02-09-2016

Pharmacist’s Conscience Clause: relinquished under pressure


When the French National Council for the Order of Pharmacists, met on September 6, 2016 to finalize the project of draft reform for the pharmacists’ code of ethics, they waived the introduction of an explicit conscience clause, which had been recommended in a pre-project. In fact, recently in December 2015, an “internal” consultation proposed by the Order to the 75,000 pharmacists on their list, revealed that 85% wished to have a conscience clause instituted.

While the intention of the National Council for the Order of Pharmacists is to develop its Code of Ethics in order to “adapt it to today’s situation, in a professional environment whereby pharmacists, the first line actors in public health, are submitted to major ethical imperatives.”

The conscience clause was suggested for pharmaceutical acts liable to endanger human life. The article on the conscience clause, in this first draft, was thus worded: “Without prejudice to patients’ rights to access or continuity of health care, the pharmacist can refuse to carry out a pharmaceutical act liable to endanger human life. He must thus inform the patient, and do everything possible to assure that the patient will be taken care of in a timely manner by another pharmacist. Otherwise, the pharmacist shall be required to perform the pharmaceutical act”.

In fact, as underlined in the current code of ethics (Art R4235-2 in the Public Health Code), pharmacists have the ethical duty to practice their profession “in the respect of life and human individuals”.

In the past few years, they have been faced with requests for delivering abortive products, with the development of medical abortions practiced by city doctors or mid-wives, and presumably in the future, for delivering lethal products. (A possibility which cannot be overlooked after the new law on February 2, 2016 regarding the End of Life, since acts of deep and continuous sedation could lead to assisted suicides and euthanasia.)

The Public Health Code (article L2212-8) authorizes a conscience clause for medical professionals regarding abortion, whether they are doctors, mid-wives, nurses or other medical auxiliaries, but not to pharmacists who were not originally involved in abortion cases.

The right to conscientious objection for health professionals “in the context of lawful medical care” was reaffirmed in a resolution by the Parliamentary Assembly at the Council of Europe in 2010 for acts which affect life (abortion, euthanasia, destruction of human embryos).

The lawyer, Jean-Baptiste Chevalier, explains in a forum on September 5: “It (the conscience clause) is however, the prerequisite to enjoy full liberty of conscience, in accordance with their duty, as established by article 10 of the Declaration of the Rights of Man of the Citizen and in article 9 of the European Convention on Human Rights.” This lawyer at the Bar in Paris even clarifies: “We cannot oblige pharmacists to deliver products destined to provoke death, without seriously violating their freedom of conscience.” Doing so would be deeply contradictory to their primary mission, which is to dispense health-care products for patients.

As a compensation for the conscience clause, the draft article which was finally rejected, specified that a pharmacist invoking the clause was nevertheless required to propose a solution for the patient, and to ensure his continued medical care.

Over fear that abortion would be contested, in mid-July a vehement controversy spread through the social networks, widely publicized by the “pro-abortion” movements, a controversy in which even the Ministers Laurence Rossignol and Marisol Touraine participated.

FOR ALLIANCE VITA

This back-sliding by the Order of Pharmacists is a symbolic episode of a collaborative ideological offensive against the right for conscientious objection. In fact, the procedures for the exercise of such a right should be adapted to the new conditions of health professionals, due to the dispensing of products liable to deliberately provoke death.

French pharmacists are thus discriminated against: they are the only medical professionals in France who are not granted recourse to a conscience clause when a life is at stake. Several other European countries concede this right. For example, recall that in Belgium, pharmacists are not required to deliver products for euthanasia.