Saturday, November 21, 2009

Guest column: As a pharmacist in the longevity concoctions business, I prefer to keep my 'oldies' alive

As Canada's Parliament debates Bill C-384, why are more pharmacists not rising up in protest over possible legalization of euthanasia and assisted suicide? Is it because we ought to remain neutral? Yet if this debate is supposed to be all about choice, then, as a pharmacist, I choose not to remain neutral on an issue that could impact my livelihood.

I'm in the business of health and wellness; longevity concoctions, my specialty. I believe it is more lucrative to keep my oldies alive and kicking longer; eliminating them is against my mission statement, and it would surely kill my business too. Unless, of course, I could charge a hefty sum for how-to-exit kits, including arsenic, asphyxiation bags, and other death paraphernalia.

But then comes another dilemma; as the elderly get knocked off, replacements will be needed -- so I can continue to offer my services. Yet most pharmacies are also in the birth control business; sooner rather than later, my clients will largely come from overseas. Time to brush up on my Arab and Cantonese.

Are health-care providers prepared for the impact a euthanasia law could have on their day-to-day practice? If, for moral or ethical reasons they find themselves unable to comply with such
a law, would they risk being fined or put in prison? Would I be accused of imposing my morality were I to dissuade sweet Ms. Jones from being euthanized by her inheritance-ravenous offspring? Yes, they will all claim it was her own choice, and really, in everyone else's best interests.

How about the lady with the severe arthritis or the man with the club foot? How about the child with the MS or the severely depressed teenager? Will our answer to their pain be their death too? If the Right To Die movement has its way, it will all boil down to "personal" choice. But whose choice will it really be? For example, as a pharmacist, I had no choice over the following briefing which states that everyone should have a choice.

In 1994, a government brief was presented to the Senate Committee Studying Euthanasia and Assisted Suicide by the Canadian Pharmacists Association. This brief clearly shows that pharmacists, like the Canadian population as a whole, are "largely divided on the issue [of euthanasia] and cannot make a strong recommendation on the legalization of euthanasia or
assisted suicide." The briefing statements make it appear as though everyone involved will have a choice, but the reality is there will need to be a balancing of rights; the right of the
patient to receive what he wants, versus the right of the health-care professional not to participate in the patient's demise. For many, referral will not be a viable option.

So if such a law should pass, I want to make something clear; I want two choices; the choice not to kill off my business by concocting death potions, and also the choice not to refer my oldies or disabled youngsters for liquidation elsewhere.

But, with all our "rights and choice" talk, are we not neglecting the underlying issues causing the euthanasia debate in the first place? And why are we not learning from the Netherlands? According to Dr. Herbert Hendin, American author of, Seduced by Death, the broad "safety" guidelines to prevent people from being euthanized against their will have been largely ignored, to the point where the doctors who help set euthanasia guidelines will privately admit that euthanasia in the Netherlands is basically out of control.

What we really need to be asking ourselves is: How did the patient reach the decision to put an end to his or her life in the first place? Was there any pressure? Was there fear of pain, of loneliness, or of the unknown? Has our society become so cold and ruthless that a sick person would rather die than be subjected to humiliating treatment by those who ought to care?
The reality is that were euthanasia to be legalized in Canada, we would be embarking on a "social experiment" of great magnitude.

Once the experiment is unleashed there will be no turning back. Your "choice" and mine may become somebody else's.

Alarcon is a Vancouver pharmacist with a masters in bioethics.
Published in Vancouver on October 29, 2009 in The Province

Sunday, October 11, 2009

Pharmacists must have Freedom of Conscience

I met Martha a few years ago, a beautiful young woman. She started frequently visiting the pharmacy, nearly every month, just to purchase a home pregnancy kit. Her hands always trembled, and there was fear in her eyes. Finally I decided to ask her whether she was okay, if not, what was the matter. She looked at me tearfully and confided, “I don’t want to go through another abortion and if I get pregnant I know he will leave me.”......(click on title to read more)


Read more: http://network.nationalpost.com/np/blogs/holy-post/archive/2009/10/08/cristina-alarcon-trusted-professionals-must-have-freedom-of-conscience.aspx#ixzz0Tg8uMRRG
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Saturday, June 13, 2009

Cristina Alarcon in National Post: Right to die? How about right to live

I had just returned from Washington, D.C., where I attended the Second International Symposium on Euthanasia and Assisted Suicide. The theme: “Never Again.”

The night before, I had mused over the intense weekend in Washington, the moving testimonials and the lively plane ride where I had become engulfed in conversations that betrayed the pervading culture of confusion surrounding assisted suicide and euthanasia. No, euthanasia is not about withdrawal of life support so as to allow a terminally ill person to die, I had explained to the lady on the plane. No, physician-assisted suicide “guidelines” are not always strictly enforced.......

Friday, May 08, 2009

LETTER IN RESPONSE TO JULIE CANTOR (NEJM)

Re: Conscientious Objection Gone Awry---Restoring Selfless Professionalism in Medicine

Dr. Cantor maintains that those who disagree with her perfectly contestable philosophical and ethical viewpoints ought to remain neutral, while she herself cannot. Accussing others of selfishly telling half-truths, while she falsely implies that a woman’s right to birth control is Constitutionally protected and self-servingly stomping on the truly Constitutionally protected rights of freedom of conscience and religion of healthcare providers, Dr Cantor betrays her own lack of impartiality.

True, Church and State are autonomous; yet this is not to say that religious believers within a secular society ought therefore to be treated as second-class citizens. .

Cantor’s obvious intent is to promote greater access to a variety of options for women, yet this cannot be done at the expense of relegating professionals to function as automatons or fragmented individuals who live via different mores in different settings.

Just as Dr Cantor has a right to live via her own beliefs and her own conscience, so do those who oppose her beliefs have the right to live with integrity as truly responsible moral agents.

Cristina Alarcon , Bpharm, Masters Bioethics


Longer version of letter:
Re: Conscientious Objection Gone Awry---Restoring Selfless Professionalism in Medicine


Unmatched is the candor of Dr Cantor in “conscientious objection gone awry…”. Not only is she transparently unfair to those who would disagree with her perfectly contestable philosophical and ethical viewpoints, but she also dares to insinuate that healthcare providers ought to remain neutral while she herself cannot.

While it is true that Church and State must each maintain their autonomy, it is false to conclude that religious believers (as opposed to non-religious believers) ought therefore to be treated as second-class citizens. She dares to accuse others of selfishly telling half-truths, while falsely implying that a woman’s right to birth control is Constitutionally protected and self-servingly stomping on the truly Constitutionally protected rights of freedom of conscience and religion of all citizens, those of healthcare providers included.

Cantor’s obvious intent is to promote greater access to a variety of options for women, yet this cannot be done at the expense of relegating professionals to function as automatons or fragmented individuals who live via different mores in different settings.

Furthermore, her myopic views on women’s health issues, which reduces women to the sum of their reproductive organs lacks vision and imagination. It is an insult to the women who, as patients, may not all share her views, and to the professionals who selflessly care for them. To compare the non provision of abortion services to non provision of lifesaving treatments such as blood transfusions and diabetic medicines shows a further lack of deep reflection on the fact that pregnancy is not an illness, and premature delivery is rarely a therapeutically lifesaving intervention. On the contrary, abortion takes the life of an innocent bystander.

Finally, just as Dr Cantor has a right to live via her own beliefs and her own conscience, be it religiously informed or not, so do those who oppose her beliefs have the right to live with integrity as truly responsible moral agents.

Cristina Alarcon
Bpharm. Masters Bioethics

Saturday, April 18, 2009

Cristina Alarcon:Mixing conscience and medicine is a good thing (National Post blog)

Let me tell you about Jane*. Jane was in her 60s and had been my patient for many years. As her pharmacist, I knew she had been battling depression for a long time, but she was always chirp and cheerful when she walked into the pharmacy for her monthly pills.

Slowly, she started going downhill. Medications were not helping and she said she just wanted to die. One day she came in and asked specifically to see me. From her pocket she pulled out several tablets, one I recognized as a powerful narcotic, the other a sleeping pill. She said, “My friend gave me these … how many would I need to take to make sure I die?”

Wednesday, April 15, 2009

Professionals or Automatons?

The right of acting according to one’s conscience is under threat in many countries at the moment. In the US, the Federal government is studying whether to rescind protection of conscience regulations implemented in the dying days of the Bush Administration. Healthcare workers there are worried that they may have to participate in unethical procedures – or lose their jobs. This interview explains what is at stake in my profession.

Wednesday, April 08, 2009

Roadkill Radio interview on Conscience

Listen-in on the important issue of freedom of conscience and religion in healthcare!

Saturday, April 04, 2009

The next moral quagmire: conscience

Thank you Charles Lewis once again for an excellent and timely article on a very important issue! Although it is inaccurate to say that I ever raised the ire of customers and colleagues over refusing to fill prescriptions for morning-after pills, it is true to say that I refuse to fill them or to refer for the drug for the reasons stated in the article. It was in Toronto that a colleague suggested I leave my beliefs at the door and in Vancouver that a pharmacy manager warned me about “imposing my morality”, after which I was let go under other pretexts. Why is this significant? Because this is a national problem for pharmacists, and not limited to Calgary, where yet another pharmacist, Maria Bizecki suffered a lengthy suspension from her job for kindly asking a customer to come back for the product she requested next day when someone else would be all too happy to meet her needs. In Ontario, pharmacist Michael Izzotti was also severely reprimanded when a doctor made a formal complaint to the Ontario College of Pharmacists; Michael had merely asked the doctor to please fax in the prescription so a colleague could take care of it next day. Many other pharmacists will not come forward with their stories for fear of losing their livelihood.
When convenience takes precedence over the basic human rights of freedom of conscience and religion, our Canadian democracy is in very bad shape indeed!
For more on this, please see “The ‘Hijacking’ of Moral Conscience from Pharmacy Practice: A Canadian Perspective” at www.theannals.com or at www.culturalrenewal.ca

Friday, April 03, 2009

Protection of Conscience Live

Freedom of conscience and religion is under attack in the US ....please take the time to listen to these videos and to reflect on the importance of freedom of conscience and of ethical thought and expression for a healthy democracy!

Wednesday, April 01, 2009

Rights of Conscience a Dangerous Issue Video

The Christian Medical & Dental Associations (CMDA) have posted a great new YouTube video outlining the rights of conscience issue and its expected impact on healthcare in America. Please watch it and pass it along!

Saturday, March 28, 2009

The "Hijacking" of Moral Conscience from Healthcare

For an interesting article on this, please visit http://www.theannals.com/ (April 2009 issue)

Today more than ever before, healthcare professionals are under great pressure to practice the art and science of medicine according to pragmatic ideologies that fail to protect their rights of conscience. This is largely because patient autonomy (not something bad in itself), has been crowned as the highest bioethical principle. Unfortunately, the notion of autonomy has falsely come to be equated to the concept of human dignity. As a child in the womb is seen by some not to have any worth, so a woman who lacks autonomy may be perceived by some to have been stripped of her dignity. This ofcourse, is nonsense. The dignity of a person is not an add-on, it is inherent because that person belongs to the human species and therefore, regardless of their being or not autonomous, that person is worthy of respect.
Respect for the person also implies respect for their integrity; this respect is due to the body and to the spirit. Thus, just as it would be wrong to physically harm a person's body, so it is wrong to attack their spirit. This applies in a special way to healthcare workers who are being forced to act against the dictates of their conscience when the perceived rights of patients to non-lifethreatening, non-lifesaving "needs" are forced upon them.