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BoF
QUOTE(Jack22 @ Apr 9 2005, 02:28 AM)
There are ample pharmacists who distribute RU486 (except where monopoly conditions exist as I noted in my post).


Let's try another approach. In the city where I live, there are a few independent pharmacies, but the market is dominated by chains like Walgreens, CVS and grocery chains like Kroger. Sam's and Walmart all have pharmacies. What the pharmacy carries is determined nationally, not by local stores. Additionally, not all pharmacies or on every insurance plan. Then there are people who get prescriptions through mail order houses like CareMark.

Why should an individual pharmacist not be required to distribute RU486 or other birth control prescriptions, if they are carried by their employer? Should someone mail in a prescription for birth control pills, only to get a call or letter from some right-wing zealot informing them that they even though they had the medication, they couldn't in good conscience fill the prescription? This has nothing to do with monopoly, but interference in the doctor/patient relationship.

I agree with kalabus:

QUOTE(kalabus)
My response is. IT'S YOUR JOB. Just shut up and fill the prescription which is legal. If you morally feel you cant then get a new job.
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Euromutt
QUOTE(BoF @ Apr 8 2005, 10:36 PM)
My opinion is that pharmacists should fill all prescriptions as written by a doctor.
Honestly, so do I. One issue I had with Doclotus' (should I use a genitive; "Docloti"?) post, which I did not bring up (but perhaps should have) earlier, was the following:
QUOTE(Doclotus @ Apr 8 2005, 09:18 PM)
I think the government has a compelling interest in regulating prescription drugs to the degree that pharmacists have the ability to distribute controlled substances and thus should be able to exercise judgement in the filling of prescriptions.
The flaw in this--as you allude, BoF--is that the basic authority to authorize the sale of prescription drugs to the consumer does not rest with pharmacists, but with physicians. The pharmacist may exercise his professional judgment to second-guess the physician if he thinks the physician has prescribed a drug which may endanger the patient's health, but let's face it, a pharmacist is nowhere near as qualified to assess a patient's health as a physician, and thus such judgement calls should really only occur if the prescription looks phony or if the medication in question has such drastic effects as to merit an extra degree of caution. And even then I'm inclined to think the pharmacist should get in touch with and confer with the physician, rather than refuse to fill the prescription outright.
CruisingRam
I think one question that has been sidestepped by Haleyanne is this- do pharmacists have a constitutional right to be pharmacists and dispense drugs?

My thoughts is they are ALLOWED to dispense drugs, so therefore, their conscious or moral issues have no bearing on their rights to be pharmacists- so therefore, there is no constitutional issue here at all.

A Dr or RN is ALLOWED to do thier job, granted to them by federal and state bodies. There is no constitutional right to be either.

But it is even more true with Pharmacists- they are ALLOWED to dispense dangerous drugs, and licensed by state and federal boards. Fail to meet the criteria of that licensure- and your license can be removed. Same with some behaviors that would be allowed under normal conditions for the "regular citizen" when it comes to behaviors of Drs or RNs, you can have your license pulled. You don't have a constitutional right to those jobs, and you don't even have a right to due process in those boards, except those that are granted by state and federal guidelines.
Doclotus
QUOTE(Euromutt @ Apr 9 2005, 01:08 AM)
QUOTE(Doclotus @ Apr 8 2005, 09:18 PM)
Frankly, I think the government should keep their noses out of it. Laws favoring either side are unnecessary extensions of power and would be protecting implied rights at best, non-existant at worst.

If that's your point of view, Doclotus, would it not be better in your opinion for the government to simply abolish the prescription requirement for BCPs, thereby making the question of the pharmacist's freedom of religion moot entirely, and removing an element of government intrusion into people's lives into the bargain?
*


Actually, I think that's an awesome idea! thumbsup.gif Though I will admit that I am unaware of exactly why this isn't currently the case. Many current BCP prescriptions have been around long enough to qualify for OTC status. I'm guessing it has to do with the fact that these drugs regulate hormones in the body and thus there may be some interest in at least minimal controls to protect people from themselves. Unlike Sudafed, I suppose a person wrongly taking this medication, even as directed, could cause some harm to their bodies. Though I'll admit to a complete lack of knowledge in pharmacology to even make this case.

If nothing else, I'd love to see someone introduce a bill to make BCP's available over the counter. The evangelical right would have an absolute conniption! w00t.gif

QUOTE(Euromutt @ Apr 9 2005, 01:08 AM)
QUOTE(Doclotus @ Apr 8 2005, 09:18 PM)
I think the government has a compelling interest in regulating prescription drugs to the degree that pharmacists have the ability to distribute controlled substances and thus should be able to exercise judgement in the filling of prescriptions.

The flaw in this--as you allude, BoF--is that the basic authority to authorize the sale of prescription drugs to the consumer does not rest with pharmacists, but with physicians. The pharmacist may exercise his professional judgment to second-guess the physician if he thinks the physician has prescribed a drug which may endanger the patient's health, but let's face it, a pharmacist is nowhere near as qualified to assess a patient's health as a physician, and thus such judgement calls should really only occur if the prescription looks phony or if the medication in question has such drastic effects as to merit an extra degree of caution. And even then I'm inclined to think the pharmacist should get in touch with and confer with the physician, rather than refuse to fill the prescription outright.

This isn't just a patient's health issue in this case, Euromutt. Its also about keeping a pharmacy from being a supply chain for narcotics. A patient may have been successful in soliciting a percoset prescription from 3 different doctors. If they are dumb enough to try and fill them all at one pharmacy, the pharmacist should have the grounds to reject their prescription. The physician acts as one check in this affair, the pharmacist provides a 2nd. Otherwise, what's the point of even having pharmacists. Why not make all drugs OTC and get rid of the middle man? The reason why is easily found on the internet if you'd like to venture to gain a prescription for viagra. tongue.gif

Doc
Mrs. Pigpen
QUOTE(Jack22 @ Apr 9 2005, 12:32 AM)
As far as I know, there aren't any laws that force all doctors to perform elective abortions-- until that happens, we shouldn't have any laws that force all pharmacists to distribute abortion pills.

Forcing pharmacists to distribute abortion pills would be a little like forcing Chick-fil-a (or any other business) to stay open on Sundays. It would be like forcing all bookstores to sell bibles, or forcing all women's clubs to recruit male members, or forcing all newsstands to sell pornography. Some groups are going to do those things on their own, and others are not-- in the interest of liberty, the government should usually stay out of it, but there are exceptions. Public health issues are an exception, but no one should be forced to deal out death against their will, if that is what they believe RU486 to be.
*



It's a small point, but one I keep correcting people on because this misconception continues in every thread about the ECP. I've taken the ECP (after a condom ripped in college)...I've certainly never taken the RU486! The ECP and RU486 are not the same. One is an abortificant, the other is NOT. I don't believe pharmacists even carry the RU486...if it's available anywhere, it would be in abortion clinics, because it would require careful monitoring. The ECP is used only to prevent implantation, for situations of rape or if the condom rips...and it has been available much longer than 1997 in this country (not sure where Euromutt obtained that date). I don't know when it became available, but my highschool health class mentioned it back in 1988. I'd hazard a guess that it's about as old as other oral contraceptives, since it is simply a higher dose birth control pill. Any pharmacist who has obtained his/her license in the past two or more decades would know about this pill.
Hugo
The opposition argument here is that pharmacists do not have the First Amendment right to practice their religion, nor do business owners have the natural right to utilize their possesions as they see fit. Of course individuals do have the right to force others to provide them with contaception drugs and devices. w00t.gif I wish I could say I was stunned.

Yep, pharmacists have their 1st Amendment rights providing they give up their jobs. I'm sorry that is putting a high price on pharmacists exercising their rights. The Bill of Rights ends at the workhouse doors, but that is only because an employer has rights the government does not have. There is no constitutional right to force others to provide for your needs.
Jack22
QUOTE(BoF @ Apr 9 2005, 03:54 AM)
Why should an individual pharmacist not be required to distribute RU486 or other birth control prescriptions, if they are carried by their employer?
*



QUOTE(Jack22)
If there is only one pharmacy in a town, a monopoly, the government can (and probably should) require that pharmacy to fill prescriptions no matter what-- if the owner of the pharmacy has a problem dealing with the added government regulation that comes from being a monopoly, the owner should sell the monopoly to someone who can meet the government's requirements in good conscience.

When there are mulitple pharmacies, then the owners of the pharmacies should set policies to serve the interest of public health, and if they object to certain medicines, so long as those prescriptions can be filled elsewhere in town, the pharmacy owner has the right not to sell anything she doesn't want to sell, especially when if they believe they would be violating "first do no harm."

Employees of pharmacies should be expected to either carry out the legal wishes of the pharmacy owner-- if the pharmacy cannot reasonably accomodate a pharmacist's conscience, then the pharmacy should be free to hire someone who can meet the job description.


QUOTE(BoF @ Apr 9 2005, 03:54 AM)
Should someone mail in a prescription for birth control pills, only to get a call or letter from some right-wing zealot informing them that they even though they had the medication, they couldn't in good conscience fill the prescription?


No. I missed the post where someone advocated such a thing. Why do you think what we have been discussing would inevitably result in that?

I make the assumption, perhaps wrongly, that any objecting pharmacists have disclosed their moral objections before being hired by the pharmacy, and that any large or chain pharmacy who hired such objectors and also did not mind distributing any prescription drug would have enough staff on hand to fill prescriptions by mail even if a few of their employees never handled certain kinds of prescriptions.

I know some grocery stores who don't mind hiring cashiers who have disclosed their objections to helping the store sell certain products-- the objectors just silently switch registers with another cashier, and there's almost never a problem. Other grocers might not want to hire people who objected to helping sell certain products, and they would be within their rights not to hire people unwilling to perform the job the employer wants them to do.

But forcing someone under penalty of law to act against their good conscience? Isn't there usually something anti-American about that?

QUOTE(BoF)
This has nothing to do with monopoly, but interference in the doctor/patient relationship.


A doctor prescribes medication, a patient gets medication. Somewhere in the middle, maybe a pharmacy is out of the drug and refers the order; maybe the guy who handles the controversial drugs fills the order instead of an objector; maybe the prescription gets referred from an objecting pharmacy to one that does not object to filling the order. None of that really matters in terms of the doctor/patient relationship. A doctor prescribes medicine, a patient gets it-- no interference happens, and no one is forced to violate their conscience-- a win-win situation-- except for those anti-religion zealots who want to force religious people to violate their consciences.

minor grammar edit
CruisingRam
QUOTE(Hugo @ Apr 9 2005, 05:53 PM)
The opposition argument here is that pharmacists do not have the First Amendment right to practice their religion, nor do business owners have the natural right to utilize their possesions as they see fit. Of course individuals do have the right to force others to provide them with contaception drugs and devices. w00t.gif  I wish I could say I was stunned.

Yep, pharmacists have their 1st Amendment rights providing they give up their jobs. I'm sorry that is putting a high price on pharmacists exercising their rights. The Bill of Rights ends at the workhouse doors, but that is only because an employer has rights the government does not have. There is no constitutional right to force others to provide for your needs.
*



You yourself have said "just because you exercise your right does not mean there shouldn't be any consequences for exercising that right" - and I believe it was about an employer firing an employee for exercising thier free speech right off the job- correct me if I am wrong, but this is a reversel of your former position, correct?

And you still have not answered this question: Does a pharmicist have an inalienable right to be a pharmicist, or is thier position a privileged one, ALLOWED by the goverment to provide drugs that are not over the counter to patients?
Euromutt
This is interesting: in the March 2005 issue of Perspectives on Sexual and Reproductive Health, there's an article on a survey conducted among pharmacists in South Dakota concerning ECPs. From the results:
QUOTE
Thirty-seven percent of all pharmacists did not understand its mechanism of action; 43% and 21%, respectively, incorrectly answered questions about the medication's link to birth defects and health risks. Only 5% correctly answered all three questions. Eighty-four percent of surveyed pharmacists believed that the medication should not be made available over the counter.
Emphasis in bold mine.

Wow... just, wow. So, that raises an additional dimension to this discussion, which is whether a moral stance should be respected even when there's rather a high likelihood that this stance is not based on full command of the facts.
CruisingRam
I keep making this point over and over- but I want to explain it correctly.

Hayleyanne assumes that somehow, a pharmicists job is some kind of right, or the completion of that job, or the performance of that job rather, has some rights involoved in it- and they do not.

Here is the deal- if all drugs were legal, like prior to the prohibition days, then an apocethary could carry and dispense whatever drugs they saw fit, the goverment had no say, or control, over the drugs, or thier quality. It was the credibility and reputation of the apocethary that made poeple go to that store to buy the drugs.

When the goverment made drugs illegal, such as morphine or cocaine, to the general public, they also set up a special class of medical personel, pharmicists. They have the unusual role of being legal drug dealers- so therefore, serve at the pleasure of federal law, and whatever guidelines and regulations trickle down to the local level from there.

So, a pharmicist has to just dispense whatever the Dr prescribes, as long as the Dr is not in error or in violation of those guidelines and regulatiobn, and has no right to do anything besides what is in those guidelines and regulations.

It is not a free market system, nor is the field open to anyone that wishes to sell drugs- so therefore, there can be no violation of constitutional rights of the pharmicist- because pharmicists serve at the pleasure of the goverment.
Google
Hugo
QUOTE(CruisingRam @ Apr 10 2005, 03:05 AM)
QUOTE(Hugo @ Apr 9 2005, 05:53 PM)
The opposition argument here is that pharmacists do not have the First Amendment right to practice their religion, nor do business owners have the natural right to utilize their possesions as they see fit. Of course individuals do have the right to force others to provide them with contaception drugs and devices. w00t.gif  I wish I could say I was stunned.

Yep, pharmacists have their 1st Amendment rights providing they give up their jobs. I'm sorry that is putting a high price on pharmacists exercising their rights. The Bill of Rights ends at the workhouse doors, but that is only because an employer has rights the government does not have. There is no constitutional right to force others to provide for your needs.
*



You yourself have said "just because you exercise your right does not mean there shouldn't be any consequences for exercising that right" - and I believe it was about an employer firing an employee for exercising thier free speech right off the job- correct me if I am wrong, but this is a reversel of your former position, correct?

And you still have not answered this question: Does a pharmicist have an inalienable right to be a pharmicist, or is thier position a privileged one, ALLOWED by the goverment to provide drugs that are not over the counter to patients?
*



I did not say there should be no consequences from the employer, or the public at large. The Bill of Rights is a restriction on government. The employer certainly has a right to fire the pharmacist. You can be fired for saying "My boss sucks". The government can't require you to lose your job for saying "Bush sucks". Understand that basic difference? The government requires pharmacists to be licensed. IMO, this is an unneccesary requirement. I do not know of any government imposed licensing requirement, on any profession, that interferes with a licensee's religious faith.

As I look at the bottom of the page I see four on-line pharmacies advertised. Aahh, the wonders of the free market!
CruisingRam
You ignore the very special status of pharmicists again though Hugo- they are not like any other profession- a rather artificle creation due to the act of making drugs illegal.
Hugo
Pharmacists have the same constitutional rights as every other American. Do they not? There is no compelling reason to deny rights of property, right to practice your religion and rights of association here. The government needs to stay out. Once again, 4 on-line pharmacies at the bottom of this page.
Lin731
QUOTE
Pharmacists have the same constitutional rights as every other American. Do they not? There is no compelling reason to deny rights of property, right to practice your religion and rights of association here. The government needs to stay out. Once again, 4 on-line pharmacies at the bottom of this page.


No one forced these folks to become pharmacists did they? Sure they have the right to practice their faith (that's why we have churches and our own homes and families) but in my opinion, their right to practice their faith ends when it infringes on MY rights to legally prescribed medication. Surely these pharmacists knew that some of the medications they'd be expected to dispense would be contraceptives? If they were unwilling to do the job they were hired to do, they should not have taken the job in the first place and if *I* owned the drug store in question, they'd be fired. Adhering to one's faith in your personal life is fine but when you attempt to impose your religious beliefs by denial of service (particularly healthcare related services) I believe you have crossed a line and are now infringing on the rights of others.
entspeak
(1) Should pharmacists have the right to refuse to fill a particular prescription if it goes against his religious beliefs?

Sure. But it doesn't give him the right to keep his job. If a pharmacist has moral issues regarding birth control, he should not work at a pharmacy where birth control is made available.

(2) Do you believe that a law that forces a pharmacist to fill every prescription regardless of religious beliefs would be unconstitutional?

Yes. An individual has the right not to be forced to do something that violates his religious belief. But with the recognition of that right, the individual has a responsibility not to put himself into a situation where he might be required, as a job requirement, to do something that might violate his religious belief. It is unreasonable, for instance, to accept that a devout Hindu would seek employment at a slaughterhouse and then refuse to slaughter the cows.
Hugo
(2) Do you believe that a law that forces a pharmacist to fill every prescription regardless of religious beliefs would be unconstitutional?

QUOTE
Yes.  An individual has the right not to be forced to do something that violates his religious belief.  But with the recognition of that right, the individual has a responsibility not to put himself into a situation where he might be required, as a job requirement, to do something that might violate his religious belief.  It is unreasonable, for instance, to accept that a devout Hindu would seek employment at a slaughterhouse and then refuse to slaughter the cows.

The employer of that potential Hindu slaughterhouse worker has the right to make that hiring decision. Certainly the potential slaughterhouse worker, just like the potential pharmacist, should let the employer know if that are parts of the job he cannot fulfill. If he fails to do this the employer should certainly have the right to fire the new hire.

Of course everyone is making the assumption that the individual comes to his religion first and then his occupation. Ever hear the term "born again". Many people find a faith when they are well into adulthood. Certainly if that faith leaves the individual unable to fulfill his job obligations he will suffer economically when his employer fires him. It is only the employer that has that right. A government should not rob a man of his career.

QUOTE
If they were unwilling to do the job they were hired to do, they should not have taken the job in the first place and if *I* owned the drug store in question, they'd be fired. Adhering to one's faith in your personal life is fine but when you attempt to impose your religious beliefs by denial of service (particularly healthcare related services) I believe you have crossed a line and are now infringing on the rights of others.


I do agree with you on one thing. I would fire a pharmacist that refused to fill prescriptions, based on his moral beliefs, too. I strongly oppose the "conscience clause" legislation.

However, other pharmacies may be willing to employ such pharmacist. That is their right. There are negative rights and positive rights. I'm not a big fan of positive rights. The "conscience clause" violates rights of property and rights of association. Forcing a pharmacy to sell any certain drug is violating rights of property and ,in some cases, First Amendment rights. Government should not have the power to tell a man he must choose between his career and his religion.
lederuvdapac
Lets try to compare this situation to another. Let's say that a US Armyman is ordered to do something that he feels is morally reprehensible. He does it anyway because he is ordered. But when the story breaks out...he is put on trial where the "iwas ordered" defense does not work as we all know.

Now let's say that he decided not to go through with the order. He would be discharged but we would all probably applaud him because he chose not to do something he felt was wrong.

Its basically the same situation...except some of us are rooting for a person to follow orders no matter how morally reprehensible the order may be.

What if it wasn't birth control? What if it was some prescription drug that the pharmacist thought would be harmful to the patient and decided not to give it?
BoF
QUOTE(lederuvdapac @ Apr 10 2005, 04:56 PM)
What if it wasn't birth control? What if it was some prescription drug that the pharmacist thought would be harmful to the patient and decided not to give it?


Leder,

Doctors write prescriptions and pharmacists fill them.giveup.gif It is already bad enough that insurance companies get between doctors and their patients, without pharmacists doing the same.

The only a couple times I think it would be appropriate for a pharmacist not to fill a prescription, is if the patient is doctor shopping and has multiple prescriptions for the same medication and the pharmacist is aware of the situation.

The second would be when a patient is already on another mediction that might interact adversly with a new one. I can see this happening if a patient goes to a doctor and forgets to tell the prescribing doctor about one or more of the medications they are already taking.

In the two situations all the pharmacist should, in my opinion, be able to do is put a hold on the medication until checking with the doctors involved.

BTW: Did you think about the possible legal ramifications a pharmacy or pharmacist might face if they denied filling a legal prescription and the patient ended up dead or in the hospital? No, not Leder. rolleyes.gif
CruisingRam
QUOTE(Hugo @ Apr 10 2005, 07:13 AM)
Pharmacists have the same constitutional rights as every other American. Do they not? There is no compelling reason to deny rights of property, right to practice your religion and rights of association here. The government needs to stay out. Once again, 4 on-line pharmacies at the bottom of this page.
*



Once again- you are ignoring the special class of health care worker that the pharmicist exists in- if it was the old days when all drugs were legal, therefore, any citizen in the United states could have access to any drug on the market as they saw fit- I would agree with you- but since those drugs are restricted BY THE STATE, then the pharmicist has no rights whatsoever to any conciense clause- exept to turn in his license to dispense meds and quit.
Hugo
QUOTE(CruisingRam @ Apr 10 2005, 07:58 PM)
QUOTE(Hugo @ Apr 10 2005, 07:13 AM)
Pharmacists have the same constitutional rights as every other American. Do they not? There is no compelling reason to deny rights of property, right to practice your religion and rights of association here. The government needs to stay out. Once again, 4 on-line pharmacies at the bottom of this page.
*



Once again- you are ignoring the special class of health care worker that the pharmicist exists in- if it was the old days when all drugs were legal, therefore, any citizen in the United states could have access to any drug on the market as they saw fit- I would agree with you- but since those drugs are restricted BY THE STATE, then the pharmicist has no rights whatsoever to any conciense clause- exept to turn in his license to dispense meds and quit.
*



I think we got the two questions confused. Currently the pharmacist who cannot in good conscience fill every prescription is not forced by most, if any, states to give up his license nor is he protected from being fired for his refusal to violate his moral code. I am the one supporting the status quo here. The free market has given greater access to all in the area of drug prescriptions. No need to go to your local pharmacist. There is no need for government to either force the pharmacist to give up his license or force an employer to keep the pharmacist employed. As usual the best solution is the no government solution. Something most true libertarians agree with

The fact a tyrannical government feels it must regulate, beyond safety, fraud and adulteration issues, what drugs adults choose to use (one exception is antibiotics, misuse of which can harm third parties) is not grounds for more government tyranny. Just because you chop off someone's arm does not justify cutting off his head.
Euromutt
QUOTE(Hugo @ Apr 10 2005, 02:12 PM)
Government should not have the power to tell a man he must choose between his career and his religion.
In this instance, this poses a conundrum, since the very existence of the pharmacist's trade is, to a large extent, the result of government regulation, namely that concerning controlled substances. Short of the government deregulating all currently controlled substances (thereby scrapping the "D" in "FDA") there is no way you can not have government involved in the pharmaceutical trade.

I've dredged up the old maxim about how one person's freedom to throw a punch stops where the nose of another person starts a few times now. Due to the existence of regulation of controlled substances, which forces a patient to go through a pharmacist in order to acquire prescription-only medications, the two parties find themselves, metaphorically speaking, in such restricted quarters that there is no way the pharmacist can throw a punch and avoid striking the patient's nose. Thus, lest the patient's freedom be violated, the pharmacist cannot be allowed to exercise his right to throw a punch at any time that he is in that room. If (he believes that) his religious beliefs demand that he swing his fist even while in such restricted quarters, he very simply cannot be permitted to stay in the room.

An individual who becomes a pharmacist does not possess constitutional rights in his role as a pharmacist. What he does as a private citizen in his own time, outside the workplace, is entirely his own affair, and your rather blatant straw man to the contrary, Hugo, I have not heard anyone argue otherwise. But the individual who becomes a pharmacist has chosen to enter a trade which is not merely subject to government regulation, but practically exists as an expression of government regulation. The pharmacy trade in effect owes its continued existence to the fact that the state obliges the patient/consumer to use the services of the pharmacy trade, and in return, the pharmacy trade has the obligation to render those services.

While it seems innocuous to permit individual pharmacists or pharmacies (or even entire chains of pharmacies like Wal-Mart's) to opt out of providing certain services , there are certain risks to this notion. Namely, it emphasizes the rights of the individual pharmacists/pharmacies without accepting the obligation of the trade as whole to provide the services which they, and only they, are licensed to perform. As a result, a situation might arise, say in a more socially conservative area, that every pharmacist/pharmacy in a given country, or even several contiguous counties, may refuse to fill a particular prescription, thereby placing an unreasonable burden on the patient in question. In the case of ECPs, which need to be taken within 72 hours to be effective, and preferably within 24, online pharmacies (which take time to deliver the order) are simply not an option. Thus, the local pharmacists have been given the power to collectively impose their religious views on other members of the community, and thus those other citizens' rights are placed in jeopardy. I find this an unacceptable notion.
Jack22
QUOTE(Euromutt @ Apr 10 2005, 10:09 PM)
As a result, a situation might arise, say in a more socially conservative area, that every pharmacist/pharmacy in a given country, or even several contiguous counties, may refuse to fill a particular prescription, thereby placing an unreasonable burden on the patient in question. In the case of ECPs, which need to be taken within 72 hours to be effective, and preferably within 24, online pharmacies (which take time to deliver the order) are simply not an option. Thus, the local pharmacists have been given the power to collectively impose their religious views on other members of the community, and thus those other citizens' rights are placed in jeopardy. I find this an unacceptable notion.
*



I am reminded of a similar situation here in Texas concerning "dry" counties. Beer runs can take two or three hours driving across several dry counties. The question becomes for such a worst-case scenario, how far can you drive in 24 to 72 hours? Is your right not to drive farther than you want more important than someone else's right not to violate their conscience?

The idea that allowing conscientious objectors in pharmacies to refer a prescription to another pharmacist or pharmacy would result in patients not getting medicine is just silly. The military allows conscientious objectors, and yet we still have an army. Pharmacies already refer prescriptions when they don't have a particular drug on hand, and it is almost never a problem. Grocery clerks who object to selling certain items switch registers without the customer even knowing why.

These end-of-the-world Chicken Little scenarios about patients not getting medicine as a result of an objecting pharmacist referring a prescription are not even worth considering-- if prescription referrals were the end of the world, we should make a law forbidding pharmacies from refering orders when they run low on stock, or forbidding grocery clerks from switching registers in order to avoid ringing up certain items. But those situations don't cause problems, and as a result, neither would allowing pharmacists or pharmacies to refer prescriptions on matters of conscience.

Allowing a pharmacist to refer a prescription currently never results in a patient not getting medicine, so the only reason I can think of for anyone to honestly oppose conscientious objection among pharmacists is if their real agenda is the atheo-fascist desire to force religious people to violate their consciences. The Chicken Little argument doesn't fly-- feel free to try another.
Christopher
atheo-fascist ??? blink.gif seriously? rolleyes.gif

So if a religious person should be able to deny a person their medication beccause of their beleifs should a medicine man be able to prescribe peyote, or a Rasta prescribe medicinal marijuana?

atheo-fascist laugh.gif

If the pharmacist owns his own place he can do what he wants, if he is an employee hopefully he gets fired although that up to the company's policies.
Julian
QUOTE(Jack22 @ Apr 11 2005, 05:47 AM)
Allowing a pharmacist to refer a prescription currently never results in a patient not getting medicine, so the only reason I can think of for anyone to honestly oppose conscientious objection among pharmacists is if their real agenda is the atheo-fascist desire to force religious people to violate their consciences. The Chicken Little argument doesn't fly-- feel free to try another.
*



Hmm. That's an interesting spin on this debate, given that it has only arisen because of the decisions taken by fundamentalist Christians (hardly anyone in the USA these days seems to convert to Anglicanism or to the other denominations that don't have problems with abortion, contraception, homosexuality, etc.) to impose their belief systems on other people by refusing to fill legally obtained and lawfully and medically accurate prescriptions. They do this not because of any potential harm that would be caused to their patients, but because of they own belief systems.

Atheists, like Jews, do not generally proselytise. They just don't usually like it when religious people attempt to impose their own belief-systems upon them - do not pretend that the refusal to fill prescriptions is a purely conscientious decision, since it is a decision that affects not only the pharmacist, but the patient too. Unlike doctors, there is no oath to "do no harm" for pharmacists.

Nobody has yet felt the need to call such people "Christo-fascists", so I can only assume that this is some kind of attempt to invoke Godwin's Law.
Euromutt
QUOTE(Jack22 @ Apr 10 2005, 08:47 PM)
I am reminded of a similar situation here in Texas concerning "dry" counties. Beer runs can take two or three hours driving across several dry counties.
For starters, I would point out that prescription medications and beer are two rather different things. Prescription drugs serve a valid medical purpose; beer merely serves a recreational purpose. In other words, you can do without beer, but you cannot necessarily do without prescription drugs. Moreover, in "dry" counties, the prohibition is at least based on an electoral mandate, rather than on a unilateral declaration of perhaps 0.1% of the population (a cursory study of numbers of licensed physicians on my part indicates that states tend to have approximately 1 pharmacist for every 1,000 inhabitants).
QUOTE(Jack22 @ Apr 10 2005, 08:47 PM)
The question becomes for such a worst-case scenario, how far can you drive in 24 to 72 hours?
What if the patient can't get the time it would take (to get that far before closing time) off work? What if the patient doesn't have a car or a driver's license?
QUOTE(Jack22 @ Apr 10 2005, 08:47 PM)
The military allows conscientious objectors, and yet we still have an army.
I've never heard of conscientious objector voluntarily enlisting in the armed forces, especially not an all-volunteer force like the American one. And once you have voluntarily enlisted in the armed forces, you're going to have to present an awfully convincing case if you want to prove you've developed conscientious objections since enlisting. Ask Jeremy Hinzman.
QUOTE(Jack22 @ Apr 10 2005, 08:47 PM)
Pharmacies already refer prescriptions when they don't have a particular drug on hand, and it is almost never a problem.
Well, of course not, because in this instance, the purpose of the referral is to provide the service pharmacies exist to provide, not to avoid providing it.

As I acknowledged in an earlier post, the scenario that all pharmacists in the country will refuse to sell a particular (type of) medication is supremely unlikely. However, my problem with it is not that it will happen, but that in the rush to pass "conscience clauses" in various jurisdictions, nobody is stopping to think of instituting safeguards to prevent it from occurring, especially in areas where pharmacies may be thin on the ground. There are already plenty of places where the only pharmacy in town is the local Wal-Mart, which already refuses to stock ECPs as a matter of company policy (ostensibly for economic reasons, but who are we kidding?).

Take this scenario as for instance, Jack: let's say, hypothetically speaking, that you live and work in a sparsely populated area, suffer from erectile dysfunction, and that your GP has prescribed Viagra or Cialis or somesuch. One lunch hour, you nip out to your usual pharmacy to get your prescription refilled, only to find that there's a substitute pharmacist on duty, who states that he is opposed to erection-inducing drugs on religious grounds, and therefore refuses to fill your script. However, from the goodness of his heart, he's willing to transfer the script to the nearest other pharmacy, which is in the next town over, an hour's drive away. You're no fool, so you call ahead to check that they will actually fill your script; the pharmacist you speak to says, yes, no problem, so you go ahead and have the script transferred. Unfortunately, you're due back at work, so you're going to have to postpone your trip to the other pharmacy until after work. By the time you get there, however, the pharmacist you spoke to at lunchtime is no longer on duty, and there is now another pharmacist, who demands that you provide proof of your being married before he deigns to fill your script. Somewhat annoyed by now, you tell him--not unreasonably--that you don't see why this is any of his business. He tells you that he is opposed to extramarital sex on religious grounds, and since erection inducing drugs serve one purpose only, he would like to see proof that you are married before he fills your script. You show him your wedding ring; he says that's not enough, and that he needs to see a marriage certificate. Which you do not have on you; it's at home, an hour's drive away. Exasperated, you point out that you do not intend to have sex with his mother, wife and/or any daughters he may happen to have, so why doesn't he mind his own damn business and fill your script? He continues to refuse, so you see yourself forced to declare this excursion a washout and ask him to transfer the script back to your own pharmacy. He refuses, again citing his religious beliefs, and lack of proof of your marital status.
If you tell me that, by this point, you're not inclined to tell the guy to go forth and multiply (though not in those exact words) and call the cops, I would say you'd be lying.

In actual fact, in one of the first cases which sparked this brouhaha, Neil Noesen not only refused to fill a script for BCPs, but refused to transfer it to another pharamacy, stating that he was opposed to artificial contraception on religious grounds. Now, I don't consider even vaguely acceptable behavior; by doing so, he forcibly imposed his own religious beliefs on the customer. Seeing as how you, Jack, have focused almost exclusively on how it isn't a problem to let pharmacies transfer scripts, I'm guessing that you don't want to go so far as to state that you find this acceptable either (but feel free to correct me if I'm wrong). The judge certainly thought Noesen's behavior was unacceptable. Assuming for the sake of the argument, Jack, that I have correctly divined your stance on this matter, it strikes me that we have then established that there are, in fact, limits to how far a pharmacist can go in exercising his religious "rights"; a pharmacist may reasonably be compelled to transfer the script, even if doing so were to "violate his conscience." And if we've gone that far (though I don't think it's exactly going far to expect someone to mind his own business and do his job), it's not taking it much further to expect a pharmacist to just belt up and fill the damn script himself. We're not talking forced conversions here, or prohibiting him from attending whatever church he wants, or keeping to whatever dietary requirements his religion demands; those would actually violate his freedom of religion. Some of us haven't forgotten the observation of Emilian Yaroslavsky (head of the Soviet League of Militant Atheists) that "religion is like a nail; the harder you pouint it, the deeper it embeds itself." But that's no reason to tolerate patients' rights being trampled.

It's interesting to note, incidentally, that for some strange reason, the "conscience clause" being proposed in Wisconsin (Senate Bill 21) in the wake of the Noesen affair only applies to religious objections to oral contraceptives. Strangely, its proponents don't seem to find it necessary to include any other types of medication, regardless of the possibility that anyone might have supposedly valid religious objections to dispensing those, including the aforementioned anti-erectile dysfunction drugs. Anybody want to tell me there isn't some rank hypocrisy at work here?
Moreover, Senate Bill 21 does not actually require the pharmacist's belief regarding the abortifacient properties of an oral contrceptive to be factually accurate, nor does it provide any guarantees to the patient that her prescription will actually be filled. This is one awful piece of legislation. If it passes, I think it would be excellent if every pharmacist in Madison refused to fill any prescription on the grounds they believe it might have abortifacient properties, even in men.

Oh, and by the way, I reported the "atheo-fascist" remark to the moderators. That was well out of order, if you ask me.
Amlord
The pharmacist's rights to religious freedoms do not end when they punch the clock in the morning. That right exists at all times and the government cannot take it away on a whim. Therefore, the government has no role in this, unless it is to protect the pharmacist's right to freedom of religion.

There is no right to convenient prescription medication. Therefore, the wild speculative calls of "what if this happened and then that" (each situation more unlikely than the last) is simply a distraction.

The pharmacy, as an employer, absolutely has the right (as I have maintained) to fire an employee who refuses to do his job. The government, however, cannot be in the business of forcing people to do things that are against their religious convictions.

Hugo
Let us look at the court ruling from Euromutt's link.

QUOTE
Baird ruled that Noesen "fell far short of satisfying the standard of care" included in the state code of ethics for pharmacists and had not "done enough" to ensure that Phiede had another way to refill the prescription, according to the Journal Sentinel. "(Noesen's) testimony gave the distinct impression that satisfying his own moral code was his only concern," Baird wrote. In addition to recommending a reprimand, Baird recommended that in order to retain his license Noesen should have to prepare written notices five days before beginning work at a pharmacy specifying which practices he will not perform and the steps he would take to ensure that customers have access to "necessary medications," according to the Journal Sentinel. Baird also recommended that Noesen be required to attend six hours of ethics education and pay court costs (Milwaukee Journal Sentinel, 2/28). The Pharmacy Examining Board is scheduled to meet in April to decide whether to implement Baird's recommendations, according to the AP/Las Vegas Sun


I pretty much agree with this court ruling. When Noeson failed to transfer the prescription he went too far. At that point he is confiscating another's property. As you see this judge is not ruling out Noeson could not decide not to fill the presciption. Just that any future employer knows what practices Noeson will refuse to perform and that a customer will be given a valid alternative to getting her prescription filled.

QUOTE
In other words, you can do without beer


That is blasphemy. I have reported this to the moderators.
BoF
QUOTE(Amlord @ Apr 11 2005, 09:11 AM)
The pharmacy, as an employer, absolutely has the right (as I have maintained) to fire an employee who refuses to do his job.  The government, however, cannot be in the business of forcing people to do things that are against their religious convictions.


QUOTE(Hugo @ Apr 10 2005, 04:12 PM)
I do agree with you on one thing. I would fire a pharmacist that refused to fill prescriptions, based on his moral beliefs, too. I strongly oppose the "conscience clause" legislation.


Hugo and Amlord may be correct. Estate of Thornton v Caldor in 1985 defines the issue of religious freedom in the workplace. Two Seventh Day Aventist cases--1986 and 1963 define the issue the religious freedom issue after separation from employment. The facts are different, but the issues seem, at least to me, to be similar. The court seemed to be saying in Thornton that allowing Sabbath considerations as an overriding factor in the workplace would establish a religion. On the other hand The Harper case in 1987 and Sherbert v. Verner 1963 indicate that religious liberty is denied by the state disqualifying the workers evolved from receiving unemployment benefits if they had been fired fo exercising religious beliefs.

Freedom of religion stops at the workplace door, but extends to the outside.

Estate of Thornton v. Caldor, Inc. (1986)

QUOTE
Upon Thornton’s informing his employer that he would no longer work his managerial job on Sunday’s he was transferred into a clerical position. The employer had rejected his offer to work in another non-supervisory role at a lower salary or to be transferred to a managerial position at a store that was closed on Sundays. Two days after being transferred, Thornton quit his job and filed a grievance. He based his challenge on a Connecticut law that stated that no employee could be forced to work on his Sabbath day.

The Court ruled 8-1 that Connecticut’s law was unconstitutional because it had a direct effect of advancing a particular religious practice.


http://religiousfreedom.lib.virginia.edu/c...hor_v_cald.html

Hobby v. Unemployment Appeals Commission (1987)
QUOTE
Appellant, a member of the Seventh-Day Adventist Church, was discharged by her South Carolina employer because she would not work on Saturday, the Sabbath Day of her faith. She was unable to obtain other employment because she would not work on Saturday, and she filed a claim for unemployment compensation benefits under the South Carolina Unemployment Compensation Act, which provides that a claimant is ineligible for benefits if he has failed, without good cause, to accept available suitable work when offered him. The State Commission denied appellant's application on the ground that she would not accept suitable work when offered, and its action was sustained by the State Supreme Court.

<snip>

The judgment of the South Carolina Supreme Court is reversed and the case is remanded for further proceedings not inconsistent with this opinion.



http://caselaw.lp.findlaw.com/cgi-bin/getc...l=480&invol=136


Sherbert v. Verner (1963)

QUOTE
After 2 1/2 years, appellant informed her employer that she was joining the Seventh-day Adventist Church and that, for religious reasons, she would no longer be able to work at the employer's jewelry store on her Sabbath. When she refused to work scheduled shifts on Friday evenings and Saturdays, she was discharged. She then filed a claim for unemployment compensation, which was denied by a claims examiner for "misconduct connected with [her] work" under the applicable Florida statute, and the Unemployment Appeals Commission (Appeals Commission) affirmed. The Florida Fifth District Court of Appeal affirmed the Appeals Commission's order.

<snip>

The judgment of the South Carolina Supreme Court is reversed and the case is remanded for further proceedings not inconsistent with this opinion.


http://caselaw.lp.findlaw.com/cgi-bin/getc...l=374&invol=398
irisfreamon
QUOTE(hayleyanne @ Apr 6 2005, 04:08 AM)
It seems that more and more I keep hearing about pharmacists who are refusing to dispense birth control or the more controversial morning after type pills.

States are taking different approaches.  Some are seeking to pass laws that would force a pharmacist to fill any valid prescription.  Others seek to pass laws that would provide a "conscience clause" exception for the pharmacist.


http://www.jsonline.com/news/state/mar05/307257.asp

My view is that the government cannot force someone to act against his religious or moral beliefs.  So I believe any LAW that would force a pharmacist to fill a script would be unconstitutional.  On the other hand, I do think a privately owned pharmacy should have the power to decide policy and if the employee does not follow such policy, he can be fired.

Question for Debate:

(1) Should pharmacists have the right to refuse to fill a particular prescription if it goes against his religious beliefs?

(2) Do you believe that a law that forces a pharmacist to fill every prescription regardless of religious beliefs would be unconstitutional?

*



Being the daughter of a pharmacist I have heard alot about this issue. Pharmacists should not be required to fill a prescription that goes against their religious and/or moral beliefs. I think that they should be required to put a sign up at the pharmacy that says something like, "Some of our pharmacists will not fill certain prescriptions. Please check before trying to fill a prescription." Or something like that. And a law that requires that they fill said prescriptions is grossly unconstitutional.
boogidboo

My personal opinion is morning after pills are immoral on few levels. Since this pharmaceutical debate resides almost entirely around contraceptives, then I agree with the right of a pharmacist to refuse to fill scripts. The only exception I see fit is in the possible case of rape, or related incidents. A solution for all those opposed to this idea is simply: Be more responsible with your sexual activity. I would hate to know that my religious and moral beliefs were being jeapordized because you are being irresponsible.
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