Delegates Confirm Policy on Pharmacists' Conscientious Objection

The AAFP Congress of Delegates on Sept. 27 reaffirmed the Academy's policy on preserving patients' access to appropriately prescribed medications and preserving the physician-patient relationship.

The action came with adoption of a resolution that called on the Academy to open a dialogue with pharmaceutical organizations about maintaining the therapeutic plan established by the physician and patient, establishing accountability for ensuring patient access to medication, and respecting an individual pharmacist's right of conscientious objection.

The resolution echoes, to some extent, the policy adopted May 3 by the Board of Directors. That policy states, "The AAFP believes that a pharmacist's right of conscientious objection should be reasonably accommodated, but to safeguard the patient-physician relationship, governmental policies must be in place to protect patients' rights to obtain legally prescribed and medically indicated treatments."

"We took an oath to provide the best care to patients," said Marty Dawn Sweinhart, M.D., of Rockaway, N.J., during reference committee hearings. "As part of the medical community, pharmacists have the same obligation. They should not hinder patients' access to appropriate care."

The issue is particularly important to rural or underserved patients, who may have no alternative pharmacy to fill a prescription refused by a pharmacist who objects.

"The next pharmacy is one stoplight away," said Alaska alternate delegate John Cullen, M.D., of Valdez. "But that next light is 300 miles away."

Moreover, pharmacists' ability to refuse to fill a medically necessary prescription may signal the beginning of scope of practice concerns, said Randell Wexler, M.D., of Columbus, Ohio, during reference committee hearings.

Ohio legislators considered a bill two years ago that would allow pharmacists to determine which specific medication within a drug class should be dispensed to a patient, said Wexler.

"There is a much larger context, and that is the ability of the pharmacist to step in and stop a treatment plan of a physician," he said.