The next battle in the never-ending culture wars is already upon us:
More than a dozen states are considering new laws to protect health workers who do not want to provide care that conflicts with their personal beliefs, a surge of legislation that reflects the intensifying tension between asserting individual religious values and defending patients’ rights.
About half of the proposals would shield pharmacists who refuse to fill prescriptions for birth control and “morning-after” pills because they believe the drugs cause abortions. But many are far broader measures that would shelter a doctor, nurse, aide, technician or other employee who objects to any therapy. That might include in-vitro fertilization, physician-assisted suicide, embryonic stem cells and perhaps even providing treatment to gays and lesbians.
Because many legislatures have just convened, advocates on both sides are predicting that the number debating such proposals will increase. At least 18 states are already considering 36 bills.
“It’s already a very hot issue,” said Edward R. Martin Jr. of the Americans United for Life, who is advising legislators around the country pushing such bills. “I think it’s going to get even hotter, for lots of reasons and in lots of places.”
There is little room for nuance in my opinion on this. If your religious beliefs interfere with your job providing any and all desired or required care for a patient, you have several options- change your job, change your religion, suck it up and hope yours is a forgiving God.
Denying people care because it upsets your sensibilities should not be allowed, and those who choose to do so should not be protected by legislation, they should have their licenses revoked. People who refuse to provide mainstream and accepted medical treatment to patients because of their own religious beliefs should no longer be considered doctors- they can hang a plaque outside their door that says the following:
“Joe Schmoe- Unlicensed Faith Healer.”
Slide
You’re on fire today John. I agree 100% – as much as that must distress you.
akaoni
Re: your previous post, I smell a wedge issue!
Steve
I agree completely with John, although I always have to pause for thought because I am a lawyer, and lawyers consider it pretty important that they can pick and choose which cases they want to handle.
One major issue I would hope everyone agrees on is that no one should be denied emergency care because of the doctor’s personal beliefs.
Moving past that, I wouldn’t have a problem saying that your everyday family practitioner has the right to refuse a patient for whatever reason he feels like, just as I can’t be forced to take a case I don’t want to. If they’re bigoted, I hope they burn in hell or whatever, but I don’t think they’re legally obligated to take a patient.
But the critical point is that you can’t take a patient halfway. When I take a case, I promise to represent my client zealously within the bounds of the law, and it would be wrong for me to say “well, it would be against my religious beliefs to tell my client to do such and such, so I won’t advise him he has the option.” By the same token, you can’t accept a patient, and then refuse to tell them about medical options just because you have a personal objection to them. Your patient has no idea what is being withheld from him and that’s not right.
chopper
the worst part:
these people don’t even realize that BC and the morning after pill don’t cause abortions. BC and the morning after pill disallow an egg from being fertilized. if that’s abortion, than so are condoms, spermicides and a woman’s period.
don’t they learn this sort of thing in pharmacy classes?
Lines
2004 – Gay Marriage
2006/2008 – Gay Health Care?
This isn’t just a wedge issue (or issues), this is a continuation of a wedge issue that will result in people like Fred “the instigator” Phelps gaining national popularity for his views on homosexuality. This is hate, pure and simple hate. As such, violence is not far behind, there will be more Matthew Shephards.
When will the persecution stop? Who will call for it? When will people figure out the “gay agenda” isn’t working or is really non-existant?
Or maybe this is just a pendulum swinging and when it swings back in the direction of equality for everyone it will stop swinging to the radical right side?
Lines
chopper: To these people the spilling of seed on the ground is an offense which will result in the soul burning for eternity. Its not about rational and intelligent thought, it is about using their religious soapbox to force America to swing to the side of the radical right.
Doctor Gonzo
The pharmacist issue angers me the most. It’s like a vegan being hired as a butcher and then claiming that his “personal beliefs” won’t allow him to touch meat, so his employer will have to accomodate them.
If you don’t want to dispense drugs, don’t become a pharmacist. Although this problem coulld also be solved by making the morning-after pill OTC, but I’m not holding my breath.
yet another jeff
Do they really want to open the door to the idea that employees that refuse to do their jobs should be protected?
John Cole
I am just wondering how long it is before someone comments that my position means I am in favor of forcing doctors to provide abortions.
ppGaz
I know that agreeing with the likes of me and slide is probably not what you were going for …..
…but, “me too.” This kind of “culture war” crap is exactly the reason why some of us decried the pandering to a nutty pseudo-christian base. The GOP has sold its soul to the devil of lunatic fundamentalism. Enough is enough. Run the crazies out of the statehouses and the Capitol before it’s too late.
Gunga Dean
Amen!
Otto Man
Well said. And nice post, John.
Davebo
I almost hate to say this but..
Yawn..
Get back to me whenever any of these states actually pass a law. I just really believe this is a bone to the base that is never intended to be passed into law.
I could be wrong, but if so these state GOP’s are nuts. This is not a winning issue to the rank and file and especially not to the all important center.
Lines
Davebo, perhaps you can explain how so many states and Republicans ran on an anti-homo marriage stance in 2004 and either successfully defended their seat or won a new one?
Why did so many states, liberal ones as well, that passed resolutions in 2004 against homo-marriage?
Can you show proof that the pendulum of Gay Hatred is swinging back towards equality?
techson
How long before the jesus freak pharmacists decide the anti-depressants aren’t necessary and tell people to discover scientomogy instead? Where does it stop? The neandercons are getting more Marxist every day. Sometimes I yearn to be a white, heterosexual, fag hating jesus freak… they seem to be the only people that matter to politicians these days.
Vladi G
Exactly. There was a time when people who made decisions based on their personal convictions did so with full knowledge of the consequences and were prepared to accept them. Nowadays, people want to have their cake and eat it too. Part of taking a principled stand means dealing with the consequences of such actions. If you don’t want to dispense medication prescribed by a licensed physician, that’s fine, but you’re gonna get fired. Any chickenshit can take a “principled” stand when there aren’t any consquences. Where’s the fucking principle in that?
Maybe I need to get on this gravy train. I work for a major accounting firm as a tax consultant. I think I need to get on one of those anti-tax bandwagons and refuse to do my job. Just as long as I keep getting paid.
docG
Steve:
You are an attorney, so I would assume you’re familiar with the slippery slope argument.
-The doctor chooses not to treat a child molester, because it violates her personal beliefs.
-The doctor then chooses not to treat Republicans because their politics violates personal beliefs.
-The doctor refuses to treat minorities because it violates her white supremicist beliefs.
That is a door we best not prop open with enabling legislation.
Also, the vast majority of health care in the United States is paid for by third parties on behalf of patients (company sponsored health insurance and government, primarily). As a health care provider, when I sign a contract with one of these entities, I am contractually obligated to provide treatment to their subscribers, regardless of my personal beliefs.
Lawyers may feel free to pick and choose cases, but health care professionals have different obligations to patients and their societal mandate allows less discriminatory behavior.
And Doctor Gonzo is so right about pharmacists. I can’t remember the comedian’s name to give credit, but the old bit was something like:
PASSENGER: “Stewardess, do you have a second?”
FLIGHT ATTENDANT (in a very aggrieved tone): “Sir, we are flight attendants, not stewardesses!”
PASSENGER: “Well, whatever the hell you are, fetch me some peanuts”.
I think this idea applies to my professional services as well.
Nathan
I can see the opening day now, “Maverick Rx, free sonograms and scientology, wednesday is free anti depressant couch jumping, thursday’s are theton only, bring a picture of your favorite crop circle for 20% off”
SeesThroughIt
Oh, they’re getting to that stuff. Don’t you fret. They want you to only have “Biblical” sex, so before long, we’ll all be singing Monty Python’s “Every Sperm Is Sacred,” only it won’t be a joke, it’ll be national health policy.
For real, these fucking religious dingbats need to sit down and shut the fuck up–or be MADE to sit down and shut the fuck up. If you want to be a faith healer, do it on your own time.
Steve
The morning-after pill sometimes prevents fertilization, but as a backup it also prevents a fertilized egg from implanting in the uterine wall (something that fails to happen about half the time even if you do nothing).
The extreme pro-life position is that life begins with fertilization, period, and so if you stop the embryo from implanting an hour after fertilization then you might as well have had an abortion at 8 1/2 months. The unfortunate thing is that obviously in Biblical times, no one had any idea about the stages of fertilization, implantation, etc., and so this position is basically something someone made up after the fact and called it the Word of God.
ppGaz
It has no basis either in scripture, nor in the Constitution. But to hear them talk, it’s right out of the Twenty-leven Commandments.
Krista
They do, but they don’t believe it. They’re actively trying to get the definition of pregnancy changed. Right now, the scientific definition is when the fertlized egg implants in the uterus. They want to change it so that pregnancy commences as soon as the egg is fertilized. Let’s say that happens, just for shits and giggles: That would make ALL hormonal birth control into methods of abortion, because they change the uterine lining so as to be inhospitable to a fertilized egg. The Pill: gone. The IUD: gone. The patch, the ring, Depo-provera – all gone.
Conveniently, of course, those birth control methods are all the most reliable, outside of abstinence or sterlization. So unwanted pregnancies would go up. But of course, abortion would be illegal, in this scenario. So, we now have another boom – of unwanted babies. Charming. These people are so self-absorbed and have their heads planted so far up their own asses, that they can’t conceive (pardon the pun) of not being able to afford and care for a child. “But children are gifts from God, for which we should be thankful!” Yeah, tell that to young married student couple who are barely making ends meet, and for whom a baby would mean the end of their education and future prospects.
If they’re not going to dispense what the doctors prescribe, they shouldn’t be in the business.
Speaking of business – why is Big Pharma so damned quiet about this? Oral contraceptives are a fairly large moneymaker for them, are they not? Why are they allowing access to be threatened without a fight?
docG
The Christian god is described as all-knowing, and presumably knowledgeable about what He created. Isn’t it amazing that all gods tend to reflect the ideas, knowledge and social context of those
creatingworshipping them.Ancient Purple
Perhaps, but the issue of pharmacists is alive and well. In Tucson a couple of months ago, a pharmacist at a Fry’s Food and Drug refused to give a rape victim the Morning After pill. That location was the only location for miles that stocked the drug and the woman spent two days before finally getting the medication, and just in time.
Fry’s issued a statement backing the decision of the pharmacist and there was no state or federal law that did anything to punish the pharmacist.
So, in effect, it is perfectly fine for a pharmacist in Arizona to deny legally prescribed medication to a patient if the pharmacist has religious convictions against dispensing a medication.
Chilling.
chopper
if taken properly it merely disallows fertilization. the morning after pill is supposed to be taken right after sex. hence the name. sex doesn’t produce a fertilized egg that quickly.
as to it not being taken properly, well hell, half the drugs out there can screw up an implantation if taken improperly in one way or another.
all the morning after pill is is a large dose of birth control medication.
Otto Man
Actually, the film we’re heading to is The Handmaid’s Tale. Not quite as funny, but we do get names like “Offred.”
Mr Furious
Davebo, you’re wrong. This shit will pass.
Michigan passed a completely draconian anti-gay measure in 2004 despite the fact that the state constitution already defined marriage as a man and a woman.
I’ve already heard talk of a shield law here in Michigan for EMTs, etc for refusing to treat patients for personal reasons. NEVER underestimate the ignorance, fear and hatred of the voters. The Republicans are running the goddamn country as a direct result of it.
Vlad
How funny would it be to see some of these theocrats pass a law legitimizing “conscientious objector” pharmacists, and then run into a Christian Scientist working at the dispensary window?
jg
What happened to the hypocratic oath? Since when can a doctor see anything but the medical issue a patient has?
ape
“objects to.. ..providing treatment to gays and lesbians”?!
how did America get so fascist? these people are surely insane. they clearly haven’t read the Bible or else think Jesus was the bad guy. he was quite upset by the idea of divorce, I recall.
capelza
This all makes me so angry. Though in the back of my mind I keep hearing a comediene several years ago who said something to the effect…”If men could get pregnant, abortion would be a God-given right”.
Krista
That is utterly, utterly disgusting and heinous. That poor woman. She’s been raped, for chrissakes! She’s been through enough! Now they’re going to have her running all over the countryside to get the medication that will help her from having to bear her rapist’s baby. Those miserable, judgemental assholes. It’s so frightening to think of the fact that you have people working in the health profession, who have not one ounce of empathy.
I’ve never ever said this before, because I think it’s a terrible thing to say…but I hope that pharmacist rots in Hell.
Scott Chaffin
Full stop.
A Balloon Juice representative will be contacting you to schedule a performance review.
Nat
Five points:
1) As Steve points out, morning-after pills (and I believe BC pills in general) can indeed prevent implantation of a fertilized embryo, and it is on this basis that pro-lifers oppose the drug. Many are sincere in this belief, but many would be happy to make all birth control illegal as well, not just the abortifacients.
1a) There are actually several quotes in the Bible that back up the “life begins at conception” doctrine; Google for it. These aren’t random Judaic laws in Leviticus, either, just various offhand remarks about God forming us in the womb. (I’m not saying I believe this, just that the pro-lifers do. And the Catholics by definition have to believe anything the Vatican says as well.)
2) Personally, I don’t have a problem with hospitals refusing to perform abortions. (On the other hand, I don’t like abortion, but I think birth control should be universally accessible.) My impression was that abortions require some degree of specialization, though, so it’s not an issue of refusing to provide a service on an individual basis. Counter-question: should hospitals be required to be perform abortions, and should pharmacies be required to stock morning-after pills?
3) An issue that isn’t mentioned here is that conservatives are asking that pharmacists not just be able to refuse to fill the prescription, but that they be able to negate it entirely. That is, if a woman comes into a pharmacy with a prescription for birth-control pills, the pharmacist can just take it and refuse to either fill it or return it. (I call this “theft.”)
4) I agree that the morning-after pill should be sold OTC; anything that prevents late-term abortions is fine by me. However, this then leaves it entirely up to the free market whether the medication will in fact be accessible. I can easily imagine drugstores in conservative areas not stocking the pills because of pressure from local religious leaders and the threat of boycotts.
5) This is another issue that will inevitably boomerang against the Christian Right. Eliminating access to birth control will directly affect middle-of-the-road women who might otherwise vote Republican and dislike abortion. It will also raise the number of clinical abortions, which are far more horrific to most voters than flushing an embryonic soul. Unlike bans on the widely-reviled late-term abortions, these laws do not have broad support and will alienate many moderate Republicans and even conservatives who never really fully believed in “life begins at conception.”
EL
Sadly, “just in time” can be relative. Delay decreases the effectiveness. From Contraception on line:
I wonder if someone got pregnant in one of these cases if they could sue the pharmacist for some or all of the child support? Any lawyers care to comment?
EL
A second issue is that most of these people seem to think only in terms of “mainstream” Christian objections. How about a Jehovah’s Witness who won’t dispense factor VIII to a hemophiliac? An animal rights activist who opposes anything tested on animals? How about an OR nurse who is Jewish or Muslim who won’t help the cardiac surgeon implant a porcine valve? (Actually, these aren’t used much anymore, but you get the idea.)
Abortions are normally scheduled, and not emergency procedures. If it is an emergency, as in to save the mother’s life, I believe any OBGYN would do it, even if they found it distasteful.
John Cole
Not following…
KC
Affirmitive action for the super-religious, that’s all this is. If I refused to write a report on something for my work for religious reasons, I’d be kicked out the door. My contract would never be renewed and someone would replace me in a day anyway.
SeesThroughIt
Believe me, I’ve seen this exact argument run against right-wingers. And do you know what the response is? “Well, those people shouldn’t have been having such irresponsible sex.” Seriously. That’s what this boils down to, though the vast majority are too dishonest to actually admit it. If you’re not having sex strictly for procreational purposes, then you’re on your own, bub.
Blue Neponset
What bothers me a lot about this is that the employee gets to veto his employer’s policy. If a pharmacy doesn’t want to carry a drug then they shouldn’t have to carry it, but if they do stock a particular drug then an employee shouldn’t get the final say on selling it.
yet another jeff
Agreed, this should not be the employee’s choice. If your pharmacy doesn’t want to carry it, that’s one thing.
Religion doesn’t belong in the pharmacy. What about the pharmacists religious/dietary beliefs?
I can just see the refusal to give out certain medications, such as cough syrup with alcohol, insulin that is pork-based, or capsules that may contain animal fats.
Steve
Well, there’s a tricky issue here. Let’s take the two cases separately.
1) Sometimes a pharmacist won’t sell a drug, and their employer will back them up, like the Fry’s incident. I personally have no problem saying this is bullshit, but let’s remember, there’s nothing that even obligates Fry’s to stock the drug in the first place, any more than they’re obligated to put any other product on the shelves. Ultimately, the best recourse may be public protests, etc., to expose this store for being bigoted.
2) Sometimes a pharmacist won’t sell a drug, and the employer will be unhappy about it. That’s the purpose of these laws like the post is about – they would shield the employee from being fired for refusing to do their job on “conscience” grounds.
There is already a body of law that says you have to respect your employee’s religious practices if they don’t interfere with an essential job function. For example, if someone wears a yarmulke or religious headdress, you normally have to let them wear it. If you have a Jewish employee who needs Saturdays off instead of Sundays, the law expects you to try and respect that. I think this is pretty normal, “let’s all try and get along” kinda stuff.
But none of this has anything to do with the situation where you just flat-out refuse to do your job in certain cases. If you have a store that always has multiple pharmacists on duty and one of them can just pass the job off to another when they have an objection to filling the prescription, fine, that’s a reasonable accomodation. But nothing in the law says the store has to stand by while its employee literally turns a customer away, and it’s a pretty ridiculous concept.
As I noted above, it gets even worse than the pharmacist example. If the pharmacist won’t fill your prescription, it may be very inconvenient, but at least you know what you’ve been denied. But if you go to a doctor who doesn’t believe in a certain procedure, so he doesn’t even advise you that it exists? That’s terrible – malpractice, in my estimation.
Vladi G
Drugstore.com. Also, if it were available OTC, chances are that you could a) get it from a friend or something, or b) there would be some sort of clinic that would hand them out. Sure, in very rural areas, this could be a problem, but that’s certainly not a reason NOT to make this available.
I would think this could lead to liability on the part of the hospital. It’s negligent to put someone in a position where the hospital has reason to believe that the person they’ve chosen is unwilling to perform their duties. Employing a nurse who is unwilling to perform a certain procedure is no different than employing a nurse who is unable to unable to perform a certain procedure. If I’m a hemophiliac patient who can’t get the right drug because the nurse is a Jehova’s Witness, and there is no other nurse to perform the procedure, you can bet that if I survived I would be on the phone to a lawyer at the first opportunity (or I would hope that a family member would). Hopefully hospitals might realize this and would not hire those people for those positions.
This is no longer an issue of religious freedom. It’s an issue of competence. I can’t sign a contract with a Major League Baseball team for millions of dollars, then tell them that my religion forbids me from playing at night and still hope to get my paycheck based on religious freedom.
These asshole pharmacists are free to practice their religion. They should not be free to be employed in jobs that they are unable or unwilling to perform simply because they are religious.
Paul Wartenberg
They don’t want to learn this sort of thing in pharmacy class.
And besides, these people hate condoms, spermicides and all other contraceptives anyway. There’s no difference in their minds between a condom and a morning-after pill: in their minds, both contribute to premarital lust and are a SIN SIN SIN AGAINST BABY JEEEEESUS.
Next up: Hindus take over managerial posts at burger joints.
ppGaz
Isn’t that consistent with Catholic teaching?
VidaLoca
In the “just when you thought it couldn’t get any worse” dept:
… damned if it doesn’t get worse. This is credible, from these people, but it’s the first time I’ve heard of it. Nat, can you provide a cite? And let me be clear, you’re saying here that the pharmacist would be able to take, not just a prescription for morning-after pills (yes, high-strength birth control), but birth control pills of “ordinary” strength as well?
Un. Freaking. Believable.
ppGaz
A pharmacy is not a “store”. It is a dispensary, and is required by pharmacy practice and by most regulation to dispense to any legal prescription. A pharmacy is expected to stock whatever it can reasonably expect it will be asked to dispense, and can usually get what it needs from suppliers within 24 hours unless located in the middle of nowhere.
Pharmacists are not empowered by the practice to “decide what to sell.” Dispensing is not selling in the sense of a hardware store deciding to sell a certain flashlight battery.
Pooh
OT, but just out of curiosity, how is it handled when a jewish player chooses not to play on Yom Kippur? My guess is that the team is ok with it, and the player donates their game check to charity. (AFAIK, Shawn Green is the only current MLB player who does not play on Yom Kippur. There aren’t that many to begin with, but Gabe Kapler, for example does play, because he’s never been especially observant and feels it would be hippocritical to not play.)
jg
And he’s not a starter so would most likely be sitting because Yom Kippur occurs during the playoff push.
DougJ
John, pretty soon you won’t be able to get a hernia operation in West Virginia because some Christian doctors don’t think God wants you to mess with that part of the body.
But at least you didn’t vote for the Democrats! I mean, after that Dean scream, forgoing all medical care for the rest of your life is a small price to pay for not having that lunatic running the country. Am I right?
ppGaz
That’s a record spit take. I just propelled my coffee clear across the office.
EL
You may have more familiarity than I do with pharmacy regulations. I agree with your general point, but my understanding is that many pharmacies don’t carry certain drugs for a variety of reasons: profit margin, special handling requirements, low demand, etc.
The key to this issue is that these are pharmacies that already the carry the drug. As another poster observed, these are simply birth control pills that are given on a different dosing schedule.
So if they want to give up the lucrative birth control sales, they can decide not to dispense Plan B. If they are going to stock (and profit from) birth control pills, they must be willing to dispense it in another form.
Steve
Sandy Koufax famously refused to start Game 1 of the World Series because it fell on Yom Kippur. The lesson is really that if you’re as good at something as Sandy Koufax, you get to make your own rules.
ppGaz, I don’t doubt what you say, but I wonder if you can point me to an example of some state regulations that require a pharmacy to stock most everything. It would be helpful to me when this argument comes up.
Cyrus
Probably not to the first, yes to the second. As for the first, in most cases I’d say no just because the government doesn’t run most hospitals, but if an otherwise modern and well-equipped hospital is unwilling or unprepared to perform a simple medical procedure even in “life or health of the mother” cases, they’d better have good reason. That principle might be impossible to legislate and/or enforce, but I wouldn’t be opposed to the effort.
As for the second, I’m too busy (or just lazy) to look up a “Code of Conduct” for pharmacists, but it seems to me that their job shouldn’t involve overruling doctors. Your doctor knows what’s best for you and hopefully, unless you’re not careful or there’s just one GP to choose from in your area, has your best interests at heart. But to the pharmacist you’re just a customer, often a complete stranger, who might or might not be worth the trouble of keeping happy.
I agree with you that leaving it entirely to the free market is bad, in the same way that lots of medical issues already aren’t whether they should be or not. But considering how that is pretty much the current situation right now, I don’t see how making the morning after pill available over-the-counter would make things worse.
Bob In Pacifica
Please, please, everyone. The internal conflicts in the fundamentalists’ program are easy to explain. They are not against killing anything. They are against sex as pleasure.
-Homosexuality is about two loving each other and enjoying sex together without procreation.
-Birth control is an admission of sex without procreation.
-Abortion is about sex without procreation.
-Sex education is about learning how to enjoy sex and how to control fertility, i.e., sex without procreation.
-Pornography. Sex without procreation.
The fundamentalists are a clear example of Wilhelm Reich’s “sex-economy” theory. That is, the sexual repression we experience as infants and children within our families becomes the model for greater totalitarian models such as churches and states as we reach adulthood.
That’s why the administration likes to use child and pornography in the same sentence, like the latest Google flap, although the law is not about child pornography, but people under 18 looking at pornography on the internet, as if all children would have no interest in sex if porn were outlawed on the internet.
While individuals may come on one side or the other on each of the above topics religious fundamentalism in the U.S. (and in variations in all cultures and religions) is essentially anti-sexual pleasure. Fundamentalists are not for “life.” They, as a group, seem without concern for healthcare, childcare, or even education unless it is a means to further their beliefs. They would rather risk people’s lives (denying AIDS programs) in ignorance than to educate people because that would be an admission that people have sex outside of marriage and they have it for pleasure. In wars people die, especially women and children.
Anti-sexual pleasure. Consider it.
AkaDad
“If men could get pregnant, abortion would be a sacrament.”
– Florynce Kennedy , Mar 1973
This is a good example why the Seperation of Church and State is so important. When you mix religion into politics, people suffer.
KC
I’d love to see my supermarket clerk refuse to sell me ham because it’s Friday. Jesus, what is this world coming to?
Vladi G
Generally, the team is OK with it. Of course, the situation isn’t analagous because a) we’re talking about 1 game, as opposed to 130, and b) anyone who signs Shawn Green knows the issue beforehand, or at least should. Not that you were necessarily equating the two.
Krista
I doubt that they’ll be granted this privilege (maybe I’m just wishful thinking here). But the fact that they’re even ASKING for this shows that they must think that the possibility exists for it to be granted – which goes to show just how much the fundies (We take the fun out of your undies!) are starting to run the show.
I’m scared for you guys. I really am.
Blue Neponset
Pharmacists are not empowered by the practice to “decide what to sell.” Dispensing is not selling in the sense of a hardware store deciding to sell a certain flashlight battery.
I agree with you that that is how it should be, but currently Wal-Mart does not stock or fill prescriptions for the morning after pill.
The 2003 link is the most recent I could find, but I don’t think Wal-Mart has changed its mind.
Kirk Spencer
Cites were requested.
re retention of the prescription – the most well-known such incident was in April of 2004. Julee Lacey of Fort Worth, TX, was the woman to whom this happened. There have been other incidents. cite: http://www.usatoday.com/news/nation/2004-11-08-druggists-pill_x.htm
re rules and laws requiring substances… Every state is different. In Georgia, however, a retail pharmacist must be in compliance with (among others) rule 480-10-12 which states in part, “(1) No pharmacy licensed in accordance with O.C.G.A. T. 26, Ch. 4, shall engage in the practice of filling, compounding or dispensing prescriptions unless it shall possess the following items … (g) Adequate supply of drugs most commonly prescribed (ONLY to be on hand after a permit has been issued by the Board).”
There is no “one true list” of those “most prescribed” drugs in the laws and rules – it is based on several factors that boil down to local needs. However, the Georgia Board of Pharmacy will provide guidance if requested, and their representative (phone call about an hour ago as of this writing) states that birth control drugs are among the “most commonly prescribed” in almost every case. Again with the caveat of “not always” and “it depends on the entirety of factors applied.”
Your state’s rules will vary.
Kirk Spencer
Blue Neponset,
Walmart does not stock the morning after pill. It does (or the local ones did two months ago) stock birth control pills. While as already noted they’re essentially the same thing in different strengths, the difference exists.
On the other hand, Walmart does allow its pharmacists to decline to issue prescriptions if their personal beliefs interfere so far as the action is specifically prohibited by law. Not, however, to retain the prescription.
ppGaz
Not in that language. It’s an extrapolation of the model code which holds that the practice of pharmacy is the dispensing of medicine as prescribed. There’s no way to meet that standard without either stocking the medicine, or arranging to get it when requested. The pharmacist is seen as a partner with the doctor in service to the patient. So if he doesn’t have the medicine, he’ll get it, or he’ll find a pharmacy nearby that has it and refer you there. The practice of pharmacy does not include overruling the doctor’s prescription. Pharmacists will consult with a physician just to dispense a generic in lieu of a brand name …. so under what authority would they deign to decide that a patient should not have the drug at all, unless it is unsafe or illegal? That was my point. A pharmacist has no such authority under the commonly accepted view of of the practice. Nowhere in the standard of practice is the pharmacist’s own personal views given any authority. The parties whose “views” count are the doctor, and the patient, not the pharmacist. The pharmacist is there to get the medicine to the patient, not to decide what medicine is dispensed.
TM Lutas
I won’t comment to the point because I’m not exactly sure how these laws would play out in the real world but the several misstatements of Catholic belief bother me.
For the record:
Catholics have historically had a variety of beliefs about when life begins. The problem is that if you’re wrong and draw the line too far out, you’re consenting to mass murder of the most innocent of all life and putting a Church imprimateur on it to boot. The only way to be sure that society does not sanction murder of the innocent is to set the mark at conception. This appears to be right to me and a smaller burden than we place on the conduct of executions in this country. You would think that the much more common case (abortion) would have greater safeguards than the less common case (execution). The opposite is true, of course, in the US today.
Anti-contraception Catholic belief does not stem from the same reasoning that animates anti-abortion thought. The general idea is that sex that is purposefully non-procreative is distorting to the shared love relationship and the souls of those who partake of these acts. Sex is supposed to promote spiritual growth and not just the empty calories of mere erotic ecstacy. There are entire volumes written about the subject and I can’t do it justice here. Benedict XVI’s 1st encyclical (God is Love) is somewhat on point and a good starter on the principles behind the eventual conclusion that non-procreative sex is a bad idea.
ppGaz
Addendum: Yes the regulations and the language will vary from state to state. But no state has left room for a pharmacist to prescribe. Refusing to dispense, without medical or legal cause, is on a par with prescription. It is basically overruling the doctor. Of course, if the patient can get the scrip filled across the street, the effect is null. But when the effect is to delay treatment, based on a refusal to dispense without legal or medical justification, then you have the pharmacist prescribing, not dispensing.
Ultimately, this can’t stand. I don’t see how the integrity of the profession can withstand it.
Scott Chaffin
Since when? There’s a reason pharmacies are also called “drugstores”. Many small-town pharmacies are owned by the pharmacist. Regardless of where they are, they are all operated for a profit.
Are you following now, John? How far are you willing to go to regulate commerce? Perhaps direct the prescribing doctor to stock and staff a full-service pharmacy? Or direct all supermarkets to sell ham 24×7?
Lines
Pharmacies don’t quite fall under regular commerce. The Federal Government, once involved in the distribution and qualification of controlled sustances made sure of that.
ppGaz
You’re conflating imprecise language with reality.
A drugstore is where you get film developed, look at magazines, and get razor blades.
A pharmacy is a licensed and regulated establishment operated under strict regulation, both state and Federal. While pharmacies are often located in drugstores, this is not always the case. A supermarket can have a pharmacy, but it’s not a drugstore. A pharmacy can operate standalone, with no retail store attached at all. In fact, it may not even have a public presence.
A pharmacy and a drugstore are hardly the same thing.
Robert Chavez
Would the pharmacist owe child support? Hurmm…..while a case certainly could be made, and I have no doubt, that under the perfect circumstances(no other pharmacy around, pharmacist refuses to return prescription, original issuing doctor goes incommunicado, plaintiff is a rape victim–i.e. father cannot be found) it would go all the way to SCOTUS, you would have to prove that, basically, a tort occured. In order to do that you’d have to prove that you were harmed by the defendant’s actions. And therefore, you’d have to prove that having a baby is a harm. Right now, the current case law doesn’t recognize procreation as a potential harm. Maybe it should….but, frankly, I’m not even going to comment on the political and legal ramifications of a case like that.
And point of order, I say this as a person who believes that any pharmacist who refuses to provide the medications should have their license immediately revoked.
Steve
No, actually, I would think that the case that was carried out by the state under state supervision would have greater safeguards than a private medical procedure between a woman and her doctor. While I don’t think it should take 15 years to resolve a prisoner’s death row appeals, it’s a heck of a lot more acceptable than requiring 15 years of paperwork before an abortion can be obtained.
Well, I dunno… what if God considers cows to be sacred? The only way to be sure society doesn’t sanction murder of the innocent is to protect cows from being slaughtered.
A cow isn’t a person, but then again, I don’t think a fertilized embryo that hasn’t even implanted in the uterine wall is very close to a person either. As Robert Bork said, just because we live on a slippery slope doesn’t mean we have to ski it all the way to the bottom. The Monty Python song “Every Sperm Is Sacred” looks less and less like satire every day.
Scott Chaffin
Or I could be pointing out a reality of which you’re unaware, or have forgotten. Regardless, using your definition, a pharmacy is still operated for a profit, and it is a commercial transaction. How far do you go in regulating that commerce?
I used to call that a dime store.
ThomasD
“I am just wondering how long it is before someone comments that my position means I am in favor of forcing doctors to provide abortions.”
Well, are you?
Explain why your position does not mean precisely that. Better yet substitute ‘gynecologist’ for ‘doctor’ so there is no question of competency. Or consider the aforementioned example of a Jehovah’s Witness M.D. and a patient in need of blood transfusion. Why does the physician get to exercise choice and nobody else?
And what about the facilities (Catholic hospitals) that refuse to allow such procedures to be performed? Or the insurors who refuse to pay for such procedures?
Rather than allowing a consciencious objector to refer the patient on to another more amenable provider you somwhow think it better to compel them to commit an objectionable act?
Free society?
Krista
TM Lutas said:
Why should the Catholic Church get to determine what society does or does not sanction?
That does NOT appear to be right to me.
Krista
It’s their goddamned JOB. They are there to dispense prescribed medications. They are not there to judge. If the medication is legal, FDA-approved and prescribed by a licensed physician, then that should be the end of the story. How DARE a pharmacist refuse EC to a rape victim because of their religious beliefs?
Ancient Purple
How about we tell people who apply as pharmacists that they must sign a document affirming that they will dispense any medication legally prescribed for by a doctor regardless of their personal or religious beliefs? If they won’t sign, they won’t get a job in any pharmacy in any place in any state in the union. If they sign and then refuse, the instantly lose their jobs and are prohibited from working as a pharmacist or working in a pharmacy for 5-10 years.
They would know the rules long before they stepped foot in pharmacological school and can change their major accordingly.
ppGaz
Doesn’t matter. The regulation of pharmacy practice and the regulation of pharmaceuticals distribution is not centered around making profits. It’s centered around the practice of pharmacy as an adjunct to medicine, and the control of substances and dispensaries.
Also, you might want to talk to your local Walgreens manager. Many large “drugstores” operate their pharmacies at break even or even a loss, as a draw to the retail part of the store where the biggest profits are made.
Why don’t you see standalone pharmacies much any more? They aren’t profitable. A pharmacist can make big bucks by signing up at a big chain that operates its pharmacy at little or no profit, so as to draw customers who will buy their high-profit sundries. Why open a pharmacy, tie up all that capital, and try to get by on the meager — and controlled — profits? Doesn’t make business sense any more.
ThomasD
“Addendum: Yes the regulations and the language will vary from state to state. But no state has left room for a pharmacist to prescribe. Refusing to dispense, without medical or legal cause, is on a par with prescription. It is basically overruling the doctor. Of course, if the patient can get the scrip filled across the street, the effect is null. But when the effect is to delay treatment, based on a refusal to dispense without legal or medical justification, then you have the pharmacist prescribing, not dispensing.”
Some states allow pharmacist to prescribe albiet usually with limitations (limited formulary or collaborative practice agreement), but even full prescriptive authority does not give any practitioner the right to interfere with the acts of another practitioner. That said, non-participation is not interference, with the only possible exception being a true medical emergency. A pharmacist declining to dispense a prescription, or a specialist declining a treatment order/request (surgeons turn down surgical candidates all the time – and not just for ‘medical’ reasons), is not ‘prescribing’ it is just professional choice.
DougJ
If Sandy Koufax didn’t have to play on Yom Kippur, then why the hell should a doctor to have perform life-saving surgery on me when the 700 Club is on?
Answer that one for me, smart guys.
ppGaz
Well, we’ll see. Pharmacy is not really an essential practice any more. Few pharmacists ever compound, or have done so since pharmacy school. They are basically highly-paid technicians.
When pharmacists, who enjoy liberal pay, benefits, work schedules and perks in a seller’s market for the their skills, decide that they have to “feel good” about their work and thereby start screwing over the people they are supposed to be serving, the people they are serving might be moved to take another look at the situation and eliminate the pesky middleman. I for one am not going to spend thousands of dollars a year on health care, to be dicked around by some ego in a white lab coat deciding to impose his moral views on me at the pharmacy counter.
Trust me, that’s a dead end road. Let these arrogant pharmacists push this envelope, and let’s see what happens.
ThomasD
Fine point ppGaz. It amazes me how many people fuss about not getting the medicince ‘my doctor ordered’ when, rather than get a piece of paper, they could have simply gotten the drug from the doctor and eliminated further hassles.
docG
How many times do you need to show Mommy you can write your name and prove what a big boy you are?
YAWN
Darrell
The moonbat left raises hell over pharmacies who choose not to dispense certain drugs. I’ve read tons of comments on BJ threads in which lefties call for the govt to dictate to private pharmacies which drugs to dispense. If you don’t like the drugstore, there are plenty of others, brick-and-morter as well as on-line looking for your business.
But in this case which John links to, it’s a similar situation, but with the shoe on the other foot. Here we’ve got legislatures trying to force pharmacies to keep pharmacists on the payroll who are not doing the job they were hired to do… and even raises the stakes to protecting therapists and technicians who refuse to treat certain classes of patients (customers).. In other words, they are trying to take away employer rights to fire employees for not doing their jobs. And that’s wrong
Pharmacies should be free to sell or not sell whatever drugs they want. Employers should be free to fire workers who refuse to do the needed work of the company. If there are enough jobs at ‘moral’ pharmacies to make up the slack, fine. Otherwise John is absolutely right.. they need to suck it up or find another line of work
ppGaz
Nope. Pharmacies are dispensaries, they are not “selling drugs.” They are dispensing them to prescription.
Big difference. Like I said upthread, pharmacists will either serve the public as the public expects them to, or they will find themselves as obsolete as gas station attendants and milk truck drivers.
ThomasD
“Nope. Pharmacies are dispensaries, they are not “selling drugs.” They are dispensing them to prescription.”
Um, wrong. Ever try to get a prescription with no means of payment? Sure there is a service component, but they are still selling drugs.
DecidedFenceSitter
*Twitch* I hate it when I agree with Darrell.
Show me the law (not the code, the actual law) that says that pharmacies must stock all medications; or pursue best efforts to obtain all medications.
Otherwise, I leave it to the business owner.
I also disagree with the business owner not being allowed to fire an employee who refuses to fulfill his duties, if the business owner decides that those duties include duty X, if the employee finds duty X too onerous or distasteful.
Someone brought up the grocery store analogy. Assuming there is no law that DOES require stocking or best effort to obtain; is a grocery store required to stock items that I need/want?
I wouldn’t frequent a place that did not fulfill these requests (Walmart’s uptight morality is one of many reasons why I do not shop there); but I give the store owner the right to make that decision.
And same as the last time, I’ll find myself blasted by John and others who seen pharmacists as a position in the community. For those that do, Krista, PPGAZ, John and others, if the sole pharamacist in a small town with no one else around it for 50 miles wanted to close up shop; would he be allowed to?
Pooh
Despite him starting his post with characteristic shots at “moonbat lefties”, I find myself agreeing in large part with something Darrell wrote…I wonder if the pharmacy has something for this condition of cognitive dissonance.
ppGaz
You sound as if you are deciding where to buy broccoli.
Pharmacists dispense. They exist for no other purpose.
If the start choosing what, when and to whom to dispense, then they will be dispensed with. They are hardly indispensable. They are a convenience operating in a tightly regulated practice.
The day they start thinking that they are little high-paid Darrells in white lab coats, deciding which lefties get their scrips, is the day they start to go away.
Trust me, this isn’t a board game we are playing here. This is real life.
jg
Check this link out ppG.
http://www.autoblog.com/2006/01/30/ford-mustang-rocks-your-phone/
Sirkowski
Why don’t these people go live in Afghanistan? Seems to me they would be much happier there. And I heard the prices on caves has gone down.
DecidedFenceSitter
PPGAZ, I understand it is life.
So I’ll ask you again. If a pharmacist, who in your mind fulfills a critical infrastructure role, was to quit, and he or she was the sole source for a reasonable distance to obtain medication, would he or she be legally allowed to close down her business and no longer distribute medication?
ppGaz
Nice car :-)
Pooh
Honest question, are pharmacies not allowed to make a business decision that a certain product is not profitable for them? Certainly, in smaller communities, stocking less common drugs seems like it would be a commercial burden. And whether you describe them as “stores” or “dispensaries” they still have to make a buck.
This is a far different question as to whether an individual pharmacist can refuse to fill certain prescriptions or, a fortiori, keep the perscription, (which seems literally criminal to me).
Vladi G
Of course, both of these statements are ridiculous. ALL commerce that comes from prescription medication is very heavily regulated. NO pharmacies are free to sell whatever drugs they want. You guys act as if the big bad government stepping in and regulating pharmacies is killing the free market, while completely ignoring the fact that this is already one of the most regulated businesses in existence.
Of course, Darrell is lying again. He doesn’t really think that pharmacies should be able to sell whatever drugs they want. He thinks they should be able to REFUSE to sell whatever drugs they want. But he’s either too stupid or too dishonest to frame it correctly. But then again, he’s a serial liar, so I’m not surprised.
Pooh
Vladi,
If I run a Taco Bell am I refusing to sell hamburgers? I know, not an exact analogy, but you get my point right?
ppGaz
If pharmacists, who play a tightly defined and even more tightly regulated role in an arbitrary model of healthcare, start deciding to imposong themselves as moral authorities in between doctors and their patients, then the model of healthcare that supports their cushy circumstance is going to change and they are going to go away. And if this thread is any indication, the sooner the better. They are no longer adding value to the process, which is remarkable considering the salaries they are being paid.
The modern healthcare model does not depend on pharmacies as we know them. Already WHI and other mega-pharmacy plans are going to the 90-day refill model, eliminating the local pharmacy altogether. Scrips are refilled on schedule by centralized dispensaries every 90 days.
Another thing to keep in mind is that in the model that supports the retail pharmacy, the citizen votes with his feet and his wallet, not just at the polling place. Citizens are not going to line up and pay money to be treated as morality students by uppity pharmacists. Pharmacists will get their wish … they won’t have to give naughty pills to bad people. Unfortunately, they will be out of work altogether if the marketplace really works. So those of you who seem to think that the pharmacy is just an extension of the market-commerce model may turn out to be right in a way you didn’t expect.
ThomasD
“This is a far different question as to whether an individual pharmacist can refuse to fill certain prescriptions or, a fortiori, keep the perscription, (which seems literally criminal to me).”
I haven’t seen any serious attempts to justify keeping the presciption with the intent of preventing the patient from obtaining treatment elsewhere. Clearly this activity is not within the bounds of any profession (not even another physician could properly do such a thing.) Such acts would be more akin to civil disobediance like the blockading of abortion clinics – something that some may find morally acceptable but is still obviously illegal.
DecidedFenceSitter
Not the question I asked, and you know it.
I have no problem with people voting with their feet. I do so every day.
So I ask again, and try to answer without prevarication; does a pharmacist have the right to close up shop when that pharmacy provides the only reasonable access to medication to an area?
Vladi G
Last time I checked, I didn’t need a note from my doctor before I could buy a hamburger, so I find the analogy (as well as the grocery store analogy) pretty stupid.
Everyone wants to act like this is just all part of the grand free market scheme of things, without recognizing the tremendous barriers to entry that don’t exist for fast food chains.
DecidedFenceSitter
Actually, not everyone, a few of us who allow for principle for freedom of choice. Even when it is a choice we don’t agree with; and find distasteful. Personally, because I think most here would find my life distasteful as well, and I try and follow a live and let live philosophy.
Is there a law requiring dispensation and/or stocking of medications? If so, then they are breaking the law, either in an act of civil disobediance or ignorance. If there is no law; and you feel that it should be law; petition your legislators to make it one, that is your right. I argue against it, on a matter of principle alone; but that is my right as well.
ppGaz
The question is bogus and not relevant to the topic, and you know it.
First of all, pharmacies are regulated separately from pharmacists. Ownership of the pharmacy does not require a pharmacist. The principle is a little like a radio station. The station license may only be valid for on-air operation when an FCC licenseholder is on the premises; at least, it used to be that way. So the station owner would hire several FCC licenseholders and put their licenses up on the wall. Same with pharmacies. The pharmacy itself can close if the owner decides to close it. But the comparison isn’t apt, as you well know. The pharmacy owner is not “closing” to a scrip he doesn’t like. He’s basically doing the same thing that restaurant owners in the South used to do when they refused to serve blacks, namely, trying to use the “it’s my property” defense. The defense didn’t stand. This one won’t either, for the same reason. The pharmacy model itself fails when operators decide who will get medicines, and who won’t, based on their own arbitrary judgments. On that day, the pharmacy and the pharmacy as we know them become unnecessary and undesirable. No longer adding value, they are simply acting as gatekeepers in a phony tableau of moralistic nonsense.
ppGaz
“pharmacist and pharmacy as we know them”
Pooh
Vladi, I guess my question is should pharmacies be required to stock drugs a-z, even though it knows it does not move enough volume of drugs X, Y, and Z for them to be profitable? It seems to me that if the answer is “yes”, then it simply moves the cultural battlefield to the administrative determination of which drugs must be included in the above bucket. (And of course Pharma gets involved because a “must” drug has a certain levels of sales built it.)
I’m with you that pharamacists refusing to fill prescriptions for drugs they have on hand is reprehensible, and violates professional ethics, I’m just trying to think ahead to the next step in the game.
DecidedFenceSitter
The reason being is that, in my mind, the ultimate act of the pharmacist is “taking his ball and going home.” That is where I am going with this. If he is not allowed to play by his rules, is there any reason why he would not be allowed to. In short, “If the state is going to force me to follow these strictures, then I shall simply not obey them.”
That is why I asked you to answer the question; to see exactly where you wanted to draw the line in the sand to say “I will force them to carry out their duties till this point and no further” and to see if there was such a place.
Vladi G
You guys are completely missing my point. Darrelliar and Scott Chaffin are acting like it would be this tremendous leap to require pharmacists to carry, quite frankly, ANY medications. They’re claiming that it would be overregulation to make a list a list of drugs they are required, by law, to carry. Feel free to make your free market argument. I’m not arguing against that. My point is that the fear of overregulation is completely ludicrous in an industry whose very existence relies on government regulation. The government regulates who can and can’t dispense medication. The government regulates what can and can’t be sold at pharmacies. Why, then, is a regulation that says certain drugs must be made available such a terrible burden?
Lines
Pharmacies in outlying areas typically have a “network” of other pharmacies to contact when X, Y or Z isn’t available but it requested and needed in a short amount of time. So if Festus in Mayberry doesn’t have drug X, he will contact Ms. Kitty in Dodge and have the requested pharma without unduly burdening his customer. But once you start breaking that chain with religious excuses? You’re just inviting liberal government intrusion. Pharmacists have it nice right now, they are well guarded against liabilities, they are well paid and they have a fairly easy job. Why do they want to chance regulation and public ire by allowing this kind of idiocy within their ranks?
Vladi G
I see your point here, but I don’t really buy it. We’re really speaking in generalities here. What is the reasonable expectation of the consumer? What are reasonable burdens placed on Pharmacists?
If I’m going to a pharmacy for a rare drug, should I expect the pharmacy to have it in stock? Perhaps not, but I should at least expect my local pharmacy to have a list of providers who regularly stock that drug. In the event I’m in a rural area, I should expect the pharmacist to be able to get a shipment in 24 hours (give or take, depending on the time of day I request it). I don’t think it’s too much to expect pharmacists to keep on hand small amounts of less profitable drugs that may be required in an emergency, with the caveat that drug companies will reimburse all or part of the cost for perishable drugs of this nature that may go unused. It’s part of the cost of doing business (someone can help me out, but what happens to milk that goes unsold in grocery stores? It used to be the case that there were credits for returns on such items, but I haven’t worked in a grocery store in 15 years).
Keep in mind that in a specific sense, we aren’t talking about places that aren’t keeping drugs on hand because they’re not profitable (and honest question, how many drugs that are brought to market fail? Seriously, how many pharmaceutical companies spend big money on developing drugs and getting them approved that end up not selling?). We’re talking about drugs that a pharmacist wouldn’t dispense if he/she had warehouse full of them. I don’t have a problem with pharmacists making business decisions. I do have a problem with pharmacists who go into a line of work knowing that they will be unwilling to perform part of their job responsibilities, then acting like victims when forced to suffer the consequences from refusing to do their jobs.
ppGaz
The “stocking” and “carrying” of drugs is not really an issue here, unless one is dealing with a standalone small-operator pharmacy, which is surely an anachronism in today’s world.
And if a pharmacy is within shouting distance of a distribution center, it can get overnight delivery of virtually anything it needs. So the “stocking” issue to me is a non-starter. There are very few situations that are pharmaceutical “emergencies” that can’t be solved in today’s world. I mean, suppose I were out at Bumfudge, Arizona and the wife needs an oddball med. I hop into the Mustang and and I’m in Huge Metro Area A (west) or Huge Metro Area B (east) in 2.5 hours. Both have plenty of 24-hour pharmacies with large inventories. But what are the odds that this happens? In the town with the little pharmacy, where does Ma get the scrip in the first place? There’s no doctor in that town. I already put her in the car and left burn marks to Metro Area A to get her to the doctor there in the first place. My leadfoot driving and constant shooting at the cops behind me have made her feel better already.
hank
Suppose an actor accepts a role, and then refuses to say certain lines because he finds them morally objectionable?hmmm… no, that’ll never happen, actors ‘ll do anything.
Can a vegan waiter refuse to serve a steak?
Has the world gone crazy?
Jesus protect me from your followers.
Pooh
Keep in mind, I’m not taking a position, I don’t know enough about how pharmacies actually work, but we have to be aware of all the effects of a change to a regulatory scheme.
Agreed, but, as is always the problem in cases involving arbitrary line drawing, you have to actually draw the line. I think we agree that refusing to sell birth control for ‘moralistic’ reasons is not ok.
Darrell
What about a private pharmacy or pharmacy chain which chooses not to sell morning after pills or other medication for ‘moralistic’ reasons? Should the stores (not talking about individual employees) be forced to sell drugs they choose not to carry for whatever reason?
Scott Chaffin
No it’s not, and you know it. Government regulations have created a protected market and sellers.
So, where do I get my pills? It’s either more government regulations about pills and the dispensation thereof, or it’s less. I know which way I want to go.
Darrell
Yeah, kind of like how bar owners have to get a govt issued liquor license to sell hard liquor and lawyers have to obtain state approval to practice law. Does that give them a ‘protected market’?
C’mon, some relatively minor govt regulation does not = govt protected market
Lines
Darrell, the whole basis of the thread is that some states are trying to protect pharmasists, doesn’t that make it a govt protected market?
Also, the number of pharmacies is probably limited by the government on the state level, much like a liquor dispensary license, thus eliminating some of the threat of competition, right? So in a sense, a protection does exist.
ThomasD
“If pharmacists, who play a tightly defined and even more tightly regulated role in an arbitrary model of healthcare, start deciding to imposong themselves as moral authorities in between doctors and their patients,”
Your argument is inapt. These pharmacists are not imposing themselves between the prescriber and patient, if anything they are withdrawing themselves from the usual position between the prescriber and the patient. That this may create an inconvenience is obvious, that it poses any real impediment to treatment is easily rectified by the prescriber assuming the responsibility for providing the medication.
ppGaz
Well, I’ll guess that you want less interference.
So, let’s get it. Much to the chagrin of Darrell, who thinks everything is about “getting lefties,” we don’t need pharmacists. They don’t make the drugs. They don’t prescribe them. They are middlemen.
If we are talking about Plan B, I think it’s common knowledge that doctors were handing out these remedies in their offices years ago. You don’t need a pharmacist to get that treatment.
If we are talking about common birth control, it’s my opinion that the day that pharmacists start interfering with that distribution is the day that pharmacists as we know them from the “Mister Gower in It’s A Wonderful Life” model start to become obsolete. They add no value today other than convenience. It’s 2006, the world does not need people to count pills and stick on labels and make $100k a year and start telling people what’s moral and what isn’t. Not going to happen. Let the Darrells of the world go fuck themselves.
Pooh
Ok Darrell, you lost me. The pharmaceutical business, from trial to sale, is vastly more regulated than liquor sales. Secondly, your analogy to law practice cuts the other way – there are significant regulations, it’s just that there is no administrative body that makes the rules. Instead, perhaps you’ve heard of the judicial branch?
ppGaz
Well, on that we simply don’t agree. The ultimate result of that withdrawal is the elimination of the pharmacist altogether, which is what I’m arguing for, and the only remedy that makes sense. The pharmacist is an overpriced luxury left over from the 1940’s, and no longer needed. Let them get real jobs and keep their moralizing to themselves.
jg
Did you get the ringtones?
ppGaz
My cel is employer-supplied, a real piece of crap, but free to me except that I must reimburse for personal use.
The lead-acid battery is especially annoying. No ringtones.
Okay, the battery isn’t lead-acid, but I think that Alexander Graham Bell actually field-tested the thing.
“What hath God wrought up there on that tower?” or something like that.
No ringtones, but thanks for the thought.
Darrell
In case you didn’t notice, the discussion was regarding the retail aspect of drug sales involving pharmacists, not the ‘entire’ pharmaceutical business from trial to sale. I hope this clarification helps you
Darrell
kisses to you too
ppGaz
I hope your kid soaks you for the cost of pharmacy school and gets his license just about the time that we eliminate pharmacists and their phony moralizing from our healthcare system for good.
Like I said, Darrell. They don’t make the drugs. They don’t prescribe them.
Fuck ’em.
Darrell
ppg, you’re throwing feces unnecessarily. Looking at the pharmacy retail business from the outside, I don’t disagree that pharmacists seem to add little value, but so far the market says our hunch is wrong. I can’t imagine that doctors, particularly specialists, would want to mess with managing and dispensing inventories of drugs as you suggested upthread. So what other distribution channel makes sense?
Krista
An “inconvenience” that just happens to carry an 18-year responsibility. And your theory is nice, but there are some problems with it. Doctors’ offices are closed on weekends, long weekends, stat holidays, etc. Pharmacies are not. Women are having a hard enough time getting a prescription for emergency contraception, in enough time for it to be effective. If we also leave the dispensing up to the doctor, then any woman who gets raped on a weekend is pretty much out of luck. It should be available over the counter. Full stop. Trust me, it’s not going to be abused…it’s not like it provides any kind of high or thrill, unless intense nausea gives you a rush.
And DecidedFenceSitter, I’ll answer your question as honestly as I can. If a pharmacist decides to pack up and go home, as it were, it is unfortunate, but that happens already in small towns everywhere. It affects all patients, seeking any and all prescriptions. But to deliberately withhold one specific type of prescription, solely for personal reasons — to me, that is unprofessional and reeks of malice.
Scott Chaffin
Good guess. But I still don’t know where I’m going to get my pills. I’m 100% opposed to state management and that leaves the merchant, with his attendant moralizing. His moralizing might be to refuse to stock Plan B, or it might be to open Sup-R-PlanB w/ Drive-Thru Service. Are you willing to accept that, and all of the follow-on consequences, including the unintended ones, without resort to courts? As a free-marketeer, I know I am. Or I think so, anyway.
(And no, Darrell, I don’t think I or you should be required to get a license from a state functionary to sell booze.)
Darrell
Malice? The pharmacist is losing money by missing out on drugs he could be selling. You may not agree with that choice, but that’s not malice, it’s principle.
Darrell
Sorry for misunderstanding your earlier post Scott. I think a lot of drugs should not require prescription. Making more drugs over-the-counter would slash drug prices while minimizing the need (and cost) of ppg’s dreaded bogeyman, the pharmacist
Krista
Darrell – no, I don’t agree with it. They might be losing out on some income because of their principles, but I think that it’s the patients who are being most hurt by this. I think it’s all well and good for people to have principles, but if your principles hurt other people more than they hurt you, it might be time to re-examine whether or not you should be in a position where your principles have so much of an effect on others.
ppGaz
One that does not present the opportunity for stupid, arrogant people to shove their moralizing into other people’s faces and interfere with their health care.
Let the shithead moralizing pharmacists continue this crap, and we’ll find out what else will work.
What do you think, Darrell … that people are just going to roll over and be fucked by people like you and do nothing? What dream world are you living in?
Darrell
I think retailers and other businessmen should be free to sell, or not sell, whatever they can legally offer. If a retailer has a moral problem selling ‘morning after’ pills, let the market decide what happens to him.
But if a business decides to sell a particular product and an employee refuses to sell and/or support it on moral grounds, that suiness owner or manager should be free to fire those employees at will
ppGaz
They made themselves the bogeyman, you stupid idiot, when they decided that their cushy, high-paid and unnecessary jobs entitled them to force their moral views on other people.
The distribution system does not require pharmacists, it only requires technology and adherence to law. The day when a true pharmacist was needed is long gone. When was the last time you saw a pharmacist compounding a medication? A well-programmed computer and a diligent technician can do everything a pharmacist does.
And don’t tell me that pharmacists are essential to preventing mistakes. Pharmacists make mistakes; I had one dispense a completely wrong med to me within the last 45 days. I caught it because I know the med … I’ve been taking it for nine years, every day. I took the bottle back to the pharmacist, who looked at the label, looked inside the bottle, and said, “Did you take any of these?”
Rather than claim injury and sue his giant national chain for so much money that I could buy my new Shelby GT500 out of my pocket change …. I told him to relax, don’t worry about it, and just refill with the right pills. But anyway, this guy makes $95k a year … to do what? Count pills into bottles, print labels, and tell people where the Metamucil is.
The day he tell me that he is going to refuse to dispense a scrip for me on moral grounds, he’s fired. Seriously, I don’t need him. And neither do you, and neither does the healthcare system.
EL
I’m not a pharmacist, but I have lots of experience with getting medications to patients. A few comments:
Most doctors do not carry a wide variety of medication. In fact, they have very little on hand and only things they expect to give for emergency reasons (nitro pills, for example, for an internist) or commonly given, like Tylenol, or samples. Doctor’s offices are not prepared to dispense regularly, and some don’t even know the proper labeling procedure for dispensing.
There are many drugs that pharmacies don’t carry. Some drugs don’t have much demand, or have extensive training and handling rules.
In this specific case, most pharmacies already carry the drug; birth control pills. They are refusing to dispense it in the dose and schedule written.
There has been one case of a pharmacist (Wisconsin, I think) refusing to fill and refusing to return or transfer the prescription. He was disciplined.
Personally, I think if someone is not prepared to dispense legal prescriptions, that pharmacist needs to get out of that job. There are speciality jobs, such as hospital based oncological pharmacists, where those issues won’t arise.
Darrell
I think that is an attitude molded out of your Canadian socialist health care system. You see, it wouldn’t occur to me and most other americans to force companies to sell certain drugs, as we know that if there is money to be made by selling a drug legally, there will be many other options available to the consumer.
ppGaz
Darrell’s perfect system: One that a large percentage of citizens can’t afford under the ruse of protecting choices for doctors and patients, while supporting the efforts of “practitioners” in that system to interfere with the choices made by doctors and patients on the basis of their own personal beliefs.
A world in which corporations and holier-than-thou practitioners get rich and control everything about healthcare, and citizens get soaked and control nothing. The families that fall through the cracks end fucked by Darrell’s beefed-up bankruptcy laws.
And you call the Canadian system “socialist?” What’s the name for your fucked-up system? “Bizarroland?”
Krista
The problem with that is that something like the morning-after pill is not needed by a large percentage of the population. If you’ve got a smaller town with an older population, like the town in which I live, then this medication might only be requested once a year, if that. If my birth-control failed, and I was refused EC at the local Pharmasave, I highly doubt that many others in my community would be willing to drive 45 minutes to another pharmacy in order to show their displeasure. Why would they? The pharmacist’s decision doesn’t affect them. So if the pharmacy refuses to dispense it, the market won’t do diddly-squat.
But in the meantime, you have a woman who might have to bear an unplanned and unwanted child because of this refusal. With emergency contraception, time is crucial. Having to travel to another pharmacy, or even having to wait 24 hours for that pharmacy to order EC…that could make the difference. For what it’s worth, I strongly feel that all pharmacies should have to carry a small supply of unexpired EC, on-site, at all times, and that all emergency rooms should have to do this as well.
Agreed. Completely.
Krista
No, it’s an attitude molded out of having empathy for others. I have my own set of morals and values. But if my job conflicted with those values, and if implementing my values into my workplace meant that many other people would suffer (while I sit comfortably smug with my ethics wrapped around me), then I have no position being there. I’d either have to suck it up, or find another profession.
Kirk Spencer
An aside, if I may, justifying pharmacists.
Pharmacists study drugs. Ponder that for a moment. They study drug interactions and side effects. Doctors don’t, as a rule. As a consequence, doctors tend to keep adding drugs to resolve ailments. This is fine for short-term ailments, but when it’s chronic problems you get the stereotypical event:
Grandma takes 22 pills before noon.
I’ve known more than a few folk in that situation. And when they start having complications due to drug interactions, it’s been the pharmacist, not the physician, who resolves the issue.
If the pharmacist is doing his/her job, he’s looking at what you already take and charting it against what’s prescribed and calling the doctor when there’s a potential problem. Note, not calling for a full stop, but working WITH the physician to get the problem corrected before there are complications.
So I’m not for removing pharmacists. They serve a significant purpose in the medical arena.
ppGaz
Yeah, that’s why every single piece of published medical advice on earth, when it comes to knowing what to take with what, says “Ask your doctor.” Because your doctor doesn’t have a fucking clue.
Every single sheet of drug patient information … same thing. Ask your doctor. Not your pharmacist, your doctor.
ppGaz
Patient: Doc, I’, taking A, D, and F. Should I take G?
Doctor: I dunno. Ask Walt, the pharmacist down at OSCO. I don’t really have a clue.
—-//
From the Bizarro Theater Presentation: Conversations We Never Had.
Sine.Qua.Non
I’m really sick of this. Do you think my job will let me refuse to meet with a particular developer or business owner because I do not personally agree with his practices? I would be fired tomorrow.
ThomasD
“An “inconvenience” that just happens to carry an 18-year responsibility. And your theory is nice, but there are some problems with it. Doctors’ offices are closed on weekends, long weekends, stat holidays, etc. Pharmacies are not. Women are having a hard enough time getting a prescription for emergency contraception, in enough time for it to be effective. If we also leave the dispensing up to the doctor, then any woman who gets raped on a weekend is pretty much out of luck. It should be available over the counter. Full stop. Trust me, it’s not going to be abused…it’s not like it provides any kind of high or thrill, unless intense nausea gives you a rush.”
If the office is closed on the weekend where did the prescription come from? Face it, if someone can provide a piece of paper they can provide a little packet of two pills? If a provider chooses not to do that as part of their practice how can you fault any other professional for doing likewise? Additionally, doesn’t the practitioner who actually CHOSE the course of treatment have the greater obligation to see that it can be obtained?
Emergency contraception is intended for use within 48 hours of unprotected sexual activity. I think the patient can find another pharmacy within two days. Fifteen minutes is much more likely.
I’d agree with the change to OTC status. For that matter I’d support the transition of most, if not all meds to OTC status. Lets eliminate both middlemen and let grown ups take care of themselves. If you want the assistance of a licensed professional so be it, otherwise why should it be mandatory?
Richard Bottoms
Why don’t just eliminate the entire Narn homeworld while you’re at it? (In joke)
Still waiting on those toll roads and private police forces.
Love you libertarians.
Rob Weiss
This may be somewhat OT, but it does follow the ethical/logical thread about refusing to fulfill one’s job requirements based on moral or religious grounds: how about consciensous objectors in military service?
I mean, if someone voluntarily enlists in the service, even in a non-combatant specialty, are they justified in refusing to fight if that service orders them to pick up a rifle and kill people? After all, the possibility surely was clear when they enlisted.
Suppose they become a born-again Quaker AFTER they’ve enlisted? Do they get a discharge? Honorable or dishonorable or administrative? Are they then entitled to veteran’s benefits? Just wondering…
Krista
I think it absolutely needs to be available OTC, and I think all emergency rooms should also have to keep a supply in stock.
The effectiveness is reduced with time. And for women who don’t live in cities, the next pharmacy might be an hour or two away. And what if that pharmacy also won’t sell EC? I just think it’s rather cruel to make women, who are already terrified about an unwanted pregnancy, run all over hell and creation and experience censure and judgemental attitudes from pharmacists, in order to get a medication that is FDA-approved and perfectly legal!
I feel bad bringing gender into this, but I used to work at an insurance company, and I can tell you that there were some men who were royally irked upon finding out that Viagra was not covered, feeling that the insurance company was judging them. I bet there’d be a much bigger stink about all of this if pharmacists were refusing to fill Viagra prescriptions, on the grounds that it promotes lustful behaviour, or some such nonsense.
ThomasD
Richard Bottoms,
No need for sarcasm here. I abhor you statists. You claim to be all about ‘choice’ and opposed to enforced morality. But really all you are about is enforcing a different set of morals. I don’t think that makes me exceptionally libertarian, just slightly less Stalinistic than you.
Krista,
You are more worried about someone running ‘all over hell and creation and experience censure and judgemental attitudes from pharmacists” than compelling another person to participate in what they believe to be an immoral act? Your own arguments clearly show this is a matter of convenience. Don’t like censure and judgemental attitudes either? Too bad, it’s a small price for for living in a free society.
And lets drop the whole thing about sexual assault victims, it is a red herring. Any ERs that don’t provide EC do so specifically to avoid confronting the same issue of compelling their staff to participate in such activities, instead they pass the buck. Don’t believe me? Then ask youself – why do these same ERs directly provide antibiotic prophylaxis as standard treatment post assault but then only issue a prescription for EC?
morfydd
If we’re going to “drop the whole thing about sexual assault victims”, how about this?
–My best friend takes birth control religiously to control violent mood swings and vicious menstrual pain (and by violent, I mean property damage in lieu of hurting herself or others). She hasn’t had sex in at least four years. Is the pharmacist who decides my friend is an immoral slut going to be responsible for the damage to her career and studies as her hormones spiral out of control?
–Over the years, I’ve been prescribed a number of drugs which, if I became pregnant, would severely damage or kill a fetus. Would I be required to show my receipt for tubal ligation in order to receive those drugs?
tbizzle
Doctors will take care of this problem quickly. Those that dislike pharmacies that won’t dispense certain drugs will steer all of their patients to other pharmacies or online pharmacies that dispense 90 day supplies of pills. If one doctor with a lot of patients walked into a pharmacy that was pulling this kind of crap and threatened to tell all his patients to sign up for mail order prescription filling for long term prescriptions like cholesterol lowering drugs and others they would quickly decide against it. The long term prescriptions are the bread and butter for pharmacies. All it takes is some tough doctors who dislike this B.S. to have the local brick and mortar pharmacists quaking in their boots.
Ross
Imagine this guy’s hypocracy if his wife or daughter were raped. He’d be getting them the morning after pill as fast as possible.
I’m an atheist so if any of these laws pass where I’m at then I might go ahead and get a job as a pharmacist. Any time somebody asks for a prescription of ANY kind, first I’ll ask them if they voted for proposition “whatever” and if they say yes, then I will refuse to fill the prescription for them as it goes against my conscience. Then I will give them a pre made flyer that basically states, “You voted for it, you live with it.”
Rasta
These pharmacists are endangering lives and livelyhoods just so they can feel morally superior? WTF?
Redleg
I believe that employers should make reasonable accomodations for an employee’s sincere religious belief. Having said that, the employer should ensure that another employee is available to provide the service (e.g., provide birth control pills). The practical impact of this is that you don’t fire an employee who refuses to fill a birth control prescription but you must make sure you schedule another employee on the same shift who has no objections to filling the prescription.