The Pharmaceutical Journal
Vol 278 No 7434 p48
13 January 2007

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• Pharmacy practice
• Health economics
• Dispensing errors
• Controlled drugs
• Ethics
• Adverse events
• Regulation
• Fitness to practise
• The Society (2)
• Retention fees (5)
• Pharmacy politicians
• The Journal (2)

Letters to the Editor

Ethics

Fight for a conscience clause in legislation

From Mrs R. M. Baker, MRPharmS

I write to commend Eileen Neilson, head of policy development at the Royal Pharmaceutical Society, for commissioning two interesting articles on issues surrounding the part that pharmacists may be asked to play in the provision of lethal drugs if or when physician assisted suicide becomes legal (PJ, 18 November, pp614–5 and 25 November, pp639–40). It is important that the pharmacy profession is ready for this legislation and that pharmacists’ involvement is widely discussed and properly thought through.

I expect that many pharmacists will seek the protection of a conscience clause and I urge them to encourage our profession to fight for such a clause to be available in the legislation and not just covered by a provision within our Code of Ethics. Provision solely within the Code of Ethics may not be enough. Currently, we have a conscience clause within our Code of Ethics, which calls upon us not to condemn or criticise a patient requiring a service that the pharmacist cannot in conscience supply. Other members of the profession, however, do not always treat pharmacists who invoke this clause, with respect.

On one occasion, a senior and respected member, who told me that I was not fit to be a pharmacist because I was not prepared to sell emergency hormonal contraception, publicly rebuked me at a local branch meeting. On another occasion, I was similarly rebuked by a senior member (now retired) who was employed by the Society. These situations were unnerving and would certainly have been intimidating if I had been less advanced in years at the time.

It takes courage to follow one’s conscience under such pressures and some pharmacists would find it easier to change their career path. In this way, good, conscientious pharmacists are lost to the profession despite the fact that, nominally, they are acting within their rights. Pharmacists who act according to their conscience should be shown the respect that they are expected to show to patients.

More recently I resigned from my position as a pharmacy manager because I was not prepared to follow a new company policy of promoting condoms at till points. Every pharmacist that heard about this situation, and there were many, presumed, as I did, that I could invoke the conscience clause. However, the advice eventually provided by senior staff in the legal affairs department at Lambeth was that the conscience clause covered supply of such items but did not include their promotion and therefore the company were within their rights to force the issue. All the pharmacists I spoke to were surprised by, though accepting of, this interpretation of the Code of the Ethics.

I cite these situations in the hope of summoning into action those pharmacists who feel they do not want to be involved in the supply of lethal drugs for physician assisted suicide. The Code of Ethics alone may not provide adequate cover for refusal to participate and inclusion of a conscience clause for pharmacists in the legislation must be sought. In addition it is important to fight for protection provided by a conscience clause to be respected by the profession as a whole and be unambiguous. A conscience will become an unacceptable luxury if we do not fight to protect it.

Rosemary Baker
Hoylake, Wirral

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