title: Mifepristone (RU486) in Australian pharmacies: the ethical and practical challenges.
abstract: OBJECTIVE
  The recent legalization of mifepristone has given women in Australia a new option for termination of pregnancy. Pharmacists are well positioned to provide information and supply mifepristone for patients. However, there are ethical and legal concerns in Australia regarding the supply of mifepristone, as pharmacists may choose to conscientiously object to supplying mifepristone and are subject to differing abortion laws between states and territories in Australia. The objective of this study was to explore attitudes and knowledge of Australian pharmacists about mifepristone.
  
  
  METHODS
  Semistructured interviews were conducted with 41 registered pharmacists working in a pharmacy or hospital in Sydney, Australia. When data saturation was achieved, audiotaped transcripts were deidentified and transcribed verbatim. Data were thematically analyzed using a framework approach for applied policy research and categorized into the following themes: contextual, diagnostic, evaluative and strategic.
  
  
  RESULTS
  Analysis of the transcripts yielded four themes: (a) pharmacists' contextual view on pregnancy termination, the role of the pharmacist and impact on the pharmacy workplace; (b) diagnostic reasons for differing views; (c) evaluation of actual and perceived pharmacy practice in relation to the supply of mifepristone and (d) strategies to improve pharmacists' services, awareness and education.
  
  
  CONCLUSIONS
  Australian pharmacists in this study perceived themselves to have a potentially important role as medicine experts in patient health care and safety in medical termination of pregnancy. However, there was a general lack of clinical, ethical and legal knowledge about medical termination of pregnancy and its legislation.
  
  
  CONCLUSIONS
  To ensure patient safety, well-being and autonomy, there is an imperative need for pharmacist-specific training and guidelines to be made available and open discussion to be initiated within the profession to raise awareness, in particular regarding professional accountability for full patient care.
authors.affiliation: The University of Sydney, Faculty of Pharmacy.
authors.forename: Rebekah Yeaun
authors.initials: RY
authors.lastname: Lee
authors.affiliation: The University of Sydney, Faculty of Pharmacy.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Moles
authors.affiliation: The University of Sydney, Faculty of Pharmacy. Electronic address: betty.chaar@sydney.edu.au.
authors.forename: Betty
authors.initials: B
authors.lastname: Chaar
mesh_terms: D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects* / Q000191:economics; D000028:Abortion, Induced / Q000009:adverse effects* / Q000191:economics / Q000941:ethics / Q000331:legislation & jurisprudence; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services; D004994:Ethics, Pharmacy; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007880:Legislation, Drug / Q000941:ethics; D015735:Mifepristone / Q000009:adverse effects* / Q000191:economics; D009517:New South Wales; D004366:Nonprescription Drugs / Q000009:adverse effects* / Q000191:economics; D010353:Patient Education as Topic; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D011247:Pregnancy; D011361:Professional Competence; D024382:Professional Role; D019037:Urban Health Services; D000078329:Workforce
chemical_list: D000021:Abortifacient Agents, Steroidal; D004366:Nonprescription Drugs; D015735:Mifepristone
keywords: Abortion; Australia; Conscientious objection; Continuity of care; Pharmacy practice