Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude

Report 2001-01

Re: College of Pharmacists of British Columbia - Conduct of the Ethics Advisory Committee

26 March, 2001


College of Pharmacists of British Columbia
Bulletin - March/April 2000 Vol. 25, No. 2

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Note: This bulletin was prepared by the Ethics Advisory Committee.16No minutes were kept of the drafting of the document; the final (published) version is the only record that exists.17 The sections relevant to this report are highlighted.

Ethics in Practice
Moral Conflicts in Pharmacy Practice

The Code of Ethics adopted by the College of Pharmacists of British Columbia acknowledges that some pharmacists have moral objections to providing certain recognized pharmacy services. As a compromise, the Code recognizes conscientious objection as long as patients are not denied legitimate services. These pharmacists must refer patients to colleagues who will provide such services, and in the end deliver these services themselves if it is impractical or impossible for patients to otherwise received them.

Pharmacy, like all professions, has been granted a monopoly right to provide services to the public. And professions have an obligation to provide recognized services to the public, because the public has no alternative. For this, professions receive prestige and financial reward. In the case of pharmacy some might argue we received one without the other, but this is another subject.

Individual pharmacists may experience conscience problems when requested to provide services to which they have a moral objection. At present these services might include provision of contraceptives, syringes and needles for drug addicts, emergency contraceptives, high doses of narcotics to control intractable pain that might hasten death in the terminally ill, and medications for terminal sedation. In future these services might expand to include preparation of drugs to assist voluntary or involuntary suicide, cloning, genetic manipulation, or even execution.

Some pharmacists have argued that if they have a moral objection to providing certain pharmacy services, neither they nor the profession has an obligation to see that patients are provided with these services, and patients should not receive them. They should be able to dissuade patients requesting these services by denying their availability, or providing information under the guise of patient counselling. In some jurisdictions so-called "conscience clauses" have recognized these arguments.

The moral position of an individual pharmacist, if it differs from the ethics of the profession, cannot take precedence over that of the profession as a whole. The public cannot be expected to consider it to be just bad luck if patients are refused recognized pharmacy services because their pharmacists have moral objections to providing them. And the profession cannot allow pharmacists to lie about the existence of these services or promote their moral viewpoint in an attempt to persuade patients not to seek recognized pharmacy services they find objectionable.