Morality Prescription 

Regulating who gets to play doctor

According to some members of the Idaho State Legislature, you and your physician cannot be trusted to make your own health-care decisions. And if these legislators have their way, it will be pharmacists, trained to dispense medication, instead of doctors, trained to determine which medications may save your life, who will have the final say.

In this most recent legislative session, David Ripley of Idaho Chooses Life, along with his sponsor, Iona Republican Rep. Tom Loertscher, pushed House Bill 216, a Pharmacist Refusal Bill. This shocking attack on personal choice and medical necessity would have codified a pharmacist's option to deny filling a prescription based on their "moral" objections.

What is additionally stunning about this infringement is that it would allow a pharmacist to refuse any medication that he or she felt conflicted about. For example, a pharmacist might have objections to filling antidepressants for religious reasons and could deny a customer access to those medications. Or a pharmacist could refuse to dispense hypodermic syringes to a diabetic ... simply because he had tattoos and looked "suspicious." Apparently, the Hippocratic oath of "do no harm" takes a back seat if a pharmacist feels uncomfortable. Or perhaps, the "do no harm" sentiment only applies to the pharmacists themselves. Imagine if every physician could be "protected" from treating patients whom they found morally objectionable.

The truth is that we know exactly what is being targeted by this misguided legislation, and that is, of course, birth control. Specifically, Ripley and other anti-choice advocates want to give pharmacists an "out" in case they don't want to dispense Plan B contraception. Plan B tends to be an easy target for this kind of legislation because it's so misunderstood. According to the U.S. Food and Drug Administration, Plan B, also commonly known as Emergency Contraception or EC, prevents ovulation or fertilization of an egg. Plan B cannot terminate a pregnancy if implantation of an egg has already occurred.

Anti-choice advocates would say that this, too, is an affront to "life." But they are not in step with public opinion. According to a national survey of Republicans and independent voters conducted in September and October 2008 on behalf of the National Women's Law Center and the YWCA, 51 percent were strongly in favor of legislation that requires pharmacies to ensure that patients get contraception at their pharmacy of choice, even if a particular pharmacist has a moral objection to contraceptives and refuses to provide it. That includes 42 percent of Republicans and 62 percent of independents. Regardless of public opinion, these activists for celibacy and moral superiority charge ahead.

And that is why we know that Ripley and friends will probably bring this bill back next year and in all likelihood will target it more specifically to something like EC. Because in times like these, we know that there is nothing quite so important as blocking a woman's access to birth control, except for some of the other pesky little problems facing Idaho and the United States right now: wars on two fronts, the mortgage crisis, job losses and a struggling economy. To these folks, those issues take a back seat to trying to control if and how you and I can access medications. I would call that misguided priorities--which is putting it mildly.

What's additionally shocking is that Idaho's Pharmacy Board is currently silent on pharmacist refusal, which means that there is already a gray area for a pharmacist to refuse to dispense any medication. According to the freedom of conscience policy that guides pharmacist conduct, "(1) No person shall be required to provide for any pharmaceutical care or drug that violates his or her conscience, [and] (2) No person shall be civilly, criminally or administratively liable for declining to dispense or distribute pharmaceutical care or a drug or drugs that violate his or her conscience." That's troubling enough. But when Ripley went before the Pharmacy Board to push for their support of his ill-conceived legislation, they did not sign up. And yet, he pursued it anyway. It appears that no one's choice makes any difference to this man and his organization's agenda ... even when it's allegedly on "behalf" of someone he feels needs to be protected.

In an article written on March 26, 2009, on the Idaho Chooses Life Web site, Ripley argues that "it is essential that we are able to trust the corner pharmacist to look out for us. The integrity of the profession is vital to all of us. We need it stocked with the best and brightest, men and women of the highest moral character. One day, your very life may depend upon that gentle lady behind the counter." I wholeheartedly agree. We must be able to trust that pharmacists don't try to play doctors or try to make health-care decisions for us. We must be able to have confidence in a pharmacist's dedication to providing care for a customer rather than using his or her personal ethics to determine who should and who should not get medical treatment.

Watch out for a repeat of this pharmacy refusal bill in the 2010 session. It may come wrapped up in a package of protecting pharmacists' moral and ethical objections, but it's really just a thinly veiled attack on our ability to count on medical professionals to do their jobs.

Donna Wade is the executive director of Idaho Women's Network.

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