American Medical Association fights pharmacists who won't dispense contraceptives
BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7507.11-b (Published 30 June 2005) Cite this as: BMJ 2005;331:11All rapid responses
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It is beyond my ken that practicing physicians would support a
conscience vote to allow pharmacists not to dispense emergency
contraception in the bible belt of the US.
To invoke the Hippocratic oath is to move medicine back 2000 years into
the dark ages. Praogestagen only pills are safe effective and do not
transgress against God's grand scheme for the world. An abomination is an
unwanted teenage preganancy and the awful consequences such misadventure
causes to mother baby and extended family.
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If you had a moral objection to capital punishment should you be
forced to supply lethal injections or ropes or required to handle the
administration of such supplies? What is the difference in the attitude of
these pharmacists?
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Dr Howe argues that it is wrong for a society to "do you good whether
you want it or not." Is it not equally wrong to deny someone the chance to
do good if they really want to do good? Two wrongs don't necessarily make
a right!
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The Christian right is wrong again. The US is becoming a theocracy
which will do you good whether you want it or not.
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I am thankful for the American Bill of Rights to protect such non-
dispensing pharmacists from the AMA, ACOG, AAFP, and possibly the drug
companies who will not profit from such rebellion against the status-quo.
Such organizations have changed the definition of the beginning of human
life in order to accomodate the mechanism of a pharmaceutical. Perhaps it
would be better to change the mechanism of a pharmaceutical to accomodate
the beginning of human life.
"I will give no deadly medicine to any one if asked, nor suggest any
such counsel; and in like manner I will not give to a woman a pessary to
produce abortion" --Hippocratic Oath
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I am surprised a paediatric neurosurgeon, Peter Carmel, wants high
dose progestogen emergency contraceptives to be available in the US.1 In
the 1960s neurosurgeons were alarmed that progestogens were causing
strokes and cerebral haemorrhages in young women. Now the health of
teenagers seems to be fair game for Pill Pushers.
Progestogens are immunosuppressive, teratogenic and carcinogenic,
causing three times more breast cancer than oestrogens, with increases
within one year.
OC and HRT use increase the risk of systemic lupus erythematosus
(SLE) and anti-phospholipid syndrome (APS) with recurrent arterial and
venous thrombosis, cerebral disease, recurrent miscarriages and the
development of antibodies. Between 1950-79 and 1995 the incidence of SLE
increased from 1.51 to 124.0/100,000 population, female/male sex ratio
becoming 9 to 1. Doses of imunosuppressants, including prednisone, used
for SLE increased with length of follow-up and drug side-effects include
diabetes, bone disease and cancers.
Carriage of Factor V mutation potentiates the clotting effect of oral
contraceptives (OCS) by increasing resistance to activated protein C
(APC). Women heterozygous for APC resistance have a 7-fold increased risk
of thrombosis, as do “third generation” OCs users. Women who are both APC
heterogygous and use OCs have a 30 to 50-fold increased risk.
1 Tanne JH. American Medical Association fights pharmacists who won't
dispense contraceptives.BMJ 2005; 331: 11-b
2 Grant ECG. Systemic erythematosus. Lancet, 2001;358:585-87.
3 Rosing J, Tans G, Nicolades GAF, et al. Oral contraceptives and
venous thrombosis: different sensitivities to activated protein C in women
using second and third generation oral contraceptives. Br J Haemat,
1997:97:233-8.
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I simply don't understand how pharmacists can refuse to dispense
psychotropic drugs and analgesics - on what belief system is this based?
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Re: Re: Conscience
To add further comments to Dr. Seidler's response, I wish to mention
that a woman who is refused emergency contraception or abortion might,
among several options: a) complete an unwanted pregnancy to full term with
long-lasting consequences for several individuals including herself; or b)
try triggering abortion herself using wire hangers, bleach, and the like,
with predictably disastrous consequences to herself.
I leave it up to those who object to emergency contraception or
abortion on moral and/or ethical grounds to cope with the effects of such
consequences on their conscience.
It is unfortunate that we cannot have Hippocrate's opinion on this
issue.
Competing interests:
None declared
Competing interests: No competing interests