The Policy Forums by Greenberger & Vogelstein and Manasse address the issue of
pharmacist refusal to dispense drugs based on moral beliefs. One side of the debate argues that
patients have the right to demand prescriptions they have obtained
from their physicians, while the other claims that pharmacists have
the right to refuse service based on moral grounds. The
assumption that goes unsaid is that one can discern the medical
condition that necessitated the drug from the prescription alone.
It is likely that prescriptions for oral contraceptives, for example,
are used for contraception. However, birth control pills are used
to treat a number of medical conditions, including polycystic
ovarian syndrome and abnormal menses. Furthermore, oral
contraceptives may also be prescribed in cases in which
pregnancy would be harmful to either the patient or the
potential fetus. Certain drugs such as isotretinoin,
chemotherapeutics, and thalidomide are teratogenic to developing
fetuses and are prescribed only if the patient is on at least one
form of birth control, even if the patient is abstinent.
Most physicians do not write the indication for a prescription on the
script. A pharmacist, who most often does not know the full medical
history of the individual, cannot assume to know the reason for the
prescription. For this reason, blanket refusal to dispense drugs for
any reason based on drug class is dangerous and discredits the
covenantal relationship between the patient and the physician.
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