Unmitigated arrogance regarding birth control

A rape victim walks into a pharmacy with a prescription for a morning-after pill that will terminate a possible pregnancy and is told politely it will not be filled, and that she must go elsewhere, no matter how inconvenient. That is, if the pharmacist has the decency even to return the prescription.

The message is clear: Tough luck. If a child has been conceived in this violation of her body, it is the victim's sacred duty to have the baby.

Another woman, whose body will not support a pregnancy, submits a prescription for simple birth control pills and is also rejected. Or a young man and woman in the throes of hormonal conflict seek a package of condoms but can't purchase one, and then end up victims of normal, post-pubescent passion.

Are these and other examples exaggerations? Hardly. They are manifestations of a real effort by a growing movement of political- and religious-based groups to withhold access to birth control and anti-abortion measures through pharmaceutical denial.

So when is a pharmacy not a pharmacy? Better yet, when can a licensed pharmacist not fill a legitimate prescription because of political or religious reasons? Should a state licensing authority permit the dispensing of male-enhancement drugs but not those that permit a female to guard her own health? Doesn't a licensed pharmacist have an implied contractual obligation to honor all verifiable prescriptions from practicing physicians?

These are health, ethical, and legal questions that most state authorities now find themselves facing with a growing number of pharmacists who refuse to honor prescribed contraceptives or sell those available over the counter on grounds it violates their consciences. Drugstores run by those who harbor strict beliefs about social issues are becoming more frequent, encouraged mainly by institutions -- many religious based -- that oppose any form of unnatural interference with pregnancy, be it wanted or not.

On the other hand, it seems, prescriptions for recently developed drugs that alleviate male dysfunction are no problem. Selling mechanical devices that do the same things as the "little blue pills" presumably is also acceptable. It is all right, then, to encourage male participation in a healthy sex life but not the woman's right to protect herself from unwanted conditions.

Realizing that I am about to bring down the wrath of those who see themselves as ordained guardians of our morals, I'm going to say it anyway:

What unmitigated arrogance! This kind of sanctimony has no place in a regulated and necessary business. Those who seek a right to dispense pharmaceuticals should never be allowed to pick and choose which prescriptions they honor based on extraneous considerations like religious convictions or mere assertions that it violates their own personal codes.

Whether they disapprove of the drug on moral grounds is completely beside the point. They should follow the doctor's orders unless they suspect some irregularity, and that is that. If they can't agree with that, they should find another profession.

It will be up to the states to determine how far they will let this abrogation of responsibility proceed. Several states -- California, New Jersey, Illinois and Washington -- already have passed laws requiring a pharmacy to fill all prescriptions or help women get them elsewhere. Ten others are reportedly considering the same legislation. And a number of pro-choice groups and those who regard conscience-based pharmacies as a threat to the health and welfare of the nation have taken up the cudgels to fight it.

Fortunately, the major drugstore chains are not likely to follow this pattern and the scope will be limited to those stores being sponsored by right to life groups. This may be a serious problem in rural areas, even if they say they will help women get what they need some place else, which seems contradictory to their mission. All this is just part of a sad trend to establish a strict religious-based social order, even in the health fields. Fertility doctors reportedly have refused to inseminate gay women and anesthesiologists have declined to participate in sterilization procedures like vasectomies.

Personal convictions are fine unless they interfere with legitimate professional responsibility, especially when it pertains to treatments we don't personally endorse but which have been scientifically vetted as safe and legally prescribed. When that is denied, a pharmacy is not a pharmacy and a pharmacist not a pharmacist.

Would a Christian Scientist, who doesn't believe in doctors, refuse to put a tourniquet on the leg of a man who would bleed to death without it?

(E-mail Dan K. Thomasson, former editor of the Scripps Howard News Service, at thomassondan(at)aol.com.)

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Christian Science and abortion

Your choice of a Christian Science analogy is ironic because the Church of Christ, Scientist does not dictate whether its adherants may or may not elect emergency medical procedures. In her seminal work, SCIENCE AND HEALTH WITH KEY TO THE SCRIPTURES, Mary Baker Eddy (the founder of Christian Science) clearly provided the option of employing surgeons for bone-setting. That said, most practicing adherants have little doubt about the ability of Christian Science -- correctly applied -- to heal the body of any injury or disease without medecine or surgery. For over a century, spritual healings of life-threatening accidents, without medical help, have been witnessed and documented in hospitals and elsewhere.

Neither does the Christian Science church stipulate a political position on abortion rights for its adherants. Christian Scientists can be found at any point on the spectrum of belief regarding abortion.

My personal aversion to abortion stems less from a conviction about sexual morality than from a fundamental respect for every living being's right to choose its own course. If one believes that a fetus is a living being -- I believe it's possible -- then I question the justice of another human aborting its life. People should have the right to choose for themselves until their choices affect the prerogatives of others. It is one of the "inalienable rights" provided in the DECLARATION OF INDEPENDENCE. Roe v. Wade aside, abortion is no less murder than killing a born baby.

You may question whether a fetus is a living being. Or perhaps you are certain that it is not. How does anyone know that it is, or isn't? Philosophers, clergy, and the medical establishment have yet to provide a conclusive answer. As medical science evolves, its opinion on human viablility suggests an earlier and earlier beginning. Uncertainty on should not serve as a license for abortion. A civilized society would protect unborn children while the question is being decided.

Adults with a vested interest in protecting themselves from an "unwanted condition" be granted the right to decide -- what a collosal (and arrogant) conflict of interest. The legitimacy of abortion should be decided by neutral bodies (the judicial system) with consideration for the impact on all of the lives involved.

Please respond.

Tim Booth
1 Maybeck Place
Elsah, IL 62028
tim.booth@principia.edu

Misunderstanding Pharmacy Practice

First, the makers of Plan B claim that it does not terminate a pregnancy. Second, the assumption is made here that because a pharmacy does not have the drug, that the pharmacist(s) would be refusing to dispense it. A pharmacy may not carry Plan B for the simple reason there is no demand for the drug. Should a pharmacy or any other business be mandated to carry certain items of inventory? What happened to free enterprise? Specialty pharmacies carry specialty items. Nuclear pharmacies specialize in radiopharmaceuticals. Will we legislate that they carry a certain inventory irrespective of the demands of those they serve?

I think there is a misunderstanding of the role of the pharmacist here. Pharmacists take oaths to serve the patients that they come in contact with. There is an obligation established both to the mother and her child in the mother's use of medications. Look at all the regulations with female useage of the drug Accutane and the multiple steps that are taken in the IPledge program to prevent fetal defects. The same could be said about the use of Thalidomide. A duty to the born and unborn is firmly established.

What we are getting at here is the right of conscious. I wonder if the author would argue that obstetricians who excercise the right of conscious and refuse to perform abortions (which is the majority) should choose another career?

Reply

This is in response to the “Personal views denying medicine” article in the 14 July edition of the Standard Times. When I read articles like this I must continually remind myself that my service to our great nation allows for freedom of speech and in some cases the freedom of the citizenry to publically document their lack of critical thinking skills. Furthermore, the statements contained herein are my own opinions and not the opinions or policy of the 17th Medical Group, the 17th Training Wing, The Air Force or the Department of Defense. I offer this retort as a citizen and a professional pharmacist.
I will begin by stating, in my professional opinion; pharmacists should avoid projecting our religious value sets on others and the overwhelming majority of pharmacists, myself included, will dispense birth control and Plan B® without reservation. Personal codes and moral foundations, however, are essential to the proper practice of medicine and pharmacy. If Mr. Thomasson, had any medical training or was in fact a medical professional, he would understand the unique role of a physician and pharmacist as a learned advocate for the patient, the underlying impetus for such being the patient’s inability to properly diagnose and treat medical conditions. My chief purpose in a response is to expose Mr. Thomasson’s poorly constructed argument and anti-religious, specifically anti-Christian agenda.
Oh where to begin,,,
Mr. Thomasson states “personal convictions are fine unless they interfere with legitimate professional responsibility”. Another statement is also troubling, “They (pharmacists) should follow doctors’ orders unless they suspect some irregularity and that is that”.
First of all who decides what is and is not our professional responsibility? Answer: It is precisely the ability to choose that makes medicine and pharmacy a profession. In exchange for specialized services, a society grants certain professions the right to “self-police” and determine what is and is not good practice. Next, what is and is not legitimate? Answer: I wonder if Mr. Thomasson considered the myriad of cultural, economic, religious and social backgrounds that impact the inescapably relative answer to this question. If I ask a strict Muslim, they may respond that under the Sharia (the body of Islamic religious law), the girl should not only be denied the medication, she should be put on trial for allowing the rape and not resisting sufficiently. If I ask a Christian, most, would allow for the use of the morning after pill (Plan B®) in cases of rape or incest, which by the way DOES NOT CAUSE ABORTIONS, but when used within 72 hours of intercourse may prevent the proper implantation of the egg thus preventing a pregnancy not ending a life. The majority of the secular American public would likely favor the pharmacist dispensing the medication.
When the author asserts “They (pharmacists) should follow doctors’ orders unless they suspect some irregularity and that is that” this again clearly demonstrates the author lacks the mind shovels for cogent thought. Answer: I only wish, along with my fellow pharmacists, it was this simple. Evaluating prescriptions encompasses not only the “five rights”; (patient, medication, strength, dose and directions) but also encompasses considerations such a global health impact, interactions with other treatments or disease states and finally may simply be a matter of a difference of professional opinion regarding the optimal treatment course for the individual patient. We also encounter the problem of physicians prescribing unethical treatments, such as a group of area physicians who prescribe, in my opinion, reckless amounts of controlled substances which miraculously find their way to addicts and local children, albeit they are “legally” prescribed. This is a clear example demonstrating the need for medical professionals to exercise some type of personal or moral code.
Regarding the business case against the author’s position, “res ipsa loquitur”. Private firms have the right to determine which products they desire to market to the public and pharmaceuticals are no exception. The market will then punish or reward the owners(s) for their business model. Corporate pharmacy firms such as Walgreen’s are compelled by diverse ownership to adopt a more liberal dispensing policy for similar economic reasons.
Now the faulty logic; the author opens with an assertion that an epidemic of rape victims are being mistreated by callous pharmacists and concludes with the following emphatic statement and I quote” All this is just part of a sad trend to establish a strict religious-based social order, even in the health fields”. Did I miss something? Has Mr. Thomasson been living under a rock since 1960 or perhaps he is simply delusional. Even a casual review of the past 50 years of news media content or court case files will demonstrate a clear move away from traditional conservative thought and values. The simple fact is that this is just another sad and poorly crafted attempt to smear Christianity as well as other people of faith. At least Sam Harris, Richard Dawkins and Christopher Hitchens present their arguments in elegant and coherent prose. Nice try, but I recommend you take a course in effective argumentation at your local university or leave the weighty subjects to intellectual adults.

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