Professional Obligations when Declining to Provide a Pharmacy Product or Service due to Conscience or Religion

GUIDELINE

Published: March 2001(originally a position statement: Refusal to Fill for Moral or Religious Reasons)

Revised: June 2016

College Contact: Pharmacy Practice


Introduction

The Code of Ethics (the Code) outlines the ethical principles and standards that pharmacists and pharmacy technicians are accountable to in practice. In a circumstance where a pharmacist or pharmacy technician declines to provide a product or service due to a conscientious objection, he or she is required to meet the expectations outlined in standard 2.13 of the Code.


Background

Pharmacy professionals are required to act in their patients’ best interests and provide an environment where the rights, autonomy, dignity and diversity of all patients are respected. The Supreme Court of Canada has determined that, although all persons right to freedom of conscience and religion are protected by the Canadian Charter of Rights and Freedoms, no rights are absolute (1)(2). The rights of patients must be balanced with those of healthcare providers, and rights can be limited, as necessary, to protect pubic safety, order, health, morals, or the fundamental rights and freedoms of others (3)(4). While the Charter entitles a health care professional to limit the health services he or she provides for reasons of conscience or religion, this choice cannot impede, either directly or indirectly, access to these services for existing patients, or those seeking to become patients.


Guideline

Designated managers are required to ensure that there is a system in place that, where a pharmacist or pharmacy technician has a conscientious objection, respects the patient’s dignity and enables the patient to access desired services in a timely manner.

The information presented in the Code of Ethics and this guideline must be considered holistically and in context with all ethical principles and standards. The following provides further information regarding the expectations of any pharmacy professional in circumstances where they are unwilling to provide a service or product for reasons of conscience or religion as outlined in Standard 2.13:

2.13: Members must, in circumstances where they are unwilling to provide a product or service to a patient on the basis of moral or religious grounds, ensure the following:

  • Further Clarification of Expectation in Practice:
    • A pharmacist or pharmacy technician is permitted to decline providing certain pharmacy products or services if it appears to conflict with the pharmacy professional’s morality or religious beliefs.

2.13 i: that the member does not directly convey their conscientious objection to the patient;

  • Further Clarification of Expectation in Practice:
    • Any communication with the patient must be in a sensitive and respectful manner that does not impose any personal moral judgements about the beliefs, lifestyle, identity or characteristics of the patient. Furthermore, personal religious beliefs must not be promoted to the patient.

2.13.ii: that the member participates in a system designed to respect the patient’s right to receive products and services requested;

  • Further Clarification of Expectation in Practice:
    • Objecting pharmacists and pharmacy technicians have a responsibility to inform their designated manager of their conscientious objection and participate in a system designed to respect a patient’s right to receive pharmacy products and services.

2.13.iii. that there is an alternative provider available to enable the patient to obtain the requested product or service, which minimizes inconvenience or suffering to the patient.

  • Further Clarification of Expectation in Practice:
    • A pharmacist or pharmacy technician must not impede a patient’s access to care. An effective referral meaning, a referral made in good faith, to a non-objecting, available, and accessible alternate provider in a timely manner must be provided to the patient.
    • A pharmacist or pharmacy technician must not withhold information about the existence of any treatment because it conflicts with their conscience or religious beliefs.
    • A pharmacist or pharmacy technician must provide care in an emergency, where it is necessary to prevent imminent harm, even where the care conflicts with their conscience or religious beliefs.
    • A pharmacist or pharmacy technician must make reasonable efforts to ensure continuity of patient care when they are unable or unwilling to provide requested pharmacy services.