The Pharmaceutical Journal
Vol 280 No 7491 p244-245
1 March 2008

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• Retention fees
• Contracts
• Prescription charges
• Responsible pharmacist
• Community pharmacy (4)
• Emergency contraception (2)
• The Society (2)
• Drug addiction

Letters to the Editor

Emergency contraception

What is the Society’s position of refusal to supply EHC?

From Mr D. Johnstone, MRPharmS

I was disappointed, and even disturbed, to read comments by Simon J. Lewis in his letter entitled, “As a Christian, I will not supply EHC” (PJ, 9 February 2008, p149). The fact that he would allow his own religious belief, personal opinion and judgement to interfere with his decision to treat or care for a patient in his pharmacy is appalling.

When a member of the public comes to a pharmacist for advice and appropriate treatment, they should not expect to be turned away, for any reason. By all means, make sure that the patient’s decision is a well informed one. However, personal opinion, in this case, that the morning after pill can cause abortion, whether true or not, must be left out of it.

Personal objectivity and professionalism should be maintained at all times. A muslim pharmacist, I am sure, will not refuse to give a cough bottle or mouthwash containing alcohol because they personally cannot consume alcohol. To do this would not be caring for the patient and looking after his or her best interest.

If I refused to treat a patient based on my own beliefs then I would fully expect that person to never return to my pharmacy or even report me for lack of due care.

Does the Royal Pharmaceutical Society have a stance on this or is it really up to each individual pharmacist? I would be concerned if this was the case.

David Johnstone
Glasgow

My position explained

From Mr S. J. Lewis, MRPharmS

I am writing in response to letters (PJ, 23 February 2008, p213) relating to my decision not to supply emergency hormonal contraception.

My decision is based on both science and conscience. First, the summary of product characteristics for Levonelle 1,500µg states: “At the recommended regimen, levonorgestrel is thought to work mainly by preventing ovulation and fertilisation if intercourse has taken place in the preovulatory phase, when the likelihood of fertilisation is the highest. It may also cause endometrial changes that discourage implantation.”

Consequently, an early embryo may be expelled or aborted. Second, as a Christian, my attitude based on conscience is to safeguard the sanctity of life.

Fortunately, the Royal Pharmaceutical Society does allow pharmacists to opt-out of provision of services that would go against their conscience, whatever their faith or absence of faith.

If EHC is requested, I inform the patient that I am unable to provide it but ensure that they are aware of an alternative means of obtaining it; this is carried out in a non-judgemental and compassionate way, and does not involve forcing my religious view onto the public.

In his letter, Colin Boucker asks about the attitudes of those sharing my views to hormonal contraception in general. A useful guide, “Contraception: a pro-life guide” written by O. Hotonu (a member of the Royal College of Obstetricians and Gynaecologists) is available from the Christian Institute.

The same organisation has also produced a booklet on EHC written by J. R. Ling (University of Wales, Aberystwyth). I would recommend all pharmacists to read these publications to help them to consider their position regarding contraception, especially EHC.

In terms of ensuring patients can make informed decisions, pharmacists are in an ideal position to provide product information based on the latest scientific evidence, irrespective of their own belief system.

Simon J Lewis
Hove, East Sussex

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