The Pharmaceutical Journal
Vol 280 No 7487 p108
2 February 2008

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Complex relationship between beliefs, ethics and knowledge leads to variability in EHC supply

Pharmacists’ religious beliefs do not always influence their willingness to sell emergency hormonal contraception (EHC). However, most pharmacists have difficulty discussing ethical issues relating to EHC sales.

These and other findings are discussed in a recently published study in which 23 UK pharmacists were interviewed about their views on EHC supply (Journal of Family Planning and Reproductive Health Care 2008; 34:47).

The researchers found that the pharmacists fell broadly into three categories: 16 pharmacists who routinely sold EHC and did not identify this as ethically problematic; four pharmacists who believed that GPs should be the main route of supply but who sold EHC in varying circumstances; and three pharmacists who were opposed to selling EHC on ethical grounds and found such requests distressing.

Richard Cooper, research fellow at the University of Sheffield and one of the authors, commented on the research: “The main message is that there was variation in attitudes to selling EHC that was not always informed by a religious belief, for example, as the popular press have had a tendency to suggest. What I think the study reveals is a complex interrelationship between religion, ethics and certain facts and, as a consequence, a potential variability in supply for customers which could be confusing.”

He said that most of the pharmacists he interviewed routinely sell EHC but, because the study was qualitative, it is not possible to make generalisations from the study to all pharmacists.

“Terminology such as ‘morning after pill’, and a perception that EHC causes abortion, are unhelpful for a profession seeking to provide a greater public health role,” Dr Cooper added.

“A striking finding,” he pointed out, “was that all but one pharmacist who would not sell or would variably sell EHC, would still always dispense EHC from a doctor’s prescription. I argue that this is due to the subordination of pharmacists to doctors in relation to dispensing and that they may feel the ethical responsibility has shifted when they see a prescription, despite pharmacists’ continued professional and ethical accountability when dispensing.”