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At a conference in Banff two years ago, a group of hospital pharmacists was asked to ponder this ethical dilemma: You are in a small town and a 16-year-old girl comes into the hospital asking for the morning-after pill. You know her parents and you are morally opposed to this form of treatment. How do you respond? After carefully weighing the question, many in the room said they would refer the girl to a colleague more comfortable with the treatment. But the ethicist conducting the seminar would not let the pharmacists off that easy, recalls Bill Leslie. "He said, 'You're the only person and there is no other pharmacist, community, hospital or otherwise, within a day's travel and there's no way the patient can get to another town to get the prescription filled.' He really pinned it down to the point where you have to do something -- you can't pass it off to someone else." There was no consensus among the assembled pharmacists, said Mr. Leslie, executive director of the Canadian Society of Hospital Pharmacists, but the answer, according to the ethicist, was very clear. "From an ethical standpoint, regardless of your beliefs, in that situation your responsibility is to the patient and patient care, to address that patient's needs."
Late last year, the National Association of Pharmacy Regulatory Authorities attempted to find a balance between the sometimes grey area of individual rights and professional responsibility by approving a model statement regarding pharmacists' refusal to provide products and services for moral and religious reasons (see sidebar). The statement, which was circulated to organizations such as CSHP, the Canadian Pharmacists Association, the Canadian Medical Association and the Consumers' Association of Canada, is now in the hands of each provincial and territorial licensing body. If it is adopted and becomes part of that province's regulatory framework, the provincial council will assume the role of interpreter and arbitrator should a grievance be fried.
The statement sets the health and safety of the public above all else, but allows pharmacists to object, as a matter of conscience, to providing a service or product. They must, however, prearrange access to an "alternative source." It also stipulates that the objection must be "conveyed to the pharmacy manager, not the...