To think if a pharmacist refuses to dispense medication due to religious or personal beliefs

[Soubriquet]

They shouldn’t be a pharmacist.

I mean, the morning after pill is healthcare. Your personal or religious beliefs shouldn’t come into this.

The General Pharmaceutical Council, who oversee pharmacists, have thought through how to balance patient and pharmacists rights. I think they’ve done a great job. From their guidelines on religion, personal values and belief:

Pharmacy professionals have the right to practise in line with their religion, personal values or beliefs as long as they act in accordance with equalities and human rights law and make sure that person-centred care is not compromised…If a pharmacy professional is unwilling to provide a certain service, they should take steps to make sure the person asking for care is at the centre of their decision-making, so they can access the service they need in a timely manner and without hindrance.

Pharmacists found to have contravened these guidelines can be sanctioned.

But that doesn't actually mean anything does it really? So if we follow this principle, the pharmacist can refuse the map because there is another pharmacy available, be it five/ten/fifteen miles away... It doesn't take into account that the patient does not drive, or has no access to public transport, or the money available to travel xyz miles away. It's a catch all, means nothing statement. I'm my case ( and this was years ago), the pharmacist refused the map but didn't check I could actually access the other pharmacy which was miles away whilst the clocks steadily ticking... I was fortunate and managed to get a lift but for those that cant, what happens then? It's extremely negligent behaviour imo.

@UpsideDownSomewhere I excerpted two small pieces. The guidelines give much more form.

But no, even just on what I excerpted I don’t think your reading is reasonable. They explicitly say so [the patient] can access the service they need in a timely manner and without hindrance.. Which a pharmacy miles away with no transport available would not provide.

I’m not claiming pharmacists never fail on this front. Just that there is a high bar they are supposed to live up to and a mechanism for holding them to that bar.

Then it should be declassified to the same as paracetamol/canestan etc, that you can buy in the supermarkets with no one supervising. I doubt it’s addictive, which is what controlled drugs usually are.

One of the reasons it's not available off the shelf is that paedophiles can get underage girls to take it so they can go on sexually abusing them without it resulting in a pregnancy. This is why a consultation is needed to check the woman is not there as a result of rape.

I know of pharmacists who have declined to dispense puberty blockers to young teens. Do you think this is wrong too? They believed it was in the child's best interest. Not to mention the prescriptions were written by a Romanian doctor who the pharmacist had no way of finding out if they are genuine. Gender GP prescription obviously!!

Maybe the answer would be to work in a clinical area where there’s no chance of your patient being a rapist. How would you know anyway? It’s hugely disrespectful to talk about “phony morals”. They’re not, they’re just different to yours.

I would love to say I'm surprised but I'd be lying.

I went with DD to ask about the pill, not because they are sexually active, but because they suffer horrific periods (which they've inherited from me) and were 6 months away from sitting GCSEs. I thought, let's see what we can try and sort out, have 6 months to find the right pill, and hopefully sit exams with one less stress. Sensible, right?

Not according to the female GP we saw. It somehow made it worse being a woman.

Her attitude was atrocious. She basically accused DD of being a slapper, apparently she is sick of all you young girls coming in for the pill, we should test you for STDs, etc etc. That stemmed from a rash my DD had which is an ongoing, stress related form of eczema, not some Victorian STD.

It made no difference when DD pointed out they are a lesbian so not sexually active. I ended up walking out with DD as I was so angry. This wasn't years ago either, but 2022!

When we raised it and asked to see someone else, the attitude was "oh yes, X GP doesn't like to deal with things like that, especially with teens due to her religious beliefs. She feels English girls have the wrong attitude towards sex". Considering to get the appointment we had to explain why we wanted it, surely the system should have flagged that this GP was not appropriate to see?

I actually changed surgery I was so annoyed because they felt that justified her lack of professionalism. Basically her view is all English teenage girls are slappers. Surely dealing with their rights to choose to prevent teen pregnancy is better than a line out the door for terminations? Not according to that GP and the fact the manager did nothing but give an excuse as religion for it was disgusting.

I've recently done a course where we were told about an employee in a pub who refused to serve alcohol due to religious beliefs. Why would you even apply?

It does take it into account. If the patient hadn't been able to access a medication and suffered harm as a result they would be in trouble.

The General Pharmaceutical Council guidelines specifically differentiate between refusing on grounds of belief and refusing on clinical grounds.

What a pointless thread. OP posted and ran and now probably watching others fighting over a moot point. Has that actually ever happened?

Yes, exactly - and pharmacists should work in areas they won't have the opportunity to dispense the MAP, not refuse it to dispense it to women. But they don't which is the point were talking about in this thread.

I know because they have been attached to police and/or prison guards.

I don't respect 'morals' which deny women the right to choose what to do with their body. Morals that can cause actual damage to women. And if you think about it for a very short while you'd understand why we absolutely cannot be forced to RESPECT other people's beliefs regardless of what they are. Maybe this one you agree with so I should respect it, but should we also be forced to respect racist beliefs? The belief men can change sex? The belief adults can have consensual sex with children? The belief women are to be slaves to their husband's?

Of course not.

I live in a small rural village which has one GP surgery, with one GP. He will not prescribe the morning after pill, nor will he refer anyone for a termination. This is all clearly stated on their website. Although neither of those things apply to me any more, I do wonder what younger women in the village are meant to do.

Racism, misogyny and paedophilia aren’t moral choices @JaneTheVirgin.

Puberty blockers may or may not be safe, and with all the studies coming out at the moment, I wouldn’t dispense those either. It is in their job to give advice about medicines if they may not actually be safe to take.

The MAP is safe. And no one could ever say that it wasn’t in a woman’s best interests to use a contraception. I can’t imagine a pharmacist ever saying that about condoms.

My council had such issues with this years and years ago, they now have a self referral number. You just call up, say you’re pregnant and seeking an abortion and they’ll book you in with a clinic/hospital depending on where you are. You can bypass the GP entirely now and self refer. I assume this is something being rolled out in other council areas too. I hope so!

Speaking as someone who has spent a large proportion of their working life in a fairly isolated area I would not be in favour of placing any further restrictions on which HCPs can work in remote and rural areas. Recruitment and retention in health care is a problem everywhere of course but it is a massive issue in many areas outside big towns and cities. Unfortunately the type of area where there is only one GP surgery or pharmacy is also likely to be the type of area where recruitment of HCPs is the most difficult and ruling out anyone from the already insufficient pool of people who are willing to take those posts could well make it even harder to fill posts. So it might end up not only being emergency contraception that that population has to travel miles for. In most circumstances it is far easier for an HCP to find another job than it is for them to be replaced, and restricting applications or insisting applicants go against their religious/ethical beliefs won't help that.
Ideally of course everyone should have equal access to all healthcare but for all kinds of reasons that isn't possible and probably never will be. Placing additional requirements on applicants in an attempt to solve this one problem could well have unintended consequences elsewhere. Whilst I would think that more or less everyone would like their HCP to provide all the services they're likely to need, most would prefer an otherwise good and committed permanent GP or pharmacist who doesn't provide emergency contraception to an ever changing string of unknown locums or worse, nobody at all. And that is the unfortunate reality for communities where permanent staff can't be recruited.
I do think that it should be very clear what is not provided though, and detailed information on how and where to access alternatives clearly displayed. It isn't in anyone's interest for a woman to have to make an appointment or queue and ask in a busy shop only to be turned away.

You believe that (as do I). But you can't tell me I'm disrespecting someone's morals I disagree with (morals which cause women harm), and then disrespect someone else's 'morals' because you disagree with them and they're not longer moral.

There's no right anywhere to have your 'morals' respected. You can hold them (as some clearly do), and I can think they're phony, abhorrent, stupid and awful - and say so.

Yes and I thought you were going to say morphine lol 😝

I wouldn't go as far as saying that holding these beliefs should prevent people from working in the profession, but GPs/Pharmacies should be very clear about what services they are able to provide and ideally have a colleague available who can prescribe MAP if they are uncomfortable with doing so.

I do think a lot of posters are naive when they say just traveling a few extra miles to the next pharmacy is no big deal. I'm someone who fell pregnant and was forced to have an abortion, because I called my local Doctors surgery the morning after being raped, asked for an appointment to get MAP which I wasn't told could be an issue by the receptionist. However I was refused it as there was no Dr in the surgery who was willing to prescribe it due to their beliefs. It took a lot of courage to call in the first place. I was then told I could go to a pharmacy 5 miles away and get it if I could get there in the next 5 minutes before it closed. I didn't drive at the time so it wasn't physically possible.

During this time I worked for a call centre and was due back at work the next day for 3 days straight. I spent hours researching all pharmacies in a radius I could reach and still get to work it time, but there was nothing. Work had literally just given me a grilling for not being at work the previous month because I couldn't get out of bed for several days with the flu. I was told I could lose my job if I had further absences in the next few months and there was no option for flexi time to just duck out for a doctors appointment without being interrogated as to the reasons why.

I absolutely agree with you and wish you hadn't had this experience. It's far too easy for people to quote gibberish from the pharmacists guidelines or to insist that it's easy to find another pharmacy that will prescribe. People are complex beings with a vast array of complicated personal circumstances, which can't all be taken into account when deciding that it's ok for pharmacists to simply refer to another chemist. I think the mere fact that this is deemed as an acceptable practice, highlights the real need for this to be looked into more carefully. It's already traumatic enough having to ask for help in the first place, without putting another barrier in the way!

@SabreIsMyFave This is incorrect. Pharmacists are the experts on medication and will often pick up GP prescribing mistakes. This is why we have pharmacists and not just a robot who selects the prescribed box of medication.

It was discussed and looked into very carefully when the morning after pill was first available. There is no way they could introduce a rule stating that hcp have to dispense or prescribe the MAP without it having an impact on the profession and ultimately patients.

That may be so, but it doesn't take away the fact that thousands of women are suffering unnecessarily due to the legitimisation of a restrictive practice. Nothing is static though, so hopefully it will be reviewed and amended given time, especially if women collectively put enough pressure on the relevant bodies to expedite such change. At its core, it's disproportionately disadvantaged a huge percentage of the adult population in accessing a healthcare need.

I think you’re exaggerating overestimating the numbers involved here. The number of women affected annually is probably in double figures.

Double figures?! How would you know this? If we count alone the posters on here who have encountered problems with accessing the map, even those would be more than double figures.