American Medical Association fights pharmacists who won't dispense con
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《英国医生杂志》
A battle is looming in the United States between doctors and the pharmacists who refuse to fill prescriptions for emergency contraception, birth control pills, and other drugs on grounds of conscience. "The has called for a meeting with pharmacists and others to get a national consensus about how this problem is to be handled," Peter Carmel, a paediatric neurosurgeon at the University of Medicine and Dentistry of New Jersey and a trustee of the association, told the BMJ.
"This is a problem of some urgency. We are all upset when our patients can't get a legal prescription filled," he said. In some states, he said, a substantial minority of pharmacists—perhaps even as many as half—are refusing to fill emergency contraception prescriptions. The "conscience clause" arose to protect health workers who did not want to be involved in abortion when the Roe v Wade decision made abortion legal in 1973.
Initially, a few pharmacists refused to provide emergency contraception because they believed that it was an abortifacient, but now their number has grown. Some have also refused to fill prescriptions for birth control pills and psychotropic and pain relief drugs ( BMJ 2005;330: 983).
The association's House of Delegates meeting in Chicago on 21 June voted to support legislation requiring pharmacists or pharmacy chains to fill valid prescriptions or immediately refer the patient to a pharmacy that would and to work with state medical societies to protect patients' rights. They also voted to enter discussions with representatives from all the relevant stakeholder bodies, in a bid to guarantee the filling of prescriptions.
As a last resort, the House of Delegates voted to seek state legislation to allow physicians to dispense drugs to their own patients when there is no pharmacist within 30 miles (48 km) who will.
William Golden, an internist and delegate of the American College of Physicians, said at the June meeting that pharmacists' refusals were "a growing problem," with many patients affected. The college, along with the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists, supports the American Medical Association's position. The House of Delegates includes representatives from most specialty and subspecialty medical groups.
Credit: KEVIN FOY/REX
The American Pharmacists Association says that pharmacists should not have "to engage in activity to which they object," but arrangements should be made to handle the situation before a patient presents a prescription.
The conscience clause had also spread to hospital workers who refuse to clean surgical instruments or handle paper-work tied to abortion as well as police officers refusing to protect reproductive health clinics, according to the US Alan Guttmacher Institute, a non-profit organisation concerned with sexual and reproductive health.(Janice Hopkins Tanne)
"This is a problem of some urgency. We are all upset when our patients can't get a legal prescription filled," he said. In some states, he said, a substantial minority of pharmacists—perhaps even as many as half—are refusing to fill emergency contraception prescriptions. The "conscience clause" arose to protect health workers who did not want to be involved in abortion when the Roe v Wade decision made abortion legal in 1973.
Initially, a few pharmacists refused to provide emergency contraception because they believed that it was an abortifacient, but now their number has grown. Some have also refused to fill prescriptions for birth control pills and psychotropic and pain relief drugs ( BMJ 2005;330: 983).
The association's House of Delegates meeting in Chicago on 21 June voted to support legislation requiring pharmacists or pharmacy chains to fill valid prescriptions or immediately refer the patient to a pharmacy that would and to work with state medical societies to protect patients' rights. They also voted to enter discussions with representatives from all the relevant stakeholder bodies, in a bid to guarantee the filling of prescriptions.
As a last resort, the House of Delegates voted to seek state legislation to allow physicians to dispense drugs to their own patients when there is no pharmacist within 30 miles (48 km) who will.
William Golden, an internist and delegate of the American College of Physicians, said at the June meeting that pharmacists' refusals were "a growing problem," with many patients affected. The college, along with the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists, supports the American Medical Association's position. The House of Delegates includes representatives from most specialty and subspecialty medical groups.
Credit: KEVIN FOY/REX
The American Pharmacists Association says that pharmacists should not have "to engage in activity to which they object," but arrangements should be made to handle the situation before a patient presents a prescription.
The conscience clause had also spread to hospital workers who refuse to clean surgical instruments or handle paper-work tied to abortion as well as police officers refusing to protect reproductive health clinics, according to the US Alan Guttmacher Institute, a non-profit organisation concerned with sexual and reproductive health.(Janice Hopkins Tanne)