Plan C, for conscience
One American state has thought better of its policy to browbeat
pharmacists into selling the morning after pill.
18 July, 2010
Reproduced under creative commons licence
I was thrilled to learn that Washington State will be creating new rules
for pharmacists who have conscientious objections to providing services or
products they find morally objectionable. The new regulations would give
plaintiffs in a Washington lawsuit -- the owners of Ralph's Thriftway
pharmacy and two pharmacists -- the right to refuse to stock or dispense
Plan B "morning after pill" based on their belief that life is sacred from
the moment of conception.
This is a great turn-around by both the state and the Pharmacy College
Board, which for several years maintained that pharmacists' freedom of
conscience had to be restricted in order to ensure consumer access to the
morning after pill. Although in 2006 Pharmacy Board members had unanimously
supported a rule that would protect conscience for pharmacists and pharmacy
owners, an ideological move by Governor Christine Gregoire saw their jobs
imperilled should they stick to that position.
Buckling under pressure, the board adopted new language mandating
pharmacists to stock and dispense the medication even when doing so violates
their conscience. The board adopted this regulation even though it admitted
that it found no evidence that anyone in the state had ever been unable to
obtain Plan B (or any other time-sensitive medication) due to moral or
religious objections. The Becket Fund, which came to the defence of the
family owned pharmacy and its two pharmacists, filed suit to prevent the new
regulation from forcing them out of their profession.
In its most recent filing, the state concedes that allowing pharmacists
with conscientious objections to refer patients to other pharmacies "is a
time-honoured pharmacy practice" that is "often in the best interest of
patients, pharmacies, and pharmacists" and "do[es] not pose a threat to
timely access to lawfully prescribed medications."
Although I am not an advocate for mandated referral -- I believe that the
onus should be on the authorities to find alternate means of service
provision -- the Washington ruling is a clear victory for the profession of
pharmacy and it sends a clear message to all: the state -- and, I would add,
professional boards -- ought to remain neutral in matters of faith and
morals as they relate to individual conscience, in so far as there is no
threat to public safety or to the common good. While the state plays an
important role in ensuring the health, peace, morality and safety of its
citizens, it should not use its power in a dictatorial way, imposing limits
on individual conscience in matters which are legitimately open to dispute.
But is this not unfair? Is it not a case of a pharmacist or store owner
imposing his or her values on others, and will it not cause great
inconvenience to customers, which, some would argue, should be a
professional's first priority?
On the question of fairness, I would answer that justice is for all. In
any agreement, one party must not be oppressed at the expense of another. In
the case of the Plan B provision, both parties can be readily respected by
placing the onus on provincial pharmacy boards to provide information on
non-dissenting providers via toll-free numbers.
Although some might argue that inconvenience is a form of oppression, in
reality it is nothing more than the frustration I might feel at having to
walk several blocks to find my favourite brew. True, coffee is not
comparable to morning after pills, but then neither is the importance of
conscience comparable to hurt feelings.
But this is not simply a question of protecting my own conscience. While
no professional would go out of his or her way to inconvenience a client,
the priority of healthcare professionals must be patient safety, which may
not always coincide with patient satisfaction. This is more obvious in the
case of refusal to fill an inappropriately written prescription, or one that
poses significant risks to the patient. As a pharmacist who refuses to sell
Plan B, my concern is for the woman before me and also for a potential new
life should conception have already taken place after a single act of
intercourse. All patients are important to me, from the weakest and most
vulnerable folks I can see, to the ones that have yet to develop and see the
light of day.
Legal counsel Luke Goodrich has summed up the issues well: "Americans
should not be forced out of their professions solely because of their
religious beliefs -- but that is exactly what Washington State sought to do.
The government should accommodate and protect the fundamental rights of all
members of the medical profession, not punish some members because of their
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