And they were singing…

(Or, Why I no longer feel guilty about shopping at Target.)

If you don’t want to hear my opinion on the so-called “conscience clause” debate, this is where to stop reading.

For those who aren’t familiar with the issue, a number of pharmacists have been agitating for the right to refuse to dispense birth control to women. There are stories from across the country of pharmacists actually doing so, and in some cases, refusing to refer women to another pharmacy that will.
Now, in the case of the pill, the delay as a woman tries to find a pharmacist willing to acknowledge that the prescribing doctor might possibly know what’s best for his/her patient might not be critical. But in the case of EC, aka the morning-after pill, every hour that goes by decreases the effectiveness.
Some states have passed legislation allowing pharmacists to refuse to dispense medication they have a moral objection to; others have gone the other direction and required pharmacists to dispense it or to have somebody else on duty who will dispense it. Also, many chains have passed policies on one side or the other. The ones allowing pharmacists to override the medical decisions of doctors have faced letters and other forms of protest from organizations and people who oppose the whole concept that people can selectively choose what parts of their job they will do.
Several months back, Target drew the ire of those groups and people because it defended the right of its employees to act on their religious beliefs under the federal civil rights act. Apparently since then, they have required all pharmacists in their stores to sign a pledge to either fill prescriptions or refer the person to somebody who will fill it.
A Missouri pharmacist refused and was fired. Good for Target!
Before anybody starts flaming me in comments, let me explain my thoughts.
I oppose the idea of a “conscience clause” on several levels.
The first is practical: If you don’t want to do a part of your job, maybe you should have chosen a different job. There are lots of things about being a reporter that repel people – long hours, low pay, covering fatal wrecks, being perennially on-call, having to talk to people in the midst of grief, etc. Don’t want to do these things? Don’t be a reporter. Some specific jobs in the business will allow you to avoid certain parts, but you can never guarantee that.
Likewise, anybody entering the pharmacy field knows they will have to dispense medications prescribed by doctors. If you aren’t willing to do it, maybe you should consider another profession. As an example, Catholic teaching opposes birth control in any form. Any Catholic entering the field of pharmacy does so knowing they will have to, at some point, dispense birth control. I know at least half a dozen Catholic pharmacists, here and at home, who basically acknowledge that yes, they do have to because it’s part of their job. If they weren’t willing to do it, they would have chosen another field.
Second, while pharmacists have to go through a great deal of training/education, they are not doctors. They do not examine people, they dispense medication. While they can be a crucial step in the process – such as seeing if prescriptions from multiple doctors might cause an adverse reaction when combined – they are not the ones who diagnose and decide on the best treatment. For a pharmacist to insist he/she knows better than a doctor is aggrandizing at best.
This feeds into my third point, which is that birth control pills, because they control hormones, are used to treat many ailments in women besides the original use of contraception. I know at least a couple of women besides myself in that boat – we’d all be worse off if a pharmacist decided to interfere with our doctors’ chosen treatment. (Fortunately, my coverage is shifting to encourage mail-order prescriptions this year, which means I won’t have to worry about this anymore. The area’s so conservative, I was getting nervous.)
Fourth, sex is not illegal, at least not as a general rule. It’s considered a crucial part in human relationships. And while I believe in taking responsibility for your actions, condoms break, rape happens and any form of birth control can fail. I once read that women are fertile for 30 years; they spend an average of five years trying to get pregnant and 25 years trying not to get pregnant.
Yes, many women want kids. But imagine that you’re 23, newly married and just starting out. You and your husband/SO want a family, but it’s not feasible now for economic and other reasons. Or imagine that your husband/SO carries a gene that causes cancer in infants who inherit it. Or imagine that you and your husband/SO have thought it out and decided you don’t want kids. Or imagine that you’ve already had several children and you’re diagnosed with a severe heart problem or other medical problem that makes having more children dangerous. Or just picture having older children and not being interested in having any more. And before anybody picks these apart as being unrealistic, I know people in all of these situations. They’re not abstract concepts; they’re people with faces and lives. Whether a pharmacist denies run-of-the-mill pills or EC, s/he is interfering with decisions couples have made for legitimate reasons without having any of the facts, not that said facts are any of his/her business.
Until our legislators step up to the plate and stop this ridiculous situation, we have to rely on companies. Let’s hope more of them are thinking the same way Target is.