No Birth Control for You!

[Fantasea]

Originally Posted by Fantasea
The pharmacist exercised the right to free expression of her belief. The employer backed her up.

Irrespective of your unsubstantiated disagreement, the first Amendment triumphed.

:roll: A pharmacist's ability to fill a prescription is not a "free expression of belief".

The pharmacist in question believed that it is. How can you disagree with her?

What is the difference between the action of the pharmacist and the permitted action of a nurse in a public hospital where abortions are performed to refuse to participate in those procedures?

 

[shuamort]

The pharmacist in question believed that it is. How can you disagree with her?

Oh, many ways, mostly with words and logic.

What is the difference between the action of the pharmacist and the permitted action of a nurse in a public hospital where abortions are performed to refuse to participate in those procedures?

There's no difference. Never said there was one either.

 

[vandree]

Irrespective of your unsubstantiated disagreement, the first Amendment triumphed.

How?

Why should the pharmacist impose his/her beliefs on someone else? If he/she does not believe in birth control or whatever, that's fine, he/she doesn't have to use it, (noone is forcing him/her to use it), so why should the pharmacist impose his/her views on someone else? Birth control after all is legal.

I understand your point, but nothing in your post removes a pharmacy from the realm of private business.

My mom is a pharmacist and owns her own pharmacy in Italy, but the government regulates all pharmacies, so I kind of assumed it was the same thing here

 

[walrus]

How?

Why should the pharmacist impose his/her beliefs on someone else? If he/she does not believe in birth control or whatever, that's fine, he/she doesn't have to use it, (noone is forcing him/her to use it), so why should the pharmacist impose his/her views on someone else? Birth control after all is legal.

Refusing to fill a prescription is not an imposition of one's beliefs onto another. The pharmacist did not in any way suggest that the customer must agree with her or must change her views. As I said in an earlier post, Target made a moral decision to quit selling firearms and ammuntion. Have they imposed their beliefs on me? Do I have a first (or second) ammendmant bone to pick with them? Guns after all are legal.

What is the difference between the action of the pharmacist and the permitted action of a nurse in a public hospital where abortions are performed to refuse to participate in those procedures?

There's no difference. Never said there was one either.

By this do you mean you believe a doctor or nurse does not have the right to abstain from a procedure based on moral beliefs? If you believe that we are so far apart on our concepts of personal freedom that the gulf may be unbridgeable. By this logic, by entering a profession you are therefore bound to perform ANY task that a customer wants within the bounds of that profession regardless of your beliefs about it's efficacy, necessity, or moral value. That is really scary.

Here a a couple of scenarios for some of you folks to chew over:

ABC drug company invents a great new drug to prevent menstrual cramping. However, in order to develop this drug, ABC drug company was forced to test it on adorable bunnies, puppies, and kittens by sticking red-hot knitting needles into their eyes. Mrs. X is a pharmacist and a card carrying member of PETA. She feels that the way in which the drug was developed is immoral and she feels it is her right as an American and a business owner to refuse to carry this drug. Can I sue?

Same scenario, but Mrs. X determines that the drug is produced by four-year old Malaysian children handcuffed to a table. Can she refuse to sell it?

Mrs. X is also a Hindu, and another new drug was developed using bovine enzymes (which is contrary to her religious beliefs). Can she refuse to sell it?

Mrs. X is a Democrat, and ABC drug company is owned in total by the Bush family. Can she refuse to sell it?

Some studies have shown that drug X is addictive, causes warts, and gas with oily discharge, however the FDA has so far not removed it from the market. Can Mrs. X refuse to fill the prescription because it is her personal belief (based on her education and experience) that the drug is not safe?

Mrs. X's rather strange religious beliefs include a proscription against small, purple pills. Nexium is a small purple pill, which comes in both over-the-counter and prescription strengths. Can she refuse to sell it? Does it make any difference whether it is sold by prescription or over-the-counter?

My doctor believes circumcision is unnecessary mutilation, however, I want my son circumcised. By shuamort's logic, I can force him to perform the procedure, can't I? Another doctor scenario - most doctors won't perform sterilization procedures on anyone under 30. Why can't I force my doctor to do this, after all - it is simply his personal belief that a person under 30 is not capable of deciding for sterilization.

Do you see the slippery slope you are descending on? I hope some people realize that their fairly small political agenda is crapping all over the much larger issue of personal freedom and freedom within one's private business.

One more thing that might clarify where I am coming from in this. I am in no way, shape, or form against birth control. An Ortho-Evera (sp?) patch resides on my wife's firm butt at this very moment. The fact that it involves birth control means nothing to me. It could be any drug, and I would still support a private businesspersons right to decide which products they will or will not carry. So quit trying to convince me that there is nothing wrong with birth control - I already wholeheartedly agree.

 

[walrus]

I hate to double post, but in reading over the thread I saw something else I had to comment on. We seem to still be stuck on whether this is permitted under the pharmacist's ethical code. I say again, it does not matter. The original question was whether statutory law should be changed to force pharmacists to fill all prescriptions. As far as I'm concerned, the governing board of pharmacists (private individuals creating regulations for private individuals) can write any regulation they want, and as long as that regulation meets the muster required within that body. My objection is the intervention of the heavy hand of government into a situation better handled by the people within that profession. If this behaviour we have been discussing violates the ethics code, then I hope the board sanctions those involved. If it does not, and enough pharmacists within that board want a regulation such as we have been discussing -I have no problem with that. I never have a problem with a private board of professionals meeting to regulate their own industry.

 

[shuamort]

By this do you mean you believe a doctor or nurse does not have the right to abstain from a procedure based on moral beliefs? If you believe that we are so far apart on our concepts of personal freedom that the gulf may be unbridgeable. By this logic, by entering a profession you are therefore bound to perform ANY task that a customer wants within the bounds of that profession regardless of your beliefs about it's efficacy, necessity, or moral value. That is really scary.

They can abstain all the way to unemployment if they wish. An employer should not be forced to employ a person who does not fulfill their job duties. If the employee finds their employer's policies to be morally reprehensible for whatever reason, they are allowed to quit their job and move to another company that would find that acceptable. Should a State Board find that the pharmicist, for instance, isn't performing their job per the State's guidelines, they would be allowed to fine or even revoke the pharmacist's license. That's their discretion as well.

 

[walrus]

I realize it is helpful to your viewpoint to continue making the pharmacist/doctor in question an employee. Unfortunately (for your case) that is often not the case. Most pharmacists and the great majority of doctors are self-employed. I agree, if my employee does not perform his/her job the way I want them to - I want the ability to fire them. Whether an employer has the right to terminate an employee who does not fill the job as they would like is not the issue. I understand you would like to make it the issue, as that is an easier case to argue. I don't think you will find very many true conservatives who disagree with an employers right to terminate an employee for cause. But, for the sake of this argument, let's assume that the person is self-employed (I know it's a stretch, and very harmful to your argument, but just humour me). Are you still going to suggest that you have the right to dictate what a private businessOWNER chooses to stock or not stock in their privately OWNED store?

By the way, I see you jumped on the easiest question I posited in my post - care to try any of my other points? I am particulary interested to hear your (hopefully) consistent opinion on the scenarios I presented.

 

[vandree]

Some background on the law:

Previous to 1998, no state board of pharmacy had adopted a conscious clause in the pharmacy laws. On March 13, 1998, South Dakota became the first state to adopt a conscience clause, which specifically addresses pharmacist liability should the decision be made to refuse to dispense a prescription in one of three specific circumstances. Missouri has introduced House Bill 1183, which is pending approval. In both instances, the conscience clause was introduced with wording that specifically stated that a pharmacist could refuse to fill a prescription based on ethical, moral or religious beliefs. The South Dakota bill, House Bill 1244, was reworded with the original language referring to conscientious objection replaced with three specific situations of when a pharmacist can refuse to dispense. A pharmacist can refuse to dispense if there is reason to be that the medication will be used to: 1) Cause an abortion, 2) Destroy an unborn child as defined by law, 3) Cause the death of any person by any means of an assisted suicide, euthanasia, or mercy killing. The bill protects the pharmacist from claims for damages, and disciplinary, recriminatory, and discriminatory action as a result of refusing to dispense under these circumstances.4

If the decision to refuse to dispense is made, what legal protection is afforded?

Numerous states have specified that it is the pharmacist's duty to refuse to dispense based on professional judgement. This is supported by the Drug Enforcement Administration rule in the Code of Federal Regulations that states that a pharmacist has violated the law if a prescription is filled that is for a use that is not in the ordinary course of treatment.14 This does not address the issue of exercising moral or ethical judgement.

The issues of the right to refuse to participate and protection of participants and non-participants in abortion have been discussed and are included in abortion laws enacted in many states. These discussions and laws pertain to surgical abortion, and do not mention pharmacists because pharmacists were not traditionally involved in the surgical abortion issue. With increased prescribing of the morning after pill and more legislation to legalize abortifacients, pharmacists are now involved in the abortion issue. Under the surgical abortion laws, nurses and other support personnel are covered under the blanket of protection afforded physicians who participate and those that refuse to participate. Will pharmacists be included under the same blanket of protection? Those pharmacists that work in clinics and hospitals may, but those that are independent from the clinic or hospital may not.

South Dakota is the only state that has adopted a conscience clause in its pharmacy act. Presumably, only pharmacists in South Dakota who refuse to dispense based on personal beliefs will be protected by law. On the other hand, there are no states that have mandated that a pharmacist must dispense a prescription. Generally, as long as a pharmacist acts in good faith and people who need medications get them, they will not face disciplinary actions. This means that if a pharmacist does not morally agree with the course of treatment, there is a need to refer the patient to another pharmacist. There may be pharmacists that feel that the act of referring makes them a participant in a procedure that they are morally against. It would appear that this is where a patient or employer would have the most leverage legally. Pharmacists have a duty to provide access to drugs to people who need them. If there is a technical problem with a prescription, or if the pharmacist must make a professional judgement to refuse to dispense, it is the expectation that the physician be contacted. The same applies when a pharmacist is faced with making a moral decision. If nothing else, the physician should be contacted; preferably, the pharmacist will refer the

patient to another pharmacist.

http://www.nm-pharmacy.com/body_rights.htm

 

[walrus]

Some background on the law:

It was very informative, and I appreciate your posting it, but I didn't see any actual law in the quote. There are a few prospective laws, and some references to laws that do not cover the issue (DEA regs covering misuse of a prescription), and some discussion of regulations enacted by state pharmacy boards (see previous posts on this) but nothing that affects the legality of this issue.

Aside from that, even if there was a specific law against this, I would oppose it as an unjust and unconstitutional law. Just because a law exists does not make it just. Hey, I live in a state which until very recently outlawed oral sex.

Previous to 1998, no state board of pharmacy had adopted a conscious clause in the pharmacy laws.... The bill protects the pharmacist from claims for damages, and disciplinary, recriminatory, and discriminatory action as a result of refusing to dispense under these circumstances.

I refer to the entire paragraph, but I omitted most of it for brevity. This section seems to indicate that most state pharmacy boards agree with me; in that they wish to reserve for themselves the right to control how they prescribe drugs.

If the decision to refuse to dispense is made, what legal protection is afforded?

What legal protection should be afforded? As I have previously said, I believe the pharmacist does have a responsibilty to transfer the RX to another pharmacist but barring that what protection do you need against a tradesperson having whatever you require in stock? What if the pharmacist just happens to be out of your prescription? Can you sue them for any damages resulting in their lack of stock?

The issues of the right to refuse to participate and protection of participants and non-participants in abortion have been discussed and are included in abortion laws enacted in many states. These discussions and laws pertain to surgical abortion, and do not mention pharmacists because pharmacists were not traditionally involved in the surgical abortion issue. With increased prescribing of the morning after pill and more legislation to legalize abortifacients, pharmacists are now involved in the abortion issue.

It is absolutely incomprehensible to me how Shuamort can feel that a doctor (or by extension, any licensed professional) is required to perform any procedure they are called upon to do or, as he/she says, they can seek unemployment. I thought my own thinking was a bit fascist at times, that sounds like something right out of the Third Reich. Personal and/or moral beliefs can have no place in our professional lives? I really don't think that is what Jefferson meant.

On the other hand, there are no states that have mandated that a pharmacist must dispense a prescription.

Sounds good to me.

Generally, as long as a pharmacist acts in good faith and people who need medications get them, they will not face disciplinary actions.

That is an extremely vauge guideline. I would certainly hate to try and wrangle the meaning of that out in court.

There may be pharmacists that feel that the act of referring makes them a participant in a procedure that they are morally against. It would appear that this is where a patient or employer would have the most leverage legally. Pharmacists have a duty to provide access to drugs to people who need them. If there is a technical problem with a prescription, or if the pharmacist must make a professional judgement to refuse to dispense, it is the expectation that the physician be contacted. The same applies when a pharmacist is faced with making a moral decision. If nothing else, the physician should be contacted; preferably, the pharmacist will refer the patient to another pharmacist.

As I have said, I agree that the pharmacist has a professional responsibility to refer the patient to another pharmacist. I would go as far as saying that a pharmacist who refuses to dispense on moral grounds has an extra responsibility to make sure the patient has their RX filled at another pharmacy (or by another pharmacist) as quickly and conveniently as possible. However, I will defend to the death their right to choose not to perform any action based on their moral beliefs. I hope we all have that right, and I further do not believe that exercising that right in this way should deprive a person of their career. And yes Shuamort, I do agree that an employer should have the right to fire a person for exercising that belief. I am the original employer's rights advocate. I believe a business owner should be able to fire an employee because they don't like the way they part their hair.

 

[vandree]

It was very informative, and I appreciate your posting it, but I didn't see any actual law in the quote.

There is only one state that has a law addressing this issue and that's South Dakota.

This is what the statute says:

36-11-70. Refusal to dispense medication. No pharmacist may be required to dispense medication if there is reason to believe that the medication would be used to:

(1) Cause an abortion; or

(2) Destroy an unborn child as defined in subdivision 22-1-2(50A); or

(3) Cause the death of any person by means of an assisted suicide, euthanasia, or mercy killing.

No such refusal to dispense medication pursuant to this section may be the basis for any claim for damages against the pharmacist or the pharmacy of the pharmacist or the basis for any disciplinary, recriminatory, or discriminatory action against the pharmacist.

Source: SL 1998, ch 226, § 1.

http://legis.state.sd.us/statutes/index.aspx?FuseAction=DisplayStatute&Statute=36-11&Type=Statute