# They're coming for your Plan-B **URL:** \ **Category:** Great Debates\ **Created:** [February 23, 2012, 6:24am UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711 "2012-02-23T06:24:08Z")\ **Posts on this page:** 20\ **Page:** 20
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [March 3, 2012, 8:05pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/381 "2012-03-03T20:05:44Z")
> [@Bricker](#): > > Why should your declaration be accepted? You cite to a Wisconsin decision – I can cite to a number of other states’ contrary decisions. Why is yours more persuasive than mine? Why don’t you cite to one, so we can see what the other court’s reasoning was? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [March 3, 2012, 8:09pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/382 "2012-03-03T20:09:41Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Thank you. **Bricker** , I withdraw my objection to your public policy argument. I still think you’re wrong, I just don’t think your underlying premise is flawed. > [@JayRx1981](#): > > Er, I’m not Bricker. > [@Bricker](#): > > I think he meant, “Thank you, **JayRx1981. Brricker** , based on the information **JayRx1981** provides, I withdraw my objection to your public policy argument.” > > He also probably meant to say how impressed he was with my general perspicacity and derring-do. Yes, that. I think one just takes the perspicacity and derring-do part as read, no? ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [March 3, 2012, 9:24pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/383 "2012-03-03T21:24:02Z")
> [@doreen](#): > > I understood you to mean there was some actual requirement that the pharmacists were violating. If you simply meant that they aren’t making sales that they are permitted but not required to make, that’s accurate . Sorry, I think i didn’t explain it clearly. My contention was that they were more violating the spirit of the law, rather than the letter of the law. Meaning, the FDA puts forth guidelines for how a medication is used. They can be underrestrictive, and violate the guidelines by providing it without a prescription for patients under 17, or overrestrictive by refusing to provide it at all. Either is a violation of the FDA guidelines for use of the medication, in spirit. I wasn’t stating that they were mandated by the FDA to provide the medication. > [@](#): > > ``` > I understand perfectly why the person who was unable to purchase Plan B would be pissed at the person who actually refused the sale. What I don't understand is why the people who have never been refused Plan B and who could simply go to another drugstore if it ever happened are outraged at the pharmacists and believe that states should pass laws with no conscience clauses requiring that pharmacists sell Plan B rather than being outraged at the FDA for requiring pharmacists to be involved in the sale of what is really an OTC drug in the first place. > > ``` Wait, let me get this straight. You’re saying that people who have not been directly affected by the pharmacists in question don’t have any right to be upset or take steps to prevent it from happening, simply because it didn’t happen to them? I mean, this is not an either/or proposition. I can say that I personally don’t agree with either of the examples you gave, I think the pharmacists should not be able to refuse to dispense the medication, and I don’t think the FDA should limit the prescription-only sale to under 17. But your contention that the FDA should just make it OTC in the first place is a misplaced one. You’re essentially arguing that since pharmacists can’t be trusted to dispense the medication within FDA guidelines in the first place, the FDA should enable a work-around to make sure that the patients in question are still able to get the medication they need. This workaround wouldn’t even be necessary if the pharmacists in question were not permitted to claim religious exemption to dispensing the medication. ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [March 3, 2012, 10:29pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/384 "2012-03-03T22:29:08Z")
> [@ladyfoxfyre](#): > > Wait, let me get this straight. You’re saying that people who have not been directly affected by the pharmacists in question don’t have any right to be upset or take steps to prevent it from happening, simply because it didn’t happen to them? I mean, this is not an either/or proposition. I can say that I personally don’t agree with either of the examples you gave, I think the pharmacists should not be able to refuse to dispense the medication, and I don’t think the FDA should limit the prescription-only sale to under 17. I’m not saying they don’t have the right to be upset or take steps to prevent it. Of course they do.I simply don’t understand why they choose to focus on the pharmacist and advocate that 50 different states should pass laws requiring pharmacists to dispense Plan B when the fact of the matter is that such a law will never pass in all fifty states and therefore there will always be states in which it is legal for a pharmacist to refuse a sale. If the goal is to make Plan B available to everyone who wants it , focusing on the pharmacists/pharmacy owners is not going to accomplish it. > [@](#): > > But your contention that the FDA should just make it OTC in the first place is a misplaced one. You’re essentially arguing that since pharmacists can’t be trusted to dispense the medication within FDA guidelines in the first place, the FDA should enable a work-around to make sure that the patients in question are still able to get the medication they need. This workaround wouldn’t even be necessary if the pharmacists in question were not permitted to claim religious exemption to dispensing the medication. No , I’m not arguing that the FDA should establish a work-around. I’m saying that if the FDA did its job, and treated this drug as it treats all other OTC drugs, there would be no issue as Plan B would be for sale in the 7-11 along with all the other OTC medications, including Tylenol, which is easier for a 12 year old to misuse than Plan B is. And it would be for sale in most drugstores as well, to be purchased in the same way as other non-prescription birth control products and OTC medications. Or the FDA could require a prescription for all OTC drugs for those under 18 and therefore require that all OTC drugs be sold by a pharmacist - and that requirement wouldn’t last long enough to be written down. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [March 3, 2012, 10:42pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/385 "2012-03-03T22:42:09Z")
> [@doreen](#): > > I’m not saying they don’t have the right to be upset or take steps to prevent it. Of course they do.I simply don’t understand why they choose to focus on the pharmacist and advocate that 50 different states should pass laws requiring pharmacists to dispense Plan B when the fact of the matter is that such a law will never pass in all fifty states and therefore there will always be states in which it is legal for a pharmacist to refuse a sale. For one thing because that’s the subject at hand. And for another because it’s a larger issue than Plan B; if a pharmacist can refuse to give Plan B out of “conscience”, than what can’t he refuse? And if pharmacists are allowed to do things like this what’s the point of mandating their existence? ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [March 3, 2012, 10:47pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/386 "2012-03-03T22:47:38Z")
> [@doreen](#): > > No , I’m not arguing that the FDA should establish a work-around. I’m saying that if the FDA did its job, and treated this drug as it treats all other OTC drugs, there would be no issue as Plan B would be for sale in the 7-11 along with all the other OTC medications, including Tylenol, which is easier for a 12 year old to misuse than Plan B is. And it would be for sale in most drugstores as well, to be purchased in the same way as other non-prescription birth control products and OTC medications. Or the FDA could require a prescription for all OTC drugs for those under 18 and therefore require that all OTC drugs be sold by a pharmacist - and that requirement wouldn’t last long enough to be written down. The FDA has said that it should be available. If you’ll remember, Secretary Sebelius was the one who blocked the application of that ruling. All of those options are fine with me. Right now we are focusing on the issue of pharmacists because pharmacists are the ones who are in behaving in a manner contrary to the goals of the profession, which is to advance patient care. ---
**Author:** ![Aji\_de\_Gallina](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aji_de_gallina/32/260_2.png) [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)\ **Post date:** [March 3, 2012, 11:02pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/387 "2012-03-03T23:02:12Z")
> [@ladyfoxfyre](#): > > The FDA has said that it should be available. If you’ll remember, Secretary Sebelius was the one who blocked the application of that ruling. All of those options are fine with me. Right now we are focusing on the issue of pharmacists because pharmacists are the ones who are in behaving in a manner contrary to the goals of the profession, which is to advance patient care. The goals of the profession are decided by the competent authorities and mostly they decided they can refuse to sell. ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [March 3, 2012, 11:20pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/388 "2012-03-03T23:20:38Z")
> [@Aji\_de\_Gallina](#): > > The goals of the profession are decided by the competent authorities and mostly they decided they can refuse to sell. Um, no. The goals of the profession as it pertains to professional ethics are decided by the leaders within the profession itself. And cite that “most” have decided that they can refuse to sell. ---
**Author:** ![Aji\_de\_Gallina](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aji_de_gallina/32/260_2.png) [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)\ **Post date:** [March 4, 2012, 5:06am UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/389 "2012-03-04T05:06:28Z")
> [@ladyfoxfyre](#): > > Um, no. The goals of the profession as it pertains to professional ethics are decided by the leaders within the profession itself. And cite that “most” have decided that they can refuse to sell. Well, those “leaders” are the competent authorities. As to cite there are two: 1. The general rule for any profession is that you decide what you do unless specifically bannes. Therefore a rule has to be in place to force you to do or ban you from doing. 2. [This cite](http://www.ncsl.org/issues-research/health/pharmacist-conscience-clauses-laws-and-information.aspx), were only Illinois and New Jersey (and in some aspects California) specifically force. ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [March 4, 2012, 2:16pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/390 "2012-03-04T14:16:16Z")
> [@Aji\_de\_Gallina](#): > > Well, those “leaders” are the competent authorities. > As to cite there are two: > > 1. The general rule for any profession is that you decide what you do unless specifically bannes. Therefore a rule has to be in place to force you to do or ban you from doing. > > 2. [This cite](http://www.ncsl.org/issues-research/health/pharmacist-conscience-clauses-laws-and-information.aspx), were only Illinois and New Jersey (and in some aspects California) specifically force. Normally when you speak of “authorities” we are talking about people in actual positions of enforcement, such as the health department and the state boards of pharmacy. Second, your cite shows that 11 states have enacted conscience clauses. That is far from “most”, which you claimed. ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [March 4, 2012, 3:54pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/391 "2012-03-04T15:54:04Z")
> [@ladyfoxfyre](#): > > Normally when you speak of “authorities” we are talking about people in actual positions of enforcement, such as the health department and the state boards of pharmacy. Second, your cite shows that 11 states have enacted conscience clauses. That is far from “most”, which you claimed. Eleven have conscience clauses, two or three have “must fill” provisions, and another allows refusals under certain conditions only. That leaves another thirty-something states in which the law is apparently silent on the issue - which means that a pharmacist can refuse to dispense until a law or a court ruling says otherwise. And while it may be that APhA’s code of ethics requires pharmacists to fill all prescriptions , its own website states. > [@](#): > > It remains the largest association of pharmacists in the United States, boasting more than 60,000 practicing pharmacists, pharmaceutical scientists, student pharmacists, pharmacy technicians, and others interested in advancing the profession. That means it is not the only professional organization of pharmacists in the US , pharmacists are not required to be members and some unknown proportion of the membership are not even practicing pharmacists. I’m sure that somewhere there is a voluntary professional association of religious pharmacists that takes exactly the opposite view - like Pharmacists for Life International. And I can guarantee that some member of _that_ organization is taking the position that the leaders of the profession have determined that it is unethical to prohibit pharmacists from refusing sales . That’s one of the problems with codes of ethics developed by professional associations- unless you’re talking about a very basic ethical issue on which there is broad consensus there’s likely to be an association with the opposite viewpoint. We can determine which government agency regulates the profession and what those regulations consist of but there is no way to objectively determine who the “leaders” of the profession are. We can determine who the leaders of an organization are and what ethical code they have adopted , although we don’t know how much of the membership actually agrees with the code, and we certainly have no idea what the non-member pharmacists think of it. It’s absolutely true that it’s unethical for a pharmacist to refuse the sale based on your understanding of the APhA’s code of ethics. But that’s no different from a pharmacist deciding that it’s unethical to make the sale based on his understanding of PFL’s code of ethics or his religious beliefs , etc. ---
**Author:** ![ABraut](https://avatars.discourse-cdn.com/v4/letter/a/258eb7/32.png) [@ABraut](https://boards.straightdope.com/u/ABraut)\ **Post date:** [March 4, 2012, 4:03pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/392 "2012-03-04T16:03:09Z")
> [@erislover](#): > > Let’s use the vaginal ultrasound “logic.” That doesn’t apply to this. These pharmacists don’t want to stock Plan-B. Unlike the hysterical hypocrites at Planned Parenthood, who already perform ultrasounds as part of the procedure. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [March 4, 2012, 4:11pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/393 "2012-03-04T16:11:53Z")
> [@FinnAgain](#): > > I’d hope that the difference between people who remove clogs of hair from your pipes, and are granted a monopoly on dispensing life-saving medicines is clear to you, furt? Phamacists’ role, coupled with the fact that they are legally the only people who can fill it, sets them in a unique position. You speak as if there is only one pharmacist who can fill your medicine just like their is only one county clerk that can provide you with a divorce form. The latter is a true monopoly and the former is not. If the Walgreen’s Pharmacy won’t stock Plan B, then go to the CVS that is on every other street corner in America. And before we go back down the road of the only pharmacy within light years and people too poor for a 50 cent bus ticket, I would really like an answer to the question I posed a couple of pages ago. How many raped and impregnated women last year were forced to get a traditional abortion or carry a child to term because the sole pharmacy they could get to refused to sell to them and they weren’t able to find it elsewhere within their budget? ---
**Author:** ![ABraut](https://avatars.discourse-cdn.com/v4/letter/a/258eb7/32.png) [@ABraut](https://boards.straightdope.com/u/ABraut)\ **Post date:** [March 4, 2012, 4:35pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/394 "2012-03-04T16:35:53Z")
> [@Der\_Trihs](#): > > Force them to dispense Plan B, or replace them with people who will comply. How do you plan on forcing someone to open a pharmacy? ---
**Author:** ![andros](https://avatars.discourse-cdn.com/v4/letter/a/e480ec/32.png) [@andros](https://boards.straightdope.com/u/andros)\ **Post date:** [March 4, 2012, 5:08pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/395 "2012-03-04T17:08:16Z")
Oh, it could be like jury duty! “Aw, man . . . I gotta be a pharmacist this week. Wonder if I can get out of it.” “Don’t worry, you’ll just sit in a room for a couple hours then go home.” ---
**Author:** ![ABraut](https://avatars.discourse-cdn.com/v4/letter/a/258eb7/32.png) [@ABraut](https://boards.straightdope.com/u/ABraut)\ **Post date:** [March 4, 2012, 5:56pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/396 "2012-03-04T17:56:17Z")
> [@Really\_Not\_All\_That\_Bright](#): > > You asked for a law and I gave you one. But you left out the relevant part: > [@](#): > > (b) Notwithstanding any other provision of law, a licentiate shall > dispense drugs and devices, as described in subdivision (a) of > Section 4024, pursuant to a lawful order or prescription **unless one > of the following circumstances exists: > … > (3) The licentiate refuses on ethical, moral, or religious grounds > to dispense a drug or device pursuant to an order or prescription.** ---
**Author:** ![ABraut](https://avatars.discourse-cdn.com/v4/letter/a/258eb7/32.png) [@ABraut](https://boards.straightdope.com/u/ABraut)\ **Post date:** [March 4, 2012, 6:49pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/397 "2012-03-04T18:49:23Z")
> [@ladyfoxfyre](#): > > Second, yes I do feel that the behavior is unethical. One such judge has agreed: > [Home - SIECUS](http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&featureID=1291) You’ve thoroughly misrepresented the judge’s decision. > [@](#): > > In February 2005, Wisconsin Administrative Law Judge Collen M. Baird ruled that a pharmacist who refused to fill **or transfer** a college student’s prescription for birth control “fell far short of satisfying the standard of care” required of pharmacists based on the pharmacists’ code of ethics. 6 She continued by stating that **the pharmacist did not do enough to guarantee that the woman had another way to fill her prescription** and recommended that his pharmaceutical license be restricted for at least two years. The judge explicitly stated that the pharmacist’s testimony “gave the distinct impression that satisfying his own moral code was his only concern.” 7 ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [March 4, 2012, 7:29pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/398 "2012-03-04T19:29:00Z")
> [@ladyfoxfyre](#): > > Second, yes I do feel that the behavior is unethical. One such judge has agreed: > [Home - SIECUS](http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&featureID=1291) > > I And further down that page a reference is made to the APhA’s position as found at [http://www.pharmacist.com/AM/Template.cfm?Section=Home2&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15688](http://www.pharmacist.com/AM/Template.cfm?Section=Home2&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15688) > [@](#): > > APhA recognizes the individual pharmacist’s right to exercise conscientious > refusal and supports the establishment of systems to ensure patient’s access to > legally prescribed therapy _without compromising the pharmacist’s right of > conscientious refusal._ When this policy is implemented correctly, and proactively, > it is seamless to the patient, and the patient is not aware that the pharmacist is > stepping away from the situation. In sum, APhA supports the ability of the > pharmacist to step away, not in the way, and supports the establishment of an > alternative system for delivery of patient care. (emphasis added) ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [March 4, 2012, 7:57pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/399 "2012-03-04T19:57:59Z")
> [@doreen](#): > > And further down that page a reference is made to the APhA’s position as found at [http://www.pharmacist.com/AM/Template.cfm?Section=Home2&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15688](http://www.pharmacist.com/AM/Template.cfm?Section=Home2&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15688) > [@ABraut](#): > > You’ve thoroughly misrepresented the judge’s decision. Both of these still rest on the idea that the pharmacist can not ethically deny care. The Wisconsin case states that the pharmacist was denying the dispensing and did not enable the patient to get care. The APhA guidelines explicitly state “In sum, APhA supports the ability of the pharmacist to step away, not in the way, and supports the establishment of an alternative system for delivery of patient care.” So both agree that if you’re the only point of care and deny the medication, you are in violation. I personally disagree that they should be able to deny care at all. ---
**Author:** ![ABraut](https://avatars.discourse-cdn.com/v4/letter/a/258eb7/32.png) [@ABraut](https://boards.straightdope.com/u/ABraut)\ **Post date:** [March 4, 2012, 8:02pm UTC](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711/400 "2012-03-04T20:02:57Z")
> [@ladyfoxfyre](#): > > So both agree that if you’re the only point of care and deny the medication, you are in violation. No, I think we agree that your source does not say what you claim and want to believe it says. [Previous page](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711.md?page=19) [Next page](https://boards.straightdope.com/t/theyre-coming-for-your-plan-b/613711.md?page=21)