Your health vs. my conscience
Medical workers have a moral conscience like the rest of us. But consider this case:
A young woman, a University of Wisconsin-Stout student, on July 6, 2002, went to the Kmart in Menomonie [Wisconsin] to fill her prescription for birth control pills. Noesen asked if she intended to use the prescription for contraception. When she said she did, Noesen, a Roman Catholic, told her that filling it was against his religious beliefs. He refused to tell her how or where she could get the prescription filled. The woman took the prescription to a Wal-Mart Pharmacy, but when Noesen was called, he refused to transfer the prescription, later saying it would constitute participating in contraception.
In a separate case (apparently also in Wisconsin), a customer whose prescription for birth control was refused by an objecting pharmacist said that she was too traumatized by the incident to attempt to fill the prescription at another pharmacy. She said she subsequently became pregnant and had an abortion.
Should pharmacists have the right to refuse to dispense legally available drugs when doing so violates their strongly held religious or moral convictions? Does this right extend to all health professionals? The Bush Administration thought so: it sought to establish regulations that would cut off federal funding for “any state or local government, hospital, health plan, clinic or other entity that does not accommodate doctors, nurses, pharmacists and other employees who refuse to participate in care they find ethically, morally or religiously objectionable.” The Obama administration has since worked to rescind those regulations.
Obviously this is a difficult and complex array of moral issues, and we’d love to get your thoughts on it. To help get your ethical juices flowing, here is some food for thought:
1. If you are not inclined to grant pharmacists the right to refuse to fill birth control prescriptions, are you also not inclined to permit a doctor to refuse to assist in the suicide of a terminal cancer patient who is in tremendous pain and has only weeks to live (assuming for the sake of argument that this is legal)?
2. If you are inclined to grant pharmacists the right to refuse to fill birth control prescriptions, how do you square that with your (presumed) rejection of the right of a white health care professional to refuse to treat black customers/patients?
3. Does an anti-gun bookstore clerk have the right to refuse to sell “Guns & Ammo” to customer who wishes to buy it?
4. Assuming that conscientious objection to serving in the military when drafted ought to be permitted, is there a feature of the draft situation that is not present in the health care situation?
What do you think?
-Paul Kelleher
May 16th, 2009 at 6:35 pm
These cases look a lot to me like a mismatch between personal and institutional values. People go to a pharmacy expecting a consistent set of background moral assumptions; after all, it’s not “The Roman Catholic Pharmacy.” So, in the first place, pharmacies should be quite clear about what their employees are required and not required to be complicit in, and those who have objections can (presumably) find another place to work. (Or, if no such places spring up, such a pharmacist might consider that she’s simply in the wrong line of work, i.e. that the whole field operates on a different moral system, and that her choice of career makes about as much sense as a Christian Scientist going to medical school.) Likewise, individuals can choose a pharmacy whose principles are consistent with their own moral beliefs – and ones that employ pharmacists who are on board with that.
So basically, the problem goes away if you situate choice at the institutional level.
May 17th, 2009 at 2:26 pm
rnadler, are you OK then with situations in which the only pharmacy around is one that has employee and employer buy-in as an anti-contraception pharmacy? (The effectiveness of emergency contraception declines 50% in twelve hours; so a delay in access increases the likelihood of an unwanted pregnancy.)
If you are not OK with this, then your solution seems to fail. If you are OK with it, we still need to know why pharmacy policies will be allowed to be based upon some values (Catholic ones, say), but not others (White Pride ones, e.g.). This is not to say that these two perspectives are equally odious–they’re obviously not. But that doesn’t change the fact that we seem to need some criterion by which to rule some exclusionary policies as admissible and others as impermissible.