Good (if heated) discussion over the private property rights of pharmacy owners—when weighed against their licensed responsibilities—here and here, here, and here. For those unfamiliar with the grounds of the debate, the story centers on an Illinois pharmacy, a state senator, a governor, and the so-called “morning after” pill
A fourth-generation pharmacist whose drugstore still sits on the courthouse square of his conservative small town downstate, State Senator Frank Watson knew exactly what side to take when Gov. Rod R. Blagojevich ordered pharmacies to fill prescriptions for women wanting the new “morning after” pill, even if it meant putting aside their employees’ personal views. “The governor is trying to make a decision that must be left to the pharmacy,” said Senator Watson, whose family business, Watson’s Drug Store in Greenville, Ill., does not stock the pill. “It’s an infringement on a business decision and also on the pharmacist’s right of conscience.”
John Cole, a traditional conservative, disagrees:
It isn’t the pharmacy’s decision, it is the decision of the DOCTOR WHO PRESCRIBED THE MEDICINE AND THE WOMAN WHO WILL USE IT. You are nothing more than someone wearing a sanitary labcoat who is paid to distribute the CORRECT DOSE.
This is not a morals issues. This is an issue about buttinski creeps trying to impose their values on others. Do you stand in judgement of overweight people when they go in for their blood pressure meds?
How about someone who needs an antibiotic to combat a sexually transmitted disease? If they are single, should you deny it so they can suffer yuor God’s wrath? If they are married, do your morals dictate that you call up the patient’s spouse?
These wingnut lunatics need to get their asses in line, check their faux morality at the countertop, and start issuing the damned pills that the people who went to MEDICAL SCHOOL FOR TEN YEARS are prescribing. Otherwise, turn in your damned labcoat, turn in your government license, and run off to seminary school. The church is short a few good men, although most of the priests and ministers I have known are not judgemental know-it-all creeps like these jerks.
Not to be outdone, The unPOPULIST straps on his Ayn Rand codpiece and sallies forth into the fray:
It isn’t the business owner’s decision, you see. If doctor and patient so choose they can compel an American citizen to provide them with the wares they desire. Moreover, if the citizen refuses to put it on offer, the state should then dictate what that citizen must make available. And, as anyone with the slightest understanding of statism knows, the government can never compel anyone to do anything but at the threat of physical force; so if the pharmacist refuses he is is free to be hunted down and fined/imprisoned/shot as necessary.
An understatement would be: This calls John Coles small-government credentials into question somewhat.
I’m not convinced, however, that John Cole is even aware of the shark he’s jumping; I’m inclined, rather, to wonder about the state of his mind, as in the end he comes off sounding like the worst kind of activist sob-sister […]
[…] Turns out this is worth making noise over–it’s statism v. self-determination itself.
Now, with this “emergency rule” (which “rules” are a staple in Atlas Shrugged) in mind, please see “The Ethics of Emergencies,” from the same book as cited above.
In all seriousness, this is the single most important debate open to mankind since the invention of government.
I haven’t thought this through, entirely, but it seems to me that what we have here is one of those classic cases where libertarianism and private property rights rub up against potential civil rights violations. As always, the market is (in my opinion) the best fix; but what happens when the market isn’t quite ready to remedy the problem? That is, what is society’s responsibility to the aggrieved individual.
For what it’s worth, here’s my problem with owners of pharmacies not dispensing certain drugs for moral reasons: in some towns, the distance between pharmacies can be prohibitive, and so simple logistics can give undo “moral” power to a town’s sole regional owner. Now, if this were condoms we were talking about, I’d just tell every kid in the town to fuck like rabbits without them until our moral pharmacist woke one morning and found a hundred pregnant and or/ syphilitic teens—and 300 or so very angry parents—asking him why he didn’t stock condoms. Free market forces at work and all that. Similarly, I’d say this was a nice place for a competing business to open its doors, offering free condom packs to the first 500 customers.
But we’re talking about prescription medication that is only available through pharmacies, and it is often quite difficult for people who work to drive considerably out of their way to get these drugs. Which means that a type of de facto social engineering is taking place, though in a mild form, I grant.
So I’m torn on this issue: on the one hand, I think business owners should be able to make their own decisions regarding hiring, merchandise stocking, etc; but at the same time, a pharmacy licensed by the government to dispense drugs probably shouldn’t be picking and choosing which drugs it wishes to dispense—at least, not for reasons that aren’t medical in nature, and that don’t cause harm to a person or fetus (which it’s my understanding the drug in question does not; in fact, it could prevent the need for abortions).
The simple solution, of course, is to offer this drug over the counter so that consumers aren’t subjected to any particular hardship (or unusual scrutiny) in their efforts to obtain the merchandise. But I suspect that some of the same folks who are unwilling to fill the prescriptions would be apoplectic should these pills be available over the counter at 7-11, where teens could pick them up along with a pack of smokes and some Cool Ranch Doritos.
So if the actions of a few conscientious pharmacy owners winds up making the drug more readily available, that is a good thing, in my estimation. But it’s those who are being prevented from having their prescriptions filled in the meantime who must be our first concern.
Hey, look, if you don’t want the pharmacy refusing to give you the “morning after” pill–don’t fuck anybody. That simple, it really is. Fuck and pay the consequences, or shut the hell up. I’m sick of bozos thinking that government, pharmacists, doctors, ERs, hospitals, police, every Tom/Dick/Harry/Jane under the sun is suppose to cater their “convenience needs” based on their own lack of self-discipline. Get over it, grow up, take some damned responsibility for your own behavior.
Nice soapbox, here.
As a professional in the health management field, I can pretty much speak for many of my peers when I say that the health provider’s main obligation is always to the patient’s health or direct requests, never to their own morals. Although a provider may not agree with a patient’s decision to stay on (or off) of a particular treatment/apparatus, use (or refuse) certain medication/procedures – the provider must always recognize the dignity of the patient’s right to an educated choice in their OWN healthcare.
Allowing a provider like a pharmacist to morally regulate the care they provide, opens the discussion; should all providers be allowed to do so? The answer here is an obvious ‘No.’ Imagine if doctors and therapists could administer or withhold treatment based on their own decisions irregardless of your own. And just to bury the bullshit, the argument that private businesses shouldn’t be regulated doesn’t work here either. Healthcare is not a private business. Healthcare is a service that is provided to patients. Those people in my field who see it as anything other than a service industry are the pointy-headed foils of the majority of us who work hard everyday for our patients, not for the almighty dollar.
Jeff H,
You do realize that the morning after pill is often prescribed for rape victims, right?
It’s wrong for any pharmacist to refuse to dispense or carry a drug based on his/her moral objections to it’s use. When you do that as pharmacist, you’re shoving your religious beliefs down the throat of another person.
Now if the pharmacy isn’t stocking the drug due to a supply and demand issue where there isn’t much demand for the drug…
Brandon,
The Pharmacist isn’t shoving his religious beliefs down anybody’s throat. He’s simply saying that he finds a product objectionable, and doesn’t want to carry it. If you don’t like that position, feel free to shop somewhere else.
Its those that want the pill that are impressing their morality on others. The Governor thinks this pill is a good idea, so, goddamit, every pharmacy should carry it.
Shank,
I’m a little confused by your position:
“Allowing a provider like a pharmacist to morally regulate the care they provide, opens the discussion; should all providers be allowed to do so? The answer here is an obvious ‘No.’”
I believe this is already going on…not every GYN doctor performs abortions. Should they be forced to? How about if euthenasia becomes more socially acceptable? Should doctors be required to perform this service?
I don’t pretend to have any answers here…I do think the pharmacists in question are being moral prigs, but I’m not so sure doctors should be forced to perform procedures they find morally offensive. Maybe I’m misconstruing what you wrote…if so, sorry ‘bout that!
Jeff H —
You do realize that by actually going to the doctor and having these pills prescribed, the immoral fucking machines you so clearly disdain are, in fact, taking responsibility for their actions?—and that it is people like you who are actually preventing them from taking responsibility for their actions by limiting their choice of remedy? These pills are not little abortion capsules after all, and asking people to stop fucking is just not a viable solution.
That is, what you want, it seems to me, is for people to act like you would act, and when they don’t—and then you succeed in blocking their remedies for their own choices—you tell them to suck it up and “take responsibility.”
As I said in my post, my only problem with pharmacy owners acting in accordance to their individual “beliefs” is that, in areas where there is only one pharmacy and the marketplace has not yet caught up with the demand, we are in effect sanctioning the moral position of a pharmacist to govern the medical treatment of certain people. And because no “person” or “fetus” is being harmed here, I believe the individual’s right to receive prescribed medication must necessarily—at least in the interim, before market forces catch up with realities on the ground—supercede the objections of the town’s one licensed purveyor of pharmaceuticals.
When exactly did “taking responsibility for one’s actions” mean “allow fertilization so that one can take an unwanted pregnancy to term,” when an early megadose of estrogen and/or progesterone can actually prevent it? Is there a huge difference between regular birth control pills and taking several in one dose?
And what about when condoms (surely a responsible precaution) fail?
Oh, I forgot – if one is sexually active, one MUST be automatically willing to have a child at any time. Because, you know, it’s not like sex is a primal urge in the same ballpark as sleeping or eating or anything. It’s not as if humans were programmed with powerful hormones, a reproductive window and short vigorous portion of a lifespan all centered around ensuring the survival of the species through almost irresistably pleasurable procreation, and now that this evolutional necessity is outmoded via modern lifespans and survival rates, 99.9% of all current sexual activity takes place for pleasure, not actual reproductive result.
And the worst part about such sanctimonious posturing is that methods like a high dose of birth control are often a preventative measure, if taken early enough, thus reducing the incidence of abortion.
Man, feel free to live your life that way, but try not to dictate the Spartan code of not getting laid to the rest of the planet, please. It’s about as futile an acivity as I can envision. Sex has ceased to be an acivity that revolves around reproduction, and any device or drug that has the capability of reducing abortion or moving the date of abortion to an almost instantaneous point so early in the term is a good thing.
<b>No one is prevented from having their prescription filled.</b> Just go to another pharmacy. Or get some of thoe cheap drugs from Canada.
Let the free market handle this problem. Don’t insist the state enforce your moral decision on others at the point of a gun.
FREE market. Free, free, free, free, free.
Free!
Shank,
Bull-sheet. There are all kinds of circumstances in which doctors refuse to perform procedures they consider immoral, such as castration or fetishist amputation.
Let the free market handle this problem.
Right, so what about lifesaving medicine? Shall the free market decide that too?
Is it ok when antiarrhythmic drugs are “Satan’s pacemakers?”
More realistically, what about prescription painkillers for patients with chronic pain? In a one pharmacy town, should Dottie the Pharmacist be able to deny Bob the Advanced Cancer Patient oxycontin because opioids are “the devil’s little white orgasms?” Or because she didn’t like the “squinty, hungry look in his sallow little eyes?”
Simple Libertarian philosophy is impractical in certain paradigms.
Jeff H, suppose pharmacists who were also eco-freaks began to deny medicines to those hurt in auto accidents based on a professed belief that cars were ruining the environment. Or pharma-kluxers denied medicines to blacks based on closely held racial beliefs.
The fact that your (or anyone’s) religious belief conflicts with the dispensing of certain drugs doesn’t change the law, and RU486 is legal in the US. We can debate that law, but the beliefs of medical professionals shouldn’t have any bearing on patient treatment.
I’m torn. If one forces the pharmacists to go against his moral objection, do we then have to force the local doc to go against his moral objections and perform an abortion?
What if he’s the only doctor within 150 miles? Does he still have to perform the abortion?
It’s the same argument, is it not? At what point do you begin to force people to act against their morals when it comes to these situations?
At what point will I stop using rhetorical questions in my arguments?
As for Cole’s comments about pharmacists–they go to school for 4 years (post graduate)–so I’d say they’re a little more than jokers in sanitary lab coats.
TallDave: the ‘state’ already enforces moral decisions at the point of a gun. See Also: Jim Crow laws, the Alabama Constitution (which to this day still mandates segregated schools)
Three words: mail order pharmacy. End of problem.
I myself think that if the pharmacist does not want to sell you a product, he should not have to and the state should not compel him to. He is a private enterprise.
If this drug is prescribed in the case of rape, maybe the doctor that examines the raped in a hospital could dispense that drug from the hospital’s pharmacy.
The government CANNOT dictate what a private business decides to sell unless it is illegal. Sorry Mr. Drug-Man, you can’t sell weed or blow. But, to tell a business owner what thye must sell is simply un-American in my opinion.
Colossus: if I operate a taxi service in your area and refuse to pick up men of Arab descent, does that not also follow from your argument?
It seems to me an obvious solution would be to simply allow doctors to dispense a limited amount of medication themselves. That way the doctor can give the woman the “morning after pill” directly, any larger prescriptions will go through the regular prescription/pharmacy process, and the morally pure pharmacist won’t be an enabler for all the irresponsible heathen sluts.
But perhaps I’m missing something.
This is a tough one, but I have to side with those saying that the pharmacist refusing medication is in the wrong here. He is not the doctor, and his code of ethics states that he must respect the value of the other health care professionals. It is not his job to decide what medicines are appropriate for individual patients. His job is to dispense the prescriptions from the doctors who examine the patients. If this is too much of a problem for him, he should get a different job or lobby to have the ethics of the profession changed.
I do not know where life begins, and if it begins at conception, then I must concede that my position may be wrong.
I myself think that if the pharmacist does not want to sell you a product, he should not have to and the state should not compel him to. He is a private enterprise.
But he (she) dispenses drugs based upon a license granted by the state. This is a privilege granted by the state, not a God-given right. You do not want to follow the code of professional ethics set down by your state, fine, sell candy and soda pop.
If we start to micromanage with social engineering every aspect of our lives based upon these “moral” arguments, we wouldn’t be able to take a crap in peace.
If there is no compelling medical reason not to distribute a drug (because its negative health effects outweigh its benefits), then state-licensed pharmacists should keep their personal moral views outside the office or get into a new line of business. Sell Bibles to people who give a shit about God and Jesus, for instance.
After all the bullshit conservatives spewed about intrusive, meddling, “nanny state” liberals over the last 20 years, many of you conservatives sure seem to be nannies in a different uniform, seeking the same magnitude of social engineering (in different ways) as the liberals you hate so much.
I feel the same about abortion, abortion pills, and contraceptives as I feel about legalizing illicit drugs: it’s my fucking body, so keep your meddling nose out of my personal business.
And that’s my brand of liberty.
Wow. I’m aghast that I’m at odds with both Bill and Jeff.
It’s a private pharmacy. Period. Don’t give me the sob story about no pharmacies within X distance either because it’s bullshit. If the pharmacist in question decides to close shop and work from home stuffing envelopes, is the state going to mandate that he stay in business because there’s nowhere else people can turn? Then what gives the state the right to tell him he will or will not sell certain items? What if he simply decides not to stock the pill? Is the state going to force him to maintain certain inventory?
And for all the idiots out there bitching about ‘shoving religion down throats’ why don’t you get off your high horses and stop trying to shove YOUR morals down people’s throats and let them do what they want? Because regardless of where you pull morals from, it’s a random construct and your ‘right’ is someone else’s ‘wrong’.
While I disagree with Jeff H 100%, I also find Jeff G’s ‘blame the pharmacist for syphilis & pregnant teens’ attitude disturbing. The pharmacist has no moral responsibility to protect anyone nor is Suzy Q’s genital warts the pharmacists’ fault.
I, for one would not shop at a store that refused to sell any particular medication for whatever reason. I find the morning after pill morally questionable, but it’s not my place to force you to find it morally questionable. So if a pharmacist thinks that he shouldn’t dispense a specific medication because of whatever reason, I won’t shop there. Heaven forbid he denies me my hemmoroidal creme because it would mean I had to rub my squeak-hole with my finger.
I guess what bothers me the most is the ‘shover-ists’ pretending that their morals are ok to mandate, but not someone elses.
“This is a privilege granted by the state, not a God-given right.”
The privilage of which you speak is the right to dispense drugs, not a mandate to dispense what is demanded. Again, he could choose to not carry certain items.
I also want to add that I think the pharmy in question is an ass. I don’t agree with RU-486 completely, but it’s up to you to decide that for yourself. As a neo-libertarian, your liberty is too important to me.
But then again, so is the pharmacist’s.
Turing word – care.
How apropos.
Rob —
To be clear: my “let the teens fuck and get disease and blame the pharmacist” thing was not meant to blame the pharmacist per se, but rather to give an example of push-back in the market forces that might have an impact on a pharmacist’s decision to foreground his morals over his functionary purpose as a drug dispensor.
It’s akin to: The Dixie Chicks have every right to protest; and I have every right to protest back.
<objections of the town’s one licensed purveyor of pharmaceuticals.</blockquote>
Quick (I hope) question on this, Jeff: isn’t that point in dispute by those pharmacists who refuse to fill the prescription? Suppose for a moment that the pharmacists are right and that filling the prescription would harm a person–would that supercede the individual’s right to receive prescribed medication?
On the other side, suppose for a moment that a pharmacist refuses to fill the prescription because he thinks people who have unprotected sex should bear the consequences of their actions. Would he still be justified under the private practice principle?
(rapid scuttling back to try to get out of bomb range….oops, looks funky in preview. hope it looks better posted.)
bloody hell…okay, I was responding to this quote from Jeff:
And because no “person†or “fetus†is being harmed here, I believe the individual’s right to receive prescribed medication must necessarilyâ€â€at least in the interim, before market forces catch up with realities on the groundâ€â€supercede the objections of the town’s one licensed purveyor of pharmaceuticals.
I know Jeff H. tried to make this point, but let me explain the teaching on this of the Catholic Church:
Human life starts with conception – defined as when a human sperm cell fertilizes a human ovum. Forget about souls, etc. This is where the Church defines the beginning of human life, and as such believes this life should be respected and recognized (thus holding up general human rights, stances against induced abortion, euthanasia, etc.)
One way the “Morning After Pill” (really just a superdose of regular birth control pills) works is by preventing the implantation of an embryo in the uterine lining. This puts an end to human life, as the Church sees it—it’s basically an abortion to the Church.
(The stance against condoms is different, and harder to explain – just check out Pope JPII’s writings on The Theology of the Body if you really care. But most don’t.)
In any case, Catholic hospitals will not dispense the “Morning After Pill”. If law forces them to do it, I’m sure they’d just consider closing down the hospitals. Most likely, they wouldn’t close down the hospitals but simply refuse to follow the law. You wouldn’t be able to force the hospitals to be involved in assisted suicide, and you wouldn’t be able to force them to perform abortions. Most likely they’d use their clout before things came to such a pass, but even if the laws tried to impose upon them, they’d just be civilly disobedient.
And that’s what I recommend to those who do not want to follow this law. You can lobby to get it changed, but if your conscience is that bothered by the situation – stand up for your beliefs and take the consequences. That may involve getting fired or being fined. You may have to enter a different line of business.
It may turn out that this law is ill-considered, when they find that pharmacies close rather than dispense medications they object to. I rather imagine this would make it through the federal court system—but we’ll see. If they want to try this, they are welcome to.
Got it Jeff. Sorry, I kind of misread that.
I’m seriously open to debate about the pharmacist’s rights as a private business owner though. Pharmacists are well educated individuals when it comes to medications. I’ve had a doctor prescribe me medication that interacted with another I was taking. The pharmacist told me he didn’t want to fill it because of possible reactions. In my case, the doctor agreed, but there are cases where the doctor feels it’s safe and is wrong.
If you’re just going to require the pharmacist to fill what is written, then a trained monkey could do the job and the stringent requirements for being a pharm should be removed.
Then you’ll have heart medication doled out by part time high-school students.
Well, the prescribing doctor’s opinion as to patient harm supercedes the pharmacist’s unless the problem is one of drug interaction.
Because there is no harm being done to a fetus or another person, then the operable principle here is not the same, it seems to me, as a doctor performing a surgical procedure. Instead, this boils down more to slarrow’s second point: can the government not regulate against what it deems discriminatory.
This is a tough question, and one that I think gets to the heart of the matter.
I’m not sure how BLT managed to work race into this. Getting knocked up is not exactly an unavoidable genetic trait.
On one side, I can see how a governor ordering every doctor in the state to perform abortions might bit a wee infringement on their rights, but I don’t think this quite reaches that level.
All retail outlets, however, should be required by law to carry Yoohoo and Mallomars.
Sharp,
Outstanding comments in re: “And for all the idiots out there bitching about ‘shoving religion down throats’ why don’t you get off your high horses and stop trying to shove YOUR morals down people’s throats and let them do what they want? Because regardless of where you pull morals from, it’s a random construct and your ‘right’ is someone else’s ‘wrong’.”
The point can’t be made too much, though it would likely have no effect on new Balloon Juice hysterics attracted by the host’s recent weirdness.
A state license to practice doesn’t = an obligation to stock & sell. What is so complicated here. And the market–and the web–would level the field, even for these hypothetical remote customers, isolated as if at a DEW station.
Cordially…
Jeff G et al,
For what it’s worth, I believe that some morning after pills have been shown to have potentially abortifacient effects. I’m looking for the papers and articles now. I don’t know how much this affects the debate in general, but you specifically, Jeff, seem to be repeating the point that it does not destroy a fetus which it, in fact, can do.
Matt, I’m sorry, but I have to completely disagree with you here. Nobody should be forced to carry that pseudo-chocolate flavored swill.
Yoohoo is an abomination of nature.
I don’t understand why this pill isn’t dispensed in the ER (in the case of rape.) All the hospitals around me have pharmacies inside the hospital as well.
Pharmacists do have a choice. They can choose to have a pharmacy or not. If they have one, they have to be licensed and dispense drugs. If they have a moral objection to some drugs, they shouldn’t be pharmacists. That simple, it really is.
If you are a district attorney in Texas, you better not have a moral objection to the death penalty. It’s part of the job description.
BLT’s enviro analogy seems very good to me: “suppose pharmacists who were also eco-freaks began to deny medicines to those hurt in auto accidents based on a professed belief that cars were ruining the environment.”
One problem with letting the free market take care of this is that it seems extremely unlikely to do so. Unless the pharmacist puts up a sign in the window that says “Morning After Pill not Available, you Godless Heathen Sluts” individuals aren’t likely to know that the pharmacist won’t dispense the pill until they actually go to request it.
And demographics being what they are, most pharmacists who make this decision will be living in communities that agree with them. The women who need the pills are a minority within a minority, with miniscule economic pressure to bring to bear.
I think ultimately the best solution would be for an organization like Planned Parenthood to make the kits available to doctors at cost or lower, to distribute to those requesting them for free. (Doctors give out drug samples all the time – this must be within regulations.)
As far as I know, most states allow doctors to abstain from providing abortions or taking abortion training. An ER doc or internist can choose not to recommend these abortaficients if they so choose, nurses can choose not to administer them. Why shouldn’t pharmacists have the same right?
We have a situation here where an individual does not want to be party to an act that he deems to be morally reprehensible; the killing of an innocent human being. It is as simple as that.
Some of you libertarians seem quite stingy with your liberty, at least when it conflicts with what you deem to be morally permissible. This individual does not want to provide a certain service, because he considers it to be wrong. Some of you are saying that the State has the right, and apparently the obligation, to force him to provide this service. Telling, that.
Carin, I think it is offered at the end of a rape exam. Supposedly, doubling up on certain types of birth control pills will have the same effect. Both courses of medication can make a woman as sick as a dog.
A pharmacist could choose to carry no birth control at all if he were worried about “screening” the unmarried or whatnot…other types of stores carry condoms and many grocery stores have pharmacies, too. Seems that would make it simpler for someone like that. Can he be forced to carry them?
Can’t we just talk about codpieces and/or rubbing up against things?
I wonder how many men would be more outraged if said pharmacist instead refused to dispense Viagra.
Because, you know, MORALLY, single men shouldn’t be having sex since they’re not married, and even married men could use ol’ Magic Blue to cheat on their wives, you just never know. Better not let them have the chance. You know, MORALLY.
Some of you libertarians seem quite stingy with your liberty, at least when it conflicts with what you deem to be morally permissible. This individual does not want to provide a certain service, because he considers it to be wrong. Some of you are saying that the State has the right, and apparently the obligation, to force him to provide this service. Telling, that.
Depends on who you erroneoulsy label as “libertarian,” doesn’t it, buddy.
Lisa,
Not many, because the market for that drug is so huge, it’ll correct very quickly.
Just as at Balloon Juice, it is striking to see so many would-be “small government” folks really clinging to the notion of state compulsion.
Not to mention (apropos again of Balloon Juice), so many “dissent-is-patriotic” leftwingnuts wanting to smite the (surely few in number) conscientiously objecting pharmacists.
Schiavo redux.
Cordially…
For what it’s worth, I believe that some morning after pills have been shown to have potentially abortifacient effects.
Yes, high enough doses of synthetic hormones can abort a fertilized egg. The intention of the morning after pill is to prevent fertilization, however. In addition, all the pill is is a multiple dose of birth control pills. So what, are pharmacists going to refrain from distributing those too? Because of possible intent?
I could down a gallon of codeine and kill myself, for a parallel.
Colossus –
No offense, but …
Three words: mail order pharmacy. End of problem.
… for a morning-after pill intended to prevent fertilization is a bit silly. Even with next-day air.
TORCH THAT STRAWMAN, NATHAN! LIGHT THAT BITCH AFLAME!
Listen. The morning after pill is essentially a large dose of birth control. If you are a pharmacist who is against dispensing birth control—the pill, spermacides, sponges, etc.—than have the courage of your convictions and just call your store “the Catholic pharmacy.” At which point you should pull KY and Vaseline off the shelves, too. And liquor. Just to be safe.
As I’ve noted, the analogy to be drawn here is whether or not denying prescribed drugs in such a way that it causes undo hardship is a violation of civil rights. Mail order pharmacies with quick turnaround are one solution, but given the nature of this drug—and what it is designed to do—time is really of the essence. And the idea that a woman would make a doctor’s appointment—and be seen—within a certain duration after they’ve ridden the spitty pony, is asking a bit much.
Make the drug available over the counter. That’s what I’d like to see. But in lieu of that, we need to make sure prescriptions are being filled. We have to trust that doctors are making the right call in situations that don’t involve drug interaction problems.
Jeff, now that’s not fair … as a Catholic, I KNOW I’m allowed to use KY jelly. And get drunk first.
Is the pharmacist required to carry any & every product & component for any prescription that might be presented? How much? Enough to fill a single prescription? Every prescription they’re presented with? Does the state get to determine the sales price? The profit margin?
Physicians are licensed, too. They are not required to treat everyone who requests treatment. They are not required to provide any treatment a (prospective) patient requests. They can, and sometimes do, refuse to provide treatment for various reasons.
We aren’t talking about a pharmacist refusing to serve a customer because they’re a member of a protected class (i.e., race, color, creed, religion, gender (though that is an interesting argument here)), we’re talking about a pharmacist who refuses to carry a single product due to personal beliefs. With internet access & mail order pharmacies, markets can correct this problem. If the pharmacist wants to forgo this product and lose the business, that should be his choice.
Well Burkedtthead, I’m interested in the argument that these people might just be able to argue protected class status in the face of de facto moral regulation.
Which, as a libertarian-leaning conservative, is why this case interests me so much.
Carin —
Heh. Thanks for having a sense of humor and taking that in the spirit in which it was intended. HundredPercenter would have consigned me to hell, I’m pretty sure.
There seems to be a lot of heartburn about the government forcing certain things on business owners.
Offering seat belts is a federal law. Chrysler isn’t given any options on this and not one local dealership is either.
Hospitals must maintain certain staffing levels at all times to comply with federal regulations.
TSA says commercial airlines can’t fly without the requisite number of pilots and flight attendants.
The EPA monitors and mandates all sorts of things for waste treatment and power generation facilities.
OSHA, FDA, SEC, IRS, and the list goes on and on.
The government regulates and controls nearly all aspects of every business. So to be licensed, why shouldn’t a pharmacy have to stock certain levels of specific meds? I don’t know if they do, but it wouldn’t surprise me and it does make some sense.
Someone has already mentioned mail order pharmacies, which kind of render the one-pharmacy town example moot.
I lean more to the pro-life side of the argument, and while I could work myself up to ambivalance on the matter, I’d hate to see the guv’ment in the business of telling me what I cannot not sell. This would be akin to forcing a vegan restaurant to offer meals with meat. The owner may find the practice of slaughtering animals objectionable, but what about the rights of the consumer? The government gave the restaurant a liscence after all. Who is the owner to decide what is good for us?
Sure, we can choose to go eat somewhere else, and we can also choose to fill our prescriptions over the internet.
I may find the vegan POV to be wrong, but I won’t force them to accomidate me. And whether I disagree with a health professional’s moral objections or not, we shouldn’t force them to accomadate us either.
If you don’t like this line of reasoning, then explain why OB/GYNs shouldn’t be forced to perform abortions. After all, that’s a service that can’t be filled over the internet.
JeffG,
The morning after pill is used for the express purpose of preventing a fertilized ovum from remaining in the woman’s body. Many people, including myself, see this as a terrible moral wrong. The Church rightly draws a difference between abortion and contraception. While contraception is still wrong, it is not nearly as wrong as abortion. I know that this must seem terribly ignorant to you enlightened folks, but please humour us foolish papists.
Were I a pharmacist, I would likely provide condoms and birth-control pills, but not morning after pills or other similar products. Similarly, were I a doctor I would not perform abortions (in essentially all cases, anyway) but I would provide people with advice regarding safe sexual activities if they requested them.
That is called being reasonable. I should think that a tiny bit of leeway could be given towards us traditional folks on issues that we believe are terrible wrongs. Perhaps that is too much to ask.
Note that I find your attitude here odd, considering that you wrote a rather nice piece on B16 elsewhere on the site.
ooh ooh ooh. I wish I was a plaintiff’s attorney with a client whose doctor refused to perform a procedure due to moral objections. the malpractice cash cow cometh home for me. Hmmm. Can a pharmacist be sued for damages resulting from a failure to fill a prescription? I haven’t done the research, but sounds like a plausible negligence theory in today’s legal climate.
I’m just trying to keep you honest, Jeff. But, really, Astroglide is much better than KY. Just so you know. Of course, I haven’t tried that new KY warming gel … what were we talking about?
Is there enough time for mail order with the Morning After pill?
http://www.morningafterpill.org/mapinfo1.htm
Emergency contraception (also known as the morning-after pill) is a high dosage of the birth control pill. It is recommended to be used after sexual intercourse, over a period of 72 hours, to achieve the goal of preventing (or ending) pregnancy.
3 days? I think that’s enough time for mail order.
Assuming that the girl is genuinely worried about pregnancy. If she starts worrying about it later on, the morning after pill isn’t the answer.
turing word – bed.
Jeff, you guys are sure happy to tell these pharmacists what they should do, and perhaps you’re right. But what is at issue is what the State should compel them to do, which is pretty much a different thing.
I can’t believe some of you guys are so pleased with your own position here that you gleefully ignore a fundamental free market argument. And acting as though the pharmacist does not have a free market right to carry what products he wants because of his license? Are you serious with that?
Nathan —
I think you find my position odd for two reasons: 1, that you haven’t bothered to understand what my position is; and 2) that you are intent on playing the injured traditionalist, replete with snark about my considering myself somewhat more enlightened than you.
But had you bothered to read my other comments, I noted that I’d have no problem with a pharmacy labeling itself a Catholic pharmacy, and so tipping off people that it likely won’t be dispensing certain drugs. In an ideal market response, a competitor would emerge to fill that need.
But I’m worried about people in the interim who might fall prey to the vagaries of the market system. Specifically, I’m worried that they might be able to argue that their civil rights are violated—which, should they prevail, would mean MORE regulation of private business.
As I’ve mentioned on a number of occasions here, I’m torn on this one—and I’m interested in the problems it raises vis-a-vis the intersection of government regulation, civil rights, and private property rights.
Your insistence on ignoring all that at trying to paint me as a sneering anti-religious bigot is annoying—and becoming all too familiar a tactic. I have lambasted the left for using homophobia or racist or some other dismissive remark to curtail thoughtful debate. So I’m going to be quick to say that this assertion of religious persecution everytime someone raises a question that brushes against your beliefs is equally as stultifying to reasonable debate.
I sometimes feel like I’m wasting a lot of words. I have MADE the free market argument. In several different forms.
I have even stated that I PREFER the free market solution.
But what I’m saying is…oh hell. I’ve said it already. Read my other comments and address those, or else address somebody else.
I have TV to watch.
Quick note, for those confused:
RU-486 IS NOT the “morning after pill”.
An absolute free-market economy is in truth: anarchy. If every vendor were allowed to sell any item for any price to any buyer, that’d be pure free-market. But anarchy turns out to be messy, thus we have dozens of government organizations to regulate things. Things like pharmacies.
No business owner is truly ‘free’ in the US, and that’s a good thing.
Jo: thanks. I was confused, obviously, but am all better now.
JeffG,
Put yourself in the shoes of a person who wholeheartedly believes that abortion is the unjustified killing of an innocent human being. Then imagine that your country allows this to happen many times every day, and for the basest of reasons. Then imagine that you have some folks considering forcing people like yourself to cooperate in these unjust acts.
I have been a little snarky, here, and I am sorry for that.
I have been reading the comments, and I am familiar with your general approach to the situation, except for the idea of apparent civil right’s violations causing further regulation. I did not see that.
I should think, however, that it is quite reasonable of me to play the injured traditionalist when I have people like yourself publicly considering the worthiness of forcing pro-life individuals to participate in abortions. Beyond what we already do when we pay taxes, of course.
This is doubly wrong, because even if a woman could not have immediate access to a morning-after pill due to an objecting pharmacist, she could still get an early stage abortion in a further location. So, you are considering forcing an individual to participate in an act he considers a terrible wrong so that the mother can have a more convenient abortion, not so that she can have an abortion at all. And I am the one being unreasonable.
Um, Jeff?
TORCH THAT STRAWMAN, NATHAN! LIGHT THAT BITCH AFLAME!
That was just the teensiest bit provocative, eh what? (It surprised me, at least, because I really hadn’t thought the initial comment was directed at you.) Actually, I just thought Nathan’s statement was a more generalized version of SaaM’s complaint about moral positioning. I think it may fall prey to the charge of overgeneralization, but I don’t quite think it was that targeted.
As for Nathan’s second response, it was an illustration of the first point I made (and thanks for the gracious mention of my second point). That puts a pretty serious moral claim in direct competition with the interim concerns you cite that might cause more federal regulation. (At least I thought it was an interesting question.) I’ve seen the vicious attacks you’ve had to endure lately. Is this really in their class?
(Besides, I’ve read you long enough to know you’re not anything like a sneering anti-religious bigot. Indeed, it’s marvelous how often I’m on your wavelength, given that I’m a socially conservative evangelical Christian and you’re a libertarian-leaning Jew. According to modern identity politics, we shouldn’t even be able to talk to one another.)
Anyway, enjoy the TV show and get yourself another Hot Pocket (maybe feed some to the little guy; I know my 18-month-old always wants everything I eat anymore.) I think I’ll go plant some trees to replace the ones the deer killed and hope my attempt to smooth the waters didn’t add fuel to the fire (to mix a metaphor.)
So what, are pharmacists going to refrain from distributing those too? Because of possible intent?
Bill,
There’s an incident here in Dallas last year where a pharmacist actually refused to fill an elementary school teacher’s prescription for birth control pills.
Astounding that the majority comment here is male dominated. This is one issue where menopausal women just might have an advantage.
..aside from some incautious words, Brendan.
National banks are Chartered by the federal government and are HIGHLY REGULATED (I should know, I work for one). There are numerous regulations regarding fair lending, discrimination, etc. which are audited by the OCC annually. Nevertheless, we have the choice on which products we make available to the public. The rub here is that if a product IS made available, it is available to every qualified individual. For instance, due to the punitive nature towards banks under Texas home equity loan legislation, our bank does not offer home equity loans. Period. And the government has no problem with this.
To put it in simpler terms:
Restaurants are licensed and regulated by the State. The State can prohibit the restaurant from discrimination based on who it will or will not serve. But can the state mandate what is on the menu?
Diana wrote:
Astounding that the majority comment here is male dominated. This is one issue where menopausal women just might have an advantage.
Uh, don’t you mean, pre-menopausal women?
http://dictionary.reference.com/search?q=menopausal
turing word – anti
Heh! half canadian – no, I didn’t!
… and no, I wouldn’t require services from an individual whose conscience forbids noted services. The pharmacist would have to adhere to completely submissive conduct of beliefs and refusal of all related services. One would expect a clear and comprehensive statement to that effect.
Interesting that this discussion is as polarized as the general abortion/anti-abortion discussion, and as generally unwilling to grant an assumption of good intentions to the other side.
Look, the pharmacist doesn’t want to provide abortificants. Can we maybe recognize that some people, even people who own pharmacies, might have deep moral qualms about ending a life? Millions of anti-abortion Americans live with the reality of a million plus abortions each year, without going ballistic about it. Must the pro-abortion crowd leave no room in our society for a man to take a stand on something he considers sacred, even if it creates an occasional inconvenience for an occasional would-be customer?
It never fails to amaze me that the pro-choice movement is so full of Pharisees who can accept no dissent, no principled objection–that they are so totally lacking in compassion.
Just to throw in another comparison, as if we were lacking. . .
Suppose a researcher has moral qualms about embryonic stem cell research. Should we force them to do that research anyways?
One could also argue that a Jehovahs Witness surgeon would be severely handicapped if they refused to give blood transfusions. I’d probably suggest another line of work rather than forcing him/her to administer said transfusions, but that’s just a practicality issue. They’re more than welcome to give physicals, diagnosis, etc.
Diana – sorry, my comprehension saw ‘advantage’ something along the lines of ‘having first say’.
Don’t ask me to explain it, I’m more than willing to own up to that mistake.
… and, as Jeff so eloquently phrased it: “I’d just tell every menopausal woman in the town to fuck like rabbits”
It should be noted that although they quote a guy from Jerkwater, Illinois in the story, the Pharmacy in question that spurred the nepotista Governor’s reaction occurred at an Osco in Downtown Chicago.
Surely in Chicago there are free market options to resolve this issue, no? The people in question are not being denied this medication in any way shape or form. They’re being denied it from their preferred choice of retailer.
Fine. But let’s be grownups and extrapolate this out to its boundaries and see where we settle. I’m a free market classical liberal, but I can still see this turning into a civil rights case given the perfect storm of circumstances.
(Incidentally, those of you who continue to play the scorned religious martyr card—despite my previous comments on the subject—will be ignored). So go play elsewhere, or actually JOIN the debate.
But, I take issue that a trumped-up situation (no other options in Chicago?) being the rally-cry for having this stuff stocked next between the tampons and vaginal cream? Personally, I have a problem with this being offered OTC. If it is similar to BC pills, why would anyone EVER need to be on BC? Women wouldn’t need to go see an OB anymore … every time they got lucky, they could just hop into Value-Rite and pick up a morning-after pill (perhaps picking up a bottle of “Chaser” too.)
I’m not playing the religious martyr, but I am going to say that this situation inflames some people simply because the dude is religious and basis his morals on his faith. Other people base their morals on how they perceive human instinct. Some people wake up and ask the magic 8-ball if today is a good day to freebase Whisker’s brand cat food. Regardless, someone objected to doing something for some reason, and many people who consider themselves free-market types aren’t happy with the situation because it doesn’t conform to their liking.
Bill from INDC, you’ll probably castigate me for saying this, but yes – If Joe Pharmboy doesn’t want to sell life preserving medicines for Mary Heartproblem, regardless of reason, he should not be forced by the state to do so. In my mind, to say he is required to do so is the same as saying a doctor is required to perform emergency surgery on his day off. If the state wishes to mandate that a pharmacist must dispense any drugs in his inventory at a doctor’s request (barring any known interactions), then that should be in the whole license system. Even so, just like in this case, the pharmacy simply won’t stock it. And if the state requires them to stock drugs X,Y, and Z (which I now think is getting out of hand for an example), then the pharmacists can quit if they don’t like it. And another pharmacist without the same compunctions will fill his slot.
It’s sad that we have gotten to a point where someone going into the pharmacy field must choose whether to be a pharmacist or a good Catholic.
I would personally never be a pharmacist because I would never sell the morning after pill no matter what the government said. End of story.
Guess young people will have to make that decision from now on.
Where they might be a problem the doctor can dispense it in the office/clinic/ER. It’s only a few pills. And it’s not like there is a line out the door with women trying to obtain it. Jeesh. The path of least resistence is sometimes the most intelligent and the best. For those so concerned with the welfare of the woman, getting it on the spot from the doc sure has its benefits: No schlepping to a pharmacy, no waiting in line, no delay in taking the pill. But, noooooooooo, that’s too damn easy.
The pro-abortion people are making this into a controversy where none shd exist. I’m bothered by the governor of Illinois and others labeling this as pharmacists refusing to dispense ordinary contraceptives as opposed to the morning after pill. The fact that they resorted to this deception shd tell you a lot.
Good lord, I have a tough time seeing what everyone’s so worked up about on this one. The way I see it, the pharmacist has every right to refuse to provide the morning after pill because of his religious convictions, but standing on conviction has consequenses sometimes.
If the people of Illinois aggregately feel that this is acceptable for pharmacists in their state, then, tough luck, go find another pharmacy. If they aggregately feel that this is not acceptable for a pharmacist in Illinois, then, tough luck, yank his liscense and let him go find another way to make a living.
There’s nothing unlibertarian (little “L”) about society setting business standards. There’s one strawman. There’s a difference between libertarians and anarchists and regulating trade and commerce is a legitimate function of government.
Why not just have doctors keep stocks of the relevant medication, thereby eliminating the need for a middleman whose morals and/or liberties are going to be trounced upon?
And again:
I think I’ve dealt with this above. If you are going to bring these things up, please have the courtesy to at least PRETEND you recognize that some of us have tried to deal with these questions, and respond to those attempts to respond.
Bill—it seems to me that a person needing a “morning after pill” would not bother with a prescription in the first place. The emergency room/clinic would simply hand it to her with a plastic cup of water. I think this whole issue is fake.
And BLT—yes, that follows. Your point?
Because one of the points of having a pharmacist is to have a second set of eyes watching for potential problems. Because there’s a fundamental difference between a service business like a doctor’s practice and a retail business like a pharmacy.
Am I missing something? When did we get a right to be a pharmacist? The privilege of having that job depends on meeting the standards that society expects from a pharmacist. You know, things like giving me the drugs I was prescribed.
Nobody’s tromping on this guy’s morals either. Even granting for argument that a morning after pill is abortion, then if he sells them he’s no more complicit in a customer’s sin than a fundamentalist landlord would be if he rented to a homosexual couple. He’s also no less a holier-than-thou busybody than a landlord who refused to rent to gays would be. The beam in thine own eye and all that.
eh, the pharmacist doesn’t have to sell anything if he/she doesn’t want to.
“the crisis where people do what they themselves regard as evil is continuous.”
a buddy of mine said that.
you shouldn’t be forced to do something you consider evil simply because it’s *your job*
the whole *know your role and shut your hole* mantra is a bit of a drag if you ask me. but no one did.
can’t you order these products cheaper online from Canada?
Oh, I’m sorry! I must have missed where you and others “tried to deal with these questions, and respond to those attempts to respond.” I guess they just must have gotten lost amoung all the other repetitive posts that you seem to have no problems with. Could you point out where you and others dealt and responded???
<blockquote>a person needing a “morning after pill†would not bother with a prescription in the first place. The emergency room/clinic would simply hand it to her with a plastic cup of water. I think this whole issue is fake.</blockquote>
Colossus – you presume a great deal. ie. that “prescriptions” are a sure bet, that a rape victim would automatically run to emerg., the subject is of majority age and unashamed, that no rape has occured, or “date rape”, or that the male involved has no responsibility.
Actually, some of you guys are pretty arrogant in assuming that the morning after pill is always a choice.
I’m not saying that anyone should be forced to go against his/her self imposed morals. All I’m saying, is that options should be available for the victims who find themselves in desperate circumstances.
l.l —
In the comment thread.
Diana,
I don’t remember saying any of those things, but if I did, or if I have given offense, I apologize.
Folks, believe what you will. I am absenting myself from the rest of this discussion.
Colossus – no offense taken. This is just a discussion.
Economics, morals, civil liberties, and choices. All relative.
I absented myself from the discussion the minute the Jeff made the post.
And the way things are going here, I guess I’ll be absent a lot more often.
Why, Pappy? It’s an interesting debate.
Well, there are plenty of sites that run Amen corners. Me, I like to think through complex problems occasionally.
I apologize.
LIBERALS SUCK! HILLARY HAS FAT ANKLES!
There. Better?
I don’t understand. Do you people not want discussion? Do you just want me to echo yoiur own thoughts? Jot them down and email them to me, then. I’ll gear my site personally toward each and every one of you.
DANCE MONKEY!
The comment thread in your head with the PRETEND responses? Sorry, I can’t see that one.
<i>Billâ€â€it seems to me that a person needing a “morning after pill†would not bother with a prescription in the first place. The emergency room/clinic would simply hand it to her with a plastic cup of water. I think this whole issue is fake. </i>
Well, there was a pharmacist that was on CNN the other morning who refused to precribe birth control pills because they could be used as morning after pills. Which is where the nutty hypothetical took corporeal form.
Damn, if this is because of me, and interjecting a somewhat female perspective to the discussion, sorry.
l.l.
Answered here many many posts before.
And now, I had to go find it for you, because you’d rather be a pain in the ass smartass than to actually read through the thread.
Par for the course for those of you who continue to try to make this post some sort of anti-Christian screed.
Don’t be, Diana. I’d like to hear it myself. You’d think this would be the kind of case that could make for a great discussion of these issues, which I’d guess is why Jeff posted it.
Well … ok, then I’m not sorry!
Bill from INDC, you’ll probably castigate me for saying this, but yes – If Joe Pharmboy doesn’t want to sell life preserving medicines for Mary Heartproblem, regardless of reason, he should not be forced by the state to do so. In my mind, to say he is required to do so is the same as saying a doctor is required to perform emergency surgery on his day off.
Yes, you are castigated. Pharmacies are extensions of the public health system. For a pharmacist to countermand a physicians order – especially in the case of a lifesaving medication that could cause death, suffering or injury to a patient – could open up a pharmacist to the same malpractice legal liability as a doctor. If they want the power and discretion, then guess what? They get the liability. There’s the catch to your libertarian theory of selective medication dispersal.
Whoever said this –
The morning after pill is used for the express purpose of preventing a fertilized ovum from remaining in the woman’s body.
the first two mechanisms rely on inhibiting ovulation, meaning the egg will not be released or altering the normal menstrual cycle, delaying ovulation. The third mechanism is to prevent a fertilized egg from attaching to the side of the uterus, which some probably (oddly to me) consider murderous.
Some folks are also cofusing RU-486 with “the morning after pill.” The MAP is simply a large dose of synthetic hormones. RU-486 is mifepristone, which blocks progesterone and causes the uterus to shed its lining. Distinctive about that protocol is the administration of a convulsant-like drug that causes uterus to expel the embryo.
RU-486 is probably somehow closer to an abortion to some folks.
subsequent “administration of a convulsant-like drug”
A few days after the first drug.