Should the "Conscience Clause" be abolished?

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"Our greatest happiness does not depend on the condition of life in which chance has placed us, but is always the result of a good conscience, good health, occupation, and freedom in all just pursuits." (Thomas Jefferson)

And how that above quote and principle one of the Medicines, Ethics and Practice Code of Ethics marry so romantically. Pharmacists are there to support patients and make them their first concern, no matter what else is going on.

As a qualified pharmacist and a man of Islamic belief, I don't ever intend to use the opt out option. That's not to say that I wouldn't enquire with a local doctor about the clinical effectiveness and safety of a patient's prescription, but when it comes to services like the emergency hormonal contraception then, as long as a legitimate need is there for EHC and the legalities of making a sale or supply are fully adhered to then there isn't a problem. 

So why isn't it a problem for me? As far as my religion is concerned, the vast majority of scholars permit contraception. And think about the name of the service provided - Emergency Hormonal Contraception. Conception is stopped by inhibition the process of ovulation. The pregnancy begins when the implementation process has taken place. EHC, such as levonorgestrel 1500mcg, cannot be taken after 72 hours since unprotected sexual intercourse has taken place. Although it isn't exactly known when implantation takes place, it is very unlikely to be in that 72 hour period.

When the pharmacy code was reviewed a few years ago, the decision was made to continue to opt out option for pharmacists who may want to take the option of refusing to sell or supply certain medicinal products. It left organisations such as the National Secular Society disappointed as they had called for the clause to be removed.

But think about it. How many pharmacists have you seen, either as a patient or whether you are involved in the profession, actually refuse to supply a medicine because of personal beliefs? In my experience, the answer is none. I imagine there may be a handful of pharmacists across these islands and beyond who opt out of providing certain services. But again, its only merely a handful and this has provoked some people in the profession to question the legitimacy of there being a "conscience clause". In fact, some may ask what is the point of having one?

But there is no need to abolish the "conscience clause" because we already have a strong code of ethics that actually guides us and defines the number one priority is as a pharmacist - our patients. And what's more, it is not my place to turn around and start dictating what a person's personal beliefs should be. It is our collective responsibility to ensure that we are acting in the patient's best interests but it is also the responsibility of the individual to reflect on past actions and critically examine whether they possess a legitimate reason not to provide a certain service or whether their personal beliefs compromise patient care. Pharmacists who choose not to provide EHC are still strongly advised to refer any patient in need of the service to the nearest pharmacy who provide it or, in some cases, an appropriate healthcare practitioner. 

It is a controversial issue that will never go away, whether it stays or goes. But what's certain is that nothing can compromise principle one of the code of ethics. Not even a person's own set of personal beliefs.