Pharmacist

Pharmacist

On April 14, 2005 lawmakers in the United States Senate introduced the Access to Legal Pharmaceuticals Act (ALPhA), a bill that purports to protect both the right of individuals to access drugs prescribed to them by a physician and the right of pharmacists to object to certain prescriptions on moral grounds and, consequently, to refuse to fill and dispense prescribed drugs.

Many of the arguments invoked by the contending parties are recycled from the preceding three decades of the abortion wars. For this reason, they may seem stylized, tired. Barring a decisive conclusion to that conflict, this particular skirmish will also remain stalemated. Although the authors do not lack views concerning whether abortion ought to be available by right to women during various stages or circumstances of pregnancy, we bracket them here so as to address the specific issue of pharmacist refusal. (Kachroo, 238-241)

A case is not established by showing that a handful of objections to it are ill-founded. Enumeration, however, can be indicative. There is a pattern to the arguments sketched out above. They are, in the main, predicated on the existence of some disadvantage or other that accrues to women whose prescriptions are not filled. They would be better off if the pharmacist had cooperated with their requests. However, the advantage of one party does not typically provide a satisfactory rationale for compelling compliance by a dissenting other. That is not a conclusion restricted to the narrow realm of pharmacological ethics but rather one that obtains generally in a liberal order. When individuals confront one another as moral equals, they are not (barring exceptional circumstances) obliged to render more than simple non-interference with the projects of others. (The Christian Institute, 95-120)

The crux of our argument is that in the case under examination, moral equality does not obtain. That is because the pharmacist is in a privileged position vis-à-vis potential clients. For a wide range of drugs, only physicians are legally entitled to prescribe, and only pharmacists to dispense. An individual who wishes to secure one of these is limited in her choices to those designated channels of supply. Her freedom to cooperate with willing others is thereby limited. This may, on balance, not amount to a disadvantage, because offsetting the liberty restriction is protection from unqualified practitioners and one's own uninformed or impulsive predilections. That is to say, in an all-things-considered accounting, the liberty deficit may be outweighed by benefits of paternalism. Nonetheless, qua limitation of choice, restrictive prescription policies do place burdens on those desirous of securing medications.

Clearer still, restrictions serve the interests of pharmacists insofar as they are shielded from competition by those outside the guild. Restrictive licensing boosts their income, because they are not in jeopardy of being undercut by alternative providers who lack the relevant credentials. They enjoy greater employment security because the supply of new pharmacists is constrained by narrowness of the educational pipeline. More speculatively, such regulation confers prestige on those who are confirmed as possessing professional ...