Medicine and Morality
Yesterday was such a busy work day, and one filled with family obligation, that little time was given to this blog or viewing others. It is time to stir up a bit of emotions here for today. Let me thank everyone who has visited my blog and let you know how much I appreciate all the provocative comments. Today's subject is generated by a comment from elsie from yesterday.
Recently, a growing number of pharmacists across America have refused to provide birth control pills, and in some instances, the morning after pill, to women with valid prescriptions from doctors arguing that the dispensing of such medications violates their religious and moral convictions. The issue has generated much controversial, and become heated in several states, which already have laws allowing pharmamacists to refuse to fill prescriptions for contraceptives, including birth control pills.
On the one hand, you have Arizona, where the House of Representatives recently approved legislation that would put into place a conscience clause for pharmacists who have objections to handing out birth control. On the other, in Illinois the governor filed a rule requiring pharmacists to dispense all such prescriptions immediately without question.
Here is the question of the day: Do pharmacists have a right to refuse to fill prescriptions on moral or religious grounds? Should they continue to be employed by the pharmacy? If you believe that such refusal is warranted, where do we and who draws the line for what can and cannot be filled by an individual pharmacist?
Thank you for your minds.
Recently, a growing number of pharmacists across America have refused to provide birth control pills, and in some instances, the morning after pill, to women with valid prescriptions from doctors arguing that the dispensing of such medications violates their religious and moral convictions. The issue has generated much controversial, and become heated in several states, which already have laws allowing pharmamacists to refuse to fill prescriptions for contraceptives, including birth control pills.
On the one hand, you have Arizona, where the House of Representatives recently approved legislation that would put into place a conscience clause for pharmacists who have objections to handing out birth control. On the other, in Illinois the governor filed a rule requiring pharmacists to dispense all such prescriptions immediately without question.
Here is the question of the day: Do pharmacists have a right to refuse to fill prescriptions on moral or religious grounds? Should they continue to be employed by the pharmacy? If you believe that such refusal is warranted, where do we and who draws the line for what can and cannot be filled by an individual pharmacist?
Thank you for your minds.
31 Comments:
No, I don't believe they have a right to refuse to fill prescriptions. That is what they were hired to do. If they are so adamently against it, perhaps they should find another line of work. If birth control is so offensive to them, why even work for a place that provides it?
Here's an instance where, perhaps, capitalism can be helpful! I mean, surely pharmacists who don't give out "the pill" (invented here in Worcester, MA, by the way!) will lose business/money. Pharmacists who DO give out the pill will then get more business and money. If I owned a pharmacy, it might make me NOT want to hire a pharmacist with qualms about the pill.
Is this a cop out? Am I being naive? Maybe.
But I guess (until someone here sets me straight, so to speak) I'd say, let them refuse to fill the prescriptions. Someone else will do it, and get that business.
I can see what you're saying, Aral, up to a point. I live in New York and I can get anything I want on pretty much any block, so it wouldn't be difficult for me to move along to the next one. But what about a woman who lives in Podunk, Mississippi, with only one pharmacy for miles, and what if this pharmacy decides that she doesn't have a right to birth control pills? I can easily see this happening in the Bible Belt, the same place where it's not easy to find an abortion provider. What is she supposed to do? Become celibate? Keep giving birth?
But the question becomes, more significantly, where does one draw the line? What if a pharmacist were religiously opposed to treatment of mental illness by anti-psychotic medications? Look at what Tom Cruise said on the issue. Should they have the same rights? It can become very complicated and subjective, it seems. I think meegan has a point about finding another line of work. Are these people not in some way playing the role of legislator of morality?
Bridger,
Our posts crossed, but is this not the next step? Where does one draw the line? It can become rather complicated it seems.
I think that the pharmacy store itself should have to fill any and all legal prescriptions.
But an individual pharmacist
could have the right to refuse to fill a particular prescription on religious grounds, provided that there was someone else available to do the job.
Freedom of choice. Birth control pills are legal. Pharmacies are where people go to get their prescribed medications. Maybe there should be a distinction between privately owned pharmacies and chains (in supermarkets or free standing drug stores.) In publicly owned pharmacies, there should be no issue - the pharmacists should dispense the prescribed medications. They are not there to judge. They are simply there to do a job.
Doctors are not allowed to turn away patients from ers because they don't agree with their life choices (for example, injured criminals get treated before the cop they shot if their injury is worse). That's just the way it is. Pharmacists have the choice of not working in a place that conducts business they can't agree with in good conscience.
Jonna,
Whereas a Scientologist may not go into pharmacy, someone who is a religious zealot may, and my fear is that the line will be drawn quite arbitralary by individuals themselves.
I think anony. makes a good point when distinguishing between private companies and public ones.
You say this law has been on the books now for awhile. Could you give me some examples please. I sited the House of Representatives approving legislation that would put into place a conscience clause but I am not certain that it is actual law as of yet, although I may be mistaken.
While I would hate to make someone do something they find "wrong", I agree with meegan that in some areas of this country there are women who might have a really hard time finding a pharmacist who would fill the script. Whole neighborhoods and towns could put pressure on a pharmacist to not provide birth control -- the kids and spouse, around town, in church and school - we all know how peer pressure works.
bridger: in an extreme case (and who decides what's extreme?) here in Pennsylvania, officials are investigating whether or not sex offenders have been getting viagra via Medicaid. This was after NY state discovered that their sex offenders HAD been getting Medicaid-paid viagra for the past five years.
Soooo ...
Jonniker: I have to admit to chuckling every time I hear about Scientology. When I took a course in Science Fiction as literature in college, the professor was a man who knew all the Big Names (L.Ron Hubbard, Arthur C. Clark, Isaac Asimov, etc) when they were all young men hanging around together. He told us a story (this would've been around 1979) that L. Ron Hubbard announced one day that he was going to start a religion. And he did. The prof had been laughing ever since.
If you do not want to fill out prescriptions - DO NOT BE A PHARMACIST! Be something else. Find another job. Be an accountant. How much different can counting pills be from counting beans?
I live in a city, so if pharmacy A is run by a turd head, I can just go to drug store B.
But lets say some turd head is a manager at a Wal-Mart, and hires his turd head friend to be the pharmacist. Now place that Wal-Mart in a small town where the mega store has put all the other stores out of business. If you need the pill, you might have to drive to Sanityville 50 miles away.
I find the refusal of pharmacists to fill PHYSICIAN-PRESCRIBED medications not only appalling but downright abusive. They have no fucking idea (sorry to the minors but I feel very strongly about this) why the physician prescribed a given medication, even birth control pills. BCPs are sometimes used to help women manage painful and troublesome disorders like PCOS. But even if a woman is prescribed BCPs because she wants to have sex 8 times a day with 8 different men, it's still her right to obtain her prescription to the legal medication that her DOCTOR PRESCRIBED.
Yes, it would be all fine and good if every pharmacy had at least one pharmacist who was willing to fill the scrip, but many small pharmacies only have one pharmacist. If that one says NO then people are forced to find another pharmacy. If you're poor (and therefore can't afford another child) and don't have a car and have to take time off work and thus take a pay cut to haul your ass across town just to get your DOCTOR PRESCRIBED BCPs, you are being S.C.R.E.W.E.D. On the aggregate level the potential for institutional racism and class discrimination resulting from pharmacists who refuse to administer prescriptions is FAR from trivial.
Analogous question: If I'm a lunch lady whose religion defines the consumption of beef as sinful, and the school I work for routinely gives kids beef for lunch, am I "exercising my religious freedom" by refusing to give the kids beef whenever it's served? Or am I simply not performing the job I was hired to do? I would vote for Option 2. No, BCPs and beef aren't the same thing, but the reasoning of the person refusing to dispense them is similar: "I can't give this to you in good conscience because my religion forbids it." The beef situation is absurd; you would fully expect the lunchlady in question to be fired. Yet kids who don't eat beef aren't hurt. Women who can't get their BCPs ARE hurt.
I hope all pharmacists who refuse to dispense prescriptions of ANY kind (but especially perfectly safe ones that are LEGAL) are fired. Their behavior amounts to nothing less than abuse. Abuse under the guise of "religious freedom" is still abuse.
Winterwheat: I completely forgot (must be having a pre-senior moment) that I was on BCP since I was about 17 because of endometriosis. Later, only pregnancy and now age have helped that problem.
Once I asked my younger sister to pick up my prescription and the pharmacist gave her a hard time. Misunderstood and thought Sis was too young to be taking the BCP. None of her beeswax! Made me mad.
If they legalized suicide and sold suicide pills by prescription, could you look someone in the eyes and sell it to them? I'd have to send them to the drugstore down the street. I think we have that freedom in our country. If a company made a toy that you felt was harmful or deadly to a child, would you have the right not to sell it in your store? Stores have the right to sell Pepsi and not sell Coke. Drug stores are stores. They can sell what they want and it up to the owner what to do with his employee.
The pharmicist who has reservations about filling certain prescriptions based on moral/religious beliefs can just choose not to fill them.
His employer then has a choice to make: Keep him employed or fire him for not filling legal prescriptions.
People should be able to get legal prescriptions filled. Those against some prescriptions can refuse to fill them, but they will have to face the consequences.
I also think it makes a difference as to whether the pharmacy is privately owned or not, as was pointed out by someone else.
In my humble opinion, a woman's decision to have or not have an abortion is a private matter. That being said, there are some laws in place that regulate and control the terms, conditions and time in which that can take place.
What I am seeing develop is that this issue of a pharamacists refusal to fill perscriptions is surrounded by the same type of moral, religious arguments which many conservatives use to speak for or against pro choice. This actually scares me more, as I believe that this type of decision could be so personal, that many abuses would result as such.
That being said, I agree with winterwheat. Regardless of the reason for filling a prescription, i.e. control of premenstral menopausal or contraception issues, there needs to be safeguards and controls in place EVEN MORE so that individuals are not legislating their own version of morality.
I should clarify something here: I do agree with those of you who argued that it should be citizens' right to exercise religious freedom. I really do.
The question is, when does religious freedom become religious persecution? If you decide not to use BCPs or get an abortion (both legal) because it's against your religion, more power to you. But as soon as you use your authority to enforce your religious beliefs on others who do not share them, and especially if such enforcement harms them, you have crossed the line from religious freedom into the realm of religious persecution.
This issue is at the heart of the debate that follows whenever Christian Scientists don't allow their kids to get lifesaving medical treatments. Are they exercising religious freedom--this perspective defines one's kids as an extension of oneself--or are they engaging in religious persecution (this perspective defines kids as separate individuals who could be harmed by their lack of choice in the matter)?
Ultimately, here's what troubles and shames me most, as someone who was raised Christian. You don't see Jews snatching pork off starving children's plates. The "live and let live" philosophy of religious freedom embraced by many nonChristians holds that you observe your religion as desired, but you don't force your beliefs on others, especially in ways that might harm them.
I see too many Christians, in contrast, who seem hell-bent (pun not originally intended, but retained) on doing as much as they can to make the lives of nonChristians as similar to their own as possible. I'm using gender-neutral terms here, but let's be honest about who are the biggest victims of Christian religious persecution: girls and women.
Before you Christians flip out, NO, I don't think you're all trying to force your beliefs on other people. Most of you are very nice folks. But I couldn't tell you the last time a Jew or Hindu came to my door to "convert" me...
To refuse to fill a prescriptions is a delerliction of duty and abandoment on the part of the pharmcist. If a health care professional abandons their patient, they are brought up on charges and could lose their licence to practice. There are instances where professionals have served jail time for abandoment.
Regarding having someone else fill the prescription. A pharmacist is hired to do a job. If s/he can't do that job--for whatever reason(s)--then they should leave said job. There is no excuse for adding to your workmates load--making them do more than their fair share--when you are perfectly capable of doing it yourself.
Here is a list of pharmacies: the good and the bad
Considering that birth control is often used for more than just that (birth control), I'd say it's a bit rediculous to say it's ok for them to not hand it out. Whether or not they believe in it, it's been prescribed by the doctor, and it really isn't their business what that person takes anyways. It would be like refusing to sell Tylonal because the person might overdose with it.
But Aral makes a good point, one that also crossed my mind: someone else will fill it if you don't! I suppose it's just the inconvenience of the matter...
Aren't birth control pills now to the point in technology where they no longer allow the woman to get pregnant and then kill of the fertilized egg (this used to be the case with some)...so in a sense all it's doing (for those that use it this way) is preventing pregnancy, not ending it....
I dunno...interesting topic though.
Thanks so much niobium for that most helpful list. I am going to print it out.
I appreciate the deriliction of duty issue that you brought up. I know that if a lawyer refused to represent h/h client, h/s would be brought up before the state bar on ethic violations. This is a critical point you brought up, and I thank you.
as Meegan said in the start, it is their job - if they don't like it, find another one!
I've been thinking about this topic all day. I was reminded of a case from a few years back -- there was a Red Robin restaurant and the waitress refused to bring a very pregnant woman an alcoholic drink. The waitress was fired for refusing to do that part of her job. I don't know what I would do in that situation. I would not feel right giving a pregnant woman alcohol. I would worry that I would be contributing to what could be very harmful to her fetus (and this is not an abortion issue). But it would be perfectly legal for her to be drinking. Some people, for reasons I am unable to fully comprehend, equate birth control with killing a baby. So for those people who truly feel that way, I guess I can understand why they wouldn't want to enable someone to "murder" a baby -- or a sperm and egg, or whatever. However, I don't think they belong behind the counter of a pharmacy in the first place. Also, does anyone know if this is an issue in any other country? It seems like a typical puritanical American dilemma.
it all makes me wonder. if a pharmacist can refuse due to his or her morality issue ... what makes him/her think that they know better than the patient and doctor. if they can decide due to their religious beliefs or moral beliefs -- well, where does that take us. i think if people are allowed to "object" in pharmacies or health care, where does that lead -- schools, businesses, restaurants? all the work to fight discrimination seems to be getting erased. i guess i just wonder where is the "freedom of choice" (who do we decide makes our decisions for us, if not ourselves?)
No, if you don't want to do the job, get out of the business. My black and white opinion.
A bus. should have the right to decide what they want to sell. When did we become a un-free country? Should the gov't take that right away?
I'm amazed by some of the responses! We insist that terrorists at Gitmo be given Qur'ans and allowed to practice their religion, but an American pharmacist who has ethical or religious resrvations about filling certain scripts is some kind of sleaze?
There are lots of pharmacies, let our free market system work.
Someone brought up the issue of "where to draw the line."
Can you imagine an EMT refusing to provide care/transport to a patient on moral grounds? Or and ER doctor/nurse refusing?
Where do caregiver rights end and patient rights begin?
Health care is a right, not a privledge. Laws such as the one in Arizona legistlate the exact opposite: that only the wealthy are entitled to a healthy body and soul. It's difficult enough to pay for health care, lets not make it more difficult under the guise of "morality."
H.R. 676, intoduced into the senate by John Conyers, proposes that health care become universal for all American residents. Here is the text of the bill. Contact your US senator to support H.R. 676
While it may not have much of an impact on my city, there is a huge impact on smaller, rural cities.
Last year, a Pharmacist in one of the smaller rural cities out here decided that he was no longer going to fulfill birth control prescriptions which left the women to either go elsewhere for the birth control pills or to go without them.
What if later on the Pharmacist says, I refuse to fulfill prescriptions for those who have diabetes or cancer.
What are the options then?
Just an aside to winterwheat's comment: "Jehovah's Witnesses" (you know, those people that knock on your door) are not Christians. They use xian lingo and labelling, but let me tell ya....MUCH different belief system, hidden by a facade of "Christianity"...
Hey, maybe I'm wrong and they're right and I'm going to hell in a handbasket, but what they're "right" about is hidden behind things they don't actually believe in!!
Some really thoughtful and great answers here. I appreciate all of your input.
Ash Kash,
Your point is well taken. Jehovah Witnesses are indeed not considered to be Christians.
No, pharmacists don't have the right to choose (which prescriptions they can fill). I agree with Meegan - they need to get out of the business if they have "moral" problems. Absurd. More evidence of the dangerous conservative mind-set.
Great posts, everyone...wow!
Post a Comment
Subscribe to Post Comments [Atom]
<< Home