When can a pharmacist refuse to sell a drug? It turns out that there are quite a few situations in which a pharmacy employee may or even have to refuse to dispense a drug to a patient. They concern not only the pharmacist's refusal to sell contraceptives due to the conscientious objection clause. Check when the pharmacist can refuse to dispense the drug.

Five years of difficult studies, MA thesis and six months of compulsory professional practice in a pharmacy. This is the education of a pharmacist in Poland, who is nevertheless perceived by many as an ordinary drug seller. However, behind this education comes enormous responsibility and rights, which not everyone is aware of. Because if a pharmacist is required to rationalize and control treatment, but also to dispose of the NHF budget as part of the implementation of reimbursed prescriptions, he must have the right to tell the patient NO at the right moment. Such situations are precisely defined in the relevant regulations, and pharmacists may even be punished for non-compliance.

When can a pharmacist refuse to sell a drug? He alth clause

The pharmacist's task is to inform the patient about drugs and rationalize his therapy in such a way that it is safe and effective for him. As a result, the Pharmaceutical Law (Pf.) Gives a pharmacy employee (both a pharmacist and a pharmaceutical technician) the possibility of refusing to dispense a drug if it may pose a threat to the patient's life or he alth (Art. 96.5.1 of the Pf.). This also applies when there is a suspicion that the medicinal product may be used for non-medical purposes (Art. 96.5.2 of the Pf.).

A pharmacy employee may also refuse to make a prescription drug if there is a need to make changes to its composition, for which the pharmacist or pharmaceutical technician is not authorized and it is not possible to contact the doctor (Art. 96.5.4 of the Pf.) pharmacies may also refuse to provide a patient with a prescription drug made for him, if at least 6 days have passed from the time of its preparation (Art. 96.5.5 of the Pf.). Obviously, this provision results from the short shelf-life of prescription drugs, which are usually free of preservatives.

When can a pharmacist refuse to sell a drug? Fraudulent prescriptions

There are more and more frequent phenomena on the pharmacy marketforgery of prescriptions. On the one hand, they apply to reimbursed drugs, for which the reimbursement is extorted. On the other hand, prescriptions for psychotropic and narcotic drugs are very often falsified. The pharmacist's task is to evaluate the authenticity of the prescription each time. If, in his opinion, there is even a shadow of a suspicion that a given prescription is forged, he has the right to refuse to implement it. But that's not all …

The conduct of a pharmacist with a potentially false prescription is regulated by two legal acts. On the one hand, it is the already mentioned Pharmaceutical Law, which in Art. 96.5.3 gives the pharmacy employee the right to refuse dispensing "in case of reasonable suspicion as to the authenticity of the prescription or need". More precise in this respect is the ordinance of the Minister of He alth on medical prescriptions, which says that "in the event of a justified suspicion that a prescription has been forged, the issuing person refuses to carry it, detains it and immediately notifies the provincial pharmaceutical inspector, provincial branch of the Fund competent for to the address of the pharmacy, and, if possible, the authorized person or the service provider "(§24).

When can a pharmacist refuse to sell a drug? Psychoactive substances

Drugs used in the treatment of severe pain, runny nose or cough - it is in them that you can most often find these three substances: codeine, dextromethorphan and pseudoephedrine. All of them can be purchased without a prescription. It turns out that these three substances, in addition to their therapeutic effects, also have a … intoxicating effect. Used in large amounts, and sometimes also combined with alcohol, they can provide sensations and experiences comparable to taking drugs or designer drugs. As a result, the Ministry of He alth decided to introduce regulations that, on the one hand, will limit the sale of this type of preparations to minors, and, on the other hand, will prevent them from being traded on a wholesale scale for the purpose of producing drugs.

Based on the literature data and voices that appeared during public consultations, the exact amounts of the substances mentioned, which are to be sufficient for effective therapy, have been determined. 720 mg of pseudoephedrine, 240 mg of codeine and 360 mg of dextromethorphan - this limitation of the content of psychoactive substances in the packaging of over-the-counter drugs was finally established by the Ministry of He alth. At the same time, these values ​​have become a restriction for pharmacists in the sale of these substances, e.g. when issuing several smaller packages. For non-compliance with these regulations, pharmacists face huge financial pen alties (up to PLN 500,000, in the case of wholesale up todrug production).

When can a pharmacist refuse to sell a drug? Patient's age

From July 1, 2015, the regulations also impose an obligation on pharmacists and pharmaceutical technicians to refuse to dispense an over-the-counter drug containing the aforementioned psychoactive substances to a person under 18 years of age. In case of doubts as to the age of the patient to whom the medicinal product is to be dispensed, the pharmacist or pharmaceutical technician is en titled to demand the presentation of a document confirming the age of such a person. In the event of refusal to present the document, the pharmacy employee has the right to refuse to sell the drug.

This is not the only time a pharmacist can ask a patient about their age. The aforementioned Pharmaceutical Law gives the right to refuse to fill any prescription if the person who came with it to the pharmacy is under 13 years of age. Again, in such situations, the pharmacist and pharmaceutical technician are en titled to require the production of a document stating the age of such a person. If such document is not presented, the medicine cannot be sold.

One of the most recent changes in the regulations is the amendment to the regulation on dispensing medicinal products from pharmacies, signed by the Minister of He alth at the beginning of April 2015. A provision was introduced into it stating that hormonal contraceptives for internal use, having the OTC availability category, are issued without a prescription to a person 15 years of age or older. In practice, this means that the so-called the "day after" pill (in Poland it is only ellaOne) can be issued without a prescription only to persons over 15 years of age. A pharmacist or a pharmaceutical technician may refuse to release this preparation to a person who, at his request, does not document it.

When can a pharmacist refuse to sell a drug? Conscience clause

Currently, in our country, doctors, dentists, nurses and midwives have the right to refuse to perform a certain he alth service that is inconsistent with their conscience - these regulations are called the conscience clause.

In the case of doctors and dentists, it is sanctioned in article 39 of the Act on the Medical Profession of December 5, 1996. He says that "a doctor may refrain from performing he alth services that are inconsistent with his conscience (…) with the exception that he has to the obligation to indicate the real possibilities of obtaining this service from another doctor or in another he alth care institution and to justify and record this fact in the medical documentation. A doctor practicing his profession on the basis of an employment relationship or within the service is also obliged to notify his supervisor in advance "

Nurses, on the other hand, have the conscience clause provided for in Article 23 of the Act on the Nursing and Midwife Professions of July 5, 1996, according to which "a nurse, midwife may refrain from performing a he alth service inconsistent with her conscience. "

There is no analogous provision in Polish law that would grant the "conscience clause" also to pharmacists. That is why some of them refer to Article 53 of the Constitution of the Republic of Poland, which guarantees freedom of conscience and religion to everyone. This right is confirmed by the judgment of the Constitutional Tribunal of January 15, 1991 (U8 / 90) saying that "freedom of conscience does not only mean the right to represent a specific worldview, but most of all the right to act in accordance with one's conscience, to be free from the compulsion to act against one's conscience. ".

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