A Personal Stake in the Issue

Heh. Good catch.

Has this been seriously discussed with an open mind and assuming good-faith here at CT? Because I think CT is a good place to discuss it with less likliehood the conversation would quickly become toxic.

The rights of the pharmacist vs the rights of the patient. As long as there is another source, the pharmacist should not be required to sell birth control. Without a reasonable alternative source, its a little more sticky.

I disagree. They’re not just any private company. They’re pharmacists. They have a _responsibility_ to provide the important stuff they are licensed and trusted to. (And I don’t know about the U.S., but in Australia they are also given local monopolies.) If they don’t like it, they shouldn’t have become pharmacists. Simple as that.

What if a pharmacist decided to stop selling any contraceptives, because they’re hardcore Catholics? What if they just stopped selling all foot treatments, because they find feet icky? Or what if they decided not to sell any medication to any black or jewish people, because they’re in the KKK? Would people really be OK with any of this? Maybe I’m naiively optimistic about human nature, but I think not.

Mill,
in the US, pharmicists are not given monopolies. Even the smallest most rural towns usually have several, or a town withing 30 minutes will have several. And there are laws against not doing business with someone based on their race, religion, age, etc. But in America Liberty is a prized value. Some prize it more than others, but it is still a strongly held value. And deciding that you don’t want to sell something, yet still being able to pursue your carreer should not be contradictory. If I don’t want to sell foot powder because my religion says foot disease is a holy virtue, that should be my choice. Granted many of my customers will think I’m a quack and I’d probably go under.

But for some reason, a large enough minority probably exists that those who decided not to sell contraceptives wouldn’t go under. So the majority is going to force them. Yet the US Constitution was designed to protect minorities from majorities. So we’ll see how this plays out. Tyranny of the PC who think rationally optimized science should be held above people’s faith, or allowing people Liberty to express their faith, even if it means having to drive 15 more minutes to the other drug store. And I can guarentee Chicago has some Wal-Marts, which sure as hell are going to sell birth control.

In at least a few cases, pharmacists have not only refused to dispense a prescription for contraceptives, but have refused to return the prescription to the customer so that she can go elsewhere to have it filled. I don’t have the details; there have been extensive discussions (with links) about this on both Pandagon and Majikthise, if anybody’s interested.

One more sticky wicket with this issue: many women are prescribed birth control pills for purposes other than birth control.

These laws are explicitly designed as a wedge. Once pharmacists have a “right of conscience” the religious zealots will come in and threaten pharmacists who don’t exercise that “right”. The net result will be depriving women in conservative areas of access to birth control. This is reason enough why it’s a terrible idea. If a woman gets a prescription from a doctor…and there are not *medical* problems with it….the pharmacist should honor it. Period. They get a license from the state and refusing to fill legal prescriptions is a violation of their ethical code. This protects patients and it protects pharmacists from pressure groups demanding that they *not* fill certain prescriptions. Next folks who don’t approve of gays could refuse to fill medical requests for, say, HIV medication. There is zero moral distinction with doing something similar for birth control.

Mill, saying that pharmacists have a responsibility to the public isn’t a reason for or against these kinds of regulations. The content of that responsibility is precisely the issue.

The notion that those who believe that certain pharmaceutical treatments are immoral should campaign to make those treatments illegal rather than merely refrain from participating in the provision of those treatments while allowing those fellow citizens who disagree to act accordingly is bizarre. I should think that a liberal regime is one in which there is freedom of conscience, which the totalizing regime you propose doesn’t provide either way.

And this question hasn’t a thing to do with “faith” vs. “science.” It’s a question of ethics, and though science may inform our ethical debates, it certainly doesn’t decide them. How a legal system could put one above the other I don’t know, but it strikes me that the horrible instances you set forth have more to do with ethical failings than scientific ones.

I agree with Thomas. I think that societies are stronger where people can refrain as much as possible from taking part or supporting behaviours that are legal but that they think are unethical.

After all, no society with more than about 10 members is going to agree on everything. And while the political climate might be with you on one issue, it could be against you on another. If you start forcing people to prescribe medications they think are immoral, would you be prepared to accept, as a condition of practising your profession, having to assist in things you think are immoral?
E.g. you can only practice as an obstetrician if you are prepared to euthanize the babies of the severely mentally disabled?
Or you can only be a therapist if you promise to turn over anyone who reveals they are a homosexual to the government for punishment?

Now I think that such policies of euthanisation or punishing homosexuality are wrong, wrong, wrong. But they are not too far from policies that some governments have pursued in the past – it is possible in the future that another government will decide that homesexuality is evil. And I also am aware that some people find contraception as immoral as the euthanization policy I gave above. Be careful about using the government to force your moral opinions on people when it is not necessary – it may come back around to bite you.

Sometimes, obviously, people have to be required to do things as a condition of employment. Most obviously, police officers cannot pick and choose which laws they enforce without destroying the rule of law. I am arguing for a policy that allows as much space as possible for us to live together while pursuing numerous different goals and opinions of the good life, not an absolute one of non-interference.

I also agree that refusing to return the prescription should be illegal, since that involves the pharmacist imposing his moral view on the customer.

And, since on the internet you can never repeat yourself too often on some issues – I think killing the children of mentally disabled people is wrong, wrong, wrong. Punishing homosexuality is wrong, wrong, wrong. I am using them as examples of bad policies, not in anyway advocating such policies myself.

I think the text of the article you link to has changed. The funny section you identify is not in the linked article, nor does it show up in a google search.

There are two arguments being made here:

1) That jobs are embedded in society. These arguments talk about licenses, which is a weak form of making this argument.

2) That jobs are the “property” of the holder, who may do as he/she wishes with them. These arguments talk about “conscience” and “moral reservations.”

While making the second argument relative to pharmacists, Tracy recognizes that it will not work for all professions.

Sometimes, obviously, people have to be required to do things as a condition of employment. Most obviously, police officers cannot pick and choose which laws they enforce without destroying the rule of law.

We are arguing 1) and 2) in the United States on all sorts of issues. After a period of time when individual pleasure was glorified, it becomes easier to accept individualistic arguments like “conscience” and “moral reservations.”

But professions are societally constructed, and the strong form of “conscience” involves deciding which societally constructed profession fits one’s preferences. If one changes one’s conscience while in a profession, it may be necessary to change one’s profession as well. If one has “moral reservations” about dispensing birth control measures, then one should not be a pharmacist.

If a person has “moral reservations” about parts of a profession and goes into it anyway (or stays in it), then that person has decided to impose his/her “moral reservations” on others. In other words, to use his/her embeddedness in society as a lever on others. Individualism is invoked in the service of a societal ideal not shared by the larger society.

Further, in the case under discussion, the individualistic arguments are being put forth by groups that have used societal pressure in the past. Look at the current availability of abortion. Not very widespread, almost absent in some states, and the reason is societal pressure, sometimes in the strong form of death threats. So we can reasonably expect that similar societal, pressure (from a narrow segment of the broader society) will be applied to pharmacists who recognize the embeddedness of their profession in the larger society.

There’s nothing inherently wrong with a hypocritical argument. It should be recognized as such, however, particularly by those of us who believe that if you’ve been born, raised by a family, and used any of the products and protections of society, you have some obligations beyond “conscience” narrowly defined for the purposes of political gain without societal consent.

“But professions are societally constructed, and the strong form of “conscience” involves deciding which societally constructed profession fits one’s preferences. If one changes one’s conscience while in a profession, it may be necessary to change one’s profession as well. If one has “moral reservations” about dispensing birth control measures, then one should not be a pharmacist.”

You do realize that you haven’t actually provided an argument in the last sentence or for the last sentence, don’t you?

(In general. And in this particular case, assuming the patient has alternatives. Refusing to participate in something that one finds morally objectionable is not the same thing as preventing other people from it. They do shade into one another, true. But, in this particular case, if the patient has an equally available alternative then the right of the patient to the treatment and the right of the pharmacist to refuse to violate his/her moral code can be preserved. Surely that’s the best outcome?)

I’m curious how many people who support anti-contraceptive pharmacists also support the OJ jurors.

Keith, your “assuming the patient has alternatives” is the whole problem, as far as I’m concerned. I believe that many patients would not have reasonable alternatives, especially after people start pressuring pharmacists to “discover” their conscientious objections. Wal-Mart has stopped carrying products before in response to protests.

This point has been touched on, but I think it is really important in this debate, and that is that birth control is often prescribed for medical non-contraceptive reasons. Oral contraceptives, or birth control, are used to treat almost all reproductive cycle issues in young women, from irregular cycles, heavy bleeding, painful cramps, to ovarian cysts, etc. This means that probably close to a majority of all young women (at least a majority of the young women I know, including myself) have been placed on birth control at one point or another for solely medical reasons. To refuse birth control to such a woman is a violation of her medical rights. This then raises a sticky issue: should pharmacists have the right to refuse some forms of contraceptives and not others? should they have the right to inquire as to the motives of each patient picking up a prescription to determine that the medicine is being used for the right reason?

Since i’m actually debating about this in my women’s studies class i thought i’d throw my two cents in. I noticed there a lot of comments about how available birth control is, or that a lot of places sell birth control. I don’t think some of yall are taking into accounts small towns where there is not another pharmacy for several miles. Secondly, the issues i not whether or not the product is avaiable in another store or pharmacy, it’s whether or not the store or pharmacy has someone available that is willing to dispense the product. The store or pharmacy can’t claim to sell the product if they’re employees don’t.

Could u imagine a retailer working in a clothing store refuse to take a customer’s money because she wants to purchase some lingerie. That retailer would be fired regardless of the retailer’s personal feelings on it.

From what i’ve read, these pharmacist’s opinions on birth control are a bit one-sided. Not all women use birth control to prevent a pregnancy. My sister gets birth control to regulate her period. Polycystic ovarian syndrome is a health issue and her physician prescribes birth control for her. For any pharmacist to simply refuse to fill out the prescription would undermine the relationship with physician and pharmacist. The decision to refuse to sell birth control has nothing to do with the actual prescription or the health of the customer.

I think if they don’t want to sell birth control, they should find a position in a pharmacy that doesn’t carry it. I’d post more but i gotta eat now. =P