Hypothetical: A new drug treatment is developed that suppresses homosexuality. It is made legal. Should a doctor be compelled to prescribe the treatment should someone ask for it, even if he or she feels that it’s a terrible thing to do? Should a doctor be allowed to decline such treatment (with a reference, perhaps, to someone who is willing to do so)? And should a pharmacist, similarly horrified at the treatment, be allowed to decline to stock the medication or sell it?
Hypothetical: A new drug treatment is developed that will gradually make black people look white — reducing the melanin in the skin, unkinking the hair, altering certain facial features, etc. It has minimal ill side effects. Some black people choose to take this medication voluntarily, because they want to “pass” in a prejudiced world. Some white parents adopting black babies choose to use it on them, to make them “more like us.” Should a physician be compelled to write a prescription for this drug treatment? Should an insurance company be required to pay for it if a doctor okays it as essential to the emotional health of the recipient? Should a pharmacist have to dispense those pills, even if they think it is a sick, twisted, racist thing to do to a child?
A parallel story has come back to the headlines — parallel in terms of questioning what role the moral beliefs of a medical caregiver can or should play in the legal treatment that can be demanded of them.
For a year, Julee Lacey stopped in a CVS pharmacy near her home in a Fort Worth suburb to get refills of her birth-control pills. Then one day last March, the pharmacist refused to fill Lacey’s prescription because she did not believe in birth control.
“I was shocked,” says Lacey, 33, who was not able to get her prescription until the next day and missed taking one of her pills. “Their job is not to regulate what people take or do. It’s just to fill the prescription that was ordered by my physician.”
Several states have — and other are considering — laws to allow medical care providers, including pharmacists, to do just that. It’s not couched, of course, as “regulating what people take or do.” Just the opposite, in fact, as it’s ostensibly to prevent doctors and pharmacists from being “regulated to do” something that they morally object to.
The American Pharmacists Association, with 50,000 members, has a policy that says druggists can refuse to fill prescriptions if they object on moral grounds, but they must make arrangements so a patient can still get the pills. Yet some pharmacists have refused to hand the prescription to another druggist to fill.
In Madison, Wis., a pharmacist faces possible disciplinary action by the state pharmacy board for refusing to transfer a woman’s prescription for birth-control pills to another druggist or to give the slip back to her. He would not refill it because of his religious views.
And I can see the argument there, too. If I refuse to sell someone a gun because I think he’s going to shoot his wife with it, it would be irresponsible — immoral, in fact — for me to give him directions to another gun shop that might be more accomodating.
The situation hasn’t gotten any less thorny since I last tackled it in April. That hasn’t kept some from treating it all as a simplistic battle of Good vs Evil — with the role of Evil being played by … well …
US druggists refuse to give out birth control because of “moral values”
A number of states have enacted (or may soon pass) laws that allow pharmacists to refuse to dispense birth control if their beliefs (read: fundamentalist Christian dogma) dictate otherwise. […] Just in time for next season’s hotly anticipated coathanger abortion fad. Welcome to Jesusistan.
It’s easy to see this all as some horrific Right Wing Bushie Jerry Falwell Conservative Christian Plot — and I’d even be willing to suggest that that there are those in the Christian Right who see this as a way to backdoor their way into preventing certain things they dislike.
But it remains a more powerful and nuanced issue than that. If I object to providing you a service on moral grounds, under what circumstances can I be forced by the state to do so anyway? And a straightforward cuts both ways — whether it’s crazy fundie pharmacists refusing to dispense birth control pills, or wise and humanistic pharmacists refusing to dispense “straight” or “white” pills in my hypothetical.
The danger, of course, is that this may mean that folks are unable to get treatment that they want, and are legally allowed to receive, if all the pharmacies in an area (especially a smaller, rural area) choose to not provide such a service. We’ve seen something similar happen with the increasing difficulty of women being able to find abortion services (though nobody has, on the flip side, yet argued that doctors should be compelled to learn how to perform abortions and provide them to anyone who asks).
I still don’t know what the answer is. But I’m pretty certain that we’re not going to get to it by simply treating it all as some “Jesusistan” plot.
Part of the problem, as I see it, is that only Christians (and some minority religions) in this country are allowed to be “moral”. If an atheist were to do such things there would be a great hew and cry for their blood.
As I said before “Care for all, Treat all”. If your “morals” are going to cloud your judgment, and not allow you to do your job, then you need to find another job. The hypotheticals for this can extend to all sorts of things.
“As a member of the KKK you hate dark-skinned people and Catholics, should you be forced to Serve/Save/Help/Hire/Treat/ one.”
And on, and on, and on.
In the hypotheticals you listed, the answer is going to be yes.
I am still unable to find a reference to oaths for pharmacists. I see references to them for some states, but not for all of them. And since the Colorado Lege last year passed a law saying it was alright not to treat people if you thought that they might be gay, I would suspect that we have this law as well.
BTW: You’re #9 on google for Colorado Pharmacist oaths.
Part of the problem, as I see it, is that only Christians (and some minority religions) in this country are allowed to be “moral”. If an atheist were to do such things there would be a great hew and cry for their blood.
And that would be equally unjust. I’m not going to dispute your point, but I don’t know that it resolves the question.
As I said before “Care for all, Treat all”. If your “morals” are going to cloud your judgment, and not allow you to do your job, then you need to find another job. The hypotheticals for this can extend to all sorts of things. “As a member of the KKK you hate dark-skinned people and Catholics, should you be forced to Serve/Save/Help/Hire/Treat/ one.” And on, and on, and on.
Oh, I understand the danger in that direction as well. It may be that we need to look at, say, Public Accomodations laws for some guidance here — except that in cases of medical treatment, we’re talking about considerations of life and death (in both directions).
In the hypotheticals you listed, the answer is going to be yes.
Yes, the insurance company/doctor/pharmacist must be compelled to provide requested treatment, even if they find it morally repugnant? I’m not sure I can agree — but I’m not sure I can disagree, either.
Yes, you can say, “Well, if it’s going to be that big a deal, you should find another job.” And, ultimately, that may be what we have to ask of people — but that’s not a trivial consideration, either (certainly I think we would societally have objections or concerns to people being driven from other jobs because their morality prevented them from staying there).
Ah, but a drug that will make you thinner, even though you have to take it for the rest of your life, that’s nothing but good. Should a pudgy pharmacist have to prescibe such a drug, or maybe he should have to take it first?
And by the way, pharmacists distribute drugs, they don’t prescribe them. Most drug stores have mutiple druggists and it shouldn’t be difficult to have one in each shop that can fill controversial orders. Or maybe a chain should market the desire to distribute without moral judgement?
I don’t know — it might be difficult for a chain to, for example, not hire a pharmacist because they’d already met their quota of folks that don’t have religious objections to XYZ. That sounds like discrimination on the basis of religious belief, also a no-no.
The biggest problem is not in some place like, say, San Diego or Denver, where one could relatively easily find a pharmacy not manned by folks who object to whatever you’re getting an Rx for. It’s more of a problem in Mentone, or East South Fork River to Nowhere, where the pharmacy might be the only one within 50 miles.
I wonder if a solution doesn’t lie in an extension of Mary’s suggestion. Rather than relying on the diversity of pharmacists in each store or town, we could allow people to have their prescriptions filled by mail or over the internet, thereby giving everyone access to the pharmacists of the big cities. Then if a pharmacist was willing to forego the income he would lose to the mail-order pharmacists, he could implement whatever policy he wanted without harming the people in his town who wanted or needed drugs he was not willing to provide.
I don’t know enough about employment law to know whether or not this would work, but it seems to me that companies that wanted to market themselves in the way Mary suggests could avoid any legal trouble for discrimination in hiring decisions by insisting that the job description for all pharmacists in that company demanded that they dispense any presription presented to them. Pharmacists who had a problem with this would either turn down the job, or they would be fired for non-performance. I think this is non-discriminatory, but the law on such things is probably more complicated than I imagine.
I don’t know. If I wrote a job description saying, “Only those individuals willing to convert to Catholicism and attend Sunday Mass need apply,” the fact that folks know the requirement ahead of time doesn’t make it discrminatory. (Unless I’m hiring a priest, that is.)
I don’t know how prevalent Internet and mail order pharmacy access is (in terms of insurance coverage). It’s certainly how Margie and I do our refills. It might be more problematic for folks who need a new prescription, or need/want one quickly.
How about requiring pharmacies that refuse to dispense legal things on moral grounds to post that fact prominently at the pharmacy window, on the outside of the business and on any advertisements?
Hmmmm. That might work (though it’s not necessarily a pharmacy, per se, but pharmacists, which are not always the same thing).
That wouldn’t necessarily help with the question of availability — if the only pharmacy in town doesn’t sell morning after pills, what do you do? On the other hand, as noted above, the same is true of abortion services (or certain abortion procedures), to be regretted, perhaps, but not warrenting legal liability or compulsion.
You’re right that making a requirement up front alone doesn’t keep it from being discriminatory. I was thinking that the job requirement I proposed was not connected to any religion, and was arguably part of what a pharmacist’s job is.
My thinking was by analogy. If a Christian Scientist decided to apply for a job in a hospital or doctor’s office, I do not think it would be discriminatory to refuse to hire them if they said they wanted the job, but they didn’t want to assist with any modern medical procedures because it was contrary to their religious beliefs. It would not be discriminatory because they would effectively be saying they wanted the job but wouldn’t do any of the work. Similarly, I don’t think it would be discriminatory to refuse to hire a pharmacist who said he wanted a job but would not dispense prescriptions that were contrary to his religious beliefs.
I like Randy’s idea; it prompted me to wonder if a pharmacy could be sued for deceptive advertising if they refused to fill certain prescriptions on moral grounds. The idea is that by advertising themselves as a pharmacy, they are claiming that they do what any standard pharmacy will do when in fact they will not since they won’t dispense certain prescriptions.
I am an ardent believer in birth control, but I see no good reason why a pharmacist should be forced to fill a prescription. The buyer of the pills has rights, but so does the pharmacist.
And, there are always other pharmacists out there. Tons of them. Jillions of them. I say, swallow your indignation and give your business to the one down the street. Jeez.
Not everyone has another pharmacy “down the street.” Not everyone can easily or quickly get to another pharmacy. And if this becomes a widespread matter (which, thus far, it does not appear to be), that could become even more the case.
That, at least, is the concern. I agree, though, that forcing a pharmacist to fill a Rx just feels wrong.
Now, as David notes, one could argue for a case of legitmate religious discrimination, where an applicant’s religious beliefs up front prevented him from performing the basic duties of the job. I think there’s a difference between being unwilling to perform any of a job, and being unwilling to perform a small fraction of it.
And, again, I can conceive of situations where some of the folks objecting to pharmacists acting on their consciences would laud other folks as heroes and brave for doing so — if it was in a moral cause that they believed in. (And I say that as someone, too, who has no moral problems with birth control in general.)