Punched Your Ticket to Hell lately?
There was an editorial in this last Sunday’s edition of The New York Times (March 25, 2009). The headline was:
“Broader Access to Morning-After Pills”
I read it with interest and wondered if smaller newspapers around the country treated it as a news story or as an editorial subject. The New York Times did both. The Northern Kingdom psp This issue needs to be before the public and it would be irresponsible for any new organization to refuse to not take into account the importance of this news report.
The editorial did what pharmacists MUST DO. It educated, “Prompt access is imperative”. The writer talked about the 72 hour rule and how the window starts closing at 24 hours. You know the drill. You have either counseled on the use of “Plan-B” or have washed your hands of the entire issue, turned your back and made mean faces into the mirror. Either way, both viewpoints are being formed with a picture of a 12 year old girl scared to death.
Judge Edward Korman ordered the FDA to make the pill available to girls as young as 17. He ordered that the FDA consider approving it for ANY age.
Thanks to the judge, the cat is out of the bag. The quack is whacked. This genie will not be put back into the lamp. Ever!
The WHO and a slew of American health groups have urged that the pill be made available to anyone. We are virtually the only major industrialized nation to lag behind.
Is Alaska an industrialized “Nation”?
The Bush administration is behind keeping the good old U.S. of A. a third world country in this matter. Bush is gone.
Governor Blagojevich of Illinois stuck his nose into this issue on the other side a few years ago. “The Old Apothecary” had some real good chops on the governor and his rules. I don’t. Perhaps P.T. can bring us up to speed. The precedent that the governor set was dangerous, if I remember correctly.
According to Judge Korman, the evidence is overwhelming that 17 year olds can use the drug safely without medical supervision.
I expressed my opinion on this matter a few years ago. I received a lot of mail. People promised to keep me in their prayers. Others were insulting. “Idiot” was a big word. “Christian” was bigger. One writer was very erudite. He expressed himself well until he said, in Bold and Italics. “Plastic Ass, you have already punched your ticket to hell.”
Twenty minutes ago, when I read the editorial, I asked, “Plastic Ass”, Do you really want to get into this again? The mail will not be nice.”
I’ll only say this, If this was 1996 and my 12 year old daughter came to me and said, “Daddy, Tommy Ference put his penis in my .. you know.. yesterday when we were playing in the tree house and Daddy, it hurt.”
Translate this to my daughter being 12 years old in 2009… I would be at the closest drug store in 5 minutes. When I got back, she would take the first pill. Then I would metaphorically get on my knees to apologize for failing to educate her. Then, and only then, would we have a conversation. There would not be a lecture. I’d ask lots of questions (The Socratic method) That talk would be both ways and there would be lots of hugs and “I love yous”.
Oh, yes, hell ticket punching is a preposterous notion, an outrageous and absurd affront to a reasoned dialogue in a civilized culture.
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A typical 12 year old growing up un the USA would absolutely be scared to death given these circumstances. We live in a society that has de-emphasized sex education in favor of fundmentalist idealogoy. However, it’s starting to look like the pendulum is swinging. The former prevailing system that favored abstinence over lessons in the use of birth control and physiology is thankfully no longer in control, at least in Washington. The world still must tolerate Pope Ratzinger. He preaches conforming with societies that are long gone and pontificates in oppostion the use of condoms and modern methods of birth control. How do the scholars at Notre Dame and Georgetown sit still for this ignorance? George Bush is gone. Impeach the Pope.
I’ve been following this issue, perhaps not closely enough but I’m trying. I have 3 girls at home (4, 6 and 12). In your post you make an important, but perhaps subtle point that I don’t hear much. In your scenario, who is it that goes to the pharmacy? Not your 12 year old daughter. My issue with the conversations I have been reading is the apparent irrelevance of the parent in the equation. Religious and moral implications aside, I don’t want my daughter to be able to buy ANY medication in a pharmacy without my knowledge. I want to have the discussions with her before during and after all medication treatments. Nor do I want her buying alcohol, cigarettes, condoms or anything else that would indicate the potential for choice that I believe, based on my value system is imprudent. In some cases the government seems to agree in others they don’t. You may call be a overly protective father. I prefer to characterize myself as someone that takes my role seriously, just as you seem to. Your responsibility as a pharmacist, I believe, is not to usurp my responsibility as a parent regardless of what our Federal government says. They don’t raise children.
Can a 17 year old use Plan B responsibly? I’m sure. a 16 year old? Probably. a 15 year old? I’m starting to have a doubt. Should a 14 year old boy be allowed to buy it for his girlfriend?
A line needs to be drawn somewhere and since 18 is considered to be the age of majority, that’s probably a good place to start. I feel comfortable with that.
The decider for medical purposes must be a responsible adult, i.e. parent, or lacking that, a physician. Making emergency contraception available to anybody who asks for it opens up a can of worms that I cannot imagine dealing with. Rules are necessary. Rules govern our profession and how we conduct our business.
As for Judge Korman, he’s a shithead. Changing the cutoff age from 18 to 17 does nothing but allow the arguement to continue and pass off the tough call to some other judge who gets a similar case in a few years.
Thanks for providing this forum.
The morning pill is a prescription medication in my country. When an desperate girl asked me if she could buy it in the late saturday afternoon,I had to say “No,You should see a doctor first.”
The girl went out disappointed and frustrated.
I knew she wouldn’t have the nerve to see a doctor!
I was upset there was no way to help her.
It’s so miserable that many pregnant teenagers have to seek illegal abortion.
When a girl comes up to my window obviously just done crying, or with tears in her eyes, I usually cringe. One of my coworkers regularly throws away the reorder tags for Plan B and more often than not, I have to send the customer/patient to another store. Fuck the ‘lost revenue’; I hate the idea that she thinks I’ve bought into the stigma of women as walking blow up dolls/uterii we’ve lived with for the past 8 years and am just passing her on to avoid dealing with what might well have been a sexual assault, or a broken condom. So, my trump card is always “I’ll see if we have it in stock and I can order it for you for tomorrow morning if we don’t, but XXX store is cheaper than ours by about $10 and they’re almost guaranteed to have it.” (Because they’re right next to the hospital and they do a lot of rape kits in the Rust Belt, but obviously I don’t tell her that part).
But sell it to a 12 year old? No. The delay in ovulation the pill causes can screw up subsequent cycles, sometimes for a couple of months. I know that because I read and understood the literature before I took it. A frightened twelve year old and her friends might not, and need an adult to explain the consequences, side effects, and most importantly how *NOT* to need it ever again. Maybe at 16, with some sort of mandatory consultation rule, but much younger than that and I worry about the child (and that’s what she’d be, still in middle school for gods’ sake!) trying to make another very grown up decision on her own.
I’m with you on this 100% JP. As pharmacist at a 24 hour store you can imagine that PlanB comes up quite often. I never ask questions, and rarely ask to see ID. I can’t beleive there are pharmacists out there who refuse to sell the morning after pill; however, I know a PhD chemist who beleives that heaven and hell actually exist. This boggles my mind…
JP has hit a point. Although it might mean that Pharmacists (as professionals) need to consult with these girls about access to Plan B along with a quick run down with sex-ed (where the parents failed to do).
Although I fear that we might run into pharmacists like Lloyd DuPlantis Jr. http://www.onpointradio.org/shows/2005/04/pharmacists-and-conscience/ of Gray, Louisiana [thanks to Drugmonkey for bringing this up].
As a pharmacist, I consider the health of all my patients. Otherwise, they’ll pull stupid acts of desperation like what happened to this girl http://www.highbeam.com/doc/1P2-1642489.html
Over in the UK we have had similar debates over an equivalent product to plan B, Levonelle. The key difference here is that over in the UK we are somewhat further down the line than most US states.
We (with appropriate training) can supply levonelle over the counter to age 16 and above (legal age of consent in uk) for a retail price.
The truly good thing is that some forward looking primary care trusts (PCT, the local body responsible for health administration outside of hospital) have instituted extra schemes where girls as young as 13 may obtain levonelle for free (after appropriate assessment and counselling).
Girls under 13 in the eyes of uk law cannot give informed consent to anything so an automatic referral to local child protection services is put in place (although they may offer levonelle as part of their services).
Naturally pharmacists participating in the free EHC schemes undergo extra training in order to be able to effectively supply and counsel about Levonelle.
UK pharmacists who object to supplying EHC on moral or religious grounds are duty-bound to find the nearest supplier of EHC for their patient. Failure to do so results in disciplinary proceedings for the pharmacist involved.
Everybody fucks up- period. What angers me more than the arbitrary limit of age 18 for purchasing Plan B, while evidence clearly shows it’s safe to use prior to 18, is pharmacists that refuse to sell it to any, and all, males. Regardless of their age.
An 18, 25, 30, 40 year old man walks in, and is refused the sale, despite being at least 18, because it might be used by someone younger. How many of you of age have been refused cigarettes, lighters, pseudo-ephedrine, while you have valid I.D., while you are there alone, because you MIGHT give it to someone that’s not of age? Never.
The ONLY situation where that is acceptable is if they are standing there with someone that does not look of age- but what’s going on is bullshit. Those of you that respect the laws governing the sale of plan B, instead of trying to find any excuse not to sell it, are awesome.
Somehow, this is related. From the website ALL-HEALTH in a comment on RPhs rights to refuse. And this guy still works for CVS?
I was in a very bad car accident. I rolled my car three times. I was prescribed a pain medication from my doctor. The pain was terrible. My sister went to CVS pharmacy here in PA. She gave the pharmacy the script from my doctor. They filled it. Just before they gave it to her, they asked her what it was for. She told them ( like it was any of their business) and the pharmacist wouldn’t give the medication to her. When she asked them why, he told here he doesn’t give pain medication to car accident victims. She got it filled at her hometown pharmacy. When I called CVS headquarters, they told me it was the pharmacist discression what medication he wants to dispence and who he wants to dispence it to. I couldn’t believe what I was told. A pharmacist has made a decision for me (whom he doesn’t even know) over my phycisian. Who gave them that power?
Chemistry Hub…
[...] I can’t beleive there are pharmacists out there who refuse to sell the morning after pill; however, I know a PhD chemist who beleives that heaven and hell actually exist. This boggles my mind DKLA says: March 29, 2009 at 8:44 am … [...]…