Pharmacy and Religion

[Bricker]

@begbert2

I think I want to become an emergency room doctor, but I don’t like children much. I think I’ll just refuse to treat anyone under the age of 18.

Man, I wish I had thought, before this, to distinguish exigent, emergency circumstances from pharmacies.

[villa]

@Kimmy_Gibbler

Well, if the debate were “Villa, if you were king of the world, would you make doctors perform abortions and pharmacists dispense contraceptives and abortifacients?”, then this remark would be interesting and/or relevant.

I responded directly to a comparison in the previous post - that not all Doctors perform abortions. My response was that this was true, but that I would not ahve a problem if they had to, into which I assume you could read (given the previous posts I made here) that I similarly have no problem with requiring pharmacists to provide contraceptives.

@Kimmy_Gibbler

Frankly, it does not seem to me that the supposed ill-effects of allowing conscientious refusal to dispense has occasioned enough of a social harm (which seems to be a real but slight burden involving finding another pharmacist*) to justify abridgment of the rights/interests listed as (1) above.

But perhaps you can show that your rule represents the most narrowly tailored approach to advancing an important state interest, the test required for overcoming limitations on free exercise rights and fundamental liberty interests.

Frankly, it does not seem to me that there is an abridgement of an individual’s first amendment rights at stake here, so it frankly isn’t encumbent on me to show that this is the most narrowly tailored approach to advancing an important state interest.

Claiming religion does not provide a get out of jail free card. Ask those who formed the Church of the Filet Mignon in prison whether they receive their sacrament each week as they asked.

First Amendment law protects all beliefs, but does not protect all actions or indeed all refusals to act. While a person may avoid the draft on religious grounds, they may not avoid combat duty on religious grounds and stay a part of the military. I would never force a pharmacist to provide contraception against their beliefs, whether religious or political. But I would take away their license to be a pharmacist if they did not, just as I would discharge any soldier who claimed that their religious beliefs prevented them from handling a weapon.

[begbert2]

@Bricker

Man, I wish I had thought, before this, to distinguish exigent, emergency circumstances from pharmacies.

Okay. What is the difference between exigent, emergency circumstances and [handing out prescribed contraceptives from] pharmacies? I suppose you could say that Thor himself declared that doctors should do it, or that the hypocratic oath has the force of law, but I’m thinking that the real difference is one of the following:

1. We as a society have just up and decided that doctors ought to have to treat exigent, emergency circumstances, and/or

2. We as a society went and made a law about it.

Kind of pathetically, I don’t know which it is - is it illegal for a doctor to stand by and watch you die?

Okay. So, supposing we as a society decided that pharmacists should do their frigging jobs and fill prescriptions. Suppose we maybe even make a law about it! How does the situation materially/legally differ then from the case of exigent, emergency circumstances?

[otternell]

@Kimmy_Gibbler

Well, if the debate were “Villa, if you were king of the world, would you make doctors perform abortions and pharmacists dispense contraceptives and abortifacients?”, then this remark would be interesting and/or relevant.

As it happens, the real debate is how to square (1)(a) a person’s liberty interest in choosing an occupation that he is qualified for, (1)(b) a person’s First Amendment right to free exercise of his religion, and (2) the public’s interest in ensuring access to medicines that occupy a place of controversy.

Frankly, it does not seem to me that the supposed ill-effects of allowing conscientious refusal to dispense has occasioned enough of a social harm (which seems to be a real but slight burden involving finding another pharmacist*) to justify abridgment of the rights/interests listed as (1) above.

But perhaps you can show that your rule represents the most narrowly tailored approach to advancing an important state interest, the test required for overcoming limitations on free exercise rights and fundamental liberty interests.

• There is no such thing as a right not to have to go to multiple drug stores or a liberty interest in pharmaceutical convenience.

That’s all well and good when you are in a large city with numerous pharma providers, but if you are in a small town with 1 pharmacist who decides that their moral compass is more important than just dispensing the pharmaceuticals, then it takes on a different light. Its not as if there is public transportation available to take someone to the next town where they may be lucky and find a pharmacist that isn’t trying to impose their personal morality on others.

[Really_Not_All_That_Bright]

@Kimmy_Gibbler

Frankly, it does not seem to me that the supposed ill-effects of allowing conscientious refusal to dispense has occasioned enough of a social harm (which seems to be a real but slight burden involving finding another pharmacist*) to justify abridgment of the rights/interests listed as (1) above.

It’s not much of a burden in Manhattan. It could be a heavy one in Manhattan, KS.

[villa]

In another somewhat tangential point, sure to distress Kimmy_Gibbler further, I’d support undercutting these crackpots by a government run postal pharmacy service.

Unfortunately then we would get mail carriers claiming a religious right not to deliver packages which might contain contraceptives to the filthy, filthy whores who ordered them.

[Aji_de_Gallina]

@villa

**But as soon as Joe Independent takes advantage of government licensing, he makes himself subject to government regulation.

I’ve got no issue at all with Joe deciding in his convenience store not to sell condoms, or beer, or cigarettes, or porn, or anything he chooses not to sell. However, I also see no problem with the government requiring as part of a license that a particular product be available.**
In practice, I would think there is nothing stopping Joe Independent doing what you want him to be allowed to do. As far as I know, nothing mandates a pharmacist to keep stocks of products. I don’t think there is anything stopping a pharmacist simply not keeping birth control pills in stock, or Plan B, or any other contraceptive item. Where this comes up is where the product is in stock, and an employee chooses not to offer it.

To change the situation slightly, Bricker, do you have a problem with the government requiring that if the product it in stock, and the pharmacist chooses to make it available to some, the pharmacist should have to make it available to all with a prescription for it? Could the government legitimately stop Joe Independent refusing to provide contraception to women under 25 for example, or to interracial couples?

(my bolding)
I agree. my position is that you shouldn’t force a person to act against their beliefs. If the law allows him not to sell a product, good for him. If the law does not allow him to follow his conscience, he goes out of business.
Of course, it would be intelligent to figure out if it is better to have no pharmacy or a pharmacy with no contraceptives.

[Jackmannii]

In general, physicians bear the greatest responsibility and have the most authority (excluding hospital review committees, insurance companies, Congress etc.) to provide medical care.

At some point it becomes untenable for people down the health care chain to be able to countermand these decisions based on criteria not related to the professional performance of their duties. Nurses can refuse to carry out certain orders if they feel proper care is at stake. Other personnel may also decline to perform duties for reasons of safety/patient care. A blood bank employee might justifiably refuse to issue blood products if there’s cause to believe they are unsafe - but not because the employee is a Jehovah’s Witness.

You want to be a licensed pharmacist with all the duties and responsibilities that entails? Good. But you may not allocate to yourself special powers based on your religious convictions unless legislators are foolish enough to allow it.

[Voyager]

@Bricker

How about a butcher that refused to sell only veal, based on his opposition to how veal are treated as they are raised?

That would seem a better analogy, since the pharmacist refuses to sell not all medicine, but only contraceptives; the butcher refuses to sell not all meat, but only veal.

I agree that this is a better analogy, and a butcher should be fired for not selling veal also. At the time of employment, a reasonable person should know that he would have to sell veal/contraceptives, and should not take a job where his moral imperatives would be violated. If the butcher started selling puppy meat, it would be a different story, since that is not an expected part of the job.

How would you feel about a pacifist who joined the army in a time of peace for employment and education benefits, and then tried to refuse combat duty? It is true that the government is the employer in this case, but think of it in terms of obligation to society that this person took on by joining the military.

[Aji_de_Gallina]

@Voyager

I agree that this is a better analogy, and a butcher should be fired for not selling veal also. At the time of employment, a reasonable person should know that he would have to sell veal/contraceptives, and should not take a job where his moral imperatives would be violated. If the butcher started selling puppy meat, it would be a different story, since that is not an expected part of the job.

How would you feel about a pacifist who joined the army in a time of peace for employment and education benefits, and then tried to refuse combat duty? It is true that the government is the employer in this case, but think of it in terms of obligation to society that this person took on by joining the military.

This work for Jack the employee, and I might agree. But Suzie the owner can decide not to stock contraceptives.

[Bricker]

@Jackmannii

If you want any or all of these folks (who have in common belonging to highly regulated professions) exempted from certain job duties based on personal beliefs, try to get those exemptions codified into law. You’ll face plenty of well-founded opposition.

With respect to the pharmacists, I have already won that victory in:
[ul]
[li]Arkansas: § 20-9-1001 [/li][li]Colorado Rev. Stat. 25-6-102 [/li][li]Florida 2003 Stat. XXIX 381.0051 [/li][li]Georgia Admin. Code § 480-5-.03 [/li][li]Maine Rev. Stat. tit. 22, 1903 [/li][li]Mississippi Code Ann. § 41-41-215 [/li][li]South Dakota Codified Laws § 36-11-70 [/li][li]Tennessee Code Ann. 68-34-104 [/li][/ul]

[DanBlather]

@otternell

That’s all well and good when you are in a large city with numerous pharma providers, but if you are in a small town with 1 pharmacist who decides that their moral compass is more important than just dispensing the pharmaceuticals, then it takes on a different light. Its not as if there is public transportation available to take someone to the next town where they may be lucky and find a pharmacist that isn’t trying to impose their personal morality on others.

Many regions of the country are sparsely populated and heavily conservative. The result of requiring a pharmacy to carry birth control and Plan B might be that no one is willing to open a pharmacy at all. In populated areas there will be someone else who have the financial incentive to carry those products, but that is not true in all areas.

I lean towards the idea of requiring pharmacies to dispense all drugs as part of licensing, but allow reasonable accommodations for employees. But I think cwthree did a good job showing this is a case of balancing rights.

Another thing to consider is that pharmacies do not carry everything, and may choose not to keep seldom-used medicines in stock. I could also see a pharmacy deciding not to carry Schedule II drugs to reduce the chance of robberies.

[Bricker]

@begbert2

Okay. So, supposing we as a society decided that pharmacists should do their frigging jobs and fill prescriptions. Suppose we maybe even make a law about it! How does the situation materially/legally differ then from the case of exigent, emergency circumstances?

Then it doesn’t. If we as a society express our public policy thus, as we are surely entitled to do, then pharmacists better shape up or ship out.

I am arguing that to express ourselves thusly is unwise.

[Tethered_Kite]

@Cumberdale

If they won’t do their job, they need to find something else.

An aside:

In the Midwest US we have noticed a similar situation when new immigrants took jobs at meat packing plants and then refused to work with pork products.

[villa]

@Bricker

With respect to the pharmacists, I have already won that victory in:
[ul]
[li]Arkansas: § 20-9-1001 [/li][li]Colorado Rev. Stat. 25-6-102 [/li][li]Florida 2003 Stat. XXIX 381.0051 [/li][li]Georgia Admin. Code § 480-5-.03 [/li][li]Maine Rev. Stat. tit. 22, 1903 [/li][li]Mississippi Code Ann. § 41-41-215 [/li][li]South Dakota Codified Laws § 36-11-70 [/li][li]Tennessee Code Ann. 68-34-104 [/li][/ul]

I’m not sure it is that much of a “victory” for you. Unless I remember the Tennessee rule wrong, it prevents an employer from firing a person for refusing to sell contraceptives. Something which you have said you oppose earlier.

Tennessee Code Ann. 68-34-104
(5) No private institution or physician, nor any agent or employee of such institution or physician, shall be prohibited from refusing to provide contraceptive procedures, supplies, and information when such refusal is based upon religious or conscientious objection, and no such institution, employee, agent, or physician shall be held liable for such refusal;

[Cumberdale]

@Really_Not_All_That_Bright

Well, not necessarily. Pharmacists are required to check for adverse drug interactions and allergies and so on that the prescribing physician may have missed, and can (and should) refuse to fill such prescriptions.

These are two completely different issues. Yes, you are correct in that type of situation.

Suppose my wife and I are just married, and we don’t want kids at the moment. I go into my local pharmacy to by a pack of condoms, which they carry. The pharmacist on duty is a Catholic and refuses to sell them to me. I don’t care if there is someone else on site who can complete the transaction immediately, I find this unacceptable. If someones religious convictions tell them something is wrong, then it is their responsibility to avoid it at all costs. If that means they have to find another job, then so be it. I have zero sympathy for them.

[Cumberdale]

@Tethered_Kite

An aside:

In the Midwest US we have noticed a similar situation when new immigrants took jobs at meat packing plants and then refused to work with pork products.

The was also a similar story of muslims working at a grocery store who refused to ring up alcohol.

I like to read non-fiction, how about I become a librarian but refuse to answer questions or do anything that deals with fiction materials?

[begbert2]

@Bricker

Then it doesn’t. If we as a society express our public policy thus, as we are surely entitled to do, then pharmacists better shape up or ship out.

I am arguing that to express ourselves thusly is unwise.

I guess I missed the argument - what was it again? Specifically, why would it be unwise for us as a society (that presumably isn’t universally opposed to contraceptives) to refrain from making it a requirement for government-licensed pharmacists to fill all legally-issued prescriptions? We don’t have a societal incentive to restrict the action itself. Do you posit there to be beneficial side effects of allowing persons to run pharmacies that don’t fully execute the duties of a pharmacy? Do you feel that enough people would refuse to run pharmacies, that we would as a result of this policy be unable to supply society with the number of pharmacies it needs to function efficiently?

[Skammer]

@Doughbag

People will just stop buying stuff from these shops and they will go eventually out of business.

This is the solution; not outlawing the practice. If I own a pharmacy, I ought to be able to determine what prescriptions/medications I will provide. If I’m not providing what people want, I’ll go out of business.

If I’m not the owner, I am subject to the owner’s policy on the matter. I can be fired for not filling the orders based on the owner’s wishes.

[Skammer]

@Really_Not_All_That_Bright

Anyway, if you feel the government has no business regulating pharmacists, why do you believe it should be allowed to regulate physicians?

Should physicians be required to provide services that conflict with their personal convictions? Like abortion or circumcision?