The Conscientious Pharmacist Assignment
Critical Thinking & Application Paper
The Conscientious Pharmacist Assignment Instructions: Read the case and answer the questions your instructor provided. Instead of writing one, long traditional essay based on the questions, reflect on and answer the questions individually, giving a detailed and thorough answer for each.
The Conscientious Pharmacist Assignment
Thomas Anselm is a newly minted pharmacist living in Adams, Wisconsin. Upon graduating from Groundhog University, Thomas accepted a job offer from a major pharmacy chain since he lacked the resources to open his own business. Thomas dreams of opening his own pharmacy but is satisfied working in his current position; he passionately endorses the pharmacists’ role in the medical aims of preserving human life and health. Thus, Thomas did not balk when the chain for which he works asked him to sign an agreement that he would dispense all legally prescribed medicine. Thomas is devoutly Catholic, spending much of his free time volunteering with children, working with his church on various charitable projects, and developing logical proofs of God’s existence.
One evening a young woman named Eve Gaunilon visits the pharmacy for a last-minute refill of her birth control pill prescription. Ms. Gaunilon presents Thomas with a legal prescription provided by her primary care physician. Thomas hesitates a moment before apologizing, “I’m sorry, Ms. Gaunilon, but I don’t believe in birth control so I will not fill your prescription.” Furious, Eve tracks down the assistant manager of the store, Bill Hume, and vociferously demands to have her prescription filled. No other pharmacists are on duty, so Hume reminds Thomas of the agreement Thomas signed when he started working.
Similar situations have become an increasing matter of concern to groups concerned with reproductive rights. “Refusing woman the Pill is a very disturbing trend, ” said Gloria Feldt, President of Planned Parenthood Federation of America. On the other side of the issue, members of Pharmacists for Life International, an anti-abortion group, contend that they have the right to refuse to fill prescriptions for the Pill. According to the organization’s President, Karen Brauer, R.Ph., “Our job is to enhance life. We should not have to dispense a medication that we think takes lives.”
Regarding the claim that the Pill “takes lives,” many anti-abortion pharmacists (and anti-abortion physicians also) accept the idea of a “post-fertilization effect” associated with use of the Pill. This idea is developed (as well as elsewhere) in an article authored by Dr. Joseph B. Stanford, Assistant Professor of Family and Preventive Medicine at the University of Utah (Archives of Family Medicine, Feb., 2000), cited widely by anti-Pill groups. In Dr. Stanford’s opinion, the Pill fails to prevent ovulation and fertilization of eggs with much greater frequency than most experts maintain. Furthermore, according to Dr. Stanford, such fertilized eggs (which anti-abortionists consider to qualify as human beings) cannot attach to the uterine wall because, he believes, the wall becomes hormonally altered when a woman uses the Pill.
The claim that the Pill hinders implantation has never been confirmed scientifically, according to Dr. David Grimes, a clinical professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine, and a leading authority on contraception. Even the American Association of Pro-Life Obstetricians and Gynecologists concedes that it is only speculation, says Dr. Grimes. Furthermore, reproductive rights groups point out that in addition to preventing unwanted pregnancies, oral contraceptives may be used for other important purposes. For example, they note that the Pill may reduce the risk of cervical cancer. “There are easily more than twenty noncontraceptive uses for the Pill”, according to Dr. Giovanna Anthony, an attending physician in obstetrics and gynecology at Beth Israel Hospital in New York City.
At this time three states, Arkansas, Mississippi, and South Dakota, have enacted “conscience clauses” that provide legal protection specifically to pharmacists who refuse services on moral, ethical, or legal grounds. Similar legislation has been introduced recently in eleven more states. The laws of most states, however, allow drugstores to require pharmacists in their employ to sign agreements that they will dispense all lawfully prescribed medications.
What should Thomas Anselm do?
This case was based on and adapted from a case published by the Association of Practical and Professional Ethics for use in the national intercollegiate Ethics Bowl competition, and is being used with their permission.
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