PROTECTING PHARMACIST SCIENTIFIC AND CLINICAL DECISION MAKING

To affirm the clinical decision-making of pharmacists and their right to refuse to prescribe, approve, procure, prepare, or dispense a medication that lacks sound medical evidence or scientific validity.

Rationale

Pharmacists have a professional responsibility to ensure the safe, appropriate, and evidence-based use of therapies throughout the medication-use process, including procurement, order review and verification, and medication dispensing. This responsibility requires the application of scientific and clinical knowledge, clinical expertise, and professional judgement to identify and address medication-related risks, including inappropriate therapy selection, dosing, drug interactions, contraindications, and other factors that may compromise patient safety.

Proposed legislation in some states requires pharmacists to dispense medications regardless of clinical appropriateness or scientific concern. This undermines the pharmacist’s role as an essential safeguard within the healthcare system. Such requirements may compel pharmacists to participate in therapy decisions that they reasonably believe could place patients at risk of harm, thereby compromising established standards of medication safety and professional practice.  

Instances in which pharmacists decline to dispense medications based on scientific objection are uncommon and typically resolved through communication with the prescriber. However, there are situations where it is impossible or unfeasible to engage in such discussion in a timely fashion. In such situations, pharmacists must retain authority to refuse the dispensing of medications when, in their professional judgement, dispensing the medication would be inconsistent with safe and evidence-based care.

In situations where a refusal to dispense is made, it is the responsibility of the refusing pharmacist to work with the health care team to implement an alternative therapeutic plan that satisfies the patient’s treatment needs.