The perversion of Freedom of Choice

[saddemocrat]

OK..I just have to ask this after being involved in another debate.

How can individuals be enraged when a pharmacist (exerting his own freedom to believe and make choices based on that belief) refuses to fill a prescription for the morning after pill....and insist that the govt/laws intervene...but in the case of a young boy who will certainly die of cancer if his parents don't get him traditional medical treatment, they are outraged at the fact that the govt. would intervene to take away the parent and minor child's right to 'choose'to act on their own beliefs?

We have the right to do to our body what we want...but not to inflict harm.

I support abortion rights and don't think a pharmacist should be able to exert their personal beliefs onto the consumer...but at the same time, I also think that parents should not be able to deny their child adequate medical care. If I support the state stepping in on abortion, gay marriage (in support of) and forcing the issue of prescribing...then I am also consistent in demanding that when I child is potentially being harmed by its parents that the state step in as well.

[rodeodance]

1. We are governed THROUGH our freedoms.

[atreides1]

2. He chose, not his parents

From the AP story

"Abraham chose to instead go on a sugar-free, organic diet and take herbal supplements under the supervision of a clinic in Mexico."

"A social worker asked a juvenile court judge to require the teen to continue conventional treatment, and the judge on Friday ordered Abraham to report to a hospital Tuesday. But Accomack County Circuit Court Judge Glen A. Tyler suspended the judge's order."

This was a freedom of choice issue, he made his choice, freely.

[saddemocrat]

3. in that case

Let's agree then, that this minor child with no education/background in the treatment of cancers is *free* to make that choice.

I'll let my pharmacist up the street know that he is now *free* to choose not to prescribe the morning after pill and I won't make any fuss over the fact that our local hospital refuses to perform abortions even in the case of serious illness of the mother or unborn child.....it is their freedom of choice...clearly...a freedom of choice issue.

I expect that this will end the whole 'freedom of choice' debate. Thank gawd the supreme court won't have to step in...

<sarcasm>

[Extend a Hand]

6. I have a problem with the

entire system that requires me to beg a doctor or pharmacist for access to medicine that I might choose to take. The entire dang prescription system is a racket.

[question everything]

20. Thank the 1962 Kefauver-Harris amendment

Until then, all you had to do was prove that a medicine, or a food supplement, does not harm people. Then, with the scare of Thalidomides, Congress voted to require medicine to be not only safe but also effective. The irony, of course, was that Thalidomide never made it to this country based on the law that was in existence.

Since then we require pharmaceuticals to spend millions to prove that a new drug is effective, using statistical analysis that can be quite misleading.

We also expect our lives to be risk free and if we are ill because of stupid decisions, or because life is not fair, we sue, and jurors feel free to spend million of dollars in rewards.

I think that if I want to use a product made of Albanian bat droppings, as long as the FDA finds no harm and as long as the production is clean and consistent, then I should be able to use it.

[Czolgosz]

24. You are AGAINST laws requiring that pharmaceuticals be safe and effective?

That's odd.

Also, you are aware that the jury verdicts which have held pharmaceutical companies accountable for their unsafe drugs have generally been based on uncovering fraud by the drug company, right? I'm assuming that you would not spout such peculiar views without looking into the issue first.

If you're new to this issue, here's a little information to get you started: http://www.newstarget.com/010613.html

[question everything]

27. Not against them being safe

and all the lawsuits are about medicine that found to be harmful.

What I am is against proving efficacy which can result with a product helping only 1% not being approved or even manufactured. But what if this is a terminal illness and you are in that 1% who will be helped?

The pharmaceutical business now is a multi-million dollar industry, of course, and drugs are super expensive because most of us get our insurance to pay for them. This is one reason why health care costs have risen; most of us do not pay for the treatments.

This issue has been dormant in the past 15 years, or so, being replaced by the real problem of the uninsured and the soaring health care costs.

But if we insisted on safety assurance and let the market determine efficacy - it would be in the best interest of the pharmaceutical company to have some studies and not to charge the patients - we would at least undermine the claims by them that it takes 10 years to bring a product to the market and they need to recoup their millions that they spent. And the reason why it takes 10 years is that they have to prove efficacy at a high statistical standard. And meanwhile, many dye because they cannot have access to experimental drugs because the companies do not want very sick people who may skew the results against efficacy.

[Czolgosz]

28. If you are in dire need and in the 1% who'd benefit from an unproven drug,

there are medical trials and other exceptions to the FDA approval process so you can receive treatment (I have received such treatments personally).

The major pharmaceutical companies spend more money on marketing than they spend on research and development. The argument that they need to be de-regulated to get medicine onto the market sooner is a Karl Rove type PR spin the put out because they could make more money if they were de-regulated. Here is some information in this topic: http://www.cbr.med.harvard.edu/page.php?branch=newsroom&page=releases&type=9&year=2005&id=21

[Extend a Hand]

32. my complaint starts in 1938

when the FDA established a class of drugs to be available only by prescription.

[niyad]

31. I don't see what is so hard to understand--in both the case of the

pharmacist who refuses to dispense the "morning after" pill, and the social worker trying to force the 16-y/o and his parents into treatment that social worker deems necessary, they are removing the freedom of choice of the individuals to decide their own lives. what is so difficult to understand about that/?

[Czolgosz]

25. Minors do not have the legal capacity to make such choices. His parents

chose notwithstanding that the child may have concurred in their decision.

[porphyrian]

4. There is also the complication of what constitutes "harm."

Most people agree that it's wrong to kill other people, or even to slap them ("touch in an offensive manner" is, I believe, the legal wording). But what if someone chooses to cut themself non-lethally? Should that be illegal? What about recreational drug use? And if that is wrong, why is alcohol legal? After all, suicide is illegal. Maybe we should make it illegal NOT to have health insurance, as that prevents people from getting proper medical care until it's too late far too often.

Complexity.

[zbdent]

5. In regards to this case, I've been saying

that the way that this kid would get his way is if his parents moved to Texas, lost all their money and went on welfare (changing skin color is not a likely option).

Conservatives couldn't kill him fast enough. Bush even signed into law the go-ahead for hospitals to pull the plug on life-saving procedures for people who cannot afford to pay the hospital bill ...

[saddemocrat]

7. you guys

totally ignored the argument at hand.

As interesting and valid as your points are about healthcare in america (I am all for universal healthcare) that does nothing about the argument that if we accept 'freedom of choice' to refuse medical treatment for minor children (this will result in this child's death, too, so is it murder?) then we should accept the 'freedom of choice' for people to make decisions about filling prescriptions/giving abortions even if we don't agree.

It's a frightening middle ground, isn't it?

[Greyhound]

8. Two separate issues...

One (abortion) is an attempt at government regulation of personal liberty. The other is a matter of professional obligation. The pharmacist is entitled to hold any belief he/she wishes, but they have chosen to make a career in a field that, by its very nature, requires the pharmacist to submit to the direction of the physicians orders. The pharmacists personal beliefs do not enter into it.

[saddemocrat]

9. Personal Liberty

also should be available to those with different beliefs regardless of their 'profession' then. Parents are entitled to hold any belief that they wish but that in order to provide for and protect their children they have to get that child the treatment with the best possible chance of cure?

I, personally, agree with you on the subject of pharmacists (for example)...however, I don't think it's possibel to have it both ways. I don't think that you can say that the pharmacist has less of a responsiblity to their patients than a parent to its child....Either in both cases personal beliefs don't enter into it or...they do. So...we support the parent not getting adequate treatment for the child and then we have to support the pharmacist for their personal beliefs and choice.

[Greyhound]

10. Personal belief does not equal professional obligation.

The difference boils down to the scope of governmental authority.

In the cancer case, what if the court ordered "treatment" is, in fact, harmful? In that case you are advocating that the parents must submit their child to life-long (however long that may be) consequences because "Daddy knows best". Well what about when daddy is wrong, or worse, when daddy knows it is harmful but has been bought by campaign contributions?

The raising of children is the job of parents as is bearing the consequences of those decisions. Fulfilling the responsibilities of your profession is a completely different matter.

[saddemocrat]

12. No offense

but failure to provide this child with the treatment is, in fact, harmful. Though chemotherapies can and sometimes do cause damage, they are also life-saving in many cases.

At the end of the day, you have to go with the best available research and evidence, not personal feelings or fears. There is research being funded on both alternative treatments and traditional medicine for all kinds of illnesses. You should do the brainwork and pick up some of the studies. The parents should be forced in this case to provide the treatment with the greatest evidence of success.

Chemotherapy can be awful...I just survived 7 months of cancer treatment...but...it isn't as bad as the alternative, which is certain death in this child's case....And this child's death will be a hell of a lot more uncomfortable than his treatment...of that, the parents can be certain.

[Greyhound]

18. None taken. I'm not one of those that take difference of opinion

personally, in fact, I love to build consensus whenever possible. I've even been swayed to a new outlook on occasion by honest debate.

My point regarding forced medical treatment is not really about this specific case, but rather, is the benefit gained from expansion of governmental power worth the inevitable price in lost liberty? My opinion is, no it isn't. That this particular child will die is terrible, but I don't hear any hue and cry for the US to cut its military budget by a measly 10% to provide food, shelter, health and reproductive care, clean water, and education world-wide, and according to a 1998 UN study that is all it would take, about $40 billion a year.

The pharmacist case however is completely different, an equivalent example would be for a physician to refuse treatment to a black man or a woman, because of what they are. We all (I think by now) agree that that is wrong and should not be allowed.

[Protagoras]

11. Did the Pharmacist take his professional oath?

Professions are positions which are regulated, highly compensated, and which have oversight, codes of conduct, and standards of ethics. They are usually licensed and commit to basic principles of behavior in the course of their duty. Pharmacists are professionals and as such they have a code of conduct and set of ethics which they agree to when they become Pharmacists...that is their choice.

www.uspharmd.com/rxcode.htm

and look at #3

III. A pharmacist respects the autonomy and dignity of each patient.

A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable. In all cases, a pharmacist respects personal and cultural differences among patients.

[saddemocrat]

13. And parents?

We don't take an oath, but we have physical, emotional, and financial responsiblity for our children.
It is against the law for a parent to beat their chilren, starve them or abuse them in any other way...therefore, there is a moral understanding that parents must recognize the self-worth of their chlidren when it comes to decisions about health.

We make a choice to become parents too...and with that choice comes responsibility..sometimes choices we have to make are hard too....


kris

[Protagoras]

14. Parents don't have Professional responsibilities

and conflating their choice with that of a profession is a non sequitor.

different relationships have both different choice options and different choice duties. And in the case of the Pharmacist there is a critical difference between an actual vs a potential/theoretical violation and an actual/immediate client vs a potential/theoretical client.

Might also want to take a hard look at the differences between Professional, Legal, and Moral requirements...

[TahitiNut]

17. So, a conscientious objector should be permitted in the military

... even though he or she refuses to carry a weapon, stand guard, load artillery, or engage in any task that would contribute to killing, even under attack?

Fine. Then there's no reason they shouldn't be drafted. :shrug: There're never enough medics.

[BurgherHoldtheLies]

15. No gov't protection for unprofessional behavior: Fire the pharmacist

There is a level of expectation to perform duties as a professional health care giver. If you refuse to perform those duties: YOU'RE FIRED!

As far as the judge intervening in the cancer tx case, the boys FIRST step, legally, should be to seek emancipation...then he's an adult and nobody can order him to get tx (Jeb Bush or Bill Frist and the rest of the GOP would disagree, even for adults :puke:)

[recidivist]

34. The employer has a right to fire. Not the government.

Except, of course, if the government is the employer, but that's not what we're talking about here.

The owner of a pharmacy should have the right, like any other professional, to set limits to her practice. We do not compel doctors (if self-employed) to perform abortions. A lawyer (if self-employed) has a right to decline a case.

[BurgherHoldtheLies]

35. Yes, the employer fires while the gov't keeps it's nose out of the firing.

No special legislation to protect professionals, particularly health care professionals, from executing duties that are expected from that profession.

If these people are sooooooo into their faith, they should stick to faith-healing...they have no business in the science based professions.

[recidivist]

36. Why do you assume the employer would fire the pharmacist?

I agree that the employer should be allowed to set the policy for the pharmacy. Of the four pharmacies that I can recall having patronized in recent years, three have (I think) been independently owned or franchised. In these cases, the pharmacist is the employer and should be able to set her own policy.

In the fourth, the owner is a large chain. The corporation presumably sets a company-wide policy in such matters. It may or may not choose to carry the morning-after drugs; that is a moral question for the board. As an entirely separate HR question, it may or may not choose to accommodate dissenting employees.

In the end, the decision rests with the business owner.

[question everything]

16. Can you imagine a nurse refusing to follow a doctor's orders

during tubal ligation or vasectomy? Or during sex change operation?

Pharmacists are supposed to fill prescriptions. Period. Nurses are expected to follow doctors' orders. Period.

If either is incapable of this then they are in the wrong field. Period.

[saddemocrat]

19. I know....

And can you imagine a parent refusing proven, life-saving treatment for their child in lieu of some unproven quackery? Unbelievable, huh?

[question everything]

23. Their right. At least for themselves

it is different with children, of course, as the parents are the guardians.

But for individuals - the power of placebo is enormous and we really do not know all the mysteries of the body. Ancient Chinese medicine kept people healthy and alive before "modern medicine" came along, before the FDA required the active ingredient of a product.

The reality is that we do not know the active ingredients of many natural products and we do not know the complex interactions between a whole product and the whole body.

[Bake]

21. Huge difference that no one has pointed out

In the cancer situation, the teen (and presumably his parents) made the decision as to what treatment the teen wanted for his own medical condition.

As to the pharmacist, however, the patient is being denied her choice of treatment and moroever, the pharmacist is refusing to fill a doctor's orders for a lawful medicine.

In the former case, the patient is deciding for himself. In the latter, the pharmacist is deciding for the patient.

Finally, as to the pharmacist's professional obligation: If the pharmacist believes he/she cannot ethically fulfill his/her professional obligation (i.e., to follow a doctor's orders in filling a lawful prescription), then the pharmacist should find another line of work. I'm a lawyer. If I cannot, in good conscience, seek the death penalty under any circumstance, then I probably ought not work as a prosecutor in a state that has the death penalty. It's as simple as that. (I'm not a prosecutor, by the way, and that's one of the reasons why.)

Bake

[Lars39]

22. I want people to make decisions based on sound science,

and neither the pharmacist nor the child's parents were doing so.

[Czolgosz]

26. A pharmacist's duty is to assist the patient without his or her peculiar

non-pharmaceutical beliefs hampering the fulfillment of that duty (and if he or she cannot perform that duty because of a superstitious belief, he or she should find another line of work).

Parent have a duty to protect the welfare of their child and withholding necessary medical treatment based on a peculiar belief is a breach of that duty (and if parents cannot perform that duty because of their superstitious beliefs, they risk losing custody).

Compelling the pharmacist to perform his or her duty without inflicting his or her irrational bias on the patient is wholly consistent with compelling a parent to provide necessary medical care for his or her child without regard for the parents' irrational bias against life-saving medical care.

[recidivist]

29. A pharmacist has every right to refuse.

Her employer also has a right to fire her; that's a separate issue. The customer, of course, has a right to go elsewhere.

Do those those who think pharmacists should be compelled to violate their faith also believe doctors and nurses should be compelled to perform abortions? Or that Catholic hospitals should be forced to participate as well?

If that is indeed your view, would you also favor eliminating conscientious objection for military service? It's the same principle.

[blonndee]

30. Assuming there IS an elsewhere. Not always an option. n/t

[recidivist]

33. Not so.

I don't want to get snarky, but let me offer 2 observations. First, we're talking about filling a prescription. Anyone with a prescription has a doctor who wrote the prescription. In the rare instances where there is no cooperating pharmacy within a reasonable range, the doctor can order and dispense the drug himself. Easy enough work around.

Secondly, the vast majority of folks have multiple options on pharmacies. Heck, I've got one in my grocery store and at least four within easy walking distance of home. A pharmacy that refuses to dispense the morning after pill or, for that matter, regular birth control pills is, in most places, putting itself at a competitive disadvantage. If the owner feels strongly enough to accept the very real financial consequences, it is wrong to force him (or force him out of business).