Conscientious Refusals in Pharmacy Practice

Abstract

It is widely accepted in the pharmacy profession that pharmacists have the right to conscientiously refuse to participate in certain practices on grounds of conscience. This is allowed in recognition of differences in moral and religious views and out of respect for moral integrity. However, the “conscience clause” does not necessarily sit easily in a professional code of ethics owing to the potential tensions between a professional’s personal moral integrity and her professional obligations. At the heart of these tensions are philosophical questions about the nature of conscience and integrity. These in turn lead to important practical ethical questions about the adequacy of a conscience clause to protect integrity and patient’s rights and guard against wrongdoing, whether conscientious refusals should be publicly announced in advance and what the acceptable bases of a conscientious refusal might be. Such questions apply not just to the professional, but also to pharmacy students, who may hold conscientious objections to some aspects of their training. It is concluded that the conventional compromise that is commonly in place in the pharmacy profession is a workable but imperfect solution and that better understanding of the concepts and competing obligations may be achieved by learning more about conscientious decision-making by pharmacists in practice.