Pharmacists and refusals

Great Debates
121

Well, as a basic first step, the professions are not fungible. A doctor can, for instance, say to his patient “here, here’s a scrip for 20 percocet.” A pharmacist can not say “I like you, you’re a nice guy, here’s 20 oxycodone.” A doctor can make medical judgments and treat a patient.

Pharmacists do not have the same role as a doctor. A doctor’s job is to consult with a patient, determine their health problems and the needs of their treatment, and then act accordingly. A pharmacist is there to make sure that patients are well informed about the medications they’re taking, that they don’t accidentally get prescribed medications with dangerous interactions, etc… They should not, in that role, have the ability to deny people medical treatment, they are not doctors.

122

I find I’m ambivalent. If every place was New York, then I’d be in favor of a pharmacist’s right not to dispense, because if one of them says ‘no’ there are still going to eight Duane Reades within walking distance (seriously, those things are everywhere), so there’s no practical reason not to indulge some people’s understandable desire not to participate in something they consider abhorrent. But if every place was [some small town with a tiny handful of pharmacies], then catering to pharmacists’ sense of umbrage would be dangerous, as it’s hardly far fetched that every druggist in a given such town would demur, and it’s not like market forces would be strong enough to correct the problem in most cases. If you throw up enough roadblocks and inconveniences to medical care, it will turn out to be, for some, effectively no different than denying said care outright.

I’d say to let localities decide, but of course the number of pharmacy alternatives generally wouldn’t be the deciding factor – probably the very small towns which are most in need of mandatory-dispense laws would be the most likely to legislate the other way. On the other hand, a lot more people live in places that are more like New York in this respect than a small town, and stepping on the freedoms* of pharmacists everywhere to address the circumstances of only a relative handful of places is irksome.

  • => Not saying we can’t step on their freedoms, but that is what’s being proposed, and all else being equal it would be better not to.
123

But the retail pharmacist who is doesn’t stock a particular drug is not denying medical treatment any more than the cosmetic surgeon who doesn’t do breast enlargements is denying treatment. Neither one is preventing you from receiving the prescription or the breast enlargement from someone else who is willing to provide it. And while theoretically there could be no pharmacist in your state who stocks that drug, equally theoretically there could be no cosmetic surgeon in your state who performs breast enlargements.

124

The law in question dealt with emergency contraception, not cosmetic products. We’re talking about drugs that effect the single most important life-choice a woman can ever make, not a certain color of lipstick that they have in stock. And the issue of whether or not they stock it is moot, anyways, if they’re only ordered by law to make it available, at the patient’s cost, by ordering it if they don’t have it in stock.

Nor is forcing someone to potentially drive for hours (assuming they even have a car and/or can make that trip) an acceptable remedy when you’re dealing with medications that have a significant temporal component.

125

By the way, the Idaho Board of Pharmacy, not to anyone’s great shock, found in favor of the Conscience Pharmacist in the case where he refused to dispense a prescription to prevent a woman’s bleeding, based on state law. As to the confidentiality issue, it appears the Board punted one that one.

“According to the Board of Pharmacy’s response, Planned Parenthood alleged the pharmacist’s inquiry violated privacy provisions of the federal Health Insurance Portability and Accountability Act, which the board is not entitled to enforce. Under the Idaho Pharmacy Act, releasing such information would be a violation, but requesting it is not, the response states.”

Fascinating. No indication there that the pharmacist was doing his job by requesting irrelevant patient history (as another poster here suggested). And it’s a-OK with the Board if a pharmacist attempts to circumvent HIPAA, but responding to his improper query would have gotten the nurse in trouble.

Something is rotten in the state of Idaho.

You realize that you’re asking Bricker to take a principled stand on an issue, rather than merely insinuating that since a court decision found in favor of something, its opponents must be wrong? Good luck with that. In all of the discussion of this subject in this and previous threads, the only example of an actual opinion I’ve seen from Bricker is an outraged declaration that he was so offended by the arguments of patient rights’ advocates that he had decided in favor of the Conscience Pharmacists and was planning to send money to support their cause. So only tone matters. :dubious:

For me and many others, the minutiae of whether the Illinois court case was properly decided is minor compared to the larger issue of whether pharmacists’ personal beliefs should be allowed to trump their professional duties. If some states’ laws (passed thanks to anti-abortion forces who seek any means possible to chip away at abortion rights) enable these Conscience Pharmacists, then the laws need to be changed, and more laws passed clarifying the duty to dispense, as exist in numerous other states in regard to contraception, emergency and otherwise. The Idaho situation of a pharmacist willing to see a woman experience potentially serious bleeding in order to make an anti-abortion statement may help galvanize opposition to Conscience Pharmacist laws.

Incidentally, rather than giving examples of pharmacists potentially denying prescriptions to people based on race, I wonder about some fundamentalist pharmacist in a small town in, for example Idaho, who has a prescription called in for an anti-retroviral drug. He has no idea if it’s intended for someone who was exposed to HIV through a needlestick, intravenous drug use, rape, consensual sex or whatever means. Should he be permitted to interrogate the physician or nurse calling in the scrip as to the exact medical circumstances and then refuse to dispense if he doesn’t get the information (or refuse to dispense if the patient was morally deficient in getting exposed to HIV)?

I think this would be grossly improper and should be illegal. In Idaho, apparently, it’d be just fine.

126

The fact is that the court held that the right of specific individuals, to exercise their religious beliefs, under certain circumstances, by refusing to provide a service was reasonable and permissible under our constitution. I don’t disagree with that. It’s stated in such clear language that even a con-law lay person such as myself can understand it. (the 1st Amendment that is)

Perhaps you should post your race-card hypothetical to the court, along with your “I told you all you need to know” cite, and ask their opinion.
[/QUOTE]

Surprise! You again dodge actually answering villa’s question. Naturally, you don’t want to admit that your “principles” would allow pharmacists to indulge racism just as they allows pharmacists to indulge their sexism.

127

Perhaps you can help Villa in this matter as his “I’ve told you all you need to know” doesn’t tell me much of anything.

Let’s examine a few issues and see if his group is in fact a religion .

Please provide the following with respect to the referenced religion;

  1. Does it have distinct legal existence?
  2. Does it have a recognized creed and form of worship?
  3. Does it have a definite and distinct ecclesiastical government?
  4. Does it have a formal code of doctrine and discipline?
  5. Does it have a distinct religious history?
  6. Does it have a membership not associated with any other church or denomination?
  7. Does it have an organization of ordained ministers?
  8. Are it’s ordained ministers selected after completing prescribed studies
  9. Does it have a literature of its own?
  10. Does it have established places of worship?
  11. Does it have regular congregations?
  12. Does it conduct regular religious services?
  13. Does it provide Sunday schools for religious instruction of the young?
  14. Does it have schools for the preparation of its ministers?

If you, or Villa for that matter, answer the above questrion I’ll consider your question seriously with respect to that religion, otherwise, your mere mention of an internet based hate group doesn’t merit my time.

128

Thank you ever so much for giving us the definitive definition of Religion. It has jack-all to do with what we are talking about, but I’m sure people will be referencing it for years to come.

129

I’ll connect the dots for you.

  1. OP posts about a court case that places religious beliefs above statutory duties, in specific matters.
  2. Poster wants to know if a hate group would receive the same protection.
  3. The discussion stalemates pending whether the group is a recognized religion entitled to constitutional protection guaranteed by the 1st Amendment.
  4. our Constitution doesn’t define a religion, so we look to the next best thing.
  5. I posted the next best thing, fully expecting those who asked the question to see how absurd classifying a hate group as a viable religion would be.
130

Very fucking wrong.

One may make the assumption that the prolifer asshole is basically some form of Christian.

If I, as a pagan had bleeding because of an abortion because I personally have my kidneys fail if i try to carry to term. My abortion was to save my life. That assfuck is forcing HIS religion onto me.

Religion has absolutely NO fucking place in the dispensing of prescribed medication.

131

What is funny is that he was the one who posed the first hypothetical.

132

Actually, what happened was:

[ol]
[li]OP posts about a court case that places religious beliefs above statutory duties, in specific matters.[/li][li]Poster responds that he feels that making this a first amendment matter is a misinterpretation of the Free Exercise clause, based on current case law; and that it will also undercut current civil rights legislation[/li][li]Morgenstern ignores that poster has said nothing about whether pharmacists should have the right to refuse to give prescribed medications, and instead posts a hypothetical based on euthanasia.[/li][li]Poster answers hypothetical on euthansia, responds with hypothetical based on religious racism[/li][li]Morgenstern refuses to answer hypothetical based on religious racism, saying he doesn’t understand it.[/li][li]Poster further explains religious racism hypothetical[/li][li]Morgenstern again refuses to address it, maintaining hypotheticals aren’t relevant, and this is clear under the First Amendment (the very point poster was addressing).[/li][li]Morgenstern then posts on bizarre definition of religion, that isn’t shared by the court system, and in fact excludes very many religions that are recognized as such by the courts.[/li][li]Morgenstern declares victory.[/li][/ol]

Kind of a cop out, wouldn’t you say?

133

I never new that Sunday Schools were integral to being recognized as a religion in the US legal system.

134

Bizarre definition of religion?

Go ahead, qualify your cited hate group as a religion then we’ll discuss it. Meanwhile, I’m not taking your “my post is my cite” argument seriously.

Otherwise, let’s just call a spade a spade, or should I say a hate group a hate group and not put it in the same class as a religion.

BTW, a quick look showed that at least 13 states have Conscience Clause Laws (allowing the refusal to fill) based on moral or religious beliefs. Not one of them allows refusal to fill based on hate.
That should pretty much answer your question.

135

And the three largest chain pharmacies in the U.S. (Walgreens, Rite Aid & CVS) don’t technically allow their pharmacists to refuse to fill contraceptive prescriptions, either, unless they’re forced to by a “conscience clause” law in the state of operation.

Okay, let’s say that’s the case.

No, because barring a career as a fashion model, no one’s ability to live or maintain their physical or mental wellbeing is hampered by lack of immediate access to eyelash thickening drugs. Antidepressants, antibiotics and yes, contraceptives are not elective. There are health consequences to not taking them, not taking them in a timely fashion and in some cases, to stopping them cold turkey.

The pharmacies in question stock these drugs. Call any national chain pharmacy, they’ll have contraceptives of various brands and formulas (maybe not yours, but many). They’ll have Plan B. The problem is that the customers are left to the whims of which PharmD is on duty at the time they come in. If you go at 2 p.m. Wednesday this week when Joe’s on duty, you get your birth control, no problem. If you go 2 p.m. Wednesday next week when Sally, regional chair of Pharmacists for Life is behind the counter, she’ll refuse to fill the script and you’ll either have to wait till Joe’s back, or go elsewhere. If Joe’s off for a week, and you need emergency contraception, what do you do?

“Go elsewhere” is only a viable answer if there is an elsewhere you can go to, and if you are physically able to do so and within the window, if you’re seeking Plan B.

136

You really are missing the point here. The very essence is the danger of involving the government in the determination of what is and what isn’t a religion. And also why you are drawing such a great distinction between beliefs based in religion (protected by the First Amendment) and those based in political speech (also protected by the First Amendment).

Can you please explain to me the legal relevance of your last sentence, as it is escaping me. While you are at it, please learn the difference between an exemption being permitted under the First Amendment, and one being required under the First Amendment.

It’s been my position the whole time that under current First Amendment jurisprudence, such an exemption for pharmacists is permitted, but not required. That is, as far as I can see, the position of SCOTUS. The Illinois Supreme Court, on the other hand (based on Bricker’s description), appears have gone against SCOTUS precedent and said that such an exemption is required.

ETA - this is a response to post 134, clearly.

137

I’m not denying hate groups their right to free speech. But that’s a far cry from finding that they are protected under the free exercise of religion provision of the same amendment.

Conscience Clause Laws recognize the right of a person to subscribe to a moral or religious belief and therefore, not be forced to violate that belief in the practice of their profession. It doesn’t give them the right to take and not return a prescription, or otherwise interfere with that party obtaining the drug elsewhere. It merely gives them the right to say “go elsewhere.”

138

The hate group that was specifically named is called the *Christian* Identity movement, so what religion do you think that the adherents are?

They are a sect of Christianity. Their “religion” is absolutely recognized, such as this country legally recognizes any religion. That their interpretation of Christian theology and holy text is not mainstream doesn’t change the fact that they claim that their beliefs are based on their religious faith.

So on that basis, why should a person who makes a decision based upon the teaching of their sect about birth control have legal insulation to do so but a person who makes a decision based upon the teaching of their sect about race not have the same legal insulation?

139

Ok, forget about the hate group, would you support a pharmacist who converts to Christian Science and decides he/she can’t sell anything from asprin to wart remover?

140

You aren’t going to get an answer. Just more weaseling.