Plan C, for conscience
I think this is fair. People who want the pill can simply go to a different pharmacy. Big deal. This reminds me a little of the counseling student issue. Surely they could have worked something out there, too. But perhaps I’m naive about people’s open-mindedness going both ways.
by Cristina Alarcon
One American state has thought better of its policy to browbeat pharmacists into selling the morning after pill.
I was thrilled to learn that Washington State will be creating new rules for pharmacists who have conscientious objections to providing services or products they find morally objectionable. The new regulations would give plaintiffs in a Washington lawsuit — the owners of Ralph’s Thriftway pharmacy and two pharmacists — the right to refuse to stock or dispense Plan B “morning after pill” based on their belief that life is sacred from the moment of conception.
This is a great turn-around by both the state and the Pharmacy College Board, which for several years maintained that pharmacists’ freedom of conscience had to be restricted in order to ensure consumer access to the morning after pill. Although in 2006 Pharmacy Board members had unanimously supported a rule that would protect conscience for pharmacists and pharmacy owners, an ideological move by Governor Christine Gregoire saw their jobs imperilled should they stick to that position.
Buckling under pressure, the board adopted new language mandating pharmacists to stock and dispense the medication even when doing so violates their conscience. The board adopted this regulation even though it admitted that it found no evidence that anyone in the state had ever been unable to obtain Plan B (or any other time-sensitive medication) due to moral or religious objections. The Becket Fund, which came to the defence of the family owned pharmacy and its two pharmacists, filed suit to prevent the new regulation from forcing them out of their profession.
In its most recent filing, the state concedes that allowing pharmacists with conscientious objections to refer patients to other pharmacies “is a time-honoured pharmacy practice” that is “often in the best interest of patients, pharmacies, and pharmacists” and “do[es] not pose a threat to timely access to lawfully prescribed medications.”
Although I am not an advocate for mandated referral — I believe that the onus should be on the authorities to find alternate means of service provision — the Washington ruling is a clear victory for the profession of pharmacy and it sends a clear message to all: the state — and, I would add, professional boards — ought to remain neutral in matters of faith and morals as they relate to individual conscience, in so far as there is no threat to public safety or to the common good. While the state plays an important role in ensuring the health, peace, morality and safety of its citizens, it should not use its power in a dictatorial way, imposing limits on individual conscience in matters which are legitimately open to dispute.
But is this not unfair? Is it not a case of a pharmacist or store owner imposing his or her values on others, and will it not cause great inconvenience to customers, which, some would argue, should be a professional’s first priority?
On the question of fairness, I would answer that justice is for all. In any agreement, one party must not be oppressed at the expense of another. In the case of the Plan B provision, both parties can be readily respected by placing the onus on provincial pharmacy boards to provide information on non-dissenting providers via toll-free numbers.
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The only problem with this is, what happens when the only pharmacy in town refuses to stock oral contraceptives. Not everyone who wants the pill has their own transportation, and can only reach the pharmacy by walking or public transportation. Women in rural areas have just as much right to contraception as women in the city.
Relax. That doesn’t appear to be the case here. The point is, people who don’t want to sell contraception, don’t have to get fired. Somebody, somewhere, is finally standing up for people who aren’t shy of saying what their conscience tells them. In other areas of modern life, you’d be denounced for hate speech. It’s rare to find an article where some one isn’t egged, or worse, for having values.
I don’t mind people having values. Values are usually a good thing. I don’t like when “values” are used to justify infringing one someone else’s medical decisions. If a pharmacist doesn’t want to touch the products, fine, but there should be an option there so that someone doesn’t have to go without. Which, is a possibility, if a pharmacy doesn’t stock or refuses to fill oral contraceptives.
Why do pharmacists get to make moral decisions about SOMEONE ELSE’S medical care? What if they start refusing to issue pain medications because they are morally opposed to the use narcotics? AAAARRRRRRGGGGGHHHHHHH! This makes me absolutely insane! If you are morally opposed to Plan B, don’t use it! If you can’t do your job as a pharmacist and fill prescriptions written by doctors, then don’t be a pharmacist! Stop trying to control someone else just because you don’t like what they do! Man, sometimes it just feels like this world (country!) is filled with moral busybodies who want to control the decisions and lives of other people! What’s next? Catholic pharmacists refusing to issue birth control at all because the Pope tells them that it is against God’s will? Where does it end? Nerdygirl, you are absolutely right about women in rural areas being unable to access this medicine if the only pharmacy in town refuses to stock it. That is just so very wrong.
Of course, the unintended consequence of denying access to Plan B could be to cause an actual, real abortion. And of course, it’s definitely morally better to force a woman to carry and bear a child that she does not want, and that was potentially created under less than ideal circumstances. Awesome.
Conscience provisions go to the heart of what sort of society we want to have. Ideally, we should have a society where both reasonably expected legal products and services are available and reasonable conscience exemptions are granted.
OK… should not pharmacists who object to dispensing contraceptives be obliged to obviously post the policy at the counter, so women can just turn around and take their business elsewhere?
Leo, I don’t disagree with you in theory. Unfortunately, the problems that arise in practice are what bother me. I grew up in a small town with only one pharmacy. The nearest town was miles and miles away. When we are talking about poor women, perhaps even those without access to transportation, I worry about the effects of a pharmacist’s decision of conscience on real people’s ability to access the medical products and services that they are entitled to have. I do think there is room for compromise, but I don’t want it to be at the expense of women’s rights to access medical services and products. And on a personal level, it bothers me that some people are deciding that they have the right to pass moral judgment on other people’s decisions in a way that could actually prevent the individual from being able to even make the decision. Especially when we are talking about health care. It’s hard for me to see why someone would choose to be a pharmacist at all if they are going to play God with people’s medical decisions.
Yes, Ahunt. Makes perfect sense to me. I knew a OB-GYN who operated that way.
Okay, now I know this is naive to think that people would even consider, but people would do well to learn N.F.P. Especially women who would otherwise have to walk several miles to get birth control. NFP doesn’t require walking anywhere; it just requires a little self-restraint when you’re fertile. No need for birth control when you can’t get pregnant because you’re not having sex when you’re fertile. This idea would be promoted more if it weren’t for an over-all doubt in people’s self control and discipline. I’m just saying is all.
I haven’t brushed my teeth since eating that everything bagel, so I wouldn’t recommend jumping down my throat.
While I appreciate suggesting a different birth-control method as opposed to just no method, not all women take birth-control for just keeping the babies away. Some women need birth-control to regulate and lessen the symptoms of their period, some have medical conditions where they can’t leave it to (low) chance, and some are prescribed to help with acne. Is it fair for them to be denied?
And personally, though I’ll admit to being more then a little paranoid at times, I wanted on the pill before I went to college as a precaution on the off-chance I was raped. (1 in 4 women are sexually assaulted)
What exactly makes the pill so controversial anyway? Why is only oral contraceptive morally objectionable?
Nerdygirl, depending on who you ask, you may get different answers to your question about the pill. The pill doesn’t prevent fertilization, but it does prevent implantation. I believe that constitutes an abortion, since a fertilized egg is a human at the earliest possible stage of development, and I oppose abortion as a method of birth control.
It just happens that the pill is taken orally–that’s not a moral reason to object to it. I don’t care how it’s taken; I think what it does to a baby is wrong.
I also don’t have a problem with going on BC for period moderation, acne, low BP, etc., but I haven’t had to do any of those things and don’t consider myself informed to make a judgment on whether there are better treatments out there. Certainly I think the pill has a huge effect on a woman’s reproductive system, and that careful research and a trusted doctor are a must before deciding to use it for any reason.
Heidi, I want to ask for clarification on a point you make.
First, what compromise do you have in mind that would allow both parties to follow their beliefs? When push comes to shove, it sounds like you want pro-life pharmacists to shut up or quit their jobs. That doesn’t respect their beliefs at all. (As an aside, you can order Plan B or the pill or an array of other BCs online with the help of Google and a prescription.) Please clarify.
Second, I was intrigued with your use of the phrase “moral judgments.” It makes it sound like people have morals primarily as a means to look down on or squash others. This is exactly the opposite of what’s going on. Right and wrong come from beyond me and what I feel. In this case, I oppose abortion-inducing drugs because they result in the baby’s death and a significant danger to the mother. To give them out would be to participate in killing someone. This is a serious moral concern and demands more than a glib “you signed up for that when you became a pharmacist”–especially since Plan B didn’t even exist when many pharmacists chose their jobs!
Norrie, some research actually suggests that a seasonal birth control pill, one that reduces the number of menstrual periods a woman has from 12 to 4 a year, lessens one’s chances of developing cervical cancer. So, there is plenty of research still to be done women’s productive systems. I mean, pregnancies themselves are very fragile, right after fertilization. I personally believe if a baby can’t survive out of the womb, it’s not alive. You may believe it’s abortion, but that doesn’t make it so, and it doesn’t give you the right to take away my (and others) access to birth control.
If something is growing inside of a living being, it’s alive, no matter how small.
If it can’t live on it’s own, is it really life?
@nerdygirl
Wow…that is just scary, Nerdygirl. A one year old cannot survive on its own; can we “abort” them? I know some 2 and 3 year olds that cannot survive on their own…and some 70 year olds too; can we “abort” them? That is a scary path you are looking down. One where we could terminate the growth (kill) of any one who could not survive on their own. I really hope that I am misunderstanding you.
I am going to have to back science on this one. There are seven factors of life of which living things show all or most of the following:
1. Homeostasis
2. Organization
3. Metabolism
4. Growth
5. Adaptation
6. Response to stimuli
7. Reproduction
Once fertilization occurs in humans, there is no doubt that they cell is a human being. It cannot, under any circumstances, become something else.
And if a baby that cannot survive out of the womb is not alive…then it would be ok to kill (abort) baby dogs, eagle eggs, penguins…etc. I mean, why not other animals since we are one as well. I am pretty sure PETA would disagree with you on that.
Oh please, PETA? You mean the organization that kills more rescued animals then regular shelters?
A one year old can’t survive on it’s own, but it doesn’t have to be inside it’s mother to live. A one year old can live outside the womb. It’s already born.
A fertilized egg dies if it’s taken from the womb. Any child before 24 weeks is expected to die if the mother goes into labor.
Not all fertilized eggs attach. Is it still abortion if egg doesn’t attach without chemical means? What if a female with an implanted egg goes sparring the next day, and takes a blow to the stomach, which causes a miscarriage? Did her sparring partner commit abortion, did she engaging in an activity that COULD cause a miscarriage commit one?
You may believe what you want, but oral contraceptives are not abortion. And you don’t have the right to take that away from me or anyone else.
Nerdygirl,
I agree that there’s still a lot of research to be done on the pill’s effects on a woman’s reproductive system. From your comment at #13, it sounds like you think I think the matter is closed and that all effects are harmful. That’s not at all what I said.
An abortion occurs when a developing baby is deliberately killed, whether for medical reasons or the convenience of the mother. That’s what some types of contraceptives do; other types prevent fertilization so that no baby results. Again, the fact that some of these things are oral has no bearing morally on the situation–it’s what they do. The definition of abortion is what it is. There’s also miscarriage, which covers the situations you detail in your second-to-last paragraph.
“If it can’t live on its own, is it really a life?”
That is a scary question. I think it encompasses a huge percentage of the population, depending on how literal you’d like to get (how many people could truly live on their own if they had to do so? Is all the specialization in our society wrong?). I’ll try to take it only in the context you meant it, which I think pertains to humans in utero. The point is not whether or not the baby (child, to use your term–though somehow one that’s not alive?) would survive outside the womb. It is in the womb. This is normal for that stage of development–we all were in the womb at that age. Do we have the right to kill someone else simply because they’re exceptionally dependent–temporarily–on their mom? When does a human become a human? Unless a human is always a human, the answer is arbitrary, and I have yet to hear one that’s logically supportable. A very young human should not have less right to exist than an older one.
But if you’re going the route that oral contraceptives are abortion, how when birth controls if prescribed for medical reasons besides birth control, any less of a moral conundrum? Does someone whose only using it for acne control deserve it less then one who has debilitating menstrual cycles? Does a women who wants on it to prevent pregnancy should she be assaulted be given more support then one who doesn’t want to use condoms with her boyfriend or husband?
You guys don’t, I get that, but why do you have the right to deny it to someone? Especially if that someone doesn’t hold the same beliefs?
Nerdy, I’ve typed this 3 times now (in various forms).
I don’t think oral contraceptives = abortion. Something that kills a human in an early stage of development is abortion (I mean, that’s what the word means). That could be Plan B, or it could be a doctor wielding a pair of scissors in a particular way. If your birth control doesn’t destroy a fertilized egg (or something older), it’s not a form of abortion.
I [personally] don’t find BC prescribed for medical reasons a moral conundrum. If you take it for acne or painful periods, there’s no baby in the equation. It’s like asking if I support kitchen knives. They’re a tool–I can use them to prepare wonderful food, or I can stab someone with them. Those things are not morally equivalent, but neither of them means there’s something wrong with the knife. I’m responsible for how I use it.
I understand that there are [a lot of] people who believe that babies in utero are not fully persons/human/[terms vary]. I believe that once you have a fertilized egg cell, you have a human life, and that if we truly value human life, we will protect it. Given this, I will respect others’ beliefs as much as I can and give them as many options and as much support as I can–until those beliefs include a demand to end the life of another person. I will oppose that wholly–I don’t see how I can do anything else.
Person A: “Not all fertilized eggs attach. Is it still abortion if egg doesn’t attach without chemical means?”
Person B: “Something that kills a human in an early stage of development is abortion (I mean, that’s what the word means).”
A pregnancy can be terminated by birth. It can also be terminated by things that occur within the womb that inadvertently harm the human in her embryonic stage of life. It can also be terminated deliberately through chemical and surgical interventions. So there are different kinds of aborted pregnancies; here the concern is about the deliberate interventions.
Pharmacists are not government slaves. And they are not slaves to customers, either.
The so-called pro-choice folks need to remember that freedom of conscience is fundamental to an open and free society. That is true in a small one-pharamacist town as it is in a big pharamacist-on-every-corner city. And it is true for the pro-choice as much as it is for the people they disagree with.
However, we speak of a fertilized egg we are really talking of a human being at the earliest stage of development. Once ova and sperm have fused, there is no egg; both have become something else together.
And, sure, miscarriages can and do occur. But these are usually not deliberately induced, as in the case of some of these chemicals that some pharmacists, due to their own deeply held beliefs, refuse to dispense.
Norrie and Paul have this just about right, between them, I believe.