When the ambulance driver won't take you, because you write porn;

[matriarch]

....

If their contract demands they dispense optional and elective drugs and procedures to anyone who ever wants one... then, hey, so be it. But I don't believe they have that.

Ah. You don't believe. OK.

I know I'm going to regret this, but I'll plough on. The word 'elective' bothers me.

If the doctor, despite his/her moral or religious beliefs, has agreed to prescribe either (a) the morning after pill, or (b) an abortion that he/she believes is necessary to save the mother's life, I don't see that as elective, I see those treatments as prescriptive, and in your own words, have been deemed necessary in the professional judgement of the doctor to maintain the quality of life of the patient in question (and lets not be pedantic here Joe, please, or obstructive, we both know those treatments are ONLY designed for, and prescribed to, women.)

This is then is the point at which I believe the pharmacist/nurse/paramedic/whatever, is in no position to refuse UNLESS they have good MEDICAL reasons (not moral or religious beliefs) to suspect that the prescribed treatment will have adverse, maybe even fatal, consequences to the patient in question. (Please note, I am NOT getting into the rights or otherwise of a foetus, that's a slippery slope.)

I think I'm going to duck out of this now, because if it continues on its usual path, this argument/discussion will become a never ending circular one, focussing purely on the semantics, and completely ignoring the rights of the patient. And yes, patients DO have rights.

Ta ta. Have a fun discussion.......I'll come back in a couple of weeks and see how far round the circle you have all gone.

 

[Joe Wordsworth]

Let's take this back to your discussion about employees, Joe, if we may.

I see this in the same light, actually.

If the pharmacist, EMT, physician, whatever, signed their "contract" for the job, their licensure, etc., without exception, then if they do not wish to lose their jobs they must not refuse treatment to someone, even if they somehow feel morally compelled to do so.

Agreed.

They are welcome to seek employment elsewhere, but before beginning their new job they should lay the basic ground rules within which they feel they can morally comply.

Agreed.

And this information should be up front knowledge, posted in large font at the pharmacy desk and even in the phone book ads of the companies that share those views. Before I choose to put the healthcare for myself and for my family in their hands or to spend my dollars at their pharmacy, I want to know. That is my right as a consumer.

More or less agreed.

 

[Joe Wordsworth]

Ah. You don't believe. OK.

That's my way of saying "it is my understanding that this is so", I /do/ have a doctor friend--he seems to believe its the case. Beyond that, I really would have to look it up. I'm not at all beyond being wrong, factually, but when I'm told I'm wrong "reasonably", I can contest.

I know I'm going to regret this, but I'll plough on. The word 'elective' bothers me.

If the doctor, despite his/her moral or religious beliefs, has agreed to prescribe either (a) the morning after pill, or (b) an abortion that he/she believes is necessary to save the mother's life, I don't see that as elective, I see those treatments as prescriptive, and in your own words, have been deemed necessary in the professional judgement of the doctor to maintain the quality of life of the patient in question (and lets not be pedantic here Joe, please, or obstructive, we both know those treatments are ONLY designed for, and prescribed to, women.)

The morning after pill is elective.. an abortion believed to be necessary to save someone's life I don't see as being elective. That they're prescribed to women doesn't necessarily mean they're grounds for discrimination of women--as there isn't anything to discriminate from.

This is then is the point at which I believe the pharmacist/nurse/paramedic/whatever, is in no position to refuse UNLESS they have good MEDICAL reasons (not moral or religious beliefs) to suspect that the prescribed treatment will have adverse, maybe even fatal, consequences to the patient in question. (Please note, I am NOT getting into the rights or otherwise of a foetus, that's a slippery slope.)

I have said I have no issue with life-saving abortions as a medical necessity... just optional and elective non-life-threatening things like morning after pills (or for that matter, coca-cola).

I think I'm going to duck out of this now, because if you continue on your usual path, this argument/discussion will become a never ending circular one, focussing purely on the semantics, and completely ignoring the rights of the patient. And yes, patients DO have rights.

I think you're misusing the term "semantics" (most people do).

Beyond that, someone coming in to buy a morning after pill from a pharmacist is not the pharmacist's patient.. they are that pharmacist's customer--precisely because it is a free relationship and he is not legally or contractually compelled to treat her condition.

Ta ta. Have a fun discussion.......I'll come back in a couple of weeks and see how far round the circle you have all gone.

K

 

[Joe Wordsworth]

Am I really reading this right? Selena, are you saying the ambulance driver in the first post was being prejudiced?


Because, that ain't it. I'm almost 100% certain if it were possible for a man to get pregnant, and for that man then to go for an abortion, Ms Ambulance woman would have done the same. It is so not an issue of sexism, and is a completely different kettle of fish to your racist, different seats on the bus example.

You know, i swear i was reading this thread not long ago and everyone seemed to be agreeing or pretty much agreeing -what happened?*L*

It seems that there's a confusion over

(1) Not getting what you want from someone who doesn't have to give it to you is wrong because you have rights and they're bringing religion as their basis for free moral choice.

and

(2) Someone who doesn't get what they want from someone who doesn't have to give it to them (because of reservations about ONLY the morality of the effects of the thing) is discriminated against if the person in question is the vastly primary demographic that buys or wants the thing being with-held. Which would mean that if black people were 99.9% of the people buying guns in this country, and a store owner refused to sell guns to anyone because he thinks killing people is wrong, that means that black people would be discriminated against.

I fundamentally disagree with both.

 

[rgraham666]

Most interesting.

I post personal experience on the cost of personal ethical decisions and there's no comment at all from anyone on any side of this debate.

I'm not hurt. I'm just wondering.

 

[Weird Harold]

Postal employees are contracted by the State, no? Different set of rules apply.

Fedex, UPS, and other delivery drivers aren't state employees though o the same question applies -- where does "concientious refusal of services" become wrong?

If a product is stocked, it should be dispensed as directed by the prescription. Period. The only exception should be adverse drug interaction problems -- which should be referred back to the prescribng physician.

A prescription is the note from the doctor that says "this person has a medical condition/right to purchase this restricted drug". It is not a "I'm the doctor and can make you sell things and take on customers and control that aspect of your business for you with a piece of paper"--the doctor, effectively, doesn't run the grocery store or pharmacy.

[/QUOTE]

No, a prescription is just a legal requirement for dispensing prescription medication.

But you're ignoring the main point -- IF a medication is stocked it is an employee's job to dispense it. There is a big difference between an employer not stocking morally objectionable products and employees selectively refusing to sell products they employers offer for sale.

I don't see the refusal of pharmacists or EMTs to provide services that their employers offer as any different from a Victoria's Secret clerk refusing to sell crothchless panties or a video store clerk refusing to rent adult movies on "moral grounds." The companies stock those items or offer those services and pay their employees to sell them.

I don't have any real problem with somone being told, "we don't stock that medication/item" but I do have a problem with an employee saying "I don't care what the owner stocks, I'm not selling this to you" -- whether it's viagra, the morning after pill, or a "gentleman's magazine."

The arguments defending the right to "concientious refusal" are almost verbatim the same arguments used to justify refusal to serve blacks at lunch counters in the sixties, BTW. I don't think they're any more valid now than they were then.

 

[Joe Wordsworth]

Fedex, UPS, and other delivery drivers aren't state employees though o the same question applies -- where does "concientious refusal of services" become wrong?

You, as a consumer, are free to not use FedEx, UPS, or other delivery companies if they don't want to deliver (1) anything too large, (2) anything organic, (3) baby-strollers, etc. If they don't like the look of a package, as a private entity they can say... "um, no". If you walk in with a "I mail bombs" t-shirt on, they can say "no" to your package on grounds of conscientious refusal.
Its a free country, afterall.

No, a prescription is just a legal requirement for dispensing prescription medication.

It's a written license to obtain medication, not a requirement.

But you're ignoring the main point -- IF a medication is stocked it is an employee's job to dispense it. There is a big difference between an employer not stocking morally objectionable products and employees selectively refusing to sell products they employers offer for sale.

I have nothing to say about the nature of employees not doing things their companies want--and have been speaking about those with the power to make business decisions and their rights. In such a case, no, even if a medication is stocked... they don't have to dispense it. They could have cases of Viagra back there and not sell a bit of it. Which would be silly, from an economic standpoint, as they had to buy the stock they're sitting on--but silly or not, they're a business.

I don't see the refusal of pharmacists or EMTs to provide services that their employers offer as any different from a Victoria's Secret clerk refusing to sell crothchless panties or a video store clerk refusing to rent adult movies on "moral grounds." The companies stock those items or offer those services and pay their employees to sell them.

I agree... employees should abide their jobs. I however mention, that I haven't had a problem with that in this entire thread.

I don't have any real problem with somone being told, "we don't stock that medication/item" but I do have a problem with an employee saying "I don't care what the owner stocks, I'm not selling this to you" -- whether it's viagra, the morning after pill, or a "gentleman's magazine."

O.k. And you're free to have the problem. But they're (if empowered to make business decisions) free to still not sell it to you.

The arguments defending the right to "concientious refusal" are almost verbatim the same arguments used to justify refusal to serve blacks at lunch counters in the sixties, BTW. I don't think they're any more valid now than they were then.

Actually... they're not. There's a difference of result and right in those situations.

 

[Joe Wordsworth]

This is getting exhausting repeating myself... the need for clarification (responses to Pure's posts, as an example) I can understand. But just repeat what's already said? Are we going to disagree with my points or just the conclusion over and over and over?

Incidentally:

http://www.pharmacy.ca.gov/faqs.htm

 

[SEVERUSMAX]

One of the breakpoints in my career as a computer programmer was when I refused to write a particular program.

Specifically it was a program to update the General Ledger without updating the audit trail. So people could make changes to the G/L but leaving no trace of what was done and by who.

Actually I didn't refuse. I insisted the client make the request in writing, signed and notarised, and my employers pass that request to me in writing, signed and notarised.

For some obscure reason they didn't do so.

But my next performance review made it quite clear that my 'inability to follow orders' was regarded as a major flaw that kept them from giving me a raise. And the scuttlebutt was the only reason they didn't fire me was because they knew I'd raise an official stink, and they didn't want any official scrutiny.

So I have some experience at the cost of personal ethics in the working world.

It sounds more like a classic case of corruption and underhanded business practices, probably illegal. That's a bit different, and I think that your approach there was perfectly ethical.

 

[Sex and Death]

Ave Maria, Florida, a planned Catholic community of 10,000 or so.

http://www.avemaria.com/

Lots will soon be available.

In the drugstores, Catholics needn't worry about being offended by condom displays 'cuz there won't be any.

Now if we could just set up Calvintown, Mississippi, and get Joe a house there, everyone would be happy. Donations, anyone?

As Falling noted, the heritage of Massachusetts colony is being revived in the US. Perhaps y'all know these colonists simply incorporated the 10C into the colony's penal code.

Pure,

How is the US republic not based on the Puritan cult, let the cult of Freemasonry, or white supremism, among others?

Our country was founded on the basis of religious freedom, including the right to practice a religion, not just the right to abdicate spiritial responsibility and reality, as is the contemporary fashion.

Pluralism is not the same as secularism.

Which of us religious wackos are you for and which against? Which one are you? Our religion ha snothing to do with whether we believe in somehting or not, it has to do with what we worship. Everyone worships something, whether it's a deity, no deity, the economy or their own ego.

Your Friendly Neighborhood Hillmaniac,
S&D

 

[Selena_Kitt]

So I have some experience at the cost of personal ethics in the working world.

I've had an experience doing the opposite... doing something very unethical for fear of losing my job... and as a single mother with two little kids to support, it was a scary proposition... I kept copious documentation about what I was doing and who told me to do what... but I knew it was wrong.

It isn't easy or so clear cut or black and white as we'd like to make it out, sometimes...

 

[matriarch]

It seems that there's a confusion over

(1) Not getting what you want from someone who doesn't have to give it to you is wrong because you have rights and they're bringing religion as their basis for free moral choice.

and

(2) Someone who doesn't get what they want from someone who doesn't have to give it to them (because of reservations about ONLY the morality of the effects of the thing) is discriminated against if the person in question is the vastly primary demographic that buys or wants the thing being with-held. Which would mean that if black people were 99.9% of the people buying guns in this country, and a store owner refused to sell guns to anyone because he thinks killing people is wrong, that means that black people would be discriminated against.

I fundamentally disagree with both.

Gotcha.
Kind of a rock and a hard place situation.

 

[FallingToFly]

Pure,

How is the US republic not based on the Puritan cult, let the cult of Freemasonry, or white supremism, among others?

Our country was founded on the basis of religious freedom, including the right to practice a religion, not just the right to abdicate spiritial responsibility and reality, as is the contemporary fashion.

Pluralism is not the same as secularism.

Which of us religious wackos are you for and which against? Which one are you? Our religion ha snothing to do with whether we believe in somehting or not, it has to do with what we worship. Everyone worships something, whether it's a deity, no deity, the economy or their own ego.

Your Friendly Neighborhood Hillmaniac,
S&D

Founded on the basis of "religious freedom"-

And then th ePuritans turned around and branded and fined Quakers as heretics for not abiding within the tenets of their religion- persecuted anyone suspected of witchcraft, and were generally religious tyrants.

^.^ This country is founded on hypocrisy, and I'm just so damn sick of it I keep wondering why I haven't been able to figure out a way to purchase a nice patch of no man's somewhere and start my own little commune.

I don't want to be part of this world anymore- period. I hope like hell my children grow up more tolerant and flexible in belief than the current population seems to be.

 

[matriarch]

This is getting exhausting repeating myself... the need for clarification (responses to Pure's posts, as an example) I can understand. But just repeat what's already said? Are we going to disagree with my points or just the conclusion over and over and over?

Incidentally:

http://www.pharmacy.ca.gov/faqs.htm

Thank you Joe, that's the kind of thing I was looking for.

I found this interesting:

Can a pharmacist refuse to fill my prescription?
Yes, a pharmacist in his or her professional judgment may refuse to fill a prescription.

Please note: 'professional judgement'...............there is NO mention of 'moral/religious judgement'.

(I know, I said I wouldn't be back.......I fibbed.)

 

[Joe Wordsworth]

Thank you Joe, that's the kind of thing I was looking for.

I found this interesting:

Can a pharmacist refuse to fill my prescription?
Yes, a pharmacist in his or her professional judgment may refuse to fill a prescription.

Please note: 'professional judgement'...............there is NO mention of 'moral/religious judgement'.

(I know, I said I wouldn't be back.......I fibbed.)

I believe I make many, many references in my many, many posts as to "professional judgement", yes. I also make references to moral judgements. Notably, a pharmacist who refuses to sell a morning after pill because, in his professional judgement, conception is the beginning of life, is not morally judging so much as preserving life based on the science he professionally judges.

That, in a nutshell, is the basis for a LOT of these problems.

 

[English Lady]

It seems that there's a confusion over

(1) Not getting what you want from someone who doesn't have to give it to you is wrong because you have rights and they're bringing religion as their basis for free moral choice.

and

(2) Someone who doesn't get what they want from someone who doesn't have to give it to them (because of reservations about ONLY the morality of the effects of the thing) is discriminated against if the person in question is the vastly primary demographic that buys or wants the thing being with-held. Which would mean that if black people were 99.9% of the people buying guns in this country, and a store owner refused to sell guns to anyone because he thinks killing people is wrong, that means that black people would be discriminated against.

I fundamentally disagree with both.

I had to read this through a few times to get it (I don't think well in high temperatures*L*) but thank you for replying to me, and I see now, what you're saying.

And yes, it seems everyone's agreeing (more or less) and I'm not sure why we keep goin round in circles*L*

 

[Pure]

Some of the law; some facts

Joe, you are not reminding people that several states do require that a pharmacist fill valid prescriptions or at least make arrangements to transfer. On the issue of contraception, Mr. Noesen, a Catholic pharmacist, took the hard line, that even to help the patient transfer, to tell her of an alternative source, or even tell the prescriber of the problem would make him complicit in evil. He was disciplined and that was upheld in court.

Incidentally the court disposed of Joe's point that refusing the bc pills did not constitute any immediate danger. That is simply not the standard, rather the welfare of the client/patient.

The first is a newsletter article summarizing the case. Next is the actual decision and an excerpt from the Wisc Administrative rules regarding pharmacists.

=====
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=29379

Daily Women's Health Policy
State Politics & Policy |

Wisconsin Pharmacy Board Reprimands, Limits License of Pharmacist Who Refused To Refill Oral Contraceptive Prescription

[Apr 15, 2005]
The Wisconsin Pharmacy Examining Board on Wednesday reprimanded and limited the license of a pharmacist who refused to refill a woman's oral contraceptive prescription because of moral objections to contraception, the Milwaukee Journal Sentinel reports (Forster, Milwaukee Journal Sentinel, 4/13).

Neil Noesen in July 2002 refused to fill university student Amanda Phiede's oral contraceptive prescription while he was working as a substitute pharmacist at a Kmart pharmacy in Menomonie, Wis. When Phiede confirmed that she was using the drug for birth control, Noesen told her that he would not fill the prescription. Phiede then asked him where else she could get the prescription filled, but Noesen refused to provide her with that information.

Phiede later went to a Wal-Mart pharmacy, but when the Wal-Mart pharmacist called Noesen to have the prescription transferred, Noesen refused, saying again that artificial contraception is against his personal beliefs. Noesen continued to refuse to fill the prescription even after two police officers and the Kmart assistant manager spoke with him. The police took no further action, and the managing pharmacist filled Phiede's prescription when he returned to work on Monday (Kaiser Daily Reproductive Health Report, 3/2).

Decision Details

The board voted unanimously to adopt the recommendations of Wisconsin Administrative Law Judge Colleen Baird, who in late February ruled that the state pharmacy board should reprimand and limit Noesen's license, the AP/WCCO.com reports. The adopted recommendations include a provision that in order to retain his license Noesen should have to prepare written notices five days before beginning work at a pharmacy specifying which practices he will not perform and the steps he would take to ensure that customers have access to necessary medications. In addition, the board approved Baird's recommendations to require that Noesen attend six hours of ethics education and pay court costs, which are estimated to be about $20,000 (Richmond, AP/WCCO.com, 4/13).

Ramifications, Next Steps

The decision brought "a measure of resolution to a case that represents a bigger national debate" about pharmacists' rights, the Journal Sentinel reports (Milwaukee Journal Sentinel, 4/13). Board Chair Michael Bettiga said the "prevailing issue" in this case was patient health and safety, adding, "You can exercise your belief, but you have to make sure there's a continuance of care and that patient is taken care of" (AP/WCCO.com, 4/13). According to Bettiga, the decision "strikes a balance between Noesen's right to object and the patient's access to proper care," the Journal Sentinel reports (Milwaukee Journal Sentinel, 4/13). Noesen might appeal the board's ruling in circuit court, but neither Noesen nor his attorneys could be reached for comment, the AP/WCCO.com reports (AP/WCCO.com, 4/13).
=====

Pharmacy Examining Board Decision is at
http://drl.wi.gov/dept/decisions/docs/0405070.htm

STATE OF WISCONSIN
BEFORE THE PHARMACY EXAMINING BOARD
___________________________________________________________________________

IN THE MATTER OF DISCIPLINARY :
PROCEEDINGS AGAINST NEIL T. NOESEN, RPH, RESPONDENT. :
: PROPOSED FINAL DECISION AND ORDER
LS0310091PHM



CONCLUSIONS OF LAW

1. The Pharmacy Examining Board has jurisdiction over this matter pursuant to Wis. Stat. § 450.10.

2. As set forth in the Findings of Fact above, by failing to clearly inform the managing pharmacist that based upon his conscientious objection Respondent would not transfer a prescription for oral contraceptives, Respondent has engaged in practice which constitutes a danger to the health, welfare, or safety of a patient and has practiced in a manner which substantially departs from the standard of care ordinarily exercised by a pharmacist and which harmed or could have harmed a patient, in violation of Wis. Adm. Code § Phar 10.03(2).

3. As set forth in the Findings of Fact above, by failing to provide information to the patient AR regarding her options for obtaining a refill of her prescription which he refused to dispense or transfer, Respondent has engaged in practice which constitutes a danger to the health, welfare, or safety of a patient and has practiced in a manner which substantially departs from the standard of care ordinarily exercised by a pharmacist and which harmed or could have harmed a patient, in violation of Wis. Adm. Code § Phar 10.03(2).
========

Wis. Admin. Code § Phar 10.03(2): Unprofessional conduct. The following, without limitation because of enumeration, are violations of standards of professional conduct and constitute unprofessional conduct in addition to those grounds specified under s. 450.10 (1), Stats.:
. . . .
(3) Engaging in any pharmacy practice which constitutes a danger to the health, welfare, or safety of a patient or public, including but not limited to, practicing in a manner which substantially departs from the standard of care ordinarily exercised by a pharmacist which harmed or could have harmed a patient.

 

[Guest]

 

[Quiet_Cool]

how about this: a pharmacist views a number of people and occupations as rightfully subject to god's punishment in the form of diseases, e.g. prostitutes, but also bikini models, and lifestyle gays.
hence he refuses to sell any antibiotics to such people! according to Joe this is just a businessman's choice, like a restauranter who doesn't like your clothing and refuses to sell you a hamburger.

Um... Joe didn't say that. He said... Well, lots of things. Not one of them touched down on this. Not that I heard. Not even close. We're talking not so close as Pluto is to the sun.


































And I mean the sun of the Andromeda Galaxy. Did I mention that?

But Joe can tell you his viewpoint, because who am I to speak for him?

Speaking for me, myself, your example is giving the "impression" that individuals are being discriminated against for "who they are" bringing us back to the black/white issue, which isn't the case. The case here is what their condition is, and their choice of "treatment" thereof.

Q_C

 

[matriarch]

I believe I make many, many references in my many, many posts as to "professional judgement", yes. I also make references to moral judgements. Notably, a pharmacist who refuses to sell a morning after pill because, in his professional judgement, conception is the beginning of life, is not morally judging so much as preserving life based on the science he professionally judges.

That, in a nutshell, is the basis for a LOT of these problems.

Sorry.
There is only one answer to that response.
CRAP. Utter and total crap.
That is totally and 100% a moral judgement, and nothing you can say will change that.

 

[Guest]

 

[Stella_Omega]

Sorry.
There is only one answer to that response.
CRAP. Utter and total crap.
That is totally and 100% a moral judgement, and nothing you can say will change that.

I was about to post the same objection. I agree with you, Mat- the beginning of life is a speculative, and hence moral stance, not a professional one.

Nothing is a pharmacists' training includes the skills -or the right- to make that judgement.

 

[matriarch]

Pssst. Mats?

You're right, and I had the same reaction. But let's just leave the death spiral, walk over here -------> and have a nice discussion about gardening and sex and cucumber sandwiches. Posting never changed anybody's opinion.

Lilred, I think you're right. I'm with you. I dipped out once before, this time I'm gone for good. I've put up electric wires around the thread so I can't get back in.

Cucumber sandwiches sound wonderful. So very, very English. All we need is a well manicured lawn to sit on, in the shade of a beautiful oak tree.

 

[Guest]

Pssst. Mats?

You're right, and I had the same reaction. But let's just leave the death spiral, walk over here -------> and have a nice discussion about gardening and sex and cucumber sandwiches. Posting never changed anybody's opinion.

Yes, and I had the same reaction.

Question, however? Shall we talk about gardening for cucumbers for sandwiches or gardening for cucumbers for sex?

Because the results are very different.

 

[English Lady]

Joe, just to be on the record -I don't think you said anything so very bad, I may even say, that if someone has that belief -fair enough.

this is where we wind up right back at the beginning where we said it came down to belief, and you can't persecure someone for their beliefs.


Oh,


And QC - I you.