Pharmacists in Washington State are suing that state over a new regulation that requires them to sell emergency contraception, also known as the “morning-after pill." The state ruled earlier this year that druggists who believe emergency contraceptives are tantamount to abortion cannot stand in the way of a patient's right to the drugs.Sold as “Plan B”, emergency contraception is a high dose of the drug found in many regular birth-control pills. It can lower the risk of pregnancy by as much as 89 percent if taken within 72 hours of unprotected sex. The FDA made the morning-after pill available without prescription to adults last year.
In a lawsuit filed in federal court, a pharmacy owner and two pharmacists say the new rule violates their civil rights by forcing them into choosing between "their livelihoods and their deeply held religious and moral beliefs."
Under the new state rule, pharmacists with personal objections to a drug can opt out by getting a co-worker to fill an order. But that applies only if the patient is able to get the prescription in the same pharmacy visit. Doctors do not have to perform abortions if that violates their personal ethics or moral conscience, and pharmacists are seeking to have the same latitude.
Opponents argue that health care providers should not be allowed to withhold legal treatments and medications based on their own moral beliefs, but must serve the needs of the patients.
At the heart of the debate is the question of when life begins. The pill prevents the fertilized egg from being implanted. For those who believe life begins at fertilization, they wee the pill's effect as ending an innocent life.
Does life begin at conception? Even some who would affirm that it does, say that conception occurs not when the egg in fertilized, but when the fertilized egg is implanted, and see no problem with the pill.
I am not sure what the penalty is for the pharmacists who deny to fill such a prescription; whether it is a fine, loss of license, or imprisonment. It the courts uphold the regulation and force pharmacists to comply, it will be interesting to see how many will risk their careers by exercising a little civil disobedience by fefusing to comply with a law they feel is unjust.
It will be interesting to see what happens if pharmacist exercise their "freedom of choice" in keeping with their own religious convictions. Keep your eyes on this case: I believe the court's ruling will impact "abortion rights" and "religious liberty" cases for years to come.
What do you think? I'd be interested in hearing your comments.
7 comments:
I'm not sure when life begins, but as you mentioned, this pill prevents the egg from being implanted. People have different views on what level of prevention or interruption of that process is religiously acceptable. For instance, the Catholic church condemns the use of contraception during intercourse.
I don't think taking one of these pills is anywhere near the same thing as ending a pregnancy through abortion, but I'm sure there are plenty of people who would disagree with me.
Now, do these pharmacists have a right to deny a legal medicine to their customers? Probably not. They can claim that they are doing it out of religious belief, but I think the government will see the needs of the patient as being more important than their choice to work in an occupation that might cause a conflict with their religion.
Let's say I'm a pacifist... Am I going to work in a gun factory or sell firearms? Even if I did and one of those guns was used to kill someone, would I be responsible or would the shooter?
Are the pharmacists responsible when a person overdoses on prescription medication and dies? If these pharmacists are going to be held responsible by God for selling a drug that people might use in an "evil" way, then they should also stop selling Lortab and Valium. One has to wonder what these same pharmacists might do if marijuana were made legal for medicinal purposes.
I'd be interested in getting Caroline's opinion on this, since she's going into the medical field.
Tough topic, but enjoyable to discuss! :)
Hi there! Brian personally directed me to this post. Interesting stuff here! Thanks for leading me here, Brian!
First of all, I guess I don't entirely agree that the heart of the matter is when life begins. I think the heart of the matter is the right (or not) of the pharmacists to adhere to their personal beliefs, whatever they may be.
Regardless, here goes my answer. I'm a second semester nursing student, and honestly, a few months ago I think my answer to this question would have been different. I used to believe that it was highly unethical to deny someone medications based on the pharmacist's moral standards. I thought it was horrendous, in fact. But in the course of a few nursing school classes, I've actually changed my mind, and here's how.
I recently read a book entitled "The Spirit Catches You and You Fall Down" (you can read a pretty in-depth review on my blog.) It was an absolute eye-opener and a huge culture lesson for me. A really fantastic book, even to someone not in health care. I basically re-examined all my beliefs on culture and here's what I came up with: the down and dirty is that it all comes down to respect. I may not agree with the way medicine is being practiced, but if it's based entirely on the wishes of the patient (who has been adequately informed,) then there can be no alternative.
I recently posted on the blog of a mother who was lambasting women who choose to have their babies in hospitals (this particular woman had a midwife-assisted home birth.) I posted a somewhat tersely-worded comment (although I did try to keep it fair) because I felt that it was not her place to judge women who made different choices than her. One choice is not "better" than another. They are merely different. Medically, yes, some procedures are obviously much riskier and can even be avoided, for example, an elective c-section. But if the mother has been informed of said risks, and still chooses the c-section over a vaginal delivery, who are we to judge? Medical decisions are personal and extremely complex, and it's not for us to decide whether they are right or wrong. My job as a nurse will be to advocate for those patient choices, and see to it that they are upheld to the highest standard.
I think I feel the same way about these pharmacists. I go to school with a woman who is a Seventh Day Adventist, and I believe there are some procedures she refuses to do, based on her religion. (As it is now, we have classes on Saturday and she is not allowed to attend, so the school worked out a different schedule for her.) I respect her beliefs as much as I respect those of my patients, as long as she finds someone else to do those procedures. Same goes for a pharmacist. No way should they be forced to give out birth control if it's against their beliefs, but I'll be damned if they don't find someone to do it in replace of them. Just as we would not be judging them, I would expect them to keep their judgments out of their work, as well.
But it's still a sticky situation, huh?
I might just link to this post on my page, if you don't mind! What a great discussion topic!
Caroline
Inrepair,
Thanks for your comments! I like the analogy of the pacifist in the gun factory :) "One has to wonder what these same pharmacists might do if marijuana were made legal for medicinal purposes."-- It would be interesting to see how some pharmacists would react to that.
Caroline,
Welcome! I love YOUR blog, by the way.
Good point about respecting the patient AND the pharmacist's wishes. I also think the same rules that apply to doctors should apply to nurses, pharmacists--anyone involved in patient care.
You are more than welcome to link this to your page--I hope it generates a lively discussion among your fellow nursing students.
JimT
I just found a really interesting article dealing with this subject.
http://www.indypendent.org/?p=1244
The following sections really stood out to me.
"Only four —California, Missouri, New Jersey and West Virginia — have laws expressly requiring pharmacies to honor all legally-written prescriptions. In these states, if an individual pharmacist has a moral objection to filling a particular order, he or she is mandated to find another pharmacist to do the job."
I agree wholeheartedly.
"According to Lisa Stone, Executive Director of The Northwest Women’s Law Center, a 30-year-old social justice legal firm based in Seattle, residents have experienced numerous refusals to honor prescriptions not only for contraception, but for antibiotics, syringes and other prescribed medications. “In one case a woman who had had an abortion went to a pharmacy with a prescription for antibiotics, typical post-abortion care,” Stone begins. “When the pharmacists saw the name of the clinic that had issued the prescription, they refused to fill it. In another case a man who was diabetic had a prescription for syringes but because he had a lot of tattoos the pharmacist thought he was a drug user and would not honor it.” In other incidents, women have been denied Plan B, oral contraceptives and Mifepristone, a drug that is routinely taken before fibroid surgery, because it can also be used to end unwanted pregnancies."
I find these actions revolting, no matter what the religious beliefs of the involved pharmacist might be.
This is much different than protests at abortion clinics.
The matter here is the concept of personal liberty. What has more weight: my religious convictions or my allegiance to state. Is this the first step in forcing the faithful to choose? I don't know, but it scares the crap out of me my friend.
Inrepair,
Thanks for your comments. It's scary when pharmacist "play God" so to speak even overriding the doctor who wrote the prescription.
Was,
I hear you. I'd like to see what the penalty is for pharacists who do not comply. Right now they can "opt out" and get a colleague to fill the prescription. What if a drug store has a handful of pharmacists and they all have the same beliefs?
JimT
"What if a drug store has a handful of pharmacists and they all have the same beliefs? "
JimT,
While that scenario is very unlikely, it does make me wonder if a pharmacy has the legal right to ask a pharmacist about his/her religious beliefs (as they pertain to medicine) during the hiring process. I would guess not.
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