Speaking of Women's Rights: Rights vs. Rights: The debate on pharmacy refusals continutes

Friday, September 10, 2010

Rights vs. Rights:
The debate on pharmacy refusals continutes

Let’s say I am vegan. For ethical reasons I eat and use absolutely no meat products. I also work as a cashier at the local food co-op. When my customers come through the line with a slab of bacon, I tell them that my conscience will not allow me to sell it to them.

Would I be allowed to do this?

A recent decision by the Washington State Board of Pharmacy to rewrite an existing rule that requires a pharmacy to dispense medication on-site and in a timely manner is sparking quite a debate in the comments section of the Board of Pharmacy website. On the one side there are those who argue that maintaining access to prescriptions for all patients is imperative and that delays in access can often cause dire consequences. On the other side, we are reminded of the efficacy of the free market, the fact that our country was founded on religious freedom, and - of course - that emergency contraception is an abortifacient (that great myth that will surely outlive us all). Let’s take these piece by piece:

The Free Market Argument

Has anyone heard of the FDA? The Food & Drug Administration regulates - you guessed it - our food and our drugs. If you make and sell certain food products, you are required to include nutrition information. Certain drugs are illegal and cannot be sold by anyone at anytime; some drugs may be sold over-the-counter; other drugs may be sold only be prescription. The FDA does not care whether you (or your business for that matter) think that a particular drug is safe for consumption. It creates a set of rules that apply to various drugs, restricting what can and cannot be sold. Same deal with the Environmental Protection Agency. The EPA has a whole page of regulations that businesses must comply with. The Washington State Health Department compels anyone serving food to keep cold foods at a certain temperature, to have hot running water, and about eighty other things that your establishment can be shut down for not doing. Need I go on?

So then, we have established that our “free market” is not so free. There are regulations; there are rules; there are general standards that we have agreed to live by, no matter what our individual morals or preferences. There may be many occasions when regulations conflict with a person’s conscience. Are we willing to allow non-compliance with each instance? And what are the consequences for others when that happens? Doesn’t that then take their personal freedom away or potentially threaten their safety?

Religious Freedom

If I remember correctly, our forefathers were reacting to religious oppression when constructing the constitution. There are two sides to the religious freedom coin: a right to practice one’s religion, and the right to choose not to practice a particular religion. I would argue that denying a person a drug that has been lawfully prescribed violates the latter. By refusing to dispense a person’s medication you are forcing them to comply with your own personal beliefs. But no matter how you see it, the current Board of Pharmacy rule requires the pharmacy to make sure patients get their medications - so the pharmacy can work with the objecting pharmacist to plan for how to make sure their exercise of conscience doesn’t harm someone else. We can respect individual religious beliefs, without imposing hardship on people who need medications.

Emergency Contraception

The fact that emergency contraception is not an abortifacient is almost irrelevant in this debate. The scope is so much wider than one particular drug. Imagine what would happen if a pharmacy were allowed to make decisions about the drugs that you may and may not have based on its own personal preferences, instead of professional judgment. Where does it end? What if your pharmacist doesn’t believe in antibiotics, or antidepressants, or __________ (fill in the prescription you pick up from your local pharmacy monthly)?

I’m all for individuals making decisions based on their moral code. What I have a problem with is forcing others to also play by the rules of that person’s conscience. As a society we are constantly creating a play-book that we all agree to follow along with. Because if we all acted exactly as each of us desired individually, we would have utter chaos. And if I have it right, that’s not exactly what we’re going for.