Walgreens
pharmacist dispensing and counseling policies revisited
by
Karen Brauer, MS, RPh
It is
unfortunate that those who are committed to upholding the sanctity of
human life, as is Mrs. Magaly Llaguno, carry additional
burdens even in the hardest of times. Mrs. Llaguno has a
serious health condition which requires her to endure arduous and
expensive medical treatments. She has been purchasing some
extremely costly medications from Walgreens specialty
pharmacy.
Of concern to her
is the fact that Walgreens has been dismissing some of its
pharmacists for refusing to dispense Plan B, which often operates by
ending the life of an early human embryo. This drug presents
ethical problems to the groups of people who would not kill any human
willfully, and who object to embryonic stem cell research.
Mrs.
Llaguno wrote to the Walgreens CEO and she wrote to
me of ethical concerns she has about doing business with this
company. I requested the information that she
obtained from Walgreens representatives, and she agreed to allow us
to publish this communication, for the benefit of pharmacists who
might be making decisions about their present or future employment,
as well as other interested people of prolife persuasion.
We thank Mrs.
Llaguno and continue to pray for her well being during this struggle
with her health condition.
Below are communications from Mrs.
Llaguno to Walgreens and replies from the Supervisor of customer
relations, and from the CEO, Mr. Jeffrey A.Rein.
At the bottom
of the letter from the CEO is some contact information if you feel
moved to let him know your thoughts. Below that are a few added
comments from me.
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Dear Walgreens CEO:
On December 15, 2005, Walgreen's put four of its pharmacists on unpaid leave, for refusing to dispense Plan B, which at times acts as an abortifacient by impeding implantation. Thus, your company tried to force pharmacists to go against their own conscience. This is unjust, unfair and dictatorial. We live in a free country, where we have freedom of religion and freedom of choice where it concerns acting in accordance with our own conscience. We have the right, given not only by the state but also by God, to refuse to collaborate in the killing of an innocent, defenseless human being.
Furthermore, Pharmacy is a life-saving profession, not a means to exterminate another human being. With assisted suicide already approved and implemented in Oregon, it might be only a matter of time before pharmacists in other states are pressured to dispense other death-dealing drugs.
I am a multiple myeloma cancer patient and at the present time I am purchasing from your Specialty Pharmacy Revlimid 25 mg, with a cost of almost $8,000 a month. I don't want my business going to a company that doesn't respect the individual conscience of their employees. Please let me know what is Walgreen's policy in this matter at the present time. Thank you.
Yours truly,
Mrs.Magaly Llaguno
***************************************************************
June 29, 2007 Dear Ms. Llaguno, Thank you for taking the time to write us with your concern. Please be assured that Walgreens takes customer comments and complaints very seriously, and we will continue to try to improve the way we do business. I received your message regarding our Illinois pharmacists. I appreciate your concerns and wanted to address them personally. In every other state in the nation, we offer pharmacists exactly the flexibility you suggest - they may decline to fill a prescription based on moral objections as long as it is filled promptly by another pharmacist in that store or a nearby pharmacy. In this way, we meet the needs of the patient and respect our pharmacists' beliefs. It generally works well. The state of Illinois is another story. The Governor's rule (approved by the legislature) states that no pharmacy can refuse to fill the Plan B contraceptive medication. To do so jeopardizes the license of the pharmacy, the pharmacist and the pharmacy manager in that store. As a retailer in this state, we have no choice but to follow state law. The real problem comes in our many 24-hour stores where there is only one pharmacist working during the night or in some less-busy stores where there is only one pharmacist for certain times of the day. In other states, we handle this by having the prescription filled in a nearby store, but that's against the law in Illinois. We have already been cited for declining to fill the drug, and disciplinary action is pending. Walgreens is between a rock and a hard place on this issue. We certainly did not initiate this ruling. We would far prefer to follow the policy we've had in place for years. We believe it respects both pharmacists and patients. We don't want to place our pharmacists in a bad position any more than you do. We have offered the pharmacists who are not able to fill these prescriptions positions in other states, especially Missouri, since the pharmacists in question are very close to the state line. We will also help them obtain licenses in another state if necessary. The problem here is not between Walgreens and our pharmacists, but between the Governor of Illinois and all pharmacists. We would certainly support a change in the state's position that would allow our pharmacists in Illinois to practice their profession as they do in every other state. Again, thank you for taking the time to write us, and to read this reply. I hope I've been able to clarify the issue and explain the root of the problem. We very much hope you continue your long-term relationship with Walgreens. Sincerely, Tonya P. Supervisor, Consumer Relations Ref # 1110736
*************************************************************
June
25, 2007
Mrs. Magaly Llaguno
Dear Mrs.
Llaguno,
Thank you for your letter regarding Walgreens policy
on the dispensing of prescriptions.
Our goal regarding
emergency contraception and the dispensing of similar medications is
to ensure that our female patients are able to have all of
their prescription needs met. We also have a legal obligation
to comply with the state and federal regulations concerning religious
accommodation to our employees. When this creates a conflict
for our pharmacists, Walgreens has strict procedures that mandate
prompt action on the part of both the pharmacist and store
management. Our policy requires that store management is
immediately alerted in this scenerio and takes all of the necessary
steps to ensure that the patient receives the prescription in a
timely manner. This policy also strictly limits communication
between the pharmacist and the patient in these situations;
specifically, the pharmacists are prohibited from voicing their
religious beliefs to the patient.
Although pharmacists
aren't required to personally fill the prescription, they are
required to take proactive steps with store management to facilitate
having the prescription filled by another pharmacist. Failure
of a pharmacist to comply with this policy is grounds for immediate
discipline. This policy is intended to ensure the patient will
receive her prescribed medication in a timely fashion. By
meeting out patients' needs in this way, while respecting the
religious beliefs of our pharmacists, we can satisfy all parties
involved.
Thank you for taking the time to communicate
your concerns.
Sincerely,
Jeffrey A.
Rein
JAR/jk
Walgreen Co. Corporate Offices,
200 Wilmot Road, MS 2234,
Deerfield Illinois
60015-4616
847-914-2002 FAX 847-914-3652
www.walgreens.com
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Karen
Brauer's comments.
It's apparent from the two letters that the
Walgreen's Supervisor of customer relations has heard from more
customers than the CEO, but the more hard line views of the
CEO are the most significant. A pharmacist who fully
informs a patient about the mechanisms of the so-called "morning
after" pill is likely to face discipline, because the motive for
fully informing the patient about this drug is somehow "religious".
The mechanisms are only significant to academics, health
care professionals, and those people who have concerns about stopping
human life. Most of us know that those concerns stem from the
religious view that human life has value, and that humans ought not
to be killed purposely.
The pharmacist "gag order"
on communication with the patients deprives the latter of the
information that they need to determine if the drug is right
for them. We know that many of the purveyors of Plan B
are quite willing to lie about the mechanism. The
continuing education materials (directed to pharmacists and
technicians) from U.S. Pharmacist, and from Power Pak contain a
deception about the mechanism, couched in very legalistic language.
Pharmacists who have had better education than this are the best
source of information about Plan B, and similar drugs, and they
should not be constrained from their most significant role to educate
patients about medications.
Walgreens'
policy in ALL states, not just Illinois, is to force
their pharmacists to be complicit in the dispensing of Plan B, and to
gag them, preventing them from offering mechanistic information
about the drug to women, because the motivation for giving it, and
the need for receiving it, is the religious conviction that all human
life has value.
From my point of view, the
"educational" and recruiting efforts of Walgreens have
noticably and considerably increased. (Pharmacists
can obtain this info by watching the job ads, the pharmacy news
journals, and their mailboxes.) It is my suspicion
that Walgreens will need to work very hard in the future to recruit
pharmacists, and especially to retain them. (Pharmacists who are
actually willing to work there might use this information to
negotiate salary.)
Please pass this message to any interested
parties.
God bless!
KB
Karen L. Brauer
MS, RPh
Pharmacists for Life International
http://www.pfli.org