The Morning After Pill -- Scarier By The Day

So, apparently there's a preliminary hearing in Illinois today brought by two pharmacists claiming that a law requiring pharmacies that stock the morning-after pill to dispense it "without delay" violates their First Amendment right to religious freedom. Stated differently, the movants believe that a woman's right to the morning after pill should come down the personal beliefs of whatever pharmacist happens to be in the pharmacy on a given day -- pretty much like a roll of the dice. Does it get any more ridiculous than that? I mean really, you allow personal beliefs in where do you draw the line? "I'm not giving her that pill because those ghetto girls don't live righteously!"

And seriously, if these folks have such "religious and moral" concerns with providing the service they are paid to provide, can't they just go work in a pharmacy where the pills are not available? (For the record, a pharmacist's appalling "right to refuse" is already the law in three states -- Arkansas, Mississippi, South Dakota. Damn shame.)

(For more on this issue and the origins of the Illinois dispute take a look at AofG all-star Riggsveda's typically tight post here.)

Comments

[steveh2]

I don't know, Jackie -- are you sure we want the state to tell professionals that they have to furnish every medicine that exists, even if they disagree with it on a moral basis?

Do you want the state to FORCE you to defend dougekurugby against criminal charges when he gets arrested for burning a cross on Howard's front yard?

[Jackie]

Interesting questions, Steve.

My answer to your initial question is no. I do not want the state to tell professionals that they have to furnish every medicine that exists, even if they disagree with it on a moral basis. However, I do feel a more narrowly tailored policy would be acceptable -- one where the state would require certain emergency drugs be provided if available (and the patient's needs could not be met elsewhere).

With a less emergent medicine, if you get refused, you can go elsewhere and take care of business. With the morning after pill, time is of the essence. If you get refused, you may not have any other options.

To me, its fundamentally wrong to permit a pharmacist to refuse a patient's request for emergency treatment solely based on moral beliefs. The patient has entered the store with an understanding that the medicine needed is available; if the pharmacist refuses, and there is no readily available alternative, the patient is essentially screwed. And that's just wrong.

I'm not expert on the issue, but I would think that the health of the patient in such an emergency has to take precedence over the morals of the pharmacist. (And if a pharmacist's moral beliefs were really that strong, they should simply avoid working in pharmacies where the pill is provided.)

As to your second question, very well played. You're cracking me up over here. And my answer, of course, is hell friggin' no. That said, the situations are not entirely analogous.

First, the kid's situation would not be an emergency -- if I declined him legal services he could seek representation elsewhere. (And even if you can somehow couch the need for representation as emergent, one can almost always postpone a court date, whereas one can't postpone the time for taking the pill.)

Two, even assuming it was an emergency, my firm and I would have made no representations that we represent folks of that ilk, nor would we pick and choose which ones to represent based on our morals. Whereas the pills are available at the pharmacy, representation for that type of behavior is not available at our firm.

In sum, because the his situation would not be an emergent one, and because such services are not provided by us, I would argue that the state should not have the authority to force us to represent the kid.

(M.C.H.T.C.)

[Riggsveda]

Steve, those professionals have a code of ethics that requires them to place their patients' welfare above all else. By picking and choosing which medications they will provide to a woman with a legal presecription--provided by and in consultation with her own physician, within the confidentiality of that doctor-patient relationship and privy to information the pharmacist does not have--the pharmacist betrays not only that patient but his or her own code of ethics. Then you get to the question, what happens if someone decides it's "immoral" to give HIV drugs to a sinning homosexual? Or any other number of similar situations that could result in a patient being refused service.
Carrying the argument to its logical extreme, see this post (and be sure to follow the link to the Belisarus post and read), then go here and read the extrapolations from commenters.

In any case, I think in this situation, as with abortion, men tend to be more cavalier about the fallout, simply because they can afford to.

[MM]

Riggsveda: Your points are great. And I think there was something going on Michigan where the legislature was trying to pass a law allowing healthcare professionals to refuse treatment to homosexuals (for non-emergencies). Unbelievable.

Discretion to dispense with medicine should not be in the hands of a pharmacist when a doctor has clearly prescribed a medication to a patient. It's not a complicated issue. Allowing pharmacists to refuse to fill doctor's prescription overrides the medical judgment of these trained professionals. What qualifies any pharmacist to do this? Medical school training? Medical residency? No. These pharmacists seek to do this purely on religious beliefs. If one's religious beliefs interfere to such a gross extent in one's professional life, then they need to find another profession. Anyone who undertakes professional training knows that there are bound to be conflicts with one's moral compass and one's professional mandates. When you elect to become a professional sometimes you have to suck it up and put one's personal moral values aside. Anyway, why should a pharmacist's moral persuasions prevail over those of a patient's when the pharmacist becomes the instrument of serving that very patient's needs?
This is PURE CRAP! It makes me mad as hell to think these types of laws are promulgated this day in age. It is sad to think that where women need birth control the most or emergency birth control, they will be denied by quack pharmacists who now find protections under the color of state law. Disgusting!

[brian]

imagine going into 7-Eleven and not being able to buy condoms because the lady at the check-out doesn't believe in birth control. or your waitress says you can't get bacon with your breakfast because it's too fatty. the old-man with 40 buttons on his vest won't let you into Wal-Mart because they sell foreign products which aren't beneficial to our economy.

less extreme cases, but you get where it's going.

physician prescribes, pharmacist distributes. if it's on the menu, let 'em have it. [unless conflict of medicines occurs, but i believe we're all on the same page with that already]

[cousineddie]

I think this is appalling. It's a pharmacist's JOB to dispense all meds that are prescribed. They don't like it, they picked the wrong line of work.

[steveh2]

I'll give on emergency angle making this different from lawyers representing certain clients or handling certain matters.

But I think it is begging the question to simply say it's the pharmacist's job. This debate is about whether it actually IS the pharmacist's job to dispense all prescribed medications regardless of personal moral convictions.

Regarding the Code of Ethics, do you have the exact language that you believe applies to this situation? I have no idea one way or the other what it says, and I'd love to see what it actually says on the matter.

The comparisons with stores not carrying condoms or waitresses not serving bacon support my point. If a 7-11 doesn't want to stock condoms, it doesn't have to, and if a restaurant doesn't want to serve bacon, it doesn't have to. The government is not stepping in to tell them what they have to sell.

On the emergency angle, I guess I would like to see hospitals being required to carry appropriate emergency medicines as part of their obligations. But I don't know that I want this to be an obligation on every pharmacist in every pharmacy in the country.

There was an article in our local paper, where our local pharmacy, the one we have always used, stated that they don't even carry Plan B, for those reasons. My thought is, I guess that's fine -- if they don't want to carry it, that's their choice. But I have the choice not to do business there anymore, and that is the choice my family is taking.

[brian]

steve, i wasn't saying that the restaurant should be forced to serve bacon because people want it. if i own a restaurant and someone WORKS FOR ME, then they should have no authority to not serve it. if you work at 7-Eleven and don't want to sell condoms, then quit and open your own convenience store.

if the owner of the pharmacy doesn't want to sell it, then that's their choice. i believe the main issue is the hit-and-miss of going into a pharmacy that has the medicine, but the pharmacist who is at the counter that day doesn't believe in dispensing it. my brother has worked in a couple pharmacies and each have different rules about selling to americans. the owner of PharmOne feels it's okay and sells to americans; the owner of PharmTwo doesn't and won't. but it's not up to my brother to decide that he doesn't want to sell to americans in PharmOne.

"...a law requiring pharmacies THAT STOCK THE morning-after pill to dispense it..." [my emphasis]