Two issues that go to the heart of what's troubling many pharmacists today--ethical dilemmas and workplace problems--have flashed onto the radar scope of the American Pharmaceutical Association, which is preparing to respond this year.
Pharmacists who refuse to dispense certain medications on moral or religious grounds have stirred up a heated debate inside pharmacy and drawn the national media spotlight. Well aware of the controversy, APhA will present a policy paper addressing the rights and responsibilities of pharmacists with regard to patients at its annual meeting in March, said executive v.p.-CEO John Gans during a recent meeting with editors at Drug Topics headquarters in Montvale, N.J.
"Do pharmacists have a moral choice?" Gans asked. "Yes, they have a choice, but they're there to serve the patient. If a patient needs a certain type of care and has determined that he or she wants that care and it's legal to have that care, it's the pharmacist's responsibility, maybe not to provide that care, but to get [that patient] to another pharmacist who can provide that care. As the policy committee looked at pharmacists who determined, based on whatever rationale, that they did not want to brew up a cocktail to end the life of a patient or inmate, [the members decided that pharmacists] had a right to step away from it but they also have a responsibility to make sure the service is available because that is what was prescribed."
The APhA position that dissenting pharmacists have a duty to refer the patient to another R.Ph. is bound to stir up even more controversy, especially among pro-life groups. Gary Kadlec, APhA president, said that it will be "interesting" to see the new policy aired and whether it ever gets through the house of delegates. "I don't know if the policy will be the end of it, because society hasn't answered the questions," he said. "But I think APhA is a good forum in which to start the discussion. APhA has to take a stand and be willing to talk about it."
Pharmacists with strongly held moral or religious views should be up front with their employers, Gans and Kadlec agreed. Pharmacists and employers should lay out a plan ahead of time, before the issue arises. "Have a plan in advance," said Gans. "That's the key element. That's what APhA can do--help people think about it in advance." Kadlec added, "Find something you both can live with. I don't have the answer, but there has to be an open dialogue because it will become more of an issue on a daily basis."
Jumping from the frying pan of pharmacists who refuse to dispense to the fire of workplace issues, APhA is preparing a white paper on labor unions. The need for a white paper became obvious after a committee charged with making a recommendation to update APhA's 28-year-old policy "threw up its hands" in frustration, said Kadlec. The paper will explain the types of labor unions and what they can and cannot do for pharmacists.
"It's clear the profession doesn't understand unionization," said Gans. "We're focusing on pharmacists and collective bargaining and whether [labor unions] can help elevate the quality of work life and standards of practice. The frustration we're hearing is that pharmacists have been trained to give information and manage patient drug therapy, not to be a third-party benefits clerk. It's a management issue as well as a pharmacy issue. The [APhA] board of trustees had a concern that because we're addressing an issue to educate the profession that it might be perceived as just a ruse for going in [a pro-union] direction. If they were voting today, I think the board and the membership would not support that."
Other points covered during the APhA sit-down included the following: