By Edward
Let me start with an explanation of why I stand where I do on this issue: Doctors and pharmacists in the US are given a license to practice their profession by the state. They do not have the right to practice without a state-issued license (in other words, their church cannot issue them a license). Our constitutionally mandated separation of church and state therefore extends to that license IMO. Few people would hesitate to call it wholly unacceptable discrimination if a doctor or pharmacist’s beliefs led them to refuse to treat a person because of their religion or race or gender, no matter how sincerely they felt their religion insisted that treating such people was repugnant. Some religions prohibit men from touching a woman when she’s menstruating, for example. Would anyone sane consider a licensed doctor in the US within his rights to refuse emergency treatment to a woman just because she was having her period?
And yet, there’s a growing trend among pharmacists who oppose abortion to turn away patients seeking birth control or morning-after medicine. Here’s one anecdote illustrating how insane this is getting (from yesterday’s Washington Post):
"There are pharmacists who will only give birth control pills to a woman if she’s married. There are pharmacists who mistakenly believe contraception is a form of abortion and refuse to prescribe it to anyone," said Adam Sonfield of the Alan Guttmacher Institute in New York, which tracks reproductive issues. "There are even cases of pharmacists holding prescriptions hostage, where they won’t even transfer it to another pharmacy when time is of the essence."
That is what happened to Kathleen Pulz and her husband, who panicked when the condom they were using broke. Their fear really spiked when the Walgreens pharmacy down the street from their home in Milwaukee refused to fill an emergency prescription for the morning-after pill.
"I couldn’t believe it," said Pulz, 44, who with her husband had long ago decided they could not afford a fifth child. "How can they make that decision for us? I was outraged. At the same time, I was sad that we had to do this. But I was scared. I didn’t know what we were going to do."
Those supporting pharmacists’ "rights" to refuse to fill certain prescriptions argue that such medicine violates the Hippocratic Oath. What violates the Hippocratic Oath, however, should probably not be determined on an individual basis. The one case that made it to court fell against the pharmacist:
But the only case that has gotten that far involves Neil T. Noesen, who in 2002 refused to fill a University of Wisconsin student’s birth control pill prescription at a Kmart in Menomonie, Wis., or transfer the prescription elsewhere. An administrative judge last month recommended Noesen be required to take ethics classes, alert future employers to his beliefs and pay what could be as much as $20,000 to cover the costs of the legal proceedings. The state pharmacy board will decide whether to impose that penalty next month.
And so, states are beginning to pass laws to protect individual pharmacists. These so-called "conscience" or "refusal" laws exist in four states already (and Wisconsin and 10 other states are considering one according to WaPo), as do laws in other states that explicitly require pharmacists to fill all prescriptions.
The American Pharmacists Association stands somewhere in the middle. Allowing pharmacists to refuse service, but insisting they ensure their customers can get their medications some other way (that isn’t always happening though). This compromise seems stupid to me. What difference does it make if one hands a patient a drug or sends them to a pharmacy that does? And groups like Pharmacists for Life agree. But this is clearly only the beginning of this brave new world for medicine.
Another front in the Medical Refusnik movement is being waged in Michigan, where the Conscientious Objector Policy Act passed last year. This gem has been interpreted to allow emergency medical technicians to refuse to answer a call from the residence of a gay couple because they don’t approve of homosexuality:
Democratic Rep. Chris Kolb of Ann Arbor, the first openly gay legislator in Michigan, pointed out that while the legislation prohibits racial discrimination by health-care providers, it does not ban discrimination based on a person’s sexual orientation.
The Michigan politician who introduced this bill nails the essence of the issue:
Republican Rep. Randy Richardville of Monroe, who introduced the main bill of the package, said the legislation is intended to protect religious, moral and ethical freedoms of health-care providers.
“Nothing in this bill, not a thing, denies a patient from receiving medical care,” he said. “This simply means a medical professional cannot violate their religious obligations.”
And so there it is. What should be a state-licensed medical professional’s top obligation: their religion or their patients’ rights to legal therapy? Medical professionals who would presumably otherwise object to the practice of "doctor shopping" are actually encouraging it through measures like this. Taken to its logical conclusions (given that access to medical care is a determining factor in where people live) eventually entire communities or counties or even states will become birth control dry or gay free (and, well, isn’t that the real objective here on one level?).
I’ve already posted on this elsewhere, but if you can’t abide by the ethics , maybe you should look into another line of work.
Hmm. Sounds like a market opportunity to me. Maybe one of our lawyer friends can tell me if I would be allowed to fire a Pharmacist for failure to dispense as long as there was a clear company policy against the discrimination described above, and the pharmacist signed a note acknowledging that s/he had been made aware of the policy prior to his/her hiring?
Did Rep. Richardville offer any explanation of how removing a gay person’s appendix, say, could possibly violate a surgeon’s religious beliefs?
I’m waiting for a Christian Scientist to get a pharmacy job, then refuse to dispense any medications at all. That’ll be a fun day.
I’m waiting for a Christian Scientist to get a pharmacy job, then refuse to dispense any medications at all. That’ll be a fun day.
Excellent!!!
i object to Republicanism. can i refuse to yield to Republicans at intersections ?
Some blogger – I can’t remember who, unfortunately – came up with the perfect comment on this:
“Cool! Can I get paid for not doing my job, too?”
What difference does it make if one hands a patient a drug or sends them to a pharmacy that does?
What difference does it make if one sells the police cocaine or sends them to a dealer who does?
Heard there are already laws on the books in Illinois and Mississippi allowing doctors to refuse treatment on moral, ethical, or religious grounds.
It’s this simple: dispensing prescribed medications is a pharmacist’s job. If you anticipate ever being put in a position where your job would require you to dispense a prescription that conflicts with your beliefs, you don’t get into that line of work. If you take the job in good faith, but later find yourself in such a situation, you find another line of work.
By way of analogy: I think unsolicited commercial email is a plague on the internet, that those who traffic in spam are scum, and that they should be prosecuted to the fullest extent of the law–and that those laws should be made much harsher than they are.
If I took a job as a dev for a company, and one day they asked me to design an app that would harvest email addresses or otherwise form a part of an unsolicited email campaign, I would quit my job. Sure, I can try to tell them that I think spamming is unethical and that I won’t participate in generating it–but I’d have a pretty high expectation of losing my job.
[obscenity-laden rant deleted.]
Why is it that so much of the Religious Right seems to be devoting so much effort to make other people’s lives more miserable? Doesn’t their god call them to do the opposite?
what’s next, an exception to lawyers’ “zealous representation” obligations? client: i want you to make a church-state first amendment violation argument. atty: nope, it’s against my principles. client: ???!!! you’re telling me this now? after i have foregone the opportunity to go elsewhere? i’ll have your license! atty: not in this state, you won’t.
beautiful.
Ah, but what I really want to see is the coming collision between (a) the Academic Bill of Rights stuff, which requires professors to teach differing viewpoints (and, my reason for objecting to it, makes this enforceable by law), and (b) some future attempt to allow professors the right not to teach views that go against their religion/beliefs. — I mean, I bend over backwards to teach opposing viewpoints, but if the general principle behind this pharmacy law is right, why should I bother?
some future attempt to allow professors the right not to teach views that go against their religion/beliefs
eventually, we’ll just end up with a system where you can choose a college to suit your particular ideology. they’ll come in all flavors and degrees of Purity. you can just pick the one that reinforces you what you already know.
it’ll be just like blogs, magazines and dating services.
I think combining doctors and pharmacists in this post doesn’t do much for clarity. Pharmacists are to dispense drugs based on other people’s decisions. Doctors are to make decisions about appropriate care. I don’t have any trouble with a doctor deciding that he doesn’t want to perform an abortion, but I would have a problem with a pharmacist who didn’t want to dispense a drug to help control bleeding which was the result of an abortion. I wouldn’t begrudge a doctor 20 years from now who doesn’t feel ok producing a cloned child to replace a killed one, but I wouldn’t be happy with people saying that they won’t treat the clone once produced.
There is a moral difference between the decision-making position of a doctor and the drug-interaction gatekeeping function of a pharmacist.
A minor nit, but there is no
constitutionally mandated separation of church and state
That’s a rather modern formulation, and not a very accurate description of the establishment clause nor is it particularly germane to this issue.
On the pharmacist front, unless they’ve been issued an exclusive license, I don’t understand most of the objections raised. It appears that they’ve made a business decision and are willing to suffer the losses from that decision. Simply shop somewhere else. I mean unless you watched the Soup Nazi episode of Seinfeld and yelled at the TV that “SERVE the soup man! Regardless of your personal views!” If a small businessperson is willing to piss off customers, that’s their choice as far as I can tell.
What difference does it make if one sells the police cocaine or sends them to a dealer who does?
Having just spent four weeks on a narcotics grand jury, I can tell you not much in the eyes of the law. If you send the police to a dealer who sells cocaine, you can still be sent to jail in New York. If I recall, there’s a slight distinction in punishment, but it’s not enough to make this a compelling parallel to the issue at hand.
I think combining doctors and pharmacists in this post doesn’t do much for clarity.
There are two distinct trends with different ramifications, I agree, but I’m comfortable combining them as both are getting mileage from the belief that one’s religion trumps a patient’s needs and I strongly disagree with that. I see a social obligation for health care professionals to not pontificate about legal therapies. That doesn’t mean they have to offer them personally, but they damned well better have immediate alternatives and/or offer the information about access in a timely, unembarassing, nonjudgemental manner for the patient who asks or get out of the business.
Sebastian,
In the case of the physician you are conflating two distinct issues:
1. A physician refusing to perform a procedure, such as abortion, of which he morally disapproves,
and
2. A physician refusing to treat an individual of whose lifestyle he disapproves on moral grounds, even though he has no objection to the needed treatment itself, and regularly provides it to other patients.
That’s a rather modern formulation, and not a very accurate description of the establishment clause nor is it particularly germane to this issue.
You saw the label had “WORMS” on it, but you found that can-opener right there and thought, hmmm?, didn’t ya, Mac?
If a small businessperson is willing to piss off customers, that’s their choice as far as I can tell.
Consider the case cited above, where a couple in a panic calls their doctor, gets a prescription, and rushes to the closest pharmacist because time is of the essence. It’s not at all clear in that story how near the next closest phramacy is, but at a certain point, this health care professional is impacting their health (adding stress, at the very least, if not risking they’ll be too late to stop a potential pregnancy with LEGAL medication).
And perhaps more importantly here, most of these types of stories suggest it’s the luck of the draw. The pharmacists are not saying the medicine is not in stock (which could be the case for any medicine theoretically), but rather that because the patient was unlucky enough to place the order when a judgmental person was on duty, they’re going to be both humilated and inconvenienced. If all that (the stress, the humiliation, the time lost, etc.) is not a violation of the Hippocratic Oath, it should be.
Bernard, actually I was trying to distinguish between the two cases which were conflated in the post. You are right, doctors should be allowed to decline to engage in procedures which (though legal) they find morally questionable. They should not be allowed to decline to treat people whom they find morally questionable.
Mac – a couple of points. One is that there have been instances of “pharmacists holding prescriptions hostage, where they won’t even transfer it to another pharmacy when time is of the essence.” (see WaPo article for more). That’s way beyond being a business decision – that’s the pharmacist intervening in patient care based the pharmacist’s morals. The other is that, in rural areas, there may be no other pharmacy within a reasonable distance. While the market may adjust (another pharmacy coming to town) it does nothing to address the patient’s current needs.
i wonder how supporters will feel the first time a vegetarian pharmacist refuses to fill their cholesterol meds because he thinks the customer is just eating too many hamburgers ?
Consider the case cited above
OK. So they rush to the nearest pharmacy. However, the nearest one happens to be closed when they get there. So are we going to force the orthodox Jew who owns it to open his pharmacy and work on Saturday? I mean if patient needs trump all, isn’t that what you’re advocating? Or how about that time I went to a convenience store in Chicago to get a bottle of water and some Tylenol, but the store was closed so the Muslim owner could say evening prayers. I was pretty sick; didn’t he have an obligation to open up right then? While we’re at it, how do you feel about a devout Muslim storeowner refusing to stock alcohol? I mean how dare he refuse LEGAL medication on religious grounds…
Mac,
I don’t think the pharmacy case can simply be viewed as a small businessman willing to piss off customers.
Most pharmacies are not small businesses these days. If you convinced CVS and Walgreen’s not to fill certain prescriptions around here there would be some options left, but not many. And make no mistake, there will be pressure on the large chains.
And of course in some regions there will be substantial pressure on all drugstores not to fill certain prescriptions. In those cases not pissing off your customers may well mean not filling prescriptions even though you have no objection yourself, and that could easily lead to some medicines simply being unavailable.
Your argument echoes some that were heard opposing civil rights legislation. “Why force a restaurant owner to serve people he doesn’t want to serve? It’s money out of his pocket.”
The trouble with this, then as now, is that patterns develop that make certain services unavailable, and that there exists the possibility – quite real in the case of civil rights – that social pressures would make it in the merchants’ economic interest to discriminate, rather than the other way around.
This sort of libertarian argument, while it may have some initial appeal, seems to me to ignore actual consequences and focus on dubious hypothetical ones.
Sebastian: “I don’t have any trouble with a doctor deciding that he doesn’t want to perform an abortion,”
A doctor can, ethically, refuse to perform any procedure for any reason he or she chooses as long as: 1. the refusal does not jeopardize the patient’s life or health and 2. the doctor refers the patient to someone who is willing to treat the patient appropriately. So I don’t have a problem with a doctor who is unwilling to perform an elective abortion but refers the patient to another ob who is willing to. However, I do have a problem with the only doctor in town refusing to perform an abortion in a woman with an ectopic pregnancy or medical condition that makes the pregnancy dangerous to her (for example, pulmonary hypertension or atrial fibrillation.) Or even refusing to perform an elective abortion if the next nearest doctor competent to perform the procedure does not practice within a day’s drive from the patient’s home. It’s part of the job of being a rural doctor to be willing and able to deal with routine surgical procedures. If the doctor in question is unwilling or unable to do so, he or she find a partner who is willing and able to complete the practice. Or quit and find a different job.
Many small towns have only one pharmacy. If the pharmicist there refuses to fill a prescription that puts a major burden on the patient. In the case of a prescription for the “morning after pill” such a refusal could mean that the patient in question ends up needing a surgical abortion, which is much more inconvenient and painful and mildly more dangerous than taking the prophylaxis.
Mac: it’s not like “separation of church and state” exactly came up for the first time last Term.
And given that the pharmacist is lobbying for an exception to his legal and ethical duty to fill prescriptions, based on religious beliefs, i find the comparision to other professions in which practitioners are required to set personal beliefs aside in service of their clients useful.
the failure to get soup when you want it is rarely life-threatening. [although, its worth remembering that one of the earliest actions of civil disobedience in the 1950’s was lunch counter sit-ins.]
the failure to get medication on a timely basis can be life threatening, and certainly life-changing, if pregnancy ensues.
legal services are rarely as time-critical, and there tend to be more lawyers around than pharmacists. but i’m speaking from big city experience. lawyers also have the absolute right to refuse representation, so the analogy isn’t perfect.
Nevertheless, it seems perfectly feasible to me that a Michael Schiavo in some small town could hire a lawyer on an emergency basis to enforce an advance directive, only to have the lawyer refuse to make the necessary arguments once the lawyer discovered the patient was, say, Catholic.
that’s just appalling. Professional services imply professional obligations. Unless you have a BIG sign on your door regarding the services you won’t provide, by hanging out your shingle you have made an implicit promise to fulfill the scope of your obligation to your client. that’s true, or should be true, of doctors, lawyers and pharmacists.
Mac,
First, as much as I use it as such, you should know that alcohol is not a real medicine. Just sayin’
But you’re constructing very convoluted excuses for this. If you knew your local pharmacy owned by the Muslim or Jew was closed during certain hours, you wouldn’t drive there then, you’d go to the one you knew was open.
The Pulz’s very likely used that phramacy for all kinds of other products/needs. It was only when they asked for a “morning after” medicine they were refused. There’s a significant difference here.
Mac: To the best of my knowledge, this isn’t about when pharmacies are open and when they are closed. This appears to be about an individual making a choice while executing their job that places their personal religious morality above patient needs.
Now if the individual pharmacist in question heard your request for Tylenol, and then told you he was closed, and unable to help you, but continued to serve other customers, that might be more of an issue…but the analogies you’ve run off there, while interesting, don’t seem to be relevant to the discussion at hand.
This isn’t about grocers, or small businessmen, either, really. It is about ethics. Pharmacists and doctors have sworn to uphold a code of ethics. Your kosher deli may not sell pork or shrimp, but they haven’t told you they would, either. They haven’t promised to sell you a ham sandwich. As I understand it, the pharmacist has promised to fulfill patient needs.
Just my two cents.
crutan
But you’re constructing very convoluted excuses for this.
Not really. I’m demonstrating that there are numerous times that moral or religious beliefs infuse the decisions business people make. The establishment clause is a double edged sword and it appears that you’re wanting to perhaps prohibit “the free exercise” portion of it. I’m wondering what is the point where a customer’s “needs” trump a business provider’s right to free exercise?
If you send the police to a dealer who sells cocaine, you can still be sent to jail in New York.
I’m shocked and dismayed. I might remark further, but I think it would be too far off topic. Suffice it to say I find a stark difference between pulling the trigger myself and directing others to others to pull the trigger.
Likewise, I think it’s possible to (1) think that contraception is bad, but (2) respect the views of those who disagree, and (3) tell them where they can go get a bottle of evil without oneself otherwise involved. Some might feel responsible enough for the “consequences” of #3 as to avoid it, but that’s a personal matter.
“However, I do have a problem with the only doctor in town refusing to perform an abortion in a woman with an ectopic pregnancy or medical condition that makes the pregnancy dangerous to her (for example, pulmonary hypertension or atrial fibrillation.) Or even refusing to perform an elective abortion if the next nearest doctor competent to perform the procedure does not practice within a day’s drive from the patient’s home.”
I suspect very few doctors have a problem with medically necessary abortions, so that isn’t really an issue. I’m not at all willing to give you the second case. If it is an elective abortion, the doctor can elect not to perform it because it isn’t medically necessary.
I’m shocked and dismayed. I might remark further, but I think it would be too far off topic. Suffice it to say I find a stark difference between pulling the trigger myself and directing others to others to pull the trigger.
I was shocked too, and although I can’t comment on specifics, suffice it to say most of my co-jurors were also shocked when such a case came up. We didn’t give the DA exactly what they were looking for, so shocked were we.
I’m demonstrating that there are numerous times that moral or religious beliefs infuse the decisions business people make.
Absolutely, but as crutan well noted, Mac, the difference is in the ethical expectations. If the Pulz’s had been happily served when placing prescriptions for all their other medicines by these pharmacists and their conversations were always quite friendly and there were no notices posted that this pharmacy would not fill a prescription of a certain type, then they have every ethical right to expect this same friendly pharmacy they’ve been patronizing to fill their emergency prescription with out humilating them and without delay.
the difference is in the ethical expectations.
Really? So if I went to my long time doctor and asked him to do something I deemed medically necessary but was against his religious beliefs, he’d have an ethical obligation to do it anyway? I don’t see how prior service creates future obligation here.
Let me ask again, at what point does customer “need” trump a provider’s right to free exercise of their beliefs?
Mac – If the medical procedure was requested was legal, appropriate to the condition in question, and a generally accepted practice, I believe the physician would be obliged to refer you to someone else.
I note that you haven’t touched on the question of a pharmacist’s refusal to transfer a valid prescription to another pharmacy.
“This sort of libertarian argument, while it may have some initial appeal, seems to me to ignore actual consequences and focus on dubious hypothetical ones.”
But that never happens!
I note that you haven’t touched on the question of a pharmacist’s refusal to transfer a valid prescription to another pharmacy.
Because it seems a minor point. If you refuse to do something on religious or moral grounds, it would seem a consistent position to not assist in streamlining the process for someone to get around your refusal.
Macallan: Let me ask again, at what point does customer “need” trump a provider’s right to free exercise of their beliefs?
Interesting that you put customer “need” in inverted commas, but not the provider’s “beliefs”.
Are you just arguing the wrong side for the hell of it, Macallan, or do you sincerely believe in it?
Why is it that so much of the Religious Right seems to be devoting so much effort to make other people’s lives more miserable?
Just another day at the culture wars, which they have been preaching for years. There is nothing benign about it.
Your argument echoes some that were heard opposing civil rights legislation. “Why force a restaurant owner to serve people he doesn’t want to serve? It’s money out of his pocket.”
The trouble with this, then as now, is that patterns develop that make certain services unavailable, and that there exists the possibility – quite real in the case of civil rights – that social pressures would make it in the merchants’ economic interest to discriminate, rather than the other way around.
Excellent argument — and this is about refusing to do business based on a form of religious discrimination.
Are you just arguing the wrong side for the hell of it, Macallan, or do you sincerely believe in it?
I always argue for the hell of it; however, I never argue the wrong side.
:-p
Macallan: I always argue for the hell of it
I meant, do you actually believe that (for example) Mormons ought to have the right to refuse to serve black people because black people are evil: certain breeds of Christian ought to have the right to refuse to serve Jews because Jews are evil: certain breeds of Christian ought to have the right to refuse to serve gays because gays are evil: and so on and so forth? This certainly appears to be the position you’re taking, and I wondered if you were taking it just so there was an opposition here for others to argue against, or if you really feel it?
I note, by the way, that you appeared terribly outraged when the Obsidian Wings collective decided to refuse services to Tacitus on the grounds of their belief that he had no right to be that rude to Edward. Was that outrage sincere, and if so, how do you reconcile it to the position you’re taking here?
Mac – it’s not a minor point. The pharmacist is now interfering with the treatment of the patient. The patient has to go back to the doctor to request a new prescription. The doctor, in order to fulfill his obligations, needs to verify that the prescription has not, in fact, been filled. Let’s say that the ensuing delay in treatment results in say, a pregnancy that because of complications causes the death of the mother. Should the pharmacist be tried for manslaughter? Can the family successfully sue the pharmacist for negligence?
I can’t help but gaze with awe at defenders of the concept that someone can selectively refuse to perform their job duties based on discriminatory religious beliefs.
You just know they’d be the first ones demanding the pharmacists be fired if the pharmacists were anything other than conservative Xtians refusing to serve the conservative Xtian’s favorite targets.
If you refuse to do something on religious or moral grounds, it would seem a consistent position to not assist in streamlining the process for someone to get around your refusal.
I disagree. To the extent you have the right to refuse to do something on religious grounds, the right is limited to controlling your behavior, not others’.
Suppose you rush to your hypothetical pharmacy owned by an Orthodox Jew on Friday afternoon and find that you are a bit late. Sundown approaches and the pharmacist is just locking up and won’t serve you on religious grounds. Is it really OK for the pharmacist to refuse to direct you to another drugstore nearby that is still open?
Holy Cow Jes!
I had no idea Tacitus was banned because of the religious beliefs of the ObWi collective. Man, you learn new things everyday ’round here.
Isn’t the pharmacist over-riding the doctor’s treatment in this case? Isn’t that equivalent to practicing medicine? Does he have a medical license?
What if the pharmacist has a religious objection to providing pain relievers? What if a nurse had objections to administering it?
Macallan: had no idea Tacitus was banned because of the religious beliefs of the ObWi collective. Man, you learn new things everyday ’round here.
Ah. So when you talk about “beliefs”, you mean religious beliefs. Do you have a reason for privileging religious beliefs above all other kinfs of belief?
“Is it really OK for the pharmacist to refuse to direct you to another drugstore nearby that is still open?”
Since you acknowledge “To the extent you have the right to refuse to do something on religious grounds, the right is limited to controlling your behavior” and they are in fact only controlling their own behavior, it seems a difference without distinction.
“I don’t perform abortions, but here’s a free phonecard to call Planned Parenthood” would certainly be polite, but I don’t see it as an obligation.
Paul Krugman had an insightful column that gives a strong reason why these “right of refusal” laws are not a good thing. If pharmacists have a “right of refusal”, then in areas where the religious right is strong they can be pressured to exercise this “right of refusal” – even if it does not accord with their personal morals.
In other words, it’s a tool for a pressure group to deprive other people living in their area of perfectly legal medicines.
I can’t help but gaze with awe at defenders of the concept that someone can selectively refuse to perform their job duties based on discriminatory religious beliefs.
…but enough about the Founders. How ’bout them Red Sox?
Do you have a reason for privileging religious beliefs above all other kinfs of belief?
Besides the Constitution?
“What if the pharmacist has a religious objection to providing pain relievers? What if a nurse had objections to administering it?”
Part of Hitchens’s case against Mother Teresa.
A quick google inclines me to suspect pharmacies’ hours are regulated and overseen by boards – as long as the pharmacist follows the law, I don’t see a problem.
Mac, maybe the kitten lets the rifle do the talking, maybe not – but Jes does not speak for the kitten.
Mac, maybe the kitten lets the rifle do the talking, maybe not – but Jes does not speak for the kitten.
I thought my answer made it obvious that I knew that. Dang. Too subtle again — it’s a problem I’ve got.
Macallan: Besides the Constitution?
No, that’s just fine. I wondered what your reason was for only allowing religious beliefs as a motivation, but if your reason is “the Constitution”, I’ll take that as an answer.
Okay, so let me get this clear: You were outraged when ObWing collective decided to deny Tacitus services (if we may so interpret the privilege of being allowed to comment here) because their motivation for doing so was not religious, but ethical/aesthetic: they objected to his rudeness.
You would not have objected to their banning Tacitus had they done so because they’d all suddenly converted to being Jehovah’s Witnesses and decided that Catholics are too wicked to comment. (Or whatever religious Tacitus is. I rather thought he’s Catholic, but I admit I’m now not sure.)
Do I have that right? Religious beliefs are a good reason for denying someone services, in your book: but rudeness isn’t?
That’s a rather modern formulation, and not a very accurate description of the establishment clause nor is it particularly germane to this issue.
Yes, so “modern” that the formulation goes all the way back to Thomas Jefferson referring to (and insisting on) a “wall of separation between church and state” in his letter to the Danbury Baptists of Jan. 1, 1802. So, if by “modern” you meant “nearly contemporaneous with the ratification of the Constitution and the Bill of Rights,” then sure.
The mind boggles at the idea that refusing to give a patient their prescription back so they can take it elsewhere is not “controlling others’ behavior.”
Mac, maybe the kitten lets the rifle do the talking, maybe not – but Jes does not speak for the kitten.
“I thought my answer made it obvious that I knew that. Dang. Too subtle again — it’s a problem I’ve got.”
Mac, I knew that you knew that – just thought the attempted Mafia tone was funny. Or did you know that I knew that you knew, and _this_ is the point at which you’re too subtle for me?
Do I have that right?
Since they reserve the right to ban to anyone for any reason, and when Tacitus was banned I told them I supported their right to do so, but also told them I couldn’t support the blog for doing so, it appears that you’re so far a field that right or wrong isn’t even possible.
I don’t actually speak for Mac, but I suspect he might point out a subtle difference between ‘outraged’ and ‘would make illegal’ or even ‘pull the license’.
I knew you knew that I knew…
I don’t actually speak for Mac, but I suspect he might point out a subtle difference between ‘outraged’ and ‘would make illegal’ or even ‘pull the license’.
…or even ‘would force them to go against their religious beliefs’.
Ah. So, by using the real-life example of your outrage over Tacitus’s banning, I think I’m actually clearer about what you think:
You think that anyone has the right to discriminate against anyone else for any reason at all.
But you cannot support a business if that business exercises their right to refuse services to a customer who is virulently rude and offensive to the staff/the management.
…or even ‘would force them to go against their religious beliefs’.
Who is being “forced”? No one forces them to become pharmacists.
Who is being “forced”? No one forces them to become pharmacists.
Wow again. I had no idea all the ObWi writers were pharmacists too! How do they find the time for two jobs and writing here?
These guys are amazing.
Macallan: Wow again. I had no idea all the ObWi writers were pharmacists too! How do they find the time for two jobs and writing here?
Oh. I thought we’d gone back to talking about the thread topic. My mistake.
Oh. I thought we’d gone back to talking about the thread topic.
Heh, I was having a hard enough time trying to follow your “outrage” track, jumping tracks only makes it harder.
I think I’m actually clearer about what you think
Err…no.
Mac –
Say a pharmacist refused to fill a prescription for birth control, and refused to release the prescription back to the customer. Say this customer complained to the manager. Say the manager fired the pharmacist for refusing to serve the customer.* Is the manager discriminating against the pharmacist because of his religion, or is he justified in exercising his right to control his workplace and offer legal services to the public?
*this presumes, of course, that store managers outrank pharmacists – I am not in that business, so I can’t say.
Err…no.
Ah. So your position in this thread is really one of devil’s advocate, and you don’t actually believe any of the stuff you’ve been spouting. Fair enough.
you don’t actually believe any of the stuff you’ve been spouting.
No, I just don’t believe any of the stuff you claim I’m spouting. Pretty simple really.
“I knew you knew that I knew…”
Ok, Mac, upping my assessment of your subtlety. I’ll add an extra layer of obfusc in my comments to you in future – hopefully exactly one.
Is the manager discriminating against the pharmacist because of his religion, or is he justified in exercising his right to control his workplace and offer legal services to the public?
That’s a excellent question.
No, I just don’t believe any of the stuff you claim I’m spouting. Pretty simple really.
Nope. I summarized what you said you believed in my comment at March 29, 2005 04:09 PM. If you don’t want to stand by it, fine, you’re playing devil’s advocate: it’s not worth arguing with you.
But you knew that I knew you knew that I knew.
Skipping all the devil’s advocate stuff from Macallan, Edward:
Would anyone sane consider a licensed doctor in the US within his rights to refuse emergency treatment to a woman just because she was having her period?
I hope not, and I don’t see it coming, because as far as I can see, these new laws are intended to privilege Christianity only, no other religion.
And so, states are beginning to pass laws to protect individual pharmacists.
This is absurd. If a soldier discovers that s/he can’t kill because their religion forbids it (I recall reading about a Catholic soldier who, after his experiences in Iraq, decided that he had to become a conscientious objector) the solution is for the soldier to leave the army, to quit being a soldier. Similarly, if a pharmacist discovers that s/he has problems of conscience with the duties required of him/her as a pharmacist, the solution is to change careers.
Freedom of conscience doesn’t mean your freedom to impose your religious beliefs on me.
“But you knew that I knew you knew that I knew.”
Yeah, I guess I did, deep down – I suspect that at some point the reference chain stopped being funny and I wasn’t sure where it broke…
Is the manager discriminating against the pharmacist because of his religion, or is he justified in exercising his right to control his workplace and offer legal services to the public?
That’s a excellent question.
And one I asked way upthread. However, I’m now wondering if the ethics that Happy Jack posted are adhered to by all pharmacists; i.e. is it a requirement of their licensing that they follow them? If so, were I a manager/business owner, I’d feel within my rights to fire the pharmacist on the basis that if s/he no longer follows the ethics required of licensing, then they have removed themselves from the field. In fact, I might see it as my duty to do so lest I, the pharmacist and the company be sued for fraud.
Crionna: In fact, I might see it as my duty to do so lest I, the pharmacist and the company be sued for fraud.
And if you do so, and the pharmacist then calls on the state laws that say s/he’s entitled to decide what services to provide on the grounds of his/her religious beliefs?
The more I think about it, the nastier these state laws sound.
“These guys are amazing.”
Ah, finally something we can all agree on. 🙂
I’m not sure which of the ethics Happy Jack linked to is actually being violated. On the same website there was this .pdf of a report of policy adoptions with the following:
FYI
I’m think it’s the bit about
but then again, it appears this means different things to different people. Perhaps the mere existance of some willing pharmacist within the same time zone as the patient is an adequate system.
wow, a whole bunch of thought fouls.
let’s slice and dice this a different way.
1. Assume pharmacists hold a state license and a condition of the license is that they fill all prescriptions. Can the pharmacist refuse? No. EEOC v. Smith — individuals cannot refuse to comply with laws of general applicability, even if it interferes with their religion. Is that the right answer? Yes. If pharmacists want to be able to get a religious exemption against filling certain prescriptions, they should go to the legislature.
2. Assume that the legis. passes a blanket law saying that any time without notice a pharmacist can refuse to fill a prescription, on religious grounds, and refuse to return it to the patient. Legal? I really doubt it. It looks a lot to me like an establishment clause violation. The licensure of the pharmacist constitutes sufficient state action so that allowing his religious based discrimination violates the first amendment.
Point 2, for those still reading, is where Mac’s soup analogy fails. there is a HUGE difference between state-licensed and state-supervised health care services and soup sales.
3. Now, the legis. passes a law saying that any time a pharmacist may randomly refuse to approve a scrip, without saying why. First, this could be one of the few times where a state law would be stricken as violating the police power to regulate the general welfare. Second, this could likely violate the Equal Protection clause. (hidden discriminatory intent plus discriminatory impact.)
4. Now, assume that i’m wrong on point 2 and the regulation stands. Can the federal congress over-ride? Despite my new-found admiration for states’ rights, sure. the federal handle is probably even stronger than it is in many other areas, given the fact that the feds already regulate medicine.
5. Can a state craft a narrow exception allowing pharmacists to refuse to fill certain scrips? Would it make a difference whether the pharmacist had a blanket refusal to fill a certain type of scrip, or whether the pharmacist wanted the right to refuse to serve certain individuals?
Here’s the hard one, and i really have to get back to work. 5a — yes. I see no obvious constitutional violation in a pharmacist refusing to stock, for example, birth control pills. 5b — yes, big difference. This is the clear, gross equal protection / first amendment violation. Once the state commits to overseeing the practice of pharmacy, it cannot allow pharmacists to violate the constitution. This is simply point 2 over again.
Sebastian: Ah, finally something we can all agree on. 🙂
True! 😉
JerryN: Perhaps the mere existance of some willing pharmacist within the same time zone as the patient is an adequate system.
Yes – more realistically, does this mean that a pharmacist who is the only one available in a small town has no right of conscience?
more realistically, does this mean that a pharmacist who is the only one available in a small town has no right of conscience?
The answer would be ‘No’. At least from that policy. AphA recognizes the right, but only supports establishing access that doesn’t compromise that right.
Right, so moving on: the part about “compromising the pharmacist’s right of conscientious refusal” is garbage.
A pharmacist has no right of conscientious refusal, except the right to quit being a pharmacist.
Were you aware of this, Edward:
A pharmacist has no right of conscientious refusal, except the right to quit being a pharmacist.
Huh? The AphA says specifically they have a right of conscientious refusal.
The AphA says specifically they have a right of conscientious refusal.
Indeed. But the AphA is not empowered to decide that a pharmacist is allowed to break state and federal laws, as Francis outlined carefully and clearly in his comment [March 29, 2005 05:40 PM].
But the AphA is not empowered to decide that a pharmacist is allowed to break state and federal laws, as Francis outlined carefully and clearly in his comment [March 29, 2005 05:40 PM].
Unless I misread it (always a possibility) none of these laws actually exist. Francis was talking lots of “assumes”. Also I couldn’t find a EEOC v. Smith case. Perhaps Francis could provide a cite.
What struck me was that the cases given in the article were pharmacists working at places like Kmart and Walgreens. If there is majority opinion against this sort of behavior, the obvious option is to apply pressure to the management of the chain. I’m wondering what others think about that option (I have lots of thoughts, but not sure if it is a good idea or a bad one)
I’m wondering what others think about that option
Well, it’s not that different than free speech for me. You have to tolerate people making asshats of themselves in order to reserve the right for yourself. You can’t say Ward Churchill out to be fired without risking everyone’s right. So I’d tread lightly on trying to infringe on people’s right to freely practice their faith lest you unintendedly put everyone’s rights in danger.
employment div. v. smith (always get that case name wrong, dammit.)
“Although a State would be “prohibiting the free exercise [of religion]” in violation of the Free Exercise Clause if it sought to ban the performance of (or abstention from) physical acts solely because of their religious motivation, the Clause does not relieve an individual of the obligation to comply with a law that incidentally forbids (or requires) the performance of an act that his religious belief requires (or forbids) if the law is not specifically directed to religious practice and is otherwise constitutional as applied to those who engage in the specified act for nonreligious reasons”
link
i think my assumptions are pretty well taken, though you’re free to disagree.
Thanks for the link
It is not “freely practicing your faith” to deny service to your employer’s customers who are seeking legally available products under the supervision of their doctors, and it certainly isn’t “freely practicing your faith” to conspire to ensure that they cannot seek that same service elsewhere as well. It’s bullying, and trying to hide it behind some noble “free exercice” excuse is a bunch of crap. Note that the only class of pharmaceuticals to which this is being applied is birth control pills and “morning-after” pills. This is just the next wedge in the abortion war.
Well, it’s not that different than free speech for me. You have to tolerate people making asshats of themselves in order to reserve the right for yourself. You can’t say Ward Churchill out to be fired without risking everyone’s right.
But mac, in the Sartre thread, you claimed that capitalism was defensible because it was individual choices (my restatement and if it’s wrong, please correct me). If I pointed out that this chain hires people who feel they can withhold medical ‘treatment’ from you based on their beliefs, why would you object to the aggregate weight of individual choices?
And if you do so, and the pharmacist then calls on the state laws that say s/he’s entitled to decide what services to provide on the grounds of his/her religious beliefs?
My point is that if s/he violates the ethics then s/he is no longer a pharmicist in the first place and MUST be replaced.
If there is majority opinion against this sort of behavior, the obvious option is to apply pressure to the management of the chain.
Agreed. The Pulzs should have a friendly party get a prescription filled by the same pharmacist and then sue the company for not employing and actual pharmacist, since this one gave up that status when s/he violated the ethics required to BE a pharmacist.
The real problem I have here is the presumptive practicing of medicine on the part of pharmacists and the lack of ability to see where it goes on the part of people who support it.
Right now its Birth Control and EC. What is to stop a concientious objector from refusing to fill a script for a medication that they deem too expensive? Or a “lifestyle” medication, you know, a Statin perhaps because the patient should just eat less fat.
It also presumes that all women taking Birth Control are wanton sluts. (Seriously, it really does seem to presume this.) I spoke with a friend this morning who takes Birth Control to help control endometriosis.
Pharmacists do not have access to invidiualized health care information such that they can have any basis on which to legitmitately refuse to provide medications, nor do they have informatino to know why a prescription was written or the effects of not having the medication on the patient.
Its a frightening push to allow pharmacists to refuse to fill prescriptions. It seriously undermines the provision of health care.
Pharmacists have to take an exam to be licensed. That seems to be a national requirement, and there seems to be a standard national test. But each state appears to have its own standards for licensure, renewal, and re-licensure after a license has lapsed.
The only professional standards I’ve found (in a brief Google search) have to do with knowing what the drugs are, not dispensing drugs without an Rx, and not disclosing Rxs to nonauthorized people. I’m not sure if these are national or state-level standards.
I can keep searching, see if refusal to fill prescriptions runs afoul of any professional licensing requirements. I would think refusing to fill an Rx skirts around the edges of unlawful disclosure.
Does anyone here know more about this?
If I pointed out that this chain hires people who feel they can withhold medical ‘treatment’ from you based on their beliefs, why would you object to the aggregate weight of individual choices?
It isn’t that I would object lj, as an individual you’re free to boycott the chain. Just be aware of the consequences.
It occurs to me that refusing to fill prescriptions constitutes unlicensed, unlawful practice of medicine. The pharmacist is deciding unilaterally what drugs a person “should” take, and not in reference to drug interactions.
Think about it, LJ: If you as a consumer insist that pharmacists dispense the drugs that patients’ doctors have prescribed without passing moral judgement on the patients or withholding service from them because they believe their souls are threatened if they use the Pill, then your right to believe in the deity you see fit might be threatened. Or something.
I note that you haven’t touched on the question of a pharmacist’s refusal to transfer a valid prescription to another pharmacy.
Because it seems a minor point. If you refuse to do something on religious or moral grounds, it would seem a consistent position to not assist in streamlining the process for someone to get around your refusal.
Maybe we could address this transfer issue from a different perspective. Whose property is the prescription? Isn’t it the patient’s? Doesn’t the patient just hand it over to the pharmacist to meet the legal requirement of proving that a doctor had issued a prescription, and also for convenience? When exactly did the ownership of the piece of paper actually change hands? If I’m unhappy with my pharmacy, or I move, don’t I have the right to take my prescription back?
If it’s my property then the pharmacist has no business withholding it if I want to take it elsewhere.
I wonder what these pharmacy prigs would say if their refusal was met with “well, I guess we’ll just have to HAVE AN ABORTION, THEN!”
If it’s my property then the pharmacist has no business withholding it if I want to take it elsewhere.
Seems like a fair point to me.
Mac – Seems like a fair point to me. It’s about damned time. To me, that’s the issue that is offensive. Guess all the crap I’ve posted wan’t clear. Gotta work on the English as a First Language stuff.
As much as it is off-topic, I can’t believe y’all are letting Macallan get away with the idiotic assertion that constitutionally mandated separation of church and state is a “rather modern formulation”
Is there any possible way to parse that quote that doesn’t make Macallan look completely ignorant, escept maybe to argue that Jefferson was a “modern” figure?
To then have the gall to refer to the founders later in the thread is just sad.
Of course, misspelling ‘except’ makes me look ignorant, too.
Big Ben, in fact Phil pointed out that “separation of church and state” goes back to Thomas Jefferson, at March 29, 2005 03:57 PM. Of course, Macallan never acknowledged that he’d erred, but then he’s arguing as devil’s advocate on this thread, supporting a right to discriminate on the grounds of religion that he does not himself believe in.
Oops. My apologies to Phil.
I guess I missed it because, as you say, Macallan failed to acknowledge a blatant error on something that anyone who has studied the Bill of Rights at all should know.
So, Macallan, were you knowingly spreading false theocratic propaganda, or were you just ignorant enough to be duped by it yourself?
Big Ben: So, Macallan, were you knowingly spreading false theocratic propaganda, or were you just ignorant enough to be duped by it yourself?
May I direct your attention to the Posting Rules? This comment easily fails the “Be reasonably civil” rule. (And, to quote Dorothy L. Sayers, “A bland and deadly courtesy is infinitely more devastating, don’t you think?”)
Reading over my last comment, I realized that one reason I like reading this blog is that people usually refrain from taking that kind of tone with other posters. I apologize for being uncivil and I’ll tone it down in the future. I stand by the content of my post, but the wording was a bit over the top.
Crossposted.
You’re right. It bothers me when I see other people doing it here, and I’m embarrassed to see myself fall into it.
Also, thanks mac for addressing my question. I agree that a boycott is a double edged sword, but if the vast majority of pharmacists are employed by companies like Walgreens and K-mart, it is the obvious pressure point.
I just realized that I’m actually running a fever, which explains, but doesn’t excuse, my intemperate comments. I’m a great admirer of the community y’all have built up here. I read ObWi every day because there is always something to learn from the discussions here, and I’m mortified that in one of my rare de-lurkings I became part of the problem rather than part of the solution. Apologies to all.
I’ll shut up now and go to bed with lots of liquids.
Come back when you’re feeling better Big Ben.
e
Ah Big Ben, bringing up the old chestnut of Jefferson’s little letter to the Danbury Baptists, a letter written 15 years after the constitution was written and 13 after it was verified. A letter not from one the key architects of the constitution or Federalist Papers. Not from Madison, Hamilton or Jay. A letter from someone who is rather famous for at one point or another taking every possible angle on issues and therefore can be quoted to support nearly any argument. A minor letter that went forgotten for a half century, and would have been forgotten except it was reproduced in a collection Jefferson’s papers in the 1850’s and then nearly 100 years after the constitution was written it was cited in Reynolds v. United States and then again in McCollum v. Board of Education in the late 1940’s.
But that’s just off the top of my head, let me phrase it in a less “idiotic” and “ignorant” manner: It is a rather modern formulation based on court rulings grasping at straws and settling on an old letter.
Oh, and you’ll need to explain the “theocratic propaganda” comment, lest I think you ignorant or idiotic for not knowing what theocrat or propaganda mean. You see, someone having a different point of view on the establishment clause doesn’t make them a theocrat or someone who systematically propagates doctrine.
Very late to the discussion, I know. But I was wondering what position Big Pharma has taken on these new laws? Wouldn’t this start to eat into their profits? And couldn’t it potentially drive another schism into the Republicans who support both sides?
Mac, really. Jes called Ben out and he apologized. Or do your religious beliefs not permit you to accept apologies when offered?
As for your thesis that Jefferson didn’t actually believe any of the Enlightenment ideals (that were arguably woven into the foundational ideals of the United States, but you don’t accept that), but just had a change of heart in his twilight years in a single multiple viewpoint minor letter, allowing modern day courts ‘grasping at straws’ to seize on it, well, in place of idiotic and ignorant, I’ll just say that it is novel, especially in light of this (or better yet, the draft version). As is the notion that Madison didn’t say anything about separation of church and state. John Jay, he’s an interesting one, especially since he didn’t initially think much of American independence, being a Tory. And I don’t think we want to talk about Hamilton, this being a family site and all, though the notion of Hamilton and Jefferson both representing the same point of view in all this is again, rather novel.
Mac: court rulings “grasping at straws” seems a little over the top. What is your view of the Establishment Clause, and why are you right?
On a purely consequentialist level, looking around the rest of the planet, it appears that the Establishment Clause may be the single most important limitation on the power of the federal (and, thru the 14th amendment, state) government. Forcing our governments to be obessively secular likely saved this country more than once. (and, since it seems we are going through yet another Revival, may yet again.)
back to the point at issue, i think the best comment to date is that the denial of a ‘scrip constitutes the unlicensed practice of medicine.
but i still think that (a) a state has the power to require pharmacists to fill all ‘scrips; and (b) a state does not have the power to allow pharmacists to discrimate based on their exercise of religion. There is too much state action in giving pharmacists a monopoly in the issuance of regulated substances. I look forward to hearing contrary views.
Mac, really. Jes called Ben out and he apologized. Or do your religious beliefs not permit you to accept apologies when offered?
lj, Ben’s apology occurred after I started my response. I wrote most of the response, had to attend to something else, then finished it and posted it. A thread continuity issue that I didn’t catch when I previewed my comment. So that’s my bad. However, given that I don’t recall stating any religious beliefs, or why you would assume anyone’s would not permit them to accept apologies — where does that come from?
You will also notice that I never stated that Madison et al didn’t write or comment about the relationship of the state and religion. They in fact did quite a bit. Also curiously, never did I put forth a thesis that Jefferson didn’t actually believe any of the Enlightenment ideals and I’m not sure where you’d come up with that. Additionally, where do I claim Jefferson and Hamilton would have the same view on anything?
Just an FYI to my point of view, the constitution is a negotiated contract between 13 newly independent nations, nations whose representatives had wildly divergent views of how a union of those nations should form and operate. Jefferson and Hamilton are excellent examples of people with contrary views, views so contrary that to focus solely on one or the other’s would be to ignore the debates and compromises necessary to achieve and ratify a constitution. IMO, the establishment clause is very well written, and captures well the debate and compromise of all the founders. To use a phrase like Edward did of “constitutionally mandated separation of church and state” is inaccurate shorthand to something more complex and nuanced. I have enough problems with the shorthand of “separation of church and state” not defining the clause accurately in any and all circumstances, let alone hanging “constitutionally mandated” on top of it. I fully support the concept of a separation of church and state, particularly as envisioned by the founders and their concerns about the Church of England. I also think it has been wise in many cases to extend beyond what was envisioned in order to protect against certain unforeseen abuses or sensitivities. However, it is risky, if not foolish, to pretend that a short phrase in a letter written by a sitting, not to mention a rather flexible-thinking, president to a tiny group in Connecticut could fully or accurately capture Founder’s Intent on the subject.
To use a phrase like Edward did of “constitutionally mandated separation of church and state” is inaccurate shorthand to something more complex and nuanced.
Only if you have an axe to grind that requires that nuance as lubricant. Otherwise the point is as simple as that made in the previous sentence: Churches cannot issue licenses to doctors or pharmacists, therefore, regarding the profession, religious obligations fall second to professional obligations.
Churches cannot issue licenses to doctors or pharmacists, therefore, regarding the profession, religious obligations fall second to professional obligations.
Hm. Does this mean that Catholic hospitals should not have “right of refusal” to carry out essential operations, as they do now?
religious obligations fall second to professional obligations.
Hmmm, I missed that ‘professional obligation’ part in the constitution. Are you saying that the state should mandate that pharmacists perform duties that violate their religious beliefs?
Should Catholic doctors have to provide elective abortions?
Just thinking, why would a pharmacy stock a medication that it won’t sell?
I can only come up with a few possible answers. The first is that they employ more than one pharmacist and at least one of those pharmacists will fill the prescription. If that’s the case, then the pharmacist who objects to the sale really should quit. I mean, that person is working for an employer who is facilitating immoral behavior.
Another is that the medication is indicated for uses other than the objectionable one. This gets tricky, because AFAIK prescriptions don’t contain any information about the condition that the medication is being used to treat. So, how would the pharmacist decide which ‘scrips to fill and which to refuse? Guess based on the dosage?
Any other thoughts?
No, they should refuse to license pharmacists who intend to selectively refuse to perform their professional duties based on the type of medication being dispensed and the genders of the persons to whom they are dispensing it.
Aside from Catholicism, which religions might genuinely have tenets that forbid providing chemical birth control to women?
Ok, let me put it this way. Why, under the rubric of professional responsibility being put forth by the liberals on this thread, should a Catholic doctor not be required to either perform elective abortions or have his license revoked?
hmmm…Mac, Jes AND Sebastian disagreeing with me.
Perhaps I need to rephrase that. How’s this?
Because licenses are issued by the secular government, the public has a right to expect that state-licensed health care professionals (whom they invest their time and money in developing a relationship with) will offer any legal therapy unless their health care professionals have made it clear beforehand that they won’t provide that therapy. This handles the Catholic hospital or Catholic doctor’s issue.
What I’m getting at here, as noted above, is the legitimate ethical expecation of health care professionals. The community places a large degree of faith (and via that authority) in the people it licenses to provide health care. For such professionals to spring upon their patients the news that they object to this or that therapy and won’t provide it, in their patients’ hour of need, is unethical.
Edward: Mac, Jes AND Sebastian disagreeing with me.
Hell no. I’m agreeing with you.
My point is that yes, a Catholic who wants to become a doctor needs to think “Am I prepared to perform an abortion on request as part of my profession?” and if the answer’s “No”, not become a doctor – or at least, stay out of any speciality where s/he could legitimately be requested to perform this operation.
I see no reason why any religionist should be permitted to impose the restrictions of their religion on anyone else. Whether pharmacist or doctor.
More importantly, doctors and pharmacists serve two different purposes. The medical decision to prescribe a medication is between a doctor and patient, and that’s it; the pharmacist’s sole responsibility is to dispense it, warn the patient of potential side effects and interactions, and send them on their way. The pharmacist is neither competent nor authorized to make medical decisions; and for patients for whom chemical birth control is a medical necessity — and even for those for whom it’s a matter of informed choice — that’s exactly what they’re doing, in the name of some supposed “free exercise” which is more accurately described as “sticking their noses where they don’t belong.”
Seeing Jes’s comment in preview, I’ll add this conundrum: Should a Jehovah’s Witness EMT or ER physician be permitted to refuse to transfuse blood for a patient who is in immediate need of one?
I really do have other things i need to be doing today, but i can’t lay off.
1. I believe that a pharmacist may simply refuse, on a blanket basis, to carry a particular medication. Marinol is against your religion? Don’t carry it. Similarly, doctors may refuse on a blanket basis to perform abortions.
why is this ok? because there is no discrimination; everyone is treated equally.
2. Once, however, doctors and pharmacists have chosen to carry the med / conduct abortions, they MUST provide the service equally.
why? A. Equal protection, to wit: discrimination based on religion is uncon. B. Establishment Clause. Doctors and pharmacists are extensively regulated by the state. State regulation is pervasive, so broad that a monopoly is granted to those holding state licenses which are difficult and expensive to get. Doctors and pharmacists are, in my view, to a certain extent state actors. The state may not, under the establishment clause, condone discrimination based on the state actor’s religion.
At some point, i believe, the right of association (also protected by the first amendment) kicks in. For example, could a restaurant require that its patrons be married? Under current California law, no. We have very broad equal access laws. (Unruh Act, if anyone cares.) But could California change its mind and allow a hairdresser / restauranteur / landlord to discriminate based on religion? I dunno; I’m pretty sure there’s a case on the landlord issue, but i gots to get working. i’ll check back later.
That reminds me — some contraceptives are prescibed not for birth control but to control hormonal imbalances (typical treatment for PCOS include bc pills).
And check this out:
gynecologist refuses to prescribe contraceptive
Hell no. I’m agreeing with you.
Phew!! Thought the planets had aligned or soemthing there.
I still think Phil’s comment about religions that don’t believe in the most standard of medical interventions is the most compelling rationale for why the line must be clearly drawn somewhere. It’s the state’s place to do that. If someone can’t abide by the law, then, as Jes suggests, they should choose another profession.
Edward: If someone can’t abide by the law, then, as Jes suggests, they should choose another profession.
I’m backing off on this a little. I see no reason why a Catholic couldn’t take a square look at the issue and decide to become an orthopaedic surgeon, or any speciality equally far removed from abortion. That’s fair enough. But a pharmacist doesn’t have that option: and a person who isn’t willing to supply drugs prescribed by a doctor because of their conscience, shouldn’t then become a pharmacist.
Your distinction is not inconsistent with my declaration Jes.
Your distinction is not inconsistent with my declaration Jes.
No. I’ve just finished reading through the article Votermom linked to, and I’m dumbfounded and outraged at this – the arrogance of these people!
the arrogance of these people!
Strikes me that way as well. I’d support legislation that required pharmacy’s that don’t fill certain prescriptions to be forced to advertise that fact on their doors, to prevent customers from being humiliated the way these pharmacists are clearly enjoying humiliating them.
that required pharmacy’s
or “that required phramacies” even…don’t know why I do that…
For such professionals to spring upon their patients the news that they object to this or that therapy and won’t provide it, in their patients’ hour of need, is unethical.
This seems clearcut, and I would endorse the legislation Edward suggests. If we’re going to allow pharmacists not to supply certain medications, then it certainly seems fair to require them to make that well known ahead of time. That would solve a lot of the problems, but not all.
I do think we have to be careful about situations arising where legitimate medications are simply not available, either in a one-pharmacy town or because of pressure on pharmacists, or because some beliefs are held by so many pharmacists in an areas as to make it difficult to find one willing to dispense birth-control pills, for example.
What would you think, Mac or Sebastian, about a pharmacist who refused to dispense birth-control pills not out of any personal convictions, but because of demonstrations in front of the drugstore?
“What would you think, Mac or Sebastian, about a pharmacist who refused to dispense birth-control pills not out of any personal convictions, but because of demonstrations in front of the drugstore?”
Same as if WalMart accepted unionization on that basis. You make a decision based on your overall business understanding.
Again…I’m going to reiterate this point…if you don’t wish to fill prescriptions, get a different job. Its fairly simple. Just because you have particular religious beliefs (or any belief for that matter…we just happen to be talking about someone claiming religous beliefs at the moment) doesn’t mean that you should be able to interfere with someone else’s health care. And lets not kid ourselves…that’s exactly what’s happening.
Its a different matter when someone has the medical opinion that care is futile. That’s not the case here. These pharmacists are basing their determination on their own judgement about the person coming to get the prescription.
Insofar as Drs who won’t perform an abortion…my answer is basically the same. Don’t be an OB. These aren’t difficult things to see. If you don’t want to do the things that are part of a job (and you can get yourself through college, med school or pharmacy school, etc) choose a different position.
OK Mac, my bad as well. If you hit preview and go to the end of the comments, you can see all the comments that have been posted in the intervening time (with your local time curiously enough) As far as religious beliefs and apologies, I suppose that this is just a snarky way of noting that you have taken a rather bloody-minded position in this, so I’m thinking that your argumentation is motivated by something more than is stated, but please ignore that.
As for Founders’ intent and Constitutional contract, interesting points, and I hope we can take them up if a thread that is closer to the topic comes up.
Since I started this by asking about boycotts, I should state my feelings about them. I think that businesses have a civic duty to avoid boycotts (I know that sounds strange to see those two terms in the same sentence, but there you are) While on the surface, this may appear like the free market influencing corporate behavior, it would really be fundamentally different. I think that the reason that corporations should avoid boycotts is because boycotts can give rise to a mob mentality that harms a lot of bystanders. Ironically, the fact that the state provides a social safety net makes the possibility of a boycott more acceptable (in that shutting down business X is not going to leave someone standing outside of town with no food and shelter) But I’m curious as to how others perceive this sort of social pressure.
As to phil‘s question about the Jehovah’s Witness EMT refusing to treat a patient, I think those who believe this don’t view this as an active prohibition (in that they aren’t picketing blood banks) but as a something that other people can do, but it’s not something they would do themselves. A lot of it would be related to (I think) how they viewed sin, and having accepted a transfusion in the past would not mean would be excluded from joining the church. I suppose we could construct an imaginary sect that feels that anyone who receives a blood transfusion is by definition unable to be a member of that church, but that’s not particularly enlightening because we can construct sects all day and then pit them against the real world to make reductio ad absurdum arguments (a vegetarian in McDonalds anyone?)
Same as if WalMart accepted unionization on that basis. You make a decision based on your overall business understanding.
I think there are ethical issues involved in pharmacies that do not appear in the WalMart unionization case. Whether WalMart unionizes or not does not affect third parties’ access to medicine, for starters.
noting that you have taken a rather bloody-minded position in this
Sorry about that, but I’m just fond of the 1st Amendment and remain less than charmed by the many situational or partial readings of it that afford “free speech for me, but not for thee” type circumstances. Nor do I think that convenience trumps basic rights. As I’ve stated previously, you’ve got to tolerate a lot of asshats in order to preserve your own rights, because you’ll be an asshat to someone when you exercise them. So bloody-minded I will go…
Macallan: Sorry about that, but I’m just fond of the 1st Amendment and remain less than charmed by the many situational or partial readings of it that afford “free speech for me, but not for thee” type circumstances.
*blinks* Are you asserting your First Amendment rights to free speech here (which I do not believe have been challenged) or are you claiming that a pharmacist denying prescription medication to a customer is somehow entitled to do so because of the First Amendment?
Jesurgislac, I suspect he is talking about the first amendment free exercise clause not the free speech clause.
Si Seb. Grazie!
I’ll ask again: Which religions hold as a tenet that women are not permitted to use chemical contraception — for any reason, including those unrelated to becoming pregnant — and that adherents are to use their power to deny it to other women as well? Someone? Anyone? Bueller?
It’s against my religion to fund phony wars of agression or occupations of countries I don’t want occupied, should I expect a tax rebate?
I guess women should not expect to be able to purchase ‘feminine’ products from certain muslim pharmacists under the Macallan interpretation of ‘free exercise’.
postit,
Would you have the state compel “certain muslim” merchants to stock and sell ‘feminine’ products?
If they want a licence from the State sure.
I still think that employment div. v. smith pretty clearly takes care of the free exercise theory, and i think that case was rightly decided.
Society will, really, collapse if people can lawfully choose not to comply with laws of general applicability on religious grounds. Who’d pay taxes? Christians might. (render unto caesar and all that.) but the Church of Tax Refusal would get a whole bunch of adherents really fast.
Let’s cut through some of this here please. The pharmacists refusing to offer medication are just now starting to do this widely…it’s a freakin’ political statement/movement, and as such makes a mockery of any claim that it’s a moral issue. If that was the case this would have been a problem long ago.
Further, I’m gonna drag this back again (this time with feeling), until those who support this address the issue of where the line should be drawn here.
There are religions for which nearly any kind of medical intervetion is wrong. There is nothing from stopping someone who’s a doctor or pharmacist from practicing such a religion and deciding at any point in their career to stop offering any therapy they wish that violates that religion.
Where does the state have the right to draw the line? Would this Christian Scientist pharmacist be within his constitutional rights to decide one day to not fulfill someones heart medication? Or give them insulin? Or whatever? And if not, why not?
I still think that employment div. v. smith pretty clearly takes care of the free exercise theory,
Employment Division v. Smith merely narrowed compelling interest doctrine, but it certainly didn’t eliminate it and it is a highly controversial decision. For Smith to even become applicable the states would first have to pass laws forcing pharmacists to provide services, and even then I seriously doubt it would “pretty clearly” take care of anything. There’s a big difference between someone getting fired from a drug rehab clinic for taking peyote and breaking drug laws, and someone being compelled by the state to violate their religious convictions.
Where does the state have the right to draw the line?
Uhmm… the State doesn’t have any rights. None. Zip. Zilch. Nada.
Which religions hold as a tenet that women are not permitted to use chemical contraception — for any reason, including those unrelated to becoming pregnant — and that adherents are to use their power to deny it to other women as well? Someone? Anyone? Bueller?
I believe certain forms of Southeast Asian Buddhism might fall into this category, although it’s hard to separate the culture from the religion at times and I’m trying to remember a seminar from over twelve years ago.
[It was a great seminar; I was tagging along with my dad’s MA students and we stopped in at Chulalongkorn University in Bangkok to hear a presentation on the burgeoning AIDS epidemic, safe sex initiatives and general reproductive issues in Thailand. I’ll bug my dad and see if he remembers the talk better than I.]
A general question to the assemblage: would it be legitimate for a Christian pharmacist to refuse to fill a Muslim’s scrip on the grounds that he had religious reservations against the other’s religion? [That is, could the state remove their license for that behavior?] What if the religions were reversed? IOW, if it is legitimate for pharmacists to refuse to perform their professional duties predicated upon their religious beliefs, does such a refusal admit a blanket ban on all potential activities or can the state enforce penalties against certain kinds of religious “exemptions”?
Where should the state draw the line?
if it is legitimate for pharmacists to refuse to perform their professional duties predicated upon their religious beliefs, does such a refusal admit a blanket ban on all potential activities or can the state enforce penalties against certain kinds of religious “exemptions”?
Good question.
If I’m reading some of the opinion here correctly, folks feel the market should/will sort this out. What that approach essentially endorses however is housing discrimination as folks need to live near services that cater to their needs.
If a small close-knit community didn’t want any folks of X religion to move in, they could have their one pharmacist refuse to sell to any of the Xers and claim it was religiously motivated.
Uhmm… the State doesn’t have any rights. None. Zip. Zilch. Nada.
Not much of an answer. The state certainly can impose requirements for licensure – you have to have a pharmacy degree, for example. And it can certainly take away a license for some things. Who would object if the state took away the license of a pharmacist who repeatedly filled prescriptions incorrectly?
So it does have the right to set rules of practice. That is implicit in its power to grant, refuse to grant, or rescind, a license.
Where should the state draw the line?
Funny, didn’t I ask you that over 24 hours ago?
Let me ask again, at what point does customer “need” trump a provider’s right to free exercise of their beliefs?
😉
That is implicit in its power to grant, refuse to grant, or rescind, a license.
The State has been granted that power, and that power can be rescinded. The State has no rights.
Thanks for the explanation Mac, it’s nice to know where people are coming from. As for me, I treat the 1st amendment more like a really really strong solvent, i.e. it should only be used in well ventilated spaces ;^)
Since you see this as a free exercise exercise (sorry, couldn’t resist), what do you think defines the state’s “compelling interest” and why would the state not have a compelling interest in seeing that people are receive appropriate medical treatment?
Let me ask again, at what point does customer “need” trump a provider’s right to free exercise of their beliefs?
Fine, let’s play it that way. First, let’s take “need” out of quotes though. Unless you want to put “beliefs” in quotes as well.
Assuming there are no quotes, let’s rephrase that question ever so slightly:
At what point should the license-issuing body be correct in rescinding the license of a person who changes their practices after receiving that license due to their religion? In other words, should a licensee be asked before they get their license if they object to birth control (or other legal therapies) and if so risk being denied that license? If not, why not?
And what happens if the licensee experiences a religious conversion (e.g. in what would presumably be the typical case for this scenario, becomes “born again”) after having become licensed? Under what criteria can the license then be rescinded?
Pharmacists currently have to be tested and licensed to practice, and the license has to be renewed annually. There are both national and state-level test and license requirements.
There is a Professional Code of Ethics for pharmacists. As I said previously, it doesn’t include a requirement to fill prescriptions, per se: the Boards assume, naturally, that since you’re a pharmacist, filling Rxs is what you do. The Code applies primarily to compliance with drug laws, accuracy in filling the Rx, and not blabbing about peoples’ medicines. There is one Code of Ethics (I don’t remember which one; I’ve been all over the Web researching this) that specifically includes a pharmacist’s right to not dispense medications that violate their religious beliefs.
I’ve contacted the International and National Boards with questions about the refusal to fill Rxs, but haven’t heard back from either one. Not sure if I will, but I’ll keep trying.
If this becomes enough of an issue that Boards have to pay attention to it, and if a new Ethical requirement pertaining to refusal is added, the logistics wouldn’t be a problem: the new ethical requirement can simply be added to the yearly license test.
My take is that religious refusals fail the generalization test: Broaden the religious license so that a practioner of “any” religion may allow their beliefs to influence “any” medication for “any” patient, and you get chaos. One example, mentioned above, is the absurd prospect of Christian Scientists refusing to fill all Rxs. Another, just as extreme in the opposite direction, is Native Americans whose religions allow and even require use of psychedelics for healing. In between you might get wiccans who refuse to dispense non-organic drugs, Hindus who refuse to dispense any drug made from bovine products, and… well, you see where this goes.
And if you make one exception, just for Christians, then it’s discriminatory against everyone else.
Since you’re the one complaining about this practice Edward, I think the burden is yours to answer the question. Also, the only reason these folks are licensed is to regulate and control the dispensing of pharmaceuticals, they aren’t licensed to encourage or force dispensing. I also don’t think they’re licensed in any way that creates a monopoly given that I can think of about a dozen pharmacies within a very short distance of where I sit. Would you argue that a Cabbie’s tag could be pulled because he declined to drive on his Sabbath, and that interfered with people’s ability to access medical care? How about if he refused to drive someone to an abortion? So at what point does a customer’s convenience trump a provider’s free exercise?
As a side note to this issue, I wonder about the hypothetical one horse, one pharmacy town scenario. Wouldn’t a town that small mean that everyone actually knows the pharmacist? Not only would the guy’s views not be much of a secret, not much of anything would be a secret. I recall a college pal talking about having to drive several towns away to buy condoms in high school so that his folks wouldn’t hear about it.
Mac: if i didn’t know better, i’d honestly accuse you of trolling.
states don’t have rights; they have powers. Individuals have rights, but those rights do not include the right to engage in whatever employment you wish.
Everyone must follow all laws of general applicability. Duh.
Pharmacy practice is governed by laws of general applicability. So, if you want to refuse to fill a ‘scrip in California you probably want to go to the Legislature first because the Board of Pharmacy has pretty broad powers to take action against a pharmacist based on “unprofessional conduct”. (Bus. & Prof. Code sec. 4301.) I suspect that your claim of religious exception would be met with disfavor.
Now, we get into the fun stuff.
Hypo 1 — Mac sues Cal Bd of Pharmacy for a writ of mandate restoring his license. Mac loses. Mac isn’t required to be a pharmacist, so there’s no denial of free exercise. Once he is a pharmacist, he must comply with the Pharmacy Code. Denial of a properly issued ‘scrip is gross misconduct meriting loss of license. His intent is irrelevant, same as the Indians’ intent was irrelevant when they tried to get away with using peyote as a religious sacrament.
Hypo 2 — Mac gets the State of Cal. to grant a religious exemption. 2a — exemption allows Mac and for that matter every pharmacist who so chooses not to stock a particular med. Does it survive constitutional challenge? probably, if the law is sufficiently general.
2b — exemption allows Mac to refuse to fill a ‘scrip. Here, I think I need Katherine’s help. I could probably draft a statute that would be narrowly tailored (ie, Mac would have to identify to the Pharmacy Board who he won’t serve and why; his pharmacy would have to give notice to consumers etc), but i’m not sure at this hour whether the “narrowly tailored to achieve compelling purpose” test even applies in this context. I think the exemption simply craters on the Establishment Clause, as discussed above.
Since you’re the one complaining about this practice Edward, I think the burden is yours to answer the question.
followed by a lengthy answer, mind you….
Given that certain states already have laws that obligate pharmacists to fill any legal prescription submitted, I think the question is being answered state by state.
Also, the only reason these folks are licensed is to regulate and control the dispensing of pharmaceuticals, they aren’t licensed to encourage or force dispensing.
Or deny dispensing arbitrarily either, IMO.
btw, see majikthise here for a map of where this lunacy is going on.
There are two separate issues here which need to be kept distinct:
1) Can a pharmacist refuse to fill a patient’s prescription on religious or moral grounds?
2) Can a pharmacist try to prevent that patient from seeking to fill that prescription elsewhere on religious or moral grounds?
This debate would be better served if we didn’t keep conflating them.
I’m sticking with my original opinion that none of this — absolutely none, zip, nada, zilch — has anything to do with any free exercise of any religious tenets whatsoever, especially considering that the article to which Lily linked (and which I’ve read before) indicates that there’s no scientific basis for believing what these arrogant shits claim is the moral problem in the first place. It’s just a new wedge in the culture wars, an attempt to again control people’s right to make their own reproductive choices, and a sick attempt to punish women for doing the right thing by trying to prevent unwanted pregnancies in the first place. (Not to mention the collateral damage caused by denying oral contraception to women who are being prescribed it for other medical reasons, who have to now be subjected to the moral judgement of the pharmacist before being humiliated.)
Yes, Phil, and if anyone was going to mount a serious legal challenge to the ‘religious exemption,’ that SCOTUS case would be a useful cite.
Majikthise’s map shows that some states – California, Missouri, New Jersey – are considering laws to require pharmacists fill prescriptions. That’s good to see. If anyone here lives in any of those states, a letter or letter-writing campaign to your state legislator in support of such a law would be a good idea.
Sebastian, thank you for explaining Macallan’s mistake.
So Macallan intended to write: I’m just fond of the 1st Amendment and remain less than charmed by the many situational or partial readings of it that afford “free expression of religion for me, but not for thee” type circumstances.
I’m not sure why Macallan slipped and wrote “free speech” instead of “free expression of religion”, but it should be clear that no abridgement of expression of religion is being suggested.
Macallan: someone being compelled by the state to violate their religious convictions.
No one is suggesting that should happen. What is being suggested, repeatedly, that if someone cannot justify doing an essential part of their job because of their religious convictions, they ought to find another line of work, or not go into that line of work in the first place.
I was brought up a Quaker, and still have many friends and relatives who are Quakers. It is a deep-held and long-standing conviction among Quakers that all war is wrong: the “peace testimony” goes back to 1660. And the long-standing response of Quakers to armies is to refuse to join up or to refuse to be drafted. (My dad was a conscientious objector to military service over fifty years ago: he did two years in the Friends Ambulance Service in what is now Bangladesh.)
What if, instead of being conscientious objectors, or simply refusing to join up, Quakers instead went into the army and refused to obey any order that had anything to do with killing people? And laws were passed granting them this exemption because doing otherwise would violate their religious convictions.
And Macallan is asserting that he would support this?
As I just commented elsewhere…the thing that’s been bugging me about this finally coalesced.
Conscientious objection is not a term that should really apply to picking and choosing particular things from the larger whole like this. If you want to object to war (and were, lets say, drafted) you don’t go to the war. And you deal with the consequences of not going. But, you don’t go to your draft board and go through training and get your rifle and stand next to other people who are also there because they were drafted and then say “oh wait, I’ve changed my mind.” I mean, you could, but you’d spend the rest of your life in Leavenworth. Point being, you object to the entire enterprise, not the particular item which you find amoral.
The same is true here…and pharmacists weren’t drafted. The chose it the whole way. So, if dispensing Birth Control is something you feel so strongly about, you should then object to the entire enterprise and stop doing it. It shouldn’t confer upon you the right to pick and choose your items of “conscientious objection.”
Because, after all, its really about people who wish to moralize as they choose and draw their paycheck.
Sebastian, thank you for explaining Macallan’s mistake.
It wasn’t a mistake
I’m not sure why Macallan slipped and wrote “free speech”
I didn’t slip. Hint, the first amendment is broader than any single clause; perhaps re-reading will help.
What if, instead of being conscientious objectors, or simply refusing to join up, Quakers instead went into the army and refused to obey any order that had anything to do with killing people?
Given how many non-combat roles there are in the army, I don’t see that as much of a problem as you apparently do. In fact, I wouldn’t be surprised if this isn’t fairly common and that the army has official policies and programs to accommodate it.
Which religions hold as a tenet that women are not permitted to use chemical contraception
I was brought up Roman Catholic, it’s my understanding that the Church teaches that only rythm, the Billings-Gate method, or withdrawal are acceptable forms of birth control. All artificial birth control is condemned. However, afaik, final choice is left up to the individual’s conscience. (Isn’t that what confession is for [/snark]).
The doctrine is that life begins at conception, so one would think that barrier methods would be ok, so I don’t exactly understand why they are not officially allowed. Maybe the Church feels it’s a slippery slope.
Despite JP II’s ultra-conservative leanings, within the Catholic Church there still seems to be a full spectrum of orthodox and liberal members, and in practice many Catholics do believe that contraception is the responsible pro-life approach.
This is all within marriage, btw, as one is supposed to be completely chaste outside marriage. *blink*
Sometimes I think the Vatican is on another planet, to be honest.
Mac-
As clinicians, we have an obligation to treat all comers, whether or not we approve of their moral choices, lifestyles, or whatnot. You can’t pick and choose what prescriptions to fill as a pharmacist, anymore than I can pick and choose which patients I’m going to treat in the Emergency Department.
And yes, pharmacists are clinicians- they see themselves that way, and so do their customers.
BTW, in my hospital in NY, pharmacists make clinical substitutions on drug orders frequently, and they do patient rounds on some serveices. There are many states where pharmacists counsel diabetics. These are valuable services, and I consider pharmacists valuable members of the health care profession. But with that professionalism goes certain moral and ethical obligations. Not filling a legal, valid prescription violates those canons.
I just knew there was a reason why I had this song going through my head. But perhaps this remedy is what the church had in mind (warning: do not play through your PC speakers at work, unless your co-workers have a decent sense of humor).
anymore than I can pick and choose which patients I’m going to treat in the Emergency Department.
Except JKC that isn’t analogous. If a patient comes into the ER seeking a procedure you deem out of line you can and should pick and choose. BTW, can doctors be forced to perform abortions against their will, even though it is a “legal and valid” medical procedure?
It wasn’t a mistake
Oh, for heaven’s sake, Macallan. Okay. So, in that case, I’ll ask again:
Are you asserting your First Amendment rights to free speech here (which I do not believe have been challenged) or are you claiming that a pharmacist denying prescription medication to a customer is somehow entitled to do so because of “free speech”?
In fact, I wouldn’t be surprised if this isn’t fairly common and that the army has official policies and programs to accommodate it.
Yes, they do: they’re called court martials:
There are some other instances of this happening here.
Jes,
Two things. One, you’re still missing the point, did you re-read that post? Second, there is a huge difference between seeking to join the military and being upfront about your religious or moral views versus waiting until it’s time to ship out. IIRC there are formal programs for conscientious objectors in the military (though with an all-volunteer army that may have gone away with the draft).
One, you’re still missing the point
Still waiting for you to answer my question, Macallan. If you think pharmacists deciding which medications they will and will not prescribe is a free speech issue, do explain why.
Second, there is a huge difference between seeking to join the military and being upfront about your religious or moral views versus waiting until it’s time to ship out.
So? Your argument throughout this thread has been to oppose any infringement of a person’s religious views at any time, no matter how it inconveniences anyone else. Of course, I do realize that as you’re arguing this as devil’s advocate (some might say troll) you don’t have to be consistent in any way. And you’re not.
If a patient comes into the ER seeking a procedure you deem out of line you can and should pick and choose.
This isn’t analogous either. It is not a pharmacist’s place to decide a prescription is “out of line.” It’s the prescribing physician’s place.
Still waiting for you to answer my question,
It’s impossible to answer questions that are based purely on your misreading of a comment Jes.
Your argument throughout this thread has been to oppose any infringement of a person’s religious views at any time, no matter how it inconveniences anyone else.
Actually that’s backwards. I’ve wanted those who are complaining to justify when someone’s convenience should infringe on another’s rights.
Of course, I do realize that as you’re arguing this as devil’s advocate (some might say troll) you don’t have to be consistent in any way. And you’re not.
You’ll need to understand the difference between your assertions and reality. Surprisingly, they aren’t the same thing. Oddly enough.
It’s impossible to answer questions that are based purely on your misreading of a comment Jes.
You said: Sorry about that, but I’m just fond of the 1st Amendment and remain less than charmed by the many situational or partial readings of it that afford “free speech for me, but not for thee” type circumstances.
I asked: If you think pharmacists deciding which medications they will and will not prescribe is a free speech issue, do explain why.
Your argument that you don’t have to answer the question because I “misread” your comment is kind of bizarre: you proposed that it was a free speech issue, and when Sebastian said that you meant it was a an “expression of religion” issue, you seemed to agree with him, and then denied it when I pointed out that no abridgement of expression of religion is being suggested.
If you don’t want to answer the question, you certainly don’t have to. I was merely interested why you thought this was a free speech issue, since it certainly doesn’t look like one.
I’ve wanted those who are complaining to justify when someone’s convenience should infringe on another’s rights.
First you’ll have to explain what right a pharmacist has to refuse to deliver a prescribed medication. I don’t see one.
As far as free exercise of religion:
1) There’s no state actor. This bill seems to outlaw private pharmacies from firing their employees for refusing to fill certain prescriptions. This is quite clearly not required by the First Amendment.
2) Even if there were a state actor–e.g. a state passed a law saying, you can’t refuse to fill a valid prescription and keep your license–that’s a neutral law of general applicability that places an incidental burden on religion. This is permitted–the relevant Supreme Court case is Employment Division v. Smith; I believe Justice Scalia wrote the majority opinion.
I don’t think either of these arguments is even controversial, as a matter of Constitutional law.
3) Even if these bills were otherwise good ideas, if there is a loophole that would allow them not to treat certain sorts of people rather than performing certain procedures, that is reason enough to reject them.
I was merely interested why you thought this was a free speech issue
I never did, perhaps that is where your confusion lies.
First you’ll have to explain what right a pharmacist has to refuse to deliver a prescribed medication. I don’t see one.
Well, since that is in fact the status quo, whether one sees it or not, I think it is incumbent on those seeking to have the State alter that status quo should justify doing so.
Macallan: I never did, perhaps that is where your confusion lies.
Ah, so your comment on [March 30, 2005 06:44 PM] was a red herring, not actually intended to contribute to the discussion. Fair enough.
Well, since that is in fact the status quo, whether one sees it or not, I think it is incumbent on those seeking to have the State alter that status quo should justify doing so.
I don’t see that it is the status quo. The status quo is that someone who decides to do a job, but who then refuses to do it, can be fired (or, if they’re in the military, court-martialled). If their refusal to do the work they contracted to do causes someone else damage, they can be sued. That’s the status quo.
It is the other side who are attempting to change the status quo, and claim a religious right to discriminate against their customers.
Ah, so your comment on [March 30, 2005 06:44 PM] was a red herring, not actually intended to contribute to the discussion. Fair enough.
Again, your assertions and reality – large distance betwixt. Try to narrow the distance if you’d like to continue the conversation.
Try to narrow the distance if you’d like to continue the conversation.
Since at the moment we seem to be having a discussion about whether or not you meant what you said, which is getting more than a little frustrating*, I don’t especially want to continue the conversation, no. Thanks for asking.
*Macallan: “I say X!”
Jesurgislac: “How do you mean, X?”
Mac: “I never said X!”
Jes: “But you said X right there.”
Mac: “No, I never said X!”
Jes: “Okay, you never said X. Fine.”
Mac: “I did! I did say X! How dare you say I didn’t!”
Jes: *wanders off*
ooo…more theater
…of the absurd.
You said it, I didn’t! 😉
Some act, some write and direct.
Mac, if you want to avoid going ’round in circles with Jes, you could respond to any of my or Katherine’s posts.
1. Do you really think that refusing to issue a scrip is not “unprofessional conduct”? Do you really think that if the Board takes your license (whether or not you’re fired) that your religious exemption argument will prevail?
2. Do you really think that creating a religious exemption by statute does not present Establishment Clause problems?
1. Do you really think that refusing to issue a scrip is not “unprofessional conduct”?
Going by the American Pharmacists Association linked above, no it isn’t considered “unprofessional conduct” and they acknowledge the right of conscientious refusal.
Do you really think that if the Board takes your license (whether or not you’re fired) that your religious exemption argument will prevail?
Yeah, I think it likely would in that case. This would be quite a different case from Emp Div v. Smith. It would be dicer if the pharmacy fired the pharmacist.
2. Do you really think that creating a religious exemption by statute does not present Establishment Clause problems?
No, if done in that manner it that would present that problem.
“Do you really think that creating a religious exemption by statute does not present Establishment Clause problems?”
Aren’t statutes supposed to affirm Constitutional Rights? If we agree that the free exercise clause has bearing on this type of conduct it is perfectly appropriate for a statute to specifically note that.
Aren’t statutes supposed to affirm Constitutional Rights? If we agree that the free exercise clause has bearing on this type of conduct it is perfectly appropriate for a statute to specifically note that.
I was assuming (perhaps wrongfully) that Francis meant an exception for a specific religion.
“Yeah, I think it likely would in that case. This would be quite a different case from Emp Div v. Smith.”
How? Here’s a link to that case, by the way. This paragraph seems unambiguous:
I’m assuming the hypothetical policy would be: a pharmacist cannot refuse to fill a valid prescription, regardless of his reasons for doing so, and repeated violations of this rule may cause you to lose your license. How is that directed against religious practice? It would certainly be constitutional as applied to an atheist pharmacist who refused to give drugs to blacks or Asians or gay people simply because he didn’t like them, or a pharmacist who wouldn’t fill psychiatric drug prescriptions because he thought it was wrong to use medication to change people’s brains, or what have you. So what’s the constitutional issue?
sorry, that’s a FindLaw summary of the holding, not a quote from the majority opinion. But this is from the majority opinion:
a pharmacist cannot refuse to fill a valid prescription, regardless of his reasons for doing so, and repeated violations of this rule may cause you to lose your license.
Are there legitimate reasons for a pharmacist to refuse to fill a valid prescription?
Katherine, I don’t think it is correct to assume that a pharmacist must fill any valid prescription. And the argument here is not that it would be constitutional to force them to do so on some sort of neutral and non-religiously oriented basis, but rather that it is unconstitutional to make a law which allows them to listen to their conscience. The argument proposed above is that it is (or should be) considered a violation of ‘the wall between church and state’ to create a statute which might permit such exercise of conscience.
Katherine, I don’t think it is correct to assume that a pharmacist must fill any valid prescription. And the argument here is not that it would be constitutional to force them to do so on some sort of neutral and non-religiously oriented basis, but rather that it is unconstitutional to make a law which allows them to listen to their conscience. The argument proposed above is that it is (or should be) considered a violation of ‘the wall between church and state’ to create a statute which might permit such exercise of conscience.
The most sensible thing for the government to do is simply drop birth control pills from the list of medicines requiring prescription.
(And everything else, too, but that’s a whole nother discussion….)
Then a pharmacist can object all he wants and never dispense birth control pills, and not actually obstruct anyone from getting them.
Of course, if that happens, birth control will get too cheap and easy to get and the shortage of unintended pregnancies will worsen, but I think we can live with that trade-off 🙂
Mac: the state of California has not, AFAIK, adopted the APhA’s right of conscientious refusal. On the Pharmacy Board’s website, the faqs state that a pharmacist may refuse to fill a ‘scrip, in his or her professional judgment. The website also has a Bill of Rights which states that patients have the right to “considerate and respectful” care.
Now, I see from Majikthise’s site that the state is considering legislation to clarify that pharmacists are obliged to serve. I thought it was pretty clear already, but clarifying legislation is not a bad idea.
I simply don’t understand how you believe that Emp. Div. v. Smith wouldn’t apply to a challenge to a license revocation. What are the characteristics of the license revocation case that allow you to distinguish Emp. Div.?
Katherine, do you want to jump in with your thoughts on the weaknesses of a statute which would specifically allow a pharmacist to assert a religious objection (as opposed to a professional one) to filling a particular ‘scrip?
Pardon the snark, Sebastian, but are you saying that in your world, if my sister lived in the bible belt, it’s quite possible that she would not be able to fill a prescription for birth control pills, which she needs to control polycystic ovarian syndrome, thus aggravating her hypertension, abdominal pain, and amenhorreah, acne, insulin resistance and weight gain?
Probably she should just go to a prayer rally and let the Lord heal her. Should she do that before or after the first heart attack?
Probably she should just go to a prayer rally and let the Lord heal her.
Or order them online or go to another pharmacist who isn’t being a prig. My recommendation would be to do that prior to the heart attack, but that’s just me.
I’m still convinced that legislating notices on the doors of phramacies that object to certain legal therapies is the route to go here.
There’s a public interest issue in protecting both the customer and the phramacist from the embarrassment of having to have this very intimate and political conversation at the moment the customer really just wants the medicine.
I believe in the power of the market. I strongly suspect that your sister could get her hands on those pills. Especially since I seem to be describing the state of the law now, which means that ‘my world’ is in fact the world we currently inhabit.
the market did not do such a bang-up job when black people wanted to be served at white-only lunch counters.
the market did not do such a bang-up job when black people wanted to be served at white-only lunch counters.
Actually, the market worked as intended. (Or would have even without Jim Crow laws).
Which is to say, it was in the economic interest of lunch counter owners to refuse to serve blacks, so that’s what they did. Similarly, it might well be in the economic interest of a pharmacist to refuse to fill certain prescriptions.
Markets do not operate in isolation from the legal, cultural, and political context.
There’s a public interest issue in protecting both the customer and the phramacist from the embarrassment of having to have this very intimate and political conversation at the moment the customer really just wants the medicine.
Or needs.
And agreed.
Are there legitimate reasons for a pharmacist to refuse to fill a valid prescription?
Mac: A valid reason might be, for instance, that the pharmacist recognized a conflict with another medication the patient is already taking. Under such a circumstance, the pharmacist’s duty would be to not fill that prescription as written and to contact or inform the patient to contact the physician to get one or the other of the drugs changed. Probably lack of ability to pay for the medicatino or the copay would also be valid.
I don’t think a personal moral judgment on the part of the pharmacist consitutes valid grounds to refuse to fill a script.
Are there legitimate reasons for a pharmacist to refuse to fill a valid prescription?
Mac: A valid reason might be, for instance, that the pharmacist recognized a conflict with another medication the patient is already taking. Under such a circumstance, the pharmacist’s duty would be to not fill that prescription as written and to contact or inform the patient to contact the physician to get one or the other of the drugs changed. Probably lack of ability to pay for the medication or the copay would also be valid.
I don’t think a personal moral judgment on the part of the pharmacist consitutes valid grounds to refuse to fill a script.
Edward: I’m still convinced that legislating notices on the doors of phramacies that object to certain legal therapies is the route to go here.
Speaks the big city kid. No offense, I’m one of those myself. That won’t work if the pharmacy in question is the only one available.
No: if a pharmacist refuses to provide legal medications, they should stop being pharmacists and get into some profession that doesn’t offend their conscience.
“the market did not do such a bang-up job when black people wanted to be served at white-only lunch counters.”
Of course not – anyone who tried to run a white-only lunch counter would attract the attention of white-sheeted terrorists – who were allowed to operate with impunity by… the local and state governments!
So, as is so often the case, improper action by the government – in this case, a deliberate refusal to protect blacks and nondiscriminatory whites and to prosecute vicious killers of same in accordance with the fundamental duties of any government, not to mention the Equal Protection clause of the Constitution – impeded the action of the free market and prevented competition from eliminating vendors offering inferior service.
“Actually, the market worked as intended. (Or would have even without Jim Crow laws).”
It worked as intended by local and state governments, and the thugs they openly tolerated and encouraged to act as unofficial enforcement for unjust and illegitimate laws.
Now, the government is acting improperly again. Favored individuals called “pharmacists” can refuse to serve customers – and potential competitors outside this favored class that could discourage such behavior or almost completely mitigate its impact are prevented by government action from serving the customer instead.
Birth control should be an over the counter drug. Then there would be no problem whatsoever, for either the customers or the pharmacists. Take the matter out of their hands entirely.
Speaks the big city kid. No offense, I’m one of those myself. That won’t work if the pharmacy in question is the only one available.
No: if a pharmacist refuses to provide legal medications, they should stop being pharmacists and get into some profession that doesn’t offend their conscience.
While I’m beginning to see the wisdom of making birth control an over-the-counter drug, I still think that notices should be legislated.
My ulterior motive here, of course, is to have pharamcists who practice this repugnant form or prostelytizing lose their other business as well.
My ulterior motive here, of course, is to have pharamcists who practice this repugnant form or prostelytizing lose their other business as well.
My ulterior motive here is to get people to realize that you have to defend repugnant proselytizing, even when you object to its consequences. I don’t like what these pharmacists are doing, don’t think it helps their cause, or is in the least bit effective because the mythical one-horse one-pharmacy scenario doesn’t actually exist.
Don’t you find it a bit ironic Edward, that on the one hand you are trying hard to get people to overcome their bigotry toward what they find ‘repugnant’ in your choice of mate, but on the other you deem their religious views repugnant?
Can you demand respect, while trading in disdain? Can we cling to some rights while we regulate others we don’t “need”?
It seems to me that their rights to freely exercise their religion are unambiguously natural rights and specifically protected by the U.S. Constitution, yet you and many others have tried to convince me that there is a concoction of constitutional provisions which should form the basis for gay marriage. If we treat fundamental rights as situational, you lose the Constitution as a foundation for your own rights. Its one of the paradoxes of ‘living’ constitution adherents, the further one strays from the text the more likely unintended consequences are unleashed against what you hold dear down the road.
IOW, if you want to respect your rights, you have respect everyone else’s no matter how “icky” their beliefs. Like any basic right issue, you have to just say, “I hate what these bastards are doing, but I defend their right to do it.” Now when you do that, people might think you’re “bloody-minded”, but that’s what you have to do if you want to reserve your own rights.
I would disagree with you on one notable point there, Macallan. I agree that it is right to defend people’s right to say things you don’t agree with. I agree it is right to defend people’s right to believe things I don’t necessarily agree with.
However, in this case, I don’t feel like we’re being asked to do those things. In this case, the pharmacist in question is making a decision for someone else based on their belief, not for themselves. That is a key difference.
The pharmacist may not believe in birth control. May think using it is a sin. Fine, then he or she shouldn’t use it. He or she may tell other people that he or she doesn’t use it, thinks it is a bad thing, etc. etc. But the moment that the pharmacist takes action that has an impact on someone else’s right to believe what they wish, then in my view, that pharmacist is overstepping his or her bounds.
I don’t feel that Edward is infringing on the right of the pharmacist to believe what they’d like to, regardless of how ‘icky’ he may find their belief. He is merely asking that pharmacist to shoulder the burden of other people’s ‘icky’ beliefs, and dispense their medications, regardless of the pharmacist’s belief vis a vis those medications.
The right to believe is not being infringed upon. The pharmacist may believe whatever they want. That is within their right. Forcing their beliefs on other people, that isn’t a right. That, in fact, seems to be restricting other people’s freedom of religion, rather than supporting the pharmacist’s.
crutan
About people still being able to get the medication in another pharmacy or online:
1) Medical access delayed is medical access denied. Just ask any EMT. Yeah, so bc pills aren’t usually an emergency need, but it opens the door for it. There are other drugs that people can validly consider icky — off the top of my head, Premarin, frex, is one that many animal rights upholders feel should be boycotted because of cruelty to horses.
2) Making the patient go to another pharmacy or online to get the drug will impose an additional burden of time and money — transportation cost of either going to the other pharmacy or shipping the drug.
The counter argument to bc pills being OTC that if it’s prescription, it gives the dr a chance to get the patient to do a pap smear annually or bi-annually, a very important step in catching cervical cancer. Pap smears are no fun, and often get postponed (not as un-fun as a colonoscopy, but still)
Macallan, you’ve yet to show how these people in the US are being denied any opportunity to proselytize or to practice their religion. Perhaps you should do so, before asserting that it would be a bad thing if they were?
What I came back to this thread to say was a jelling of thoughts about convenience and conscience.
I respect people who are willing to stand up for what they believe. I respect them even if I don’t agree with what they believe – there is something in the act of standing up and paying the price for what you believe in that I find intrinsically admirable.
And I had never realized so clearly before that the reason why I’ve felt admiration for people standing up for what they believe is their willingness to pay the price. If you are not willing to pay the price, your willingness to “stand up” is mere show.
These people who do not want to provide prescription medication may claim that it would violate their religious beliefs were they to do so: but the fact is, they’re most notably unwilling to suffer for their religious beliefs.
What they want is not to stand up at cost to themselves, but to stand up at cost to others. They are the exact equivalent of a politician talking big about the nobility of war, who has taken care all his life to stay out of harm’s way in any war that happened to be going on when he was of fighting age.
If a pharmacist truly believes that it would be against their conscience to provide prescription medication, they should prove their conscience by retiring from that profession. So long as they remain in their jobs and cause inconvenience to others but not to themselves, I remain doubtful that it’s really a point of conscience for them.
These people who do not want to provide prescription medication may claim that it would violate their religious beliefs were they to do so: but the fact is, they’re most notably unwilling to suffer for their religious beliefs.
Ironically, one of the reasons I’m able to write from here — to you there — is that this country was founded by people escaping from having to suffer for their religious beliefs over there. It seemed to make an impression because they codified that the state should never make people suffer for their beliefs. One can certainly admire people who suffer for their beliefs, but here it’s just illegal to force them to suffer so you can admire them.
Macallan: is that this country was founded by people escaping from having to suffer for their religious beliefs over there.
Ah, that old myth. Sorry, not so. If you are referring to the famous Pilgrims who left England in 1620, they left because the Church of England wasn’t making people suffer for their beliefs as the Pilgrims felt they should.
It seemed to make an impression because they codified that the state should never make people suffer for their beliefs.
Indeed. Unfortunately, these pharmacists appear to have decided that was a bad move: people should suffer for their beliefs. That is, other people should suffer. That’s why I find them less than admirable: these are people who are willing to sacrifice others to their beliefs, but not to suffer for them themselves.
Mac, your last sentence is just plain wrong. States prohibit people from using certain drugs and prevent minors from using certain additional drugs (alcohol).
These laws are a gross interference with many people’s religious beliefs. Christians break the law when wine is given to minors; peyote plays a long-standing role in certain faiths.
The Free Exercise clause has very rarely allowed people to ignore civil law.
Not getting something when and where you want it isn’t suffering.
These laws are a gross interference with many people’s religious beliefs. Christians break the law when wine is given to minors; peyote plays a long-standing role in certain faiths.
The Free Exercise clause has very rarely allowed people to ignore civil law.
I believe that US Rastafarians are also denied their reasoning ceremony as well because of some archaic laws.
“It seemed to make an impression because they codified that the state should never make people suffer for their beliefs.”
Do you seriously think this is the case? That anyone can assert a bona fide religious belief and avoid the penalty associated with violating applicable laws?
Here’s one example, just off the top of my head. There are people who have sincerely held religious beliefs that prevent them from paying tax dollars that could be used to fund the military. I believe they are willing to pay if the money went specifically to social services, but not if it went to the general fund. Of course there was no way the IRS would accommodate them, and last I heard their house had been auctioned off.
Or perhaps, as best I can understand your comment on Empl. Div. v. Smith, you think that this should only be true for “mainstream” religions, or perhaps mainstream versions of Christianity?
Mac, your last sentence is just plain wrong. States prohibit people from using certain drugs and prevent minors from using certain additional drugs (alcohol).
Well, actually I’d declare the State to be just plain wrong in those instances. I’m odd that way. Funny though, I’ve never seen the cops bust a bunch of minors at communion before, but I’ll take your word for it.
Really? Where?
There’s plenty of places where sacramental wine (taken in service, natch) is specifically allowed under law for minors. I’d guess that most municipalities or states don’t forbid this, but it’s your point. Now run with it.
Macallan: Not getting something when and where you want it isn’t suffering.
That’s simply untrue.
There are a whole range of things – certainly including essential medication – which, if you don’t get them where and when you want it, you will suffer for it.
Well then, what about sacremental marijuana? Is that allowed?
Seriously.
It probably is, somewhere. Not here, though. I’d be all for it, even in non-sacramental form, JFTR.
Not getting something when and where you want it isn’t suffering.
“Want.” That’s your characterization of prescription medications?
There are a whole range of things – certainly including essential medication – which, if you don’t get them where and when you want it, you will suffer for it.
Not the products being discussed here… Oh wait… I get it! The pharmacist is responsible for people’s poor planning and lack of common sense that creates a sudden emergency need for widely available products. Oops. My bad.
“Want.” That’s your characterization of prescription medications?
No that’s the characterization of “when” and “where”, but then that was pretty clear.
I’m going to busy the rest of the day so you Statists will just have to pick on Slarti or Seb.
Well, no it isn’t. Not in English, in any case.
Of course, I’ve still yet to see you explain in precisely what way refusing to perform your job duties selectively based on the genders and prescriptions of your customers is a free exercise issue. And neither you nor anyone else has named a single religion for which this is a tenet.
Macallan: Not the products being discussed here…
If you’ve never known a need for emergency contraception, Mac, you’re either exclusively homosexual or have an incredibly well-regulated sex life. Seriously. 😉 These things happen.
The pharmacist is responsible for people’s poor planning and lack of common sense that creates a sudden emergency need for widely available products. Oops. My bad.
The pharmacist’s profession is to provide prescription medication as required by their customers. Why their customers need it is none of the pharmacist’s business.
Just as someone who comes into a EMC will be treated whether they need help because they did something stupid, or because someone else did something stupid, or because a concatenation of events that no one could reasonably have foreseen meant they needed help. It’s not the doctor’s job to decide that this person doesn’t get helped because they obviously got that way thanks to “poor planning and lack of common sense”.
If you allow some pharmacists not to dispense bc pills because of personal reasons, you will have to allow other pharmacists not to dispense other kinds of medications for personal reasons. That’s just the way legal precedents work.
Now, apparently, not only are prescriptions “wants” rather than “needs”, but “going to your doctor, getting a prescription, and taking it to your local pharmacist” is characterized as “poor planning and a lack of common sense.” Since I guess women are supposed to have the power to read minds and know that their pharmacists are about to say, “Sorry, slutbag, no pills for you!” and plan accordingly. Or something. Amazing how these women are the victims of these newfound and convenient pangs of conscience and imaginary religious tenets, yet Mac finds a way to blame them for the situation.
And by “amazing” I mean “predictable.”
If you’ve never known a need for emergency contraception, Mac,
Funny, but I didn’t mention that. I just mentioned who actually bears the responsibility for our little emergencies.
Funny, I thought this was a first amendment thing. Now it’s problematic wants and needs. Thus, the compelling state interest in all this is not letting people do what they want when it doesn’t bother anyone else, it’s enforcing some sort of public morality.
Christ, Mac, I hope to hell you’re not an EMT or ER medico of any kind. Your notions of triage would be, shall we say, somewhat eccentric. I can just see you telling some poor bleeding fool who’s just been pried out of a crushed car they lack common sense, their “little emergency” is their own damn fault, and they’ll have to wait while more blameless patients go first.
Macallan: I just mentioned who actually bears the responsibility for our little emergencies.
Nope: you tried to imply (“Not the products being discussed here…”) that needing contraception isn’t ever an emergency. That was what I found flat unbelievable. 😉
However (to everyone else but Mac) there’s good news coming out of Illinois:
– Gov. Rod Blagojevich approved an emergency rule Friday requiring pharmacies to fill birth control prescriptions quickly after a Chicago pharmacist refused to fill an order because of moral opposition to the drug.
– The Illinois Department of Financial and Professional Regulation has also filed a formal complaint against the Chicago Osco pharmacy for the February 23 incident. The pharmacy was cited for “failing to provide appropriate pharmaceutical care to a patient.” Penalties could include a fine, reprimand or revocation of the pharmacy’s license. cite
(And, same news report: “In February, a judge recommended that a Roman Catholic pharmacist in Wisconsin be reprimanded and required to attend ethics classes after the pharmacist blocked a woman’s attempt to fill a prescription for birth control pills in 2002.”)
I have no idea what Mac is trying to argue here, but it bears minimal relationship to the subject at hand. Impressive in an orthogonal sort of way.
Thought this was quite amusing as a wind-up comment on the topic – though no doubt it will crop up again, as long as people think they have the right to impose their religious beliefs on others.