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Pharmacist Cristina Alarcon
Steve Weatherbe

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BC pharmacists free to deny abortion drugs: new ethics code

Steve Weatherbe

VANCOUVER, British Columbia, March 9, 2017 (LifeSiteNews) – Christian pharmacists in British Columbia can now practice with a clear conscience.

Under the B.C. College of Pharmacy’s new ethics code, they cannot be forced to prescribe for abortions, euthanasia, or artificial contraception.

Cristina Alarcon, a Vancouver-area community pharmacist who was a driving force behind the new code, says it “covers everything.” For the first time, pharmacists can refuse to dispense any prescription that violates their conscience.

“This means that we as a profession fully recognize not only the fact that we have a conscience, but that as professionals we are persons first and foremost, not automatons. We do not have a personal conscience that we park at the door when we go to work,” she told LifeSiteNews.

Alarcon has practiced since 1991 in both hospitals and pharmacies, but she began working to change the College’s code of ethics in 2000. At that time, a pharmacist could conscientiously refuse to fill a prescription — unless there was no one else available to do so. The same disabling qualification exists in many health profession codes.

“I realized I couldn't work according to this code of ethics because it’s telling me that if no one is available to dispense a product … I must dispense it,” she told B.C. Catholic.

Alarcon worked unsuccessfully for years to persuade the College to remove the reservation but always met opposition. She gathered support from other pharmacists, got a Master’s degree in bioethics, and became a frequently published commentator on health ethics. She also refused to fill prescriptions for contraceptives and abortion pills.

Fortunately, she said, she had an employer who supported her right to her conscience; if not always, the positions her conscience led her to take. The only time this landed her in trouble was when she worked in a hospital. She told her supervisor she could not dispense abortion pills or a drug used to kill unborn babies when the mothers are in medical difficulty. “My supervisor took me into her office and delivered a reprimand. She told me, ‘Who do you think you are, imposing your beliefs on others.’”

Alarcon recalled, “I realized the College couldn’t protect me in this kind of situation.”

Ironically, the Supreme Court of Canada’s 2015 decision to legalize assisted suicide and the federal government to legislate “assisted dying” opened the door to reforming the code. Fellow pharmacists who did not sympathize with Alarcon’s concerns over contraception or abortion did see the problem that many in the profession would have with euthanasia.

“They realized you cannot force people to kill,” she told LifeSiteNews.

It also helped that, in June 2016, Alarcon became the chair of the College’s ethics committee. She brought in an ethicist and won the committee’s approval and then the board’s for strengthening the code’s conscience protection.

Only now, with the publication of a story in B.C. Catholic, have the new provisions become generally known.

“I debated with myself,” she told LifeSiteNews, “about going public with this because it might attract the wrong kind of attention.”

However, in the end, she decided the reforms could provide “some hope” for other health professionals across Canada.

The new protections for freedom of conscience are complex and hedged with reservations. For example, pharmacists with conscientious objections must advise their employers before they are hired or, if they develop them after being hired, must do so “at the earliest opportunity.”

They can say their conscience prevents them from filling a prescription but must do so in a “nonjudgmental manner.” They must not reveal their own beliefs. They must not ask about the customer’s beliefs.

Pharmacists must also provide the patient “with enough information and assistance to allow them to make informed decisions for themselves,” and they must help the patient find service elsewhere if the patient requests it.

However, they do not have to initiate this process and, most important, “They are not required to make a referral” to another pharmacist who will dispense the objectionable drug.

Alarcon explained,” If you are required to refer, it is the same as being complicit. Someone is committing a crime and you are helping them.”

When the ethics committee debated the issue, some people wanted the conscience provisions to apply only to euthanasia. Alarcon successfully defeated this by arguing the “conscience is universal. We can’t tell people they can have a conscience over euthanasia, but they can’t have one about contraception.”

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Sean Murphy, the head of the Protection of Conscience Project, which advocates for freedom of conscience in the health professions nationwide, said the College of Pharmacy’s new code “is very fair and workable.”

Alarcon’s important role in their implementation, Murphy said, “reinforces something I’ve been saying since Day One. Most of this is common sense. All that it takes to put in place is good will and a little effort.

The problem with the code of ethics developed by the Ontario Physicians and Surgeons, said Murphy, was “the absence of good will” toward doctors with conscientious objections to euthanasia and assisted suicide. That code requires them to refer patients asking for “aid in dying” if they will not provide it themselves. As well, they must provide it themselves if no one else is available. It is being challenged in court.

Alarcon insists that the new code protects patients as well as pharmacists. She relates how she once refused to fill a young woman’s prescription for a “morning after” pill. When the woman asked why, she explained that this would destroy “a beautiful life.” The woman gave her a hug and left. Ten years later, she returned with a child to pick up a prescription. She recognized Cristina and reminded her of the incident. “This is your son,” she said, indicating the child.

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