I'm not sure I understand

[susandennis]

There is much discussion around here these days about a law that would require pharmacists to either provide the morning after pill upon request or in some other way (like tell the requester where, very nearby, it can be purchased). 

There are few other rights that I treasure more dearly than my reproductive rights.  I came of age when abortion was illegal and birth control was difficult to find easily.  Those days were crewel and should never ever ever be revisited even for a minute.

But, I am not at all comfortable with a law that requires a private retailer (which is what a pharmacists really is) to sell anything.  That does not make any sense to me and I think it is as wrong as the antiquated laws were.

I don't understand it.

EDIT: To clarify... I honestly believe that every female of child bearing age should have easy (and, free would be great) access to any kind of birth control she wants for whatever reason she wants it. And I would love to have laws that required that.

What I can't get my arms around is the hit that free enterprise has to take take. If the relgiously bent pharmacist is required to do business against his beliefs, what does this do to my beliefs and my ability to live and work by them?

Comments

[cathboblet.livejournal.com]

The problem is that the morning after pill is no longer provided by prescription, so anyone who wants to get hold of it has to get it from a pharmacist. There have been multiple instances of pharmacists refusing to dispense Plan B because of their religious beliefs - i.e. they believe it's more or less abortion. Without laws that compel pharmacists to dispense Plan B if asked to do so, Plan B could become impossible to find, especially in particularly conservative areas. If the problem were that phamarcists felt there was a medical reason to withhold Plan B, or had doubts about its application to a given case (in the sense that they can decide if you should really be taking massive doses of ibuprofen when you have a history of stomach ulcers - there, they're being asked to use their professional expertise) then I agree, it would be bad news. But this is an attempt to merely make pharmacists do their job and dispense medically necessarily drugs to those who qualify, rather than allowing pharmacists to pick and choose what they dispense according to their private moral code.

[susandennis]

It's not that I haven't heard the arguments. It's that I don't 'buy' them.

A pharmacist is a retailer. He has his own business. He should be able to make his own decisions about how to run that business regardless of the reason.

Does the government dictate that a grocery store sell disposable diapers?

Or a Bible store sell a dreidel or the Koran? The Bible store's job is to sell religious stuff. The governement doesn't require them to 'do their job'.

Why is this pharmacist any different than the owner of the Bible store?

[cathboblet.livejournal.com]

But the government regulates what pharmacists - and doctors and other medical professionals - do all the time, particularly as a way of protecting the public from the whims of their personal preferences. So someone who has a medical history of drug abuse, for example, can't be refused narcotics for pain relief if they have a valid prescription, no matter what the pharmacist's opinon on the matter. Pharmacists can't refill certain prescriptions earlier than a given date - not always because of insurance regulations, but often to prevent drug abuse or fraud. In Iowa, they have to dispense all the cold meds, rather than leaving them out on the shelves, and record some form of ID from the person buying the drugs in order to let them have it - all as a way of trying to target the at-home production of meth. (I bring that up because many pharmacists had a problem with the ID thing as an invasion of privacy, but it doesn't make any difference - they're obliged to do this by law). If they want to dispense a generic and you insist upon the name-brand, they can't do a thing about it, even if they think you're a nut who's wasting money.

This isn't a new thing - pharmacies have long been regulated by the government, at both the federal and state level. And so have other stores - retailers aren't supposed to sell alcohol or cigarettes to those who are underage. (In Minnesota, crazily, you can't buy liquor or cars on a Sunday - oh those crazy Lutherans) Heck, cinemas aren't supposed to let anyone under the age of 17 into an NC-17 movie. Regulation runs through almost every industry we have, dictating what is and isn't permissable.

[susandennis]

To me there is a huge difference between restricting someone from doing something and forcing someone to do something.

There are many things that you are not allowed to sell, services you are not allowed to provide, restrictions on things to sell and services.

I'm desperately trying to find some way to understand how and why a government should require a private entrepreneur to sell anything.

I appreciate your efforts but I'm not there yet.

[davmoo.livejournal.com]

I'm afraid I have to agree with cathboblet. While I hate government regulation with a passion, and think government should regulate as little as possible, I think there are times its needed, and this is one of them. If there were a medical reason to deny someone these pills, because of a reaction to another drug, etc, I would think that the pharmacist was properly doing their job to warn the customer. But they can take their religious objections and shove them up their butts. And were I to be the boss in a pharmacy and a pharmacist refused to dispense something because of his personal beliefs, that pharmacist would be immediately fired.

[susandennis]

See my answer to Cathboblet. If an employee breaks a rule then the owner has the right to fire that employee.

If a store wants to sell anything legal and they have the correct license then they should be able to. If they don't want to, they shouldn't have to.

My liquor store does not stock a particular burbon. I can't buy it in all of Seattle. Why don't I just ask the state to require them to stock it?

Because that's ridiculous.

[kyrielle]

Bourbon is not recognized as a sometimes-necessary medical treatment (even if some folks use it that way, for sanity). In some cases, morning-after pills could be.

It really comes down to two rights in conflict. Which right is more important: the right of the pharmacist to refuse the service, or the right of the woman to avoid becoming pregnant (which might, in some cases, be a health issue, even if a subsequent abortion might be possible)?

The conflicting right about brands of bourbon is clearly on the side of the seller. I don't believe the pill is. You live in Seattle. Now imagine we are talking about a girl who lives in a small, rural town, with one pharmacy. She has no car: the pharmacist sells her the pill, or she does without. Does it make a difference if she's been raped? If she hasn't, but she has a medical condition that could make pregnancy dangerous to her? Why should she have to undergo the dangerous abortion procedure when the morning-after pill could avert the scenario?

[susandennis]

I understand what you are saying. I just don't agree with it.

I am sorry that a girl in a small town may well have to pay more dearly than most. I honestly do believe the pharmacists beliefs in this case are nuts and mean and sad. I do. But, I value their right to operate their livelihood according to what they believe because that is critical to my having the same right with my own beliefs.

[davmoo.livejournal.com]

Wait wait wait wait wait. Wrong!! Bourbon is in fact a necessary medical treatment!! Live with some of my relatives for a period and you'll need some too :-)

[davmoo.livejournal.com]

Okay, I see where we're looking at it differently here. You are looking at the business as a whole. I'm looking at the individual pharmacist behind the counter.

If its a store-wide policy not to sell the morning after pill, then I could agree that government should not interfere. However, and this is the much more common scenario, an individual pharmacist should not be able to decide on his own that, even if his store carries the pill, he personally will not fill that order.

Since you are so pro-business rights, I assume then you are also against several proposed laws that are circulating that would require a pharmacy to NOT fire an individual pharmacist for refusing to fill a morning after order, right?

As for your other replies, I have to agree with what others have said...if I have to buy Old Grandad instead of Makers Mark, that is not going to adversly affect my health if I can't get Makers Mark within 24 hours.

[susandennis]

Since you are so pro-business rights, I assume then you are also against several proposed laws that are circulating that would require a pharmacy to NOT fire an individual pharmacist for refusing to fill a morning after order, right?

AU CONTRAIRE!!!

I am against any laws that prevent me from running my business any way I see fit. Including the ability to hire and fire whomever I want for whatever reason I want.

[davmoo.livejournal.com]

Um...that's what I said. You're against laws that would say the pharmacy can't fire someone for certain reasons.

[susandennis]

yeah sorry, i got lost in all the negatives. i want the government to keep their hands out of my livelihood.

[davmoo.livejournal.com]

Would that be some of those "nattering nabobs of negativity" that Agnew was always talking about? :-)

[susandennis]

Wow... now there's a blast out o' the past!

[davmoo.livejournal.com]

I had to say it...its not that often that I get to use it with someone else who is also old enough to "get it".

[susandennis]

oh, very excellent point. it is nice to know people who were there then.

[geordie.livejournal.com]

Running a pharmacy isn't like selling books, it's effectively a franchise for a government defined service. As such I don't think it is unreasonable to require them to provide the full service.

[susandennis]

Ok, now that's an interesting take on it. And a complelling one. But I have questions...

What other items does the government require that a pharmacy sell?

My drug store does not carry the shampoo (over the counter) that my Doctor told me to use. In fact, it isn't available in Seattle at all. I should get a law to make them sell it?

And, isn't a liquor store 'a franchise for a government defined service'? So if my liquor store doesn't stock something I want, I can just have the state pass a law to require them?

[geordie.livejournal.com]

There's probably a stock answer for this somewhere...

Could the failure to immediately provide a fifth of scotch or your shampoo be considered life threatening? With the morning after pill there's a very small window of opportunity. How'd it be if 9 months after they refused to dispense someone came in and deposited a baby on the counter.

[kyrielle]

I think you can safely wait for those to arrive, though, as geordie notes. The morning after pill must be used in a very short window - moving to mail-order to get it isn't viable. Unless you pre-order it, and I devoutly hope no one views its use that way!!

[qnetter]

Sorry, I don't buy your fundamental premise. The part of a so-called pharmacy that sells soft drinks and stuffed toys is a retailer. The pharmacy department is a health care provider.

[susandennis]

i'm ok with that distinction but it makes no difference in my confusion.

[qnetter]

Do you think a doctor should be able to pick and choose which procedures and therapies within their specialties they provide and which they refuse to perform?

[susandennis]

absolutely!

they do that every day.

[susandennis]

Ok, I retract what I said. I was under the impressionm that doctors, or instance, had the choice of whether or not to perform abortion on demand - and other proceedures.

I don't know and don't care. It's beside my point. It has nothing to do with pharmacists being required to sell a product they don't want to.

[qnetter]

It has everything to do with it. They are health care providers, not simple retailers.

[jwg.livejournal.com]

Another point would be whether is it the Pharmacy that has decided to not sell this drug or is it the individual pharmacist. I think these are two completely different situations and I think the latter is the one that is more common these days.

What if a pharmacy decided to not sell aspirin, or vitamins? Would that be OK? I don't think so.

[susandennis]

If the individual pharmacist refuses to adhere to store policy then the store owner should fire the pharmacist.

What if a pharmacy decided to not sell aspirin, or vitamins? Would that be OK? I don't think so.

Ok, this is where you and I will need to sit on different sides of the room. I think it would be more than ok. I would not have a problem with that any more than I would have a problem dictating what any retail outlet should sell.

[qnetter]

And if they're the only store in town?

[susandennis]

Makes no difference - my rights and beliefs are still in jeopardy regardless.

[jwg.livejournal.com]

This is an interesting discussion.

Suppose the pharmacy (all the pharmacies in town, state,... ) decide to sell no condoms, birth control pills, birth control devices then a large number of individuals and their rights and beliefs would be impacted at the expense of the pharmacy/pharmacists rights.

Pharmacies are regulated and licensed by the state - I glanced at the Mass regulations. They have tons of rules about record keeping of prescriptions, offering counselling about drugs, etc., dealing with controlled substances, etc. They don't really address non-prescription drugs though.

[susandennis]

I do severely sympathize with those who suffer in small towns.

But, I still come back to me. It is all about me.

Should my government force me to change the way I run my totally legal business because a group of people want me to do it in a way that that is in line with their beliefs and against mine?

I can't get there. Small town, large town, monopoly. Doesn't matter. The point is still the same.

You am smart...

[gavin.livejournal.com]

I agree with all of your points. A pharmacy should not be required to sell anything they don't want to. As far as I know, a pharmacy is not a government office, and shouldn't be forced to sell anything.

I certainly don't like the idea that a woman could be denied a morning after pill, I don't think the pharmacist should be forced to provide her with one.

What if the pharmacy is the only one in town, or no pharmacy in the state will sell it? Easy...plan for an "in case of emergency" moment and order a supply from an online pharmacy in advance (although really, if you are using that pill as your sole method of birth control, you have bigger things to worry about than getting pregnant).

Re: You am smart...

[susandennis]

Yeah, sadly, if birth control is left to the morning after pill, it's likely that planning ahead is not an option that was every considered.

Freedoms aren't cheap. This one is expensive. And I hate that and I hate that it's women who have to pay it, too.

[jawnbc]

I also disagree.

In fact, according to the American Pharmacists' Assocation Code of Ethic:

"III. A pharmacist respects the autonomy and dignity of each patient.

A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable. In all cases, a pharmacist respects personal and cultural differences among patients."

And

"IV. A pharmacist acts with honesty and integrity in professional relationships.

A pharmacist has a duty to tell the truth and to act with conviction of conscience. A pharmacist avoids discriminatory practices, behavior or work conditions that impair professional judgment, and actions that compromise dedication to the best interests of patients."

A pharmacist who refuses to offer a legal, approved medication because of their own beliefs is working against the patient'self-determination. Since these pharmacists aren't claiming that their concerns are medical, they're being discriminatory.

[susandennis]

I don't think anyone is arguing that the practise of not selling this stuff is not discriminary. It is.

Stores discriminate all the time. No shirt, no shoes, no service.

I think it's wrong. I think it's mean. I think it's evil but I think that an over the counter drug is like shampoo. The store should have the right to sell it or not.

[jawnbc]

it's not an over-the-counter drug. Over-the-counter drugs are stackable on shelves; this isn't. It's still a controlled medication, just one that doesn't require a prescription.

Here in Soviety Canuckistan™, pharmacies sell pain pills with codeine in them. But they're not stackable: they are kept behind the pharmacy counter. And non-pharmacies cannot sell them, though Safeway sells cold meds etc.

[susandennis]

Oh that is a distinction that I had not considered.

I still come back to abhorring government interference with my legal livelihood. BUT... if the government is already involved by restricting the sale by non-pharmacies, that could protect me...

I'm going to have to chew on this for a bit.

Thank you!

[jawnbc]

thanks for giving the normal LJ Saturday meh some oomph!

[susandennis]

But that is what scares me the most... having the government dictate what the pharmasist should do.

Once they can do that with impunity then they can also legislate (even more than they do now) what I should do. And I can say goodbye to even more of my freedoms.

(And health care professionals deny services all the time with no law saying they can't.)

[dragonvpm.livejournal.com]

But that is what scares me the most... having the government dictate what the pharmasist should do.

I dunno, but taken out of context, I find it more terifying to consider that the government might not tell a person what it they are legally obligated to do as a pharmacist. Otherwise, what's to stop an unscrupulous pharmacist from improperly filling prescriptions with drugs that are "good enough" without concern for side-effects or potential drug interactions? Or what's to stop a business from hiring a high school kid who can barely read to work as a pharmacist for $5.50 an hour?

I suppose it really depends on how the government goes about doing this. If they add a requirement to every state's licensing regulations stating "a pharmacist will dispense all drugs available in a pharmacy to everyone who presents a valid prescription or is otherwise capable of/allowed to purchase them" then I think it would be an acceptable intrustion by the government into the pharmacists life. After all, that would also cover things like a racist pharmacist who refuses to sell to members of minority group X, or a sexist pharmacist who decides that he knows better than a woman (or her doctor) what drugs she should be taking.

I think one reason that this is such a touchy issue is that pharmacists are state licensed professionals who are expected to perform up to a certain standard and in many instances the way that some pharmacists have handled requiests for the morning after pill (which ONLY they can provide) has been seriously unprofessional.

Personally I'm a big believer in actions and reactions/consequences. If the pharmacists' actions were justified then they should bear the legal obligation to help support any child that might result from their decision not to dispense the morning after pill if their pharamcy carried it (obviously you can't dispense what you don't stock). I wonder how many people would stick by their convictions if they were made to pay for the consequences of their actions. IMO far too many people hide behind their bible, koran, religious-book-of-choice, or they hide behind their politics, or they hide behind their illnesses (thinking about alcoholism and the like) and I'm kind of fed-up with it. If people want to exercise beliefs and they exercise them in such a way that it directly affects someone else then they should bear a financial responsability to that person for butting in and making decisions for them.

[howeird]

But that is what scares me the most... having the government dictate what the pharmasist should do.
Hogwash. You son't really believe that. If you did, you would be against the prescription system completely, because if the government did not tell pharmacists how to conduct their business, morphine would be sold over the counter.

[howeird]

I have no sympathy for anyone who pursues a career which requires doing things against his/her religious beliefs. Take this to its logical conclusion:

Christian Scientist surgeon
Islamic bartender
Chasidic Broadway actor (there's always a performance Friday night)

Someone who has any kind of religious beliefs regarding the sale of any legal drug whatsoever should not be given a pharmacist's license.

[susandennis]

not something I've ever thought about but a really good point!