The Illinois plan for Plan B and reluctant pharmacists
If a proposed settlement in Illinois is approved, pharmacists in the state who oppose filing Plan B or other emergency contraceptive prescriptions on religious grounds would not be forced to do so. The settlement comes as a response to a series of lawsuits filed by disgruntled pharmacists against Wal-Mart and Walgreens pharmacies as well as the state of Illinois, complaining of religious discrimination.
Under a law passed in the state two years ago, pharmacists have a duty to stock and fill any lawful prescription for contraceptive. The rule was passed in order to ensure women would have immediate access to the “morning-after” pill, therefore avoiding the need for abortions. Several pharmacists opposed this prescription for religious reasons, claiming that by preventing implantation of a fertilized egg to the uterus, the pill itself acts as an abortion. After refusing to fill patients’ prescriptions for the emergency contraceptives, the pharmacists were subject to disciplinary actions by their respective employers. The resulting lawsuits claim the pharmacists are protected by the First Amendment (free exercise of religion) as well as Title VII (employment discrimination based on religion).
If approved, the settlement would allow an objecting pharmacist to relay the prescription to an off-site pharmacist, who would then process the emergency contraceptive prescription instead. As with all settlements, however, parties on both sides remain unsatisfied. Those who religiously oppose Plan B are still unsatisfied that pharmacies would be required to stock the prescription, even though the pharmacists would no longer be required to dispense it. And proponents of the current law have a right to be concerned with the potential ramifications the settlement may have on patient care. What if, for example, the off-site pharmacist also refused to fill the prescription based on moral grounds?
The implication of this settlement also raises interesting questions about other prescriptions linked with strong religious beliefs. Aside from emergency contraceptives, could the argument similar to ones filed currently against Walgreens and Wal-Mart be stretched to include more traditional forms of birth control? Or taking the slippery-slope, would a pharmacist religiously opposed to premarital sex be justified in denying an unmarried individual a prescription, of, say, Valtrex? Those who worship at the temple of Big Pharma shudder at the thought, but perhaps consumers should also be concerned. Moral judgment, perhaps, is better suited for church than it is the local Walgreens.
-Roopali Malhotra
Earlier on blog.bioethics.net:
+ Federalism and Bioethics -- the Case of Emergency Contraception
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No perhaps, consumers should be concerned. The woman in need of the pill is a much more pressing ethical case than the company who wants to make 50c off the sale.
- by emily on Oct 16, 2007 at 1:13 PM | link
I believe that the Governor made an Executive Order requiring all pharmacies to stock and dispense Plan B right about the time of Katrina, before the protocol went behind-the-counter-without-a-prescription.
The Valtrex example is pretty lame. I've never even heard anyone suggest that unmarried people should suffer their Herpes. I do know lots of people who won't prescribe Viagra to unmarried men, however.
There's no evidence that Plan B acts as an abortifacient and tons of evidence that it doesn't. It's hard to get the word out, though. It seems as though both sides of the abortion debate seem to have so much invested in allowing people to continue to believe that it is an abortifacient. It works, when it works, for the 5 days before ovulation and it may be able to interfere enough with sperm function to prevent fertilization. But it doesn't affect the lining of the uterus or the embryo's ability to grow or implant as far as we can measure.
As to the conscience exemptions -
Every person who can be forced to act against his conscience becomes a person who can be forced to do wrong.
The woman may have a "need" for emergency contraception, but she doesn't have the right to force the action or make a slave of another person. If she's hungry, does she have the right to force a restaurant to feed her or if she's homeless, does she have the right to move into any building?
- by Beverly Nuckols on Oct 16, 2007 at 5:35 PM | link
There's a word for people who reserve their moral behavior for church: "Hypocrite".
- by Laura(southernxyl) on Oct 16, 2007 at 6:08 PM | link
And those who impose their moral choices on others: tyrant and bigot.
- by emily on Oct 17, 2007 at 9:06 AM | link
Seriously, she is 'forcing' the pharmacist to make a legal retail transaction. My vegetarian 7/11 worker sells me bacon, my Catholic doctor prescribes the pill. They make their choices for themselves and provide their professional services to others--repsecting their automony.
On the other hand the pharmacist may be forcing the customer to have an unwanted child and also shaming her in the public area of the shop. I see no equivalency. I assure you women aren't running around aggressively asking for these meds, but chemists are often rather loud in making it difficult to get them--already booming out the required questionaaire in the UK so the whole shop can hear it.
We each make our own moral choices and so long as they are legal, we should have the right to access to our legal options. If a person does not wish to fulfill all legal dispensing duties s/he, like a doctor or teacher, can go into another subfield of the profession. Teachers have to teach all of the curriculum whether they like it or not because we as a society have decided on it, I see no difference.
- by emily on Oct 17, 2007 at 9:16 AM | link
If you are interested in learning more about the lawsuits filed by the pharmacists, two prominant cases from Illinois are Vanderstand v. Wal-Mart Stores, Inc. (federal court) and Morr-Fitz, Inc. v. Blagojevich (state court).
Additionally, Dean Olson, a staff writer for The State Journal-Register, recently published a brief article about this issue which can be found online.
The settlement needs to be approved by the Illinois General Assembly before taking effect. A decision is still pending.
- by Roopali Malhotra on Oct 17, 2007 at 1:41 PM | link
Emily, we force our moral choices on other people all the time. The prisons are full of murderers and thieves and robbers and rapists who see nothing wrong with what they've done. You yourself want to force your moral choices on pharmacists who don't want to provide these drugs.
"On the other hand the pharmacist may be forcing the customer to have an unwanted child ..."
So the customer wants to do what she wants to do without consequences (to herself; her unborn, if any, is on its own), and it's the pharmacist's job to make sure she can. And if she has consequences, it's the pharmacist's fault. That's not a very mature outlook, IMO.
- by Laura(southernxyl) on Oct 17, 2007 at 9:33 PM | link
I can't find the line between Emily and the "tyrant and bigot" she opposes. She's perfectly willing to impose her moral view on the pharmacist.
Years ago I worked with Muslims at a restaurant serving pork. Muslims weren't required to handle pork products, not because we agreed with their view or with what their religion required, but because we respected them enough not to demand that they violate their conscience to keep their job. But the kind of accomodation made by those working dead-end fast-food jobs in red-state America certainly is for some reason beyond the comprehension of our "liberal" friends.
- by Thomas on Oct 18, 2007 at 1:51 AM | link