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	<title>Comments on: Forcing Pharmacists to Dispense Drugs.</title>
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	<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/</link>
	<description>Life. Liberty. Pursuit of Happiness.</description>
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		<title>By: Standard Mischief &#187; Blog Archive &#187; Plan B, personal responsibility, and the FDA</title>
		<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/comment-page-1/#comment-1055</link>
		<dc:creator>Standard Mischief &#187; Blog Archive &#187; Plan B, personal responsibility, and the FDA</dc:creator>
		<pubDate>Tue, 06 Jun 2006 15:23:45 +0000</pubDate>
		<guid isPermaLink="false">http://standardmischief.com/?p=42#comment-1055</guid>
		<description>[...] (I?ve already covered EC, Plan B and it?s off-label, but still safe and effective alternatives here and here.) [...]</description>
		<content:encoded><![CDATA[<p>[...] (I?ve already covered EC, Plan B and it?s off-label, but still safe and effective alternatives here and here.) [...]</p>
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		<title>By: Standard Mischief &#187; Blog Archive &#187; Wal-Mart Ordered To Stock Contraceptives In Massachusetts.</title>
		<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/comment-page-1/#comment-88</link>
		<dc:creator>Standard Mischief &#187; Blog Archive &#187; Wal-Mart Ordered To Stock Contraceptives In Massachusetts.</dc:creator>
		<pubDate>Fri, 17 Feb 2006 03:04:57 +0000</pubDate>
		<guid isPermaLink="false">http://standardmischief.com/?p=42#comment-88</guid>
		<description>[...] Heck, I&#8217;ve even posted a blog entry on how emergency contraceptive is the same exact drug as regular birth control pills. So if your doctor writes out you prescription a little differently, and gives you different dosing instructions you can even get your emergency contraceptive at Wal-Mart, if that&#8217;s your only option. I hashed this out with tgirsch over at SayUncle&#8217;s place, but I have little to add to this specific argument. (There are other issues that I&#8217;ve promised to address.) tgirsch Says: But again, this is where our philosophies differ. I think that all that should matter is that a product has been proven safe (FDA approval), that the patient wants or needs it, and that a physician has recommended it (via a prescription). You, however, would add profitability to this equation. In other words, if a patient needs something, and a doctor agrees that the patient needs it, you would allow the market to decide (based on profitability) whether or not the patient actually gets it. That?s why I make my complaint that the market ought to serve us, rather than the other way around. [...]</description>
		<content:encoded><![CDATA[<p>[...] Heck, I&#8217;ve even posted a blog entry on how emergency contraceptive is the same exact drug as regular birth control pills. So if your doctor writes out you prescription a little differently, and gives you different dosing instructions you can even get your emergency contraceptive at Wal-Mart, if that&#8217;s your only option. I hashed this out with tgirsch over at SayUncle&#8217;s place, but I have little to add to this specific argument. (There are other issues that I&#8217;ve promised to address.) tgirsch Says: But again, this is where our philosophies differ. I think that all that should matter is that a product has been proven safe (FDA approval), that the patient wants or needs it, and that a physician has recommended it (via a prescription). You, however, would add profitability to this equation. In other words, if a patient needs something, and a doctor agrees that the patient needs it, you would allow the market to decide (based on profitability) whether or not the patient actually gets it. That?s why I make my complaint that the market ought to serve us, rather than the other way around. [...]</p>
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		<title>By: Standard Mischief</title>
		<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/comment-page-1/#comment-22</link>
		<dc:creator>Standard Mischief</dc:creator>
		<pubDate>Thu, 10 Nov 2005 21:52:50 +0000</pubDate>
		<guid isPermaLink="false">http://standardmischief.com/?p=42#comment-22</guid>
		<description>I&#039;m only going to contest the first part of point #1. Although professional licenses do differ from business type licenses, pharmacist predate the FDA. You use to be able to buy a brand name preparation, or chose to let a pharmacist compound a generic equivalent from their book of recipes. Prescriptions were just recommendations written by a doctor in a jargon filled language on plain paper. No triplicate forms, &quot;pop-up voids&quot;, DEA numbers or any such nonsense.

I&#039;ll concede  point #2. Yes, they were not really great analogies. Your doctor/lawyer one is better.

I&#039;m somewhat confused by point #3. My understanding is that doctors are free to not provide abortions if that&#039;s what they wish to do. In an emergency, good samaritan laws require them to render emergency aid to the best of their ability, but I think that&#039;s the extent of their compulsion to serve.

Lawyers, too I think are able to pick and choose their clients that they accept in most cases. There is a number of rules where they can&#039;t accept clients, like they are already a lawyer for someone&#039;s opponent, but by and large if you walked in to a lawyers office and waved a bunch of cash around, I don&#039;t think they would be &lt;i&gt;required&lt;/i&gt; to offer legal aid (unlikely as that is to happen in real life). If they do agree to provide legal services, they must, as you say, do so in an impartial manner.

Under this analogy, a pharmacist would be required, if he chose to fill the prescription, (take the case, treat the patient) to count those pills out to the best of his ability. And I&#039;m sure it would be a breach of professional ethics, as well as a spectacular trial, if a pharmacist were to dispense sugar pills where birth control or emergency contraceptives were indicated on the script.</description>
		<content:encoded><![CDATA[<p>I&#8217;m only going to contest the first part of point #1. Although professional licenses do differ from business type licenses, pharmacist predate the FDA. You use to be able to buy a brand name preparation, or chose to let a pharmacist compound a generic equivalent from their book of recipes. Prescriptions were just recommendations written by a doctor in a jargon filled language on plain paper. No triplicate forms, &#8220;pop-up voids&#8221;, DEA numbers or any such nonsense.</p>
<p>I&#8217;ll concede  point #2. Yes, they were not really great analogies. Your doctor/lawyer one is better.</p>
<p>I&#8217;m somewhat confused by point #3. My understanding is that doctors are free to not provide abortions if that&#8217;s what they wish to do. In an emergency, good samaritan laws require them to render emergency aid to the best of their ability, but I think that&#8217;s the extent of their compulsion to serve.</p>
<p>Lawyers, too I think are able to pick and choose their clients that they accept in most cases. There is a number of rules where they can&#8217;t accept clients, like they are already a lawyer for someone&#8217;s opponent, but by and large if you walked in to a lawyers office and waved a bunch of cash around, I don&#8217;t think they would be <i>required</i> to offer legal aid (unlikely as that is to happen in real life). If they do agree to provide legal services, they must, as you say, do so in an impartial manner.</p>
<p>Under this analogy, a pharmacist would be required, if he chose to fill the prescription, (take the case, treat the patient) to count those pills out to the best of his ability. And I&#8217;m sure it would be a breach of professional ethics, as well as a spectacular trial, if a pharmacist were to dispense sugar pills where birth control or emergency contraceptives were indicated on the script.</p>
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		<title>By: Tino</title>
		<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/comment-page-1/#comment-21</link>
		<dc:creator>Tino</dc:creator>
		<pubDate>Thu, 10 Nov 2005 14:53:15 +0000</pubDate>
		<guid isPermaLink="false">http://standardmischief.com/?p=42#comment-21</guid>
		<description>I think that you are missing the point, primarily for three reasons:

1. Yes, gas stations are licensed by the state, but the pharmacist class is entirely a creation of the state.   I am sure that you have noticed what happens to people who are caught dispensing drugs without the blessing of the state&#039;s pharmacist-licensing apparatus.  The precise purpose of the drugs being sold may well vary, but you can&#039;t deny that one of this country&#039;s greatest priorities -- right up there with catching Osama Bin Laden --  is to make sure that drugs are only dispensed by physicians and official pharmacists. 

2. The comparison to office and gas-station hours is particularly inapt.  Nobody is saying that the pharmacy fails its customers by not dispensing morning-after pills at 2 a.m. on a Sunday.  And gas stations that owe their existence to the state to the degree that the pharmacist class does -- I am thinking here of the gas stations on turnpikes -- generally *are* required as a condition of their franchise there to sell gas 24 hours a day.

3. Pharmacists hold themselves out as &#039;professionals&#039;, though they are admittedly on one of the bottom rungs of that ladder.  Physicians and lawyers also have their personal codes of ethics, but their *professional* codes hold that they should provide medical care or legal services in an impartial manner regardless of their personal feelings (though obviously one would prefer to have a lawyer who is genuinely sympathetic to one&#039;s cause).  

This not only results in the public having greater access to these services, but it protects the professionals against reprisals and scorn from the community for treating or representing an unpopular client.  Thus the medical and bar associations can at least say that their members are leaving the ultimate disposition of one&#039;s life or liberty up to God or the law, respectively.  If physicians and lawyers had more ethical latitude in whom they were willing to treat or represent, they could legitimately be held more responsible for the outcome of cases.

If pharmacists want to be able to pick and choose which prescriptions they will fill, they will find themselves in a bad position: not only will their decisions then be individually subject to the judgement of the community, but they&#039;ll also probably find themselves legally liable for any bad effects of the drugs they *do* dispense.</description>
		<content:encoded><![CDATA[<p>I think that you are missing the point, primarily for three reasons:</p>
<p>1. Yes, gas stations are licensed by the state, but the pharmacist class is entirely a creation of the state.   I am sure that you have noticed what happens to people who are caught dispensing drugs without the blessing of the state&#8217;s pharmacist-licensing apparatus.  The precise purpose of the drugs being sold may well vary, but you can&#8217;t deny that one of this country&#8217;s greatest priorities &#8212; right up there with catching Osama Bin Laden &#8212;  is to make sure that drugs are only dispensed by physicians and official pharmacists. </p>
<p>2. The comparison to office and gas-station hours is particularly inapt.  Nobody is saying that the pharmacy fails its customers by not dispensing morning-after pills at 2 a.m. on a Sunday.  And gas stations that owe their existence to the state to the degree that the pharmacist class does &#8212; I am thinking here of the gas stations on turnpikes &#8212; generally *are* required as a condition of their franchise there to sell gas 24 hours a day.</p>
<p>3. Pharmacists hold themselves out as &#8216;professionals&#8217;, though they are admittedly on one of the bottom rungs of that ladder.  Physicians and lawyers also have their personal codes of ethics, but their *professional* codes hold that they should provide medical care or legal services in an impartial manner regardless of their personal feelings (though obviously one would prefer to have a lawyer who is genuinely sympathetic to one&#8217;s cause).  </p>
<p>This not only results in the public having greater access to these services, but it protects the professionals against reprisals and scorn from the community for treating or representing an unpopular client.  Thus the medical and bar associations can at least say that their members are leaving the ultimate disposition of one&#8217;s life or liberty up to God or the law, respectively.  If physicians and lawyers had more ethical latitude in whom they were willing to treat or represent, they could legitimately be held more responsible for the outcome of cases.</p>
<p>If pharmacists want to be able to pick and choose which prescriptions they will fill, they will find themselves in a bad position: not only will their decisions then be individually subject to the judgement of the community, but they&#8217;ll also probably find themselves legally liable for any bad effects of the drugs they *do* dispense.</p>
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		<title>By: Standard Mischief</title>
		<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/comment-page-1/#comment-20</link>
		<dc:creator>Standard Mischief</dc:creator>
		<pubDate>Thu, 10 Nov 2005 13:56:57 +0000</pubDate>
		<guid isPermaLink="false">http://standardmischief.com/?p=42#comment-20</guid>
		<description>I&#039;ve never heard of any pharmacy &lt;i&gt;not&lt;/i&gt; dispensing birth control pills, only emergency contraceptive. The point was that birth control pills &lt;i&gt;are&lt;/i&gt; emergency contraceptive, if you dose them differently, and are already easy to get. This is sorta like taking 4 over-the-counter Ibuprofin tablets at 200mg each instead of jumping through the hoops to get your prescription filled for the 800mg horse pills. Same drug, same dosages, different packaging.

Although &quot;plan B&quot; is mildly controversial, I&#039;ve never known any chain or bigbox to not dispense birth control pills. If Mall-Wart, Bullseye/Red Dot, J-mart. CVS tree, Mallgreens, or any of the other big chains refused to dispense birth control, I&#039;m sure they would quickly have a boycott on their hands.

Remember, amoral corporations just want to make as much money as possible. They have the right to cater to the majority to seek that money. If they refuse to serve a market, someone else usually comes along to fill that need. This is someplace where letting the free market work things out is a good idea. 

As a person hiring for a pharmacists position in one of the big chains, I&#039;d  want to see if there was any reason why the person seeking the position would not dispense anything on religious grounds, but it would be a question that would be illegal to ask. Perhaps you could ask them if there was any reason why they would not dispense any legal drug, assuming they were presented with a valid prescription. Let &lt;i&gt;them&lt;/i&gt; bring up religious grounds.</description>
		<content:encoded><![CDATA[<p>I&#8217;ve never heard of any pharmacy <i>not</i> dispensing birth control pills, only emergency contraceptive. The point was that birth control pills <i>are</i> emergency contraceptive, if you dose them differently, and are already easy to get. This is sorta like taking 4 over-the-counter Ibuprofin tablets at 200mg each instead of jumping through the hoops to get your prescription filled for the 800mg horse pills. Same drug, same dosages, different packaging.</p>
<p>Although &#8220;plan B&#8221; is mildly controversial, I&#8217;ve never known any chain or bigbox to not dispense birth control pills. If Mall-Wart, Bullseye/Red Dot, J-mart. CVS tree, Mallgreens, or any of the other big chains refused to dispense birth control, I&#8217;m sure they would quickly have a boycott on their hands.</p>
<p>Remember, amoral corporations just want to make as much money as possible. They have the right to cater to the majority to seek that money. If they refuse to serve a market, someone else usually comes along to fill that need. This is someplace where letting the free market work things out is a good idea. </p>
<p>As a person hiring for a pharmacists position in one of the big chains, I&#8217;d  want to see if there was any reason why the person seeking the position would not dispense anything on religious grounds, but it would be a question that would be illegal to ask. Perhaps you could ask them if there was any reason why they would not dispense any legal drug, assuming they were presented with a valid prescription. Let <i>them</i> bring up religious grounds.</p>
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		<title>By: Jacqueline</title>
		<link>http://standardmischief.com/blog/2005/11/09/forcing-pharmacists-to-dispense-drugs-emergency-contraceptive/comment-page-1/#comment-19</link>
		<dc:creator>Jacqueline</dc:creator>
		<pubDate>Thu, 10 Nov 2005 02:12:03 +0000</pubDate>
		<guid isPermaLink="false">http://standardmischief.com/?p=42#comment-19</guid>
		<description>$70 may be the full list price, but very few people at PP pay full price because they charge on a sliding scale based on income.

I don&#039;t think the government should get involved, but I wish more pharmacy chains would make it a condition of employment for their pharmacists that they must fill all birth control prescriptions.  If they have a moral problem with dispensing medications then they should choose a different career.</description>
		<content:encoded><![CDATA[<p>$70 may be the full list price, but very few people at PP pay full price because they charge on a sliding scale based on income.</p>
<p>I don&#8217;t think the government should get involved, but I wish more pharmacy chains would make it a condition of employment for their pharmacists that they must fill all birth control prescriptions.  If they have a moral problem with dispensing medications then they should choose a different career.</p>
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