Again; Should Pharmacists Be Allowed To Refuse To Dispense Drugs They Object To?

Great Debates
241

[QUOTE=villa]
The government should not avoid forcing ME to do things I don’t agree with if it is reasonably possible.
[/quote]
If I understand you, then my position is rather closer to Stratocaster. My belief is that the government should do nothing at all whenever possible. Thus they should not be involved (even to the extent of granting or withholding licensing) in influencing the decision to support or not support abortion.

The relevance of the drugs being sold OTC is that it cuts out the involvement of the pharmacist altogether, and thus avoids the issue.

I was talking about elective abortions, and I certainly agree that contraception is better than abortion. But, in principle, it seems to me that a pharmacist being compelled to provide Plan B drugs is in the same moral position as a doctor being compelled to perform an elective abortion. In both cases, a person is being deprived of their right to choose on threat of losing their job. IYSWIM.

And I am not sure if this will add to the discussion, or muddy the issue, but I bet many if not most experienced pharmacists got their licenses before Plan B was on the market. Thus, there was no implied duty to prescribe the drugs included when they were granted the licence. Does this matter, do you think?

Regards,
Shodan

242

[QUOTE=Stratocaster]
But that’s not what’s happening here. As I mentioned earlier, a license that limits competition (e.g., the FCC only granting certain broadcast licenses) is a different kettle of fish. That’s not we we have here. There’s different kinds of licenses. Some licenses are to regulate entry into a market, limiting the total number of participants. Some are principally to raise revenue (e.g., fishing licenses). Some, like this, are to ensure qualifications. The government is conceding nothing in granting this license. It is acknowledging the person’s competence. Period.
[/QUOTE]

If you think a licensing scheme does not reduce competition, then you don’t understand a licensing scheme. Period.

[QUOTE=Stratocaster]
The difference here (I’m avoiding the whole “all drugs should be legal” debate) is that providing lortabs without a prescription actively creates harm to another.
[/QUOTE]

So you do accept restrictions on the moral freedom of a pharmacist, but only based on things that can “actively” do harm. Withholding medication OK, providing medication not OK. There doesn’t seem to be a significant difference to me. These are two sides of the same coin - in order to get a license you accept restrictions. Restrictions such as not providing controlled substances to all and sundry, and potentially restrictions saying make a particular drug available to all adults who want it. I don’t see a major difference, personally.

243

[QUOTE=Shodan]
If I understand you, then my position is rather closer to Stratocaster. My belief is that the government should do nothing at all whenever possible. Thus they should not be involved (even to the extent of granting or withholding licensing) in influencing the decision to support or not support abortion.
[/QUOTE]

But they are involved in this matter already. I think less government intervention is generally a better thing, but once there is government intervention, I think it has to be made to work as well as possible.

The distinction I was drawing was between general government non-intervention (the government should not make people do things they don’t want to) and non-intervention with a person (the government shouldn’t make me do things I don’t want to/find morally objectionable). It’s the free rider problem. If you have any government at all, individuals will be made to do things they don’t want. That’s because if there is to be a government at all, it should act ‘fairly.’

[QUOTE=Shodan]
The relevance of the drugs being sold OTC is that it cuts out the involvement of the pharmacist altogether, and thus avoids the issue.
[/QUOTE]

But it isn’t purely OTC as far as I understand, is it? It can only be sold at a licensed pharmacy I thought. So the issue of licensing and pharmacists is not cut out. If this can be sold from a street corner or in Macy’s, then my position might be a little different.

[QUOTE=Shodan]
I was talking about elective abortions, and I certainly agree that contraception is better than abortion. But, in principle, it seems to me that a pharmacist being compelled to provide Plan B drugs is in the same moral position as a doctor being compelled to perform an elective abortion. In both cases, a person is being deprived of their right to choose on threat of losing their job. IYSWIM.
[/QUOTE]

But how would you feel about revoking the license of a doctor who refused to perform an abortion that was the only way of saving the life of the mother, based on moral grounds? Or a doctor who refuses to perform other surgery based on his own morality?

And again, we get back to this idea of what is a protectable right. And while you haven’t convinced me that a government licensed pharmacist has a protected right to refuse to sell a particular drug if the licensing body decides he or she has to sell it, I am pretty certain that I have not convinced you that the benefits of not advancing that protection exceed the losses.

[QUOTE=Shodan]
And I am not sure if this will add to the discussion, or muddy the issue, but I bet many if not most experienced pharmacists got their licenses before Plan B was on the market. Thus, there was no implied duty to prescribe the drugs included when they were granted the licence. Does this matter, do you think?

Regards,
Shodan
[/QUOTE]

Not a fundamental change as far as I am concerned. I have already said I wouldn’t have a problem with grandfathering licenses in, to make things run more smoothly, but I think we all realize that the world changes and situations may be different tomorrow than today. The abortion/contraception(/euthanasia) debates have been around for a lot longer than anyone who is a practicing pharmacist, I would assume.

244

[QUOTE=Shodan]
in principle, it seems to me that a pharmacist being compelled to provide Plan B drugs is in the same moral position as a doctor being compelled to perform an elective abortion. In both cases, a person is being deprived of their right to choose on threat of losing their job. IYSWIM.

[/QUOTE]

Did you know that some types of regular birth control pills, when taken in specific dosages and intervals, become the functional equivalent of Plan B? Details here. And if you didn’t already know that, does knowing that change your opinion about whether pharmacists should be allowed to refuse to dispense a legal OTC drug? Or do you think they should also be able to refuse to dispense oral contraceptives?

245

You get a job, you do the job. You don’t want to do the job, you don’t take the job or you don’t get the job or you lose the job.

Anything else is insanity.

246

[QUOTE=villa]
If you think a licensing scheme does not reduce competition, then you don’t understand a licensing scheme. Period.
[/quote]
Your response makes it clear to me that you don’t understand the breadth of license types. Period right back at ya. Fishing licenses don’t limit competition. Neither do licenses for barbers or drivers. Licenses intended to ensure competence restrict competition, I suppose, if you feel the incompetent have a right to compete in a particular arena. But that would be silly.

But this is beside the point. The government creates the barrier of licenses. To point to this barrier–did I mention the government created it?–and say that the government deserves some form of quid pro quo for letting you through is pretty circular. It’s the equivalent of mafia protection money. “Well, it really is right to pay this. Otherwise you’d be roughed up.” Yeah. By the same guy I’m paying.

Yes. It’s wrong for me to put poison in your prescription. I shouldn’t be compelled to actively participate in something I find objectionable.

Why do you attach such significance to the fact that a license if involved? There is either a compelling reason to force such behavior, or there isn’t. The fact that the government is involved, for whatever reason, good or asinine, in some endeavor, doesn’t mean that they can do as they like now that their involvement is a given.

247

[QUOTE=Quiddity Glomfuster]
You get a job, you do the job. You don’t want to do the job, you don’t take the job or you don’t get the job or you lose the job.

Anything else is insanity.
[/QUOTE]
This is silly too. Who decides what “doing the job” is? The government again? Should they do this for everyone?

248

[QUOTE=villa]
And again, we get back to this idea of what is a protectable right. And while you haven’t convinced me that a government licensed pharmacist has a protected right to refuse to sell a particular drug if the licensing body decides he or she has to sell it, I am pretty certain that I have not convinced you that the benefits of not advancing that protection exceed the losses.
[/QUOTE]
I think you’re missing the point. There is no cost/benefit analysis required in such matters for those of a more libertarian inclination. If I don’t want to do something–by and large, for the most part, as a general rule, etc., etc.–and that inaction does not somehow actively create harm for another (and most inactions do not), I shouldn’t be forced to do it. I needn’t provide a justification to be left alone, to be left to my own conscience.

249

[QUOTE=Eva Luna]
Did you know that some types of regular birth control pills, when taken in specific dosages and intervals, become the functional equivalent of Plan B? Details here. And if you didn’t already know that, does knowing that change your opinion about whether pharmacists should be allowed to refuse to dispense a legal OTC drug? Or do you think they should also be able to refuse to dispense oral contraceptives?
[/QUOTE]
Not to answer for Shodan (though I suspect I am), yes, I believe they can refuse to dispense whatever they’d like, for whatever reason they’d like. If they have enough restrictions, people will take their business elsewhere, if such an option exists. But if someone wants to be a pharmacist who sells only drugs with names beginning with vowels, or only drugs that have an even number of letters, or only drugs that are colored blue, that’s up to him. I don’t think he’ll be in business too long, but that’s his problem.

250

[QUOTE=Stratocaster]
Not to answer for Shodan (though I suspect I am), yes, I believe they can refuse to dispense whatever they’d like, for whatever reason they’d like. If they have enough restrictions, people will take their business elsewhere, if such an option exists. But if someone wants to be a pharmacist who sells only drugs with names beginning with vowels, or only drugs that have an even number of letters, or only drugs that are colored blue, that’s up to him. I don’t think he’ll be in business too long, but that’s his problem.
[/QUOTE]
I also suspect Shodan would come up with a similar answer, and so would I.

251

[QUOTE=Stratocaster]
I think you’re missing the point. There is no cost/benefit analysis required in such matters for those of a more libertarian inclination. If I don’t want to do something–by and large, for the most part, as a general rule, etc., etc.–and that inaction does not somehow actively create harm for another (and most inactions do not), I shouldn’t be forced to do it. I needn’t provide a justification to be left alone, to be left to my own conscience.
[/QUOTE]

And I think you are missing the point. The government is already in there. So we aren’t arguing about some intervention or no intervention. We are quibbling about the degree of intervention.

Make Plan B available in any retail outlet, and I won’t support making it compulsory for anyone to make it available. Limit it to places that the government licenses, and I don’t see a problem with a requirement of that license being to have it available.

And responding to your previous posts, licenses for barbers, fishing and driving certainly do reduce competition. A license limits the number of people who can do something. If that something is a profession, then competition is limited within that profession. And when competition is limited, those who have the license are placed at an advantage as compared to the situation they would be in without a license; if it was not financially worthwhile, one has to assume they would not go to the effort of getting such a license.

On the one hand you require me to find a “compelling force” for intervention, then on the other you say there is no cost/benefit analysis. I personally think the compelling force behind availability of Plan B is strong enough to require those who choose to be licensed to provide pharmaceuticals by the government to be required to provide it. You don’t. We aren’t arguing about the principle, however, because you accept the necessity of government regulation of the field, it seems. All we are arguing about is the degree of regulation.

That’s why I don’t buy this active passive thing here. The government has actively restricted the availability of this method of contraception - they have prevented a whole bunch of stores from selling it, and (I believe, if I am wrong here please someone correct me) required only licensed pharmacists can make it available. As such, there is much more of a distinction than you are permitting yourself to draw, here.

252

[QUOTE=villa]
And I think you are missing the point. The government is already in there. So we aren’t arguing about some intervention or no intervention. We are quibbling about the degree of intervention.
[/quote]
Indeed we are. We are likewise arguing about the nature of the intervention.

Again, you assign some sacred weight to the license that I do not.

Again, when that restriction limits competition only for those who are incompetent, I think your point is silly. The government is not, in its benevolence, permitting some favor. They are acknowledging the pharmacist’s competence.

I’ve made my position quite clear. “Compelling” means that the government is protecting someone from actively attacking another’s rights. “Compelling” does not require that we weigh what everyone thinks is the best outcome, whether or not this tramples on someone’s right to act according to his own conscience.

No, we are arguing about the nature of the regulation. The government has an interest, IMO, in ensuring that only competent individuals dispense drugs. The do not have a legitimate interest in making sure I have to do what you want.

I think this has been identified as an OTC drug in this thread, except for minors. Is that wrong?

253

[QUOTE=Stratocaster]
I think this has been identified as an OTC drug in this thread, except for minors. Is that wrong?
[/QUOTE]

Not what I am saying at all. I am meaning that I believe this cannot be retailed by any store, but only by licensed pharmacists, whether it requires a prescription or not.

If I am wrong on this, it alters the whole basis of my argument. But the question is whether Foot Locker can sell this.

254

[QUOTE=villa]
Not what I am saying at all. I am meaning that I believe this cannot be retailed by any store, but only by licensed pharmacists, whether it requires a prescription or not.

If I am wrong on this, it alters the whole basis of my argument. But the question is whether Foot Locker can sell this.
[/QUOTE]
I understand your question better, but I still don’t see it as an important distinction. So long as any pharmacist may provide it, so what? What if there are no pharmacists in a given region. Should the government force someone to become a pharmacist so that Plan B is available? Is it the government’s job to ensure that a supply of Plan B is available via private citizens who may disagree with the practice?

255

I’ve said (multiple times) what I see as possibly the best solution possible - a centralized overnight shipping availability of this drug.

It’s relevant because, if my assumption is correct, by its licensing scheme, the government is limiting the outlets where this drug can be purchased. Deciding one does not want to sell a product is fine. Deciding that one does not want to sell a product when the government limits the outlets for that product, and yet still taking up one of the licenses for selling that product is a different thing.

Let Foot Locker sell it, and I promise not to infringe upon the morals of a pharmacist by requiring them to hand a box over a counter.

256

[QUOTE=villa]
I’ve said (multiple times) what I see as possibly the best solution possible - a centralized overnight shipping availability of this drug.
[/quote]
Why do you think it’s the government’s responsibility to ensure that some ideal occurs? Why do you think the government knows what is ideal?

That’s the government’s issue. If the government determines it’s critical that every man, woman and child has access to Plan B, don’t restrict its availability. Let it be available in convenience stores. It’s either important to subject this sale to the scrutiny and judgment of a pharmacist or it isn’t. If it is, then don’t bitch when the pharmacist opines. If it isn’t, why are you making it his problem?

Whether Foot Locker can or can’t sell it is something you need to take up with the government. It’s not the pharmacist’s decision or problem.

257

[QUOTE=Sarahfeena]
I also suspect Shodan would come up with a similar answer, and so would I.
[/QUOTE]
Not surprised at all. Great minds and all that… :wink:

258

[QUOTE=Stratocaster]
Not surprised at all. Great minds and all that… :wink:
[/QUOTE]
Right! Just wanted to let you know that I’m still following the thread, and figured I would jump in if I had anything novel to say, but you are covering all the same bases I would, anyway.

259

[QUOTE=Stratocaster]
Why do you think it’s the government’s responsibility to ensure that some ideal occurs? Why do you think the government knows what is ideal?
[/QUOTE]

Because the government created the problem. The government is the one restricting where this drug can be sold. They should either get out of that business altogether, or work to regulate it in the best possible fashion.

[QUOTE=Stratocaster]
That’s the government’s issue. If the government determines it’s critical that every man, woman and child has access to Plan B, don’t restrict its availability. Let it be available in convenience stores. It’s either important to subject this sale to the scrutiny and judgment of a pharmacist or it isn’t. If it is, then don’t bitch when the pharmacist opines. If it isn’t, why are you making it his problem?.
[/QUOTE]

I’d happily do that. But the pharmacist, like it or not, is involved in this now. His or her profits, to some extent or other, depend on the situation created by the government regulating his or her business. The government places restrictions on him or her already as a result of this. No sale of Lortabs without a prescription; minimum levels of education to sell this; etc. He or she is absolutely entitled to his or her opinion about the morality of contraception. But when he or she accepts a government permit to enter into a restricted field, he or she is accepting government regulation of that field. Phil Pharmacist can (probably) refuse to sell condoms until the cows come home as far as I am concerned.

[QUOTE=Stratocaster]
Whether Foot Locker can or can’t sell it is something you need to take up with the government. It’s not the pharmacist’s decision or problem.
[/QUOTE]

The pharmacist made a decision to accept a license and in return accept regulation. You accept regulation. Just on the areas you like. That’s why I have little time for libertarianism-lite. It presumes and ability in the lib-lites to know exactly what government regulation is right and what is wrong.

260

[QUOTE=villa]
Because the government created the problem. The government is the one restricting where this drug can be sold. They should either get out of that business altogether, or work to regulate it in the best possible fashion.
[/quote]
Why in the world do you think it is, de facto, the government’s job to regulate things? In my opinion, in most instances, it’s the government’s job to mind its own business.

Like it or not? We are not discussing whether or not someone has blue eyes, or if it will snow tomorrow. Like it or not, this is an artificially created dilemma.

No. Disagree completely. A pharmacist’s profits do not out of necessity depend upon the government’s bullshit. Can you really not see the circular nature of your position?

As a result of what? Why do you seem to feel that if any form of government interference is warranted, then some further intrusion is fair game?

Nonsense. No I don’t.

Now this is plain nonsense. I’ve set an exceedingly bright line. If you don’t actively step on my rights, do whatever the hell you want. What about this confuses you?