A rchive Date
[ 12-06-2000 ]
Category
[ International Relations ]
sub-Categoy
[ Canada ]
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[Any spare prescriptions?
By MARIANNE MEED WARD
Toronto Sun
June 12, 2000
In the biblical story of Cain and Abel, when Cain's sacrifice to God is rejected but his brother's is accepted, Cain becomes so enraged with jealousy that he murders Abel. Later, when God asks Cain where Abel is, Cain replies: "Am I my brother's keeper?"
Like his father Adam before him, who blamed God for creating Eve who gave Adam the apple that tempted him to sin, Cain was merely trying to shift blame for his own actions. "It's not up to me to look after my brother," was the message.
God didn't buy it, nor did much of civilization since. Instead, we more or less embraced the notion that we are all each other's keepers.
It has a nice community-minded, sentimental feel about it, and might have survived untarnished if it hadn't been for that pesky George Orwell who redefined the meaning of brother in his novel, 1984. In it, we meet a meddlesome Big Brother who arranges lives in whatever way he thinks is best for those living them. There is no choice, and no opportunity to negotiate.
I thought of these two notions of brotherhood as I read that the Manitoba Pharmaceutical Association (MPA) endorsed a protection-of-conscience clause last week that allows pharmacists to refuse to fill prescriptions they believe are morally unpalatable. Ontario is also considering one.
Prescriptions for, say, the morning after pill which prevents implantation of a potentially fertilized egg. I say potentially fertilized because the day after sex, a woman can't know from any kind of test whether there actually is a fertilized egg inside her. Blood tests aren't accurate till at least two to three weeks later, and urine tests longer. Even telltale morning sickness takes at least a week or two to kick in.
So what, exactly, is the conscience issue here? That someone might be preventing a pregnancy that possibly wasn't even there in the first place?
And is the alternative any better? Is it really so ethical to force a woman to wait till she knows whether or not she is pregnant, then face a much more difficult procedure - and difficult decision - to end it? Pharmacists may believe she will decide to carry to term if she can't get her drug. They may think this is what it means to be "my brother's keeper," to help someone make the choice you think you would were you in his or her shoes.
Pharmacists may be interested to know that all this does is shift the ethical burden entirely to the woman's shoulders. So much for the community sharing her struggle with her.
The issue isn't about the morning after pill. The MPA says pharmacists can refuse to dispense any drug they don't think you should have. And they don't have to give you a reason. In fact, they can't give you a reason. The clause prevents pharmacists from stating their opinions about the drugs they refuse to hand out. And they don't have to refer you to another pharmacy where you can get your prescription filled.
Makes you wonder what pharmacists think about the ethics of doctors. Makes me wonder: do we really want pharmacists trumping our own doctor's decisions about what is appropriate care for us?
The association argues the clause merely formalizes an existing right that pharmacists have always had. Now we're getting to the atom of the matter.
This is indeed about rights, though it's much more palatable to use the language of conscience. More precisely, this is about the right of an individual not to engage in a business transaction. Period. Should pharmacists have that right? Sure, but let's call it that.
Because this clause is more Big Brother than brother's keeper, though it masquerades as the latter.
The pharmacist who won't give out a drug because of his own conscience does so in order to sleep easier at night - without any regard for whether the person who can't get the drug his doctor said he needs is able to slumber so peacefully. It's a selfish, I-know-what's-best-for-you choice, but not one that ultimately looks out for the desperate patient trying to buy a product in the marketplace.
Marianne Meed Ward, a freelance writer with an interest in social and ethical issues, appears Mondays. Her e-mail is:pward@interlog.com
 World Fact Book (CIA)]
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