Speaking at the final evidence session on the assisted dying bill, Baroness Finlay last week (November 5) said that she had “concerns for pharmacists”.
She questioned where liability would lie if the approved substance “is dispensed in community pharmacy and there has been an error”, particularly if the dispensing was “actually done by [a] pharmacy technician under authorisation from a pharmacist”.
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In response, Royal Pharmaceutical Society (RPS) director for Scotland Laura Wilson said it was aware “that pharmacists do retain some of the liability for the provision of substances on prescription to the patients.”
She stressed there would “have to be a process by which the pharmacist is satisfied” that what they’re supplying is the “approved substance”.
And she added it would be necessary that the “agreed protocol” is “compatible with what the patient wants to happen”.
Exemptions must be made
Wilson also told the Lords that the RPS believes “there is a potential issue with [the] supply mechanism and the responsibilities” set out in the bill, which is formally known as the terminally ill adults (end of life) bill.
“There needs to be a decision about how the supplies are made, what protocol is used” and “whether or not that is an existing licensed product which would then be used in an unlicensed way, and what authorisation is given for that to happen,” she added.
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“As legislation stands, a pharmacist will supply a prescription to the patient,” Wilson said, but noted that this “can’t happen because of the clauses within the bill”.
She explained that as currently set out in the bill, pharmacists would have to supply the prescription “to the doctor”.
“So there will need to be exemptions made if the retail supply is the route that is gone down,” she added.
Conscientious objection
Also responding to Baroness Finlay’s question, barrister and pharmacist Greg Lawton said that he would “have some concerns” about “supervision by pharmacy technicians”.
In terms of the drug “being supplied in error”, he said that it was “a possibility” but noted that “it’s not clear from the bill whether the intention is that it would be supplied from pharmacies or dedicated centers”.
“It’s not clear whether there’d be other drugs on the shelf that it could be supplied in error” of, he added.
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Lawton also touched on the possibility for pharmacists to “opt-out” of dispensing the approved substance to patients, questioning whether it would work “at an organisational level or an individual level”.
At the moment “there is provision in standards issued by the General Pharmaceutical Council (GPhC) as to conscientious objection and that seeks to strike a balance between religious belief, personal belief, for example, and the needs of a patient”, he explained.
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“This would be a new process and might invoke a greater prevalence of people seeking to rely on conscientious objection,” he said, adding that if this is the case, “that would need to be re-examined”.
It comes after MPs voted in favour of the bill at its final reading in the House of Commons in June, narrowly passing it to the Lords with a majority of just 23.
