Wednesday, November 10, 2004

Another Brick in the Wall

Courtesy of USA Today:

"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.'

Some pharmacists, however, disagree and refuse on moral grounds to fill prescriptions for contraceptives. And states from Rhode Island to Washington have proposed laws that would protect such decisions."

Stories like this have been popping up for a while now, and we can expect to see lots, lots more of them in the months to come. This particular piece has been bouncing around cyberspace all morning, and it's clear that reproductive rights groups are going to bring out the heavy artillery on this one.

Which is as it should be. But the battle plan had better be sound, and the objectives realistic, or they're going to end up looking as bad as the other side in the public eye.

No reasonable person would question any woman's right to ready access to birth control pills when appropriately prescribed by her physician. Conversely, however, if repro rights groups adopt the stance that all health care workers, pharmacists and the like should be forced to act against their consciences and pony up birth control pills on demand, well, that's going to strike the public and state legislators as pretty repugnant.

And understandably so. We don't want the state telling physicians that they can't perform abortions, can't prescribe marijuana in medically-indicated cases or can't prescribe lethal-dose barbiturates in assisted suicide cases (or I don't, anyway). By the same token, it's unfair to tell a physician that they must do any and all of those things. This rule of thumb seems to be fairly applicable to pharmacists; I'd be interested to know if pharmacies are even compelled to carry birth control pills at all.

The American Pharmacists Association's position on this seems to be about right. Their policy, as reported in the USA Today article, is that "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." From their point of view, the real culprits are those pharmacists who refuse to pass the prescription to a colleague or, in some cases, even refuse to return it to the customer. It seems that the best--or at least, the most winnable--sort of legislation in this instance would protect individual pharmacists' rights, even while guaranteeing access to medications and providing for sanctions against pharmacists who attempt to obstruct, rather than avoid, the process.

I know, I know. The bigger issue here is that it's one more slip down the slope toward the Talibanization of America. It may be that our best weapon involves economics, not politics; big businesses (are you listening, CVS?) are not going to let a little thing like their employees' principles get in the way of their bottom lines. Can't get birth control pills at the corner Walmart pharmacy? Then don't shop there for anything. And if the prices there are so good that you feel compelled to overlook the fact that their pharmacist thinks you're going to burn in hell, well, you get the America you deserve.


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