I’m sure others have suggested this, but doesn’t there seem to be a great job opportunity available in those American states which carve out (as some are considering) a “conscience exemption” for pharmacists who do not wish to fill prescriptions for birth control or emergency contraception? Just get certified as a pharmacist, hired at Walgreen’s, and then reveal that you are a Christian Scientist and it is against your religion to dispense any medicine at all. Then just sit back, read chick magazines, and eat expired candy while the money rolls in. “I’d like to fill this perscription for an asthma inhaler?” “Sorry, ma’am, that’s against my religion.” And you can’t get fired! Awesome.
{ 31 comments }
Otto 04.18.05 at 9:17 am
The idea is that there are various aspects of American health policy where indivual preferences are agreed to be so intense that restriction of indivual choice is not acceptable in all areas of consumption, production, retailing and funding. So in the areas of abortion or contraception, no one can be restricted in their decisions to use these services and no one else is obliged to pay for them or in any way enable them against their will. So the argument that “Sorry, ma’am, that’s against my religion” could be used against provision of any health care services is really the same argument that “it’s my right to choose” from Roe etc will be taken to overrule all government restrictions on individual choice. The logic of the situation is that both apply only in very limited domains.
Belle Waring 04.18.05 at 9:21 am
otto, you’re a killjoy.
Otto 04.18.05 at 9:22 am
alas, too true
Lorna 04.18.05 at 9:31 am
really the same argument that “it’s my right to choose†from Roe etc
I thought Roe versus Wade was decided on the right to privacy, not the right to choose. So I can’t see that the two are equivalent.
Belle, have you seen this cartoon?
Ryan Miller 04.18.05 at 9:31 am
Why is there a provision that you can’t be fired for this? I support not requiring pharmacists, simply by virtue of their licensure, to fill certain prescriptions, just like lawyers should be able to avoid certain clients and Catholic hospitals don’t have to perform abortions. But by the same token, a law firm can fire a lawyer who doesn’t deal with their clients.
This sort of material job duty doesn’t seem to trigger the civil rights act in other areas–to my knowledge an orthodox Jew can’t, say, be hired explicitly for a Saturday shift somewhere, then reveal that he can’t work on Saturdays and roll in the dough. So if this bill is worded to disallow private pharmacies from establishing job expectations for their pharmacists, then that’s disastrous and I hope most states avoid that requirement. Then again, I’m a libertarian not a neo-Con, and sometimes wierd neo-Con logic slips into otherwise rational provisions of late.
Troutsky 04.18.05 at 10:20 am
The State has an interest in limiting population growth (people cost more than they contribute) and therefore should supply free birth control available at every retail counter.You buy some gum and batteries and the gal drops the birth control in the bag”don’t forget your pills”
Saw E.O.Wilson onPBS Sunday morning and he’s not giving the planet such a great prognosis.(and he pays attention)
lemuel pitkin 04.18.05 at 10:27 am
people cost more than they contribute
Thius explaining the economic powerhouse that is Lemuria (poulation 0).
CT, where do you find these people?
Redshift 04.18.05 at 10:42 am
Why is there a provision that you can’t be fired for this?
Because that’s what these laws that are being passed are all about. Pharmacists already have every right to refuse to fill prescriptions if they’re willing to risk getting fired over it. The right-wing push is for laws saying that they can’t be fired for refusing to fill prescriptions because of “moral” objections.
dsquared 04.18.05 at 11:08 am
CT, where do you find these people?
We shake the trees and they fall out.
Steven 04.18.05 at 11:28 am
redshift-
Are you sure about that? This Washington Post article, http://www.washingtonpost.com/wp-dyn/articles/A5490-2005Mar27.html, seems to argue otherwise.
Relevant quotes: “It has also triggered pitched political battles in statehouses across the nation as politicians seek to pass laws either to protect pharmacists from being penalized — or force them to carry out their duties .”
“Women’s advocates say such policies are impractical, especially late at night in emergency situations involving the morning-after pill, which must be taken within 72 hours. Even in non-urgent cases, poor women have a hard time getting enough time off work or money to go from one pharmacy to another. Young women, who are often frightened and unsure of themselves, may simply give up when confronted by a judgmental pharmacist.
‘What is a woman supposed to do in rural America, in places where there may only be one pharmacy?’ asked Nancy Keenan, president of NARAL Pro-Choice America, which is launching a campaign today to counter the trend. ‘It’s a slap in the face to women.'”
Now I might be misreading this, or the Post story might be in error, but I’m not sure the issue is entirely whether a pharmacy has the right to fire someone for not dispensing birth control. Also at issue is whether ANY pharmacist can not fill those prescriptions.
paul 04.18.05 at 1:40 pm
(Damn, I’ve been calling these bills the Christian Scientist Full Employment Act for months now…)
There’s some confusion in the WaPo quote. Right-wing loons are pushing the “freedom of conscience” laws — which in some cases apply not only to pharmacists but to any provider of medical care, and to moral objections to patients as well as treatments. Meanwhile, some sensible people are pushing legislation that would clarify a pharmacist’s responsibility, as a condition of being licensed by the state, to either fill a prescription or pass it to another pharmacist who will. (The most egregious of these “conscience” cases, remember, involve pharmacists who refuse to fill a prescription and also refuse to give it back to a patient so that it can be filled elsewhere.)
abb1 04.18.05 at 2:08 pm
The solution is simple: there has to be a law that requires every pharmacy to have such a set of employees available at all times that their consciences overlap in such a way that all theoretically possible prescriptions are covered.
Next.
Uncle Kvetch 04.18.05 at 2:34 pm
Right-wing loons are pushing the “freedom of conscience†laws—which in some cases apply not only to pharmacists but to any provider of medical care, and to moral objections to patients as well as treatments.
A very important point. Under the legislation that was proposed (and defeated–for the time being, anyway) in Michigan, an emergency medical technician with a “moral objection” to homosexuality would be perfectly within their rights to, say, refuse treatment to a heart attack victim upon arriving at the person’s home and finding that he/she shared a bedroom with a member of the same sex.
Uncle Kvetch 04.18.05 at 2:36 pm
The “very important point” that I wished to highlight in that last post was the words “moral objections to patients as well as treatments.” How do I bold again? I tried “em,” obviously without success.
Eric 04.18.05 at 2:53 pm
In most states right now you can be fired ( people have been ) for failing to distibute perscritions on moral grounds. I think that is 100% right, if you WILL NOT perform the dities for which you were hired you get canned.
People who get perscriptions get them for so many and varied reasons that it’s impossible to know 99% of the time if the person is going to use then for “non moral activity” so the pharmasist has no ground to not distribute the pills. For them to demand proof that they will be using them for moral grounds is a blaent invasion of privacy.
Eric 04.18.05 at 2:58 pm
To claim that someone can just go somewhere else to fill the perscription is ludicrious. Unlike large cities smaller towns often only have 1 drug store. If this store does not fill thinks like emergency contreception it is EFFECTIVLY stoping the person from talking it because of the time limit on effectiveness.
Even if they strike or otherwise drop the “obection to patients” that would still allow a biggoted person to fail to fill HIV meds under the moral objection that they are going to hell anyways. Woudn’t matter if they were gay, straight, druggie, or a hemophiliac.
otto 04.18.05 at 3:19 pm
Eric: Even if it is true that this causes real difficulties in small towns, it is not clear why the burden of solving this problem should fall on the pharmacist who has moral objections to the service being provided. I am sure there are many small towns where there are no doctors willing to perform an abortion and that this is a real problem for many women. Nevertheless, the local doctors should not be commandeered into providing the service.
Eric 04.18.05 at 3:26 pm
otto,
Elective sugery is diffrent than emergeny sugery. In a small town a Dr cannot claim moral objection to an emergency abortion. To do otherwise they risk loosing their license.
Elective perscritions are easy to make the user get somewhere else, EMERGENY perscriptions the pharmasis should be required to fill if they have it.
Also there is the problem of the tyrany of the majority, even in larger towns it does not mean that a user will be able to find a pharmasist willing to distribute controversial drugs. Especially in the “bible belt” how will reasonable people avoid the bigoted BELIEFS of the majority?
otto 04.18.05 at 3:50 pm
The emergency argument has some merit. It would not apply to regular birth control supplies and I suppose there is a question about what sort of emergency is associated with the concept emergency contraception. Whatever emergency is involved, it’s not the same as an emergency abortion where threat of death might be a possibility.
Alas, the bigoted nature of the local population is not a good reason for requiring those who have intense moral objections to certain practices to be commandeered into performing them.
paul 04.18.05 at 4:13 pm
I don’t see why someone licensed by the state to preform a certain job (and thereby in significant part protected from the ravages of the “free” market) shouldn’t agree to certain terms when accepting the benefit of that license. If they have moral objections to the job they taking serious pains to become qualified for, then they should become qualified for another job.
What other jobs do you see this kind of self-selection into the job followed by “principled” refusal to do the job? Are members of PETA joining the meat-cutters’ union in droves, or members of MADD becoming bartenders? Or is it just anti-choice loons becoming doctors and pharmacists?
Uncle Kvetch 04.18.05 at 4:24 pm
I am sure there are many small towns where there are no doctors willing to perform an abortion and that this is a real problem for many women. Nevertheless, the local doctors should not be commandeered into providing the service.
Otto, how do you respond to another point that Eric raised: the fact that birth-control pills are often prescribed for other purposes than contraception? Should pharmacists take it upon themselves to interrogate customers in order to reassure themselves that the pills they prescribe will be used only for purposes they approve of?
Eric 04.18.05 at 5:35 pm
Otto,
You only back up my point. The pharmasist is not in a position medically OR MORALLY to decide what is an emergency. To claim that emergency contreceptives are somehow diffrence from a medical condition that poses a serious and immediate threat to the health or welfare of the patient is not sound.
Also, no one forces the pharmasist into a position of public service either, so to say that we are somehow forcing them against thier wills of doing a job that they have studied for and done ( sometimes for years ) is also specious.
If I have a moral objection to the turn signal does that mean that I don’t have to use them? No one forced me to drive my car. There are some things that people do not becuase they believe, but because there are legal and social reprocussions.
Eric 04.18.05 at 6:19 pm
Ok for a simple and complete argument.
1) this applies to people of the medical profession, police, firefighters, and other people who server the public at large with necessary services.
2) It is wrong for anyone to deny emergency care for any moral reason.
3) Only a doctor with a full medical record is legally and ethically in a position to determine emergency care.
4) Only the patient or thier health care proxy can refuse care.
Therefore
A) It is not ethical for people other than the Dr to decide that a treatment is no an emergeny.
B) It is not ethical for anyone but the patient to decide not to pursue a course of treatment.
—
A morality objection for pharmasists is not ethical based on those criteria. The only reason for a pharmasist not to dispence is if they do not carry the medication and then they are ethically required to help the patient secure the perscription from another facility.
h luce 04.18.05 at 7:36 pm
Pharmacists are licensed by the state to dispense pills and other medicine on the written instructions of a licensed medical doctor. Both the doctor and the pharmacist are forbidden to practice their professions, unless they are granted permission to do so by the state. In other words, a license is permission from a governing authority to perform an act which is otherwise prohibited by state (or federal) law. This grant of permission to dispense pills and medicine is discretionary on the State’s part, although revoking a license will normally have due process implications.
Common people may not go out and buy medicine without first seeking and obtaining the permission of a doctor, and then conveying proof of this permission to a licensed pharmacist. There is, however, no way to force a doctor to serve a patient (except perhaps in a life-threatening emergency, where the doctor has started to give aid to a patient and decides for one reason or another to cease his or her efforts before the rescue is complete). “Morning after” contraception is not emergency treatment for a life-threatening condition, it is a substitute for elective surgery. The only conceivable life threatened is that of the fertilized egg if in fact it has been fertilized; the mother’s life is not at risk, and an elective abortion may be used to end the pregnancy. This procedure is well-known and is generally recognized as safe for patients to undergo, often on an outpatient basis if performed early enough in the term.
On the same note, pharmacists may pick and choose with whom they will do business. They are not obliged to serve any customer for any reason which they may choose (except on grounds of racial, ethnic or other prohibited forms of discrimination). Also, the employers of pharmacists may hire and fire their employees for any reason they choose, right, wrong, or none at all, if the employment is “at will”. Pharmacists are perfectly free to not fill prescriptions on “moral grounds”. They are not free to retain your property (the prescription slip). You paid for that permission slip, and it’s yours.
The solution is to abolish laws which require the licensing of medical doctors and pharmacists, to make it possible for common people to go out and buy medicine as they please without first seeking and obtaining permission from a state authority. As long as it is necessary to get permission from the state to buy medicine, this kind of political meddling will continue to occur.
PS – Most reasonable people would seek the advice of a doctor and a pharmacist before buying and taking medicine. Unreasonable people would probably shorten their lifespan…
Anthony 04.18.05 at 8:20 pm
If “emergency contraception” were for a medical emergency threatening the life of the woman, it would not likely be prescribed for the woman to go down to the pharmacy, it would be administered directly by the doctor; it seems it would be irresponsible of a doctor to do otherwise.
softdog 04.18.05 at 10:54 pm
1. Re: Otto’s lame attempt at being a killjoy -depending on one’s historeligious definition, many treatments ARE optional. For a Christian Scientist, choosing to take ANY medicine is a matter of choice, a choice which goes against Gods will. Or if you want to do SOME work, you could quote chapter and verse which allows you to opt out of, say, allergy medicine. Thus I killjoy the killjoy.
2. Let’s not even get into “maybe the pill is for another medical reason.” The pill is not abortion. It prevents sperm and eggs from starting the process. Even in the case of emergency contraception it is prevents the potentially fertilized egg from meeting the wall, stopping the process before conception.
The important word being “potentially.” Let’s be honest here:
a) These Christian nuts are anti-science morons.
b) They’re real belief is all sex should result in conception.
3. Why have we not heard about Christian pharmacists refusing to sell Viagra and condoms. Two things which are also meant for satanic sex for pleasure? Oh yes, that’s because they’re almost all men and they all hold a misogynist double standard.
4. Or maybe that’s the next step. Soon we’ll hear of advocates saying no cashier should be forced to ring up Astroglide if it violates their beliefs. I’m not making light here, I’m sure it’s in the Christian Taliban handbook.
Eric 04.19.05 at 12:14 am
Ignoring the flamebate…
H Luce, you are still ignoring the meat of the argument. [b]The pharmasist is not in an informed position to dictate medical treatment for an individual.[b] Especially when the witholding of that medication seriously hurts the chances of the success of that treatment. Dispite the common belief otherwise being pregnant is many many times more dangerous to the woman’s health that not being pregnant, and unfortunatly abortion is still safer than carrying the child to term ( by a factor of 2-5 times safer ). So pregnancy is a dangerous proposition for a woman, although the pharmasist may disagree, if they have the pills they need to dispense them.
Your argument boils down to… A private company can discriminate against anyone it wishes to. Unfortuanly that idea went out of style in the 60’s civil rights movement. A store open to the public cannot arbatraily discriminate against any adult who is not breaking any law. Why don’t we just allow christian hospitals to stop serving jews and muslims? they are private institutions you know.
Your solution is almost as amusing as your argument! Just let almost anyone buy drugs on an open market, sure that will make everything better. If you want a silly, but reasonable solution, I say just make the pharmasist legally responsable for the child support!
sara 04.19.05 at 12:54 am
Why are we debating this point when no one challenges the right of Catholic hospitals to save the baby instead of the mother, if the mother is undergoing life-threatening pregnancy complications? If the mother’s life cannot be saved without killing the fetus, they prefer to let the mother die and hopefully save the fetus (if it has reached a viable stage of development). I don’t know if they refuse to let the mother transfer to a non-Catholic hsspital.
On this issue the war was already lost, regarding Catholic hospitals, which I have vowed never to patronize should I ever intend to become pregnant. If anyone can reassure me that this policy is an urban legend I would be very happy to be mistaken, but my sister (an OB-GYN) tells me this policy is real.
Being unable to obtain morning-after pills due to pro-life Christian pharmacists seems like a minor quibble in comparison with this.
Dave 04.19.05 at 1:28 am
If you are claustrophobic, don’t expect to get a job mining coal. If you suffer from vertigo, then skyscraper window cleaning probably isn’t for you.
If you believe in a magical God-king who lives in a mythical paradise in the clouds, then don’t go into medicine. In fact, don’t do anything which involves people. And don’t ever buy a gun.
Eric 04.19.05 at 7:42 am
sara,
While that point is disturbing, it does sound like urban legeng and or a misinterpretation of a complicated medical situation. Legally after the fetus is viable they must make an attempt to save the fetus.
While it may seem like a minor quibble this is a very slippery slope where we suddenly override the rule of law and legal reprocussions for not doing your job with a blank cheque for the moral minority to act in whatever way they feel fit. The stroy you tell would go from an urbal legend to openly stated policy with 0 legal recouses for those unfortunate enought to have only christan hospitals in there area.
Tim B. 04.19.05 at 10:00 am
Maybe I don’t understand all the subtleties involved, but it seems simple to me. If a pharmacy *stocks* the medication, then all on-duty pharmacists must fill the prescription (no deflecting to a coworker). Failing to do so should result in the immediate firing of the pharmacist-employee. Failing to fire that pharmacist should result in the immediate revocation of license for the pharmacy-employer. If the pharmacy is owned by the pharmacist, then he or she can just refuse to stock the item that offends their conscience.
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