Sunday, May 02, 2004

First they came for abortions, but I wasn't having an abortion, so....

For years, reproductive rights activists have warned to laughing derision that if abortion is successfully outlawed, birth control will be next.

Well, guess what. Abortion isn't illegal - at least not yet - but birth control is already under attack. In a trend Lisa Boyce, vice president of public affairs for Planned Parenthood of Wisconsin, calls "not an epidemic, but noteworthy," pharmacists are claiming their consciences won't allow them to fill prescriptions for birth control pills - or even, on at least one occasion, to transfer the prescription to another pharmacist.

The pharmacists have in some cases faced disciplinary action; some have been fired. The one who refused even to transfer the prescription, in effect denying the medication to the customer altogether, faces a disciplinary hearing on Tuesday which could cost him his license.

His lawyer, not surprisingly, claims it's a matter of religious freedom: "He sincerely believes he would be committing an act of sin to dispense [birth control], and to call someone else to dispense it." That is, he was not only obligated to refuse to fill the prescription, he was also obligated to prevent, to the extent he could, anyone else from filling it.

Now I admit I don't see the overall issue as cut and dried: I do believe in the right (and power) of individual conscience. But as Linda Rankin, a medical ethicist and philosophy professor at the University of Tennessee in Knoxville, says,
"When people take on the life of a pharmacist, they have to realize what might be asked of them."
They need to realize - and damn well should realize - that filling prescriptions that might violate personal beliefs comes with the territory. Most times, that shouldn't be a problem. Michael Stewart of the American Pharmacists Association says the association holds that
[a] pharmacist who objects to dispensing a particular medication must tell an employer. If one pharmacist refuses to fill a prescription on grounds of conscience, another pharmacist must do it. Some customers may be referred to another pharmacy. Other prescriptions may be delivered by mail.

"In the great majority of cases, the pharmacist's right to conscience is exercised appropriately and seamlessly, so the patient is not even aware that the pharmacist has exercised that right," Mr. Stewart says. "A pharmacist can say, 'Let me get Bob for you, ma'am,' and that's the end of that."
There is a huge difference between that and cases such as the above, between saying "I can't do it" and "I will prevent you from doing it."

Oh, and please don't try to tell me it's "civil disobedience" unless you're also claiming that the intent is in fact to put an end to the availability of birth control. Because if you're not, then the intent is to impose one's personal morality on others with no consequences to oneself - and that is not civil disobedience of any form I can recognize. But if you are, I will resist that effort and applaud moves to put an end to it, including firing and revoking the licenses of offenders.

As Lisa Boyce said,
"No woman should have to shop around until she finds a pharmacist who will dispense her doctor-prescribed birth-control prescription."
That's especially important in many rural areas, where there may only be one pharmacist for some miles. Linda Rankin put it well:
"Would they be able to fill these prescriptions? If they can't, then they have a moral obligation not to practice at a place where they are the only pharmacist, and where not to do this would cause serious harm to other people."
But I truly wonder if such considerations are driving or would drive the people involved here.

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