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Illinois Board Of Pharmacy

As a third-generation pharmacist, I was alarmed to hear about Illinois Gov. Rod Blagojevich's order to force pharmacists to dispense contraceptives with "no delays, no hassles, no lecture. Just fill the prescription."

Subsequently, in a commentary published in the Washington Post by Ellen Goodman called "Filling a prescription not a matter of conscience," the author proposes that pharmacists who object to dispensing abortifacients and other harmful drugs should quit.

Now, the two pharmacists and the American Center for Law and Justice are suing Blagojevich and seeking an injunction against the emergency rule.

Does this mean that the practice of pharmacy will be defined by non-professionals or by judges?

Obviously these people have no idea about what it takes today to become a licensed professional pharmacist. It requires six years of college, a grueling state board examination, state licensure and ongoing continuing education of 30 hours every two years.

On one hand, it is wrong to say that professionals should be forced to do something they morally object to against their will.

On the other hand, pharmacists must ensure that the patient is not harmed. Some pharmacists fail to see how preventing the death of an unborn child is causing harm.

What many observers don't seem to understand is that there is more to dispensing a medication than just filling it. It is important to know why the patient is requesting the prescription being as there are multiple indications for Food and Drug Administration-approved medications. As pointed out by Gail Street of the American Pharmacists Association, many medications may be prescribed legally, but can result in unintended outcomes, even death. Patients need to be screened for the existence of a host of possible health conditions and potential drug interactions. Furthermore, patients need to be counseled on how to take the medication properly in order to receive the intended outcome and should be informed about the potential side effects, how to manage them and how to store the medication.

If the outcome is one that is morally objectionable, it becomes cruel and unusual punishment to force the pharmacist to discuss an issue that is believed to be morally wrong and ask them to dispense a drug that will result in the death of an unborn child. Many pharmacists also feel obligated to protect the life of the unborn child by not providing a referral to another pharmacy or pharmacist. Yet, only three states--Arkansas, Mississippi and South Dakota--protect the pharmacist's right to object consciously and not fill the prescription.

Pharmacies make significant financial investments in inventory with the prospect of poor or inadequate reimbursement. In fact, Illinois provides free birth control to eligible women in the state. Why has this governor decided to target pharmacists when they are the ones providing the benefit? Why not let them distribute the drugs themselves just as some employers and health plans (including Medicaid) have done.

Pharmacists should not only remember the Hippocratic oath to first do no harm, but also to remember the pharmacist oath to consider the welfare of humanity and relief of suffering and to maintain the highest standard of moral and ethical conduct. Pharmacists are now being threatened with fines, sanctions and even being told to quit because of their moral beliefs. Pharmacists are not civil servants or robots. They are professionals. Every pharmacist must take an active role in defining his or her profession.

Jim Wilson, R.Ph., MBA, is president of Wilson Health Information LLC, New Hope, Pa., info@wilsonrx.com.

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