I could just as easily storm into that situation and ask the pharmacist why my 15 year-old patient just came in with a hematocrit level of 20, passed out and confused, because they apparently thought my prescription to treat anemia was a joke.

 

[Peregrine]

Come on now, the point isn't if the chemical is foreign or not to the woman's body.

Let me be more clear. Preven is a mixture of an estrogen and progesterone-like chemicals, which are two top gun hormones in female reproduction. First, it's not OTC and never will be. It's steroids. Second, the same two drugs found in preven are the same two drugs in the patch. The pill. The dial-thingy in all women's purses. The only difference is most likely the two drugs' concentrations, or their delivery. Or maybe not. The only difference may actually just be the name and the wrapping.

If you were to not know what preven was as a PRODUCT and looked at its active combination of drugs, you'd think nothing at all. You'd think typical birth control. But when you look the actual product up you see all this social implication crap that cannot be ignored.

 

[Peregrine]

Bottom line in the preven case is that it's the physician's fault if that prescription didn't get filled. They should have known their community better and not ignored social forces.

But when a pharmacist gets handed a prescription note for birth control pills from a sixteen year-old accompanied by her mother, and denies her the prescription based on her age and an assumption that the drug's primary indication is why it was prescribed...that can't be tolerated from a medical standpoint. You don't pay pharmacists a hundred thousand dollars a year to assume. That's what you pay the physician to do.

 

[Kat]

Very very interesting guys. I'm diggin' it. Very informational.

Anyway Pere, no Heather does not smoke. She's totally against it. Well cigarettes anyway^^.

 

[Firestreak]

Denying preven is one thing. The doctor might just as well have been the one loading the gun if he sent a 15 year-old to a Winn-Dixie in Mississippi with a Preven prescription. Or he could have known that no one filled preven prescriptions within a 2-hour drive of his office and was trying to "fulfill his moral obligation" as well. Or more likely, a Lawyer for planned parenthood got ahold of a shady doc and got himself a client with a preven prescription to milk. That brand name is a loaded gun, and responsibility falls on the physician to get that type of prescription filled if they prescribed it. I'm sure planned parenthood would like you to think that pharms should have to carry this stuff, but they don't have to. You can't tell a smalltown pharmacy they have to carry a morning after pill. You can't tell a WalMart chain to carry a socially controversial drug.

The real sticking point that people have legit argument against is when pharmacies give birth control pil regimens to some women and not to others, solely based on the pharmacists' moral judgment. That is not safe. They aren't trained to make those types of medical decisions. I could just as easily storm into that situation and ask the pharmacist why my 15 year-old patient just came in with a hematocrit level of 20, passed out and confused, because they apparently thought my prescription to treat anemia was a joke.

I'd agree with you to the point actually that denying birth control for any reason except potential health risks to a specific patient is beyond the moral realm of a pharmacist's allowance. Afterall, unless they are a real old-timer, birth control being a part of pharmacy has been around longer than the have. What I don't like is trying to attach different things to the title of "birth control". Sure, by performing the abortion you certainly do control the birth. But pro-choicers have been playing word games for years. I loved it when watching some democrat senator call people "anti-choice." I guess that makes him "Anti-life?" Just by the logic you can call damn near anything birth control.

Here, let's see em spin this into birth control...

 

[Peregrine]

Attaching different things to the title of "birth control" is something that the physician needs to be aware of and account for when writing prescriptions. You can't write a prescription for a morning after pill in a small town in the South without knowing the society you live in. Rite aid might fill them since they have a hard liqor license framed on the wall not twenty feet from the barbiturates and really don't seem to care about moral obligations too much. But if there's no Rite Aid, and no one carries the drug you're prescribing for 90 miles around, you have to know that.

Keep in mind that if you take this preven as a regimen and not as a kit, it will prevent ovulation just like every other birth control pill. A secondary indication is to stop implantation. Birth control is a flawed term. Pregnancy control is a more specific term within the category of Birth control that people should be talking about. Pregnancy control does not include abortion. Abortion doesn't keep you from getting pregnant. It stops the pregnancy. Preven and hormone pills and patches prevent pregnancy.

Pregnant is a word we can control as physicians. Fertilization isn't pregnant. Implantation isn't pregnant. Pregnant is a clinical finding--once you're pregnant you will eventually find out you're pregnant regardless of whether you carry or lose the baby. You'll either carry it, miscarry it, or abort it. That's much easier to handle than "birth control." A fertilized zygote can implant and self-abort and she'd never know it. She was never clinically pregnant. The only trick would be to convince the public that you can be inseminated, fertilized, and even implanted without ever being pregnant. People think the line is fuzzy when in this case it's really not. You have about a week or two after fertilization, including quite a few days after implantation, where you would have never known you had another human's DNA replicating in you if it self-terminated. To stop it there has no consequences IMO. She won't pass it. She won't see it. Won't feel it. Will never even know if it was really there or not.

If you go to the doctor up to a week after having sex and get these blockers, you will never know if you were going to become pregnant or not. In that sense, it's the same as a condom--you'll never know if it worked. But as soon as you take it past 5 weeks, the thing has a heart, and you WILL know you were pregnant sooner or later no matter what you do.

That's a pretty clear line, and honestly a reasonable one for both sides. We can get some public service announcements to kill the ignorance, and get all women into the clinic within 3 days of having sex. Easily. No one wants to see the doctor. It's a half day out of your life. If she's concerned and responsible enough to come in post-sex and go through all that trouble just to protect the 10 percent chance that she's fertilized and 5% chance that she'll become pregnant...that's more responsible than most patients. She deserves that option.

Development is so unbelievably predictable in the first 3 weeks of implantation. Even so, lines will always be opinion. You can't control minds. You have to account for them, and ethical physicians account for moral pharmacists. Ultimately that's probably how it should continue to be.

 

[Firestreak]

Looking at it from a moral perspective, the reason I can see the line drawn differently is that once fertilization does occur, while medical facts will draw lines in the development of new life, the fact remains that the process has begun and of many possible DNA combinations for life one has been locked in place. On the reverse, for the extremists... to consider a condom wrong is to consider abstinence wrong. As far as after fertilization is concerned, there are obviously many different lines in development, and whenever you cross one, more people will feel for them it is unacceptable to kill. Then you have girls who drop their babies off in a toilet or the side of the road and don't give a fuck.

So probably the best thing is to simply stock any controversial medication like that in the hospital's pharmacy, I'm sure there are PLENTY of pharmacies out there that don't give a fuck and wlil stock Preven in their shelves to make it more convieniant, and elsewise, just do the smart thing.