I'm having a hard time finding where the disagreement between left and right is in this case. If Pharmer Bob hates birth control pills or pimple cream so much that he refuses to sell the stuff, he'll be fired or lose business. If there was a law that said Pharmer Bob had to sell the stuff, he'd . . . what would he do? What would the law do to him that would be worse than getting fired or go OOB? Fine him a few dollars? Sheesh. We don't require doctors to perform abortions, do we? Or perform vasectomies or tie tubes?

Nick, this is a good post, but you are missing closing quotes on the font tags beginning with your first advertisement example, which butchers your HTML.

Jeeze, did I call you Nick? Sorry for the incredible insult, Mitch.

The issue I myself am having is that the laws that are being passed are protecting the pharmacist so that he/she cannot be punished for refusing to supply the perscription. In Illinois it was passed and called the "Conscience Clause." The governor stepped in to overrule.

Were it not for the legislature stepping in to protect Pharmer Bob, we would choose not to go to his establishment and let the chips fall. Eventually he would go out of business if it was his own pharmacy, or could be fired if he was an employee. the law that was passed protected him from the consequences of his action, and made us unable to apply market pressure.

Say you own a local bar. You have a fantastic barender named Freddy. One night, Freddy just misses being hit by a drunk driver, and realized that alchohol is bad and he can't serve it anymore. You would wish Freddy good luck, because you need a bartender who can serve your patrons. But the legislature has passed a law saying Freddy can't be let go just because he no longer wants to serve alchohol. What happens with Freddy?

"If Pharmer Bob hates birth control pills or pimple cream so much that he refuses to sell the stuff, he'll be fired or lose business. If there was a law that said Pharmer Bob had to sell the stuff, he'd . . . what would he do?"

In order to keep his conscience, he'd have to find another line of work.

"If Pharmer Bob hates birth control pills or pimple cream so much that he refuses to sell the stuff, he'll be fired or lose business. If there was a law that said Pharmer Bob had to sell the stuff, he'd . . . what would he do?"

In order to keep his conscience, he'd have to find another line of work.

Rew:

Whether the law required it or not, I'd move Freddy back to the kitchen, or have him do cleanup or spin records or run the pulltabs - one of the zillion other jobs in my bar besides bartender. He's a good employee, and you gotta look out for your people.

To address your analogy more directly, a bartender's line of work IS a bar's line of business (although, as I've shown, a little conservative ingenuity goes a long way), but BCP are a tiny fraction of the pharmacy's trade. Now, I'm not saying I'd appreciate a pharmacist doing this, but if Pharmo Phred didn't want to fill BCP, I'd send the BCP scrips to Polly Pillpusher, who is not just a BCP dealer but a client, and let Phred stick to arthritis and earache meds.

Also:

"the law that was passed protected him from the consequences of his action, and made us unable to apply market pressure."

Huh? The law required you to keep your scrips at the same pharmacy? Sounds more like single-payer healthcare than an ethics protection law. What facet of the law enjoined you from taking your business elsewhere, or complaining to management and getting a different pharmacist?

Was this a slip, or was this the near-universal lefty myopia about the market? Just curious...

:-)

From the tone of the previous messages, I'm going to assume that none of us finds it reasonable to compel a pharmacy to continue to employ a pharmacist that is unwilling to perform his assigned duties. I realize that there are such people, but find their position impossible to support and unworthy of rebuttal, at least in this forum.

Let's step back a bit from the moral/ethical swamp that is birth control/abortion; reasonable people can disagree as to the importance and propriety of these. I submit that there is no principled difference between allowing a pharamacist to refuse to fill a subscription for reasons I find important, reasons you find important, and reasons some third person finds important.

Let us postulate a person who feels that engineering a drug to interfere with the "life"cycle of a virus (say, for instance, a drug like Tamiflu) is an unwarranted interference with the "natural" world, and immoral. (I don't know of any such person and would find such a position risible, but not more risible than other opinions I see expressed every day. If you find that too far-fetched, postulate that the reason for refusing to sell the drug is that it was tested on "our animal friends".)

Let us further postulate that such a person is the only pharmacist on duty at one of many all-night pharmacies in a major metropolitan area during a flu outbreak -- the pharmacy that I first stop at to get this drug for my wife and child after the drug has been prescribed. While I wait in line only to find out that he is unwilling to dispense that drug, the few remaining doses available at other all-night pharmacies are sold. While I wait for a different pharmacist to show up for his shift or for the day-only pharmacies to open, the efficacy window for using the drug closes.

Note that this is really quite close to my actual experience last fall. In that case, the pharmacist was willing but the drug wasn't available and the efficacy window didn't close for a few hours after the day pharmacies opened, but it's not an especially long leap.

Now, we have a federal law that requires emergency rooms to treat every patient that comes through the doors, even if that patient is a known dead-beat, a murderous pedophile, or a former concentration camp guard. Protestations that every doctor, nurse, and janitor on staff has a moral objection to treating said patient avail nothing. The hospital has a legal requirement to provide treatment.

How can it be ethical to compel a doctor to treat in opposition to his morals, but not a pharmacist to fill a prescription in the same situation?

It may well be the case that neither is ethical; in fact I might be persuaded that that is the correct position. Were you to try to persuade me that holding a different view is entirely unreasonable, however, your success would be far from assured.

As I said, I think both you and Luke understate the difficulties of finding the one true path to the right answer.

My last post got eaten. I hope. Otherwise it will show up and I'll be annoyed becaue it was much better.

"The law required you to keep your scrips at the same pharmacy?"

The pharmacists are refusing to transfer percriptions to other pharmacies to be filled. They are alos lying to their patients, telling them there is no product there or that no one else is there that can fill it. You would need to go back to your Dr, which takes time, and find another pharmacy, if you can. And this is happening in small towns which do not have many options.

Also, you can't move Freddy to the kitchen. The clause says he gets to keep his job, so you cannot move him anywhere else, especially if it would involve loss of wages through pay decrease and/or tips.

Doug:

I admitted early on that I had no idea what the actual ethical guidelines for pharmacists are; if there's a hippocratic oath, or some sort of law analogous to the emergency room laws, then that's different. But bear in mind that emergency rooms have to treat people for emergencies, not cosmetic surgery (which is what most BCP prescriptions are for).

Again, I'm personally torn; I favor allowing people (within reason) to object conscientiously to things; I'd also be pissed enough to take my business elsewhere if it were applied to me.

Rew:

It's my bar. I make the decisions. I know, you lefties have trouble with that whole "private property" thing, but work with us here.

Mitch sez:

...if there's a hippocratic oath, or some sort of law analogous to the emergency room laws, then that's different.

Well, here's Minnesota Pharmacy Board Rule #6800.2250(c), unprofessional conduct:

"Refusing to compound and dispense prescriptions that may reasonably be expected to be compounded or dispensed in pharmacies by pharmacists, except as provided for in Minnesota Statutes, sections 145.414 and 145.42."

145.414 gives pharmacists the right to refuse to perform abortions (which would knock out Ru486, but not standard birth control), and 145.42 does the same.

In other words, the rules of professional conduct for pharmacists compels them to provide ordinary birth control under any rational reading of the rules--and Plan B under the most common interpretation of its effects.

I'm just a caveman, but I think you have to say that a pharmacist in Minnesota has a duty to provide birth control pills, until and unless the laws change.

"Rew:

It's my bar. I make the decisions. I know, you lefties have trouble with that whole "private property" thing, but work with us here."

Mitch:

I agree with you. You should make the decisions. If you owned the pharmacy that Pharmer Fred worked at, you are not allowed to move him to a different position, according to the Illinois Conscience Clause.

The government is telling the business owner what he can or can't do with his place of business in order to protect the pharmacist who is not dispensing the perscription.

I would think this was the one case where we are on the same side. The business owner should have the right to decide what to do with the employees of his/her establishment.

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