May 2005
Why Are Some Pharmicists Refusing Birth Control?
The moral dillema that is leaving women baffled
By Coonoor Behal
Queen City Forum Magazine staff writer
In a 1985 meeting, a female student at one of the oldest Roman Catholic universities in Belgium had the temerity to confront Pope John Paul II about birth control issues. The Pope’s only response to such a daring confrontation from a practicing Catholic?
A kiss on the forehead.
Ten years later, women are still getting the big kiss-off from their male leaders when it comes to their reproductive and health rights – and never more so than in this country.
The recent trend on the front for the so-called “culture of life” war on citizens’ rights is to protect pharmacists who deny patients their medication based on moral, religious, or ethical beliefs. Not surprisingly, it’s not Viagra that is being refused but rather women’s medications such as birth control and emergency contraception (EC). Men are free to do with their bodies what they wish, but a woman’s right to control the effects of their artificially randy male partners is under attack.
Accounts of women of all ages in all parts of the country who have been denied what their doctors ordered are surfacing at a rapid pace these days. By far the most egregious instances involve pharmacists who have tacked on self-righteous lectures to the women or have refused the necessary treatment for rape victims. Some have even refused to return prescriptions to the patient.
The movement towards protecting pharmacists with so-called “refusal clauses” (those on the right with different dictionaries have termed them “conscience” clauses) is on the march in state legislatures across the country. The proposed state bills vary from mandating pharmacists to fill any and all prescriptions; to allowing refusals as long as the pharmacist arranges for the patient to get their medicine through other means; to permitting health care professionals to deny any services based on any criteria.
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Invoking such refusal clauses is nothing new for health care providers. Immediately after Roe v. Wade was decided, states began passing clauses exempting doctors and other providers from performing abortion-related services if they so chose. Such clauses also protect medical school students from participating in training sessions on abortions if it is against their beliefs. The American Pharmaceutical Association has long supported a pharmacist’s right to refrain from filling a prescription as long as they make other arrangements for the patient to be served.
Refusal clauses are old hat by this point. It is the debate on who has the better moral claim to something -- right to refuse versus right to legal healthcare -- that is disturbingly new. |
Karen Brauer, fired from a Delhi, OH Kmart pharmacy for refusing to dispense birth control and current president of Pharmacists for Life condemns “the use of medication to stop human life” and says dispensing such medications “violates the Hippocratic Oath that medical practitioners should do no harm.” Her reasoning is simply false. The medically accepted definition for when life begins is at implantation. Brauerites claim birth control violates their beliefs because it might prevent fertilized eggs from being implanted in the uterus – they believe life begins at fertilization. If these overly conscientious pharmacists are so intent on strictly following the tenets of medical practice, shouldn’t they also stand by the professional standard that says birth control does not, in fact, stop human life? The invocation of the Hippocratic Oath is also specious: the oath says nothing about inflicting harm. The oath does, however, explicitly stress sympathy and understanding, not playing God, and taking into consideration how afflictions may affect a person’s family and economic stability. Legally aiding a woman in preventing an unwanted pregnancy involves all these accepted standards for practice.
Though I respect pharmacists’ roles as intermediaries that screen for physicians’ mistakes, they are, in the end, essentially working in a service industry. Their job is to serve customers just as it is the duty of the checkout girl in the same drugstore to sell condoms to a man if he brings them to the register. The Pharmacists Code of Ethics is quite heavy on these professional obligations of a pharmacist and doesn’t include much room for ideological ambiguity in fulfilling those service responsibilities. These are established professional and business standards that have been made known to nascent pharmacists; it is pretty well advertised what you are getting into. You’re not going to find many Muslims applying for wait staff jobs in a chophouse. So why should a person who has severe personal qualms about required professional duties have a right to amend those duties to their own specifications?
Brauer’s lawsuit against Kmart, for one, is based on claims of employee discrimination. But it goes without saying that employees don’t have unlimited rights. When you go to a company you are first subscribing to the policies of that company or you don’t work there. There are, of course, protected classes within the Equal Employment Opportunity standards such as sex, age, race, and of course, the class afflicting this debate: religion. But the stipulations regarding an employee’s right to actively exercise religion on the job are limited: “ An employer is not required to accommodate an employee's religious beliefs and practices if doing so would impose an undue hardship on the employers' legitimate business interests.” I think most employers would see callous refusal to serve customers as hardship on their business interests. As lawyer Phyllis Bossin points out, “We have employment at will in this country. Not everyone is in a protected class and not following the rules of the employer does not fall into one. You don’t have the right to do whatever you want under those state protections”
The ruling principle must be one of ethics and not morals. Those so violently against the “activist judges” who slammed down the Terry Schiavo bill seem more than willing to back up activist pharmacists who could be responsible for women existing in an equally undesirable state: unwanted pregnancy.
And just how thin will these refusal clauses be allowed to stretch? Will a pharmacist be allowed to refuse EC to a woman with cancer? Will an AIDS patient be denied more effective medications that come to market? Will our right to benefit from any future medical treatments be obstructed if they resulted from stem cell research? And will the recent popularity of living wills be rendered inconsequential if physicians are allowed to ignore the expressed wishes of a patient?
This debate is ultimately not so much about employee rights or even religion: it is about privacy rights and the irresponsible infringement of them that is taking place in this country every single day. As if measures like The Patriot Act weren’t enough, America can now proudly add the 95% of women using contraception to the list of those being targeted for second-class, unprotected citizenship.
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