Small victory for women's rights over Wal-Mart

[bouv]

Wal-Mart stores in MA forced to carry emergency contracepetion and fill prescriptions for it. (http://www.cnn.com/2006/HEALTH/02/15/walmart.contraception/index.html)

AFAIK, Illonois is the only state that requires every pharmacy to stock the drug, but this is a small step towards MA making the same ruling.

[Antigen]

I have such a hard time understanding why people are against emergency contraception. Or just plain contraception, for that matter. I'm glad that Wal-Mart has to have it in stock now (well, in 2 states at least). But it's sad that they have to be forced to.

But then, I'm from Quebec, where you don't even need a prescription for the "Plan B" pill. Anyone over 14 can get one after consulting the pharmacist or a school nurse.

[Cardinal]

The abortion debate will never end, because there's always a group that sees a united fetus as having human DNA, and deserving the protections of a human.





I'm one of them.

[Diogenes the Cynic]

The abortion debate will never end, because there's always a group that sees a united fetus as having human DNA, and deserving the protections of a human.





I'm one of them.
The Morning After Pill is a contraceptive, not an abortion pill. It prevents conception. If conception has already occurred, it does nothing. Emergency contraception has nothing to do with the abortion debate except in the minds of people who don't understand what it is.

That's not to say that the reasons woman's personal medical prescriptions are any business whatseover in any case. Their jobs are to put the pills in the bottles and ring up the sales. If they feel they can't handle those responsibilities they should find other lines of work.

[Cardinal]

The Morning After Pill is a contraceptive, not an abortion pill. It prevents conception. If conception has already occurred, it does nothing. Emergency contraception has nothing to do with the abortion debate except in the minds of people who don't understand what it is.If that's true, then I've been misinformed. Wouldn't be the first time, and by people that I agree with on more important subjects than most of the people here. This is why I find it so hard to deal with so many people. Off to the research...

[Ferret Herder]

The Morning After Pill is a contraceptive, not an abortion pill. It prevents conception. If conception has already occurred, it does nothing. Emergency contraception has nothing to do with the abortion debate except in the minds of people who don't understand what it is.
Diogenes is right. Here's the drug info from the FDA. (http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202757.html) It's just a high dose of progestins, one of the hormones typically found in oral contraceptives. Progestins act by preventing ova from "ripening" and being released by the ovary for a chance at fertilization, and by thickening the cervical mucus to try to keep sperm from getting through. If sperm and egg have already met up, neither of those effects will do anything since obviously the egg is already out and the sperm is already through the cervix.

[Diogenes the Cynic]

The irony of phramacists who refuse to dispense emergency contraception is that so doing actually increases the chance that a woman may have to terminate a pregnancy.

[lavenderviolet]

Take note of this part of the link Ferret Herder posted:
The fertilization of the woman's egg with her partner's sperm is less likely to occur while she is taking, receiving, or using a progestin, but it can occur. Even so, the progestins make it harder for the fertilized egg to become attached to the walls of the uterus, making it difficult to become pregnant.

For those who believe life begins with the union of the sperm and egg (which occurs in the fallopian tube several days before the zygote tries to attach to the uterus lining), then the problem with the morning after pill is that it may kill the zygote by not allowing it to get a foothold in the uterus.
Some people (particularly conservative Christians, who as a group TEND to be wary of artificial contraception anyway) perceive that as being morally equivalent to having a surgical abortion.

I consider myself pro-life, to the point of being an activist on the issue, but I've never identified much with the conservative Christian, abstinence-only arm of the pro-life movement (some people are surprised to find out that there are feminists, gays, atheists, Democrats, etc. within the pro-life movement). Personally, I don't feel that emergency contraception is morally equivalent to abortion. I do indeed feel it is preferable for people to be using emergency contraception rather than having an abortion later on down the road. I firmly believe one of the biggest social problems in America today is that so many people simply don't use contraception correctly or consistently. Nearly half of the women who obtain abortions weren't using contraception during the month of conception (see here for a study on the topic (http://www.guttmacher.org/pubs/journals/3429402.html)). Many European countries have extremely low unplanned pregnancy and abortion rates compared to America, so it is clear we could be doing better on this issue.

[Diogenes the Cynic]

Take note of this part of the link Ferret Herder posted:


For those who believe life begins with the union of the sperm and egg (which occurs in the fallopian tube several days before the zygote tries to attach to the uterus lining), then the problem with the morning after pill is that it may kill the zygote by not allowing it to get a foothold in the uterus.
Some people (particularly conservative Christians, who as a group TEND to be wary of artificial contraception anyway) perceive that as being morally equivalent to having a surgical abortion.
It should be stated that this same small theoretical chance (that a fertalized egg may be prevented from implanting) also exists with normal birth control pills.

Also, the medical definition of "pregnancy" requires that the egg be implanted. No implantation, no pregnancy, There is no development of the zygote until implantation occurs.

[Ferret Herder]

It should be stated that this same small theoretical chance (that a fertalized egg may be prevented from implanting) also exists with normal birth control pills.
The results of a recent study suggest that progestin-based emergency contraception does not inhibit implantation at all, and only works via prevention of ovulation or inhibition of sperm. Unfortunately I don't have access to the referenced journal at work, so I'm judging this by the summary I read as I can't check the source.

Croxatto, Horatio B., et al. (2003). "Mechanisms of Action of Emergency Contraception." Steroids, 68, 1095-1098.

[Motorgirl]

The results of a recent study suggest that progestin-based emergency contraception does not inhibit implantation at all, and only works via prevention of ovulation or inhibition of sperm. Unfortunately I don't have access to the referenced journal at work, so I'm judging this by the summary I read as I can't check the source.

Croxatto, Horatio B., et al. (2003). "Mechanisms of Action of Emergency Contraception." Steroids, 68, 1095-1098.

Here is a link to the abstract at PubMed (http://www.ncbi.nlm.nih.gov.ncoimage.neco.edu/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14668003&itool=iconabstr&query_hl=2&itool=pubmed_docsum)

[Diogenes the Cynic]

Here is a link to the abstract at PubMed (http://www.ncbi.nlm.nih.gov.ncoimage.neco.edu/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14668003&itool=iconabstr&query_hl=2&itool=pubmed_docsum)
Thanks, Motorgirl and Ferret Herder. This study would seem to remove even the one remaining straw that the pro-life demagogues were clinging to.

[RyJae]

Wal-Mart stores in MA forced to carry emergency contracepetion and fill prescriptions for it. (http://www.cnn.com/2006/HEALTH/02/15/walmart.contraception/index.html)

AFAIK, Illonois is the only state that requires every pharmacy to stock the drug, but this is a small step towards MA making the same ruling.


It must just be me, when I do not think the government should be able to force any company to sale anything. Nothing to do with women's rights, I support a womans right to choose.

[eleanorigby]

<sigh> I hesitate to go here, but "united fetus"? What is that when it's at home?




All I can think of now is fetuses (feti?) with American flags tattooed all over them or the United Arab Emeritus. Civil War fetuses also come to mind. Perhaps I need meds.

If the fetus is not "united"--if part of it has seceded or wandered off--are all parts of it, Life? If, assuming you mean gross (not in the icky sense) congenital anomalies not being present by the term "united", why not just say so, instead of using a very odd term indeed for a normal (not malformed) fetus?


sorry for the hijack, but that phrase caught my eye.


The movement against this medicine (and the pharmacists who desire to act as obstacles in something that is none of their business), shows me that this is NOT about "saving babies" or "the sanctity of Life"--it's about controlling women and their sexuality. Thank God Illinois has this law--Rod may have just gotten my vote on the strength of that alone.

minor aside: The Daily Show riff on this whole issue was perfect. Jason Jones telling that pharmacist, "how dare the state hold moral judgement on you? You're supposed to do that to the women who come in your pharmacy." (paraphrase)

[eleanorigby]

<sigh> I hesitate to go here, but "united fetus"? What is that when it's at home?




All I can think of now is fetuses (feti?) with American flags tattooed all over them or the United Arab Emeritus. Civil War fetuses also come to mind. Perhaps I need meds.

If the fetus is not "united"--if part of it has seceded or wandered off--are all parts of it, Life? If, assuming you mean gross (not in the icky sense) congenital anomalies not being present by the term "united", why not just say so, instead of using a very odd term indeed for a normal (not malformed) fetus?


sorry for the hijack, but that phrase caught my eye.


The movement against this medicine (and the pharmacists who desire to act as obstacles in something that is none of their business), shows me that this is NOT about "saving babies" or "the sanctity of Life"--it's about controlling women and their sexuality. Thank God Illinois has this law--Rod may have just gotten my vote on the strength of that alone.

minor aside: The Daily Show riff on this whole issue was perfect. Jason Jones telling that pharmacist, "how dare the state hold moral judgement on you? You're supposed to do that to the women who come in your pharmacy." (paraphrase)

[Terminus Est]

Also, the medical definition of "pregnancy" requires that the egg be implanted. No implantation, no pregnancy, There is no development of the zygote until implantation occurs.
Your last statement is incorrect. The zygote is the single cell formed immediately after fertilization. This almost immediately starts to divide, first forming a ball of cells called a morula. At around 40-150 cells, a fluid-filled cavity called the blastocoel forms the embryo; at this point it's called the blastocyst. This process takes place as the embyro is moving down through the Fallopian tube into the uterus. At the blastocyst stage, the embryo is ready for implantation into the uterine lining.

[Diogenes the Cynic]

I meant to say blastocyst...really......

::slinks away::

[eleanorigby]

Would a mod be so kind as to fix my double post?

thank you.

[thirdwarning]

It must just be me, when I do not think the government should be able to force any company to sale anything.

I was kind of wondering when somebody would bring this up. No, it isn't just you. I don't like the precedent this is setting, and I wonder where it will lead. Will the government start making sales and buying decisions for all businesses, or just the ones that go against the governor's agenda?

[casdave]

One sees these threads, along with the pro gun lobby threads, and pro death penalty threads, and then you see threads that justify Guantanamo Bay, justify torture and "extraodinary rendition", you see threads that insist even now the Saddam Hussain, the US supported dictator, had WMD, and you you begin to wonder what state the US morals are in.

Pro life and pro war and pro murder and pro lying and anti justice.

The good folk in the US are losing the most important war of all.

[levdrakon]

Small victory for women's rights over Wal-Mart

I wouldn't call that a "small victory." I'd call it a huge, scary victory. thirdwarning is right to ask, "where will it lead?" What's next under the hubris of "women's rights?"

If we want Wal-Mart to sell something, then we should demand they sell it and stop shopping there until they do what we want. But getting the government to force Wal-Mart? Not sure I like that.

[Doctor Jackson]

Adding another dissenting voice. This is not about abortion, women's rights or sexual morality. It's about the idea that NO governmental authority should be able to tell ANY private business what product(s) it MUST carry. End of story. End of a sad, sad story.

[Dangerosa]

Adding another dissenting voice. This is not about abortion, women's rights or sexual morality. It's about the idea that NO governmental authority should be able to tell ANY private business what product(s) it MUST carry. End of story. End of a sad, sad story.

Unless that business is a monopoly. Which in many markets WalMart is. It is not appropriate for a WalMart pharmacist to determine what medicine a woman should or should not take - if he has concerns, he can talk to her doctor, but they should be concerns regarding drug interactions or other concerns he has.

A person should not become a policeman if they have an ethical problem carrying and firing a gun. A person should not go into family law if they think divorce is immoral. A person should not become a pharmacist if they don't want to fill perscriptions for birth control or the morning after pill.

[JohnBckWLD]

One wonders, if Hoa Thuy Tran had gotten her RU 486 at Wal-Mart, would her family also included them in the 10/2005 suit against Danco & Planned Parenthood? They do have the deepest pockets of the three.

[missbunny]

I don't like the idea of the government telling any store what they MUST sell either.

BUT: maybe a pharmacist here can answer this: I would assume that the granting of a license to sell pharmaceuticals must have some kind of agreement as to what, exactly, that means. If a license states something like "All licensed pharmacies must as a normal course of business carry or provide all drugs listed in Schedule XYZ of the Big Giant Pharmaceutical Law Book"; and Wal-Mart is choosing to not carry certain of those drugs because they are "immoral" (according to the Wal-Mart board), the the pharma license should either be revoked OR the government should force Wal-Mart to provide those Schedule XYZ drugs.

Is there any kind of standard as to what a "pharmacy" is? Can a pharmacist get a pharmacy license, set up a tall counter, hand out Robitussin and aspirin, and advertise his business as a "pharmacy"?

Just wondering here if this is completely the Evil Government imposing its will.

[missbunny]

If you click on the Full Story Here link, yes, the state does have requirements in the license to provide certain drugs. And Wal-Mart chose to ignore them. So screw them, if they don't want to follow the rules, then they should close down the pharmacy entirely.

[RyJae]

Unless that business is a monopoly. Which in many markets WalMart is. It is not appropriate for a WalMart pharmacist to determine what medicine a woman should or should not take - if he has concerns, he can talk to her doctor, but they should be concerns regarding drug interactions or other concerns he has.

A person should not become a policeman if they have an ethical problem carrying and firing a gun. A person should not go into family law if they think divorce is immoral. A person should not become a pharmacist if they don't want to fill perscriptions for birth control or the morning after pill.


Then force Walmart to sell porn, and rated AO games and stuff where it is legal. As they have no right to push there morals onto me.

[RyJae]

I don't like the idea of the government telling any store what they MUST sell either.

BUT: maybe a pharmacist here can answer this: I would assume that the granting of a license to sell pharmaceuticals must have some kind of agreement as to what, exactly, that means. If a license states something like "All licensed pharmacies must as a normal course of business carry or provide all drugs listed in Schedule XYZ of the Big Giant Pharmaceutical Law Book"; and Wal-Mart is choosing to not carry certain of those drugs because they are "immoral" (according to the Wal-Mart board), the the pharma license should either be revoked OR the government should force Wal-Mart to provide those Schedule XYZ drugs.

Is there any kind of standard as to what a "pharmacy" is? Can a pharmacist get a pharmacy license, set up a tall counter, hand out Robitussin and aspirin, and advertise his business as a "pharmacy"?

Just wondering here if this is completely the Evil Government imposing its will.

It is still the evil government imposing its will, telling pharmacies what they must offer. I guess the government doesn't know that in a free market, people will visit the pharmacy that carries what they need. And the one that doesn't will lose money.

[Diogenes the Cynic]

In many cases, it's NOT a free market. When Wal-Mart is the only place where a woman can fill her prescriptions, then it cannot be allowed to place itself in between doctor and patient in this manner.

I'd like to see anything in the Constitution which states the government can't require a store to sell something. I'd also like to know what's so evil about it.

[Diogenes the Cynic]

Then force Walmart to sell porn, and rated AO games and stuff where it is legal. As they have no right to push there morals onto me.
I'll sign that petition but I think it's disingenuous not to acknowledge the aspect of medical necessity when it comes to drug prescriptions. Do you think a phramacy should have the right to refuse to fill a prescription which is necessary to keep a person alive and which that person cannot easily obtain anywhere else?

[Ferret Herder]

I think there need to be some requirements about stocking medications - if pharmacies decided not to stock things like Viagra (which Wal-Mart apparently has no compunctions against) because men don't need to get it up, or antiretrovirals because people with AIDS are immoral and should die, or cholesterol-lowering drugs because people who need them have crappy dietary habits and are probably evil meat-eaters, or painkillers because it's too much of a pain to weed out the real customers from the junkies, or whatever drugs are the most commonly filled ones by Medicare or AnnoyingInsuranceCompanyX because the billing issues are irritating/too cost-ineffective, it'd be terribly disturbing. Pharmacies provide a public service of sorts, and many small towns have only one option about where to fill their prescriptions. The rise of mail-order prescription services helps open up options, but immediate-need prescriptions (like emergency contraception, painkillers, and various other meds) are poorly suited to those.

[missbunny]

It is still the evil government imposing its will, telling pharmacies what they must offer.

Doesn't the government tells lots of types of stores what they can or cannot sell? Don't they tell lots of different types of businesses that if they want to be a Whatever Business, then they have to do or not do some certain thing? If a pharmacy license states that certain things must be sold in order for that place to be called a "pharmacy," then stores that don't want to sell those items shouldn't be able to get a pharmacy license.

If Wal-Mart is really concerned about selling any kind of pill, they ought to use some of their huge profits to lobby their legislators to change the laws that govern pharmacies.

[JThunder]

The Morning After Pill is a contraceptive, not an abortion pill. It prevents conception.
Only as a primary effect. It also has a secondary effect that would prevent implantation after conception has already occured.

"After fertilization, the pre-implantation embryo remains extremely vulnerable. The "morning-after" pill, with its high estrogen content, alters the endometrium so that implantation fails to occur..." -- Human Embryology and Developmental Biology, Bruce M. Carlson, M.D., Ph.D., 1994, p. 110.

[RyJae]

I'll sign that petition but I think it's disingenuous not to acknowledge the aspect of medical necessity when it comes to drug prescriptions. Do you think a phramacy should have the right to refuse to fill a prescription which is necessary to keep a person alive and which that person cannot easily obtain anywhere else?


I have seen WalMart close many local store's, but every town I have ever been in still has either a local pharmacy, or a big box pharmacy other then WalMart. I am a firm believer in allowing market dictate what a company should sale, not the government.
If company B sold the rights pills, and company A does not, market will either force company A to sale them as well. Or company B makes all the money and expands.

[Ferret Herder]

Only as a primary effect. It also has a secondary effect that would prevent implantation after conception has already occured.

"After fertilization, the pre-implantation embryo remains extremely vulnerable. The "morning-after" pill, with its high estrogen content, alters the endometrium so that implantation fails to occur..." -- Human Embryology and Developmental Biology, Bruce M. Carlson, M.D., Ph.D., 1994, p. 110.
Plan B doesn't have estrogen. It's progestin-only.

[Diogenes the Cynic]

Only as a primary effect. It also has a secondary effect that would prevent implantation after conception has already occured.

"After fertilization, the pre-implantation embryo remains extremely vulnerable. The "morning-after" pill, with its high estrogen content, alters the endometrium so that implantation fails to occur..." -- Human Embryology and Developmental Biology, Bruce M. Carlson, M.D., Ph.D., 1994, p. 110.
Scroll up. This has been debunked. Conception is not complete until implantation anyway.

[Diogenes the Cynic]

I have seen WalMart close many local store's, but every town I have ever been in still has either a local pharmacy, or a big box pharmacy other then WalMart. I am a firm believer in allowing market dictate what a company should sale, not the government.
If company B sold the rights pills, and company A does not, market will either force company A to sale them as well. Or company B makes all the money and expands.
There are many rural areas where Wal-Mart is the only option. There is no "Market B."

What Constitutional right is being violated by this kind of law?

[RyJae]

In the pursuit of being open I will say this. I am against forcing a company to hire women, hire men, hire disabled people, etc. I believe firmly that the market can dictate the proper way.
If you needed shoes and you knew Bigot and Awesomeo both made some nice shoes, but Bigot didn't hire women, or minorities and Awesomeo did whose shoes would you buy?
The market is a great equalizer. Some will say that it didn't work for minorities, or whatever in the past, but thats not entirely the whole picture. The only reason it didn't work, was the outside meddling of the government by using laws discriminating against people. Or people using terror to enforce there bigotry.


As for the Constitution, what if they get in an anti-gay marriage ban amendment or a anti abortion one in place, does that make it right because it is in the Constitution? Hey its been but a blink of an eye in time for us as a nation. And I see many more mistakes before we get it right. You seem to think only government can choose whats right or wrong for me, I don't like that view.

[Diogenes the Cynic]

The market is a great equalizer.
This is a myth. The market is no such thing. Capitalism is predatory and cannibalistic. People don't always have options.
As for the Constitution, what if they get in an anti-gay marriage ban amendment or a anti abortion one in place, does that make it right because it is in the Constitution? Hey its been but a blink of an eye in time for us as a nation. And I see many more mistakes before we get it right. You seem to think only government can choose whats right or wrong for me, I don't like that view.
If they get those bans in the Constitution then they'll be Constitutional. "Right or wrong" has nothing to do with what is Constitutional. It sounds like we can agree that nobody's civil rights are being violated by forcing a pharmacy to fill legal prescriptions.

[threemae]

Thanks, Motorgirl and Ferret Herder. This study would seem to remove even the one remaining straw that the pro-life demagogues were clinging to.

Not so fast, Dio.

I completely agree that all pharmacies should carry and all pharmacists should dispense EBC, but here's a more extensive study:

"Low-dose treatment with mifepristone has emerged as a
highly effective, convenient and safe method for emergency
contraception. A single dose of 10 mg mifepristone within
120 h of an unprotected intercourse has been shown to be
equally effective as 50 or 600 mg doses but with significantly
less side effects. A great advantage with the lower
dose, besides economical aspects, is that the effect on the
menstrual cycle [6] and delay of the next menstruation is
dose-dependent and less pronounced with the lower dose.
Not only does such delay add to worry about an unintended
pregnancy, but also later ovulation exposes the women to
the risk of pregnancy should she have further acts of unprotected
intercourse.
The spatial-dependent expression of progesterone receptors
in the Fallopian tube may reflect the importance of a
tight regulation of the microenvironment during early embryonic
development [27]. A single dose of 200 mg mifepristone
on LH
2 changes steroid receptor expression in
the Fallopian tube, inhibits endometrial development, and
effectively prevents implantation in humans and monkeys
[28,44]. Preimplantation embryo growth on day 6 after
ovulation was significantly affected in the morula-blastocyst
transition stage in mifepristone-treated monkeys compared
with that in control animals. Corresponding data on embryo
development are lacking from humans, however, it has been
shown that mifepristone does not affect human fertilization
rates in vitro [24]. Thus, although information on the situation
in humans is scarce, available data indicate that mifepristone
has no direct effect on embryo development and
that the effect seen in vivo is likely to be secondary to
changes in the tubal and uterine milieu.
Low-dose mifepristone (10 mg) administered after ovulation
seems to have some effect on endometrial development
and progesterone receptor expression, although not as
pronounced as the effect of the higher dose (i.e., 200 mg).
The effect seems to be variable, possibly reflecting individual
sensibility or the 10-mg dose is at the threshold of being
effective to affect the endometrium. However, the high
efficacy of mifepristone as well as the possibility to postpone
treatment until 120 h after the unprotected intercourse,
indicate a possible effect on implantation. Furthermore,
daily low-dose treatment with 0.5 mg mifepristone, which
had a similar effect on the endometrium (as 10 mg  1)
without influencing ovulation, significantly reduced fertility
[38]. The possible effect of low-dose treatment on the human
tubal microenvironment remains to be investigated.
Thus, although doses ranging from 10–600 mg seem to
be equally effective, it is still possible that the mode of
action could be both dose- and time-dependent. It is also
likely that not a single mode of action but rather various
effects contribute to the contraceptive effect.
However, taken together, available data from studies in
humans indicate that the contraceptive effect of mifepristone
used as a single dose for emergency contraception is
mainly due to impairing ovarian function, either by blocking
or postponing the LH surge, rather than inhibiting implantation."

From:
Mechanisms of action of mifepristone when used for emergency contraception.
Contraception. 2003 Dec;68(6):471-6.

It's certainly still up for debate.

[RyJae]

This is a myth. The market is no such thing. Capitalism is predatory and cannibalistic. People don't always have options.


I disagree again. If people did not want Walmart around they would never shop there. Its over, Walmart is no more. But Walmart offers lower prices so people stay going there, it was decided by the market.
If Walmart does not wish to sale something they should not be forced to, whether its the anti rejection drugs my wife takes, to the pill we are discussing now. If the government is so concerned about it, open up there own pharmacies to compete with those that do not sale what they want them too. Same with anything else in the business world, you do not like it, shop somewhere else.

McDonalds does not sale healthy food those SOB's I propose making them sale fat free fries, soy burgers and soy ice cream. Since it is the only fast food place in my lil' town they should have too!

[even sven]

A pharmacy is a matter of public health, and there is a wide precendent for companies involved in these things to be subject to additional regulations.

My electric company cannot decide that they do not want to serve my block anymore. I believe phone companies must allow 911 access from all phones and must offer a basic/low cost plan. The private companies that sell food in public schools have to follow certain nutrituional guidelines. Private schools must provide certain cirriculums. Private prisons must house the prisoners that the state sends over.

When it's a matter of public health or public good, the government can, does and should step in.

[RyJae]

A pharmacy is a matter of public health, and there is a wide precendent for companies involved in these things to be subject to additional regulations.

My electric company cannot decide that they do not want to serve my block anymore. I believe phone companies must allow 911 access from all phones and must offer a basic/low cost plan. The private companies that sell food in public schools have to follow certain nutrituional guidelines. Private schools must provide certain cirriculums. Private prisons must house the prisoners that the state sends over.

When it's a matter of public health or public good, the government can, does and should step in.


Make every restaraunt sale health food then, for public health. Make every gym free, for public health and well being. Make every car on the road illegal without a governor maxing out at 10mph, for public health. Open up all amusement parks for free, for the public good. Be sure to make all garages free so my vehicle stays road safe, you know for the public. Better give everyone a free cell phone, ya know in case there is en emergency while we are at it, all cars better have OnStar in case of trouble, for public good. While we are on it, we better not allow stores to sale cigarettes, fatty foods, high heels, steps, fireplaces, lighters, matches, furnaces, anything that contains a poison, etc. You know for the public health.

Yeah I am making it more then it is, but thats because you all are making it less then it is.

[levdrakon]

If you want a license to sell booze, you gotta conform with the regs. You wanna sell tobacco, you gotta conform to the regs. You wanna sell prescription drugs, you gotta conform to the regs. You wanna run a company with more than X number of employees, you gotta conform to the regs.

But regs that only apply to Wal-Mart? Scary. Perhaps the government should just take over Wal-Mart and make it a state-run utility.

[Qadgop the Mercotan]

Yeah I am making it more then it is, but thats because you all are making it less then it is.
What you seem to be advocating then is a government that can't require anybody to do anything.

In which case, what is the use of government at all?

[RyJae]

What you seem to be advocating then is a government that can't require anybody to do anything.

In which case, what is the use of government at all?

No I am advocating a government that does not replace personal responsibilty, ownership of a business and/or property. I see nothing but bad coming of this, when the government can decide to force a private enterprise to sale something. Be sweet though if I made something if the government decided it was "good" for the public health and force private companies to sale my stuff.
Not to go off topic totally, but it is the same as a slip on a sidewalk, you fall, you sue. Sure that crack could of been fixed by the property owner, but damn it you where walking and should of looked down. Sure cigarettes kill, I know it, I knew it when I was a smoker, so get cancer, sue. It is called personal responsibilty I do not need a watchdog to watch out for it for me, by forcing cigarettes off the monetary scales.
Nor do I need a government entity telling me what I have to sale. If I open a computer store, selling only Window based machines, the government can decide Linux based are safer for the public and force me to sale them? Same thing. Walmart is a private company, if the people would like them to have something they do not carry in stock, don't shop there.
People say about the slippery slope all the time, I do not think people realize we are down the other side already, never to return as it is now just the way it is. Some people grow up but never want to leave daycare, I do.

[Qadgop the Mercotan]

Walmart is a private company, if the people would like them to have something they do not carry in stock, don't shop there.
Wal-Mart chose to go into the pharmacy business, which is already highly regulated by state and federal authorities, requires oversight of dispensing practices, adherence to community standards, and is already full of mandates to supply unprofitable (but vital) prescription medications for the public good.

Now I don't favor targeting Wal-Mart specifically for this issue, but neither do I favor excusing them from serving this aspect of the common welfare. Public health policy has consistently over-ridden individual rights in this country since the late 1700s, when government officials quarantined sailors with contagious diseases.

If you want a piece of the lucrative pharmacy trade, you must knowingly put yourself into a business with a very very high degree of regulation.

[Hostile Dialect]

This fetus unites with no-one. I'm a rebel, baby!

[thirdwarning]

The private companies that sell food in public schools have to follow certain nutrituional guidelines. Private schools must provide certain cirriculums. Private prisons must house the prisoners that the state sends over.

When it's a matter of public health or public good, the government can, does and should step in.

The private companies that sell food in public schools are paid by the state, in one form or another. Same for private prisons. Yes, it's a matter of public health or public good, but it's just as much a matter of the consumer calling the shots. "If you want my money you'll do things my way."
Private schools must provide certain curricula if they want to be accredited by the state or whatever governing body is appropriate. That's actually a better analogy than the other two.

How about we just make this easy and require doctors who prescribe this medicine to dispense it? That way we don't have to worry about time sensitivity or anybody's rights of conscience. Yes, I know that makes an exception for this one thing, but that's happening anyway. And doctors dispense medicine all the time. I can't count the number of times I've been sent home with samples, including a whole first month's supply of the birth control pills I take now.

[Qadgop the Mercotan]

How about we just make this easy and require doctors who prescribe this medicine to dispense it? That way we don't have to worry about time sensitivity or anybody's rights of conscience. Yes, I know that makes an exception for this one thing, but that's happening anyway. And doctors dispense medicine all the time. I can't count the number of times I've been sent home with samples, including a whole first month's supply of the birth control pills I take now.
Your experience is not universal. More and more doctors are giving up dispensing samples, because of increasingly stringent regulations on keeping and dispensing them. And in-house dispensaries are subject to even more regulations than that. To require physicians to also dispense prescription medications adds another level of bureaucracy, regulation, fees and oversite, and would represent a loss in revenue for the vast majority of physicians who would undertake this.

[bouv]

Mods, this thread has completly lost its original purpose and is already in GD territory, so I request that it be closed.

[Giles]

Mods, this thread has completly lost its original purpose and is already in GD territory, so I request that it be closed.
I'm not sure how you expected a read about WalMart, women's rights and contraception not to stray into GD territory.

[bouv]

I'm not sure how you expected a read about WalMart, women's rights and contraception not to stray into GD territory.

If it went into GD because of women's rights and so forth, I mgiht allow it, as that was the intention of my OP. It wa NOT to discuss what the government can and can't do. If people want to start a thread discussing that, they are more than welcome to.

[Jeep's Phoenix]

I'm still waiting to hear an explanation of "united fetus." At this point, I can't help but think that there might be a confederate fetus too.

Seriously though -- "united" with what?

[Doctor Jackson]

Unless that business is a monopoly. Which in many markets WalMart is.
Fact: Wal-mart is never a monopoly. It may be, in some cases, the only store within X number of miles but that does not constitute a monopoly. Any other retailer is free to open next door and compete.

It is not appropriate for a WalMart pharmacist to determine what medicine a woman should or should not take - if he has concerns, he can talk to her doctor, but they should be concerns regarding drug interactions or other concerns he has.
Agreed, and if this were happening you'd have a point. In this case it has nothing to do with the pharmacist or his concerns. It's a Wal-mart corporate policy. Wal-mart has every right to determine what they will or will not sell in any department. IMPORTANT CAVEAT: If this drug has been determined to be vital to the public health and is listed for that reason in state or federal regulations as a "must carry" drug for all pharmacies, then by operating a pharmacy you agree to abide by those regulations. Public health does trump personal freedom. Whether RU-486 is, or should be, a public health drug is a whole 'nuther debate.

I'd like to see anything in the Constitution which states the government can't require a store to sell something.
How very disingenious! The Constitution of the United States sets forth the powers of government. If a power not is expressly given the government in the Contitution, then the government does not have that power. Perhaps you can show me where the Constitution grants the power for government to control the merchandise offered by private business. Found it yet? Didn't think so.

I'd also like to know what's so evil about it.
It's not, if the system of government is socialism, communism, or dictatorship. Though we may be heading that way, the US didn't start there ain't there yet.

What Constitutional right is being violated by this kind of law?[quote]
Off the top of my head I'd say the right to privacy, the right to liberty, and the first amendment right to freedom of expression.

[quote=Diogenes the Cynic]Do you think a phramacy should have the right to refuse to fill a prescription which is necessary to keep a person alive and which that person cannot easily obtain anywhere else?
While I answered that question in my caveat above, my question to you is "What does that have to do with RU-486?"

There are many rural areas where Wal-Mart is the only option. There is no "Market B."
But there is always the option for a market "B" to open and sell all those things that market "A" doesn't. Put your money where your mouth is and open or invest in a business that will do just that. Be part of the "market myth" (adressed below).

"Right or wrong" has nothing to do with what is Constitutional.
As long as it doesn't affect those things you think are right, appparently.

It sounds like we can agree that nobody's civil rights are being violated by forcing a pharmacy to fill legal prescriptions.
I think I can speak for Abby here and say "Wrong!".

This is a myth. The market is no such thing. Capitalism is predatory and cannibalistic. People don't always have options.
This post is getting very long, so the short answers are:
1) No, market forces are not a "myth"
2) Yes, the market exists. Whether the people or the government control it, it exists.
3) Sometimes capitalism is "preditory and cannibalistic". So is nature. It works as a controlling factor in both areas.
4) Yes, people always have options. They may not have easy options, but they always have some options.

[Motorgirl]

Not so fast, Dio.

I completely agree that all pharmacies should carry and all pharmacists should dispense EBC, but here's a more extensive study:

"Low-dose treatment with mifepristone has emerged as a
highly effective, convenient and safe method for emergency
contraception.

[snip]
From:
Mechanisms of action of mifepristone when used for emergency contraception.
Contraception. 2003 Dec;68(6):471-6.

It's certainly still up for debate.



IMPORTANT CAVEAT: If this drug has been determined to be vital to the public health and is listed for that reason in state or federal regulations as a "must carry" drug for all pharmacies, then by operating a pharmacy you agree to abide by those regulations. Public health does trump personal freedom. Whether RU-486 is, or should be, a public health drug is a whole 'nuther debate.


It seems to me (though I could be wrong) that there is some confusion as to what MA is requiring Walmart pharmacies (and all pharmacies in MA) to dispense.

They are requiring all pharmacies to dispense Plan B, a.k.a the "morning after pill" - which is levonorgestrel - a synthetic progestogen.
Plan B does not contain mifepristone.

RU-486 contains mifeprestone (an abortifacient / antiprogestin) and is not what the ruling of the Massachusetts Board of Registration in Pharmacy was about.

[AHunter3]

The government doesn't allow me to fill folks' prescriptions, even if I have a ready & available source for the prescribed substances.

All in all, this is a good thing. (IMHO. You may dissent). While I may not approve of everything they do, the general idea of a Food and Drug Administration to license and oversee businesses that hand folks drugs as described on Rx pads by their physicians meshes very well with my idea of what a government ought to be doing.

So from a strictly administrative / responsibility-tree vantage point, yes, the government has the authority to say that Wal-Mart must dispense the morning-after pill if a physical prescribes it. Similarly, from the same vantage point, the government has the authority to tell every pharmacy in the land that they may not dispense that pill, nor any form of abortifacient, nor any contraceptive of any form or fashion.

Meanwhile, shifting from whether they should have that authority to whether it is a morally righteous and medically defensible decision for them to reach, my opinion is that yes, it is good that they are requiring Wal-Mart to carry and provide that medication; that, furthermore, the morning-after pill should be available on an over-the-counter basis without prescription, as recommended but not acted upon awhile back; and that, as a broad general rule, anything that increases people's control over their own fertility and put that decision in their hands and free them from the various limitations that their bodies and its organs may have, is a good and righteous thing.

[Motorgirl]

RU-486 contains mifeprestone (an abortifacient / antiprogestin) and is not what the ruling of the Massachusetts Board of Registration in Pharmacy was about.

Though if I could spell, it would contain MIFEPRISTONE.

[eleanorigby]

This fetus unites with no-one. I'm a rebel, baby!

Right on!


Is your name Sybil?






:cool:

[Ferret Herder]

It seems to me (though I could be wrong) that there is some confusion as to what MA is requiring Walmart pharmacies (and all pharmacies in MA) to dispense.

They are requiring all pharmacies to dispense Plan B, a.k.a the "morning after pill" - which is levonorgestrel - a synthetic progestogen.
Plan B does not contain mifepristone.

RU-486 contains mifeprestone (an abortifacient / antiprogestin) and is not what the ruling of the Massachusetts Board of Registration in Pharmacy was about.
Thank you for clarifying this (again). Progestins are found in regular old oral, injectable, and implantable contraceptives. Taking Plan B is just like taking a big dose of a progestin-only (NB: no estrogens) oral contraceptive.

(RU-486/mifepristone stops the hormones that maintain the uterine lining, causing the lining to release and, essentially, the menstrual period to start.)

[Cardinal]

I'm still waiting to hear an explanation of "united fetus." At this point, I can't help but think that there might be a confederate fetus too.

Seriously though -- "united" with what?Not sperm and egg. I was too lazy to look up the bio teacher terms for it.

Jeez.

[irishgirl]

Question:
When an American woman wishes to get an IUD, does her doctor prescribe it for her, and then she picks it up from a pharmacy before returning to the doctor to have it placed? It's what happens in the UK and Ireland anyway.

It lead me to wonder, will Walmart stock IUDs?
If they will stock IUDs and IUSs, they have absolutely no defence in not stocking Plan B, as IUDs and IUSs may work by preventing implantation in some cases.

Personally, I'd recommend that all women reliant on barrier contraception or oral contraceptives and who have no physical contraindications or moral objection to emergency contraception get a "just in case" Plan B/Levonelle prescription and have it filled. That way it doesn't matter if you can't see your doctor/get to a pharmacy within the 72 hours, you just take the pills you have at home.

It's what my sister and several of my friends did before they travelled the world, on the recommendation of their doctors. None of them used the pills, but they felt safer knowing that should they meet the man of their dreams on the Inca trail/ halfway up the Mekong/on a desert island, and their contraception failed, they had other options available.

Just because you have to take the pills within 72 hours of unprotected sex, doesn't mean you have to buy them within the 72 hours.

Personally, if Mifepristone proves to be safer, more effective and better tolerated than Levonorgestrel I'm all for its use as Emergency Contraception. It's a choice for each individual woman and her doctor to make, not the state and not the pharmacy.

[eleanorigby]

Question:
When an American woman wishes to get an IUD, does her doctor prescribe it for her, and then she picks it up from a pharmacy before returning to the doctor to have it placed? It's what happens in the UK and Ireland anyway.



I am now torn between fantasies of meeting Harrison Ford types in a primitive village somewhere and having "native" sex and also astonishment at how other countries solve these issues.


American pharmacies do NOT dispense IUDs (to the best of my knowledge--mine didn't come from a pharmacy!). Docs or clinics keep them in their office or clinic. It's a sterile object and needs to be kept that way--I can only imagine the liabililty if women were allowed to take it home and then go to the doc the next day or whatever. My mind reels, actually. Some idiot is bound to open it and let BF play with it or try to replicate it out of paper clips or some ungodly thing. :eek:

But I guess it works for Ireland. I am puzzled as to why the need for two separate visits for you all, though. Is this the way BC is made more difficult in Ireland ?(I am not up on the status of Irish contraceptive laws).

[irishgirl]

Birth control is easily available and pretty cheap in Ireland (it's free to women with low enough incomes). Mirena contains a drug, so it is prescribed, and thus dispensed, by a pharmacy. The gynae hospitals, of course, have their own supply, for women who have them fitted under anaesthesia.

As fitting an IUD is usually done at certain times of the month and usually requires a second visit after the decision is made by the woman to have one fitted it doesn't slow anything down much at all. There are tamper-proof seals on the packaging so the docs know if it has been opened, and very few women would waste 300euros by messing with their IUS anyway!

However, I do know of a couple of elderly Irish GPs who won't prescribe contraception at all, or only to married women or something like that (but there are only about 5 of them, all their patients know who they are and they all live out in the rural West).

The only story that really scared me was one friend who, when asking for emergency contraception, was told by her extrememly elderly family doctor that she wouldn't need it as long as she'd "got up quickly afterwards"! :smack: :rolleyes: :eek: Thankfully, she knew better and got what she came for.

[Cat Whisperer]

This fetus unites with no-one.<snip>
You know, most guys wouldn't brag about that. :D

I think the elephant in the room that no one in North America ever gets around to discussing in these debates is the morality of continuing to have unchecked population growth. I am aware that the common attitude towards over-population is that it's someone else's problem (read: China, India, and Africa), but when are all the people who are against any form of contraception going to wake up and realize that they're morality doesn't mean much when it's up against the real possibility of human beings ceasing to exist on this planet because we've so spectacularly fouled our own nest?

[eleanorigby]

I agree. How are all the mouths to be fed. Oh wait--the Deity will provide or some such. Of course, the current admin is helping overpopulate the rest of the world with the lack of funding to clinics that support AB etc. <sigh>


I don't recall my IUD needing 2 visits--but there may have been. At any rate, the IUD was there and ready at the doc's office when I was ready for it. Best BC I ever used-I recommend them highly.


But to answer the question--Walmart would not stock them here. I am not sure about condoms--though I am sure that Walmart stocks Viagra--yet another disconnect in our strange morality about sex over here.

[thirdwarning]

I know this is a hijack, but I just have a quick question. I don't understand how stocking Viagra and not stocking Plan B is a moral disconnect about sex. The two are for entirely different purposes.
And yes, Wal Mart carries condoms.

[eleanorigby]

You don't find it disingenous to carry meds that can increase (or restore) sexual function, but not carry meds and stuff that aid contraception? Do you believe in sexual responsibility? One comes (sorry) with the other.

I was not aware that Walmart carries condoms--I have never seen them there, but I don't condom shop. My tubes are tied (just heading off the next question).

It surprises me that they do stock them, for some reason. My Dutch Reformed owned local grocery won't stock pregnancy tests, condoms or evenK-Y. :rolleyes:

[Cat Whisperer]

Just as an FYI, a local drug store here stocks not only a nice selection of condoms, but also boxed up vibrators and dildos.

[Northern Piper]

I'd like to see anything in the Constitution which states the government can't require a store to sell something.How very disingenious! The Constitution of the United States sets forth the powers of government. If a power not is expressly given the government in the Contitution, then the government does not have that power. Perhaps you can show me where the Constitution grants the power for government to control the merchandise offered by private business. Found it yet? Didn't think so.Well, since the point in issue is regulation by the State of Massachusetts, via its Massachusetts Board of Registration in Pharmacy, it's a red herring to ask what the U.S. Constitution authorises. The point is to ask, what does the Constitution of the Commonwealth of Massachusetts (http://www.mass.gov/legis/const.htm) authorise?



PREAMBLE.

The end of the institution, maintenance, and administration of government, is to secure the existence of the body politic, to protect it, and to furnish the individuals who compose it with the power of enjoying in safety and tranquillity their natural rights, and the blessings of life: and whenever these great objects are not obtained, the people have a right to alter the government, and to take measures necessary for their safety, prosperity and happiness.

...

PART THE SECOND
The Frame of Government.

Chapter I.
THE LEGISLATIVE POWER.
SECTION 1.
The General Court.

Article IV. And further, full power and authority are hereby given and granted to the said general court [i.e. - the Legislature of Massachusetts], from time to time, to make, ordain, and establish, all manner of wholesome and reasonable orders, laws, statutes, and ordinances, directions and instructions, either with penalties or without; so as the same be not repugnant or contrary to this constitution, as they shall judge to be for the good and welfare of this commonwealth, and for the government and ordering thereof, and of the subjects of the same,
... and to set forth the several duties, powers, and limits, of the several civil and military officers of this commonwealthSo it would appear that the citizens of Massachusetts, through their Constitution, have granted extensive powers to their state Legislature to pass laws on "all manner of wholesome and reasonable" topics, "as they shall judge to be for the good and welfare of this commonwealth", and for the citizens of the Commonwealth. Further, the Preamble indicates that one of the purposes of government is to assist citizens to be able to enjoy their natural rights.

Overall, that's a very broad grant of legislative authority, and does not have any immediate restriction that I can see that would prevent the Legislature of Massachusetts from passing this sort of law, compelling those who wish to enter the heavily regulated business of selling drugs, to provide certain types of drugs for sale. That is particularly the case when the drug in question relates so closely to the personal choices of the person wanting to buy it: the decision to conceive or not seems a very strong candidate for a "natural right" in this context. As well, the state Constitution leaves it to the good judgment of the elected officials to pass such laws. Personally, I don't see a restriction there on the state government's ability to pass a law regulating drug-stores.

[Auntbeast]

This is a step forward. My employer's health insurance requires that I fill my prescriptions at Walgreens. It is just as feasible for them to require I fill them at Walmart. If that is the case, then it is more imperative where our choices are limited by our employers.

The bottom line is, if MY doctor prescribes it, who is well aware of my medical condition, history and health, then the pharmacist should fill it.

It isn't about pro-choice/pro-life, it's about someone/something imposing their moral values in an arena they are sorely suited to battle in.

[Qadgop the Mercotan]

My Dutch Reformed owned local grocery won't stock pregnancy tests, condoms or evenK-Y. :rolleyes:
Heh. My Dutch Reformed owned local grocery is part of a national chain, and was told that if they wanted to keep their franchise they'd have to either stock liquor or open up the store on Sunday.

They stocked liquor.

But they don't have condoms, pregnancy tests, or spermicide either. I don't know about K-Y tho. I'll have to check!

[Guinastasia]

No pregnancy tests? I can see the other stuff, but why on earth wouldn't they sell pregnancy tests?

[davenportavenger]

No pregnancy tests? I can see the other stuff, but why on earth wouldn't they sell pregnancy tests?The KY doesn't make any sense either. It has uses beyond sex.

Just as an FYI, a local drug store here stocks not only a nice selection of condoms, but also boxed up vibrators and dildos.Wow, Canada is awesome.

[Cat Whisperer]

<snip>
Wow, Canada is awesome.
Got that right. :D

[Ferret Herder]

No pregnancy tests? I can see the other stuff, but why on earth wouldn't they sell pregnancy tests?
WAG: If you know early, it's easier to do something to end it, should that be your intent.

[Cat Whisperer]

I can see your point, Ferret Herder, and you're probably right, but that kind of thinking (I mean the thinking that produces that action, not yours) just burns my butt. How presumptuous, to think that they can assign motives to people, and try to guide people's actions into what *they* consider the right path. It fills me with grrrr.

[eleanorigby]

Yes, apparently, ignorance is bliss (having had truck with the DR community in the past-my husband worked in a bank that had a lot of DR employees), and since you shouldn't be having sex outside of marriage anyway, why should you need to know if you're pregnant? And if you are married, all babies are to be born-because they are miracles from God, so why the need to know then? (I don't ascribe to this way of thinking, I have just experienced it).


But I really think it comes down to avoiding the whole messy subject entirely--I think that they wouldn't sell toilet paper or tampons, either, if they could get away with it. I've never met such a group of people so natural funciton averse. Odd to say the least.
The only other thing I have ever used K-Y for is inserting NG (naso-gastric) tubes into pts--not something that is done at home (normally). My mind boggles re the uses of KY (and please, don't share them!). :)


feather --I agree, and hence my glee at Jason Jones on the Daily Show skewering the Righteous Pharmacist...I believe his words were (paraphrased), "how dare the state of Illinois sit in judgement of you? It's your job to sit in judgement of the women who use your pharmacy!". Perfect.