June 27, 2018 at 1:35 am #732
Pharm For Life
A recent case in the news reported on an Arizona pharmacist who refused to dispense a prescription for misoprostol based on moral objection. On the surface this is not particularly unique/complex/interesting, however, it does strike me how much variability there was in the news headlines to describe the same situation:
“Walgreens Pharmacist Refuses To Give Woman Prescription To End Pregnancy”
“Pharmacist denies woman miscarriage drug on moral grounds”
“US pharmacist denies woman abortion medicine based on ‘moral objection'”
Even reading the content of some news articles it was difficult to ascertain the exact details of the situation because of subtleties in the language used.
As a pharmacist, the formal education I received on misoprostol in women’s health focused on its use for abortion (i.e. Mifegymiso here in Canada). It was only recently when I started working in hospital pharmacy did I learn of other uses in women’s health (i.e. postpartum).
I certainly wouldn’t want to deny morally licit, medically appropriate drugs, but also need to feel certain of its indication when there is a chance it could be used to terminate a life. Based on the information in the articles, the patient told the pharmacist she was pregnant and the baby stopped developing. Perhaps the situation could have unfolded differently if there was clear information such as fetal heartbeat no longer present, misoprostol used for medical management of intrauterine fetal death.
(Sorry if this didn’t quite meet the criteria for “interesting case” – I found it helpful writing about it, as such situations can be difficult & delicate to navigate.)
Any comments on what you see misoprostol used for in women’s health in practice? (is it used on its own anymore for abortion?) Any thoughts on the case?June 29, 2018 at 1:42 pm #743
I think it’s definitely a very difficult situation from a moral point of view, in determining whether the use of misoprostol is terminating a life or simply helping to clear out remaining products. As you say the terminology is pretty unclear. An indication of “miscarriage” would not differentiate between an inevitable miscarriage that still has a heart beat, and one where foetal death has occurred. So it may be impossible to tell unless specific details of the case are provided, and I don’t think this could be enforced due to the need for confidentiality?July 2, 2018 at 12:50 am #751
The below article states that the there was no heartbeat.
However, in her facebook post, she did NOT mention that fact. This leads me to believe that she did not mention that to the pharmacist. All she mentions in her facebook post is “the baby’s development had stopped and I ultimately will have a miscarriage.” Just like Cecily mentioned, that description of the baby could still allow for a heartbeat, which would make the drug an abortifacient.