When should we chose our own medicine?
PHARMACISTS want more freedom to sell homeopathic and herbal treatments, even when there is no evidence they will help patients.
A proposed tweak in the Pharmacy Council’s code of ethics on complementary medicines, such as homeopathy or health supplements, has sparked vigorous protest from doctors.
The debate focuses on whether the obligations to protect patients from bogus remedies trumps the patient’s rights to decide their own treatment.
The changes proposed by the Pharmacy Council would remove the obligation for pharmacists to only sell complementary medicine where there ‘‘is credible evidence of efficacy’’, in other words where there is substantial evidence showing the medicine does what it says on the box.
Instead, pharmacists would only have to provide customers with information about a medication’s ‘‘risks and benefits’’ and whether better alternative treatments are available. Pharmacists should still not ‘‘promote’’ ineffective complementary medicine, and needed to be confident it was safe, but they could sell it.
‘‘Pharmacists must . . . respect patients’ rights to freedom of choice or autonomy in relation to their treatment options.’’
But Dr Kate Baddock, chairwoman of the New Zealand Medical Association’s GP council, said pharmacists were health professionals and shouldn’t be offering products they knew didn’t work.
‘‘I think its a fine line between selling these products and promoting them,’’ she said.
‘‘If you’re selling something with credible evidence and right beside it you’re selling something without credible evidence, the edges are always going to blur.’’
The proposed changes would send a signal to pharmacists that it was ethically acceptable to sell ineffective products, resulting in more of them on the shelves.
‘‘It ups the ability to sell more products. Whether there is a commercial imperative there, you’d have to ask pharmacists.’’
But Pharmacy Council chairman Dr Andrew Bary said the rules as they stood were ‘‘unworkable’’ and many pharmacists, including himself, were already selling complementary medicines, even if they didn’t believe their claims. The proposed changes would strengthen pharmacists’ obligation to tell the patients if a pill, supplement or ointment didn’t work while retaining patients’ right to choose it anyway.
‘‘There seems to be some anxiety that pharmacists will be prescribing homeopathy and herbal remedies but that’s just not the case,’’ he said.
‘‘What we [the council] can’t do is direct which products are fit for the shelves.’’
Ann Privett, partner at the Unichem Pharmacy in Miramar, Wellington, said she sold homeopathic remedies and herbal supplements with no scientific evidence proving they worked.
Any customers
requesting these products were told they wouldn’t do anything medically. However, some chose to buy them anyway and still believed they worked.
‘‘Some people find a particular product works for them even though the science isn’t there,’’ she said.
‘‘If it makes them them think they feel better, and it’s not doing any harm, that is still a benefit.’’
Removing complementary medicines from pharmacies would just drive customers to less reputable sources, paying too much for mythic cures that could actually put them at risk.
‘‘At least in the pharmacy they get the right information.’’
Submissions on the proposed change close today.