By Rob South
Where do the rights of the patient end and the rights of the health care worker begin?
Pharmacists in Manitoba are no longer required to dispense certain drugs they find morally objectionable, and they do not have to give a referral to where the prescribed drugs are available. The motivation for this policy appears to be some pharmacists’ objections to the "morning-after-pill."
Maria Bizecki, a spokesperson for Concerned Pharmacists of Conscience, says, "By pushing their morality on health care workers, the public violates a pharmacist’s autonomy, integrity and basic human rights in a country that protects its minorities." Clearly the argument here is the law should not force people to perform actions they find objectionable, and the principle of this argument is a good one–it can be found in the Universal Declaration of Human Rights.
However, Ms. Bizecki’s argument is flawed. The law does not force any pharmacist to dispense prescriptions because the law does not force any person to be a pharmacist. If someone is unhappy as a pharmacist they are free to quit anytime.
True, it is extreme to ask a person to quit their job because they have an objection to one small facet of it. Therefore, the real issue from this side of the debate is why shouldn’t our society tolerate people performing their job within the limits of their own moral framework?
From the other side, we have to question the effects on the patient. What this policy will mean to patients will vary immensely from situation to situation. Considering the arguments for pharmaceutical freedom are based on principle, let’s base the arguments for patient access on principle as well.
Consider the possibility of someone in a remote northern town whose pharmacist will not give them their prescription. That person’s access to health care is now compromised. True, instances like this may be rare, but in principal they should not occur. Access to health care is a part of the UDHR, and who can say what health care may end up being denied on moral grounds?
For example, the Catholic Church does not believe in birth control of any form. Does this mean a patient could have birth control denied because their pharmacist is Catholic? Remember, some women go on the pill merely to regulate their periods, not because they are having sex.
If we proceed on this slippery slope argument we could probably find a reason for a pharmacist to not give out virtually any prescription, not just those related to reproduction. Admittedly, the Manitoba Pharmaceutical Association only allows for certain drugs not to be distributed, but does that mean only certain moral objections are valid?
Health care in Canada is public; a pharmacist is a private citizen who chooses to participate in a public program. To my mind if you commit to participating in the public health system, you commit all the way; the public deserves no less.