It used to be that, to get hold of the morning-after pill, you had to get a prescription from your GP or go to a Family Planning Clinic or A&E (that genuinely was the advice; A&E must have had quite different priorities in the 90s).
Nowadays, you can buy it over the counter at a pharmacy, albeit for a shocking price, and get on with your life. Whether your condom split or you took antibiotics with the pill, you can reassure yourself that a pregnancy scare is off the table. You might feel rough for a day or two, but that’s usually better than an unwanted pregnancy.
The more quickly you take the morning-after pill, the more effective it is, so it is important that people are able to access this medication as soon as they need it. And when a woman called Siani needed the product last Sunday, she ordered it online with Lloyds Pharmacy then went to pick it up in store. There, the pharmacist told Siani that the product was ready but that, due to her personal beliefs, she was not going to dispense it.
There were no other pharmacists working at that outlet who could dispense the medicine and there were no other Lloyds Pharmacies open in Brighton that day, because services are limited on Sundays. Siani was advised to go to a Lloyds Pharmacy in another town or to come back the next day.
This is utterly unacceptable. Siani needed some medicine, paid for the medicine, and went to collect it. Somebody else’s beliefs – probably religious, though we are not sure – got in the way of her getting the service, and in the way of the pregnancy prevention she needed.
The guidelines from the General Pharmaceutical Council explain that pharmacists have the right to allow their personal values to affect their “day-to-day practice, particularly whether they feel able to provide certain services” but that they should “recognise and value diversity, and respect cultural differences – making sure that every person is treated fairly whatever their values and beliefs.”
They should “take responsibility for ensuring that person-centred care is not compromised because of personal values and beliefs”.
The guidelines go on: “If a pharmacy professional is unwilling to provide a certain service, they should take steps to make sure the person asking for care is at the centre of their decision-making, so they can access the service they need in a timely manner and without hindrance. For example, this might include considering any time limits or other barriers to accessing medicines or other services, as well as any adverse impact on the person.”
It is not just pharmacists who have the option to opt out of doing their jobs in reproductive health. GPs can refuse to prescribe contraception or refer for abortions and gynaecologists can even opt out of providing abortion services. Why they would become a gynaecologist if they don’t want to get involved in a key procedure that helps the people they serve is a mystery to me, but it’s not unheard of and it does people – especially women – a disservice. It does not exclusively affect women, though. Of course, trans men and non-binary folk can need these services too and can face even more obstructions than cis women do because of the double whammy of adding transphobia to the mix. In terms of numbers, it affects far more women, but this does not mean we should ignore the predicament of those who can face even more barriers when we look at these issues.
But whoever the patient is, their need for reproductive services should come before the whimsy of the professional they are standing in front of, expecting a service from. I remember a friend at college going to her GP to start on the pill. The GP examined her, took her blood pressure and told her that yes, she was suited to the medication but that he didn’t want to prescribe it. He recommended she come back to see one of his colleagues, so he was still enabling her to access the drug; he just didn’t want to put his name to it and that is cowardly and pointless.
Like bakers who only want to bake cakes for straight people and registrars who only want to marry opposite-sex couples, I can only advice medical professionals in one way: if you don’t want to do all of your job, you should find a different job. If you’re a gynaecologist who’s squeamish about termination procedures or a pharmacist who does not want to dispense the pill, you are in the wrong job. Go and be a gastroenterologist. Or a gardener. Or a painter and decorator.
Just don’t put your misguided ethics in the way of the reproductive health of people who need you to provide them with a proven, safe and effective service.
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