Social attitudes towards the pharmacist's right to conscientious objection – research on the Polish population

Abstract

Introduction: The right to conscientious objection in the pharmacist profession, as in the case of other medical professions, has been the subject of a lively ethical and legal discussion in Poland and abroad for many years. This is related to the introduction to pharmacy trade of products and devices whose purpose of use or mechanism of action is inconsistent with the religious beliefs or moral convictions of some pharmacists. Pharmacists practicing in Poland do not have the so-called conscience clause in law regulating their professional activity, but there are attempts to introduce such a legal solution similarly to the doctors and nurses. Aim: The aim of our study was to analyze the attitudes of Polish society towards the conscientious objection of pharmacists. We tested the hypotheses that social attitudes may vary depending on the circumstances and are modified by psychological and sociodemographic variables, such as: perception of the prestige of the pharmacist profession, tendency to seek advice from pharmacists, age, gender, education, financial conditions, health status and place of residence. Material and methods: The research was conducted on a group of 600 people over 18 years of age. The sample was representative of the Polish population. A mix mode technique was used based on personal and telephone interviews, i.e. 84% CAPI (Computer Assisted Personal Interview) and 16% CATI (Computer Assisted Telephone Interviewing). Respondents were asked whether a pharmacist, guided by his or her own conscience, could refuse to sell selected products or devices such as: hormonal contraceptives, morning-after pills and intrauterine devices. Results: The majority (78-86% - depending on the case) of respondents believe that a pharmacist has no right to refuse to sell a product or device available in pharmacies. A small number of respondents indicated that the pharmacist has the right to refuse to sell contraceptives (2.7%, n=16), intrauterine device (8.7%, n=52), post-coital pill (10.5%, n=63). Statistically significant differences were observed between the level of acceptance of the pharmacist's conscientious objection in different cases: refusal to dispense hormonal contraceptives (Me=0.14), for intrauterine devices (Me=0.21) and post-coital pills (Me=0.25) (p=0.01). The acceptance of conscientious objection by pharmacists correlates statistically significantly negatively with the respondents' age, financial conditions, level of perceived prestige of the pharmacist profession, and positively with the tendency to consult OTC medicines with pharmacists. There was no relationship with education, health status and place of residence, and no differences between women and men. Conclusions: The level of social acceptance for introducing a conscience clause into laws regulating the practice of the pharmacist profession seems to be low. However, it varies depending on the type of pharmaceutical product or medical device, which may result from the perception of a different mechanism of action, which may be morally objectionable to a greater or lesser extent. The level of social acceptance of the pharmacist's right to conscientious objection is also dependent on the social perception of the pharmacist's role, and is also modified by psychological and sociodemographic variables such as: perception of the pharmacist's prestige, tendency to consult a pharmacist when purchasing medications, as well as age and financial conditions.

Keywords

• hormonal contraception
• pharmacists
• conscientious objection
• postcoital pills
• intrauterine devices