Conscience and the morning-after pill

This is ridiculous... What if I work in a small shop where I'm frequently the only cashier on duty, and a patron wants to buy something I object to? Do I get to sue for discrimination after I'm fired? Does the customer get to sue for discrimination when the cashier won't sell him something?

There is a distinction to make between owner and employee. The owner, not the employee, should have the right to refuse to sell an offensive product. But an employee can not impose such a burden on his employer. If Kroger wants to sell the pill, a pharmacist who objects needs to find another job.

Well, the whole issue just shows yet again that the whole term "pro-choice" is a joke. It's really about the sexual revolution at all costs, which means pro-abortion, not pro-choice.

rr

Let the medical professional give up his/her license and have them open up a bookstore. Let them open up their own pharmacy and let them put up a sign saying, "We refuse to dispense some medications prescribed by your doctor. You've been warned." But as an employee and medical professional, they need to do their job or be fired. If their employer chooses to have employees who refuse to assist customers, they do it at their own peril.

"f the engineer won't approve the plans for the bridge he should be fired. His boss is paying for him to sign plans.

That's the equivalent argument."

Actually, it is equivalent. Presumably, the engineer will be asked for his reasons. If he says, because the bridge is unsafe, we hope his employer will investigate. On the other hand, if he says, because I object to the fact that the materials come from China, the employer has the right to fire him and hire another engineer.

Allen,

I don't know about Rod, but I personally would defend to the end the right of a pharmacy run by Scientologists to not sell psychiatric drugs. I'd defend the right of any business to not sell anything it doesn't want to sell, as long as it's not refusing to do business with certain customers out of some kind of discrimination.

But pharmacists do not have the right nor the authority to deny a patient the medication a doctor has prescribed.

They aren't "denying" patients anything. They are simple refusing to take affirmative actions to fill those prescriptions -- which is anybody's legal right.

The State generally lacks authority to COMPEL people to sell things they do not wish to sell, for whatever reason. I have a right to buy alcohol (unless I live in a dry county), but a Baptist, Muslim or any other store owner who objected morally to alcohol consumption has no obligation to sell it to me.

And if every store I can possibly visit refuses to sell alcohol to me(and how realistic is that, anyway?), then I'm just out of luck. My right to buy doesn't trump another person's right not to sell -- and a doctor's prescription doesn't change that.

The paradox of liberalism: a non-consenting adult may be coerced by the state to help facilitate the acts of other consenting adults, since the state does not have a right to interfere with the liberty of consenting adults.

This is why liberalism is not "neutral," as its proponents claim. It is a full-orbed worldview with its own philosophical anthropology that requires that dissenters acquiesce or suffer punishment by the full force of the legal system. This is why in the liberal universe "Debbie Does Dallas" has far more legal protections than a political action committee seeking to advance its views in the public square.

I get the distinction, Rod. I don't support a law that compels an employee to perform a certain task. That is government interfering in an employer/employee relationship. On the other hand, I do support that employer's right to terminate an employee's job when they refuse to perform that task.

In other words, I don't believe in a freedom of conscience law for the exact same reason. That's government interfering in an employer/employee relationship. (again, realizing that is peripheral to your point in the post).

I'm a geek, not a lawyer, dammit. Our healthcare system is made up of private enterprises performing what is arguably a public service.

If every doctor across this country suddenly decided to stop performing C sections for ethical reasons, would the parents of the children who die or the husbands of the mothers who die as a result have grounds/standing for a civil or criminal lawsuit?

I'm guessing this is not something we worry about because we live in a real world where we can reasonably assume that where there are hospitals, there will be doctors who will perform reasonable procedures to save the life of mother and child.

If Christians (and observant Jews for that matter) are seeking opportunities for martyrdom, they may be coming sooner than you think.

Oh, how cruel. I can't discriminate against homosexuals. It's the end times! And I'm sure that's the hill Jews and Christians want to die on -- landlord/tenant laws.

One thing I've seen no one brought up so far the case of the small town pharmacy -- what if there is only one store to get a morning-after pill, and the town's only pharmacist objects on moral grounds to dispense the treatment? That patient is paying an awfully high price to assuage the pharmacist's morality.

Further, the whole notion of withholding treatment, much like the recent HPV vaccination issue in Texas, has more than a whiff of paternalism involved -- if a patient and doctor has already agreed to a treatment, why should a morality-stricken pharmacist get to sternly object? It's one thing to follow one's moral precepts, it's another to enforce this on others.

There's also a slippery slope argument. Why stop at the morning-after pill? What about the regular Pill? In fact, why give out medicine to people with STDs at all? Why, if I treat STDs I'll only encourage the behavior that led to the patient getting the STD, no?

I don't approve of needless violence or criminality, so I won't treat this bar patron who started a bar fight and got knifed. His loss.

Also, I find Rod's analogy from the original post misleading. A more proper analogy can be made to the legal profession. If I don't believe in defending the guilty in a court of law, and hold myself out as a criminal attorney, I won't just lose business, maybe I shouldn't be a criminal attorney to begin with.

Another analogy that comes to mind is that of a conscientious objector in wartime. One can be a committed pacifist, but this means you do not get to be a soldier, or get any of the benefits thereof. If I can't do the things required of me to obtain a professional license, I shouldn't practice that profession, or get to hold myself as being in that profession.

I think there's numerous public policy arguments in favor of making these trained professionals follow professional guidelines, as opposed to their own moral guidelines.

DU

Well, I donno, DU. You can be a criminal defense attorney, but that doesn't obligate you to take every case that comes along. Lots of criminal attorneys refused clients they think guilty, clients they think especially guilty, clients they don't like the hairstyle of....there is no obligation to take every client who comes along.

Daniel: If you've been raped, or your birth control has failed, or you just have been careless, you shouldn't have to run all over town to get a prescription filled just because a medical professional has decided they want to force their values on you.

Ah, so you would rather live in a society that forces its values on people of whose values you disapprove. I get that. But please, do us the favor of owning up to what you're doing. It's not a matter of the pharmacist "forcing" her values upon someone else, any more than the striking auto worker, by freely withholding his labor, is "forcing" his values upon the member of the public who wants to buy a car.

you shouldn't have to run all over town to get a prescription filled just because a medical professional has decided they want to force their values on you.

That would make sense if someone were forcing these customers to shop only at a particular pharmacy.

And if advocates of coercion have to resort to hypotheticals involving rape victims who live 200 miles from the nearest alternative pharmacy, you know the coercion is fundamentally unjust.

Rod:

Then you're saying it's "scientific" for Tom Cruise to spout to Matt Lauer on the Today Show about how Brooke Shields shouldn't take Prozac for postpartum depression because it's evil.

The analogy is exact to me, IMHO.

1) Plan b is not 4u-486

2) Plan b "may" prevent implantation of a fertilized egg like I "may" win the lotto.

3) If a woman is pregnant and takes Plan B, she'll still be pregnant.

4) Plan b can be obtained without a scrip by grown up, however most pharmacies do not put it out with other OTC

I am astounded by the ringing ignorance of the general population on this controversial subject. It seems all a religious figure has to do sometimes is state "it is so" and the crowds trot along with out expending any effort to see if it is true. Intellectual vigor is sorely lacking in many health care debates and we are going to suffer some stiff consequences in the next 10-30 years .

Copy & Paste please:
http://www.drugtopics.com/drugtopics/Community+Pharmacy/Plan-B-and-unfair-dispensing-practices/ArticleStandard/Article/detail/426523

From Discovery Health
More spontaneous abortions are caused by mature women...should those over 35 be forbidden sex?

How often do miscarriages occur?
About 15 to 20 percent of all pregnancies end in miscarriage. Most of them occur in the first 13 weeks, or first trimester.

Does age affect miscarriage rates?
For women in their 20s and early 30s, the chance of miscarriage is about 15 percent. At 35 the chance of miscarrying rises to one in four, and at 40 the miscarriage rate is close to one in three.

There are too many good sources of factual information including pubmed, and emedicine, let alone google to justify the amount of misinformation in the collectives post!

Again, forcing one's beliefs upon others through outright coercion.

Wow. Newspeak at its best.

You want to buy something from me, but I choose not to sell it. Therefore I am "imposing my values" on you. And my declining your offer to purchase from me is by itself an act of "outright coercion" on my part.

Doubleplus ungood, verge crimethink.

When Big Pharma concocts some drug designed to "correct" homosexual orientation, and a few gay pharmacists decline to sell it, I look forward to hearing Daniel and Larry Parker explain indignantly that those gays are guilty of "imposing their morality" on the public.

If the medical establishment and FDA approve it, I'd object to a pharmacist refusing to dispense a drug that had been approved for use. I'm actually pretty consistent about that. Would you be as keen if it were Muslims who were following the Koran and a fatwa to deny medical services?

If an emergency room doctor had to perform an emergency abortion and she was the only doctor available, it would be unethical for her not to perform the abortion and risk the health of the mother and the doctor could lose her medical license. So, in fact, sometimes ethical and legal requirements do sometimes supersede religious values.

1) Plan b is not 4u-486

2) Plan b "may" prevent implantation of a fertilized egg like I "may" win the lotto.

3) If a woman is pregnant and takes Plan B, she'll still be pregnant.

4) Plan b can be obtained without a scrip by grown up, however most pharmacies do not put it out with other OTC

I am astounded by the ringing ignorance of the general population on this controversial subject. It seems all a religious figure has to do sometimes is state "it is so" and the crowds trot along with out expending any effort to see if it is true. Intellectual vigor is sorely lacking in many health care debates and we are going to suffer some stiff consequences in the next 10-30 years .

Copy & Paste please:
http://www.drugtopics.com/drugtopics/Community+Pharmacy/Plan-B-and-unfair-dispensing-practices/ArticleStandard/Article/detail/426523

From Discovery Health
More spontaneous abortions are caused by mature women...should those over 35 be forbidden sex?

How often do miscarriages occur?
About 15 to 20 percent of all pregnancies end in miscarriage. Most of them occur in the first 13 weeks, or first trimester.

Does age affect miscarriage rates?
For women in their 20s and early 30s, the chance of miscarriage is about 15 percent. At 35 the chance of miscarrying rises to one in four, and at 40 the miscarriage rate is close to one in three.

There are too many good sources of factual information including pubmed, and emedicine, let alone google to justify the amount of misinformation in the collectives post!

This issue is difficult and I write as a lawyer who has helped the medical profession enforce standards of medical ethics for 19 years. An assumption behind professional codes is the concept that each profession has its own underlying moral principles unique to the nature of the profession. For lawyers, it is the principle of zealous advocacy within the adversary system; for physicians the provision of therapy for disease that is rational according to the principles of scientific health care. I think it has been an expectation for those who set the ethical standards in the respective professions that becoming a professional requires the individual to put aside the ethical principles of the lay person in favor of the professional standards unique to the profession. Thus, as a law student, I was taught that it was a professional duty to ensure that no one --- even the person accused of the most heinous crime -- went without a zealous advocate to defend him with every tactic permissible within the rules of the system. I think the expectation of medical ethicists is that the patient will receive the care that is indicated, as determined by standards of the profession alone, for her problem.

I also think we have to be mindful, as pointed out by others, that a principle that would protect the pharmacist here, would quite possibly protect the Muslim cab driver who might not want to transport two persons of opposite genders in his cab or passengers carrying alcohol.

"That's great, unless that pharmacy is the only one in town, and that individual then becomes psychotic and a danger to themselves and others."

So what happens when you try to force him to sell what he's morally opposed to selling, and he responds by simply shutting the pharmacy down altogether?

If there's a demand for a particular drug, someone's bound to come around and sell that drug. But someone shouldn't be forced to sell all drugs just because they sell some drugs, just like a religious bookstore shouldn't be forced to sell pornography just because they've chosen to sell Bibles. The simple fact of the matter is that the government has no legitimate authority to force anyone to sell anyone to sell anything. Sure, this may lead to occasional tragedies that might have been prevented if the government had such authority, but frankly, what you're suggesting is, in my eyes, the moral equivalent of imprisoning all Muslims just because there might be a few potential terrorists among them. COncerns for public health and safety simply do not justify coercion.

Imagine your wife needed to fill a prescription late at night while you are out of town for work. And the only pharmacy that was open in a 10 mile radius was run by Muslims, who believe it is against their religious faith to wait on women who aren't accompanied by men. So they refuse to fill the prescription for your kids because your wife is alone, which violates the basic tenets of their faith.

This is perfectly acceptable from a religious freedom standpoint. They don't have to fill the prescription. You want everyone to agree with your moral views. Your moral view and mine is that an unescorted woman should have her prescription filled. Of course, the Muslims in your scenario believe that to be immoral. Well, one side is going to win here and I'm not going to run roughshod over them to make them violate their morality. Now, the company that employs them can fire them or someone else can open a competing pharmacy. But, I don't have a right to demand they violate their beliefs.

It's interesting that you're always complaining about people concerned about Muslim immigration and beliefs. Yet, you use a possible example of such Islamic incompatibilities with our society. I just recognize that maybe being separate is best for both of our cultures. You want to dictate what they can and can't do.

quote" Imagine your wife needed to fill a prescription late at night while you are out of town for work. And the only pharmacy that was open in a 10 mile radius was run by Muslims, who believe it is against their religious faith to wait on women who aren't accompanied by men. So they refuse to fill the prescription for your kids because your wife is alone, which violates the basic tenets of their faith."

It's worth pointing out that unless said pharmacy was located in an area with a large Muslim population it would probably go out of business pretty fast because non-Muslims simply won't shop a place that treated women like that. I wouldn't.

rr

I was thinking last night of possible real-world objections to my viewpoint on this matter (as opposed to a woman is raped by a jihad warrior in the backwoods of Wyoming, and can't find a cab to the nearest pharmacy, 3,000 miles away, through a driving snow...), and it occurred to me that we have one from the not too distant past in the US: Southern merchants who refused to sell goods and services under equal conditions to black customers.

It is illegal now for a merchant to refuse the same goods and services to a black customer as he provides to a white customer. And I support that law. In other words, I support the government coercing a merchant to sell something under conditions he finds deeply offensive. I am willing to make this exception to my rule. Similarly, I believe in the right to strike (that is, the right for a person to withhold his or her labor), but I don't believe in the right of firefighters, doctors and police officers to strike, for obvious reasons.

Doesn't this mean I'm inconsistent? Or put another way, doesn't it mean that I don't believe the right to refuse to participate in the exchange of goods and service is absolute? That being the case, isn't this a matter not of whether or not lines will be drawn, but one of where the lines are drawn, and for what reason? That being the case, isn't it a stronger argument for our side to make (I'm talking to Simon, Nate W, Erin, rr, et alia) that a case that a just society is one in which a merchant who genuinely believes his transaction involves a matter of life and death -- the gravest possible moral situation -- not made subject to laws coercing him to participate in such a transaction?

But that standard would not protect the hypothetical atheist bookstore owner from being forced by the state to stock Bibles (or, contrariwise, a feminist bookstore owner being forced to carry copies of Playboy). And for that matter, I have no problem with the Taxicab Authority compelling Muslim cabdrivers to take passengers who might be carrying pork or alcohol, the refusal of which is a ridiculous refusal to accomodate people in the society in which they live (the refusal wouldn't be ridiculous in Jeddah or Rawalpindi, of course). Anyway, again, isn't this less a matter of firm principle and more one of cost-benefit choice?

I would not want my society to force anyone to violate his or her conscience by direct participation in what they believed in all sincerity to be an act of unjustified killing. I don't even believe that in the case of war, the state should compel its citizens to do that (that's why I support conscientious objector status). So why are some liberals so dead-set in defending the sexual revolution that while they would allow for the right of conscience under which a man wouldn't be forced to pick up his gun and shoot someone attacking his own country, they would deny the right of conscience under which a man wouldn't be forced to provide the poison that would kill an unborn human being? It seems to me that that is where the more persuasive political argument is to be made, and not one based on taking a firm stand over the right to refuse to participate in a commercial transaction. While I believe that right should be upheld in most cases, to defend it in principle is to defend the right of Southern merchants to refuse service to black customers.

Right? Simon?

It also should be re-emphasized (as a couple people above have) that the morning-after pill is designed to prevent fertilization of the egg by the sperm. It MAY also prevent implanation of a fertiliezed egg--no one is sure, but they think it might. (remember, sperm sits around for a few days and typically only makes it to the egg some time after sex, often a day or two after sex, and it can be up to five days after.) So it is NOT a designed abortifacient by ANY definition, and no one is sure if it is--they think that (at most) it probably would also prevent the fertilized egg from implanting, but its never been proven that it does. The manufacturer warns that it might (being cautious, which is appropriate for them) but no one is absolutely sure.
http://en.wikipedia.org/wiki/Plan_B_%28birth_control%29#Plan_B
(scroll down to "mechanism of action"--i don't know how to pinpoint the cite in a long article)

So, while it is certainly understandable for those who beileve that life begins at fertilization to be concerned about the morning-after pill, it is NOT clear-cut that it is an abortifacient.

Plan B does not cause abortions. It is a drug that can be of great benefit and because of faulty information, assumptions, and blind belief, it is being refused to people who need it.

That has nothing to do with the issue at hand. Certain pharmacists object on ethical grounds to selling Plan B. The State wants to force them to sell it anyway.

What Plan B does or doesn't do is irrelevant. Fill in any other product you like. The issue is whether the government can force you to sell a product, or provide a service, against your conscience.

While I believe that right should be upheld in most cases, to defend it in principle is to defend the right of Southern merchants to refuse service to black customers. Right? Simon?

Rod, It's a thoughtful point, but that analogy can be (and inevitably is) raised in virtually every discussion about individual or states rights.

The disgraceful mistreatment of black Americans in the American South (and, to a lesser extent, elsewhere in the US) is a unique problem that our country has addressed in unique ways: We fought the bloodiest war in our history, we have specifically amended the U.S. Constitution 4 different times to address that issue, and have passed major national civil rights and voting rights legislation with large bipartisan majorities.

So the line protecting the rights of an individual professional or business owner needs to be drawn not according to abstract characterizations of the individual's motives (e.g., is this a life-or-death question?). The line should be between racial discrimination, which we do not permit, and other forms of conscientious objections (for pharmacists, military draftees, etc.), which generally we do.

An excellent discussion all around. I'm particularly grateful for the contributions of Rod and Simon.

"Where do we draw the line?" I believe that we, as a society, would be well served by focusing on that question, and revisiting it frequently to make sure that where we drew the line in the past is where it needs to be in the present.

I want to emphasize VR's legal perspective. Pharmacists are not voluntary employment positions. They require advanced, esoteric training. They have already imposed upon them responsibilities for which, should they fail them, they can be punished.

The twist in the topic I'm thinking about is the chronology of intent.

Pharmacist A has the health of the customer as the highest priority, and refuses to second-guess the customer's choices or instructions from the physician.

Pharmacist B has very strong moral positions, and sees hir position as one of responsibility to those morals.

Now, B can also be described as A was, no doubt, no intention of loading the question. But intent becomes important because in a consentual situation, intent must be the most important factor.

A intends to dispense all drugs carried by the pharmacy where sie works. B intends to not dispense those drugs carried by the pharmacy to which sie objects. B should be fired, and seek employment at pharmacies that refuse to stock the offensive drugs. Where B does find such employment, the state must not be allowed to coerce such places to carry drugs they have no intention of dispensing.

The other line that must be clearly drawn is the one that defines convenience. I have little sympathy for emotional emergencies that have no bearing on physical emergencies. A woman who wants to abort or prevent pregnancy can either stock the OTC drugs she needs, or travel as far as it takes to get them. She has no right to bring action against the drugstore on the corner because it refuses to stock what she wants. I have a very large head of steam built up around all the applications of convenience in this society, so don't think I'm singling this topic out in that regard.

Pharmacists participate in health care. It is hardly an analogous situation to "forcing" bookstores to carry certain titles. OTOH, most libraries will bend over backwards to secure books - ANY books - requested, even if they are not readily available 'on the shelf' without so much as a hint of censorship, nevermind the attendant condescention inherent in anti-choice pharmacists.

You can do what you want to with you own body, ex-P; just don't ask the government to require other people to help you do it.

If my daughter was raped at a young age(say 11), I would consider it "health care" to offer her a pill that would prevent her from becoming pregnant. The fact that it's possible that this same pill might keep a fertilized egg from being implanted in her uterus wouldn't change that. It's appropriate treatment, and it's legal. If a conscientious objector believes that to be "killing a person," then I agree that they shouldn't participate in providing health care to that person. I agree with Franklin. A conscientious objector should work at a place that doesn't carry emergency contraception or any other product that the pharmacist is hired to dispense.

"You can do what you want to with you own body, ex-P; just don't ask the government to require other people to help you do it."

So the government shouldn't require a doctor to deliver a family's 11th child if the doctor believes the parents can't afford to have more children? The government shouldn't require a doctor to perform a surgery on a drunk driver or lung surgery on a smoker?

Rod wrote, "It is illegal now for a merchant to refuse the same goods and services to a black customer as he provides to a white customer. And I support that law. In other words, I support the government coercing a merchant to sell something under conditions he finds deeply offensive."

There's an important difference, Rod. In the case of Plan B, the pharmacy is deciding not to offer for sale a particular product, an eminently legal thing for them to do. A pharmacist could randomly decide not to stock cotton balls, for instance, because his profit margin on them is too low; similarly, a rare, expensive prescription drug with a short shelf life might be an item he doesn't regularly stock because the benefits of stocking it outweigh the costs. There should never be a law requiring anybody to stock each and every product the absence of which might theoretically inconvenience someone, because otherwise you've mandated that every store become a super giant big-box.

However, it would clearly be illegal (and immoral!) for a pharmacist to decide only to sell Plan B to African-American women, on the grounds that he hates them and doesn't want them to reproduce, or to sell Plan B to everyone but his fellow Catholics, on the grounds that he doesn't care if a bunch of non-Catholics go to hell for fornicating and then contracepting or aborting. That would be similar to the situation you describe, in that specific groups of customers are being treated differently from all other customers, a type of action which does violate the laws against discrimination.

Erin, I don't follow your logic.

A person who will sell Plan B (sticking to your example) to African-American women but refuses to sell it to anyone else is in violation of the law. A person who will sell Plan B to anyone but Catholics is also violating the law.

A person who refuses to sell Plan B at all in a store that stocks it is violating his terms of employment. A company who refuses to stock Plan B is making a business decision (whether on moral grounds or not is immaterial).

The first person is engaging in legally defined criminal activity. The second person or company is not. My reading of Rod's posts is that he is in fact making that distinction.

Maybe I need to go make and eat dinner. I'm not following you at all. I'll come back when my blood sugar is a bit higher. :-)

I believe that Erin nailed it with regard to Rod's analogy. It's about the product, not the customer. The pharmacy owner can decide what to sell or not sell based on a variety of criteria, some of which Erin mentioned. Discrimination based on customer is a different issue, but interesting in its own way - think about how we don't sell certain items (alcohol, cigarettes, Sudafed, spray paint) to minors.

It seems to me that the logical extreme of the pharmacy refusing to sell Plan B is for the owner to just shut down the pharmacy all together. Would you force him to remain open against his will? Would you conscript someone else and force him to open a pharmacy?

Erin, thanks for taking the time to expand your point. I'm sorry for being dense.

Scrappy, employment law is something I have some professional exposure to, though I must emphasize that I am not a lawyer.

Your first question is badly stated, I'm afraid. There is no such thing as a conflict between employment and crime. The issue is not that an employer can coerce an employee to do something illegal, the issue is whether the employee has done something illegal. A court decides on the possible mitigating circumstances, such as the employer deceiving the employee, or the employee feeling threatened in some way. The simple progression is that if an employee knowingly commits a crime, regardless of duress, that person is subject to criminal prosecution. It's all about the trial thereafter.

Your second question can be at least partially answered by the concept of at-will employment. Non-union jobs in most states are formally described as at-will. You need to research it in each state to be sure. Essentially, either party -- employer or employee -- can terminate the relationship. The reasons for termination are covered by legal concepts, if not directly by certain laws. The two-week notice thing is more an etiquette than a formal practice, at least from the employee's side. A matter of conscience is not something I've seen discussed. I'm thinking, as a first step, that the chronology of the matter is important.

If you take a job knowing that one or more duties of the job will violate your beliefs, conscience, what have you, and you then refuse to fulfill one or more of those duties, you will get fired and you will have no recourse. You might even be denied unemployment benefits in some states. If, after you take a job, the employer adds duties that you find objectionable, fair labor practices might come into play; certainly, the employer has changed the original at-will agreement, and the employee will usually have recourse of some sort if fired for refusing to comply.

which can be abortifacent in that it prevents a fertilized egg from implanting in a woman's uterus.

There's NO evidence at all that this is even vaguely true. None. At all. The morning after pill stops the release of an egg, it doesn't do anything about implantation.

Progestin has never been show to affect implantation, there's not even any plausible medical way that could even happen with Plan B, as even if it affected the endometrium (Which is not likely.), there's no way on earth it could effect it fast enough to stop implantation.

Seriously, that false concept is from the Pill, which possibly could affect the endometrium, although that's never been proven, and that theory exists only because a contraceptive company made it up to sell pills. But the incorrect theory there is that the Pill affects the endometrium as it grows, during the cycle, making it thinner, and thus affecting implantation.

But with Plan B, there's no vaguely possible way to hormonally affect the lining after it's grown, in the few hours after taking Plan B that fertilization and implantation might happen. (Well, it could trigger a period and just throw all the lining away, but I think people would have noticed it does that by now.)

And, incidentally, people have taking Plan B and still gotten pregnant from what they were taking it for, presumably because their body managed to hit exactly the wrong window when releasing an egg.

Now, we can talk about whether or not pharmacists should have the right to refuse to sell birth control if they want, including Plan B (Although picking a single certain type not to sell is rather irrational.), but that's not really the question here. The question here is why the religious right is lying about a type of birth control to try to get pharmacists to not offer it?

If, after you take a job, the employer adds duties that you find objectionable, fair labor practices might come into play; certainly, the employer has changed the original at-will agreement, and the employee will usually have recourse of some sort if fired for refusing to comply.

Franklin,

Thanks for your thoughtful response.

I suspect the thought I've snipped above is relevant to the discussion we've been having about the professionalism of pharmacists. I'm sure that there are many who entered into the profession and began their current jobs before the development of Plan B. So their conscience, informed by both their religious beliefs and their professional ethics could lead them to refuse to comply with this unanticipated demand placed upon them.

Now, we can talk about whether or not pharmacists should have the right to refuse to sell birth control if they want, including Plan B (Although picking a single certain type not to sell is rather irrational.), but that's not really the question here. The question here is why the religious right is lying about a type of birth control to try to get pharmacists to not offer it?

DavidTC, I think you're rather missing the point here. You're arguing that "the religious right" (whoever that is) is wrong when they have moral objections to Plan B. But, so what? You could just as well go to an observant Orthodox Jew and tell him that the Scriptures are wrong about not working on the Sabbath, or that there really isn't a God anyway, or that the Hebrew Bible is hopelessly corrupt, or whatever. The point is not whether you have moral objections to Plan B (or working on the Sabbath), or even that you think other people are incorrect when they have such objections.

The point is, rightly or (in your view, wrongly), people really do have strong objections to certain behaviors which they feel have been forbidden by Almighty God.

The question presented here is, "to what extent shall we force people to violate their own deeply held moral beliefs?" Not, "Does DavidTC think those moral beliefs correct or not."

The question presented here is, "to what extent shall we force people to violate their own deeply held moral beliefs?" Not, "Does DavidTC think those moral beliefs correct or not."

I didn't even vaguely ask as to whether or not those moral beliefs were correct or not. I pointed out that people are being lied to about the behavior of Plan B, causing them to think it violates their moral beliefs when it actually doesn't violate them. (Or, at least, it doesn't violate their carefully stated justifications, which is that it can kill a fertilized egg and thus causes the death of a person.)

If people wanted to argue they have the right not to sell contraceptives, they can argue that. If they want to argue they have a moral right not to sell a specific contraceptive, well, they can argue that too, although it's a somewhat stupid position to take and weakens their claims. (In much the same way you can't be a contentious objector to just the current war.)

When we actually have that discussion, I will probably disagree with them. A licensed pharmacy should be required to provide all medications, regardless of anything else. Internally, they can work out who sells what however they want, but either the pharmacy is required to provide any prescribed medication or we need to rethink this whole government licensing thing. That is neither here nor there, but it, at least, would be a valid debate.

What is not a valid debate is what is currently going on, where a few religious leaders are lying about the behavior of Plan B to make more people object to it. And almost every single person, including everyone here on both sides, has fallen for it. The Right, with these Plan B lies, are fighting contraceptives, not abortion.

And, let me assure you, the pro-life movement has a lot of people who are not anti-contraceptive. I know many people who will assert with all their heart that abortion is murder, but they assume that newly wed couples are using birth control until they decide to start a family. (I've actually overheard these very conservative women talk about not forgetting to schedule starting the Pill a good distance before their wedding so it's actually working their wedding night.) It's those people that these lies are targeting.

Next they'll be claiming spermicide in condoms 'might' kill a fertilized egg. They love that word 'might', as they've discovered scientists and doctors will not dispute it until they've disproved it, and it's near impossible to talk about what 'might' happen inside the functioning human body if nothing obvious happens as a result.

Sig's point is important. If there is no scientific/medical support for the idea that Plan B causes an abortion, than a pharmacist's "conscience" concerns aren't really legitimate. If they are creating a fantasy scenario for the sake of having a conscientious dilemma, then it is not a medical ethics problem but a political statement that doesn't even seem to be connected to a "deeply held religious belief" but instead "a belief concocted in a pro-life boardroom in order to further a political agenda."

If we are going to let medical professionals to have a conscience exception that exempts them from their professional obligations, shouldn't there be some rational relationship between their objection and medical/professional reality?????

If there is no scientific/medical support for the idea that Plan B causes an abortion, than (sic) a pharmacist's "conscience" concerns aren't really legitimate.

According to the Ultimate Moral Authority, in this case, Daniel.

"If scientific/medical support is lacking for the restriction on working on the Sabbath, then an Orthodox Jew's "conscience" concerns aren't really legitimate." (My restatement.)

If they [those who object to whatever on grounds of conscience] are creating a fantasy scenario for the sake of having a conscientious dilemma, then it is not a medical ethics problem but a political statement that doesn't even seem to be connected to a "deeply held religious belief" but instead "a belief concocted in a pro-life boardroom in order to further a political agenda."

You can construct your own restatement of this one.

Thus Daniel.

Without a doubt Orthodox Jews will benefit by your analysis, Daniel. Without a doubt they've "concocted" this whole thing "in a pro-Jew boardroom in order to further a political agenda."

My point is not to score on you, which you've made laughably easy - my point is to highlight the issue, which is, to what extent does or should the conscience of the individual impact on his/her professional behavior?

Oh and this. To what extent are you, Daniel, in a position to judge THIS moral problem "a fantasy" and THAT one realistic?

To cite an outrageous example, there were MD's in Germany who conducted experiments on concentration camp prisoners, and MD's who executed euthanasia on the unconsenting mentally ill. Are we incorrect in assuming that a doctor assigned to such a duty would be...disadvantaged...by his or her refusal of such duty on grounds of conscience? Was this refusal "concocted in a pro-life boardroom in order to further a political agenda"? How far does your analysis go?

Were these individuals - if anyone did indeed refuse to go along with this - "creating a fantasy scenario for the sake of having a conscientious objection"?

Maybe it's not the same thing. Proabably not.

How do we know the difference?

[Phweeeeet!!] Penalty flag on the play. Excessive use of straw by Susan, 10-yard penalty.

Susan, if you can "concoct" a scenario where a non-medical-profession Jew is putting someone's safety, let alone life, at risk by insisting on observing Shabbat, please share it with us. Be sure to include, in your scenario, the Jew's employer also refusing to find someone to take the Jew's place while he is insisting on his observance.

Godwin's Law, indeed.

But support for not working the Sabbath is "clearly" articulated in Jewish tradition. Wearing certain clothes can be backed up by pointing to certain passages in holy documents. While believing abortion is a mortal sin may be supported by Scriptures, giving medication not related to abortions doesn't fall under that umbrella.

This is all "clear" or "not clear", "backed up" or not, according to whom? According to you. From the seat of Your Rightness. Who made you judge of what is and is not "supported by Scriptures"?

Don't for the sake of reason start in on "Godwin's Law." I'm just reminding you, by reference to Nazi Germany, of how far this "I and I Alone Am the Judge of Morality" position can go.

I don't even necessarily disagree with you on the question under discussion. I'd just like to see something with a little more intellectual integrity than "Daniel thinks - on his own authority - that the views of other people are unsupported (and politically motivated, Those Bad People), therefore they are off base morally, and therefore everyone should conform their actions to Daniel's ideas."

Can you do better?

I'm just trying to fill in the blanks in your logic, Susan. Your strawman is very large, and an easy target.

Ok, let us suppose that a drug dispensed by a pharmacist is intended to, and in fact results in, the death of a human being. A vulnerable human being, one who cannot speak in her own defense. You believe this or you do not, your choice. The pharmacist in question believes this to be true, the calculations of you and Daniel to the contrary.

Now we have the pharmacist handing out such a drug. The Old Law (now abrogated why again?) prohibited the taking of innocent human life. So, a pharmacist handing out such a drug is in the position of taking such a life, as he believes. For the drug has no other legitimate purpose.

Does the pharmacist give the drug, knowing well what the effect will be?

Daniel is all, "well, the drug doesn't 'really' (according to him) have that effect (to the contrary, the information available to the pharmacist) and so it's all OK or should be." According to Daniel. Like, "well, God doesn't 'really' prohibit working on the Sabbath (so it's all OK or should be (according to the Omniscience of Daniel)).

So, it's all good, yes? Because Daniel's omniscient view of morality trumps everyone else's?

And Daniel's view would trump everyone else's why?

Let's say the Jews work for an ambulance service in town and most of the other employees of the company are down with the flu leaving the company unable to properly service the city. Are you going to force them to show up at work?

Thanks, Chris, this is a good one.

I am not (obviously) an orthodox Jew, but from what I understand, the question you propose is a real one. It is, do you work to save (temporary, of course) human life, or do you observe the laws of the eternal God?

And if your values (temporary physical life) trump the values the Orthodox Jews are defending (the Law of the Eternal God) why exactly would that be?

I like this one because I in no way sign up for the position of the hypothetical Jews in this situation. But I see the question.

What say all you secular humanists? Why are your values automatically more important than everyone else's?

'What say all you secular humanists? Why are your values automatically more important than everyone else's?'

As a faithful Catholic, I can't speak for secular humanists, but I'll give my opinion anyway. Under the Jewish ambulance driver argument, church law would permit her to drive the ambulance and not observe the Sabbath. Joe Lieberman was asked these very questions during his run for VP and explained that Jewish laws are not nearly as absolutist--and allow for exceptions in extreme circumstances--than most people believe.

But let's assume the that the person said they couldn't work despite the business' inability to accommodate the employee's needs. A court would likely rule for an employer that disciplined an employee who couldn't let the employee off because part of the analysis is business necessity. An ambulance service has a business necessity to assist sick people and therefore may not be able to accommodate the employee's need to be off.

An employer is not required to accommodate every religious belief if it interferes too much in the running of the business. If there is usually two pharmacists working, then they can accommodate an employee believes that their religion requires them not to give out birth control. But if the pharmacist is the only one working, the court may be more willing to believe an employer who says business necessity prevents him from accommodating an employee who refuses to fill that part of their job.

Daniel,

As a faithful Catholic, you must have gone to mass this morning and heard the first reading from 2 Maccabees 7 where they tried to force the Jewish guys to eat pork and they responded "We are ready to die rather than transgress the laws of our ancestors".

I immediately thought of this thread when I heard this reading.

Do people really think that holding a particular moral stance and acting along those beliefs should be easy or pain-free? Such things sometimes have consequences. These conflicts are inevitable in any society because not everyone shares the same moral views. Sometimes things don't fall the way you'd hoped. If you really have a strong moral belief, be prepared to accept that it can impose a cost *to you*. There are some professions or work out there that I simply will never do. If at any time I am asked to preform work I cannot do with a clear conscience, I am free at all times to walk away from that job. Tough beans... I'll get a job doing something else.

If someone thinks they will have a problem filling a prescription, perhaps he/she shouldn't get a job at a pharmacy.

I have a moral issue with killing cats and dogs. But I do not go out, get a job at the county animal shelter, and then expect to be exempted from that duty because of my morals. One should investigate a job before taking it on, and decide if it will fit with one's moral values. If not, find employment elsewhere.

Chris, Susan, I respectfully reject the Jewish ambulance driver as a morally equivalent comparison. Besides the superceding injunction concerning saving a life (one can well imagine, for example, an Jewish physician doing everything regardless of Shabbat to care for a heart attack victim, traffic accident injuries, or the like), the key here, for me, is the fact of voluntary association.

Consider the chronology I suggested in my post to Scrappy. The moral position is pre-existing. The pharmacist knows, for the sake of argument, that he will be called upon to dispense drugs that he finds offensive (sinful, fill in the term you want). When he knows that is the deciding factor. The post I wrote for Scrappy does attempt to cover the major scenarios.

If he knew at the start of pharmacy school that abortifacients (and equivalents) will be part of his training and job, he makes a voluntary association decision at that point to continue. When he takes a job at a pharmacy, if his moral position is that strong, he should ask about those drugs and, upon finding that he will in fact be called upon to dispense them, go looking elsewhere for employment.

The moral question is not to be decided at the counter facing a customer. The question is to be decided before that happens. The Jew training in EMS, knowing that he will be called upon to work during Shabbat, is faced with the same voluntary association decision. If he continues, he simply doesn't say anything when he finds himself scheduled to work on Shabbat, and certainly has no grounds to complain if, in Chris's example, he is asked to fill in because of unusual circumstances, but especially if his employer has already acted in good faith and adjusted the schedule to not make him work on Shabbat as a regular assignment.

In case it was missed in my previous posts: I fully oppose legislation that forces a business to engage in non-emergency services when the core issue is the convenience of the customer. Requiring pharmacies to carry Plan B is just as wrong as requiring that convenience store to carry and sell alcohol. It is not a reverse-monopoly situation. Customers have other options without the law.

"The State generally lacks authority to COMPEL people to sell things they do not wish to sell, for whatever reason. I have a right to buy alcohol (unless I live in a dry county), but a Baptist, Muslim or any other store owner who objected morally to alcohol consumption has no obligation to sell it to me."

But the Baptist etc. has no right to open a LIQUOR store and then refuse to sell alcohol. It is reasonable for a would-be liquor purchaser to presume that a place that advertises itself as a liquor store will sell liquor. Similarly, it is reasonable for a patient to presume that a place advertising itself as a pharmacy will sell all legal prescription meds. It may not keep all of them on hand all the time, for various practical reasons, but by holding itself out as a pharmacy, it makes a commitment to make all reasonable efforts within a reasonable time to obtain any legal prescription med the patient and doctor request.

And, BTW, yes there are a lot of pharmacies that don't carry some of the analgesic meds most popular with addicts, for practical reasons. But this IS grossly discriminatory against patients who live in bad neighborhoods and are suffering extreme and chronic pain. Some of us have actually been in this position, and though we currently have no legal protections, we bloody well ought to have.

But there is an effort in the religious right to restrict access to contraceptives and contraceptive information and, arguably, these "conscience clauses" are just the first line of the pro-life movement to reach beyond abortion into access to contraceptives generally. Dismantling R v. W, which is based on Griswold, then allows for attention to be paid at attacking Griswold and access to contraceptives. The battle over the FDA administrator illustrates the lengths religious conservatives influenced the Bush administration over contraceptives and Plan B, including distorting data and research. This is also the movement that influenced the naming of contraceptives opponent to head the agency in charge of family planning.

While Kuo and DiLulio may be right about the failure of faith-based initiative generally in the Bush administration, they would also acknowledge that religious conservatives have been influential in taking over much of the HHS infrastructure related to contraceptives and family planning.

DavidTC,

You're paranoid and delusional.

This from the Plan B website:

http://www.go2planb.com/ForConsumers/TakingPlanB/faqs.aspx#AL2

2. How does Plan B® work?
Plan B® contains a dose of the hormone levonorgestrel that is higher than in a single birth control pill. Levonorgestrel has been used in birth control pills for more than 35 years. Plan B® works like a birth control pill to prevent pregnancy mainly by stopping the release of an egg from the ovary. It is possible that Plan B® may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the uterus (womb), which usually occurs beginning 7 days after release of an egg from the ovary. Plan B® will not do anything to a fertilized egg already attached to the uterus. The pregnancy will continue.

Game over.

Scrappy,

"This is about the freedom of choice of individual pharmacists, remember?"

Freedom of choice can only by placed on one's self, not on others. Freedom of choice for a pharmacist would and should mean that if they believe taking a morning after pill is immoral, then they shouldn't take one. They HAVE that freedom

Meanwhile, their job is to dispense pharmaceuticals to other people. It is NOT to second guess those other people. It is NOT to judge other people's actions. It most definitely is NOT to make personal decisions for other people. They have TAKEN AWAY that freedom of choice for their customers.

Game on.

Scrappy, there are two possibilities: the objector has had the objectionable thing foisted upon him; the objector has taken the job with the intent to not sell the objectionable thing.

I grant the former pharmacist at least the benefit of the doubt. I want the latter pharmacist fired.

How does that sit with you?

Well, let's apply this to other fields.

Should a cashier who believes that alcohol is evil (no, doesn't work at a liquor store, but at a store that happens to sell liquor as well as other products) be able to refuse to sell it to customers?

Can a Scientologist who becomes a pharmacist, refuse to dispense psychiatric meds?

Can a Muslim cabbie refuse to transport people who are carrying alcoholic beverages among their baggage? Or a Muslim cashier in a store refuse to vendor pork products?

By the way, at least a few of the above have HAPPENED, so we aren't dealing with hypotheticals.

To what degree do are people allowed religious accomodations when it comes to intrinsic, and forseeable elements of their job?

By the way, yes, the STATE did say those cabbies HAD to transport customers as long as what was in their baggage was legal. Same goes for cashiers.

So, why exemptions for pharmacists, other than their qualms of conscience match your own? Are you willing to allow the same exemption for any religious or philosophical objections, in other professions?

Doctors who refuse to give blood transfusions because they are Jehovah's Witnesses, for instance?

I don't know. I mean, if I truly believed that selling, or even handling such things was evil, or threatened my eternal fate, I wouldn't put myself deliberately at risk to do so by being in a job where I would be required to. One of the prices I would be willing to pay in order to put my faith foremost.

Of course, I could also simply acknowledge other people have free will too, and not try to enforce that they follow my moral decisions.

"To what degree do are people allowed religious accomodations when it comes to intrinsic, and forseeable elements of their job?"

It should be complete, no one should be forced within a job to do anything against their religion. And now the other shoe drops: a company should be allowed to reassign or release someone who can not perform the position necessary if those requirements are there. A person gets to determine what job they take, this isn't the only job out there, there should not have to be compunction on either side. Using your example, would you find a Muslim or Hindu working in a butcher shop? This was a gut reaction and would be happy to reevaluate on the basis of additional insight.

"By the way, yes, the STATE did say those cabbies HAD to transport customers as long as what was in their baggage was legal. Same goes for cashiers."

I think we're confusing that the State isn't going to be right about everything. A cab driver should be allowed to refuse passage to a person. It is then up to the cab company to determine if the person's actions are acceptable to the company's policies. Those policies are to be in compliance with the law, and then to the company's best interests (namely, creating value). If the company determines that the cab driver's individual policy, much like poor driving or inappropriate language, is bad for business, why should they not be allowed to redirect or release the employee?

We talk about making exceptions within a framework for a person's religion...shouldn't the person's religion dictate that they can't do something?

Again, I'd be very happy to hear more about this.

KHC,

"It should be complete, no one should be forced within a job to do anything against their religion."

Hmm, I can't think of one religion that teaches it is "immoral" to dispense pharmaceuticals and medical devices. I know some religions that forbid a person using them (eg. birth control) but that reverts back to who's freedoms are (or are not) being abrogated. If a person, because of his/her beliefs, thinks using BC is "immoral", then that person should not use BC. They cannot, nor should they be allowed to, make that decision for other people.

"A cab driver should be allowed to refuse passage to a person."

Based on what, exactly? I think you answered it yourself with your words: "It is then up to the cab company to determine if the person's actions are acceptable to the company's policies. Those policies are to be in compliance with the law".

I don't think any cab company has a policy that forbids a passenger from carrying a bottle of alcohol or a package of pork. Such "policies" would definitely NOT be in compliance with the law.

"shouldn't the person's religion dictate that they can't do something?"

Absolutely - when it comes to their own actions (eg. USING BC). That person's religion cannot "dictate" what other people, specifically (but not limited to) people of OTHER religions. It is NOT against my religion to consume (or even carry) alcohol. No cab driver is ever going to tell me I can't. It's none of his business.