What’s in a word – specifically in the words, the ‘right to refer’ or a ‘duty to dispense’? What difference does the one phrase rather than the other make? In the case of proposed ‘new standards for pharmacy professionals’ and ‘behaviour guidance’ which are due to come into effect this year, rather a lot.
Replacing the former with the latter – which is what the General Pharmaceutical Council proposes to do to change the regulations around prescription dispensing – not only puts the principle of individual freedom of conscience at stake but also raises fundamental questions of medical ethics.
There are only a few days left in which anyone can object.
The question is whether pharmacists should be forced to dispense drugs for what they consider to be unethical practices – like emergency contraception, gender reassignment, abortion or even, should the legislation ever be passed, for assisted suicide?
Or should they retain the right to exercise freedom of conscience by either referring to a colleague or opting out?
Just to take one current example – pharmacists who believe that human life should be respected from the time of fertilisation generally object to dispensing potentially abortifacient drugs like levonelle and ellaOne.
Although marketed as ‘emergency contraception’ or the ‘morning-after pill’, these drugs are known in some cases to act by preventing the implantation of an early embryo and causing, in effect, an early abortion.
Currently pharmacists don’t have to. They have a right to refer these cases to another pharmacy or colleague. However under the new draft guidance, which the GPhC admits represents ‘a significant change from the present position’, this right would be removed.
The GPhC have couched their proposal in the ‘newspeak’ and euphemistic language of ‘person-centred’ care. They argue that ‘person-centred care’ puts the dignity and best interests of the client first. But does it? The Council goes on to frame this care in terms of a universal right for clients to ‘access’ legally prescribed drugs and devices, ‘rights’ which would trump the pharmacist’s freedom of conscience. He would thereby be pressured to comply or risk disciplinary procedures and/or possible loss of employment. Potential trainees could be dissuaded from pursuing a career in pharmacy altogether.
Yet there is little real evidence of widespread complaints by clients denied access to drugs under the current regulations that would justify the change. Ironically the British Equality Act 2010, which is the sole legal precedent that the GPhC quotes in their consultation document in support of their proposal, lists nine protected characteristics, one of which is ‘religion and belief’. It is therefore almost inconceivable that their draconian draft proposal will not be challenged in court by an aggrieved individual or organisation.
But it should not come to that. It is just not worth the time, energy and expense and can be avoided. The regulator, it seems, is using a sledgehammer to crack a walnut. The GPhC’s proposal to remove pharmacists’ conscience rights is disproportionate, unethical, unnecessary and quite possibly illegal. For the sake of professional freedom and reasonable accommodation, essential in a pluralist multi-faith democracy, let’s hope that they chose instead a more flexible, tolerant, respectful and eminently sensible path.
To understand the full complexity and import of what is being proposed please consult my full article here.
The consultation on the draft proposal is open until 7 March 2017 – there are three days to respond. You can find the background here; the full consultation document here – the response form is on pages 23-30 and is summarised on p31).