Hospital Pharmacy – Volume 46 – Number 5 / May 2011 – RxLegal – Pharmacist Conscience Clauses: Continuing Debate – Journal Article.
When the “experts” are called upon to provide commentary in professional Journals, it would help if they research their work sufficiently to write something accurate and useful.
Michael Gabay, Pharm D, JD, BCPS, has attempted to present the topic of Pharmacists conscience clauses, which have led to legislation excusing pharmacists from dispensing drugs which may operate to kill a human organism.
Listed below are a few of the troubles with Gabay’s article:
1) The implication that RU-486 contributed to pharmacists’ conscientious objection conflicts. Mifepristone/misoprostil regimen was highly regulated, and dispensed by the abortion practitioners themselves, rather than pharmacists. The article gives no mention of ulipristal acetate, the new analog of mifepristone which is now approved as a morning after pill, doses of which may be accumulated to accomplish a later abortion. (Way to keep current, Dr. Gabay.)
2) Glaring omissions of significant, current, judicial decisions. Dr. Gabay is a Clinical Associate Professor in the Dept. of Pharmacy Practice, University of Illinois, Chicago. Yes, he is in Illinois, a member of the Chicago Bar Association, and inactive member of the Illinois Bar. His article failed to mention the group of lawsuits recently decided in his own state, involving conscientiously objecting pharmacists and pharmacy owners, Walgreens and former Gov. Blagojevich. It is possible that Dr. Gabay, JD, was not aware of these significant court decisions, or perhaps he did not approve of them.
3) Garbled facts of the K Mart controversy, which actually involved a refusal to dispense progestin-only birth control drugs, not all “oral contraceptives” as the article incorrectly states.
4) Attributing the statement that oral contraceptives can prevent “implantation of a fertilized ovum”, to a person who knew better than that. Embryology lesson begins here: Fertilization of the secondary oocyte, produces an evanescent form called the zygote, that immediately begins cellular division, and proceeds to the next stage. By the time the human organism reaches the uterus to begin implantation, its embryonic form has differentiated into a blastocyst. (Dr. Gabay forgot the basic anatomy/physiology stuff which should have been prerequisite to his Pharm D.)
5) Dr. Gabay still appears not to know what Ms. Brauer knew about the mechanisms of birth control drugs, and the progestin, norethindrone, in particular. The actual disagreement in the K Mart case is still readily visible on the net: Page 1 and Page 2.
6) The crux of ethical objection to dispensing drugs which act, to a significant extent, to stop the life of a human organism is just that. It is not tied up in the various newer concepts of “abortion” and “pregnancy” which exclude the early human embryo. Abusing these terms to obfuscate the issue violates the patients’ right to give informed consent. The law has established no cogent or consistent basis for determining which human organisms may be willfully killed and which may not.
The complimentary review and editorializing will end here, to prevent reader fatigue.
The take home lesson for users of the literature in science and medicine is to read critically. Much of it is incomplete and factually “challenged” whether it is primary literature, or review and commentary, as in the case of Dr. Gabay’s article.
The value of extensive, formal education (as currently supplied) is also called into question, as it increasingly appears not to be helping with the quality of intellectual output.
*Note: This commentary has not been subjected to editorial review.