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Moral boon or immoral boondoggle?
April 12, 2005 12:21 PM Subscribe

A new Texas billseeks to give pharmacists the right to object to dispensing emergency contraceptives. The bill was spurred by over a year's worth of debate about an incident in Denton where a rape victim was denied a morning-after pill by a pharmacist at Eckerd's. Supporters say that pharmacists should be able to opt out of dispensing drugs that are used for abortions, but the opposition points out that the bill's definition of emergency contraceptives can be construed to include all birth control. Should pharmacists be allowed to morally object, or is this an anti-birth-control boondoggle?
posted by rush (118 comments total)

This is my first post here, so please tell me how I might have done better. Thank you.
posted by rush at 12:23 PM on April 12, 2005

You could have made a post about something that hasn't been discussed before.

But as a christian scientist and a pharmacist, I applaud this potential precedent. It will substantially decrease my workload.
posted by Mayor Curley at 12:30 PM on April 12, 2005

Physicians determine what medicine a person should have, pharmacists give them out. If you aren't willing to give out medicine based on a physician's orders, don't become a pharmacist.
posted by nathanrudy at 12:34 PM on April 12, 2005

You may have included a pic of Tom Delay as poster boy for immediate contraception. Otherwise, good post.

Eckerds is not a public outlet. Yes, in theory it is there to provide a community service, but so is a tavern. And if the bartender doesn't like to make white russians or long island iced-teas, then I can take my business somewhere else.

It's plain and simple: if you do not like a particular retailer's method of doing business, go someplace else.

Unfortuynately, activist congresspeople have to create laws that protect everyone in case of a lawsuit. That's what we've become here.
posted by jsavimbi at 12:35 PM on April 12, 2005

That is fair. IF a pharmacist also has the option to reject some obese piece of shit's prescription to heart medication. Or to reject a some Republicans viagra prescription if he can't prove 100% that he is ONLY going to use it to fuck his wife.
posted by tkchrist at 12:37 PM on April 12, 2005

"But as a christian scientist and a pharmacist"

Well, we're all out of Cortisone 5 cream, but just rub this picture of Jesus on that rash and it'll clear right up.

Seriously though, If this isn't the slipperiest friggin slope ever. I'm not going to perform the Heimlich Maneuver on you because you're choking on a piece of steak and I'm a goddamn vegan.
posted by Divine_Wino at 12:38 PM on April 12, 2005

I'm not going to give you contraception because you're white, and we need the soldiers for the coming race war.

Or, to answer your questions, not really and yes.
posted by klangklangston at 12:41 PM on April 12, 2005

Jsavimbi, some consumer goods--like medicine--are more important than others--like white russians. If there are only so many bars in town and none of them makes the drinks you like, big deal. If there are only so many pharmicists in town and none of them dispense the medicine you need, that's another story.
posted by kenko at 12:42 PM on April 12, 2005

Should pharmacists be allowed to morally object,
No. What nathanrudy said.

or is this an anti-birth-control boondoggle?
Absofuckinglutely.
posted by Specklet at 12:48 PM on April 12, 2005

Electronic prescription card keyed by doctor/clinic/hospital, handed to patient.

Patient can order online or take to the APM.

The APM takes the card, patient enters password.
APM processes prescription, returns card to patient along with the expected wait time.
APM sends prescription details to pharmacist who sees only the prescription and authorization keyed by doctor/clinic/hospital.
Pharmacist fills the prescription and returns it to APM.
Patient returns to APM after expected wait time, enters card, keys in password.
APM spits out prescription.

For refills, the bottle must be returned via a deposit bin when first submitting the prescription in order to receive the refill.

Pharmacist remains blissfully ignorant of forming an opinion of a person and their prescription as pharmacist receives only the prescription and the authorization.

No more friendly visits, but then again, you don't miss your bank teller, do you?
posted by linux at 12:48 PM on April 12, 2005

I'm guessing Eckerd's started a home for adopted kids then, if they're going to refuse birth control even in the case of rape?

They didn't? Hmm. Some culture of life they got going there.
posted by mathowie at 12:48 PM on April 12, 2005

So does this mean a chain pharmacy can't fire a pharmacist for refusing to dispense these medicines? It hardly seems fair to the store -- one individual pharmacist could give them a lot of bad PR and there's nothing they could do.
posted by selfmedicating at 12:50 PM on April 12, 2005

Should pharmacists be allowed to morally object,

No. You like your salary and paid vacation? Check your opinions at the door.

or is this an anti-birth-control boondoggle?

Yes. And that's putting it politely. I for one am not shopping at Eckerds anymore. (I'm not under the impression this will make them crumble, but it will make me feel slightly somewhat better.)
posted by scratch at 1:00 PM on April 12, 2005

The Michigan Catholic Conference recently supported legislation that would allow health care providers to opt out of procedures that conflict with their faith. So, if you want an abortion, or you are a practicing homosexual, or you wear a pentagram, or whatever, you can be refused treatment based solely on another's impression of who you are. So much for the Hippocratic Oath.
What's next? Will the cops get to decide when and if they enforce the law, based on their "faith?" If your faith puts you into that much conflict with the responsibilities of your job, you should find another.
posted by cows of industry at 1:00 PM on April 12, 2005

I'm guessing Eckerd's started a home for adopted kids then?

Is Eckerd's on record as supporting the bill? I know they disciplined the pharmacist in Denton, and ISTR that they fired his ass.

This bill would protect you from your employer. I don't know why Eckerd's would support a bill that could only prevent them from firing people they'd want to fire, but I dunno for sure.
posted by ROU_Xenophobe at 1:01 PM on April 12, 2005

A couple of quick notes:

1. Eckerd's fired the pharmacist in question. This incident was (and is) against their store policy.

2. The bill defines an emergency contraceptive as "a prescription drug containing an elevated dose of hormones that is used to prevent pregnancy."
posted by rush at 1:06 PM on April 12, 2005

Pharmacists are in no position to make this decision. If there needs to be some kind of oversight, make sure it requires a prescription. That is why we have prescriptions.
posted by sophist at 1:08 PM on April 12, 2005

I'm against all medicine for any purpose, so I'm going to go work at a pharmacy and get paid for doing absolutely nothing. That's my right as a christian, after all. My morals are more important than everyone else's.

Seriously... what nathanrudy said. A pharmacist's job is to fill perscriptions correctly. If we could trust people to self-serve vats of pills, we wouldn't need pharmacists, but we can't for several reasons. Pharmacists are not doctors, though, and their only purpose is to count the right number of pills, make sure they aren't mixed with other things, and make sure the customer isn't using two incompatible drugs.
posted by odinsdream at 1:09 PM on April 12, 2005

If I were a wingnut working at Eckards, I'd give out placebos in place of birth control. I'd just be doing what I believe is right, so it'd be cool.

Also, I heard that these people were tearing up the prescriptions as well, so you couldn't just go to another store. But that's just what I heard.

Please, make it stop.
posted by belling at 1:09 PM on April 12, 2005

This is looking to be yet another red state/blue state culture-war issue. Both Illinois and California are moving in the opposite direction.
posted by mr_roboto at 1:10 PM on April 12, 2005

I'd like to know if Self-Righteous Pharmacist knew the woman was a rape victim.
Because how you could think you were a good, moral person for refusing to aid a woman who'd just been raped is beyond my comprehension.

But then again, so are a lot of acts done by so-called religious people.

If I were a wingnut working at Eckards, I'd give out placebos in place of birth control. I'd just be doing what I believe is right, so it'd be cool.

There's a story in my family about some relatives/friends of many, many decades ago who owned a store or gas station or something and supposedly used a pin to put holes in the condoms they were dispensing. See, in the old days, warped people just *did* stuff like this, and it never made the news.

The Michigan Catholic Conference recently supported legislation that would allow health care providers to opt out of procedures that conflict with their faith.

cows of industry, that reminds me - a couple of kids here in Detroit, Michigan have been victims of shootings the past few days. I'm waiting for those fine proponents of the Culture of Life to finally get behind stricter gun-control laws.
But I'm not holding my breath, as blue is not an attractive face color on me.
posted by NorthernLite at 1:18 PM on April 12, 2005

Let pharmacists posture themselves right out of the workforce.
posted by docpops at 1:24 PM on April 12, 2005

I applaud this potential precedent.

Yikes, Mayor Curley. Really? That's the kind of society you want to live in?

If a racist E.R. physician wants to refuse to treat minorities, is that cool with you too? I mean, it's against the doctor's beliefs, so he shouldn't have to treat them — and the nonwhite patients can simply take their business elsewhere if they doesn't like it...

While we're at it, how about if cops only enforce laws they agree with?

Someone cue Louis Armstrong... "And I think to myself, what a wonderful world...."
posted by Mr Pointy at 1:28 PM on April 12, 2005

Mr Pointy, adjust your sarcasm detector.
posted by kenko at 1:33 PM on April 12, 2005

If I go to a Catholic church I have got a reasonable expectation to meet a pastor who will held a mass....

...what If I find that the pastor is a Muslim and he's now bent to the East praying ? Similarly if I go to a mosque I don't expect to find a pastor.

Therefore, If I go to a pharmacy I have got a reasonable expectation that (if needed with a valid doctor prescription) I will obtain the drug I want or need...

... what if I find the pharmacist doesn't believe in that particular drug ? He can certainly tell me more about that and he may as well be right, but If I don't wish to listen he must give me the drug without further delay and ado.

That's the thing with extremist people..they don't propose they impose and if you don't care they'll get worked up and impose more , eventually betraying their own values just to win you to their "cause"
posted by elpapacito at 1:34 PM on April 12, 2005

Hang on, though, Mr Pointy and Divine_Wino, those are a slippery slope argument. We're not talking about E.R. physicians, nor cops. This bill only addresses pharmacists, so we should be able to address it on it's own.

Please keep in mind that a slippery slope is a logical fallacy.
posted by rush at 1:36 PM on April 12, 2005

If the asshats who run the medical establishment would just let the damn pills be sold over the counter, none of this would be necessary.
posted by trharlan at 1:42 PM on April 12, 2005

northernlite: yes, as we've seen, the so-called Culture of Life is not applied consistently. See, it doesn't matter what kind of life they have, only that their mothers are forced to bear them no matter what the consequences.
posted by cows of industry at 1:42 PM on April 12, 2005

Slippery slope may be a logical fallacy if you're on the debate team, but the fact is, it happens. And you're a fool if you insist on looking at everything absolutely in a vacuum. All things have context. What impacts one may impact another. And saying one form of health-care professional may discriminate based on "faith" does indeed open the door to other forms of health-care professionals gaining the same "right".

Otherwise, please feel free to talk about the slippery slope fallacy to every lawmaker, lawyer, and judge who uses precedent to help make new determinations.
posted by InnocentBystander at 1:44 PM on April 12, 2005

rush: In Michigan, the bill is not confined to pharmacists, and it's vague language not confined to abortion, but potentially affects many "lifestyle" issues, as well. This seems very slippery to me...
posted by cows of industry at 1:47 PM on April 12, 2005

Please keep in mind that I stand corrected and your hauling out of that tired ass logical fallacy link is AWESOME.
posted by Divine_Wino at 1:48 PM on April 12, 2005

My husband and I recently had a discussion about this issue, and his hesitation about any kind of legislation restricting pharmacists from right of moral refusal lay in the dangers of Big Pharma these days (i.e., what if a pharmacist wanted to refuse to fill, say, a Vioxx prescription if s/he was aware of the kind of damage it did, even though the drug companies refused to admit that and kept it on the market?). I had to admit I could see his point on that one.

I ended up conceding that maybe the pharmacist should have the right to voice an objection (whether it be "you might want to recheck this prescription with your doctor because it's had some nasty results" or "you're going to burn in hell") as long as the customer has the absolute right to say "shut the f*** up and give me my pills" and the pharmacist can't do anything else but.

A friend of mine from Chicago (where an episode like this recently happened and spurred the bright and decent Illinois governor to pass an emergency bill saying that pharmacists CAN'T refuse without finding someone who'll fill the scrip) suggested that Planned Parenthood or someone of that ilk keep a nationwide log of pharmacists/cies who refuse, and provide it to the public as a service. I liked that idea. Something like that might well inform my consumer choices.
posted by dlugoczaj at 1:50 PM on April 12, 2005

InnocentBystander, I disagree. Do you believe that this law would provide a precedent that would permit an ER physician to refuse treatment to minorities?

On preview, cows, I am not familiar with the Michigan law. Your statement seems to indicate that it merits broader consideration. That wouldn't be slippery slope, though - it would be rational assessment.
posted by rush at 1:51 PM on April 12, 2005

Also get your plurals straightened out before you go prancing around sprinkling pedant dust all over everything.
posted by Divine_Wino at 1:52 PM on April 12, 2005

jsavimbi,

A bartender not serving me a martini is not going to irrevocably change my life, but a delay in the morning after pill because some pharmacist is making decisions for what's appropriate for a stranger will. This is not going to affect me as I live in the heathenistic east coast and I have all the options in the world, but people living out in the midwest may only have one pharmacy within 50 miles.

Please do a Google Map search of pharmacies in the Denton, TX area. Yup, ten or so. Hey wait, it's next door to Dallas. Bet you can find ten more.

An unidentified friend of the woman seeking the prescription told the newspaper she got the drug from a neighboring pharmacy.

And there you go. She went someplace else where they served her. So, this is a private citizen who was denied a service at a private establishment, she took matters into her own hands and voted with her feet. Big deal.

What is wrong here is that government activists are trying to intefere with the rules governing the conduct of a corporate establishment. So much for small government.

And yes, if you had just met the person of your dreams while simultaneously ordering a frozen strawberry margarita, I, not just as a bartender, but as a fellow citizen, would have to stop you and set you astraight.
posted by jsavimbi at 1:56 PM on April 12, 2005

Jsavimbi (and on preview, Rush), how might you feel about calling an ambulance, and having the medics refuse to treat you or take you to the hospital because they were morally opposed to what you'd done to get injured?

Like, say you were planting a bomb at an abortion clinic*, and it went off prematurely.

*I'm NOT SUGGESTING YOU WOULD DO SUCH A THING; I am merely trying to suggest something that a few fringe pro-life folks might consider reasonable and moral, but an average person might not.

Seriously, I want to know how you might feel.

By the way, Rush, I know you said that pharmacists aren't like ER doctors or cops, but in certain cases they are -- specifically, in any case where the necessary drugs must be obtained and used within a specific time period, and where the person who needs the drugs does not have a car or other timely transportation to visit more than one pharmacy within that window -- especially in smaller towns with no public transportation and only one pharmacy.
posted by davejay at 1:56 PM on April 12, 2005

Are there remedies (sorry) for this in civil court? I could imagine large damage awards possible there. One case of refusal to a woman with significant endometriosis could make the pharmacies think twice about letting "their representatives" create this kind of legislation.
posted by Pliskie at 1:57 PM on April 12, 2005

This is why I obtain contraceptives through a Family Planning, but even those are losing their funding now...

Say I worked at McDonalds. I don't like eggs, so I refuse to sell Egg McMuffins. I would get my arse fired. Last time I checked, both I and the pharmacist are doing a service.
posted by sian at 2:02 PM on April 12, 2005

Kenko, d'oh! Done :-)

Rush, I'm not arguing that bad pharmacists *lead* to bad cops and ER docs. I'm saying that society suffers whenever the professionals we entrust with our health and safety cannot be relied upon to do perform their functions.

Some people may consider pharmacists a bit player in the health system, but I think dereliction of a pharmacist's duty is every bit as troubling as the failure of a cop or physician. Inclusion of those professions was intended as rhetorical emphasis, not logical proof.
posted by Mr Pointy at 2:02 PM on April 12, 2005

It's your job, and if you think you're going to have problems with some aspect, get another job. I worked at a Barnes & Noble for six years. We sold everything from the Satanic Bible to the Turner Diaries, Anarchist's Cookbook to Robert Mapplethorpe, Playboy to The Story of O. Selling and handling those items never bothered me (although the Turner Diaries makes my skin crawl), and if I had any objection, I kept it to my self because THAT WAS MY JOB! I was there to provide customer service. What the customer wanted, the customer got.
posted by Sharktattoo at 2:06 PM on April 12, 2005

trharlan

actually, the over the counter deal was negged by Bush's political appointees at the FDA. All the science said it was perfectly safe, but it then got voted down at the last minute

dlugoczaj

Vioxx is not actually a bad drug. It's a very good drug marketed by idiots at Merck who didn't disclose all the safety information about it to paint it as a miracle drug. It still helps tons of people, but care has to be taken in who it's proscribed too. In all, pharmacists are not qualified and should not be making this decisions. Their job these days is to count pills and track history. Soon even that will be performed by computers.

Jsavimbi
That's seriously asinine. So she would have a lot of choices in one of the most populous cities in Texas. Texas is a big place, I'm sure there are many people who drive 30 minutes to the pharmacy already. What happens when that one stops giving out birth control? Also, as soon as this passes, these nut jobs are just going to start harassing pharmacists to stop giving out the prescriptions. They aren't doing this for the moral plight of the poor, hapless pharmacist. And you're saying we shouldn't regulate people's abilities to get drugs a doctor has written them a prescription for?
posted by slapshot57 at 2:09 PM on April 12, 2005

what if a pharmacist wanted to refuse to fill, say, a Vioxx prescription if s/he was aware of the kind of damage it did

dlugoczaj, pharmacists have always been able to refuse a prescription on medical grounds.

Refusing on moral grounds is a huge expansion of pharmacist power. If this power were legally protected, it puts the drugstore and the patient at the mercy of one individual pharmacist.
posted by selfmedicating at 2:10 PM on April 12, 2005

Sharktattoo, good point. I had a job for a while as a video tape duplication facility a long time ago, and one of the "regulars" was a video that I viewed as a horribly excessive pro-life propaganda film. Did I duplicate it? You bet. Did I sabotage it, or delay fulfillment of the order? Nope. Did I ever complain to my boss? Nosir.
posted by davejay at 2:11 PM on April 12, 2005

I've been following this story in Illinois since two women were refused emergency contraception at a Chicago pharmacy. The order that Gov. Blagojevich enacted is already under attack from conservative and religious groups. I know that Pharmacists for Life has also been involved (who, charmingly, refer to Blagojevich as "Slobodan" on their home page).

It sounds like in Illinois that the courts will end up deciding whether pharmacists can be held to this order or are, in fact, covered by the state's Health Care Conscience Act.

As alarming as this all is to me, what concerns me even more is whether these groups are also objecting to filling birth control pill prescriptions (and not just those used as a morning-after pill). Quotes and articles I've read would seem to indicate so, and the Pharmacists for Life Web site muddies the waters with anti-BCP propoganda.

How on earth are BCP a pro-life issue? They prevent an egg from even being released, so there's no fertilization, no conception, nothing.
posted by Sully6 at 2:12 PM on April 12, 2005

I weep for humanity.
posted by mervin_shnegwood at 2:13 PM on April 12, 2005

How on earth are BCP a pro-life issue?

Good question. I've never understood this, either. Maybe pro-life is really pro-religious-dogma under a more palatable name?
posted by davejay at 2:15 PM on April 12, 2005

Maybe this will open the door for the revokation of standing licenses of certain pharmicists and the refusal to grant licenses to new pharmacists if say a secular individual were permitted to make that determination based on their moral disgust at the righteous...
posted by juiceCake at 2:16 PM on April 12, 2005

Don't weep, mervin -- it's always two steps forward, one step back, and when it isn't, then someone else comes in and bombs you.

Oh, wait...maybe we should weep after all.
posted by davejay at 2:16 PM on April 12, 2005

I was under the impression that the slippery slope fallacy would apply if we said A was wrong because it would lead to B.

It seems like people haul that out whenever anybody engages in a simple hypothetical parallel. Its not unfair to say, like, "What if other professionals were to refuse to do X because of their beliefs," so that you can examine the logic behind the argument and try to figure out what the implications of that manner of thinking actually are.

Slippery slope would apply if I said that this law was invalid Because it would lead to police refusing to protect, say, gay people. It's still fair to say that the logic that supports this argument could be used to justify another thing, if it's an even parallel and not some grossly exaggerated scare tactic. And the fact that we establish that the parallel is undesirable isn't any kind of win position in the argument because of the slippery slope. It's still worth saying though isn't it, even if it doesn't make your entire case?

I mean we have to compare things to other things otherwise we don't have much to go on.
posted by SomeOneElse at 2:19 PM on April 12, 2005

In all, pharmacists are not qualified and should not be making this decisions. Their job these days is to count pills and track history. Soon even that will be performed by computers.

Wrong. The doctor of pharmacy degree is a four-year graduate program. Pharmacy technicians (the people you are most likely to interact with at your local walgreens) do a lot of the pour and count work. Pharmacists help protect patients from doctor error, help people manage chronic diseases like hypertension and diabetes, etc. The whole point of computerizing routine activities is to free up pharmacists to do their main job, which is patient care.
posted by selfmedicating at 2:19 PM on April 12, 2005

I guess "because it would lead to B" is a little simplistic, if it was provable that B was a direct consequence and all...etc....well you get what I meant though hopefully.
posted by SomeOneElse at 2:20 PM on April 12, 2005

I guess "because it would lead to B" is a little simplistic, if it was provable that B was a direct consequence and all...etc....well you get what I meant though hopefully.

You're right. It's only a logical fallacy if there is no necessary causal relationship between events in the proposed chain.
posted by ludwig_van at 2:24 PM on April 12, 2005

Right,
The point is that to be a pharmacist, one must be specially trained and licensed and in fact a primary duty is to mediate and enforce the law as it relates to prescribed and proscribed medicines. Cops don't create or debate the law, they ENFORCE it, and that is legally what they have to do. It is a very apt comparison. If I was a pharmacist who gave someone a fistful of Percocets because they looked like they needed a groovier time and they did not have a prescription, I would also be breaking the law and not doing my job.

Confidential to Rush:
so we should be able to address it on it's own.
it's is a contraction of "it is", not the possessive of "it".
posted by Divine_Wino at 2:25 PM on April 12, 2005

Dinine_Wino, is it true that a logical fallacy has no negative impact on your argument, and yet ESL grammar has one on mine?
posted by rush at 2:29 PM on April 12, 2005

What is wrong here is that government activists are trying to intefere with the rules governing the conduct of a corporate establishment. So much for small government.

The Texas bill would not only allow pharmacists to refuse dispensing medications they were opposed to; it would also prevent pharmacies from firing pharmacists who so refused, or refusing to hire pharmacists who would refuse to dispense such medication.

In other words, if I owned a Texas pharmacy which employed, say, a dozen pharamcists, and I wanted to dispense emergency contraception, I would not be able (if the bill were made law) to fire one of my pharmacists who refused to do so, even if I had made it clear that dispensing emergency contraception was a required part of the job. I also would not be allowed to ask candidates for pharmacist positions whether they would dispense such medication.

A truly consistent small-government position would be that pharmacists could refuse to dispense emergency contraceptions, but also that pharmacies could fire pharmacists on the grounds that they had refused to do so, or refuse to hire them on the grounds that they would. This is distinctly not what the bill in question does, so the bill cannot be defended from a limited-government position.
posted by DevilsAdvocate at 2:34 PM on April 12, 2005

Feel free to tell me I'm simplistic, or not thinking things through....but you are a pharmacist. You get paid to be a pharmacist. I come in with my prescription. You give me my pills.

That's it. There should be no further discussion. If you were a voluntary pharmacist, you know, doling out pills through the goodness of your heart and not accepting payment, then you might have a leg to stand on with regards to refusing service.

*of course, then you'd also be known as Wayne, the creepy guy who lives down the block and chats up all the kids who come by*
posted by Sharktattoo at 2:35 PM on April 12, 2005

Rush,
No but your pedantic tone is annoying, I have no problem with your argument, I was pointing out that what I said was perfectly clear if somewhat flippant and then you come charging in with your "please bear in mind"s as if that has any bearing on the what is being discussed and isn't just a chance to show off that you've bookmarked the logical fallacies page and enjoy pointing that out. It is traditional to not correct people on essentially minor points unless your shit is tighter than a Nuns hoohah on Good Friday.

Or maybe I'm being a dick and I need to go home and drink beer for a while, only Allah knows for sure.
posted by Divine_Wino at 2:39 PM on April 12, 2005

Or maybe I'm being a dick and I need to go home and drink beer for a while, only Allah knows for sure.

You're not being a dick, at least about the "it's" correction. I mean, wouldn't you correct someone who horribly and repeatedly mispronounced a word during a face-to-face conversation? They might be a bit embarrased, but you've just saved them years of shame down the road, right? Besides, this one isn't a matter of opinion; it's a fact.

Of course, if you're going to start arguing the "language is fluid and there are no strict rules so long as you know what I was trying to say" argument, well, your english teacher would like to speak with you about how poorly you're doing in class this year.

Oh, I'm sorry, your activist english teacher. Heh.
posted by davejay at 2:46 PM on April 12, 2005

So, slippery slope really means misrepresenting something as a casual relationship when it is not, not just pointing out parallels.

So I can say: The logic behind this law, (as I interpret it), if applied to other professions would have consequences that many people, (I think), would find improper. It might be worth reconsidering the logic behind this argument

And I can't say: This law is wrong because it means that something will (or "will be more likely to"?) happen that many people find improper, if i can't prove the direct causal link.

I guess with the generous use of sarcasm here it is hard to determine which people are arguing that this law will bring on the apocalypse and which are just making some fair (and some unfair) parallels to point out what they think about the logic behind it.

I'll stop this now.
posted by SomeOneElse at 2:47 PM on April 12, 2005

Pharmacists have a medical obligation to patients just a doctor does. A pharmacist can be sued for malpractice just as easily as a doctor can. They are obligated to refuse treatment that they judge to be dangerous to the patient. The problem is that these pharmacists allow moral consideration in their evaluation of the medical danger to their patients.

I support this guy's right to refuse to give medication. He isn't obligated to give medication. He is obligated to refuse to give medication if he perceives it to be a danger.

That being said, I would also support Eckerd's right to fire guys like him or to hire nothing but guys like him. I would also support the Board of Medical Examiners to peer review him and take away his license for failing to use good medical judgment that threatens quality health care.
posted by dios at 2:48 PM on April 12, 2005

As a nurse, it has always been my understanding that I do not have to perform/assist with a procedure that I have a moral objection to, unless my not participating endangers that person's welfare and there is no one else available.

I would think that the same ethical limitations would apply also to pharmacists, who as a rule are very smart people.
posted by puddinghead at 2:51 PM on April 12, 2005

Divine_Wino, you are not a dick. I apologize that I sounded like one. If you lived anywhere near me, I'd buy the beer.
posted by rush at 3:01 PM on April 12, 2005

Dios and I agree, sort of. So long as other pharmacies exist in the area to serve the medication.
I say, the pharmicist can say no, the business can fire him, and the pharmicist can be held liable for any harm coming out of his "moral decision." All of that without this law! Woohoo! We almost agree! (That's pretty good...)
posted by klangklangston at 3:02 PM on April 12, 2005

there is no one else available.

I think that is crucial, puddinghead. While it would be inconvenient and annoying if the pharmacist at one chain refused to fill my prescription, there are four pharmacies within walking distance of my home. I wonder about people in smaller towns, rural areas, where there may only be a handful of pharmacies. Wonder if no pharmcist near you will fill your doctor's prescription? What the hell do you do then?
posted by Sully6 at 3:03 PM on April 12, 2005

As it is illegal to ask a person ones age, marital status and religious belief when applying for a job, here in Canada, then why, if someone walks up to a pharmacy with a prescription, by what right, has that pharmacist to refuse filling said prescription out? Obviously that pharmacist is then unqualified for the job, ie: personal opinion gets in the way of them executing their obligations of the job at hand. Period. Why the hell should I drive to Abilene to get a script filled if a pharmacist is in my area?

Over to the Bill, "...pharmacist, nurse, staff member, or employee of a hospital, [or other] health care facility, or pharmacy who objects to directly or indirectly performing or participating in an abortion procedure or dispensing an emergency contraceptive may not be required to directly or indirectly:
(1) perform or participate in the procedure; or
(2) dispense or participate in the dispensing of the
contraceptive."

furthermore, it states those not participating in the above statement, will not be punished [discriminated against].

So even though they choose to discriminate, they will not be discriminated against for their own discrimination!

Worse yet, it repeals the abortion law [last paragraph]. "Sec. 103.005 [103.004]. DUTY OF CERTAIN PRIVATE ENTITIES TO MAKE FACILITIES AVAILABLE. A private hospital or private health care facility is not required to make its facilities available for the performance of an abortion unless a physician determines that the life of the mother is immediately endangered."

That is, if they even have abortion rights in Texas, which I don't know...

And long tea [dlugoczaj], this nationwide list of pharmacists who refuse, should they be made to wear a scarlet letter, perchance? As delicious as an outing sounds.....

So, YES it is an abortion issue.
posted by alicesshoe at 3:05 PM on April 12, 2005

"How on earth are BCP a pro-life issue? They prevent an egg from even being released, so there's no fertilization, no conception, nothing."

This isn't entirely correct, especially in the case of emergency contraception. While preventing ovulation is the principal mechanism by which every version of the pill (to my knowledge) works, mature (about to ovulate) follicles are somewhat resistant to this effect and may rupture anyway. This happens infrequently in regular birth control as well. After this point, a few alternative mechanisms come into play, in which the contraceptives prevent implantation of a newly fertilized embryo into the uterine lining or interfere with the functioning of the corpus luteum, a structure formed from the ruptured follicle which secretes hormones critical for proper response to an embryo.

From here you know the story. Since the last two effects start post-conception, abortion opponents claim that it's basically the same as any other first-trimester abortion, snuffing out a tiny soul, etc. etc. blah blah blah. I should mention the New York Times Magazine article a few weeks ago that estimated the population of Limbo to be twice that of Heaven, Hell, Purgatory, and the actual, non-fake world combined if this is true: 2/3 of conceived embryos fail to develop anyway.

References:
(you can get abstracts from the links, but you won't be able to read the full text unless you have institutional access.)

Gemzell-Danielsson K, Marions L. "Mechanisms of action of mifepristone and levonorgestrel when used for emergency contraception." Hum Reprod Update. 2004 Jul-Aug;10(4):341-8. PMID: 15192056

Glasier A. "Emergency contraception." Best Pract Res Clin Obstet Gynaecol. 2002 Apr;16(2):181-91. PMID: 12041961
posted by monocyte at 3:06 PM on April 12, 2005

Hmm.
Just to clarify. The Occupation Code already has this protection for physicians and nurses, so I support the amendment of 103.001 (which will now be called 103.002) to include protection for pharmacists. I support 103.002 in its entirety: medical providers shouldn't be compelled to do anything.

I disagree with 103.002 (which will now be caleld 103.003) and the amendments to it that protect these doctors, nurses, etc. I think the hospital or pharmacy should be able to penalize these doctors if they choose to take a stand. I generally believe in the right of people to do what they want, but I also believe that they should be prepared to accept the consequences.

Worse yet, it repeals the abortion law [last paragraph]. "Sec. 103.005 [103.004]. DUTY OF CERTAIN PRIVATE ENTITIES TO MAKE FACILITIES AVAILABLE. A private hospital or private health care facility is not required to make its facilities available for the performance of an abortion unless a physician determines that the life of the mother is immediately endangered."
posted by alicesshoe at 3:05 PM PST on April 12

That's incorrect. In fairness to you, you don't have the benefit of having the Texas Occ. Code right in front of you. But this language cited above was already in the code as 103.004. They re-codified it which means they re-numbered it to 103.005. So it is not new or changed. Just the number. They need to make room for 103.001, the definition section, so everything got bumped down a number.
posted by dios at 3:11 PM on April 12, 2005

Worse yet, it repeals the abortion law [last paragraph].

I'm afraid I don't follow you. I'm not aware of anywhere in the U.S. where private hospitals are required to provide abortions.

That is, if they even have abortion rights in Texas

They do, as they do anywhere in the U.S.: the right to receive an abortion from a provider willing to perform one.
posted by DevilsAdvocate at 3:15 PM on April 12, 2005

So what is a "close enough" pharmacy if your pharmacy of choice won't serve you? Within 2 miles? Within 10 miles? Is a pharmacy that is "close enough" for someone with a car and a tankful of gas also "close enough" for a poor woman with three kids who walks or takes public transit everywhere?

I don't think you can define "close enough" reliably and fairly. Pharmacists have a duty to dispense legal products: as long as birth control is legal, they should dispense it or find some other work.
posted by maudlin at 3:16 PM on April 12, 2005

How on earth are BCP a pro-life issue?

I know there's a movement among some in pro-life to call BCP "chemical abortions" based on some edge case that once in a while an egg accidentally gets out, might be fertilized, then hormones from BCP kick in and release/kill it. It's quite rare, but they believe that it is killing.
posted by mathowie at 3:20 PM on April 12, 2005

I don't know if I should laugh or cry.
posted by notreally at 3:43 PM on April 12, 2005

Seriously, this whole "they have a right to refuse on moral grounds, the patient can go somewhere else" argument is bullshit. THEY ARE PHARMACISTS. IT IS THEIR JOBS TO FILL THE PRESCRIPTION.

I'm sorry, but fact is, if this was ANY OTHER MEDICATION being denied people would go batshit crazy against it. The entire issue of pharmacist "rights" is a front to conceal the real issue, which is basically just another pro-life tactic to deny women reproductive choices.
posted by scarymonsterrrr at 3:51 PM on April 12, 2005

Taking this "you can go to another pharmacy" to the extreme...

what if there are no pharmacies in your area with sane people employed? What if there's ONE pharmacy that dispenses the medication you need? Is that still reasonable? One pharmacy total, in the entire country. You could still get your medicine, right?

No, it's ridiculous. This is the very definition of a slippery slope. You can't argue that it's "okay" because it's on a small scale when the scale isn't even Mentioned in the legislation. There's no provision or protection for that sort of consequence. Every single pharmacy anywhere (in the state) is allowed to refuse your perscription under this law, that means it makes no sense to say "just go somewhere else."
posted by odinsdream at 3:52 PM on April 12, 2005

As far as pharmacists go, selfmedicating had it right about pharmacists training. I came very close to going to pharmacy school and the reality is that in many scenarios, the pharmacists has more medical knowledge about drugs than doctors. Hell, in the major hospitals I've visited in Atlanta, there is a pharmacist on each floor with whom the doctors confer with to ensure they are prescribing the right thing if anything ever is in doubt. IF anything, I could see us moving more towards pharmacists being allowed to prescribe some prescriptions as they become more and more knowledgeable in the area of drugs. It is also worth noting that a lot of older pharmacists are not doctors of pharmacy, but rather completed a 2-year associate degree which have all but gone by the wayside.

That said, you could also turn this whole debate around where the pharmacists argues that they are protecting the life of the innocent life of the child...after all, if someone's pro-life, they are most likely going to hold that life begins at conception (note: this IS relevant because the birth control pills also work to abort the fertilized egg. If birth control only worked to prevent fertilization of the egg, I don't think we'de see as much objection).

On preview: mathowie already beat me to why there's objection among the pro-life movement to BCPs.
posted by jmd82 at 3:56 PM on April 12, 2005

I'd be OK with individual pharmacists who refuse to dispense 'immoral' perscriptions if the consumer could be informed in advance where and when they were working so that we could avoid them (and I, among others, would avoid them for ALL my presecriptions...)
posted by wendell at 3:59 PM on April 12, 2005

hey here's an idea,
how about ppl do their jobs, and stop trying to inject their beliefs into other ppl's lives,,

and how about the govt stop doing the same by trying to legislate morality
posted by MrLint at 4:19 PM on April 12, 2005

As an Aztec and a pharmacist, I too applaud this potential precedent.
I look forward to dragging out with hooks the hearts and genitals of the brave pharmacists standing up for their morals and placing them in the fire to appease Huehueteotl.
I also look forward to replacing the Diltiazem , Enalaprilbirth and control pills of the unbelievers with cyanogen chloride for the glory of Huitzilopochtli and Tezcatlipoca

"which people are arguing that this law will bring on the apocalypse"

Actually, SomeOneElse, like my own Mesoamerican beliefs, the fanatic Christian beliefs behind this are very much an eschatological system.

tetlapaloliztlatolli!
posted by Smedleyman at 4:36 PM on April 12, 2005

*birth control pills
posted by Smedleyman at 4:39 PM on April 12, 2005

Dios and DevilsAdvocate, I stand corrected and enlightened to the abortion law as it stands in the USA.

But, Dios, "medical providers shouldn't be compelled to do anything"? What of the hippocratic oath?

The Modern Hippocratic Oath

Because of this site, suddenly you have to ask your physician to which school they went and which version or part thereof the Hippocratic Oath they took.

mathowie, so the pro lifers want to enlighten the unwashed masses what is a birth control pills' function. Although BCP is a precaution against an unwanted pregnancy, how do they prove a pregnancy would ensue with or without the BCP? You can't. It's a personal choice, thankyou, they shouldn't be so concerned what goes on in other peoples bedrooms, whether they can or can't bear the responsibility of a child. Splitting hairs to achieve their end, I see, by any means available.
posted by alicesshoe at 4:51 PM on April 12, 2005

Ahem, I find it interesting that these pharmacists care so much about their morals that they do not quit the jobs that require them to do immoral things. Apparently their morals are only important when they inconvenience other people. Another detail you may not know about the Denton case listed in the post: the pharmacist in question called her pastor for advice which is a violation of a Federal patient privacy law called HIPAA. Violating company policy is bad, violating Federal law is worse.
posted by ilsa at 4:53 PM on April 12, 2005

Pharmacists should be free to follow their beliefs, as long as they are not putting anyone at serious risk by their actions.

Pharmacists should be able to get fired for doing so; any major chain is going to kick their ass to the curb in two seconds flat if they stop dispensing birth control.

Pharmacists should be forced to post very large, very visible warnings about the drugs they refuse to dispense. That way, they will go out of business even faster.
posted by _sirmissalot_ at 5:03 PM on April 12, 2005

People with a genuine desire for helping people should go into medicine/nursing/pharmacy whatever.
People with a genuine desire for furthering their own salvation should not.
posted by spazzm at 5:08 PM on April 12, 2005

People should not be told by the government how to live their lives, as long as they are not putting anyone at serious risk by their actions.
posted by _sirmissalot_ at 5:14 PM on April 12, 2005

Since the public has little or no say in what the pharmaceutical companies sell and what they charge, why should pharmacists have any say in what drugs people have access to?

FDA? Don't make me laugh.
posted by telstar at 5:17 PM on April 12, 2005

Just another reason to start a war of genocide against Texans.
posted by warbaby at 6:22 PM on April 12, 2005

Every McDonald's commercial ends the same way: Prices and participation may vary. I wanna open a McDonald's and not participate in anything. I wanna be a stubborn McDonald's owner. "Cheeseburgers?" "Nope! We got spaghetti, and blankets." - Mitch Hedberg

Yes, I know the sign says "Pharmacy". Oh, you're here for to fill a prescription for birth control? Sorry, can't help ya, but we do sell cigarettes and bumper magnets.
posted by edverb at 6:37 PM on April 12, 2005

As I've read this thread, I've been in agreement with both sides at some time. The arguments are very good either way: protection of religion is important -- that's why Sikhs get to wear turbans instead of a Mounties' Hat -- and protection of people's health is important.

Employers are not allowed to discriminate based on religion. You can not be fired or not-hired based on your religion. This tends to me to indicate that employees, then, are obligated to not allow their religion to interfere with their job duties.

What employers can fire for is failure to do the work to an acceptable level of performance. Likewise, professional associations and regulatory agencies can dismiss/delicense for the same sorts of reasons.

In almost all cases I can conceive, professional associations and regulatory agencies do not allow religion to dictate their rules and private laws.

The government can, I think, make these associations and agencies to accept the force of law. Laws against discrimination based on religion, for instance: neither group can deny membership based on religion.

It appears that the big problem here, then, is that the government is passing law that prevents employers from firing employees for non-performance, when that non-performance is the result of religious belief.

This sets up a judicial nightmare. If this law is passed, fired employees will inevitably litigate based variations of the theme.

The government should not be doing this not because it's a shady ploy to further convert the country to a religiously-ruled Christian nation, but because it breaks business. Employers simply can not survive if employees can not be fired for non-performance.
posted by five fresh fish at 7:06 PM on April 12, 2005

To borrow a phrase from Terry Pratchett: I have filed this under the category of things known as 'bloody stupid.'

You're a heart surgeon? You do cardiac surgery.
You're an EMT? You respond to the scene and do everything necessary to revive and/or sustain life.
You're a pharmacist? You fucking well dispense the fucking medications that have been fucking prescribed by a doctor, unless dispensing of same will result in an adverse drug reaction. End of fucking story.

This is all part and parcel of the horrifying (North) American attitude of "No, I'm going to do whatever the hell I want. sucks to be you." So what if you want to be a pharmacist? If you're not willing to fulfill the duties of the job, you can't be one. Would we allow firefighters to not go into burning buildings? Would we allow EMT's to refuse treatment based on moral judgements? Absolutely not. Pharmacists, like any other medical professional, fill a need in society: to uphold and maintain health, wherever possible. Allowing any medical professional to abstain on 'moral' grounds is bullshit, and dangerous.
posted by dirtynumbangelboy at 7:19 PM on April 12, 2005

Yes, this is Texas. The same state that mandates kids not only say the Pledge of Allegiance to the U.S. Flag, but also to the Texas Flag. I told my sons that if they didn't want to say the Texas pledge, they should point out that they are citizens of the United States, but only residents of Texas. (The older son makes a break for it this fall when he starts college in Iowa.)
posted by Doohickie at 7:35 PM on April 12, 2005

So what if you want to be a pharmacist? If you're not willing to fulfill the duties of the job, you can't be on

I agree with this, but would say "if you aren't prepared to do certain parts of a job, like fill prescriptions for BCPs or whatever, then take a job where you won't ever be required to do so". Just as doctors and nurses can choose to work in areas where they will not be expected to do anything at odds with their beliefs, a pharmacist can work in research, or other fields. As I've said here before, I have no problem with a pharmacist making this decision, but the time to make that decision is before you're in the position of having to turn someone away who is relying on you to do your job. When you choose to be a health care professional, you have certain responsibilities which outweigh your personal feelings, and you need to be aware of those feelings and choose your place of employment with them in mind (and I say this as a former RN). It's not like birth control is an unusual prescription.
posted by biscotti at 7:37 PM on April 12, 2005

What of the hippocratic oath?

A couple of people have alluded to this, and I feel compelled to point out that the Hippocratic oath does not legally compel you to do anything. It's not a legal thing, it's a professional ethics thing. Also, no one actually uses the "original" hippocratic oath anymore, except as an initiation rite-of-passage thing, and there are more variations than you can count that are tossed around. Anyway, the point is that the oath and variations thereof are used to impress upon people the importance of professional ethics, not actually to force you to do anything under the law.

Regardless, this is bullshit. I have no tolerance for people who believe that their morality should never be inconvenient for them. The onus of morality should be on the person holding the belief, not on bystanders or employers.
posted by LittleMissCranky at 7:52 PM on April 12, 2005

I know folks are ragging on Texas, but in Chicago, one of the pharmacists who refused to fill a prescription for emergency contraception actually called the woman's parents at home to tell them. Can I get a nomination for Asshat of the Year?

That's deeply, deeply disturbing about "chemical abortions." Given that birth control pills, when used correctly, have a 1-3% failure rate, obviously some do occasionally ovulate while on the pill. But, hey, let's take away one of the most effective methods of preventing pregnancy and send women to abortion clinics instead.
posted by Sully6 at 8:05 PM on April 12, 2005

My empathy-ometer tends to swing into the red for a woman who, the morning after enduring a rape, an invasive medical exam, an interview with the police, and telling the people who love her what's happened to her if she can bear to, must then further endure the judgment of some moralizing pharmacist who thinks he knows better than she or her doctor what treatment she needs. For the pharmacist, it's firmly stuck on go hurl yourself down a slippery slope, fuckface.

A short, but eventful debate season.
posted by melissa may at 8:20 PM on April 12, 2005

So, can checkers refuse to sell stuff they find morally offensive too? Or does this sort of bullshit only apply to "professionals"? At my job my right to negotiate what I want to do involves a fair amount of convincing the higher-ups that it's a good idea for the company, my morals don't really enter into it. Anyone else find that this is the case for them?

This is not a pharmacist's decision, this is a company decision & the appropriate reaction is publicity & boycott. These fucking companies believe that they can pander to the religious right & get away with it in the rest of the country, but we are wising up. If your company policy is that individual employees can do this sort of thing then, hey post it on a pole outside your store in Seattle. If they don't want to then I will.
posted by Wood at 10:49 PM on April 12, 2005

"The onus of morality should be on the person holding the belief, not on bystanders or employers."
Are you talking about the pharmacist's belief or the customer's belief? Are you implying only one of the parties holds a moral belief? Do you not think the customer is making and acting upon a moral judgement?

I thought the pro-choice view maintains that one should not be compelled to comply with an externally-imposed moral code with regards to abortion and birth control. (Strawman not intended, that's really my understanding.) So, why shouldn't the pharmacist allowed the same freedom from others' morality?

You want him to sit on his hands and watch what he considers murder? - okay, fine. You want him to lift his hands to be an accomplice to what he believes is murder? - now that's imposing your morality on another.

Pro-choice is looking more and more like pro-abortion.
posted by klarck at 5:07 AM on April 13, 2005

Oh, man. I need to become a pharmacist in Texas, stat. How great would the job be? Don't feel like working? Just say you morally object to filling out Ms. Smith's arthritis medication because only Christ can heal ailments like that. With the right amount of righteousness and stubborness, you could live like a king and never have to fill out a single prescription you didn't feel like doing.

Goddamn that sounds like a great job.
posted by shawnj at 5:26 AM on April 13, 2005

I wonder whether there may be some connection between the perception in some quarters on some occasions where pharmacists are making political decisions yet are unaccountable to the public, that it builds and builds to the point where some people engage in violence.
posted by Optimus Chyme at 6:11 AM on April 13, 2005

You want him to lift his hands to be an accomplice to what he believes is murder? - now that's imposing your morality on another.

Ma'am, I can't give you that amoxicillin prescription. No, ma'am, those bacteria have chosen you as their host and I will not help you kill those helpless innocents.
posted by Optimus Chyme at 6:13 AM on April 13, 2005 [1 favorite has favorites]

Klarck: I don't get the "pro-abortion" thing here. Emergency contraception helps avoid abortions.
And the reason why pharmacists should have to comply with the externally imposed morality is because it's their job to do so. I mean, I hate it as much as the next guy when a business decides that it can fire people for smoking, but at a certain point any place of employ has to be able to set out what the job duties are and be able to fire people who don't do them. That's pretty basic.
posted by klangklangston at 6:20 AM on April 13, 2005

alicesshoe--Long tea? Interesting. I got "dlugoczaj" from an "Old Polish pagan name generator" several years ago that claimed it meant "long wait"--which was very appropriate to my situation at the time, so I kept it. Goes to show, I guess, you should never believe anything on the internet (although you're the ONLY person in those years who's even had an inkling of what it means). Sort of like those fools who get Chinese-character tattoos that turn out not to mean anything, or to mean "I'm a dumb-ass." I don't even *like* tea.
posted by dlugoczaj at 6:44 AM on April 13, 2005

We already have a parallel, that's not hypothetical. At one time, many businesses found it "immoral" to allow black people to sit at their lunch counters, use the same restrooms as whites, or enter the premises at all. It would have been more "small government" to allow that state of affairs to continue, and tell black people they could "choose to go elsewhere" but we didn't. We (or rather, civil rights protesters and the legislators ultimately persuaded by them) decided that on this issue, the government had to intervene because segregation was so harmful to the society at large, and caused so much injustice on such a wide scale.

Things have not yet reached that stage for women seeking contraception, but I see on reason to wait for that to happen before putting an end to it. Pharmacists and health professionals can make decisions for their careers that will not involve them in reproductive issues or other issues they might have religious conflicts with. It is *their* responsibility--not the customer's or the drugstore's--to accomodate their religious beliefs by not putting themselves in a position that would cause conflict. Some here are acting as though pharmacists and "pro-life" physicians are somehow being forced to do things abhorrent to them. Please. They have plenty of choices that will allow them to keep their consciences clean, that don't involve denying choice to innocent patients and customers who are trying to seek legal medical help.

Medical professionals who were truly acting on their consciences would simply work in other areas of medicine. These people are doing something different...using their power as medical professionals as a weapon to harass innocent citizens, who are doing something they disapprove of. It is wrong, it is dangerous, and we cannot allow it to continue. Period.
posted by emjaybee at 7:03 AM on April 13, 2005

on reason=no reason. oops.
posted by emjaybee at 7:05 AM on April 13, 2005

I hope that in lieu of prescribed medication, objecting pharmacists at least give out miniature American flags before they go twirling, twirling towards freedom.

Does this legislation cover the counter jockeys as well? I know in my local drug store, there's always a bored looking young adult slouching at the drug counter.
posted by robocop is bleeding at 7:05 AM on April 13, 2005

For pete's sake, does everything have to devolve into an analogy of racism? One can't be against anything on moral grounds lest some fool brings forth "this is the same thing as opposing civil rights."

Does this legislation cover the counter jockeys as well? I know in my local drug store, there's always a bored looking young adult slouching at the drug counter.
posted by robocop is bleeding at 7:05 AM PST on April 13
No. This is specific legislation aimed at licensed pharmacists---the ones with the education and the medical and legal obligation to care for their patients in the manner they see best fit.
posted by dios at 8:04 AM on April 13, 2005

k.k. ston: Yeah, maybe I was overreaching by tying my comment to typical PA, AA and PC positions.

It seems most of the comments imply that the pharm is unfairly foisting his personal moral agenda upon his victim. By (I/you/we/society/law) forcing the pharm to dispense a drug for which he has an objection, aren't we imposing a moral agenda every bit as oppressive as the one we ascribe to him? At what point does the pharm's right to inaction end and the customer's right to compel action begin? My right to happiness does not compel another to provide me with happiness. These seem like equal and opposite arguments.

I just can't buy the "shutup and do your job or get one that doesn't require a moral conscience" argument. I work on top of a 75-yr-old, potential superfund site. There have been injuries and death from unsafe working conditions here. All because employees "fucking well" did as they were told. There are no morally neutral jobs.
posted by klarck at 8:25 AM on April 13, 2005

And there you go. She went someplace else where they served her. So, this is a private citizen who was denied a service at a private establishment, she took matters into her own hands and voted with her feet. Big deal.

She's not really "voting with her feet." She doesn't have a choice. Voting and/or choosing a different establisment implies that she has the option of getting it filled at the pharmacy she wanted to fill it at.

Man, I am so proud of Illinois for passing that emergency bill.
posted by agregoli at 8:36 AM on April 13, 2005

Klark: The difference, of course, is that unsafe working conditions are illegal, and that emergency contraception is legal.
posted by klangklangston at 8:48 AM on April 13, 2005

Would it be OK for an animal rights-minded pharmacist to refuse to fill your prescription because the drugs you need were tested on animals, or because extending the life of a carnivore means death for hundreds of innocent, helpless animals? I used to know people who held some very strong animal rights positions - for them killing or harming an animal was as big a deal as abortion is for pro-lifers. They used holocaust imagery about battery hen farms and saw animal lives as equivalent to human lives. How about letting these sort of pro-life people have control over what is available to others at a pharmacy?

Animal rights and fetal rights are both, like it or not, debatable ground in our society. If it's OK for a human pro-lifer to force their mores onto someone else in the workplace because they believe something is murder - then why is not OK for an animal pro-lifer to do the same thing on the same grounds? This is part of living in a plural society where people do not share a consensus on these issues, there need to be ways of protecting one side from the other. If you don't want to dispense a drug, fine, but then your employer should provide another pharmacist who will fill the prescription promptly, so that people who don't hold this view about the morning after pill equaling abortion are not disadvantaged or harmed by people who do. The same should apply if Mr Right-to-Human Lifer finds himself facing a militant animal-rights pharmacist who is not going to supply him with his pain relief medication because it was tested on animals - in that situation his rights need to be protected.

Any such legislation needs to make sure that there is a prompt and easy alternative to protect the rights of the person seeking medication, so the pharmacist is not exercising his or her conscience at the other person's expense. If the government wants to safeguard tender consciences without compromising other people's rights then it needs to pay so that plenty alternative emergency pharmacists are available to come and quickly fill those disputed prescriptions. Any legislation which doesn't provide such cover is not about protecting consciences but about forcing a certain pro-life viewpoint onto other people regardless.
posted by Flitcraft at 9:04 AM on April 13, 2005

Are you talking about the pharmacist's belief or the customer's belief? Are you implying only one of the parties holds a moral belief? Do you not think the customer is making and acting upon a moral judgement?

Eh, maybe. I would say that taking a chance on an unwanted pregnancy as a result of rape goes considerably beyond the scope of a "moral belief" question. But have it your way -- let's call it a moral belief. Here's the difference: the moral decision made by the customer ONLY necessarily affects her. She is not inflicting consequences on anyone else (and no, the potential bunch of cells that may or may not be in her fallopian tubes, created courtesy of her rapist, don't count as "anyone else"). She will have to deal with the consequences of that.

Furthermore, the choice of the customer does not impinge on the choices of anyone else. This bill impinges on the choices of both the customer and the employer, which isn't right.

In the case of the pharmacist, this bill ensures that not only are the primary consequences of his decision on the customer, but that the pharmacist has no consequences at all and instead displaces his share of the consequences solely on his employer. That's not right. You have a right to make decisions according to your morality; you do not have the right to insist that those decisions have no consequences to you. Once again, the moral thing to do here is to stand by your morality and accept that the consequences of that might be that you need to find a profession or a position within your given profession that doesn't require you to violate your moral code. I, for example, have chosen not to work as an executioner. However, if I had chosen to do so, I would be expected to be fired if I refused to execute people. In fact, I would expect to be fired if I only refused to execute some people, because I didn't have a moral problem with executing the rest.

I just can't buy the "shutup and do your job or get one that doesn't require a moral conscience" argument. I work on top of a 75-yr-old, potential superfund site. There have been injuries and death from unsafe working conditions here. All because employees "fucking well" did as they were told. There are no morally neutral jobs.

You're confusing the argument, here. No one is arguing that it is always best to do what your employer requires. It might very well be best to quit your job or defy your employer and be fired. What IS being argued is that, if you take a job, you must be prepared to DO THE TASKS THAT ARE EXPLICITLY PART OF THAT JOB. In the case that you mention, working in unsafe conditions was a) probably not explicitly part of the job description, and b) illegal. In addition, no one is saying that you shouldn't complain about your working conditions or try to make changes in your workplace. But if someone refuses to do the job for which they were hired, they should be terminated.

In sum, the government should NOT legislate morality. First, it shouldn't mandate people's moral choices whatsoever. Yes, I believe that this man should not be legally compelled to do anything that he finds immoral. But just as importantly, the government cannot legislate protection for moral choices such that a moral code only has consequences for people other than the person who holds it.
posted by LittleMissCranky at 9:57 AM on April 13, 2005

That was a damn fine arguement LittleMissCranky
posted by Smedleyman at 11:21 AM on April 13, 2005

"She is not inflicting consequences on anyone else (and no, the potential bunch of cells that may or may not be in her fallopian tubes, created courtesy of her rapist, don't count as "anyone else")."
Oh, I'm sorry. If only everyone knew you had resolved that issue. Well done. Excellent use of non-sequitur. Damn fine argument.
posted by klarck at 12:18 PM on April 13, 2005

What issue, klarck? There's no proof whatsoever that her taking the morning-after pill is going to cause any zygote, let alone person. One takes the morning-after pill to prevent having a full-on abortion.

If you want to take issue on a chance that there's something in there that shouldn't be lost, you're going to also have to deal with the problem of fully one-third of fertilizations naturally not being retained by the body.
posted by five fresh fish at 4:12 PM on April 13, 2005

Oh, I'm sorry. If only everyone knew you had resolved that issue. Well done. Excellent use of non-sequitur. Damn fine argument.

No, no, I'm sorry. If only I had known that you were someone who was part of the every-sperm-is-sacred crowd, I wouldn't have bothered making a cogent argument and just distracted you with something shiny instead.
posted by LittleMissCranky at 5:50 PM on April 13, 2005

posted by mcsweetie at 6:01 PM on April 13, 2005

Firstly, a pharmacist absolutely must have the discretion to fill drugs on a case by case basis. However, this should only be either prescriptions that are contraindicated to the patient or the habitual issuance of prescription narcotics by doctors (AKA Dr. Feelgoods). Morality cannot and should not play any part in the filling of prescriptions, as it should not with any member of the healthcare community.

That said, I'm a Pharm. Tech in Training at a pharmacy in Denton, TX and we have always been willing to fill any kind of birth control or "morning after pill" available.
posted by ktrey at 7:25 PM on April 13, 2005

I don't know about anyone else, but my perception is that many of these laws regarding birth control seem to be generated by old men and oil companies. Figuratively, of course, but everytime I hear of a law maker backing these bills, they all ways seem to be rich, crotchety old men. People that have no business in, or real knowledge of what they are legislating against.

As has been said many times before, if men were the ones that got pregnant, this would never be an issue. (abortion, birth control, condoms, etc). Like when viagra first came out, and many insurance companies covered that but STILL didn't cover birth control pills. I dunno, I want to see the tables turned and some pharmacists refuse to fill some get-your-weener-up drugs under the moral grounds that old men having sex is just "icky".

But alas, we know that birth control is only used by tramps, not woman who may have hormone troubles and without it can't get out of bed for a week each month. Or whom are in a stable monogamous relationship but just don't want to have kids. And of course the men seeking help from viagra are poor soles that are suffering horribly in their self-esteem and certainly need it to keep their marriages together.

Fuck that noise.
posted by [insert clever name here] at 8:18 AM on April 15, 2005

dlugoczaj, That's funny, an Old Polish pagan name generator! Actually, czaj, means tea, but in Russian. The Polish word is cherbata [Poles once were occupied by Russia and everyone had to learn Russian][this is not a Quebec reference]. Makes me think it's a coloquialism then, which makes sense.
posted by alicesshoe at 11:07 AM on April 15, 2005

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Moral boon or immoral boondoggle? April 12, 2005 12:21 PM Subscribe

Moral boon or immoral boondoggle?
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