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

Great Debates
261

Yes you do accept regulation. You stated that you did not mind the government restricting the sale of Lortabs by pharmacists only to those with prescriptions. Or did I misunderstand you?

I don’t go for regulation by default. I have said multiple times in this thread that if you allowed anyone to sell this drug, then it would be a different situation. But that, as far as I know, is not the situation we are faced with. And in that situation, the government has said, “If you want to sell Plan B, you have to have a license, and you must jump through hoops X, Y and Z to get and keep that license.”

If you support the removal of that licensing requirement, then we are in a totally different situation. But instead, you try to maintain that the existance of the license is irrelevant, despite the fact that you think some of the restrictions it imposes are valid (hence your pick-and-choose nature as to regulation).

My whole point is that there is no qualitative difference between a pharmacist who decides he or she has a moral imperative to provide lortabs to all who ask for them, and one who decides he or she has a moral imperative not to sell Plan B to anyone. Given that you seem to accept the regulation banning the first pharmacist from keeping his or her license, I find it odd that you think the second one is totally different. Unless you think that a moral obligation not to do something is automatically more important than a moral obligation to do something. In which case I hope you would feel the same way about a pharmacist who refused to maintain a log of those who purchased whatever the drugs that are pre-cursors for meth are, and provide that to the government. Because I am pretty certain (and this is a guess here) that refusal to participate in that little scheme would lose someone their license.

And while you are right, that absent regulation a pharmacist could make profits, their current level of profits are, to an extent, influenced by the existence of licensing and regulation. Remove it and see how many drugs are ordered online from Canada.

262

Yes, I pretty much would.

Maybe we are coming at this from different angles. What I am debating is whether or not the government should say, “In order to get and keep a license, you must jump thru hoops X, Y, Z, and Z[sup]1[/sup]”, where Z[sup]1[/sup] = “you must agree to sell Plan B”.

My contention is that the only “hoops” that the government has any right to impose pertain to the safe dispensation of drugs - the pharmacist won’t sell Class II narcotics OTC, or wrongly fulfill a prescription, and so forth. Licensing, IOW, has only to do with matters affecting the public safety, and not at all on an opinion that abortion is good or bad. That decision on the moral validity of abortion is solely up to the individual, and may not be imposed on another, either by the government or another citizen.

So, having granted a license to protect the public safety in the matter of pharmaceuticals, the government may not extend that license to try to interfere with things that licensing may not affect - morality being a prime example. It would be wrong for the government, for instance, to require a kosher butcher to sell pork products. This is because the sale of pork is not a matter of public safety, and the effort to force it on a reluctant person is a transgression of the uses of licensing.

Gotta do some real work.

Regards,
Shodan

263

Well, no, you didn’t misunderstand, and I think I’m on the record here regarding what regulation I consider reasonable. My point was that I do NOT accept that there’s some inexorable progression toward some “water level” of regulation we need to accept once the government is already involved. I don’t care if they already have their toe in the water of regulation or not–more is generally worse, not better.

Shodan’s responded quite nicely to this. You continue to assert that the government–the architect of the licensing requirement–is entitled to create restrictions by virtue of having installed the licensing hurdle. Again, I suggest to you that this is a circular argument. The existence of the licensing requirement is completely irrelevant to me in this situation. I still don’t see any argument why I should feel differently.

This is not an accurate summary of what I said. “Pick and choose” suggests that all alternatives are valid and should be in play–i.e., one either accepts no regulation or is open to what the government decides. I’ll leave it to anyone reading this thread to decide which is a more reasonable position.

I find it curious you find that odd, and I’ll leave that reaction at that. I’m not trying to explore the debate of whether or not regulating narcotics is a good or bad thing. But, if one accepts that the providing a free flow of narcotics actively harms others, than it ought to be regulated. If you hold that this does not, you could conclude otherwise. But in no instance does someone not selling Plan B actively harm someone else.

I don’t know what you mean by “more important.” I’ll say again, I simply hold that society has no legitimate interest in regulating others’ behavior, except to the extent that it prevents someone from creating harm to another. Society has no business compelling someone to “do good,” whatever “good” means.

264

That’s fair enough. And I think in many/most cases the exactly right approach. However (and you knew there would be a however) my issue comes about because the government has deliberately chosen to restrict the availability of this drug on grounds other than public safety to a small percentage of retail outlets. This may well leave people completely unable to purchase it. Given the government has made that restriction, and we are in the world of next best solutions, I am willing to tolerate what I accept is a restriction on the freedom of choice of a pharmacist to stock/make available whatever he or she sees fit.

265

Not following you - what are the grounds other than public safety that you mention?

Regards,
Shodan

266

You know what, scratch that. I honestly believe that the purpose of restricting the availability of Plan B is morality based not public safety based, but I can’t prove that obviously, and there is an argument that would pass muster claiming it is about public safety.

That part isn’t strictly needed for my argument, which boils down to the fact that the government has chosen to restrict access for a product in this way, it may be necessary to take further action to ensure availability. It probably wouldn’t matter up in my part of the world, where there are 40 drug stores within easy access. I can see it being more of an issue in certain parts of the country with far fewer retail options, and more potential for consumer pressure by groups for a store not to carry this.

That said, it does without a doubt involve some kind of imposition on the pharmacist, which is generally speaking a bad thing. Hence I think it would work nicely if there was a central agency (state or private) that could send one this stuff and keep the pharmacist’s soul pure.

But, absent that situation, and in a situation where the government has artifically limited availability of this product, I am not going to see it as a major reduction in liberty for there to be a requirement that a store makes this available. In the same way that I don’t see it as a major issue that it is a requirement of government licensing that a person not refuse to serve black people, or women, even if that has no correlation to the purpose of the licensing. I view accepting the license as opening the door to government regulation, and, if you don’t like it, don’t take the license.

267

I honestly am still not following your argument. You seem to be saying (please correct me if I am wrong) that, because the government has restricted access to Plan B for any reason, they can then further interfere with the rights of citizens to increase access.

So by restricting access, they then gain the option of forcing citizens to work against this restriction.

My argument would be that they shouldn’t try to affect access at all (except for reasons of public safety). Licensing is part of the process of protecting public safety, thus licensing cannot be used to affect access.

And I view accepting the license as opening the door to government regulation ** which is designed to protect the public safety**. This is the only legitimate reason the government has for interfering with the right to decide on abortion - nothing else. You don’t lose your right to decide about abortion by becoming a pharmacist.

It would be like the government requiring you to sign a statement promising that you will not put pro-abortion stickers on your bumper before it will grant you a driver’s license. The license to drive a car has nothing to do with abortion rights; it is purely a matter of public safety and order. The government has a legitimate interest in promoting safer driving, but does not therefore gain the right to restrict people’s rights for unrelated reasons.

Surely you agree that the restricted access of driver’s licenses does not “open the door” to further government interference with unrelated rights. Same for pharmacists. Same, in fact, for all areas of government action - the government has to justify each and every instance in which they are interfering with someone’s rights. They never and cannot do so by default, no matter what. There is never a case where the government can say “you let us take away one right for some legitimate reason, therefore you can’t complain if we take away another”. IYSWIM.

Regards,
Shodan

268

I completely see what you mean. My argument, reduced down to the basic level, is that if the government were to restrict access to a pharmaceutical product, for reasons of public safety, to one outlet per state, for example, then they should ensure that outlet makes the product available.

I don’t think the initial restriction is a good idea, but once it is there it creates an obligation to attempt to make it work in the best possible way. And the difference between us is I don’t necessarily think maximizing the pharmacists ability not to do something is the best possible outcome here given the existence of the restriction.

269

I’m late to this party, but villa’s viewpoint is similar to my own. As a society, we have decided to artificially restrict the availability of certain substances. The pharmacist, acting as an agent of society (or, specifically, the government, the means by which more important social restrictions are enforced), may not use the power vested in him to enforce his personal beliefs. He only has the power to restrict the sale of this item due to the power vested in him by the rest of us; he may not, in turn, use that power for personal reasons, however noble or compelling he may find them.

All of the pseudo-libertarian arguments advanced here treat the pharmacist as if he’s acting strictly on a personal level, and ignore the fact that his restrictive power is granted to him only so that he may use it for the good of society.

On a personal level, if I so choose, I’m free to elect not to take photographs of people based on race, not to transfer those photographs with accompanying identifying details to laminated cards, and not to transfer possession of those cards. But if I work for the DMV, I don’t get to retain those natural rights while I’m acting in my official capacity. I don’t see this situation as fundamentally different.

270

No offense, but Plan B is already non-prescription for adults. So I guess I don’t see how the government is restricting access, and therefore I don’t see the basis for the government interfering with the pharmacists’ right to choose. And again, regulation for the public safety does not (IMO) grant a default permission to interfere with anyone’s rights for other reasons. But I guess I have said that before.

See above. The pharmacist isn’t using his licence to deny anyone access, he is declining to participate in a transaction he finds offensive. And thus he isn’t acting as an agent of society anymore than any other retail sales clerk would be. They all have the right to sell or decline to sell abortifacients - it is their right to choose to do so or not.

It would be roughly similar to trying to force some one to sell, say, sexually explicit magazines in his privately owned bookstore. Does someone have the right to buy such magazines? Certainly he does. Does the state restrict access to such material to minors, just as they do for Plan B? Yes indeed.

Does the state have the right to compel someone to vend such magazines? Not in my opinion - the right to choose whether or not to support such things has to include the right to say No, or there is no meaningful right.

I think we are coming at this from opposite directions.

I assume that the pharmacist has the right to do whatever he wants. He can sell whatever he wants whenever he wants, and the state has nothing to say about it. The only restrictions the state can legitimately impose are those relating to the public safety - site licenses, the commercial codes, pharmacist licensing, etc. But the pharmacist remains a private citizen while he is abiding by these laws, and does not forfeit any of his other rights by agreeing to abide by them.

Now a customer wants to buy something he does not want to sell - Plan B, pornography, whatever. Must he then sell whatever he is asked for, because he is careful to obey the laws on commerce? ISTM no. He has the right and the moral duty to choose.

Suppose one of his customers is a smoker, and he thinks tobacco is inappropriate to sell in a pharmacy. Has he forfeited his right to choose about tobacco, because cigarettes are no longer sold in vending machines?

Regards,
Shodan

271

And I have said (multiple times) before that I thought that this product could be sold only at licensed pharmacists, though not requiring a prescription. As I have said before, if that is not true, the analysis changes. But as far as I know it is the case. And hence its availability is restricted, by the government, to a limited number of people called licensed pharmacists.

If I am wrong on this, please someone let me know. As I have stated before, this analysis would be very different if Foot Locker could retail this product.

The difference there is, I believe, that cigarettes may be sold elsewhere. Were the government to only license one cigarette store per state, I would have issues with the person having that license deciding they had a moral objection to retailing cigarettes. And while I would go to the wall to defend their right not to sell them, I would also support the government being permitted to remove that license and grant it to someone else.

272

Maybe the solution should be, then, to make it more widely available. If it is true that it is only available from a licensed pharmacy, then get rid of that restriction and allow it to be sold at convenience stores and the like. I think some of us actually suggested this way back in the thread. That way, the pharmacist can have a concientious objection, and still not interfere much with the customer’s likelihood of being able to get the product.

273

I think we could come to agreement on that, Sarahfeena. In fact I think we did much earlier…

274

Maybe we did…I don’t remember! :slight_smile: That’s the problem with these long threads…they DO tend to go in circles sometimes.

275

And if the government were to
license only one pharmacist per state or per county. I would agree with you. But pharmacists licenses are not like taxi medallions in NYC- there are x number issued, and no one can get one until someone gives one up. They’re like driver’s licenses- you meet the requirements and you get a license. No numerical limit. The number is only limited by the number of people who meet the qualifications and apply. There’s no need to remove a license from one person to grant it to another.

276

Doesn’t alter the fact that they limit the number of outlets for the product. I was trying to clarify it by reducing it to one outlet. The principle remains the same - government regulation reduces the number of outlets for the drug.

Now this might not matter in DC, or New York City, or LA, or Chicago. But it may make a fundamental difference in a small town.

277

Even in a small town, the government is not limiting the outlets. The government is not stopping a second pharmacist from opening up in that small town. The market is. That’s just part of life in a town so small that there’s one pharmacist- the one doctor might not deliver babies, the one dentist might not do braces. I’m not even sure it the small town issue matters - is there really a person who can’t get to a Walmart ( which does stock Plan B, although it does not require each individual pharmacist to sell it), any other chain pharmacy (which generally seem to have the same policy as Walmart) , any supermarket with a pharmacy department and also can’t order from drugstore.com, which sells plan B and has overnight delivery?

278

That’s really the question, isn’t it? How limited ARE the resources these days, even for people in small towns? Not that limited, in reality.

279

If it’s the government’s job to ensure the ready supply of Plan B, don’t restrict it, sell it in convenience stores. I said it before, the sale of Plan B either requires the scrutiny of a pharmacist or it doesn’t. If it does, don’t bitch when he opines negatively. If it doesn’t, sell the friggin’ stuff in 7-11s. The government has complete control over both sides of this.

BTW, and I asked this before, in response to the, “Well, what if it’s a region that has only a single pharmacist” question, I’d ask, what if it’s a region where there are NO pharmacists? Should the government interfere to create a supply in some manner? Or do we accept the fact that in some locales, those that can support only one (or no) pharmacies, maybe you don’t get everything you want–and it’s the not the government’s job to make sure you get whatever you want.

Let me ask this a different way. Is that backwater locale best served by forcing the one pharmacist to either voluntarily go out of business or move (for reasons of conscience)? What if the choice is between one pharmacist who will not sell Plan B or no pharmacists? Which best serves that community, if you’re from the “greatest good for the greatest number” camp?

280

We are indeed coming at from opposite directions, and I find it interesting that we can apply essentially the same principles, but arrive at different conclusions depending on our vantages.

I assume that the customer has the right to obtain the product from any willing seller. However, the state has restricted his access by limiting the number of sellers, in the name of public safety. In return for the artificial restriction granted him by the government, I feel that the seller must, in turn, supply the product unless public safety is actually threatened, since this is the state’s nominal basis for the restriction, and that they may not do so for any other reason.

Under a purely libertarian framework, a customer could obtain Plan B directly from some channel other than the pharmacy system. But as it is, I think it’s unethical for a pharmacist both to subscribe to and benefit from government regulation in this matter, and yet claim that his own behavior is not subject to it.