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Catholic pharmacist ends career over EHC requirements

Mr Majchrowicz was first sanctioned in 2013 for subjecting a patient to a "distressing lecture" on the ethics of EHC

Piotr Mikolaj Majchrowicz, registration number 2069549, quit over the need to refer patients to a willing provider

A Catholic pharmacist who equated emergency hormonal contraception (EHC) with abortion has ended his career because of the General Pharmaceutical Council’s (GPhC's) stance on its supply.

The GPhC banned Piotr Mikolaj Majchrowicz, registration number 2069549, from supplying the morning-after pill for three years in 2013 after hearing that he told a patient she was “ending a life” and taking the drug would be “on her conscience”.

At a review hearing last month (August 28), the GPhC found that his stance on EHC had since “hardened”. Mr Majchrowicz was not present, but wrote a letter to the fitness-to-practise committee saying he has no wish to work like a “vending machine” or to withhold his “knowledge about the abortifacient properties” of EHC.

Mr Majchrowicz also expressed dissatisfaction with the GPhC requirement for pharmacists who refuse to supply EHC to direct patients to another pharmacy where the pill is available because it goes “against their conscience”. He cited the GPhC's stance as the reason behind his decision to end his pharmacy career. 

The regulator said it had “no choice” but to continue to impose conditions on Mr Majchrowicz's registration until he changed his view. He will be informed of how to voluntarily remove himself from the register, although it is “entirely” up to him whether to do so, the GPhC said.

A 'chemical abortion'

Mr Majchrowicz initially appeared in front of the GPhC after subjecting a patient to a “distressing lecture” on the ethics of EHC in 2012, while working at Boots. He took the patient to the consultation room to discuss the supply, but “kept on sighing” and seemed “very uncomfortable” with the situation, the patient told the GPhC at the time. He told her that supplying the drug went against his religion because it amounted to a chemical abortion.

Although Mr Majchrowicz agreed to supply the drug, the patient was too upset to take it and “broke down in tears” at home soon afterwards, the GPhC heard.

In his 2013 hearing, Mr Majchrowicz admitted telling the patient that EHC was against his faith and amounted to abortion, saying that was “how the Pope would see it.” He added that he had supplied EHC in a similar way before but had received no complaints. He denied saying the act would be on the conscience of the patient.

The GPhC ruled that his advice had been “anything but impartial” and he had instead given a “distressing explanation of why his religion regarded EHC as morally wrong”. This went against the regulator's code of conduct, which requires pharmacists to respect cultural differences and ensure their views do not affect their professional service, it said.

Although Mr Majchrowicz had a previously unblemished record, he was “wholly unrepentant”, the GPhC ruled at the time.

Read Mr Majchrowicz's review hearing here.


What do you think of the GPhC's decision?

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52 Comments

Farmer Cyst, Community pharmacist

I don't really understand why this chap is being villified in the way that he is here. His opposition to EHC is such that he considers referring patients to receive it elsewhere to also be against his faith. As he felt he was unable to do this, he decided to stop practicing as a Pharmacist. His lecturing of the patient initially was not not in accordance with professional standards, but if you genuinely thought that the patient was about to murder their child then it's understandable to me why you might try and dissuade them. I suspect Mr Majchrowicz real problem was being open with his views. I suspect most Pharmacists who morally object pretend that they cannot supply it for some other reason (not qualified, no stock etc). I personally am an atheist, and do not share Mr Majchrowicz views on EHC at all, however I applaud his honesty surrounding this matter. He did not allow himself to be strong armed into something he felt was wrong - most Pharmacists couldn't say this about themselves.

cathryn brown, Community pharmacist

If I recall the original hearing correctly, he was making supplies of EHC but then as part of his "counselling" explaining to women that they were murdering their unborn children... The GPhC quite rightly said this was unacceptable, and said that he wasn't allowed to supply EHC, but had to direct women elsewhere. He obviously feels constrained by not being allowed to lecture women, and has chosen to chuck his toys... I would be quite happy for the registrar to refuse his request to come off the register, and make him keep paying his fees.

Gerry Diamond, Primary care pharmacist

The catholic faith has lots of rules and dogma about sex and sexuality which conflict with many others attitudes beliefs and values. And if you don't believe in EHC then it's fair to signpost elsewhere and that should be the end of the matter. Equally many catholics use the pill, EHC, have abortions, gay and lesbian and pick and choose what to believe and practice as at the end of the day the catholic faith allows for you to follow your conscience too.

Leon The Apothecary, Student

Well said Mr Diamond. Would it have sense in your opinion that aforementioned pharmacist simply did not undertake the training to supply EHC so he could simply say he was eligible to supply it?

Gerry Diamond, Primary care pharmacist

He should follow his conscience and refrained from evangelizing the poor woman, as what he did was quite sexist. Personally, I'm always happy to supply EHC as a catholic as we need to put the patient first in my professional opinion, because it is the patients moral choice not mine in sexual matters. And I don't believe in judging people on social morality as that is their private business. And as a gay person I'm not too interested in the machinations of heterosexual people either..lolx

janet maynard, Community pharmacist

Just to point out to many people here who are saying that if those of us who invoke the conscience clause shouldn't be pharmacists - that when we went into the profession the clause was active so we knew that we could carry out our responsibilites without compromising our faith. I am now in my late 50s, having been a pharmacist all my life. I have a life style that depends on my salary and wouldn't be able to train as another professional now! I also think it is a generalisation to say that most pharmacists are atheists!

Gerry Diamond, Primary care pharmacist

I agree Janet with the conscience clause although I supply the pill and yes not all of us are atheists.

Leon The Apothecary, Student

Last time a Pharmacist refused to give EHC on those grounds, I simply asked them to clinically assess the patient for suitability of the medication and then allow me or one of the other members of staff to supply.

Leon The Apothecary, Student

Religion should play no part in the application of healthcare. It's the same as doctors treating enemy soldiers on the battlefield. In my opinion anyone who goes against this has no place in this industry.

James Mac, Community pharmacist

http://www.sheldrake.org/research/the-skepticism-of-believers - also I find rupert sheldrake's perspective helpful. Here he talks about skepticism - but the idea he puts forth is, the skeptics believe as much as those they decry do (obviously not the same things though).

Leon The Apothecary, Student

Creationists also believe that evolution is a myth so that's a nice example of how credible that particular cult is.

Ms B Wilson, Pharmaceutical Adviser

I feel sorry for him, especially having an unblemished record, but as one comment says, you do not have the right to pass judgement on someone's decision, even if it is at conflict with your own. The job is to support the person as best you can. A more holistic approach may have been a better outcome for how the patient could move forwards from such a tragic mistake. What is the world coming to!!

David Tambyrajah, Community pharmacist

Pharmacists a have choice to or not to participate in EHC supply, but must make their intentions clear so employers can recruit pharmacists willing to provide EHC. Patient care must be the upmost priority and all pharmacy professionals must act in a supportive non judgemental way.

James Mac, Community pharmacist

"Consequently, from the ethical standpoint the same absolute unlawfulness of abortifacient procedures also applies to distributing, prescribing and taking the morning-after pill. All who, whether sharing the intention or not, directly co-operate with this procedure are also morally responsible for it" - vatican statement on http://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents...

James Mac, Community pharmacist

http://morningafterpill.org/catholic-teaching.html - one very last thing! I'm sure no one cares much anymore, but I thought this helps clarify what the catholic church says about it.

Richard Lee, Community pharmacist

I can understand that catholic doctrine is a view, however, it is important to understand that it is a view drawn up by a group of men, that pretend to know that there is an invisible man in the sky, or wherever they currently decide he lives (outside space and time?). There is no evidence for the invisible, magic man, and certainly no evidence that he has personally given guidance to the men that drew up the doctrine. Our moral code will always be a consensus view of people which changes overtime, the sooner we drop the idea of listening to those that pretend to know the view of a supernatural being we can have a grown up discussion.

James Mac, Community pharmacist

"in the end, since these procedures are becoming more widespread, we strongly urge everyone who works in this sector to make a firm objection of moral conscience, which will bear courageous and practical witness to the inalienable value of human life, especially in view of the new hidden forms of aggression against the weakest and most defenceless individuals, as is the case with a human embryo."

Lancelot Spratt, Accuracy checking technician

What an idiot. If he is too stupid to realise that the woman is not pregnant simply because she had unprotected intercourse, then he is too stupid to practise as a pharmacist. Not every episode of intercourse results in pregnancy so the vast majority of women who come for EHC are not and never would be pregnant. It is a precaution against pregnancy. If he ever choses to return to pharmacy he should do some study into human reproduction. Good riddance, the profession is better off without him.

London Locum, Locum pharmacist

His stance on EHC is neither here nor there but leaving Pharmacy will probably turn out to be a blessing in disguise.

John Willetts, Locum pharmacist

PMM has a right to his religion and his viewpoint. He does NOT have a right to require other people to behave according to his perspective. He is required by his prof responsibilities to provide EHC. If he won't it seems perfectly reasonable to insist he informs the pt where she can get the service she wants elsewhere. What next? Refusal to supply condoms or the contraceptive pill? Finally guilt manipulation by individuals, the state or any religion is abhorrent and shd be resisted - always.

James Mac, Community pharmacist

Just to play devil's advocate don't you think that your perspective is manipulative? You seem to say that this gent was wrong to refuse to act according to his beliefs, and instead should act according to either yours or what the pharmacy profession's is supposed to be. Wouldn't a mandate to provide such a service in conflict with one's genuine perspective be coercion (by the state, profession, law or what have you)?

Stephen Eggleston, Community pharmacist

James - pharmacy does not operate on a belief system. As I said originally, we should act in the best interests of the patient. I can accept that the gentleman in question finds conflict between his religion and his profession, but for me, that is the point at which he should decide which he wants. In this case, his religion was of greater worth to him and he took the appropriate action and for that I applaud him.

James Mac, Community pharmacist

Ok I do agree with you but I really think pharmacy does have a belief system. It's based around scientific materialism and is therefore antagonistic to a religious, or non-material, view of the world. This seems to be borne out by the reaction here to this gent (most people are furious that religious beliefs could get in the way of selling EHC). People base their view of the world around what they believe, where you think you base your opinion around fact or evidence you're still engaged in the act of believing.

James Mac, Community pharmacist

Very lastly if pharmacy wasn't based on a belief system, there would be no relative "right" or "wrong". For example, if a pharmacist refers someone to a faith healer rather than a doctor, you'd probably say that was the wrong thing to do, because it's not borne out by the evidence. But if pharmacy had no underlying belief system - no criteria on which to make that assertion - that would be a fine thing to suggest. And also, Mr. EHC would not have done anything wrong by telling these ladies not to take EHC.

Edwyn Parry, Community pharmacist

There is no relative right and wrong, and the practice of pharmacy is based on evidence, not belief. This is why we do not (or at least should not) refer to alternative medicine.

James Mac, Community pharmacist

OK I see your point but in order to assert "pharmacy is based on evidence, not belief" we still need to believe that evidence is meaningful. In and of itself, and out of context, it doesn't have any import or meaning. The idea of absolute right and wrong is also a belief - there's no such thing as right or wrong in the natural world. So pharmacy as we understand it in the UK, is undoubtedly based on a belief which is informed by the scientific materialistic point of view, which therefore excludes alternative medicine. Ultimately, pharmacy rejects the idea of "alternative medicine" because of belief, rather than research per se.

Leon The Apothecary, Student

What you just said made no sense Mr Mcmurray. Firstly, scientific process is based on factual evidence. You cannot argue this. Then you make a random quote irrelevant to your following statement to attempt to support your non-existant point. Thirdly, you should do some more research into what an alternative medicine actually is in the context of scientifically proven remedies. Those that are proven to be true, guess what they become? That's right. Medicines. Fourthly, your lack of knowledge on the subject worries me.

James Mac, Community pharmacist

A shame Mr. D'. I hoped you would be able to argue properly rather than setting me up as a "villain" who commits some sort of logical fallacy. Of course I know what an alternative medicine is. But what you don't seem to realise, is that you reject it because of your philosophical position - which might well be based on research, or a logical mode of thinking, but is still just an assertion. My point here is that it can be ethically consistent for a pharmacist to refuse EHC. A great danger are those like yourself, who are interested in closing down the debate by attacking your antagonists as "dangerous" or cranks merely for speaking up for the other side. If you get your way, and the conscience clause is lost, pharmacy will suffer greatly. Thanks for the replies, but you aren't considering my points, just trying to gainsay them and that, sir, isn't an argument. https://www.youtube.com/watch?v=kQFKtI6gn9Y

James Mac, Community pharmacist

Furthermore, the idea that an "alternative medicine" is simply one that didn't make the cut to be a "proper medicine" is a fallacy, propagated by noted scientist... tim minchin. What would he say to the proposition that EBM is in crisis? Would it undermine your confidence in medicine? http://www.bmj.com/content/348/bmj.g3725 There's certainly a lot of thought and research into this, and scandals involving fabricated research abound. As someone who believes in EBM - and I admit it's a belief - I'm concerned that you don't seem to acknowledge there's dissent of opinion in medicine in general, and this profession in particular. I hope this helps you to see that there is a real discussion, not some cut and dried set of ready made answers which divide everything into right and wrong.

Super Pharmacist, Community pharmacist

Both sides of the argument are valid to an extent. If a pharmacist's beliefs are against supply, he/she should be given the choice to not supply but with the option of directing to someone who can (& before I get my head bitten off, I do supply ehc privatley & on pgd). You cannot enforce some things, it's a bit like forcing a doctor to carry out euthanasia when they are against it!

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