Monday, April 25, 2005

The elitist "Right to Conscience" campaign

The right wing conservatives (that is, the religious extremists) are pushing the state legislatures (including Texas) to allow pharmacists to refuse to fill prescriptions they morally object to. The main focus is to allow them to refuse to sell “Morning After” birth control drugs when the patient provides a valid prescription.

John Belisarius at The Emerging Democratic Majority has a lengthy discussion of the Elitism involved in this effort. The conscience clause may be reasonable for an MD, DO or Registered Nurse, but a pharmacist is not in such a critical position. He or she is really no different from a clerk selling cigarettes or alcohol to customers.

Pharmacists […]do not personally select medications, prescribe them or administer them. They dispense them in accordance with a doctor's instructions. Drug store pharmacists may have more specialized education and greater responsibilities then other retail salespeople, but when they package and sell a customer a product they personally consider ethically objectionable their individual moral involvement and responsibility - which is what we are talking about here -- is in absolutely no way greater or more direct then that of a ordinary convenience store cashier who sells condoms of which he or she morally disapproves or a supermarket, gas station or 7-11 cashier who sells cigarettes that he or she personally considers addictive and poisonous and therefore deeply immoral on ethical and religious grounds.

We license MD’s and DO’s to make the decisions regarding what medications a patient will take. We license Pharmacists to obtain or formulate, warehouse, package, dispense, and ensure the reliability of the medications the physicians have prescribed. That is a very technical and important job, but the pharmacist is NOT licensed to refuse the orders of a physician. The pharmacist is a member of the medical team and is not the leader. He can advise the physician, he can report a physician for malpractice, but he cannot countermand him.

One pharmacist refused to fill a prescription for a child's ritalin. A number have refused to fill prescriptions for birth control pills. A pharmacist in Denton, TX refused to fill a prescription for a day-after pill for a woman who had been raped.

I do tax returns for people through one of the larger chains. The refund anticipation loans cost up to 780% (annualized per year) for a loan that gets them the refund perhaps two or three weeks before the IRS would get it to them. I find such usury to be immoral. My choice is to perform the job or to quit. The customers came to get their taxes done, not to listen to me tell them how they are being ripped off (they are – big time.)

The pharmacists have the same choice I have. They can do their job – all of it – or they can quit and find other work if their morality won’t let them function as they are expected to. If they really want to make the decisions regarding what medications people will be prescribed, then they should go to Medical School and become physicians.

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