to think that I shouldn't have to swallow my principles to save the NHS money?

(252 Posts)
Tollund Wed 12-Dec-12 10:36:50

I was seen by a practice nurse this morning and prescribed antibiotics for my chest infection. When he wrote the prescription I said that if they were capsules with gelatine in them I couldn't take them and would need the medicine instead. He told me that he didn't know if they did or not and didn't have time to research it, and if I really couldn't bring myself to take them I'd have to ask the pharmacist what they would recommend. I've been here before so I said that they wouldn't prescribe anything and I'd end up having to come back to pick up yet another prescription. He said to go and see what they said but he wouldn't prescribe the medicine as it was more expensive. (I'm guessing he doesn't see a lot of Hindus and not sure how far he'd get suggesting that people should take things containing boiled up connective tissue and bones whether they've spent a lifetime avoiding them or not.)

So I went to the pharmacist and exactly what I had said would happen, happened and I've wasted over an hour trying to get them to liaise amongst themselves so I didn't physically need to run between the surgery and chemist to pick up prescriptions myself. (With a chest infection when it's -2!)

AIBU to think that the practice nurse was being a total arse and that I shouldn't be made to run around wasting time because he "was too busy" and clearly thought I was being stupid for not just taking the gelatine?

Tollund Wed 12-Dec-12 10:38:09

(Sorry, just realised that I hadn't made clear that I'm a lifelong vegetarian and don't take/eat any animal products.)

If its a religious thing (which it looks that way as you mentioned you're Hindu?) then of course yanbu. In fact, even if you weren't religious, he should still be prescribing you things that fit with your moral stance. The doctor was BU but unfortunately, I have no advice on that, but no, YWNBU.

rotavirusrita Wed 12-Dec-12 10:41:44

I was ready to say yabu but actually as its for religious reasons i dontthink u r. Send a letter to your gp practice aking then to add to your notes that u cant have gelatine et. and ask for a new script. I dont think the price difference is huge

MissCellania Wed 12-Dec-12 10:42:07

I understand your principles, but personally I would say that if you don't want the prescribed drugs, there should be a facility for you to pay in full for the ones you do want. If they are a lot more expensive, you should make up the difference yourself. But since I presume that isn't possible, they should haev just given you the presecription to suit you.

squeakytoy Wed 12-Dec-12 10:43:13

I think I would rather be well than stick to my principles to be honest.

Tollund Wed 12-Dec-12 10:43:38

Sorry, I'm not a Hindu but have been a lifelong vegetarian, and I don't really see why there should be a difference; I have many reasons for my choices which are surely as valid (if not more so) than saying that it is for religious reasons?

The antibiotics would have been tested on animals, I don't really see the difference tbh.

You need to make it clear that you are Hindu and can't eat animal products - I would complain if I were you about her sensitivity if you told her and I would get it recorded on your medical notes.

Most capsules use pork gelatine so Jewish people won't use them either and they need to be sensitive to religion here.

JellicleCat Wed 12-Dec-12 10:46:24

YANBU and I would ask for a note to be put on your records as Rota says.

I might also be thinking about a complaint to the practice saying you are being discriminated against on religious grounds, and I am NOT ususually one to use the complaint route at the drop of a hat.

Tollund Wed 12-Dec-12 10:46:40

The difference is that the medicine contains no animal products and the capsules do contain parts of dead animals that cause problems for many groups including Hindus, Muslims, vegetarians and vegans...

blondietinsellyminx Wed 12-Dec-12 10:46:43

Complain to the practice manager, explain you're Hindu and cannot eat gelatine at all and that you explained this to the nurse you saw. You've now had delay to treatment and been sent runnning snout in freezing temps, whilst suffering a chest infection. not only is the nurse's attitude unhelpful and inefficient but also, they're leaving themselves open to possible religious discrimination claims (which would bump up their professional insurance costs somewhat...)

Hope you get suitable antibiotics and feel better soon.

And they can give you a private prescription - my dh is veggie (not for religious reasons) so he would just pay for them himself.

Tollund Wed 12-Dec-12 10:47:59

Sorry - I'm not Hindu! grin

blondietinsellyminx Wed 12-Dec-12 10:48:08

iFail, *about, not snout!

MissCellania Wed 12-Dec-12 10:48:09

Well then if they can do that, they should. Your principles are your own affair and shouldn't be paid for with nhs money.

gordyslovesheep Wed 12-Dec-12 10:48:52

yanbu - hope it gets sorted soon

Tollund Wed 12-Dec-12 10:48:58

But yes, this has never been a problem before when I've said that I can't have gelatine, I've always just been prescribed something else and no one has ever kicked off about the price!

cantspel Wed 12-Dec-12 10:49:16

Just open the capsule remove the medicine and take it and throw the capsule in the bin. Why does everything have to be suck a big deal?

OutragedAtThePriceOfFreddos Wed 12-Dec-12 10:50:06

If you want free medicine when you are ill, then you have to take what you are offered if it will o the job it's required to do.

If you want the luxury of choice, then pay to see a private GP and pay the full price for the medication you want to choose.

You think you shouldn't have to compromise your principles to save the NHS money, I think the NHS shouldn't have to waste money to bow to your principles. They are your choice, so you pay for them.

renaldo Wed 12-Dec-12 10:50:34

YABVU

Yabu. The medicine costs 10 times as much as the capsules, when you could just open the capsules, put content on spoon and leave caps behind.

Tollund Wed 12-Dec-12 10:52:44

cantspel - a lot of medicines aren't effective if you do this.

Thank you blondie and Laurie - I will definitely write a letter to make sure that something goes on my file...

The problem is the price difference can be enormous (£20 versus £200 for example). The price difference is ridiculous clearly, but it may be that the practice nurse doesn't have authorisation to write the more expensive script. Or it may be unlicensed.

DS1 is severely autistic and can't swallow capsules and although I don't tend to give him medication if we wanted, for example, liquid melatonin, it would have to be paediatrician prescribed - whereas we could now get a capsules from the GP.

He should have explained the situation clearly to you though.

AllSnowballsAndNoKnickers Wed 12-Dec-12 10:53:29

What Freddos and cantspel said.

YABU, there are people who are being denied life saving and life prolonging treatments because of cost. It is your choice to be a vegetarian, therefore you should pay the difference between the cost of the medicine offered and the cost of the medicine that you want.

How do you feel about the fact that medicines are tested on animals?

OutragedAtThePriceOfFreddos Wed 12-Dec-12 10:54:36

You are prepared to write a letter but you aren't prepared to pay for your own choices? hmm

Tollund Wed 12-Dec-12 10:55:40

So, to people who are saying IABU - would you still be saying this to me if I was Hindu/Muslim/Jewish etc?

On balance, YANBU. Surely this must be a problem the NHS encounters with increasingly frequency? Could you ask the practice if they have a policy in place?

I think you should have asked for a private prescription, then you will pay the cost price of the drugs.

ViperInTheManger Wed 12-Dec-12 10:57:06

Practices who deal with a lot of Hindus, Muslims, etc are very skilled at what contains what, when to take stuff during Ramadan, etc so the information is out there. Having said that most healthcare professionals only have at their fingertips the information they need most often.

In our practice we do accomodate these kind of requests but surely, if you have had this problem before, you could have found out very easily that with an antibiotic you could just have opened the capsule, tipped the powder inside into a little water and drunk that down? Problem solved.

It sounds like you are all to blame, the practice nurse and the pharmacist for not knowing/volunteering the right info and, to a point, you for wanting to stick to principles but expecting others to do everything for you to do that.

Just out of interest, if the NHS had to pay significantly more for liquid, would you be prepared to pay for your principles?

And yes, I would be saying that for religious reasons too. Just like Muslims lose money on savings accounts because they are not allowed to earn interest.

Tollund Wed 12-Dec-12 10:58:57

Viper I would of course pay for my principles - I do not consume things made from animals and if I have to go without/pay then that's what I do.

If NHS hospitals are prepared to cater to the dietary requirements of vegan/vegetarian inpatients at no additional cost, I can't see a reason not to extend the same principle to medication. I'd ask practice to clarify their policy.

And another example - I don't believe in eating factory farmed meat, so I pay more for my ethical belief.

Tollund Wed 12-Dec-12 11:00:17

Viper but I'm not sure what you mean by me "expecting others to do everything for you to do that". I raised a problem, it was dismissed which has now caused more effort for everyone.

doublecakeplease Wed 12-Dec-12 11:01:16

Could you have paid for the medicine seing as it's more expensive. Appreciate that you have principles but tbh people are being refused cancer drugs because of the cost - depends on extra cost too - few pence v lots more money.

shesariver Wed 12-Dec-12 11:01:22

Why did you say "I'm guessing he doesn't see a lot of Hindus" if youre not Hindu?? confused

I assume you are a vegetarian from a moral viewpoint (apologies if I have that wrong) in which case why is it ok for an animal to suffer to test the medicine but not ok to use and animal by product in it. I'm not being snarky I am genuinely interested in where you draw the line.

Afaik there are types of gelatine that Hindus and Muslims can have (correct me if I'm wrong).

OutragedAtThePriceOfFreddos Wed 12-Dec-12 11:02:25

I woudo still say the same to you if you were Hindu/Mulsim/Jewish, absolutely I would!

No adult in this country is forced into a religion they don't want to be in, we have freedom of choice. If your choice means that you want something that is more expensive, the you have the choice to stand by your principle or take what is on offer to get well.

Your choice, your financial responsibility.

Why did you say "I'm guessing he doesn't see a lot of Hindus" if youre not Hindu??

I think because Hindus may share her concerns about the meds? Could just ad easily substitute that sentence for "guessing he doesn't see a lot of veggies".

OutragedAtThePriceOfFreddos Wed 12-Dec-12 11:04:23

Viper I would of course pay for my principles - I do not consume things made from animals and if I have to go without/pay then that's what I do.

It's not what you're doing here. Why are you saying you are prepared to pay for your principles when you are clearly expecting the NHS to pay for them?

What medicine did you end up with and who paid for it?

Peetle Wed 12-Dec-12 11:07:05

You can open the capsules and take the medication without taking the capsule...

BridgetBidet Wed 12-Dec-12 11:09:29

Have you thought about getting a copy of the British National Formulary? It's a book that has details of all the drugs for UK prescribing in it. I'm not sure if it has details of if drugs are vegetarian or not but you could check if it did.

Actually, if it does it should have been really, really easy for the nurse to check, he should have access to a copy to look it up. I think the nurse should have checked for you TBH, I think he had a bit of an attitude not doing that.

Tollund Wed 12-Dec-12 11:09:36

At the moment I have no drugs at all, and to be honest I wasn't given the option of paying- as I said this has never been a problem before...

SolomanDaisy Wed 12-Dec-12 11:12:11

There's no real reason why the medicine should cost ten times as much, is there? Given that added together the number of vegetarians, vegans, Hindus, Muslims and Jewish people in the UK must make up a very significant portion of the population, the NHS should agree with drugs companies that vegetarian capsules or medicines are standard.

I think the advice to open a capsule is a bit like saying if you take that chicken out of the casserole, it will be vegetarian.

shesariver Wed 12-Dec-12 11:17:31

Yeh I get that pumpkin but in that case why not just say the word veggie then? Mentioning hindus confused the whole story!

It's not necessarily a solution to open the capsule and take the contents. The capsule protects the active ingredients until they reach the right part of your stomach to be absorbed.

The capsules will be produced, not taking them will not stop that.
It is more like saying you can't eat a vegetarian meal if it has touched a jelly baby...

MerryChristmasEverybody Wed 12-Dec-12 11:19:16

It is your choice to be vegetarian, not the NHS. If you want something that will cost more, then its up to you to pay the extra.

I would say the same to anybody who wouldn't take something due to religion, as well. You CHOOSE to be vegetarian, or to follow a religion.

If it was because you were allergic to an ingredient then that would be completely different.

YABVU

beingginger Wed 12-Dec-12 11:20:42

The capsules cost £1.06 the liquid is £1.32 assuming you were getting Amoxicillin, So about the same price.
In future you should ask for Penicillin Tablets (no gelatin).

I would say the same to anybody who wouldn't take something due to religion, as well. You CHOOSE to be vegetarian, or to follow a religion

So should the NHS just tell non meat eating inpatients to suck it up or order in takeaway if they can't/won't eat the standard hospital fare? Hospitals cater to patients dietary choices so why not their medication ones?

Kalisi Wed 12-Dec-12 11:25:36

They should have given you the choice to pay. So in that respect yanbu as they seemed to make no effort towards fixing the issue. It surely can't be the only time that a patient has refused a treatment for something other than medical reasons so the surgery should have a system in place.
On the other hand, the NHS should not have to pay more to respect your principals. I would absolutely say the same to any religious objection seeing that religion is also a choice

Kalisi Wed 12-Dec-12 11:32:13

As for hospital foods, I suppose it depends on the price. Hospitals can probably provide a Veg option for limited fuss and around the same price. If I decided off my own back that I would only eat Organic food for example I doubt they would be so accomodating.

PenelopePipPop Wed 12-Dec-12 11:32:13

On this occasion I'd be in the YANBU camp. Whether he gave you a private or NHS prescription if your stated position is you wouldn't take the gelatin capsules he needed to make a prescription for something you would take. To be fair to him he probably does not realise that pharmacists cannot just fill an NHS prescription with something else instead, i.e. if it says 2 x 250mg tablet but the patient says they are happy taking the 500mg tablets that is no good without a dr's signature. I have had to explain this to my GP umpteen times because one of the more obscure meds I take is actually now quite hard to get hold of in 250mgs. So he may have assumed the pharmacist could sort you out.

And more generally I am not sure the NHS should put it's staff in the position of having to choose between a validly help ethical position and a religious position they will support. Either way if you have a significant objection to consuming gelatin they should prescribe an alternative on an NHS prescription. I would have thought many antibiotics will still come out cheaper than the prescription charge anyway (though poss not liquid suspensions).

I am curious to know what you would do if the only med you could take was available only in gelatin capsule form. I take anti-epilepsy drugs which are only available in gelatin capsules - they have to be so that they are slowly released in the stomach. The only med which works for me is only available in this format. Would you endure seizures rather than consume gelatin?

PeazlyPops Wed 12-Dec-12 11:35:45

YABU. I'm a lifelong, very strict veggie, but even I suck it up and take antibiotics with gelatine.

* Hospitals can probably provide a Veg option for limited fuss and around the same price. If I decided off my own back that I would only eat Organic food for example I doubt they would be so accomodating.*

True, but the fact is they are willing, within reason, to accommodate different dietary requirements. It isn't a case of "one size fits all eat it or starve/buy your own" viz a viz food so its not immediately clear to me why the same policy doesn't extend to meds.

CheeringBell Wed 12-Dec-12 11:39:35

I can't believe your Practice Nurse acting in that way. Very unprofessional and not following the Nursing and Midwifery council code of conduct. It takes a few seconds to look up drugs in the BNF (a book that all prescribers should have) - even quicker on the net. Anyway being a prescriber your nurse should have known that most antibiotics are available as a suspension (i.e. in liquid form). The suspensions are not expensive - a bottle of Amoxicillin, a common antibiotic used for chest infections, costs £1.30!

If you feel like complaining and don't feel able to approach the Practice Manager then maybe the Patient Liaison Service (Pals) can help as they can advocate for you. http://www.pals.nhs.uk

Good luck with getting your medicine and I hope you feel better soon.

Ephiny Wed 12-Dec-12 11:47:08

I am vegetarian too, I wouldn't for example eat a dessert with gelatine in. But when it comes to essential medication like antibiotics, I would put my health before my distaste for animal products.

But for those saying the OP should pay the difference/pay for the medication -- as far as I know the NHS doesn't work like that, you can't 'top up' your care. She could of course go fully private if there's a private GP in the area, though the consultation would be quite expensive. Or can NHS GPs give private prescriptions? (this sounds like the ideal solution if so).

FredFredGeorge Wed 12-Dec-12 11:47:39

YANBU - the prescribing individual and pharmacist should have comfortably met your needs for gelatin free medicine in this case. As noted most common generic drugs are freely available in either non-gelatin capsule or suspension form at minimal or no extra cost.

YWBU if there was a significant cost difference that you would not meet, but in the case of a basic anti-biotic it's unreasonable for the practice nurse to force another appointment to resolve it.

trueblood1fan Wed 12-Dec-12 11:57:05

im vegan but as the nhs are funding mine/your drugs i also suck it & take what im given & am bloody grateful. yabvu, pay if you want special treatment.

CheeringBell Wed 12-Dec-12 12:02:31

I don't get the argument that it's the OP's choice so she has to pay or put up with it. What about those people who's choice it is to smoke, eat poor diets, drink to excess? Should the NHS not treat them too?

trueblood1fan Wed 12-Dec-12 12:06:19

alot of posters probably do think smokers shoud pay for treatment rather than the nhs BUT have you seen the amount of tax smokers pay in? op wants more expensive drugs for free on the nhs, suck it up & pay :-)

samandi Wed 12-Dec-12 12:12:06

I'm not sure why some people think different rules should apply because of "religious reasons". Personally I think if you're happy to take medicines which have been tested on animals then it's not much of a step further (if any) to take medicines containing animal products.

Does anyone else remember the case about 10 years ago where, if memory serves me, the NHS was doling out standard issue (ie, WHITE) prosthetic limbs to ethnic minorities?

Seem to recall those who protested getting told to suck it up or pay for "more ethnic" models themselves if they as a black person had some objection to wearing a white prosthetic.

CheeringBell Wed 12-Dec-12 12:17:33

trueblood1fan > But her prescription charge would most likely cover the cost of an antibiotic in liquid form..

My main concern is that the nurse didn't seem to know what to do and didn't check with someone who did. It's not like antibiotics are uncommon drugs to prescribe. What if that same nurse was prescribing to an child or someone who couldn't swallow solids safely? Should they go without too? Any delay in treatment is a cause of concern. If the infection were to get worse then the costs would be much more that an extra 30p or whatever...hospital stay, IV antibiotics......

samandi Wed 12-Dec-12 12:17:38

I don't get the argument that it's the OP's choice so she has to pay or put up with it. What about those people who's choice it is to smoke, eat poor diets, drink to excess? Should the NHS not treat them too?

It's two different scenarios. In this case the OP would be refusing treatment.

The practice nurse does sound a bit dim though, and I can't see why he couldn't prescribe a non gelatine alternative if it's readily available and not much more expensive.

TheCraicDealer Wed 12-Dec-12 12:18:11

The argument about obese people or smokers doesn't really apply. There's a difference between refusing to treat someone altogether and being reluctant to prescribe a more expensive drug (that works only as well as the more cost-effective version) because the patient fancies it.

Personally I think that if you're going to get all finger-wavy about it you should do your research and realise decanting the powder from the capsule isn't going to impact the effectiveness in this instance. But I suspect the OP is trying to limit not only her intake of animal products, but also her complicit support of their use by accepting products that include gelatine.

sashh Wed 12-Dec-12 12:20:06

OP

I would probably have phoned the pharmacy from the doctor's office but you are right, you should complain.

The nurse didn't know so should have checked. The same if you had an allergy.

All surgeries have a copy of the BNF and it is also available online so easy to check for interactions, but I don't think it lists ingredients, you would need the information sheet for that.

Casserole Wed 12-Dec-12 12:21:15

Do you pay for your prescriptions OP?
If so, she is already overpaying for either option. The meds, as has been said, are about 20p different in cost. And the prescription charge is about 4 times the cost of either!

I think you should have been given the choice.

samandi Wed 12-Dec-12 12:21:39

So, to people who are saying IABU - would you still be saying this to me if I was Hindu/Muslim/Jewish etc?

I would say exactly the same. Religious beliefs should not be some kind of magical reason for getting exemptions or special treatment, and it irritates me when they are. Actually I might be more disparaging of those wanting special treatment for "religious reasons", especially if they can't justify exactly why they feel they should have it.

Tollund Wed 12-Dec-12 12:22:48

Ok, sorry, I've been a bit distracted this morning as am still at work so haven't been quite as clear as I could have been! (But many thanks to PumpkinPositive for still getting where I was coming from anyway!) In my OP I wasn't clear and clearly my brain was working faster than my typing fingers - when I said about him not seeing many Hindus I meant that as an example - I now live somewhere very non-diverse where everyone is white CofE, so perhaps he's just not very clued up, as when I lived in a city where there was much more diversity I have never had this problem! But obviously I didn't explain that properly so apologies if that was misleading.

Why I posted this is because I have never in all my adult life come across this before - I've always been prescribed something suitable without being made to feel like an idiot for having the convictions that I do, and not once has anyone said to me that prescribing me alternative tablets/liquid costs more or is a pain in the arse.

I do find it genuinely interesting that some people think that it would be ok if I was, say Jewish, but not if I choose to be vegetarian. I think that we live in a society that accommodates diversity of belief - there are vegetarian alternatives which may or may not be more expensive, but at what point do we start getting out the calculators and saying what people are entitled to? I think CheeringBell makes a very good point:

"I don't get the argument that it's the OP's choice so she has to pay or put up with it. What about those people who's choice it is to smoke, eat poor diets, drink to excess? Should the NHS not treat them too?"

I'm otherwise healthy and don't make decisions that mean that I end up taking more out of the system than anyone else, arguably I have used much less of the NHS's resources than many - it just all feels a bit churlish.

And to people who say that they are strict vegetarians/vegans and yet still swallow animals' connective tissues without finding out whether there are alternatives available, well you're not really that strict, are you? wink

samandi Wed 12-Dec-12 12:29:10

Why I posted this is because I have never in all my adult life come across this before - I've always been prescribed something suitable without being made to feel like an idiot for having the convictions that I do

if I really couldn't bring myself to take them I'd have to ask the pharmacist what they would recommend. I've been here before so I said that they wouldn't prescribe anything and I'd end up having to come back to pick up yet another prescription.

Is this the first time it's happened then, or has it happened before?

I do find it genuinely interesting that some people think that it would be ok if I was, say Jewish,

Who said that? Have only skimmed but by far most people are saying it wouldn't make a difference.

You haven't answered the query about testing medicines on animals either.

trueblood1fan Wed 12-Dec-12 12:29:31

op you say you work so i presume you pay? then you should be given a choice.

samandi Wed 12-Dec-12 12:29:49

And to people who say that they are strict vegetarians/vegans and yet still swallow animals' connective tissues without finding out whether there are alternatives available, well you're not really that strict, are you

Perhaps not so precious.

quietlysuggests Wed 12-Dec-12 12:30:03

I dont eat bugs but if you told me my medicine contained a small amount of bug protein it would disgust me and i

Sirzy Wed 12-Dec-12 12:30:48

I'm pleased to see some sensible vegetarians on here who put their health first.

If you aren't happy with the medication being provided then you should pay for an alternative yourself.

quietlysuggests Wed 12-Dec-12 12:31:52

oops, anyway, I was saying I would wash the antibiotics down even if they contained some small amount of something I did not wish to eat.

So I am saying, why the big fuss over small amounts of something you dont normally eat?

I really dont get it.

CatPussRoastingOnAnOpenFire Wed 12-Dec-12 12:32:42

YABU. Why should the NHS pay for your private preference. If you want the alternative, you should pay the difference.
Vegetarianism is your choice. By demanding the more expensive drug you are taking money from the NHS for no other reason than your lifestyle choice. I would say the same thing to someone with religious reasons too. The Nhs isn't there to cater for your personal choices. You want something different, you pay.

maddening Wed 12-Dec-12 12:34:40

You can buy empty caplets - so you could empty the contents of the capsules into one of those?

I know you put a wink at the end but having a bash at other vegetarians is silly.

samandi Wed 12-Dec-12 12:38:13

Ah, sorry I see some posters have replied that yes it would definitely be unreasonable if on religious grounds and also that you answered the animal testing query with this:

The difference is that the medicine contains no animal products

So why are you a vegetarian? You can't stand eating animal products even in medicines. But you're ok with them suffering to provide medicines. That makes no sense to me but I'm sure you have your reasons.

RedToothbrush Wed 12-Dec-12 12:40:23

I'll be honest, in saying I'm best described as a rabid 'Bacon Butty Taunter' when it comes to veggies.

BUT I'm with the OP on this one.

Why? Not because she should have the right to alternative treatment, but because concerns over the contents of medications should be taken seriously even if the HCP thinks its a waste of time or money.

They should either reassure the patient OR satisfy the patient that its the best option available to them OR give them an alternative solution OR suggest an alternative and where they can source this from if its not available on the NHS (could be simply suggesting going private rather than anything more than that). Not to simply take a snotty attitude about it, which this sounds like.

This isn't so much about rights, but respecting patients without judgment and making sure that they are happy about the medication and treatment they have been given and if they aren't seeking to properly explain things. This is basic decency and bedside manner.

More worryingly, the practice nurse should be aware of the contents of drugs they are prescribing, especially if they have the potential to be something that could cause sensitivity to certain groups - which does include for religious reasons AND for common dietary preferences like being veggie - so that the patient can give educated consent about their medication. A lack of knowledge about what they are prescribing and an unwillingness to check something when asked because 'they are too busy' is never excusable. That type of attitude is the type of attitude that leds to someone getting sued or worse still harming someone when they make a mistake.

No one should EVER, EVER be made to feel a nuisance or shitty for questioning their medication for whatever reason.

ENormaSnob Wed 12-Dec-12 12:42:32

Yabu

Wingedharpy Wed 12-Dec-12 12:43:48

It sounds to me as if the practice Nurse was out of his depth ie. had no idea what the issue was.
Instead of sorting it out with you properly, which in his mind may have made him feel he'd lost face, he tried to pass the buck on to the Pharmacist.
Things like this often happen when the member of staff concerned is relatively inexperienced, ignorant of all the facts or bone idle.
Some (but by no means all) NHS staff feel very uncomfortable when dealing with a knowledgable patient.
He'll never expand his knowledge if he never has time to research things and a Nurse who simply ploughs on regardless rather than taking a moment or two to find something out is potentially a very dangerous Practitioner IMHO.
I don't think your request was unreasonable and he should have made an effort to meet your request.
I would write to the Practice Manager outlining your experience today and leave them to deal with it.

knittedslippersx3 Wed 12-Dec-12 12:45:52

What does the doctor normally prescribe? I'm confused, in your posts you say it hasn't happened before but in your op you say "I've been here before".

Tollund Wed 12-Dec-12 12:46:29

Thank you RedToothbrush.

samandi I'm not ok with animals suffering, so you're making some assumptions there because I just can't be arsed to get into a hypothetical philosophical debate with someone whose motives are to deconstruct my beliefs.

whois Wed 12-Dec-12 12:46:48

I take issue with the posts that say "oh, seeing because it was for religious reasons then YANBU"

What? So someone who chooses not to eat meant for religious reasons is more entitled to that and more valid than someoe who chooses not to eat meat for other (ethical?) non religious reasons?

Thats bull.

Either everyone who doesn't want gelatin casuals is U, or no one is.

Personally I think OP should suck it up or pay for a private prescription, the NHS is a 'one size fits all' type of organisation and can't bend to accommodate everything. Although really the GP should have just perceived the liquid.

samandi Wed 12-Dec-12 12:49:22

What is hypothetical about it? And what's wrong with wanting to deconstruct (in the sense of analysing) your beliefs?

CatPussRoastingOnAnOpenFire Wed 12-Dec-12 12:49:48

Wouldn't the BNF list the ingredients of a medication? Isn't that what it's for? Surely every practitioner would have a copy?

Tollund Wed 12-Dec-12 12:49:59

knittedslippers - sorry, again I wasn't clear! I had this problem last time I had something prescribed where I live now, but prior to that, when living in a city this was just never a problem.

I will write a letter as like WingedHarpy and RedToothbrush said, it's really not acceptable from an HCP.

samandi Wed 12-Dec-12 12:50:48

Particularly when the title was "Am I being unreasonable to think I shouldn't have to swallow my principles" ... any answer to that question really needs an understanding of those principles in the first place.

Tollund Wed 12-Dec-12 12:51:12

samandi believe me, I deconstruct them on a very regular basis but that wasn't what this thread was for.

Tollund Wed 12-Dec-12 12:53:12

And yes, maybe I should have posted this in philosophy or somewhere similar...

FredFredGeorge Wed 12-Dec-12 13:01:22

whois I'm pretty sure every single NHS authority will have a policy supporting the prescribing of non-gelatine medicine and more importantly informing of their patients about the contents of medicines. The practice nurse was failing in their basic duty of care to their patient.

RSVPforChristmaslunch Wed 12-Dec-12 13:03:48

YABU

Sirzy Wed 12-Dec-12 13:04:16

When someone has a medical reason to not be able to take something then in my experience staff are very good at ensuring medication is safe.

When someone wants something special for non medical reasons then they shouldn't expect the NHS to provide that. If it means so much to the OP she should make sure she knows which medications are "safe" and which aren't

Tollund Wed 12-Dec-12 13:07:18

Seriously Sirzy. Even though in some instances there might be no price difference whatsoever? And the fact that I asked him to confirm that an ingredient was present and he refused to check is fine with you?

Sirzy Wed 12-Dec-12 13:12:08

Yes. Taking them won't make you ill. It is your choice so if you want an alternative you shouldn't expect the nhS to provide it.

FredFredGeorge Wed 12-Dec-12 13:16:51

Sirzy So you don't believe at all in the need for consent in what medical procedures and drugs you take - you believe it's wholely the responsibility of the prescriber what you take and they do not have to provide you even with the information of what you're taking?

FelicityWasSanta Wed 12-Dec-12 13:21:39

OP I am shock at the reaction you are getting in this thread.

As a eat-anything- tax paying-occasional user of the NHS I wholeheartedly support your point.

Of course they should have provided you with the vegetarian alternative. Just as they would have done if you were admitted and needed food. Speak to the practice manager- they are in the wrong!

RedToothbrush Wed 12-Dec-12 13:22:08

Tollund, I'll be in honest in saying that the very thing I get most frustrated about vegetarians is selective or competitive ethics and I do think you are a little guilty of this with what you have posted in this thread.

I think you do need to be more aware just how many drugs are tested on animals and be realistic about it than perhaps you are from your posts. However I do agree that I think its important that you should know whats in the medication if it worries you.

You need to be able make an informed decision and so you can take medication you feel as happy as possible with if this is such a strong concern of yours. You may ultimately may have a stark choice of refusing medication or compromising your ethics, but you should be in a position to make that the decision about where you think the line in the sand for you is, and be as comfortable as possible when you do that. Its not up to anyone else to draw that line. Only you can do that.

I don't think thats trivial or petty like others are suggesting. And in this case I don't think your request was an 'out-there' request which isn't easily accommodated. Being vegetarian or vegan is pretty common and these type of question are ones that you won't have been the first, nor the last, to raise. We are all different and certain things are a lot more important to some people and not to others especially when it comes to our health. The NHS is great, but it shouldn't be a conveyer belt or machine that treats patients are something to be processed not listened to, even when there are the financial concerns, there are at the moment. Good health is about emotional wellbeing being part of the package of physical health and shouldn't be overlooked.

I think this is about addressing patient concerns effectively and properly. Afterall, if its going to haunt you and plague you with guilt or you feel forced to have a drug its not a productive outcome.

Its also particularly of note, you are talking about anti-biotics which have particularly characteristics as drugs. If you are given them, you need to be taken for the full length of the course otherwise it has the potential to stop the drugs being as effective in future - which is a potential harmful problem. If you are uncomfortable for whatever reason taking the drugs, you are far more likely not to complete the course; that has implications for your health and potentially for other people's health.

People might not agree with your moral stance on the limits of your vegetarianism. As I've said, I don't particularly. I don't think you have necessarily have a right to other drugs on the NHS, but I do think you have a right to be fully informed and properly reassured to the best ability of the HCP treating you so that you can make decisions about your health that you are happy with.

madmouse Wed 12-Dec-12 13:22:08

I think YABU. I sympathise with your principles, but we have a limited amount of money going round on the NHS and if you want something that is significantly more expensive for a non-medical reason you should not feel you are entitled to it for free.

It is medication which you need to get well which in my view exempts it from any religious discussion as taking it should not be held against you.

FelicityWasSanta Wed 12-Dec-12 13:30:24

But madmouse- the price difference in this case is less than 30p and the OP pays the prescription charge which is significantly higher than the cost of the drug.

I don't see why the OP should have to accept medication containing animal products any more than I think a veggie/Hindu should have to eat meat during a hospital stay or a black person should have to wear a white prosthetic limb.

But madmouse- the price difference in this case is less than 30p and the OP pays the prescription charge which is significantly higher than the cost of the drug.

Plus there's unlikely to be a stampede by the rest of the population for the fractionally more expensive gelatine free medication.

squeakytoy Wed 12-Dec-12 13:35:48

But it is a miniscule amount of animal by-product. And it is incomparable to the doctor suggesting the OP go away and eat a few lamb chops or saying that muslims in hospital should have no choice but to eat pork dishes.

During the course of our lifetime we will have eaten quite a few bugs and flies, probably more animal product there than in a few anti-biotics.

TheCraicDealer Wed 12-Dec-12 13:36:36

It may only have been 30p in this instance, but where do you draw the line once the precedence has been set? £30? £3000? And that's before you look into the implications of keeping higher levels of one drug available as opposed to another option, which may have a longer shelf life and reduce wastage.

freddiefrog Wed 12-Dec-12 13:42:02

YABU

I do understand where you're coming from but I think you need your own money where your mouth

The NHS doesn't have an endless pot of money, they provide the most suitable medication that does the best job for the least amount of money

FelicityWasSanta Wed 12-Dec-12 13:45:52

It may only have been 30p in this instance, but where do you draw the line once the precedence has been set? £30? £3000? And that's before you look into the implications of keeping higher levels of one drug available as opposed to another option, which may have a longer shelf life and reduce wastage.

Where to draw a line is an interesting argument. Possibly one best had by HCPs and not us!

If the cost was prohibitive then steps should be taken to alleviate the burden on the NHS - perhaps part payment could be considered.

However treating the OPs concerns as unimportant, trivial or a waste of time are not the way to deal with these issues.

And in this case the liquid form is routinely kept for children. So it's not too much of a stretch to extend that to vegetarians as well.

madmouse Wed 12-Dec-12 13:51:21

I do not accept that it is the same as suggestions that she should eat meat in hospital. This is a precision prepared medical product that is not taken by choice or to eat while there are easy alternatives available. You should only be prescribes ABs if you have an infection that will not get better by itself. And therefore the ABs are necessary, not at all the same as a choice between chickpeas and lamb chops.

And indeed Craig where does one draw the line. My newborn ds had special alcohol free anti convulsants prescribed after I worked out aghast that the meds they were giving him contained as much alcohol as a half pint of beer A DAY. They agreed it was bad for his liver and his already damaged brain. The cost? £175 a WEEK (normal meds £30 a month) and that is 5 years ago. Thankfully only for 4 months. It can be done, if needed, but we simply cannot afford to give everyone a choice and I believe alternatives should only be offered on a medical need basis. I would not have expected alcohol free meds on a religious basis (and I am very religious).

CatPussRoastingOnAnOpenFire Wed 12-Dec-12 14:01:33

Say there are 4 million veggies in this country. If they all, just once a year, asked for 30p more expensive meds, that's over a million pounds that the NHS could spend elsewhere. Combine the veggies with the people with religious viewpoints to consider, and any other non medical viewpoint come to that, and those whose requested meds cost more that 30pence extra, then this small issue could cost the health service a LOT of money. Where DO you draw the line?

LeBFG Wed 12-Dec-12 14:04:22

Having a meal choice in hosptial is important because people frequently undereat at hospital. Patients are encouraged to eat as much as they are given and not waste meals. So it seems sensible and cost-saving to provide meat-free alternatives.

Eating medication is clearly not comparable. We don't gain anything significantly nutritive from the pills we take.

Should the NHS be providing alternatives to those with religeous objections? My instinct is to say no as I'm pretty anti-religion to be frank. Though I appreciate that many, even a majority, would say yes this is acceptable. Is this the same as allowing for ethical choices? Not in the book of most people. People's ethics and religion do not carry the same weight. Religious brigade would have us believe they have no choice - it's their religion, they have to follow it. I think it's this distain for OP's ethical choice that explains the nurse's behaviour.

My opinion (fwiw) is that OP is BU because she is a hypocrite. If animal rights were so important to her as the gelatin incident seems to imply, she shouldn't be taking antibiotics. Perhaps one day all capsules will be made veggie - I don't care really. I think you accept the bog-standard, what's available now and swallow quickly (this is not the same as wearing a prosthetic leg of the wrong colour btw - how silly to trivalise one by comparing with the other!).

FelicityWasSanta Wed 12-Dec-12 14:05:51

If the 4million veggies did demand this medication one would assume that the NHS order with the drug company would go up to the extent that a better deal could be negotiated and the cost of the medication would go down.

CatPussRoastingOnAnOpenFire Wed 12-Dec-12 14:13:01

I never said "this medication" I said "30pence more expensive meds" actually!

RedToothbrush Wed 12-Dec-12 14:13:02

If its an issue of cost, then there needs to be options to allow people to choose though still. The NHS dominates things so much, it acts as a barrier to allow people to 'top up' if they want. As things stand the OP wasn't told that the drug was not veggie friendly. She wasn't told anything because of arsey nurse. And if the NHS can't afford something then people should be told the real reasons why, not phobed of so that they can make a decision to seek a viable alternative elsewhere if they want.

In terms of cost, there are a lot of drugs which maybe suitable for a particular use. I do think its fine to prescribe the cheapest one if its the most cost effective one. But cost effective is a funny little phrase. Cost effective can mean using a drug that costs more but has fewer side effects or is less likely to taken incorrectly. NICE will generally approve the cost effectiveness of a drug based on a wide range of factors, not just the price tag.

And as I mentioned upthread, if giving anti-biotics to an unhappy veggie means they are less likely to complete the course then perhaps its not actually the most cost effective treatment.

this is not the same as wearing a prosthetic leg of the wrong colour btw - how silly to trivalise one by comparing with the other!).

Why? People were saying the OP should accept standard issue medication and to pay for the meds herself if she was unwilling to accept standard issue. I recall the very same argument was put forward to justify giving standard issue prosthetics on the NHS irrespective of the patients ethnicity. Management within the health service were using the very same arguments viz a viz the prosthetics that are being applied here.

Kalisi Wed 12-Dec-12 14:19:06

Ethnicity is not a choice. For that analogy to be fair, the standard issue prosthetic limbs should have been green or something and NOT in favour of white skin colour, therefore discriminating against other ethnicitys. Two very different ethical scenarios.

LeBFG Wed 12-Dec-12 14:24:14

Doesn't matter if the argument was the same Pumkin. Wearing something visibly ridiculous that impacts on self-confidence, self-esteem and a host of things aside means people were perfectly entitled to refuse standard issue (and the powers-that-be, totally ridiculous for suggesting they had to just accept it). Not wanting to ingest a few milligrams of gelatin is not even in the same league - they are so different you can't compare them.

madmouse Wed 12-Dec-12 14:26:24

I'm with LBFG on this one

(and that's rare!)

FelicityWasSanta Wed 12-Dec-12 14:29:50

I agree redtoothbrush

And I would go as far as to say the people that don't agree are coming across as very disrespectful towards vegetarians and their choices.

Ethnicity is not a choice. For that analogy to be fair, the standard issue prosthetic limbs should have been green or something and NOT in favour of white skin colour, therefore discriminating against other ethnicitys. Two very different ethical scenarios.

Ethnicity is not a choice, the choice lay in whether or not to wear the prosthetic. Ethnic minority amputees felt (rightly) they should not have to use something that was going to flag up fairly quickly they were an amputee. NHS policy apparently was "tough cheese, this is how prosthetics are standardly manufactured, we're not going to make accommodations for anyone. Take it or leave it." Technically they were right, BMEs could have worn the white prosthetics. But was it reasonable to expect this? (No)

I think the policy changed in the end. Obviously they are not directly comparable because one involves ethnicity and the other ethics/religious belief. My point was that the NHS doesn't expect patients to just suck it up and accept standard issue in all cases. It makes accommodations in the case of prosthetics (due to something the patient has no choice in, their ethnicity) and vegetarian dietary requirements (something the patient does have a choice in).

As such, and particularly in the case of hospital food, if the NHS is prepared to accommodate patients in this way, I think OP has a case for gelatine free meds.

LeBFG Wed 12-Dec-12 14:32:00

I think the thing that grates is most people want things personalised. Medical courses that suit one and one's lifestyle. But unless we go private, we just have to take what we're given. I think people object to people demanding a choice just because.

I eat meat but not beef so I don't want the pills made with beef gelatin....I find the flavour a bit sickening, I want it in chocolate....I'm on a caffeine cut-down, I want ones without caffeine....

These sorts of things seem so trivial (esp when compared to real health issues) that when some sub-groups try and get their way it can grate on the rest of us, even if in theory it would be relatively easy to provide for.

madmouse Wed 12-Dec-12 14:32:30

Really Felicity?

Wearing something visibly ridiculous that impacts on self-confidence, self-esteem and a host of things aside means people were perfectly entitled to refuse standard issue (and the powers-that-be, totally ridiculous for suggesting they had to just accept it)

Agreed. But many vegetarians (whether for religious or ethical reasons) are so strongly opposed to meat eating that ingesting something containing even minuscule particles of animal product could conceivably have a profound impact on their self esteem and well being.

If you are of the view that meat is murder, that eating an animal is just as bad as eating a human being, I suspect the amount of animal trace in the product will be academic.

KenLeeeeeeeInnaSantaHat Wed 12-Dec-12 14:37:41

Ok, firstly I hate this idea that the NHS is "free". It isn't free, we all pay for it through taxes and NI contributions. That NHS provides a framework for everyone to receive the appropriate treatment for their condition - and that ought to (IMO) encompass religious restriction, moral preferences, intolerances and allergies indiscriminately.

So on that basis, I think YANBU.

Sirzy Wed 12-Dec-12 14:37:55

The NHS is struggling. They in a lot of cases can't afford to prescribe the best course of drugs when it is needed. They certainly can't afford to prescribe different drugs because they may have a tiny amount of gelatine in.

If the op wants a different drug fine, but don't expect the NHS to provide it.

Sallyingforth Wed 12-Dec-12 14:42:43

Many medicines and antibiotics are prepared using animal byproducts. If you are strictly vegetarian then you will need to analyse not just the coating but the production process as well.
Where do you draw the line?

Tollund Wed 12-Dec-12 14:47:25

It's not really a case of saying "I'll have pork gelatine but not beef" though, is it?

I'm sure each vegetarian has their own reasons for going vegetarian but in my case I was born into it. Then for a period of time from when I was 6 I was brought up by someone who was not my mother who would physically force me to eat meat. I was bullied and terrorised into swallowing parts of dead animals, which was a totally new experience for me, and then I was punished for "making myself sick" when I couldn't physically keep it down.

So yes, as I got older (and the abuse of that kind stopped) I went back to vegetarianism again and have never since eaten any kind of animal product. This is partly due to my concerns over welfare etc, but also because I don't like the thought of having to incorporate the dead flesh or matter of a previously sentient creature into myself, and certainly not against my will. So perhaps it sounds fucked up, or "precious" but I have some fairly big issues around being forced to consume parts of dead creatures, no matter how minimal the parts seem to someone who can't relate to where I'm coming from.

LeBFG Wed 12-Dec-12 14:48:08

Nah felicity, plenty of veggies on here have already said OP is BU. I was a long-standing veggie and have my family still are. We all take the standard issue pills though smile.

Sorry Pumpkin, I can't agree: It makes accommodations in the case of prosthetics (due to something the patient has no choice in, their ethnicity) and vegetarian dietary requirements (something the patient does have a choice in). As I've said, hospitals have to provide people with veggie options, they have a hard enough time enticing us to eat their food at the best of times grin. Making a veggie eat a steak is, I reckon in most people's books, an outrageous thing (like giving sprouts everyday to someone who hates sprouts).

I've had good friends who were on the extreme end of meat-is-murder etc. To them, a vegetarian, even a strict one, was still hypocritical position. If meat is murder, so is eating milk products (calves made and slain to make milk) and a host of other things veggies still eat (this was in the end why I started eating meat again - you really rather have to be a vegan if you follow this path...and I couldn't contemplate life without chocolate). So, really, the milligram of gelatin is no big deal. Many veggies probably eat this quantity most days without realising it.

Tollund Wed 12-Dec-12 14:49:10

"If you are of the view that meat is murder, that eating an animal is just as bad as eating a human being, I suspect the amount of animal trace in the product will be academic."

yy, Pumpkin.

RedToothbrush Wed 12-Dec-12 14:52:01

Sorry, but the NHS is struggling is the crappest argument going.

can be applied as an excuse for anything eg:
You don't NEED pain relief in childbirth. We can't afford to fund it on the NHS. If the op wants pain relief fine, but don't expect the NHS to provide it.

Trouble is, that its not that simple in the slightest, and all these cuts in the NHS are being made on purchase price and not on the basis of holistic care and long term care.

One of the major foundations of this is treating people with respect and in a non-judgmental way.

Studies have shown that there are differences in recovery time between patients who are happy and satisfied with care and those who are unhappy that can not be reasonably explained purely by the physical medical attention they receive.

Its something we really, really shouldn't be loosing sight of in debates about the NHS and funding.

It should be about spending a pound well, not spending as few as possible.

Tollund Wed 12-Dec-12 14:52:32

"Many veggies probably eat this quantity most days without realising it." Eh? And I can assure you that I don't! smile

specialsubject Wed 12-Dec-12 14:55:11

the medication will probably have been tested on animals. So if you are THAT principled, don't take it.

I hope you also don't use cosmetics, don't wear wool or leather and all the other things that go with stringent no harm to animals.

the disabled boy who can't swallow capsules has a case. You do not, go pay for private medicine.

(ill husband waiting ages for NHS treatment due to funding issues - and I won't be alone in this). angry

As I've said, hospitals have to provide people with veggie options, they have a hard enough time enticing us to eat their food at the best of times.

By the same token, wouldn't they have just as hard a time getting a vegan to ingest a medication containing a (murdered) animal? I'm having a hard time seeing the difference.

I don't think it's the amount of animal in the product that makes a difference to a veggie/vegan, it's the fact animal is in there at all.

you really rather have to be a vegan if you follow this path...

It's for this reason all my attempts at vegetarianism have ended in disaster.

honeytea Wed 12-Dec-12 15:01:51

Tollund why do you take medicine that has been most probably at some point tested on animals? If your that strict and against the suffering of animals surely you should only ever use prodects that have caused no suffering to any animals. I am sure that the animals used to test the safety of the drugs had more pain caused to them than the cow who was killed for meat anyway.

I assume if you developed diabeties you would refuse to take insulin as it is derived from animals? How far do you take your own values? If it is for your own health you are willing to use medicine that has caused animal suffering but if it is to save the (very stretched) NHS money you are not willing to take the medicine.

IneedAsockamnesty Wed 12-Dec-12 15:03:56

Never thought I would ever do this outragedbythepriceoffreddos

But

*If you want free medicine when you are ill, then you have to take what you are offered if it will o the job it's required to do.

If you want the luxury of choice, then pay to see a private GP and pay the full price for the medication you want to choose.

You think you shouldn't have to compromise your principles to save the NHS money, I think the NHS shouldn't have to waste money to bow to your principles. They are your choice, so you pay for them.*

Exactly what she said.

Sorry, but the NHS is struggling is the crappest argument going.

No, I'm sure I saw someone saying veggies don't have a leg to stand on because they must (unwittingly) ingest a few insects here and there.

Or maybe I dreamt that. confused

Tollund Wed 12-Dec-12 15:06:09

ffs - please read what I wrote at 14:47:25 for an explanation of my aversion to dead things.

I have no idea how far I would take my own values in real terms as fortunately it's never been tested...

PenelopePipPop Wed 12-Dec-12 15:07:10

I am still intrigued and would like to know at what point you would be prepared to set aside your principles in order to achieve the benefits the drugs can offer. As I said the drugs I take are only available as gelatin caps - and they are the only meds which work for me. What call would you take in my position (given the parameter that uncontrolled epilepsy is obviously fucking horrible)?

I don't think it is wholly irrelevant to your original question. I completely agree with you on your original point: Where a readily available and inexpensive alternative consistent with your ethical position can be provided it should. But there will be lots and lots of situations where this does not happen - where there is no readily available and inexpensive alternative on offer. What do you do then?

honeytea Wed 12-Dec-12 15:07:29

I have no idea how far I would take my own values in real terms as fortunately it's never been tested...

it has been tested, you are willing to ingest medicine that has caused suffering to animals because it will make you feel better.

Tollund Wed 12-Dec-12 15:08:04

"If you want free medicine when you are ill" - I fricking pay £7 something for medicine that costs roughly a quid, how am I not paying?

LeBFG Wed 12-Dec-12 15:08:29

Ah, pumpkin, but what about the animal that didn't get in there? Those animals that died to produce the drug...

Tollund, what is a bigger deal to you - promoting the meat industry indirectly by eating diary products or eating a milligram of gelatin?

honeytea Wed 12-Dec-12 15:10:33

Doesn't milk have all sorts of puss and blood in it? Drinking milk you are probably ingesting more cow body than the gelitine in a pill.

Tollund Wed 12-Dec-12 15:12:20

I have no idea what I would do in an assortment of made up hypothetical instances and I overthink enough as it is so am not going to spend hours agonising about that. I do what I can to have a minimal impact within reasonable bounds, and to be honest I don't think that wanting a medicine that is readily available and prescribed and just happens to cost 20p more and doesn't contain dead things is a cardinal sin.

Tollund Wed 12-Dec-12 15:14:54

honeytea - you're talking bollocks (and making assumptions, as fwiw I don't actually drink milk either.)

Right, thanks for all the feedback but I think I'll bow out and take my chest infection to bed. Thanks to pumpkin, Redtoothbrush and others. smile

You think you shouldn't have to compromise your principles to save the NHS money, I think the NHS shouldn't have to waste money to bow to your principles. They are your choice, so you pay for them.

The thing is though, the NHS is willing to "waste" money pandering to its doctors principles.

Cue my friend's sister, who moved to a new area and signed up with a GP. Off she goes to renew her prescription for roaccutane only to be told by GP that due to her principles, she will not be renewing the prescription for the only medication that worked for this woman. Why? Because doctors were obliged to put women of child bearing act on the pill if they prescribe roaccutane, and this doctor had religious objections to the pill. Didn't matter that friend's sister wasn't sexually active, she couldn't get her meds.

So that was a total waste of one appointment, without even taking into account the amount of annual waste of NHS resource by having a GP in a practice who will no under any circumstance prescribe the pill for her patients.

And yet the NHS employed her.

RedToothbrush Wed 12-Dec-12 15:18:54

LeBFG, I agree with the hypocrisy issue and I find the whole debate about whats acceptable and not acceptable as a vegetarism just about lines in the sand and sometimes wilful ignorance. Certainly there are vegans out there that if they knew the truth about bugs in flour, then they probably wouldn't eat anything at all. And I can certainly get on my Bacon Butty Waving platform as much, if not more than the next person if I want to.

BUT in the context of a medical question, I do see things rather differently. I think its an area where you have to suspend what you believe more. The argument you are making here about stretch of commitment to being a vegetarian, is one that you can make similar comments about religion. Logic and reason often come second to belief and very often its something fundamentally important to someones value in themselves and their identity as a person when you have views of this strength. And thats what you should be careful of in a medical context and the position of power that HCP's have over people.

Religion and being vegetarian are very different things, but I do think HCP should be aware of boundaries of sensitivity and be willing to explore whether reassuring a patient or providing them with enough information so they are able to take control of the situation themselves might be a better solution than simply refusing a request. Its worth remembering that there are some people who would compromise their religion a lot more easily than a vegetarian would compromise their beliefs but should we ask them to? Morally, ethically and legally we probably shouldn't do, unless all other avenues have been pursued. Ultimately it just comes down to listening to the patient and treating their beliefs, no matter how unreasonable or crazy they might seem with as much respect as humanly possible.

And I do I think Tollund's most recent remarks about where her views on being vegetarian come from are perhaps the most telling on this thread about why she perhaps should be allowed to have an alternative medication or at the very least be in a position where she is able to make an informed decision rather than have it forced upon her. When you read that, it immediately becomes clear that there's perhaps a little bit more to this and its very much about a mental issue and feeling in control of the situation is so far as she can be.

Thats important.

PenelopePipPop Wed 12-Dec-12 15:19:33

If the made up is directed at me Tollund it is a bit uncalled for. Which bit are you saying I made up exactly?

The point a lot of people are trying to make is that the difference is actually one of degree rather than nature. You are not really making a point of principle. If the difference between the two drugs on offer is minimal you would prefer the gelatin free one to be prescribed. Fair enough. But as soon as the difference is one of significant cost or inconvenience or going untreated would cause you serious distress or discomfort then the animals get it in the neck again. That isn't a principle, that is a price point.

nickelbabylyinginamanger Wed 12-Dec-12 15:21:15

YANBU.

I was forced to take a prescription that had gelatine covers - I had to undo the capsules and pour the powder out - fucking gross taste.

in this day and age, why the hell can't they just make the fucking tablets that don't have gelatine wrapped parcels? (like they perfected in the first 10 years of the 20th century)

and yes, I know what you mean, we are made to be soooo awkward for wanting animal free tablets, but why the hell don't the GPs actually tell us that they're trying to give us the capsules when they do the prescription, so that we can tell them we don't want that form and then they can prescribe the correct form of drug.

nickelbabylyinginamanger Wed 12-Dec-12 15:22:00

and this that say it's choice to be vegetarian - it's also a choice not to be, and it's a choice to be a Muslim or a Jew, but they're given that dispensation.

Tollund Wed 12-Dec-12 15:40:43

"But there will be lots and lots of situations where this does not happen - where there is no readily available and inexpensive alternative on offer" - Penelope I was referring to this, not saying that you made something up yourself. Sorry if it sounded like that! But there are no "animals getting it in the neck" or "price points" - I'm currently without any meds at all, and if I could pay 20p for no gelatin, I gladly would. If I could pay £20 and have something that hadn't been tested on animals I'd do that, but short of turning to homoeopathy, (which I'm sure in the eyes of the people shouting down vegetarian principles is an even bigger sin!) I'm a bit fricking stuck, aren't I?

Thanks again RedToothbrush for understanding and being fair.

And yes nickelbaby - why the hell do they persist in using gelatine when there are options, so many capsules are vegetarian friendly. Are they massively more expensive?

Crinkle77 Wed 12-Dec-12 15:44:28

Sorry but vegetarianism is a life style choice and the NHS should not have to foot the bill. On the other hand this opens up a huge can of worms as there are lots of things that make people ill which come down to life style choices which cost the NHS (smoking, drinking, drug-taking to name a few)

IneedAsockamnesty Wed 12-Dec-12 15:52:49

You do have a choice.

You can choose a private gp to cater for your life choice

You can chose to ask for a private prescription

You can chose not to take the medication.

Prescription charges are made so medicine s accesable to all, its the cheapest medication possible to sort the medical issue sometimes that means you pay £7 for a medicine costing £1.50 sometimes it means you pay £7 for one costing £150. You are not baying for the actual medication but for the ability to get the medication your gp feels you need at the time you need it,with no risk that the medication would be to expensive for you to afford.

LeBFG Wed 12-Dec-12 15:54:08

...when you have views of this strength - this is where my questioning was going Redtooth. I don't really believe OP really has the strong moral convictions she puports. Certainly not the equivalent of a religious person in any case. I do think you're right, however, that OP's aversion to meat is pretty extreme - I suppose the equivalent would be to ask how far the NHS go to accomodate preferences. I'm finding it hard thinking of an example - perhaps providing larger seats for obese people - providing a smoking area for patients who smoke - these are examples where the NHS may go out their way a little to provide for their needs but not excessively and often (rightly or wrongly) a but unwillingly.

Sallyingforth Wed 12-Dec-12 16:04:21

I'd still like an answer to my question as to whether people who refuse capsules with gelatine are checking on all the ingredients to see if they were prepared from or using animal products.

Tollund Wed 12-Dec-12 16:08:47

"I don't really believe OP really has the strong moral convictions she puports" - sorry, based on what? Oh, actually, sod it. I really am bowing out now!

Sorry but vegetarianism is a life style choice and the NHS should not have to foot the bill. On the other hand this opens up a huge can of worms as there are lots of things that make people ill which come down to life style choices which cost the NHS (smoking, drinking, drug-taking to name a few)

And that's not even touching on conditions which aren't caused by or demand accommodations on account of life style choices. NHS paid for my alopecia treatment. It would have paid for a wig had I pushed for it. Obviously losing my hair isn't a life style choice, but neither do I actually need hair.

I was upset at having alopecia, but not psychologically traumatised at the deep existential level that (some) veggies might be at the prospect of ingesting medicines containing murdered (their view) animals. Yet the NHS prescribed me those meds for years without murmur.

I suppose the equivalent would be to ask how far the NHS go to accomodate preferences

^ Yes how far would they go?

If I went in and said that I have a strong preference not to have white tablets, should they go out of their way to make sure I have a different coloured tablet, or should I just deal with it?

If I went in and said that I can't stand anything round, should they go out of their way to find a tablet thats a different shape?

In either of these instances I'm sure everyone would say if thats my preference I should go private and they will accomodate my lifestyle choices. To me this is no different.

Sallyingforth Wed 12-Dec-12 16:27:20

I'm glad you said that missy. It was in my mind as well.

Sirzy Wed 12-Dec-12 16:33:57

I agree missy. I really struggle to swallow tablets and I'm much better with capsules however I would never insist on being prescribed capsules

If I went in and said that I have a strong preference not to have white tablets, should they go out of their way to make sure I have a different coloured tablet, or should I just deal with it?

Simply having a preference for something if there is no internal logic to that preference (unlike vegetarianism) would not be a strong indicator for accommodation.

If you were a child or learning disabled adult with a phobia though, maybe? Don't know.

If you're "just" a phobic adult, highly unlikely. NHS might pay for the counselling sessions you'd need to overcome the phobia though. wink

It would not be appropriate to offer counselling to a veggie to help them "overcome" their moral/religious beliefs.

If I went in and said that I have a strong preference not to have white tablets, should they go out of their way to make sure I have a different coloured tablet, or should I just deal with it?

Simply having a preference for something if there is no internal logic to that preference (unlike vegetarianism) would not be a strong indicator for accommodation.

If you were a child or learning disabled adult with a phobia though, maybe? Don't know.

If you're "just" a phobic adult, highly unlikely. NHS might pay for the counselling sessions you'd need to overcome the phobia though. wink

It would not be appropriate to offer counselling to a veggie to help them "overcome" their moral/religious beliefs.

Yermina Wed 12-Dec-12 16:41:13

Should Muslims and Jews be refused medicines that don't contain porcine products if a cheaper porcine product be the standard prescription for the NHS?

Why are only religious people allowed to have principles which are respected by others?

Yermina Wed 12-Dec-12 16:43:18

~"Sorry but vegetarianism is a life style choice"

For some people. For other people it's the expression of a deeply held ethical belief that animals should not be killed for consumption.

RedToothbrush Wed 12-Dec-12 16:43:24

LeBFG, I think my most basic argument is that you and I can be as 'anti-veggie' and as logical as we like in our views as randoms on the internet, but we aren't in a position of power and trust and making ethical decisions on the behalf of other people.

As soon as you are in that position as a doctor or a nurse, the value of you judgment is much more significant. People need to feel the need that decisions are made with them and that they are properly informed and that they are listened to as much as possible. There are always going to be occasions where the views of certain individuals can not be accommodated but just talking that through can make all the difference to how the patient feels and what they are prepared to compromise for.

Frankly I don't care if someone comes in saying "I don't believe in red pills, because red is unlucky and symbolises death and my mother died after having red pills. I will have any colour pill except red ones" and the only pills that are available are red ones. The doctor can't magically paint them, and its the job of the doctor to deal with that belief sensitively. The Red Pill patient might have issues dealing with the grief of their mother. And the placebo effect it very powerful.

I think in focusing on the fact that the OP is veggie and the logic behind that, everyone really misses the most important issue here which isn't about the merits of being a veggie at all or how hypocritical they might be. Its about HCP listening to concerns of patients and taking on board belief which do have very important implications to us as humans. A belief in God, has been shown to increase life expectancy in more than one study of the subject. A positive outlook in life compared to a more pessimistic one has also been shown to prolong life. Logically and scientifically there shouldn't be a difference if the mind had no power over the physical body. Yet we choose to dismiss belief as trivial and unimportant and we argue of the cost of 30p, £3, £30, £300 or £3000.

We do need to treat patients as individuals, as this is the thing being lost more and more in the NHS and I'd argue the case till I'm blue in the face about how this doesn't save it money and help people.

Personally I don't see the logic to not taking a tablet because it has a tiny amount of animal product in it, and it is a very tiny amount, when the same product sould have been tested on animals.

Also the OP admitted upthread that it is in a large part down to her childhood issues rather than being particularly from a moral stance so I don't think that point is relevent here anyway.

RedToothbrush Wed 12-Dec-12 16:46:37

The point is, logic isn't always relevant though.

Belief has to be dealt with in certain ways. And just saying, "I don't get your belief" if not acceptable from a HCP.

honeytea Wed 12-Dec-12 16:52:18

OP to me it sounds like you are more concerned about you not having to eat the animal than you are about the suffering of an animal. I think if you are unwilling to take a tablet containing animal matter (even a small bit of waste matter) then you should also refuse to take medicine that has been tested on animals. The suffering of a lab animal will have been much much greater than the death of a cow.

nickelbabylyinginamanger Wed 12-Dec-12 16:53:32

belief is more important.

i believe that people's choices should be respected.

if you don't want to consume animals then you shouldn't be forced to, especially when there are viable alternatives.

DoingitOnTheRoofTopWithSanta Wed 12-Dec-12 16:55:04

YANBU, the fact that you are not religious and made a reasonable decision not based on a belief but because of a fact should not mean you are taken less seriously either.

If enough people ask hopefully they will start making the capsules in veggels anyway

DoingitOnTheRoofTopWithSanta Wed 12-Dec-12 16:57:18

Also has anyone mentioned the many conditions that are more likely to be exacerbated by meat eaters? I suspect vegetarians cost the NHS less in the long run anyway!

But then where is the line drawn? In that case anyone could go in demanding anything and claim its a belief.

If you have certain beliefs and morals thats fine, but its down to the individual who holds those beliefs to find a way to incorporate them into their lives not for everyone else to have to find the solution. The OP could easily go to a private doctor who would cater to her every whim, she didn't choose to do that.

a very quick Google shows empty vegetarian capsules are readily available to buy online. Perhaps chemists stock them too. You can then take whatever medicine your ethics permit you like by transferring the contents into veggie caps (if a veggie cap prescription was not available).

nickelbabylyinginamanger Wed 12-Dec-12 17:01:57

the same as a Jehovah's Witness doesn't receive blood, and the NHS has to fund finding other treatment routes.

the point is that vegetarians are usually choosing not to eat meat because they believe it is wrong to kill animals for consumption.
that means that other byproducts of the slaughterhouse are wrong too - gelatine being one of them.

it's not more expensive to cold press drugs into tablets than coat them in gelatine.

the other option for a number of drugs is a powder or liquid form. again, not more expensive.

If you have certain beliefs and morals thats fine, but its down to the individual who holds those beliefs to find a way to incorporate them into their lives not for everyone else to have to find the solution

Should we kiss goodbye to Xmas and Easter hols then?

RedToothbrush Wed 12-Dec-12 17:08:31

A belief does not have to be completely catered for. It should be respected and talked through. The patient should be given all the alternatives if they question things. If the belief can not be catered for, then a best fit compromise should be suggested and the patient left to make the decision in the end. Ultimately a patient has the right to refuse treatment if they aren't happy with the alternatives aren't good enough. But they are in control of the situation and were given support to make that decision thats right for them, rather than bullied into it.

Doctors and nurses having a poor attitude to patients no matter how trivial can deeply impact on the trust a patient has with future encounters with HCPs. They will go into situations in a defensive manner and less open to discussing potentially important information as they think that their concerns will be dismissed as trivial or unimportant.

Why? The terms are set out so there are school breaks every 6-8 weeks(ish) there are also october and summer holidays so I don't get your point there confused

Solola Wed 12-Dec-12 17:11:40

YABU and cringingly precious. I would imagine in places like India, many Hindus would just be grateful to have access to life saving antibiotics.

DoingitOnTheRoofTopWithSanta Wed 12-Dec-12 17:11:57

Exactly nickel, why not just have them already in veg caps?

nickelbabylyinginamanger Wed 12-Dec-12 17:14:51

exactly, there's no reason why not - food manufacturers can manage to use other substances to make their food veggie, why not pharma?

nickelbabylyinginamanger Wed 12-Dec-12 17:17:26

RedToothbrush - you're dead right, and the attitude of the nurse in the OP's situation was awful - saying she doesn't have time to research it and so the OP has to find out herself and ask them to change the scrip which she knows can't be done (and the nurse knows too!)?
that's awful.

littleducks Wed 12-Dec-12 17:20:20

I always ask for tablets/liquid instead of capsules because of the gelatine thing. I also gag on capsules so prefer tablets. Never had any complaints, did once have to mix up suspension myself (easy just add water to powder in bottle).

I would happily pay the difference but if there isn't the system in place I expect thats impossible.

RedToothbrush Wed 12-Dec-12 17:21:09

Cos pharmaceutical companies don't have the same pressures of consumer demands as they have almost guaranteed markets and its difficult for patients to push pressure on doctors and hospitals to respect their desires.

You only have to look at the responses to the OP about this particular issue to see how others do not feel she should even be raising the question and should just lump any old shit they are given.

Until people like the practise nurse respect the views of the OP then why should the pharmaceutical companies be remotely interested?

I work as a pharmacist in an area with a high BME population. I can't remember the last time I was asked for a vegetarian (non-gelatin) product. I think there is a general acceptance that for some things you have to compromise.

It is fairly simple and cheap to change some items to a liquid (some, but not all antibiotics included), but for other products the cost difference is in the hundreds of pounds. I remember providing liquids medicines for a patient a few years ago who had had bariatric surgery and her drug costs per month increased from less than £50 per month to over £2K.

You need to consider that as you get older and possibly suffer with a life-limiting long term condition - will you refuse treatment?

As for why they can't make tablets - It is often due to the stability of the drug and manufacturing costs.

badbelinda Wed 12-Dec-12 17:21:38

I agree with Freddos. The NHS spends a huge amount of it's budget on prescriptions and prescribers are responsible for keeping the cost as low as possible in a climate where budgets are frozen or being cut each year. Prescribing liquid rather than capsules is hugely more expensive and if it's done often enough throughout the country soon adds up to the cost of a course of chemotherapy/ kidney transplant/ neonatal incubator. You have to decide where your priorities lie.

FelicityWasSanta Wed 12-Dec-12 17:23:51

I don't really believe OP really has the strong moral convictions she purports

That's outrageously rude and offensive.

The OP appears to have had a hard time on this thread because people have decided to take against her and vegetarianism as a whole.

I've never seen this vicious attitude towards this/similar issues before. Is MN having a bad day or is a sign of a wider society trend I wonder?

OwlLady Wed 12-Dec-12 17:24:45

i agree with musttidyplayroom. My sister was chronically ill all her life, which ended when she was really quite young, she was a vegetarian, anti animal testing, anti vivisection etc etc we boycotted proctor and gamble, but she still had to take drugs that were tested on animals uin order to live. I know she felt guilty about it but she had no other choice

OwlLady Wed 12-Dec-12 17:26:37

felecity I think it's most probably more to do with stretched services, a recession and patient choice tbh. I do understand patient and parental choice, but for us with my daughter it means if you choice a more expensive service/[product you have to shore it up yourself iykwim

OwlLady Wed 12-Dec-12 17:27:59

oh go that didn't make sense, I meant if you choose a more expensive product or service you have to top it up out of your own pocket, not rely on the nhs to do that. That has happened for years btw, even under labour, it's not something new

I think there will be a time when we have - The NHS offer is ...

And for anything else you will have to pay. The current NHS reforms are only the start.

merlottits Wed 12-Dec-12 17:31:33

I saw someone walking down the high street wearing a T-shirt saying "Vegans are just attention-seekers".

Just swallow the bloody pills and stop ya whinging.

OwlLady Wed 12-Dec-12 17:36:42

the op is a hindu

MissCellania Wed 12-Dec-12 17:37:02

no, she isn't.

nickelbabylyinginamanger Wed 12-Dec-12 17:37:29

no she's not.

she was using hindus as an example of vegetarians whjo wouldn't be asked to compromise

OwlLady Wed 12-Dec-12 17:39:04

oh okay

I heard she doesn't wear a bra though and lives with a goat

FelicityWasSanta Wed 12-Dec-12 17:55:19

oh go that didn't make sense, I meant if you choose a more expensive product or service you have to top it up out of your own pocket, not rely on the nhs to do that. That has happened for years btw, even under labour, it's not something new

The OP hasn't said she isn't prepared to pay a top-up fee. Her actual complaint was that the nurse was rude to her and didn't offer her the relevant information/opportunity to pay the difference.

ClaraDeLaNoche Wed 12-Dec-12 17:55:53

Poor OP. She has effectively been denied a public service because of her belief. I do think that there is a prima facie case of discrimination here with reference to the Equality Act, which covers religion OR belief. Veganism has been held to be a belief which is covered under the Act, so I would imagine vegetarianism is as well. So her clinic would need to show that they could objectively justify their decision on the basis of cost- 20p? And if they did think they could objectively justify it, they should still have looked at mitigation ie saying "Sorry, we"ll write you a private script"

Leave her alone you flamers! YANBU

Vegans and vegetarians are totally different though. Veganism can be classed as a belief, but I don't think vegetarianism can.

ClaraDeLaNoche Wed 12-Dec-12 18:37:18

You'd be surprised about what has been held to be a belief before eg the belief that carbon emissions should be cut has been held to be a belief worthy of protection. I'd give it a go especially as there is guidance from the NHS saying that vegetarianism probably is a belief.

FredFredGeorge Wed 12-Dec-12 18:38:07

Yes the main problem for me is that the prescribing nurse abjectly failed in her duty to provide care - he refused to provide or even obtain the information required to get consent to the treatment, almost certainly against the prescribing guidelines of his NHS authority.

He also increased the cost of providing the service much more than the difference in medicine cost as a 2nd appointment is required by his "go and away and find out yourself". So it's not saving money in the slightest.

FelicityWasSanta Wed 12-Dec-12 18:40:01

I agree Fred.

Also....

Veganism can be classed as a belief, but I don't think vegetarianism can.

A quick google search has confirmed my belief that this is bollocks!

I don't mean legally, I have no idea about that, but I don't see how vegetarianism is a 'belief' rather than just a preference not to eat meat.

Vegtarianism still contributes to the deaths of animals, I also know a few 'vegetarians' who eat fish, I even know one who eats chicken. Vegans take nothing to do with any animal products because they are fundementally against animals being used to make food. Vegetarians choose not to eat some animal products but happily eat others.

RedToothbrush Wed 12-Dec-12 18:52:53

But some Christians do this, some Jews do this, some Muslims do this

and some do something completely different when it comes to how they practise their religion.

OwlLady Wed 12-Dec-12 18:55:16

isn't all this info included in that little big book they all look in when prescribing?
if not, maybe that's the problem

I also know a few 'vegetarians' who eat fish, I even know one who eats chicken

Well, they're not vegetarians then, are they? Vegetarians don't eat meat (including fish).

FelicityWasSanta Wed 12-Dec-12 19:07:39

I don't mean legally, I have no idea about that, but I don't see how vegetarianism is a 'belief' rather than just a preference not to eat meat.

Riiiight, so the OP is totally unreasonable to expect care and understanding from a HCP, but it's totally ok for you (and a bunch of other posters) to declare her precious, entitled and undeserving of special treatment because you don't agree with the seriousness of her belief.

helpyourself Wed 12-Dec-12 19:07:45

It's incredibly simple OP. your principals don't allow you to eat meat and the NHS' budget is finite. Would you rather the extra money went to you or towards a hcps' wages, new hospital, more comfortable palliative care. Where would you place your need in the list of needs the NHS has to meet?

FelicityWasSanta Wed 12-Dec-12 19:09:24

I also know a few 'vegetarians' who eat fish, I even know one who eats chicken

I also know Christians who commit adultery. It doesn't detract from the validness of the whole religion though does it?

I never once said the OP was precious or entitled I don't think she should get special treatment though no.

I buy fair trade products wherever I can due to my morals, but I don't demand shops sell me the products at the same price as their own brand stuff, because its my choice based on my beliefs. I also don't agree with the ethics of some companies so I avoid their products but I go out out of my way to find alternatives, I don't expect anyone else to go out of their way or go against their policies because of my beliefs.

I also know a few 'vegetarians' who eat fish, I even know one who eats chicken

I also know Christians who commit adultery. It doesn't detract from the validness of the whole religion though does it?

No, but I see you have chosen one sentence rather than taken that post as a whole.

FelicityWasSanta Wed 12-Dec-12 19:27:00

I'm at it again but....

* I don't expect anyone else to go out of their way or go against their policies because of my beliefs.*

If anything the OP is asking the nurse to follow their own policies of discussing treatment fully with the patient and getting consent. She didn't at any point say - I should get the veggie tablets for free. She said the nurse should have discussed it properly with me and given me the options.

And the OP is correct the HCP should have done this.

grin I'm at it too -

He told me that he didn't know if they did or not and didn't have time to research it, and if I really couldn't bring myself to take them I'd have to ask the pharmacist

The nurse didn't now and told her where she could get advice from. Doctors and nurses refer people to specialists on subjects they don't really know about this is just an extention of that imo. He would have had to research every drug in the antibiotic to see what it contained before guaranteeing the OP it was Veggie. Would it have been better if he had a quick look, said they didn't contain animal products, prescribed them and then the OP discovered later on that they did contain some?

FelicityWasSanta Wed 12-Dec-12 20:03:03

No, it would have been better if he had either known or looked it up!

It's unnaceptable to say he doesn't know what's in the medicine he's prescribing!

There are thousands of different medicines that doctors and nurses prescribe, its ridiculous to think that they know whether each and every one is vegetarian or not.

Would you expect someone who works in a shop to know the exact contents of every product? Before foods had labels on them to say whether things were suitable for vegetarians would you have expected a shop assistant to go and research every ingrediant for you before you bought it?

I don't think that he should have spent half an hour looking up each ingredient to see if it complied with the OPs moral viewpoint and made every other patient run late , he pointed the OP in the right direction to get the information herself.

LeBFG Wed 12-Dec-12 20:18:30

FelicityWasSanta is on a role.

I don't really believe OP really has the strong moral convictions she purports

That's outrageously rude and offensive.

The OP appears to have had a hard time on this thread because people have decided to take against her and vegetarianism as a whole.

1) I can believe what I like. I'll justify it for you (you don't have to agree): OP has gone on a bit piously about being a strict veggie. I'm thinking to myself that to go to the extent of not taking gelatin pills means you're probably also interested in animal welfare and death etc enough to be a vegan...which she's not. She then admits her 'beliefs' stem from a rather extreme distaste for ingesting meat..which isn't the same as having 'strong moral convictions'.

2) I have zero objections to veggieness - I was one for 12 years (I was strint'n'all) hmm.

Redtooth - I get your point, and possibly to some point agree on a personal level. However, from a general health perspective we actually don't have to pander to every person's individual needs and desires, or even should do. Lines to have to be drawn etc. As some other poster says, conselling might be a more profitable line to go down.

Wrt costs and making veggie pills etc. This is a bit of red herring. I imagine if the political will was there, we'd all be chomping on veggie pills at no real extra cost. OP should be campaigning to kick-start pharma into making veggie pills...wonder how many MNers would support that one? Not as many as are defending her on here I suspect...because the issue just isn't that important to most people.

FelicityWasSanta Wed 12-Dec-12 20:53:51

LeBFG, I said people have taken against vegetarianism - not neccersarily you. You seem to have taken against the OP, and, apparently me. But hey ho...

Moving on...

There are thousands of different medicines that doctors and nurses prescribe, its ridiculous to think that they know whether each and every one is vegetarian or not.

True, bit we're talking about amoxicillin here, hardly rare. And most laymen know the capsules contain gelatin. They should (and can) access the information quickly though.

Would you expect someone who works in a shop to know the exact contents of every product?

If it way medicine yes- and at the very least know how to look it up!

Before foods had labels on them to say whether things were suitable for vegetarians would you have expected a shop assistant to go and research every ingrediant for you before you bought it?

Red herring, the OP was asking for clarification - she knew enough to know the capsules probably weren't vegetarian. Also in a shop if you are unhappy with service you go elsewhere. If you have to do this with the NHS it wastes appointments and costs money- you should be able to rely on each appointment being high quality,

I don't think that he should have spent half an hour looking up each ingredient to see if it complied with the OPs moral viewpoint and made every other patient run late , he pointed the OP in the right direction to get the information herself.

Half an hour! One google search told me all I needed to know. Approximately 20seconds, the nurse should have had access to better reference material than me! His signposting was ineficient, if the OP gets advice from a pharmacist she will have to make another HCP appointment afterwards for a new script. This costs money.

Also, have you forgotten the OP was ill and vulnerable during all this?

GhostShip Wed 12-Dec-12 20:56:06

Look, I'm a veggie, but I accept the medication I am given because I am very appreciative of the fact I'm being given it at a much lower price than if I were to buy it without the NHS.

It's something I have thought about, and it may seem hypocritical, but hey ho.

I'm not willing to take more money away from the NHS because of my lifestyle choices.

Your lifestyle choices shouldnt effect anyone else.

NightFallsFast Wed 12-Dec-12 20:57:40

Personally I feel the HCP could have been more accommodating in this instance, however:

"It's unacceptable to say he doesn't know what's in the medicine he's prescribing! "

How can a HPC know every ingredient of every medication they prescribe. I've signed prescriptions for probably well over a hundred different medications today, all with many ingredients. Who's brain would remember all that as well as well as the interactions/dosage/contraindications etc and all the medical information?

The BNF contains the drug, the brand names, the dosage for different conditions and age groups, when you can't use it or are cautioned against using it and side effect, amongst other things. It's several hundred pages long. It doesn't contain complete ingredients list for every medication, though pharmacists can access this information.

To the person with the relative on roaccutane who's GP wouldn't prescribe it, no GPs in the country are meant to prescribe it. It's only available for consultants to prescribe as it requires careful monitoring and as it accumulates in the bones it cannot be prescribed for long periods.

I don't mean legally, I have no idea about that, but I don't see how vegetarianism is a 'belief' rather than just a preference not to eat meat.

Among other things, vegetarianism can involve a belief in the sanctity of animal life and a desire not to exploit those lives for human gain. It's not just about preferring tofu over steak.

If you are someone who believes that killing animals for human exploitation is tantamount to murder, it makes little sense to characterise one's decision not to partake of animal products as a "preference". It is a profound moral belief.

We don't talk about "preferences" not to cannibalise each other (and to vegans there is no difference between eating an animal or a human being, irrespective of what distinctions current legislation make).

(And to some vegans) that should read.

Whyyyy can't we edit posts???? sad

I'm not willing to take more money away from the NHS because of my lifestyle choices.

What IS a lifestyle choice though? Should we not treat smokers, drinkers, crisp eaters on the NHS? What about those who participate in risky sports?

I missed where the OP said it was amoxicillin in particular. Capsules generally contain gelatin but he may not know offhand if the rest of the contents were suitable. We don't know the exact medical details of the OP either which the nurse would know so there may have been any number of reasons that the medicine wasn't suitable maybe they didn't have it in the correct strength for example.

If she was happy with information from google she could have done a 20 second search on her phone and showed him. I personally wouldn't be happy with a nurse getting an answer from google.

If a medical proffessional wasn't sure about something for me then I would rather they sent me to someone who did know. The pharmacy could have called and got a prescription sent through seeing as she had already been in and she could have popped back in the morning. NHS staff, especially at this time of year are under a lot of pressure the OP had a choice whether to go and seek out the exact madicine to fit her preference or take the one on offer is she was that ill and vulnerable then she would have taken the medicine on offer.

Among other things, vegetarianism can involve a belief in the sanctity of animal life and a desire not to exploit those lives for human gain

But the animals lives are still being exploited to provide milk, eggs etc. Since its roughly 50/50 males to females being born and the females are needed to provide dairy products then it still means male animals are being killed because they aren't needed and farmers have to keep up with supplying females to provide products.

However the OP said upthread that it wasn't really a moral choice it was about childhood issues so its a bit of a side issue anyway.

samandi Thu 13-Dec-12 08:54:03

when you have views of this strength - this is where my questioning was going Redtooth. I don't really believe OP really has the strong moral convictions she puports. Certainly not the equivalent of a religious person in any case

Plenty of "religious" people don't have particularly strong moral convictions. Plenty of them just do things because that's what they're told to do.

But the animals lives are still being exploited to provide milk, eggs etc

Hence veganism. Or keeping your own poultry. Or justifying eating milk/eggs on the grounds that you are still taking steps to remove yourself from the animal consumption/exploitation treadmill, even if there is still more you could be doing. Or not having 100% total coherence between your various beliefs (few of us do, so why should vegetarians be any different?)

However the OP said upthread that it wasn't really a moral choice it was about childhood issues so its a bit of a side issue anyway.

Just as well I wasn't responding to that point then. smile

DrRanj Thu 13-Dec-12 09:06:37

I really don't know where I stand on this one. I have to agree that it would be wrong not to give a Muslim/Jew non gelatin tabs on the nhs, but on the other hand I am a life long vegetarian and coukdn't imagine kicking up such a stink and making demands on an already over stretched nhs, and a probably very busy overworked hcp. I can't help feeling you were being a bit precious tbh...

Or not having 100% total coherence between your various beliefs (few of us do, so why should vegetarians be any different?)

My point exactly, if its about animal welfare she isn't 100% committed anyway so what difference will an insignificant amount of gelatine make. As its merely a preference of the OPs anyway then she should just suck it up.

I can't stand tomato sauce (I promise I'm going somewhere with this) I have special rubber gloves that I wash up with when the kids have had some. The smell of it makes me feel sick. Personally I would rather gnaw my own arm off than let it pass my lips.

But if they put it in a tablet that would make me better then, no, I wouldn't like it, but I would take it because my health is worth more than my personal preference.

(loving all the quoting going on throughout this thread grin )

ICBINEG Thu 13-Dec-12 09:48:25

Sorry - somewhat off topic...but I wanted to ask the veggie presence at what point the animal products stop being animal enough to cause a problem?

In the OP's case it looks like eating flesh is an major psychological issue..but I don't understand the connection to gelatin capsules. They don't look, smell, taste like flesh and if someone told you you had the veggie version you would never know that they were lying. So how does it trigger the same response?

It's all atoms at the end of the day...and if you aren't bothered about the animal welfare side of it then why should you feel differently about one long chain molecule than another very similar one of synthetic origin?

Animal products are recycled by nature in the form of plants all the time. When do the atoms stop being "animal" and start being "plant" again?

FelicityWasSanta Thu 13-Dec-12 09:55:54

My point exactly, if its about animal welfare she isn't 100% committed anyway so what difference will an insignificant amount of gelatine make

We don't know exactly what difference it would make to the OP. It's breathtakingly rude to assume that she doesn't have a right to her emotions about it though. Apparently it matters a good deal. And the HCP isn't doing their job if they don't patiently and fully go through everything with her.

RedToothbrush Thu 13-Dec-12 10:04:20

The HCP didn't know the basis of her belief in vegetarism when he was so dismissive. He didn't know why it was so important to her, because he didn't bother to ask or to reassure her.

Her commitment to the cause isn't the key issue here. Its the attitude of the HCP that is.

HoratiaLovesBabyJesus Thu 13-Dec-12 10:23:15

Drugs have to be tested on animals to get a licence - but once Phase I trials are over, no more animals need to suffer or die. I don't think it inconsistent to draw a line between strictly limited licensing trials and continuing to kill animals to produce every single dose of the final drug, where an alternative is available.

But for me the important part of the story is the attitude of the nurse. Even if OP's objection had been utterly stupid, it is still his job to look it up in MIMS and give her the information with a smile, even through gritted teeth, and save his exasperation and eye rolling for after her departure.

Get well soon, OP.

She has every right to her emotions about it. I have never denied that. Its not fair to go in making demands on the NHS based on a preference and using up the time of a nurse who would have been rushed out the door at this time of year anyway to look up whether pills were suitable for vegetarians or not. He didn't have time he advised her to go and see someone who would know the answer to her query and said he would write her a prescription based on what he said.

When I had gallstones I didn't go to the doctor and expect him to know everything about them, he sent me to a specialist who would know about it, I didn't sit there telling him to look up all the information I needed to know there and then. She made the choice not to take the medication on offer, why shouldn't she be the one to find an alternative?

What about if someone was going in demanding homeopathic pills because her morals didn't allow her to take convential medication, would the nurse then be expected to go and research that too?

Are you all more than happy to wait 2 or 3 hours for your doctors appointments because the nurses and doctors sit and explain fully every tiny little detail of every medication to every patient? In my surgery the appointments are 5 minutes long, if every patient went in doing what the OP did it would take twice as long.

There are private doctors if you wish to have longer to go through every detail and have particular medicines.

Does the basis of her vegetarianism matter?
Why is belief in religion - which is a made up fairy story to some people- more important than if it were an animal welfare issue.

It's nothing to do with it, it's the attitude of the HCP.

Viviennemary Thu 13-Dec-12 10:54:38

I think this is a tricky situation. If somebody was allergic to gelatine then I think the NHS obviously would have to profide the correct medicine. Or needed an alternative for a health reason. But I think in this situation you should have to have a private prescription and pay for the tablets yourself. Or remove the medicine from the capsule as others have suggested.

WhoWhatWhereWhen Thu 13-Dec-12 10:57:32

Why dont you research the Antibiotics you can take and provide them with a list?

No the basis of it doesn't matter at all. There were/are other options though, to pay privately for a longer appointment and a medicine to suit her particular preferences or to ask the pharmacist as the nurse suggested (although it seems she did this and left anyway because it took too long confused )

If it was so simple surely the pharmacist would have looked it up and one quick call later it would have been sorted. There was possibly other reasons why the medicine wasn't suitable in this case. If it took an hour in the pharmacy to liase about a suitable alternative then it would have taken an hour in the surgery too. It was better the OP being put out than everyone else for the whole day surely.

Most things can be googled in seconds, I actually did this the other day for a locum in the middle of an appointment.
Lots of people use too much of nhs resources, I can think of far worse cases.

RedToothbrush Thu 13-Dec-12 12:16:07

If it took an hour in the pharmacy to liase about a suitable alternative then it would have taken an hour in the surgery too. It was better the OP being put out than everyone else for the whole day surely.

But it just comes back to respect and how its handled sensitivity, rather than the actual end result. You are just making excuses to justify someone to act in a shitty way thats not acceptable on the grounds that one person isn't as important because there are ten other patients. No, actually they are ALL important and ALL deserving of a certain level of respect.

Its a question that can not be that unusual or unexpected and the information should be freely available given the sensitivities of diet/culture. The fact its clearly not, is actually pretty shit especially given there are real inequalities of health along cultural lines in this country and initiatives like this could do a long to help encourage people to use health services more. An hour spent trying to sort out information, for a very commonly used drug, could have far reaching consequences.

And honestly if someone did ask the same question along religious lines like the OP stated in her opening post, I would seriously question whether it would be treated like this. I would would be more surprised if they didn't make that effort to find out because they think the request is 'more legitimate' both legally and morally (and as others have pointed out that is actually questionable).

The attitudes on this thread questioning the depth of her belief is really revealing. It just points to values on what people think is an acceptable request rather that being concerned about how the attitude and professionalism of a HCP, which should be better at all times regardless of judgment. When it isn't, it can more often that not, affect how the patient feels they were treated and easily damages the fragile bond of trust and respect between patients and HCPs.

Lets not loose site of the fact that the NHS is supposed to be equal as much as possible and HCPs are supposed to be at least respectful of ALL beliefs even if they can't fulfil the request (and that includes stuff like when a doctor has beliefs such as being opposed to abortion, they are supposed to simply pass the patient to someone else).

Its ingrained into the system that can not go round judging religious choices but also lifestyle choices no matter what you feel about them. And in cases where one group is likely to have a similar request treated with respect then another group deserves equal respect and attention regardless.

nickelbabylyinginamanger Thu 13-Dec-12 12:26:30

Look, I'm a veggie, but I accept the medication I am given because I am very appreciative of the fact I'm being given it at a much lower price than if I were to buy it without the NHS

fuck that - I don't give a shit what my beliefs are - I shouldn't be treated like a problem or a nuisance because I want first class care.
I should expect to receive the best care from the NHS regardless of what my problem is.

ICBINEG Thu 13-Dec-12 12:48:53

no answers to my questions - well i guess this prob isn't the place.

I am absolutely on the fence about the OP BU though.

On the one hand I could develop a strong moral feeling that one shouldn't take medicines that begin with the letter "S". That doesn't mean the NHS need to supply me with a whole different swathe of treatments surely?

If people have allergies to the medicines it is necessary to provide an alternative. If people have moral/religious objections then it is no business of the NHS's surely? They deal in the evidence based treatment of illness! Their responsibility is to provide something that will treat the illness, if you have a problem with the taste, colour, contents of the treatment, the way they found that treatment, tested it, packaged it or packaged the packaging then that is surely your problem to deal with? You always have the option of declining treatment.

The reason I am on the fence is that I believe that mental health is a key part of the NHS's remit. In the case that the OP is psychologically unable to take the medicine because of the contents then I believe a substitution should be made if available. So if you view a pathological level of vegetarianism (it is pathological if the OP would rather die than let animal product (what ever the definition of that actually is) pass her lips) as a mental health issue then yes the NHS should provide an alternative.

LeBFG Thu 13-Dec-12 14:05:10

I don't suppose the nurse really did know all of OP's hang-ups over meat tbh. She just asked for some awkward information in the name of vegetarianism and her request was given short shrift. Just that really.

We live in society that values people's religious beliefs over animal rights ethics .... and have an overstretched, less-than-perfect health system...and so not many people are sympathetic with OP. Not sure what more can be said really.

RedToothbrush Thu 13-Dec-12 14:21:09

I don't suppose the nurse really did know all of OP's hang-ups over meat tbh

Because they didn't spend two minutes to ask. Cited they were too busy, and shoved the problem onto someone else in the health service to deal with. Which doesn't actually solve the problem and doesn't cut the cost. It just takes the problem out of his budget.

Which is just about where the health service is at right now, playing a game of pass the problem until the music stops and someone lands in a particular department who then has to deal with it. Doesn't save money and doesn't solve over-stretching. If anything it has quite the opposite effect.

But everyone is just happy to sit there and justify it by holding their hands up and saying, well we have to prioritise and we have to make cuts.

The best way to solve a problem is to understand it before trying to come up with a solution. Listening and gathering as much information at the start of the process in order to fully understand what the problem really actually is, rather than making it up as you go along and hoping for the best, has always been and will always be the best to solve the problem in the most effective and cheapest way.

I would love to put it on a brick and beat every person who makes decisions about health care with it.

HoratiaLovesBabyJesus Thu 13-Dec-12 14:28:29

Yy, redtoothbrush. Early accurate diagnosis saves lives and money.

Hell, a pair of sympathetic ears are sometimes half the cure.

Pictureperfect Thu 13-Dec-12 14:48:19

I'm on a lot of medication (thank god for the nhs, I don't know how I could survive in other countries) and the doctors keep trying to change my medication to cheaper ones, I am not alone with having this problem. We can't just be changed if the medication is working well for us, found the perfect dose and moved past all the early side effects. I would be annoyed if I heard people are being given much more expensive medication due to personal preferences rather than need. Have you looked the drug up on the BNF? It will have the price for different forms, sometimes the difference will be penny's and sometimes hundreds. If its just penny's then I would point that out next time you get a prescription

LeBFG Thu 13-Dec-12 15:08:31

I'd be a hell of a lot more sympathetic to your position red if we were talking about an old biddy whose concerns were swept under the carpet, or an emotional possibly PND women was treated in the same way as OP was. As it is, I think most people, including me, find it hard to sympathise with such trivialities.

nickelbabylyinginamanger Thu 13-Dec-12 15:10:42

it shouldn't matter whose concerns are swept under the carpet.
all patients should be treated the same.

nickelbabylyinginamanger Thu 13-Dec-12 15:15:09

Picturepefect - yes, and that's dangerous too - there are loads of people who have to have a certain brand because of reactions to the fillers in the other brands, including generic.
it's bad form to change the scrip for a cheaper brand without checking it out first (usually by asking the patient or their guardian)

nickelbabylyinginamanger Thu 13-Dec-12 15:17:46

I don't agree with your second point though - medicines should be allowed for all requirements, dietary are just as important.

because it goes back to treating each patient as human beings and all things being equal, offering them first class care.

lancaster Thu 13-Dec-12 15:21:45

YANBU. I think you might have got a different reaction if you had seen a GP rather than practice nurse.

RedToothbrush Thu 13-Dec-12 15:33:39

So sweeping EVERYONES concerns under the carpet to make the health service better is what you advocate LeBFG?

Thats part of the point in a way though. HCPs thinking they are able to sweep things under the carpet actually makes them do it, rather than solve problems which would actually probably work out cheaper in the long run.

And it ends up being precisely 'survival of the fittest' as it comes down to being pushy rather the HCPs trying to do the best by the patient in every case without exception. We aren't all the same so why try and do things the same way for everyone? You should do it the right way for everyone.


Just as an example, my grandmother has been in hospital recently to have an operation which they didn't know if she would survive. She 87. She complained to my mum about the nurses bullying her to get out of bed and sit in her chair but she didn't want to. She was really upset about it and the attitude of the nurses was adding to her distress. Why?

Because my grandmother is tiny. And the chair she had was giving her pain after her operation.

The nurses refused to listen to why she didn't want to get out of bed. My mum got involved and got the hospital to find a smaller chair. But she had to fight for it. She eventually managed to get hold of a smaller version of the same chair, one of only four in the entire hospital, and bought at the time at some expense.

Thing is though, my grandmother was actually able to sit in this chair without being in pain. So she started getting out of bed. Which probably speeded up her recovery time and meant she freed up the bed quicker.

But she was ignored and left in pain cos they couldn't be arsed to listen to a simple problem. And that chair even though it wasn't cheap probably would be a worthwhile investment if it was used to similar people in similar situations on a regular basis but on paper it looks like a shit investment.

The trouble with trying to standardise everything to fit the average person like the chair is simply that not everyone is as is an average person with the same needs in the first place.

LeBFG Thu 13-Dec-12 18:11:08

Eh red? Don't get where I implied it would be a good idea to sweep everyone's concerns under the carpet. In fact I said certain categories of people/problem should be taken a whole lot more seriously than someone whining about a milligram of gelatin in her pills (given the non-perfect world we live in).

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