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Ethical Principles in Health Policy Decision-Making
On August 24, 2006 the Food and Drug Administration (FDA) approved Plan B emergency contraceptive (EC) for behind-the-counter sales to individuals 18 years and older. Women under the age of 18 may obtain it with a prescription from their physician (Harris, 2006). In November 2006, Plan B was shipped to pharmacies around the country for distribution (Allen and Goldberg, 2007). Yet, despite the FDA’s action and the manufacturer’s ability to distribute the drug, people across the country continue to face barriers obtaining Plan B including: pharmacies not stocking Plan B (Langston,1007); pharmacists not filing prescriptions or providing it to patrons who request it (e.g., McKoy,2007); pharmacist having insufficient knowledge about Plan B (e.g., French and Kaunitz, 2007); and patients having insufficient knowledge and/or awareness of Plan B (e.g., Foster, et.al.2007).
These barriers have very real consequences since EC is most effective the earlier it is taken. Rodrigues et al. (2001) conducted an observational study comparing two groups of women who took emergency contraceptives after unprotected intercourse. Group one sought help within 3 days (or 72 hours) after unprotected intercourse and group two sought help 4 to 5 days (or 96 to 120 hours) after unprotected intercourse. The authors concluded that EC is most effective (87% to 90%) if taken within 3 days. However, they also noted that EC is still effective (72% to 87%) if taken within 4 to 5 days. Unfortunately, no data is available for the effectiveness of EC after five days (120 hours).
As part of an independent study, Beth Haymore, MPH Student and Graduate Assistant in the the Center for Women’s Health and Wellness along with the Director has developed a survey to learn from women pharmacists about bio-ethical principles and the decision making process. Learning from their experiences as women pharmacists will provide us with a wonderful opportunity to learn more about people’s perspective on different bio-ethical arguments, especially when different bio-ethical principles are brought into direct conflict with one another.
The survey was implemented at the South Carolina Girls of Pharmacy Leadership Weekend, January 16-18, 2009. In total, 150 women and men were registered for the conference. Ninety-two surveys were filled out and returned, which is a 60.66% return rate! Currently, we are analyzing the data.