Pharmacist Knows Best? Enacting Legislation in Oklahoma Prohibiting Pharmacists from Refusing to Provide Emergency Contraceptives

Article excerpt

Misty Cooper Watt, Pharmacist Knows Best? Enacting Legislation in Oklahoma Prohibiting Pharmacists from Refusing to Provide Emergency Contraceptives, 42 TULSA L. REV. 771 (2007).

Since the FDA made emergency contraceptives available over-but-behind the pharmacist counter, physicians have been excluded from the decision of whether a patient should receive emergency contraceptives. However, prescriptions are still required to receive emergency contraceptives for women under the age of eighteen. In such instances, physicians, rather than pharmacists, should be the gatekeepers of prescription medications. The traditional role of physicians, as far as prescriptions are concerned, is to be the prescriber. The physician diagnoses what medication the patient needs and writes a prescription. The pharmacist, on the other hand, is the dispenser. The pharmacist fills the prescription and gives it to the patient with very few exceptions. When pharmacists decide not to fill valid, legal prescriptions without a solid basis such as drug interactions, they take themselves out of the role of dispenser and put themselves in the role of physician. This presents major problems because the professions are meant to be separate and pharmacists are not in a position to overstep the decisions made by physicians. Pharmacists have different relationships with their customers than those between physicians and their patients. Likewise, pharmacists are trained and regulated only to be dispensers of medications.

Recently, there has been a debate concerning whether physicians should be able to dispense medications. Pharmacists and other critics of this developing trend argue that it is important to keep the professions separate. Besides obvious financial motivations influencing this argument for pharmacists, there is also a belief that the division of labor in these two professions developed out of necessity. Pharmacists and physicians have different education, training and skills. Over time, these differences evolved into a separation of the two professions. Allowing physicians to dispense medication would disrupt this traditional separation and the customary "checks and balances." It also creates a likelihood that patients will not be served as effectively because pharmacists and physicians specialize in different fields. In an era in which specialization in medicine is considered good for creating health care providers better able to treat the patient's specific needs, it would curtail the positive effects of specialization to allow the professions of physicians and pharmacists to overlap. Arguments, often made by pharmacists, that physicians should not cross the line and serve as pharmacists can easily be used to support the argument that pharmacists should not cross the line to serve as physicians deciding whether a patient should receive a medication.

The personal relationship between doctor and patient is typically built upon trust. Much of this trust stems from the conduct physicians practice under the Hippocratic Oath. The Hippocratic Oath commands the physician to protect the patient's privacy. It explicitly states that "[w]hat I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about." Thus, patients' knowledge that the physicians must keep their information private results in a higher likelihood that patients will trust their relationships with physicians. …