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Target targeted for boycott?
November 15, 2005 10:16 AM   Subscribe

Via AmericaBlog: Target responds to recent coverage of their policies on dispensing emergency contraception with a fluffy PR email that invokes, of all things, the Civil Rights Act of 1964. (No news yet on whether Jewish cashiers can refuse to sell pork or vegan cashiers can refuse to ring up all meat...) Unfortunately, Target isn't the only company doing this. But their popularity has made them a ripe target (!) for criticism. Whose civil rights are more important? Pharmacists' or customers'?
posted by bitter-girl.com (108 comments total)

 
Customers'.
posted by surferboy at 10:17 AM on November 15, 2005


Civil rights nothing. It's a private company. Vote with your wallet. Next we'll be hearing that private companies are trampling our Constitutional rights...
posted by Captaintripps at 10:22 AM on November 15, 2005


And just how do you vote with your wallet when you live in a rural community, with no other options?
posted by surferboy at 10:26 AM on November 15, 2005


Is Target actually trying to "stop women from preventing unwanted pregnancies" or are they just permitting their employees to not sell one such method? They still carry condoms, right?

I'm not saying I agree or disagree with Target here, but I do think the last link is a bit of an exaggeration.

Incidentally, at my grocery store, the muslim cashiers put on thick gloves before ringing up any pork products.
posted by Pollomacho at 10:30 AM on November 15, 2005


The reason pharmacists are getting away with this is that there's a pharmacist shortage, so companies like target are stuck trying to retain their weird fundie pharmacists. You've got to have at least one pharmacist (as opposed to pharmacy technician) there when the pharmacy is open - no pharmacist on duty means the pharmacy, a big profit center, is closed. Believe me, if there was a cashier shortage, then you would hear about cashiers who had "moral objections" to ringing up condoms and similar. Personally I think it would be great if laws changed to allow pharmacists to delegate more dispensing responsibility to techs - that way the pharmacist wouldn't be standing between you and your perfectly legal birth control.
posted by selfmedicating at 10:32 AM on November 15, 2005


surferboy: You go somewhere else. Besides, the "poor, shithole community with one phramacy" schtick is such a canard that I don't even know why it gets trotted out to be flogged during these discussions.

Where is the proof that this is a major problem (it's certainly not in media covering what appear to be exceedingly rare instances for a few years)?

That the private business can make whatever decisions it wants is right. And Target are weasly shits for doing it this way, too. No one's rights are being trampled and it's The Suck as far as the situation goes.

If people care so much, they should encourage more like-minded people to become pharmacists and create a non-profit program to send them to work in the much-vaunted, but little supported, areas of no ortho.
posted by Captaintripps at 10:43 AM on November 15, 2005


Do these pharmacists demand proof of a valid marriage before dispensing a prescription for Viagra?

The time for Plan B to be available over-the-counter is long overdue, and would put an end to this particular attempt to turn back the clock.
posted by ambrosia at 10:48 AM on November 15, 2005


And just how do you vote with your wallet when you live in a rural community, with no other options?

I don't think there are that many, if any Targets in rural communities. Feel free to correct me.
posted by drezdn at 10:49 AM on November 15, 2005


Simply go elsewhere.

If you insist on sticking it to target, for some reaosn, go try to get your script filled there, and when the pharmiscist refuses, give teh store manager teh email/letter, and have the manager call in your script elsewhere for you, and give you driving directions...

That being said, I would like to get a part time job at target, and refuse to sell soda to fat people. That could be a lot of fun.
posted by das_2099 at 10:54 AM on November 15, 2005


I sent Target an email about this policy and they assured me that while they "respect their pharmacists civil rights" (I'm still not sure that there is a civil right of a pharmacist to reject a legal prescription, but whatever) that it is also their policy that every prescription be filled.

So I guess that means that fundie pharmies aren't allowed to work alone.

Which I doubt, but this is what makes me glad that I have an old fashioned actual pharmacist around the corner from me.
posted by illovich at 10:55 AM on November 15, 2005


Are pharmacists licensed by a professional body in the US? If so, then the professional organization should be the target (no pun intended) of any lobbying activity by Planned Parenthood or concerned citizens. This has nothing to do with individual employers.
posted by rocket88 at 10:55 AM on November 15, 2005


Hmmm...I wonder if Target allows their Christian Scientist pharmacists to refuse to fill any prescriptions?
posted by sexymofo at 10:56 AM on November 15, 2005


drezdn: My hometown had a Target. A SuperTarget, in fact. I grew up in Iowa, with cornfields bordering my house on two sides. Of course, you had to drive twenty minutes and two towns over to GET to Target...but in that rural area, driving twenty minutes for anything was pretty standard.
posted by ArsncHeart at 10:57 AM on November 15, 2005


Whose civil rights are more important?

I'm not sure this has anything to do with civil rights. Pharmacists are in business, they chose to sell things for a profit. They're aren't required to sell things, and aren't required to turn a profit. Just like employees are under no legal obligation whatsoever to work. They can chose not to work, and consequently not to be paid. It's business.
posted by scheptech at 10:57 AM on November 15, 2005


Maybe Target cashiers who don't agree with this policy should begin refusing to accept any and all cash with the phrase "In God We Trust" printed on it. Seems to be within their rights.
posted by notmydesk at 10:58 AM on November 15, 2005


Do we respect any and all beliefs that any pharmacist may hold, or just the ones sanctioned by recognized religions? Could a pharmacist refuse to dispense lifesaving antibiotics because he practiced Ahimsa and cannot condone the killing of bacteria? Could he refuse birth control pills as promoting sin? Pharmacists who won't do their job need to find another line of work.
posted by George_Spiggott at 10:59 AM on November 15, 2005


Captaintripps, your rant is amusing. The civil rights language is Target's language. The people annoyed by this are organizing a boycot. In other words, your free market outrage seems to be completely backwards in it's direction.

And I've been to many one-Targe towns (or one Wal*Mart towns).
posted by teece at 11:01 AM on November 15, 2005


Pollomacho,

You are kidding right? You really believe it's ok if someone goes to a doctor, gets a prescription, and the pharmacist (gimme a break) doesn't want to fill it? That's the job. And no condoms are not an alternative to the morning after pill if you have been raped.

What if Tom Cruise was your pharmacist? Would you want him telling you you can't have your doctor prescribed pills for your depression, because he recommends vitamins?
posted by xammerboy at 11:04 AM on November 15, 2005


Voting with your wallet in a rural community is not as easy as it is in a metropolitan area. But then, what is? That the trade-off of living in the sticks. Deal with it!
posted by wavespy at 11:04 AM on November 15, 2005


captaintripps: This is not necessarily an argument that pharmacists should be legally compelled to dispense every prescription, but I don't agree with your argument that because Target is a private company, the government has no business regulating how it fills prescriptions.

If Target wanted to install vending machines that dispensed Ciprofloxacin for a quarter, the FDA would rightly step in and say, "No, we don't think so."

Dispensing drugs is a heavily regulated industry and the government is perfectly within its bounds to impose rules on what pharmacies are required to do if they wish to remain licensed.
posted by justkevin at 11:05 AM on November 15, 2005


"Pharmacists are in business, they chose to sell things for a profit. They're aren't required to sell things, and aren't required to turn a profit."

You mean like restaurants can turn away black people?
posted by xammerboy at 11:07 AM on November 15, 2005


I've never been to a Tar-jhey, but in the DC area their marketing campaign has always been on the hip side (and yes, I guess that makes me a sucker for Madison Avenue, but I can't think of a better word for it). This is not going to fly in the sub- or ex-urbs, and it's strange that Target HQ doesn't seem to get it either. I'd always thought of them as kind of the anti-Walmart, at least in terms of public perception. Guess I was wrong.
posted by bardic at 11:08 AM on November 15, 2005


justkevin: You know, that's the first legitimate reasoning against this that I've read. The counter to this would be that it is regulating whether it fills perscriptions. They cannot compel them to stock any type of drug (to my knowledge) and I don't see how legally they can be compelled to dispense something they stock.

Vending machines would be regulating how they dispense, not whether. Which sounds nitpicky, but should this come to laws and legal action, I figure that would be a sticking point.

Bottom line: I hope Target gets nailed for this and is forced to carry the child of that nailing to term in a very public and financially ruinous fashion. I just want it done in the right way with the right reasoning.
posted by Captaintripps at 11:12 AM on November 15, 2005


justkevin: maybe but I'm not 100% sure on your point about government regulation compelling that the prescription should be filled. I mean, are all doctors required to perform elective abortions? I have a feeling there are a lot of doctors that won't.
posted by sexymofo at 11:14 AM on November 15, 2005


I believe there was a bit of controversy about that AmericaBlog post. Robert Brown did a little research about Target's policy.

I don't believe this is the case with Target, but I have carried health insurance that allowed me to fill my script at only one pharmacy chain. What say you when you can't go somewhere else?

"I am all for the diversity of team members. And no one should be refused a job based on their religion. But, if your religion won't let you fill your duties then find a new career. If Target has refusnik pharmacists the company should ensure they are never working without a "fully functional" pharmacist." (10/20 quoted from my blog)
posted by ?! at 11:20 AM on November 15, 2005


You mean like restaurants can turn away black people?

No, like they don't serve breakfast if don't want to.
posted by scheptech at 11:27 AM on November 15, 2005


Why do people get jobs that require them to do things they are morally opposed to in the first place?

I am morally opposed to murder. Therfore I didn't pursue a profession in the Armed forces or as a hitman where it is likely for me to be asked to do such things.
posted by sourwookie at 11:28 AM on November 15, 2005


You mean, they don't serve breakfast, even if they have it to black people?

That's the analogy here. The company has the drugs, and this is the only drug a pharmacist is able to balk on.
posted by xammerboy at 11:28 AM on November 15, 2005


And no condoms are not an alternative to the morning after pill if you have been raped.

Yeah, I guess you're right, the first place a woman who's just been raped wants to head is over to Target to pick up some prescriptions.

I would hope that a doctor handling a rape case is most likely in a hospital, no? Hospitals have their own pharmacies. Realistically, how many people are buying emergency contraception in a retail outlet? I'm not saying this isn't a possibility or that it couldn't happen or even that it shouldn't happen, but how many purchases of these drugs at Target are in emergent circumstances?

Again, I'll repeat, as I'm pretty sure it was missed, I am not agreeing with or disagreeing with the company's decision here. If Tom Cruise was my pharmacist, I would most likely be a Scientologist and not buying prescription pills in the first place.
posted by Pollomacho at 11:33 AM on November 15, 2005


Next we'll be hearing that private companies are trampling our Constitutional rights...

Um, private businesses cannot violate peoples' constitutional rights. Private businesses are not countries, they operate under the same laws everyone else does.

Here's the thing: A pharmacists' job is to dispense medication according to a perscription from a doctor, provided that medication doesn't endanger the patient by conflicting with other medications. This is what their job is.

A doctor's job is to perscribe medication after consulting with a patient. This is a doctor's job.

Target's job is to pay its employees when they perform according to their job description.

Who's falling down on their obligations? Target - for not firing pharmacists who aren't capable of performing the job of a pharmacist.

I don't fault the pharmacist at all - if they don't feel comfortable dispensing certain medication, for whatever reason, that's perfectly within their right. However, they should realize that this is a failing on their part, and they should be fired and replaced for failing to do their job. It would be no different if the pharmacist decided to dispense advil instead of birth control - it's a failure, and should cause them to lose their job.
posted by odinsdream at 11:33 AM on November 15, 2005


Perhaps I should pick an analogy with less loaded language:

Let's say I kept Kosher. It would be stupid for me to get a job as a judge on Iron Chef.

Anyone morally opposed to dispensing medications has no business being a pharmacist.
posted by sourwookie at 11:34 AM on November 15, 2005


bitter-girl: "No news yet on whether Jewish cashiers can refuse to sell pork or vegan cashiers can refuse to ring up all meat..."

Well, urm, yeah. Why the hell not? When did it become a crime not to do your job right? I say, if someone would prefer not to, they don't have to.

sourwookie: Why do people get jobs that require them to do things they are morally opposed to in the first place?

That seems like the ticket to me. If they want to stay in business, and not have right-wingers hiring up just to throw a wrench in the gears, it seems as though the best thing pharmacists can do is also the easiest: they can do what they should've been doing all along, and just ask people when they hire them what their views are, and whether those views will keep them from doing their jobs.
posted by koeselitz at 11:36 AM on November 15, 2005


(Presumably, though, such a pharmacist would be refusing them to everyone. A pharmacy whose policy was "White people get birth control, black people don't" would clearly be breaking the law.)
posted by nebulawindphone at 11:37 AM on November 15, 2005


(Er, that was re: xammerboy's remark.)
posted by nebulawindphone at 11:37 AM on November 15, 2005


Well, anyway, it's just bad business. Pharmacist shortage or not, you've got to go ahead and fire people who refuse to do their job.
posted by maxsparber at 11:44 AM on November 15, 2005


This may be linked somewhere else, but it's relevant: fillmypillsnow.org is a Planned Parenthood campaign to encourage pharmacies to not let wingnut pharmacists bow out of fulfilling their ethical obligations:

III.A pharmacist respects the autonomy and dignity of each patient.

A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable. In all cases, a pharmacist respects personal and cultural differences among patients.



"Free market" rhetoric isn't the solution to every problem, Captaintripps. It's a pharmacist's legitimate role to make sure your medications don't interact badly and that you know how to take them properly--not to act as your self-appointed ethical guide.

(Disclaimer: my wife is in pharmacy school).
posted by wheat at 11:45 AM on November 15, 2005


surferboy: You go somewhere else. Besides, the "poor, shithole community with one phramacy" schtick is such a canard that I don't even know why it gets trotted out to be flogged during these discussions.

These are the same eye-rolling sentiments that lead to one abortion clinic left in the state of Mississippi.
posted by surferboy at 11:45 AM on November 15, 2005


odinsdream has this precisely correct. A pharmacist should not be allowed to play this bullshit game (which is exactly what it is to these pharmacists: a publicity stunt, a game, an attempt to proselytize to some random woman). What's next? Letting pharmacists refuse to dispense birth control?

A reasonable accommodation of said pharmacist's religious beliefs should be granted. That is, if there is another pharmacist on duty, we'll let you pass it off. If not, fill the prescription or get fired. If your religious beliefs prevent you from doing your job: GET A NEW JOB.

It's just that simple, and shame on Target for allowing this bullshit behavior. Hence, the boycott.
posted by teece at 11:45 AM on November 15, 2005


Um, private businesses cannot violate peoples' constitutional rights. Private businesses are not countries, they operate under the same laws everyone else does.

odinsdream: That was sarcasm on my part.
posted by Captaintripps at 11:46 AM on November 15, 2005


Anyone morally opposed to dispensing medications has no business being a pharmacist.

So a pharmacist that is morally opposed to dispensing what he/she considers is a lethal drug should be forced to do so? (And I'm not sure you can say "they should have known that before they became a pharmacist" because plan b hasn't be around forever. Then again, maybe God would want you to quit your job if your job mandates you sin.)

True story: I worked at a byob restaurant where one of the waiters refused to open wine for customers since he believed drinking was a sin. "It's just like preparing a needle for a drug addict." He was a great waiter and a nice enough guy so someone always would just opened the bottle for him.
posted by sexymofo at 11:46 AM on November 15, 2005


I would hope that a doctor handling a rape case is most likely in a hospital, no? Hospitals have their own pharmacies. Realistically, how many people are buying emergency contraception in a retail outlet?

The doctor handling the rape case? What fucking country/year/alternate reality are you living in? You think all victims run to the hospital after being raped? The majority of rapes aren't reported (even to police) due to shame and fear.

So, yeah, I think the majority of rape victims hit the pharmacy within 24 hours. If Target is their pharmacy, that's where they'll go. The hospital perhaps later, to check for STDs, but even then the crime is probably not mentioned.
posted by dobbs at 11:48 AM on November 15, 2005


A restaurant dosn't have to serve breakfast if they don't want to be open for breakfast no matter who is standing outside looking at the closed sign.

A pharmacist is a retailer, a free enterpriser, in business to turn a profit. They sell whatever product mix they figure will help them fulfill their responsibility to support themselves financially. That's it. Marketplace response tells them what products to carry and it's up to them to perceive and manage that however they see fit.

Hence, the boycott.

Yes.

Meanwhile, I'm not following the racial intolerance angle.
posted by scheptech at 11:50 AM on November 15, 2005


Refusing to fill a valid, legal prescription for solely religious reasons should result in a revocation of the pharmacist's license; clearly, they're not interested in performing their duties.
posted by Optimus Chyme at 11:53 AM on November 15, 2005


So a pharmacist that is morally opposed to dispensing what he/she considers is a lethal drug should be forced to do so?

All drugs are lethal; it's merely a matter of quantity.
posted by Optimus Chyme at 11:55 AM on November 15, 2005


wheat: Number six is more pertinent:

VI. A pharmacist respects the values and abilities of colleagues and other health professionals.

When appropriate, a pharmacist asks for the consultation of colleagues or other health professionals or refers the patient. A pharmacist acknowledges that colleagues and other health professionals may differ in the beliefs and values they apply to the care of the patient.


odinsdream: I would not consider refusal to dispense one type of medication a failure in capability to perform one's job. At least if they're a member of APhA, they should follow #VI above and have another pharmacist handle it.

Target should really bow to the pressure from this and change its policy. Still leaves those who use single-owner pharmacies out in the cold, but there's not much that can be done legislatively (or that I believe would stand up in court).
posted by Captaintripps at 11:56 AM on November 15, 2005


The "poor, shithole community with one phramacy" schtick is such a canard
No, it's not. My wife grew up in a town in Illinois where you could go to Walmart or Target. The local pharmacist died some years back, and nobody stepped in to take his place. Not exactly a wealth of choices.

This thread's been filled with a lot of really terrible logic, and it makes my head hurt. I'm going to stop reading it now, but I felt compelled to call out your myopic, insular view on rural living.
posted by boo_radley at 11:57 AM on November 15, 2005


sexymofo, that waiter sounds like a jackass.
posted by NationalKato at 11:58 AM on November 15, 2005


I had no idea Target had a pharmacy so this is kind of a non-issue with me.

My guess is Target will adjust its policies, they're a more publicly oriented company than Wal-Mart.
posted by fenriq at 11:59 AM on November 15, 2005


In Target's response posted on Americablog, Jennifer Hanson says, "Under no circumstances can the pharmacist prevent the prescription from being filled, make discourteous or judgmental remarks, or discuss his or her religious beliefs with the guest." I would love to be a fly on the wall when a Target pharmacist refuses to fill a Plan B prescription -- how will he or she do so without making reference to religious beliefs?
posted by neko at 12:02 PM on November 15, 2005


boo_radley: You're right, there is a lot of terrible logic and lack of knowledge here. I grew up in Rural America and moved to Urban America. Hardly myopic or insular.

The fact that I completely disagree with Target's stance, that of its conscientious-objector pharmacists and the poor logic of how people want to deal with it seems to shoot right past you.
posted by Captaintripps at 12:04 PM on November 15, 2005


sexymofo:
I didn't say that government regulations should compel pharmacies to dispense all prescriptions. I said that the government has a legitimate interest in telling pharmacists what they need to do to remain pharmacists. This was in response to captaintripp's argument that this was a free market issue.
posted by justkevin at 12:07 PM on November 15, 2005


dobbs - So, yeah, I think the majority of rape victims hit the pharmacy within 24 hours.

But doesn't the rape victim require a prescription before they can get it filled?

I'm not defending the (activist) pharmacists' actions. If they are unable to perform their job duties, they should be dismissed.
posted by PurplePorpoise at 12:07 PM on November 15, 2005


Hospitals have their own pharmacies. Realistically, how many people are buying emergency contraception in a retail outlet? I'm not saying this isn't a possibility or that it couldn't happen or even that it shouldn't happen, but how many purchases of these drugs at Target are in emergent circumstances?

It's already happened to more than a few women trying to get Plan-B at their local pharmacy. Also, many religious hospitals don't offer any emergency contraceptives or even information about them after rape cases.

And thanks to dobbs for the response about rape cases - it's true that many are not reported even to the police, much less to a hospital.
posted by agregoli at 12:08 PM on November 15, 2005


It's not just Target.

Read ?! 's comment - Americablog, to my horror, seem to have quite seriously misrepresented this situation. Several pharmacies are doing this, and Target are getting the flak. Maybe you can see whether your local pharmacy has a policy on this - but don't assume it's just Target, and only Target.
posted by dash_slot- at 12:09 PM on November 15, 2005


I believe one case last year was a Wal-Mart, dash_slot.
posted by Captaintripps at 12:14 PM on November 15, 2005


Several pharmacies are doing this, and Target are getting the flak.

There was an Americablog post about 2-3 weeks ago detailing a situation in which a non-Target pharmacy (Rite-Aid, maybe?) pulled this sort of shenanigans.
posted by rxrfrx at 12:15 PM on November 15, 2005


Damnit, your arguers for argument's sake folks, READ MORE CAREFULLY.

The civil rights idea is an idea that belongs TO TARGET! The poster seems to be riffing off that in a sarcastic way.

So can we drop all the bullshit about "Target is wrong, but I can't agree with this argument about why they are wrong."

Target made this bed, not those protesting Target. Target chose to frame this as a civil rights issue. Read that again if it didn't sink in.
posted by teece at 12:18 PM on November 15, 2005


So a pharmacist that is morally opposed to dispensing what he/she considers is a lethal drug should be forced to do so?

That was my husband's original reservation when I started fuming that pharmacists should HAVE to fill all prescriptions. Someone told me, however, that pharmacists have always had the right to refuse to fill a prescription for MEDICAL reasons, not moral reasons (e.g., the drug is potentially lethal, might react badly with another drug, etc.). (Come to think of it, I think it was someone in a previous MeFi thread; I'd link to it, if I knew how to do so.)

I think that right should, in fact, remain within the realm of a pharmacist's professional rights, largely because they're trained specifically to judge med safety. However, objecting to Plan B (which has gone through extensive testing to prove its safety--FAR more than is really needed, in fact, which is probably a way of stalling for the FDA) falls squarely within the camp of moral objection rather than medical, and any pharmacist who dares to make this kind of judgment and still call him/herself a professional is seriously deluded.
posted by dlugoczaj at 12:18 PM on November 15, 2005


Actually, nix the Wal-Mart thing. It appears that they do not carry emergency contraception at all.
posted by Captaintripps at 12:20 PM on November 15, 2005


Incidentally, at my grocery store, the muslim cashiers put on thick gloves before ringing up any pork products.

Give the fundy pharmacists these gloves too.

Problem. fucking. solved.
posted by Heywood Mogroot at 12:22 PM on November 15, 2005


Just in case anybody from Target is checking out this thread, you should know that although I have been a Target customer in the past, I didn't even know they filled prescriptions. Of course now I would never use the pharmacy and I doubt I'll be going to Target next time I need a few odds and ends because I have other choices.
Nice job, guys.

And by the way, if a pharmacist really had principles, he wouldn't dispense any product that was manufactured by the companies involved.
posted by 2sheets at 12:24 PM on November 15, 2005


Captaintripps: The counter to this would be that [the government would be] regulating whether [Target's pharmacy] fills perscriptions. [The government] cannot compel [Target] to stock any type of drug (to my knowledge) and I don't see how legally they can be compelled to dispense something they stock.

PlanB's active ingredient is also used in birth control pills. Before PlanB, doctors occaisionally wrote prescriptions for a single month's worth of birth control pills, with instructions for the patient to take several at once, achieving exactly the same effect.

So the question of whether the pharmacy can be forced to stock the drug in question is moot. Even a pharmacy that doesn't carry or refuses to sell PlanB almost certainly carries the birth-control pills with the same ingredient. There's simply no need to force pharmacies to stock or dispense PlanB, because they're already doing so, one way or another.

Similarly, it's clear that the pharmacists in question aren't refusing to sell a particular drug; they're refusing to sell that drug to certain customers, based solely on that customer's intended use of that drug.

I think the real question is: Is it OK for a pharmacist to discriminate based on the customer's intentions, when those intentions aren't self-destructive?

It looks like a violation of the APA's code of ethics, to me.
posted by Western Infidels at 12:28 PM on November 15, 2005


Apparently there are a lot of really, really, remarkably stupid pharmacists in this country.
posted by wakko at 12:37 PM on November 15, 2005


odinsdream: That was sarcasm on my part.

My apologies. Believe me, it's hard to tell.
posted by odinsdream at 12:38 PM on November 15, 2005


when those intentions aren't self-destructive?

Ok, but then you get into the quaqmire of how they judge what "self-destructive" is exactly, based on what criteria, who monitors the validity of these judgements, and what sort of appeals process is needed to moderate the behavior of individual pharmacists. This is always a basic problem with any regulatory solution, simple cost and impracticality, and why things are so often left up to the marketplace to decide.
posted by scheptech at 12:40 PM on November 15, 2005


odin: Backhanded or no?

Anyway, here's the testimony given by the APhA before Congress on this subject. I think it does a good job of outlining all sides fo the equation and offers some excellent solutions. It also clarifies what their interpretation of their own ethics code is.
posted by Captaintripps at 12:45 PM on November 15, 2005


Yeah, I guess you're right, the first place a woman who's just been raped wants to head is over to Target to pick up some prescriptions. I would hope that a doctor handling a rape case is most likely in a hospital, no?

Uh, no - a lot of rapes are never reported. Only rape victims that report the rape to the police go to the hospital. Man, I hope you don't have a girlfriend or a sister and grew up without a mother.
posted by xammerboy at 12:52 PM on November 15, 2005


True story: I worked at a byob restaurant where one of the waiters refused to open wine for customers since he believed drinking was a sin. "It's just like preparing a needle for a drug addict." He was a great waiter and a nice enough guy so someone always would just opened the bottle for him.

If he wouldn't open the bottle, he wasn't a great waiter. A waiter provides service to a table. This guy wouldn't do that. If he waited my table, I wouldn't tip him, and if he worked for me, I'd fire him.

Likewise, these pharmacists should also be fired. They have the right to refuse to dispense something, fine. Their employer has the right to fire them for their failure to do their goddamned job. According to the article, Target ensures that prescriptions are filled, either by that pharmacy or another. I think it's fine if Target wants to pay two people for the work of one - that's their prerogative. But I think it's outrageous to send someone elsewhere to get a prescription filled, and they deserve to be boycotted if they do that.
posted by me & my monkey at 12:54 PM on November 15, 2005


So a pharmacist that is morally opposed to dispensing what he/she considers is a lethal drug should be forced to do so?

You mean have men with guns show up and actually force him to do the dispensing?

No.

Do you mean present the pharmacist with a choice between filling each and every valid prescription with no medical contraindications, or face immediate firing for cause, and maybe a fine or imprisonment?

Fuck yes.

Personally, I'd favor just firing most pharmacists and replacing them with software expert-systems linked to robotic dispensing systems.
posted by ROU_Xenophobe at 12:55 PM on November 15, 2005


A restaurant dosn't have to serve breakfast if they don't want to be open for breakfast no matter who is standing outside looking at the closed sign.

I really don't want to keep this argument going, because I don't like the analogy. However, it's like a restaurant that DOES serve breakfast (that is, has the drugs) but some waitresses do NOT serve it to some types of people based on their religious belief. This is an example of commerce being regulated, which is why the federal gov't got involved with integration to begin with.
posted by xammerboy at 12:57 PM on November 15, 2005


Personally, I'd favor just firing most pharmacists and replacing them with software expert-systems linked to robotic dispensing systems.
posted by ROU_Xenophobe at 12:55 PM PST on November 15


This is a bad idea and will continue to be a bad idea for at least the next fifty to a hundred years.
posted by Optimus Chyme at 12:58 PM on November 15, 2005


Apparently there are a lot of really, really, remarkably stupid pharmacists in this country.

Allow me to introduce you.
posted by Otis at 1:01 PM on November 15, 2005


What's so alarming about this thread is so many MeFites, who generally skew liberal, being completely open to the idea of handing over their civil rights to big businesses.

Why in the world are people defending this? Why would you want a business to be able to discriminate based on their values?
posted by xammerboy at 1:10 PM on November 15, 2005


All drugs are lethal; it's merely a matter of quantity.

Not weed, man. Not weeeeed!

Funny story: I was driving with my sister-in-law and 2-year-old niece a few weeks ago, and we turned into Target for some diapers.

"Oh no! Daddy says Target bad!"

If you're not boycotting Target already, it's a great new reason to start.
posted by mrgrimm at 1:14 PM on November 15, 2005


IANAL, but I think that Target is probably following their corporate counsel's advice. If they fire the pharmacist for refusing to dispense the prescription, they risk a discrimination lawsuit. Assuming there are multiple pharmacists refusing to fill these prescriptions, this could be a class action suit. The attorneys representing the pharmacists could probably find a jurisdiction favorable to their clients' point of view.
posted by justkevin at 1:15 PM on November 15, 2005


Holy shit, Otis.
posted by Captaintripps at 1:19 PM on November 15, 2005


This is a bad idea and will continue to be a bad idea for at least the next fifty to a hundred years.

Oh, probably, but a man can dream. At least a bundle of software won't sit in moral judgment of you at inopportune moments.
posted by ROU_Xenophobe at 1:21 PM on November 15, 2005


mrgrimm:

I don't think you should be simultaneously boycotting Target for allowing pharmacists to refuse emergency contraceptives on religious grounds AND for refusing to allow a Pro-life group to solicit donations on their premises.
posted by justkevin at 1:23 PM on November 15, 2005


As loathe as I am to defend even slightly the stupidity of a faceless corporate entity, Target is really in a bind here. Right now they have a rep as "the Wal-Mart it's okay to like," and they'd prefer not to blow that. However, once the issue was raised they were stuck -- either discipline the pharmacist and incur the wrath (and boycott) of anti-choice groups, or allow the pharmacist to refuse service to the customer and incur the wrath (and boycott) of pro-choice groups.

Frankly, the best course of action for publicly traded companies operating pharmacies is to refuse to stock controversial drugs. It's much more difficult to sue a company for failing to carry a particular product line. Of course, that's not the best policy from the consumer's perspective, but corporate interests usually trump consumer needs anyway.
posted by mkhall at 1:38 PM on November 15, 2005


Wow. I guess that means all those Target Pro-Life pharmacists now have no other moral choice but to leave their jobs... Sad.
posted by xammerboy at 1:44 PM on November 15, 2005


And no condoms are not an alternative to the morning after pill if you have been raped.

Nor are they helpful if you were using them and the condom breaks, or slips off.

I would hope that a doctor handling a rape case is most likely in a hospital, no? Hospitals have their own pharmacies.

When I went to a hospital to get emergency contraception when a condom broke when I was 16, they wouldn't see me until I started panicing and crying and shaking. It was a Sunday, so I couldn't see my doc or Planned Parenthood and I know that the sooner you take it, the better. They told me it wan't an emergency. I told them it sure as hell is when you're sixteen. They managed to fit me in (bless them) and the doc wrote me a prescription and he sent me to a retail pharmacy to go buy it.

Now, ECP is available here without a perscription. You have to have a private consultation with a pharmacist (it takes maybe 10 minutes) and fill out some forms, but you don't have to see a doctor first.

how many purchases of these drugs at Target are in emergent circumstances?

The sooner you take the ECP, the more effective it is. Basically, anytime you're taking ECP, it's emergency circumstances.
posted by raedyn at 1:46 PM on November 15, 2005


being completely open to the idea of handing over their civil rights to big businesses

99% of the time I'd agree, big business has far too much self-interested influence over how we live.

But this is a little different. Liberal societies will tell you what you can't do and assume everything else is legal (which is obviously a much larger number of things and leaves the door open for new things). Oppressive societies will tell you what you can do and assume everything else is illegal.

Retailers are prevented from selling us harmful products. They are not obligated to sell any specific products, no matter what component parts those products are made of. Regulation determines what they can't sell, and they determine what they do sell.

Another example, there are some TV shows I don't like much because of what they emphasize in people. Gerry Springer comes to mind. Gerry is appropriately prevented from presenting anything too realistically violent but, even though I don't like what he does I believe only the overall market should be telling him what he should present or how to design his show.
posted by scheptech at 1:59 PM on November 15, 2005


Whose civil rights are more important? Pharmacists' or customers'?

I'm ashamed this question has to be asked.

It is also asked incorrectly. Let me fix it for you:

Whose civil rights are more important? The person who desperately needs a medication, or the people who control the only legal access to it?

We've covered this so many times it has become wearying.
posted by Ynoxas at 2:06 PM on November 15, 2005


This is a bad idea and will continue to be a bad idea for at least the next fifty to a hundred years.

Somebody better tell the folks at Instymeds then.

Getting a prescription through InstyMeds works much like getting a prescription through a pharmacy.

The doctor takes the patient information, enters a prescription into his computer system and gives them an order number. They go to the machine, enter that number and their birth date and uses a credit card, debit card or cash to pay for it (even handles insurance co-pays).

The medication is automatically labeled and a comprehensive bar-code check system ensures that the patient gets the correct medication. In most cases the medication is dispensed in less than five minutes.

You can read more about the specifics here.
posted by Orb at 2:08 PM on November 15, 2005


Sure, Orb, that'll work great until the mechanics who service the machine refuse to do so because they feel it's against their civil rights.
posted by notmydesk at 2:27 PM on November 15, 2005


CIVIL RIGHTS ACT OF 1964, Title VII
(e) Notwithstanding any other provision of this title, (1) it shall not be an unlawful employment practice for an employer to hire and employ employees...on the basis of his religion, sex, or national origin in those certain instances where religion, sex, or national origin is a bona fide occupational qualification reasonably necessary to the normal operation of that particular business or enterprise...
-------------
There's the question from Target's point of view. Is it reasonably necessary for them to require that their pharmacists dispense all legally obtained prescriptions? I believe it is, the American Pharmacists Association (APhA) does not:
As a portion of the recently adopted American Medical Association (AMA) pharmacist conscience clause resolution indicates, pharmacists and physicians agree. Patients should receive their medications without harassment and interference, but pharmacists should not be compelled to participate in activity they find objectionable.
--And--
APhA’s policy supports the ability of a pharmacist to opt out of dispensing a prescription or providing a service for personal reasons and also supports the establishment of systems so that the patient’s access to appropriate health care is not disrupted.
Notice that APhA does not require that the first part be contingent on the second.
posted by Edible Energy at 2:27 PM on November 15, 2005


There is a loophole in Targets logic. So, I think I've found the perfect job....I convert to Christian Science and get a job as a pharmacist, I say that all medicine is against my religion and I just hang out at work reading the paper all day and getting paid well for it!!
posted by Megafly at 2:36 PM on November 15, 2005


Sorry for another analogy, but would it be the same if a cashier at a store refused to sell cigarettes to customers because they are known to be bad for you? Would them asking another cashier to ring the sale up or if no one is available telling the customer where the nearest store that also sells cigarettes is solve the problem?
posted by dindin at 2:51 PM on November 15, 2005


your analogy misses the point. The question is not whether or not they have a moral standpoint, but who should regulate what the pharmacist will or won't dispense? The government, pharmacy, or the pharmacist?
posted by Edible Energy at 3:06 PM on November 15, 2005


And what I'm saying is that regulation typically is aimed at what can't be dispensed rather than at what must be dispensed. Meaning the other option about who should do the regulating is: the market.
posted by scheptech at 3:12 PM on November 15, 2005


scheptech, so you wouldn't be opposed to Target requiring their pharmacists to dispense Plan B to those with a prescription for it?
posted by Edible Energy at 3:18 PM on November 15, 2005


dindin: that's not really the same situation. There are scientific studies showing cigarettes are damaging to your health. There are no scientific studies showing that Plan B contraception is damaging to your immortal soul.
posted by notmydesk at 3:43 PM on November 15, 2005


Taking two scenarios: pharmacist as employee and pharmacist as business owner.

Target, in their case, is the policy-making "pharmacist", the people doing the dispensing are employees. If Target can find enough employees to avoid the problem, fine, it's a solution. If not, they should be free to seek other solutions which may involve not requiring their employees to do things they don't want to and which potentially open them up to civil rights issues with the people they're providing employment to. It's up to them to manage all this and they should have the latitude to do so.

There are also individual pharmacists who work for themselves, run their own businesses. Again these people should have the freedom to sell to whatever they figure their market is, and to not sell anything they don't want to for whatever reason. There's no way government should be in the business of forcing products into the retail channel.
posted by scheptech at 3:54 PM on November 15, 2005


I don't think you should be simultaneously boycotting Target for allowing pharmacists to refuse emergency contraceptives on religious grounds AND for refusing to allow a Pro-life group to solicit donations on their premises.

Oh, I'm not really boycotting them. I was just offering suggestions for those who'd like to, for one reason or another. Boycotting can be fun! It makes you think you're important without affecting any significant change. Kind of like posting here. ;)

I don't shop at Target b/c I live in San Francisco, and there is no Target. When I visit my parents in Louisville, I will occasionally stop there for ... hmm. Maybe I haven't been to one in a while. When I was a candy freak, the days after Easter and Halloween were holiday weeks at Target. $1 for 3 lbs of candy!
posted by mrgrimm at 4:03 PM on November 15, 2005


they should be free to seek other solutions which may involve not requiring their employees to do things they don't want to
so a possible "solution" is to allow their employees to refuse to dispense the prescription? This is not a solution, this is exactly the problem restated. You also did not answer my question, so I'll restate it:
This action against Target is aimed at convincing Target to require that their employees dispense this prescription. Is their anything wrong with Target mandating that? Isn't it within their rights as an employer to require this?
posted by Edible Energy at 4:08 PM on November 15, 2005


Could he refuse birth control pills as promoting sin?
posted by George_Spiggott at 1:59 PM EST

What's next? Letting pharmacists refuse to dispense birth control?
posted by teece at 2:45 PM EST

That ship has sailed.

From the first link:
While some pharmacists cite religious reasons for opposing birth control, others believe life begins with fertilization and see hormonal contraceptives, and the morning-after pill in particular, as capable of causing an abortion.

"I refuse to dispense a drug with a significant mechanism to stop human life," says Karen Brauer, president of the 1,500-member Pharmacists for Life International. Brauer was fired in 1996 after she refused to refill a prescription for birth-control pills at a Kmart in the Cincinnati suburb of Delhi Township.

posted by Secret Life of Gravy at 4:10 PM on November 15, 2005


neko: I would love to be a fly on the wall when a Target pharmacist refuses to fill a Plan B prescription -- how will he or she do so without making reference to religious beliefs?

Me, too, neko. Not only would I love to see these pharmacists try to wiggle out of filling the scrip without making reference to religion, but one even refused to give the written prescription back or transfer it to another pharmacy (see here and here)...I'm sure he's not the only one who's done that, either.

The free market "well, just go to another pharmacy" argument fails when something like that happens -- the woman in question even came back with the police & he still wouldn't fill it. A managing pharmacist filled it several DAYS later...
posted by bitter-girl.com at 4:13 PM on November 15, 2005


scheptech: Exactly.
posted by Captaintripps at 4:47 PM on November 15, 2005


Is their anything wrong with Target mandating that?

No.

Isn't it within their rights as an employer to require this?

Sure and if that works for 'em, fine. However, as a practical matter they are responsible for finding employees willing to do it and without compromising their employee's civil rights in the process.

Let's say they can't find a qualified employee willing to dispense morning after pills at a salary they want to pay. And I volunteer to move there and do the job for $250,000 per year. Should they be forced to accept my offer? What if they chose to close the pharmacy instead? Should the goverment force them to continue operations?

Btw, we've developed a range of scenrios here. A pharmicist who choses not to stock morning after pills is well within their rights imo and what I am actually talking about. The status of one who has the pills but refuses to dispense them based on some sort of judgement call is a mystery to me, who knows, a legal grey area? A pharmacist who takes things a big step further and holds onto a script and refusing to pass it along to someone else is another case altogether and doubtless breaking already-existing law.
posted by scheptech at 4:55 PM on November 15, 2005


"Whose civil rights are more important? Pharmacists' or customers'?"

This is another one of those false dichotomies I keep hearing so much about.
posted by Eideteker at 5:09 PM on November 15, 2005


Gilliard's NewsBlog: Do your fucking job and hand out the pills (featuring this caption: Here at Target we offer stylish, low cost goods and vagina control)
posted by amberglow at 5:35 PM on November 15, 2005


So what are they going to do about customers taking Accutane for acne that could also cause birth defects should a person taking that drug become pregnant. Are they gonna turn away that customer away, if they also want to take birth control pills?

You know where all this is leading to....eliminate all forms of birth control because all of it is "against God's will".
posted by SweetIceT at 6:00 PM on November 15, 2005


SweetIceT, they'll just tell em to stop taking Accutane I guess.
posted by Edible Energy at 6:50 PM on November 15, 2005


So, what if your doc prescribes the heavy-duty, non-OTC meds for a badass yeast infection?

"I can't fill this prescription. Clearly, you're a sexually active hussy, and you deserve all the itching you get. It's God's will, y'know..."

On a more-related-to-this-topic note: my boyfriend said tonight he'd feel sorry for any pharmacist that tried to pull this crap on me. I've got what they call a "theatre voice" (read: loud). People in the next county'd be hearing my opinion on the matter...
posted by bitter-girl.com at 7:34 PM on November 15, 2005


So.. uhm.. what does a pharmacist do that can't be done by a computer and an automatic drug dispensing machine?

The Pharmacists were hired to do a job, and they refused to do the job in some instances. I've also been hired to do a job, and I also can refuse to do things asked of me on ethical grounds. If I do, there's a chance my employer will fire me and find someone else to do the job, or hire an additional person who will do what's asked of them.

Hmm.. That's actually kind of interesting. Why are ethical grounds treated differently from religious grounds?

...And then there's pharmacists that refuse to fill standard birth control pill prescriptions. Don't they realize that they're used for things other than birth control, like endometriosis?
posted by Laen at 8:19 PM on November 15, 2005


If it's any consolation, it's not just the US.

In the UK, any registered pharmacist can refuse to sell emergency contraception.
"the Royal Pharmaceutical Society's Code of Ethics does allow a pharmacist to refuse to sell an item on religious grounds and they must advise the patient of alternative sources for the service."
I'm surprised there hasn't been a huge uproar about this problem in the allegedly too-secular UK.
posted by badlydubbedboy at 3:13 AM on November 16, 2005


So.. uhm.. what does a pharmacist do that can't be done by a computer and an automatic drug dispensing machine?

Talk to patients. Answer questions. Computers aren't very good at answering questions not specifically formulated by computer scientists. If your grandma can barely handle AOL, what makes you think she can deal with Johnny-5 when she goes to get her monthly supply of twelve different pills?

Shit, for all the wolfing that was done about InstyMeds upthread, note this on their website: " A telephone located near the dispenser provides a direct line to a support center staffed by pharmacists and pharmacy technicians 24-hours a day, 7-days a week. This is especially helpful for patients who may have questions about their medications, including when they should be taken, how they should be stored and possible side effects, if any."
posted by Optimus Chyme at 5:59 AM on November 16, 2005


Y'know, I suspect this problem is easily enough settled: post advertising all over the place near the Target store that "outs" this idiotic decision of theirs.

It can be big. It can be direct. It can state flat-out that Target is allowing religion to interfere with the duties of its pharmacists.

The negative publicity will cause a change of policy.

Or if it does not, some competitor will step into the market and fill that role for them. I should think any town that is large enough to host a Target is also large enough to have a second or third pharmacy.

All that it requires is a bit of fighting back.
posted by five fresh fish at 1:31 PM on November 16, 2005


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