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Pharmacy Has a Conscience Problem
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Kmart fires Pharmacist for not distributing abortifacient birth control methods.

In at least 45 out of the 50 States of the U.S., an employee pharmacist can be fired for refusing to dispense an abortifacient drug. They have no legal recourse against their employer. I am sure that most of the public is unaware of this fact and will be disturbed when it is revealed to them.

According to Gallup Poll for the last eight years, pharmacists have been rated as the most trusted professional (above even the clergy). Given that most Americans do not believe in abortion-on-demand, one wonders if pharmacists will continue to be held in such high regard if the American people understand what may be required of employee pharmacists, and perhaps eventually all pharmacists.

In the April 28, 1997 issue of Time Magazine an story was run about a pharmacist John Boling, who was under fire by his employer in California for refusing to dispense the Morning After Pill regimen. Any medically educated person should be given to understand that this regimen works primarily by preventing the implantation of an already fertilized egg. This is not contraception. This would be most accurately classified as an extremely early abortion. The Morning After Pill regimen is only 75 percent "effective" in killing a human zygote. The main reason for this has been theorized to be due to the extreme nausea and vomiting, a side effect of the high doses of hormones which can cause the woman to toss up part of her "therapy". This regimen is also a curveball thrown at pharmacists, since it has only had FDA approval for about a year. You might say that the "rules" of community pharmacy practice have changed.

Happily, John Boling's home state of California has one of the few Pharmacy Associations which had accepted a pharmacists conscience clause. This being part of the standard of practice prevented his employer from feeling so free to dismiss him for his refusal to dispense, although he was criticized for refusing to refer the patient to another pharmacist. Michelle Crider, the patient whose MAP prescription was refused, decided to raise a stink about it. Her husband, a reporter, aided her in this effort, hence the article in Time Magazine. He unwittingly did me and many other pharmacists like me a huge favor by bringing our conscience problem to the attention of the public.

My name is Karen L. Brauer. My "alphabet soup" is M.S. R.Ph., and I am a practicing community pharmacist. Prior to this (my favorite) career, I had enjoyed a brief time in the field of medical research. On December 19, 1996, I was fired from my position as a pharmacist with the KMart Corporation for refusal to dispense Micronor, a progestin-only "minipill", for the purpose of birth control.
"Many of the women were pleased that I would care enough to explain the forms of birth control to them, whether they agreed with my prolife position or not. Over time, I discovered that most women who had had experience with progestin only birth control had not been aware of its mechanisms of action." My opinion of this form of birth control was formed 20 years ago, because that is when I became aware of its most prominent mechanism to prevent implantation (as distinguished from a primarily contraceptive mechanism). My instructors in dispensing lab at pharmacy school were made aware of my opinion of this type of birth control, as was the District Manager who hired me to work for KMart. For the seven years that I worked for KMart, I turned away prescriptions for progestin only birth control, more often than not, talking the women out of filling the prescription at all. The Greater Cincinnati Area is a very conservative part of the country, and "minipills" were never very hot sellers here. Many of the women were pleased that I would care enough to explain the forms of birth control to them, whether they agreed with my prolife position or not. Over time, I discovered that most women who had had experience with progestin only birth control had not been aware of its mechanisms of action.

My "troubles" with KMart began with a downsizing effort that caused the closure of at least four pharmacies in the Cincinnati area and a reduction in hours of service at most of the remaining stores. Instead of managing the new pharmacy that I had opened, I found myself working 20 hours a week at each of two stores. The new manager at the second store had Micronor in his stock. So I let him know that I did not dispense them, and asked him to get his patient to come in on the days that he would be there. He seemed to agree to this. But on a day that I covered for him, I met up with his patient, who requested a refill. Rather than doing as usual and telling her why I don't dispense those pills, (which could possibly have made the manager look bad if he had not counseled her), I told her we were out of stock. In Ohio, a refillable prescription belongs to the patient and must legally be transferred at the patient's will. I asked her which pharmacy she would like to have the prescription transferred to, and fulfilled her request. Somehow this patient found out that we really did have Micronor in stock and complained to KMart headquarters.

The District Manager, (not the same one who hired me) received orders from headquarters to reprimand me, and that if I would not comply to their demands to dispense Micronor and "any legal prescription" and to not "send customers to the competition", to fire me. Since I would not give into these demands, the District Manager was forced to process my dismissal. It should be noted that this DM expended considerable effort in trying to preserve my job.

Since I am not the only pharmacist who has run into this sort of trouble with KMart, it could be concluded that such reprimands and firings are an expression of corporate policy.

KMart's Interview and Corrective Action papers signed at termination

Since I believe that women should be permitted to make informed medical decisions, it should be mentioned that the new low dose combination birth control pills are potentially abortifacient also. Combo B.C. pills were originally designed to prevent ovulation. As the hormonal dose is decreased (in order to decrease other side effects) the possibility of breakthrough ovulation increases, and prevention of implantation becomes a more prominent mechanism of action. For a multitude of medical and ethical reasons, hormonal birth control modalities should never have become the treatment of choice in human beings. Birth control pills for men are currently in development. When these drugs fail in the marketplace, women will truly know that they have been had

What do YOU think about KMart's policies? Why not call them and tell them?

KMart's "customer care" number: 1-800-63-KMart.
Or, if you prefer,
Send Kmart a comment right on-line!

More information on this issue and the Pharmacist's Conscience Clause (CC) can be found at Pharmacists For Life International


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