Defending freedom of conscience on emergency contraception

CMF Blogs
Reproduced with permission

Philippa Taylor*

The UK’s biggest abortion provider, British Pregnancy Advisory Service (BPAS), has attacked pharmacists who do not sell the ‘morning-after pill’ for conscience reasons. 

After one incident when a pharmacist would not dispense emergency contraception to a woman for ‘personal’ reasons, BPAS condemned both the pharmacist and the conscience protections provided to pharmacists. A petition was set up to prevent pharmacists from claiming freedom of conscience rights. 

Under the current law, covered by guidance from the General Pharmaceutical Council (GPhC), pharmacists with a genuine conscientious objection to selling the pill may refer the customer to another pharmacist.

However, BPAS complained that it is ‘impossible to overstate the significance of even one pharmacist conscientiously objecting to selling the morning-after pill’. 

Fortunately, the General Pharmaceutical Council, in this case, upheld its guidelines and the consequent media coverage has now died down, temporarily at least.

This may seem like a one-off minor incident, but it is an illustration of increasing pressures on freedom of conscience protections. It is often assumed that the role of the conscience in medicine is relevant only to a few specialised and limited areas such as contraception or abortion, but in fact, the concept of the conscience goes right to the heart of what it means to act in a moral way, to act with integrity.

If we do not stand by those who are under pressure, the problems will only get worse and will spread. A well-known quote, often attibuted to Burke though it may have come originally from J S Mill, warns: ‘He should not be lulled to repose by the delusion that he does no harm who takes no part in public affairs. He should know that bad men need no better opportunity than when good men look on and do nothing.’

The Christian Medical Fellowship (CMF) has therefore written to the General Pharmaceutical Council to ensure they are aware of our concerns and to thank them for holding to their guidance. The text of our letter is as follows, with their response after it:

‘I am writing to you following the recent news coverage of a Lloyds pharmacy worker who, according to news reports, conscientiously objected to selling the morning-after pill and directed a customer to another pharmacy instead. I note that a petition has since been set up to prevent pharmacists from claiming conscientious objection rights.

‘The Christian Medical Fellowship is the UK’s largest faith-based group of health professionals and we contributed with both written and oral evidence to your review of your Guidance on Religion, Personal Values and Beliefs. We publicly welcomed the new Guidance and the statement accompanying it, in which the Chief Executive of the General Pharmaceutical Council highlighted the positive contribution that pharmacists’ faith can make in their provision of care. We also welcomed the clear statement that: “Pharmacy professionals have the right to practise in line with their religion, personal values or beliefs”.

‘We all aspire to person-centred care. In any care scenario, there are (at least) two parties – the carer and the one receiving care – each of whom has rights. The General Pharmaceutical Council guidance helpfully achieves a balance between the patient’s right to service access and the pharmacist’s right to freedom of conscience.

Respect for the sincerely held religious and moral beliefs of employees is essential and we are concerned that some of the demands being made, based on this one recent case, would marginalise the beliefs, values and religion of pharmacists disproportionately and unnecessarily, and trivialise their right to freedom of conscience under the law. Despite widespread coverage of this case, we have yet to see evidence of recurring complaints under the present provisions.

‘While we strongly support the right to freedom of conscience for pharmacists, we do also emphasise the importance of openness and sensitive communication with colleagues and employers; any refusal to supply should be made courteously and sensitively.

‘On behalf of CMF, I want to thank the Council for protecting the right of pharmacists to refuse to engage in certain procedures that violate their most profound moral convictions.

‘I also encourage the Council to continue to make it clear, publicly, that all pharmacy professionals have the right to practise in line with their religion, personal values or beliefs.

Yours faithfully

Dr Mark Pickering
Chief Executive, CMF

The General Pharmaceutical Council replied with the following two sentences:

‘Our existing guidance In practice: Guidance on religion, personal values and beliefs (to which you refer) remains in place. We have no current plans to review it. As you are aware, the guidance sits under our standards for pharmacy professionals and relates to standard 1, Pharmacy professionals must provide person-centred care.’

The point here is simple but vital: if we care about liberty and personal integrity, we must make a reasoned defence of it in the public square, from the smallest incident to the biggest.

Pharmacist refused to give morning after pill on a Sunday ‘for personal reasons’

Metro

Martine Berg Olsen

A mum was told she couldn’t have emergency contraception because it went against the beliefs of the only pharmacist working that Sunday.

Siani, 41, visited her local LloydsPharmacy at Sainsbury’s on Lewes Road, Brighton, when a female member of staff refused to give her the morning after pill for ‘personal reasons’.

Knowing that there are not many pharmacies open on a Sunday, Siani ordered the contraception online and paid upfront for collection. . . [Full text]

Indiana bill extends conscience protection to medical abrtions

Sean Murphy*

Indiana Senate Bill 201, proposed by Senator Liz Brown, has been amended in committee and is progressing through the Indiana General Assembly. Existing Indiana law protects freedom of conscience for physicians, nurses and institutional employees in relation to surgical abortion. Bill 201 amends the statute to include medical abortion and extends protection to physician assistants and pharmacists.

Chamber of Pharmacists warns professionals against incorrect dispensing of Morning After Pill

Malta Independent

Rebekah Cilia

The Chamber of Pharmacists (Kamra tal-Ispizjara) has sent an email to its members stating that there is a standard question protocol that pharmacists must follow when dispensing the Morning After Pill without a prescription.

These guidelines, the email said, are professional tools and should be kept confidential.

The Chamber also noted that pharmacists should avoid engaging in public discussions on social media. “The Chamber reprimands pharmacists who do not uphold such standards bringing the profession to disrepute.” [Full text]

Home abortions ‘could see more objections from GPs and pharmacists’

BBC News

A midwife who campaigned for staff to opt out of abortion work fears plans for “at home” abortions could see a rise in objections from health staff.

Mary Doogan lost her fight to not be responsible for other colleagues involved in terminations.

She thinks the plans to allow women to take the second abortion pill at home will implicate GPs and pharmacists.

She supports a law change to extend conscientious objection to those not directly involved with the process. . . [Full Text]

Community pharmacists’ attitudes on suicide: A preliminary analysis with implications for medical assistance in dying

Andrea L. Murphy, Claire O’Reilly, Ruth Martin-Misener, Randa Ataya, David Gardner

Conclusion

Canadian Pharmacists Journal

Pharmacists are likely underestimating their frequency of interactions with people with thoughts of dying or with intentions to die either by suicide or through medical assistance in dying procedures. Pharmacists report empathetic responses for those with severe and incurable diseases wishing to end their life, but most do not support death by suicide or through medical assistance. From the preliminary analysis, a personal connection to mental illness or suicide does not appear to influence the permissiveness of pharmacists’ attitudes towards suicide. Framing effects in survey research for pharmacists have not been adequately considered, and more work is needed to determine how this influences the responses of pharmacists.


Murphy AL, O’Reilly C, Martin-Misener R, Ataya R,Gardner D. Community pharmacists’ attitudes on suicide: A preliminary analysis with implications for medical assistance in dying. Can Pharm J (Ott). 2017 Dec 1;151(1):17-23. doi: 10.1177/1715163517744225.

Poll: would you dispense Voluntary Assisted Dying drugs?

Debate about Victoria’s Voluntary Assisted Dying legislation is dividing the country… but what do pharmacists think?

AJP.com.au

Megan Haggan

Victoria’s controversial Voluntary Assisted Dying bill – which would introduce legislation that would be the most “conservative” of its type in the world – has passed the State’s lower house, bringing the process one step closer.

Under the legislation, pharmacists would be part of the process, supplying lethal medicines in a locked box to eligible patients. . . [Full text]

 

Catholic leaders attack ‘erosion of respect’ for doctors who oppose abortion

Christian Today

Harry Farley

Catholic heads in the UK are issuing a robust defence of the Church’s abortion teaching after criticism of bishops’ stance from within the Catholic hierarchy.

Describing having a termination as a ‘grave decision’ the two leaders of the Catholic Church in England, Wales and Scotland attack the ‘contradiction’ in abortion laws for disabled babies and praised politicians who try to change the law.

They also lambast an ‘erosion of respect’ for those who oppose abortion, saying doctors and nurses ‘face increasing difficulty in being able to combine their dedicated professional work with their personal conviction’.

Pointing to recent cases where doctors and pharmacists feel they cannot refuse to offer abortion services, the senior bishops write: ‘So much talent is being lost to important professional areas. Personal conscience is inviolable and no-one should be forced to act against their properly formed conscience in these matters. This is something which needs greater debate in our society.’ . . . [Full Text]

 

Victory For Christian Pharmacists’ Conscience Rights In Great Britain

Cross Rhythms

Heather Bellamy

Heather Bellamy spoke with Ciaran Kelly, the Head of Communications at the Christian Institute, about the importance of reasonable accommodation in balancing people’s rights, and how after consultation, the General Pharmaceutical Council have chosen to continue to value their pharmacists faith and conscience, as well as patient care.

For the past few months, Christian pharmacists in Great Britain anticipated having to choose between their faith and their job, but after a huge campaign and the threat of legal action from the Christian Institute, their regulatory body has backed away from ending conscience rights. Heather Bellamy spoke with Ciaran Kelly, the Head of Communications, at the Christian Institute, to find out more. . . [Full text]

 

To dispense or not to dispense…

Eastern Daily Press

Nick Conrad

I was drawn to a news story which snuck under the radar this week. This issue is a classic ‘contract’ versus ‘conscience’ battle facing some pharmacists, which was brilliantly highlighted on the BBC Radio Norfolk Sunday Breakfast programme.

I pen this week’s article with genuine interest, a will to impartially provoke a healthy debate rather than trying to influence opinion. In a U-turn on proposed policy, Britain’s pharmacy regulator has declared that pharmacists should not be forced to dispense medicine and substances against their consciences. This includes drugs such as the morning-after pill or even contraceptives. The pharmacist can object if it goes against their religious beliefs, forcing the customer to go elsewhere. . . [Full text]