Friday, October 28, 2005
The Cookie Flies Both Ways
Well, the cookie flies both ways. Just as much as a pharmacist should not be making decisions for an individual, that individual should not be making decisions for the pharmacist just because that individual chose to bring their prescription to that pharmacy. In other words, the individual's choice to bring a prescription to a particular pharmacy should not be the end-all to the pharmacist's professional judgement as to what he will and will not fill. And by professional judgement, it is a combination of what he has learned (side effects) as well as his own personal positions.
However, that is not the point. The approach that most people take towards the Plan B debate is as one dimensional as a line. It is always the pharmacist who is making decisions and victimizing the rest of the world. But what if the editorial had said: "But the FDA should not be making decisions for the rest of us." Or how about "But the doctor should not be making decisions for the rest of us."
Consider the case of the doctor first. In order for patients to receive medications that are kept behind the counter, the patient must first visit his doctor who decides on the course of action and the medication. If the prescription does not come from the doctor's office with his signature, the pharmacy cannot fill the script (unless the medication is kept behind the counter but is not considered to be a legend drug, such as insulin, syrringes and other diabetic testing supplies, and, more recently, products containing pseudoephrine).
But what if the patient wants a particular medication that the doctor won't prescribe (doesn't happen often)? What is the next course of action? Finding a new doctor to give you the medication or procedure you want.
This is what should happen when you are trying to find a pharmacist who is willing to dispense Plan B.
But unlike in the case of a doctor refusing to prescribe a certain medication or preform a certain procedure and where we see no uproar from the public, we see a backlash toward the store and pharmacist who refused to fill a prescription based upon personal persuasions.
Now consider the case of the FDA: every year, the FDA rejects hundreds of drugs already approved elsewhere. With each rejection, many patients who would be helped through those medications are not and are forced to suffer unduly.
Although the purpose of the FDA is to prevent just one picture of another thalomide baby from reaching the press, it inadvertantly causes the death of many others. Should it not be the choice of the patient (and, potentially, their doctor) to decide what medications should go into their body? True, many drugs are harmful to individuals, especially in combination with others. (Take Coumadin (warfarin); it interacts with everything.) However, there are many legend drugs that cause mininal side-effects; and likewise, many over-the-counter drugs can cause fatal reactions.
In the case of the FDA, are they not acting as a pharmacist, making decisions for the rest of us? Where is the uproar? Where is the backlash? Oh wait, they are protecting us.
So what's the solution to this? If we don't want any individual (whether it be the pharmacist or doctor and ignoring the FDA) making decisions for us, why not put Plan B over the counter? (FDA rejected that option a while ago.)
Or, alternatively, why not allow the doctor to dispense emergency contraception or allow the pharmacist to prescribe it. After all, doctors routinely give out free samples of statins, birth control pills, and a variety of other medications; similarly, the pharmacist is often the first person the doctor consults with to find a medication that suits their patient and the pharmacist counsels on and recommends medication to patients on a daily basis.
With all these solutions out there to prevent another incident like this from happening, all we hear from the press is how absolutely "troglodytic" these pharmacists are and how their reign of terror must be ended by laws forcing them to dispense medication.
There are other ways out there to preserve the women's choice and pharmacist personal choice without forcing either of them to give up what they both dearly want to hang onto.
*And, on a side note, Viagra is a bad argument to use. I don't know of anyone having a problem with a person having sex or an erection, for that matter. Yes, there are some individuals who do not like premarital sex or extramarital sex, but can you really tell the difference when you give that man his Viagra? I think not.
However, the purpose of Plan B is quite clear. And it is that purpose that a pharmacist is opposed to and openly knows about as he goes about checking and dispensing the medication.
Take note Wildcat and others: the comparison is a faulty one.
I know it is late, but the AZ Daily Star featured an editorial on Tuesday about the rape victim who was denied access to Plan B. In it the author wrote: "But that person [the pharmacist] should not be making decisions for the rest of us [the victim? society?]."
Well, the cookie flies both ways. Just as much as a pharmacist should not be making decisions for an individual, that individual should not be making decisions for the pharmacist just because that individual chose to bring their prescription to that pharmacy. In other words, the individual's choice to bring a prescription to a particular pharmacy should not be the end-all to the pharmacist's professional judgement as to what he will and will not fill. And by professional judgement, it is a combination of what he has learned (side effects) as well as his own personal positions.
However, that is not the point. The approach that most people take towards the Plan B debate is as one dimensional as a line. It is always the pharmacist who is making decisions and victimizing the rest of the world. But what if the editorial had said: "But the FDA should not be making decisions for the rest of us." Or how about "But the doctor should not be making decisions for the rest of us."
Consider the case of the doctor first. In order for patients to receive medications that are kept behind the counter, the patient must first visit his doctor who decides on the course of action and the medication. If the prescription does not come from the doctor's office with his signature, the pharmacy cannot fill the script (unless the medication is kept behind the counter but is not considered to be a legend drug, such as insulin, syrringes and other diabetic testing supplies, and, more recently, products containing pseudoephrine).
But what if the patient wants a particular medication that the doctor won't prescribe (doesn't happen often)? What is the next course of action? Finding a new doctor to give you the medication or procedure you want.
This is what should happen when you are trying to find a pharmacist who is willing to dispense Plan B.
But unlike in the case of a doctor refusing to prescribe a certain medication or preform a certain procedure and where we see no uproar from the public, we see a backlash toward the store and pharmacist who refused to fill a prescription based upon personal persuasions.
Now consider the case of the FDA: every year, the FDA rejects hundreds of drugs already approved elsewhere. With each rejection, many patients who would be helped through those medications are not and are forced to suffer unduly.
Although the purpose of the FDA is to prevent just one picture of another thalomide baby from reaching the press, it inadvertantly causes the death of many others. Should it not be the choice of the patient (and, potentially, their doctor) to decide what medications should go into their body? True, many drugs are harmful to individuals, especially in combination with others. (Take Coumadin (warfarin); it interacts with everything.) However, there are many legend drugs that cause mininal side-effects; and likewise, many over-the-counter drugs can cause fatal reactions.
In the case of the FDA, are they not acting as a pharmacist, making decisions for the rest of us? Where is the uproar? Where is the backlash? Oh wait, they are protecting us.
So what's the solution to this? If we don't want any individual (whether it be the pharmacist or doctor and ignoring the FDA) making decisions for us, why not put Plan B over the counter? (FDA rejected that option a while ago.)
Or, alternatively, why not allow the doctor to dispense emergency contraception or allow the pharmacist to prescribe it. After all, doctors routinely give out free samples of statins, birth control pills, and a variety of other medications; similarly, the pharmacist is often the first person the doctor consults with to find a medication that suits their patient and the pharmacist counsels on and recommends medication to patients on a daily basis.
With all these solutions out there to prevent another incident like this from happening, all we hear from the press is how absolutely "troglodytic" these pharmacists are and how their reign of terror must be ended by laws forcing them to dispense medication.
There are other ways out there to preserve the women's choice and pharmacist personal choice without forcing either of them to give up what they both dearly want to hang onto.
*And, on a side note, Viagra is a bad argument to use. I don't know of anyone having a problem with a person having sex or an erection, for that matter. Yes, there are some individuals who do not like premarital sex or extramarital sex, but can you really tell the difference when you give that man his Viagra? I think not.
However, the purpose of Plan B is quite clear. And it is that purpose that a pharmacist is opposed to and openly knows about as he goes about checking and dispensing the medication.
Take note Wildcat and others: the comparison is a faulty one.
posted by Laura Keslar at 11:19 AM | |
Thursday, October 27, 2005
And we were doing just fine
It doesn't come as any surprise, especially with 1 in 5 public schools failing to measure up to federal standards.
And as much as Governor Napolitano touts education (see all-day kindergarten and increased spending), nothing has happened. In fact, it is funny that the article quotes Napolitano spokeswoman Jeanine L'Ecuyer as saying, "...[The report] appears to reinforce the need for exactly the kind of education reform the Governor has been leading since she took office in 2003." Yes, the educational system wasn't the best in 2002 when Napolitano was elected (Arizona was ranked 44); however, since Napolitano took office, the educational system was gotten worse (mind you, this year's report differs from the last few years in that spending for public schools has been "de-emphasized"*).
*Consider, however, the fact that in 1999, there was only one state who spent less per student than the state of Arizona; that state was Utah. And in 2002, Arizona was still ranked #49 in student spending. According to Morgan Quinto Press, they emphasized spending per public schools back in 2002-2003 but not in 2005-2006. If, then, Arizona was ranked #49 in student spending when the Morgan Quinto Press based their scores more heavily on spending than in 2005-2006, it would not be that difficult to assume that the state of education in Arizona has declined even more drastically than the report indicates. (One caveat: the rankings compare Arizona with other states--not Arizona with itself. If other states have improved education while Arizona remained stagnant, then obviously, Arizona's rankings would drop. However, with the constant attention paid to education by our lovely governor and her cohorts, I would doubt this was the case; hence some of the assumptions made.)
You can find the report referred to in the article at Morgan Quinto Press as well as the individual factors influencing the rankings.
So Arizona's quality of education isn't exactly up to par. In fact, it appears that, along with crime, Arizona ranks as #50.
It doesn't come as any surprise, especially with 1 in 5 public schools failing to measure up to federal standards.
And as much as Governor Napolitano touts education (see all-day kindergarten and increased spending), nothing has happened. In fact, it is funny that the article quotes Napolitano spokeswoman Jeanine L'Ecuyer as saying, "...[The report] appears to reinforce the need for exactly the kind of education reform the Governor has been leading since she took office in 2003." Yes, the educational system wasn't the best in 2002 when Napolitano was elected (Arizona was ranked 44); however, since Napolitano took office, the educational system was gotten worse (mind you, this year's report differs from the last few years in that spending for public schools has been "de-emphasized"*).
*Consider, however, the fact that in 1999, there was only one state who spent less per student than the state of Arizona; that state was Utah. And in 2002, Arizona was still ranked #49 in student spending. According to Morgan Quinto Press, they emphasized spending per public schools back in 2002-2003 but not in 2005-2006. If, then, Arizona was ranked #49 in student spending when the Morgan Quinto Press based their scores more heavily on spending than in 2005-2006, it would not be that difficult to assume that the state of education in Arizona has declined even more drastically than the report indicates. (One caveat: the rankings compare Arizona with other states--not Arizona with itself. If other states have improved education while Arizona remained stagnant, then obviously, Arizona's rankings would drop. However, with the constant attention paid to education by our lovely governor and her cohorts, I would doubt this was the case; hence some of the assumptions made.)
You can find the report referred to in the article at Morgan Quinto Press as well as the individual factors influencing the rankings.
posted by Laura Keslar at 3:34 PM | |
Thursday, October 13, 2005
Arizona is rank
Based solely on Arizona's sales tax (and whatnot), we sadly ranked 45th in the nation. And as for crime, well, let's just say that the only state that is worse than Arizona is not a state and full of politicians: District of Columbia.
Read the actual report.
Well, maybe not "rank"--just ranked. This time Arizona is ranked 17th by the Small Business Survival Index, indicating its level of friendliness toward entrepreneurship. At the top of the list was South Dakota and at the bottom was the District of Columbia and California (what a surprise).
Based solely on Arizona's sales tax (and whatnot), we sadly ranked 45th in the nation. And as for crime, well, let's just say that the only state that is worse than Arizona is not a state and full of politicians: District of Columbia.
Read the actual report.
posted by Laura Keslar at 1:21 PM | |
