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Policy Changes 

Editor's note: After this story was published, Duquesne University issued a statement clarifying that its Hill District pharmacy does not offer contraceptives. In a statement sent to City Paper on Jan. 6, Dr. J. Douglas Bricker, dean of the university's School of Pharmacy, asserts, "The Duquesne University Center for Pharmacy Services has not and will not dispense contraceptives or Plan B. This has been the case since the inception of the pharmacy." We will have more details in our Jan. 12 edition.

For the first time in a decade, Hill District residents won't have to leave the community to get prescriptions filled. They'll even be counseled one-on-one at Duquesne University's Center for Pharmacy Services, which opened in Centre Avenue's Triangle Shops on Dec. 20.

But Hill District residents aren't the only ones receiving a dose of change. When it comes to contraceptives, the pharmacy doesn't draw the hard line you'd expect from a Catholic university.

Oral contraceptives -- including the emergency drug Plan B, commonly referred to as the "morning-after pill" -- are available to patients, says pharmacy director Terri Kroh, and the center has no policy that limits whose prescriptions can be filled.

But Kroh is quick to add that employees at the center, which will include some of the school's students, are protected by the "conscience clause." As is the case statewide, pharmacists don't have to fill a prescription if they feel morally jeopardized. Another employee could handle it, or the patient could be referred elsewhere.

"It's been well thought out how to balance it to meet everybody's needs," Kroh says. "They make sure the services are available."

Thomas Mattei, associate dean of the university's pharmacy school and staff member at the center, says contraception is as much an issue of addressing serious health threats as it is a moral concern for some.

"We'd be remiss if we didn't have the capability to provide those services," Mattei says. 

Still, Kroh says, at least part of the decision to provide contraceptives stems from the fact that the center is full-service, and most insurance contractors require pharmacies to carry those drugs. Although Duquesne funded the center's launch and provides staffing and student employees, the business model is designed to be self-sufficient. 

Mattei downplays the significance of the contraceptive policy, saying the center's patient-based counseling is more important for the larger community, especially seniors. Nonetheless, it marks a departure from the way the university has treated the issue in the past. 

At Duquesne's campus Health Service, for instance, doctors won't write contraceptive prescriptions for students. And when the university-owned public radio station WDUQ aired underwriting from Planned Parenthood in 2007, Duquesne ordered the station to stop, saying the reproductive-rights group's message clashed with its own.

The Vatican has held that contraception, by any means, is morally wrong because it impedes the transmission of life from God to humans. But that view may be shifting among Catholics, says Rebecca Cavanaugh, a spokesperson for Planned Parenthood of Western Pennsylvania.

"The overwhelming majority of Catholics across the country believe that contraceptive health care is something that should be available," Cavanaugh says, adding that Planned Parenthood is "thrilled" Duquesne's pharmacy offers the drugs.

And though the conscience clause can be problematic in rural areas, where patients have few alternatives to the pharmacy that denied them, it's less of an issue in a city like Pittsburgh, Cavanugh says.

Contraceptives may not be taboo at the center, but you'll still find pamphlets touting the benefits of sexual abstinence wedged into a rack of medical brochures. The mission statement at the bottom of an FAQ sheet the pharmacy distributes does not mention religion, but says the pharmacy school's goal "is to educate and mentor students who advance the profession of pharmacy and pharmaceutical research to improve the health outcomes of patients and their communities." 

Kroh and Mattei say the center is committed to serving the public on their terms. The way Mattei sees it, the bigger change at the pharmacy is the way it interacts with the public, providing affordable generic drugs and meeting privately with patients.

A typical visit, he says, would go like this: A patient enters the pharmacy, drops off a prescription at the window and takes a seat in an area resembling a physician's waiting room. As the prescription is filled, a pharmacist meets with the patient privately, going over any concerns he or she has with medication, assessing its effectiveness and ensuring it's taken correctly. After the counseling, the patient picks up the drugs and is ready to leave.

The process adds a phase of human interaction in addition to physician visits, Mattei says, and if pharmacists note any problems they can contact the patient's doctor. The idea is to prevent negative drug interactions and overdoses that lead to emergency-room visits, in turn reducing health-care costs and better addressing patients' needs. 

"I think it's all about -- what do they want?" Mattei says. "Not, what do we want them to do."

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