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Dispensing Morals

An increasing number of pharmacists around the country are refusing to fill prescriptions for birth-control and morning-after pills, saying that dispensing the medications violates their personal moral or religious beliefs.


"This is a very big issue that's just beginning to surface," said Steven Aden of the Christian Legal Society's Center for Law and Religious Freedom in Annandale, Va., which defends pharmacists.

"More and more pharmacists are becoming aware of their right to conscientiously refuse to pass objectionable medications across the counter. We are on the very front edge of a wave that's going to break not too far down the line."

And I'm sure more and more people are becoming aware of their right to tell their pharmacist they are no longer going to do business with them if this is the way they operate. But that's besides the point, isn't it?

I'm of the school that believes if you can't perform your job to the fullest, you don't belong in that job. Don't want to dispense legitimate prescriptions to women? Find another line of work. Or maybe open up a morally superior pharmacy that is bereft of things like birth control or anything else one finds morally repugnant. Give it a clever name. Open the door to only to those who follow your strict moral guidelines. State your biases right up front, like have a sign on the door that says "All who enter here must be pure of soul and live life according to the pharmacist's guidelines." And then just hope he's not one of those people who think that pain brings you closer to god, especially if you're looking for Vicodin or something of the sort.

"There are pharmacists who will only give birth-control pills to a woman if she's married. There are pharmacists who mistakenly believe contraception is a form of abortion and refuse to [dispense] it to anyone," said Adam Sonfield of the Alan Guttmacher Institute in New York, which tracks reproductive issues. "There are even cases of pharmacists holding prescriptions hostage, where they won't even transfer it to another pharmacy when time is of the essence."

I don't know about you, but I find that morally reprehensive. If your moral beliefs interfere with your ability to do your job correctly, find another line of work. To shove your beliefs down someone's throat to the point of interfering with their life is bordering on criminal.

Make a choice. Do you want to be a pharmacist or a priest?


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» SDLH from Plum Crazy
I've been a bit off my game this month. I think the trip to West Des Moines in early March started me off on a weird footing. I was unable to muster the energy to do much link-searching from a hotel room whilst exhausted. But I'm going to make up for t... [Read More]

» Drugs from Cake Eater Chronicles
Courtesy of Michele, we have a story about the increasing frequency of pharmacist refusals to fill prescriptions they have moral objections to. This could include any number of prescriptions, but for some strange reason seem to focus on birth control,... [Read More]


Faith-based pharmicists. Oh how I hope their daughters become pregnant. Actually, that's pretty mean.

The whole 'go shop elsewhere' is good in theory for quasi-urban settings. But if you live in Buttfark, Kentucky, and there are no other pharmicists, then you could be in a heap of trouble. Even worse, what if some of the local mouth-breathers decide to boycott the birth control dispensing guy in favour of the Jesus-loving guy? Politically motiviated pharmacies?

Wonder if they only dispense Viagra to married men.

next thing you know, pharmacists will start molesting altar boys...

wait, can i say that? feel free to delete this if you think it's too offensive...

Actually, it's nice to have a new excuse not to use a condom.

Just kidding.

And some out there wonder why there are still so many abortions...

They'd never call it "Faith-based Pharmacy"? They'd call it "Family Pharmacy" or "Community Family Pharmacy" or "Family Care Pharmacy", and stick a fish somewhere on the window?

Good luck to them - no, really. I'd wish them well as I departed elsewhere. So long as there is an elsewhere.

What I can never understand about this is the same people that don't want to be told where they can or can not display their religous beliefs want to stop others from practicing non-reproductive sex. "Don't tell me what to do, but I have to approve of your actions."

Not too far off from refusing service to those of other races. Disgusting really.

"There are even cases of pharmacists holding prescriptions hostage, where they won't even transfer it to another pharmacy when time is of the essence."

Okay, at this point it becomes criminal, up to that point who cares...

Faith makes a point that I'd prefer "the market" to take care of rather than legislation.

Note that there are no numbers discussed in this "movement" and that both sides of this issue interviewed have a vested interest (in other words, new donations) for making this mole hill into a mountain.

Birth control is not just used for contraception. There are many people out there that use it for other disorders and for regulation of their menstural cycles. If pharmicists continue to do this, it could be a problem for these individuals as well.

You are a godless heathen.

No. Let me try that again.
YOU...are a GAAAWDless HEEEathen!

I was thinking that exact same thing when I read the article earlier this morning. Don't want to fill perfectly legal prescriptions? Don't become a pharmacist. Since pharmacists have to be licensed by the state, I don't have a big issue with the state setting requirements for them to get/keep their licenses. Like having to fill any legal prescription. One exemption employers get from having to accommodate an employee's religious beliefs is if those beliefs would unduly interfere with the employer's business. Seems to me this is one of those cases.

Yeah...hate to educate those pharmacists but "the Pill" is also prescribed for other health issues. Things like, well, endometriosis and ovarian cancer....

The rethugs have declared war on women. Pure and simple.

They are the American version of the Taliban.

First of all, I really hate the phrase "rethugs" and I'll edit it out next time.

Also,I don't think they've declared a war on women. I think they have declared a war on all those who are "less" moral than them, in their pious eyes.

If they can't dispense the meds that they are paid to do, then they should find a new line of work.
They can be disgusted and judge people if they want to but it is not up to them to make a customer go somewhere else because they are opposed to the medication.
That is ridiculous.
Imagine being a cashier at a supermarket.
A really heavy woman comes through the line with 10 boxes of twinkies.
You live a healthy life and think they shouldn't eat those twinkies so you refuse to ring up her purchase.
You'd be fired on the spot.

Think about this in a different situation and you'll really see the absurdity. Can you imagine someone whose religion prohibits digging up the earth by artificial means getting a job working on a construction crew? Dispensing legal, prescribed drugs as directed by a doctor should absolutely be a requirement for obtaining and keeping a Pharmacists' license.

However, I don't believe that a bunch of pharmacists just suddenly got this idea on their own. What seems to be happening is that activists are contacting churches who have pharmacists as members are attempting to convince them to coerce the pharmacist into towing their dogmatic line. Being threatened with expulsion from one of the major social institutions in one's life is not an easy thing to handle, and I can halfway understand why some pharmacists would succumb to the pressure, even if their personal beliefs didn't compel them to deny prescribed medications.

The whole issue should be resolved by a modification or clarification of existing law to the effect that refusing to dispense legally prescribed drugs will result in forfeiture of one's pharmacist's license. Being a licensed pharmacist is NOT a religious right. However, I have no doubt that any effort to make that change in the law would result in more dire threats of retribution against anyone who dared to vote for it or speak out in its favor.

You know, it's been my observation that the people who are loudest about their faith and most interested in enforcing their beliefs on others usually fail miserably to live by those high standards in their own lives. I just have a really hard time believing that Jesus would see threatening doctors and pharmacists - or bloggers - as a good "Christian" thing to do.

I want more Jehovah's Witnesses morally opposed to blood transfusion to enter the cardiology track at medical schools. And Amish pimps.

geez jillian, no broadbrush personal attack there!

BTW..from the article
No one knows exactly how often that is happening, but cases have been reported across the country
Comeon, guys... is this an increase from 5 cases to 6? or from 500 to 1000? Is this truly a problem or just a "gotcha" with which to flog the usual suspects?

Obviously, these handful of cases need to refered to their local licensing boards and be subjected to discipline.

But this is different from the gal suing Costco over her "religious" piercings ... how?

jillian, can I assume you use the term "rethugs" as a small (or, what I believe: very, very, small) number of right wingers who feel this way or do you honestly believe this is a mainstream Republican view? If the case is the latter, there's no reason to discuss the issue any further; you're a lost cause.

If the case is the former, I seriously doubt this is a case of misogynistic behavior. After all, the only specific person that the newspaper quoted with this twisted set of values was a woman pharmacist. I'm sure these pharmacists would not allow condoms to be sold if they required a perscription.

The issue of whether an employer can enforce a dress code that is at odds with an employee’s religious beliefs was again recently addressed in Cloutier v. Costco Wholesale. In violation of Costco’s newly-revised dress code, a cashier came to work wearing an eyebrow ring. When asked by her supervisor to remove it, she refused and stated that wearing facial jewelry, which she had done for three and a half years at Costco, was a tenet of her religion. Specifically, she stated that she was part of the Church of Body Modification, a religion that espouses spiritual growth through the display of facial piercings and tattooing. Although the employee offered to cover her eyebrow ring with a band-aid, the store manager sent her home. Costco subsequently, reconsidered its position and informed the employee that she could return to work if she covered her eyebrow ring with a band aid or wore a transparent retainer, a less noticeable object that would prevent her piercing from healing and closing. The employee rejected both of Costco’s offers of accommodation and filed suit, alleging that Costco discriminated against her due to her religion.

Apples, oranges? Hell not even. At least oranges are fruit. Apples and stop signs, maybe. I don't see how they even relate.

You have a someone whose job it is to dispense prescription medication NOT giving someone their prescription medication because he doesn't like their lifestyle. This can cause medical and emotional problems for the personwho is supposed to be getting the prescription. I don't care if this happened ONCE in America. It shouldn't happen AT ALL. Ever. Do your job right or, you know, don't do it at all.


Federal Law title VII

An employer is required to reasonably accommodate the religious belief of an employee or prospective employee, unless doing so would impose an undue hardship.

Per state law, your mileage may vary

An employer is required to reasonably accommodate the religious belief of an employee or prospective employee, unless doing so would impose an undue hardship.

Doing so in a case like this would cause undue hardship to the person trying to obtain the prescription.


It's apple and oranges according to what they do, but not the motivation.

Fed law says the government is really held to strict standards on deciding what is/is not a sincerely held religious belief. Notice as the girl DID lose her job, it wasn't because her religious beliefs were bogus but because her employer demonstrated their REASONABLE accomodation of her beliefs.

All I'm saying is the burden in this situation is going to be upon the employer... in a big city where there are several pharmicists in one store it's going to be harder for the employer to prove "hardship" because they can just get Joe to fill the prescription and not Jan who has a religious objection.

I'm only trying to point out some inherent problems that comes with the attempt to balance employer needs with employee needs.

I could easily use, too, the lawsuit against Dell because they are charged with not giving prayer time to moslem employees.

"Reasonably accomodate?"

I don't know, but when your religion prevents you from doing the damned job you're paid to do, then there's some "undue hardship" to the organization.

Certainly, it can cause hardship to the person getting the prescription

but the customer has no standing in this case, where the employer does.

Yes, I think such people as these pharmacists are idiots in this respect and I think they are deserving of discipline, even firing.

But then, I'd give a lot more leeway to employers than the law does at present.


Excuse me, but when do pharmacies dispense birth control pills as their only drug?

The lone pharmacist in Blinknmissus, Montana WILL create a huge and easily proved hardship on his employer.

Not so at RiteAid in Los Angeles.

See, in this case I don't think it's a pharmacist saying "Gee, this goes against my strong religious beliefs and I cannot give you the prescription without feeling like I'm sinning." It's more like "You are doing a bad, bad thing, you whore and I'm going to try to make you live your life in accord with my beliefs. Heathen."

Maybe with a quiet "mwahahah" too.

in a big city where there are several pharmicists in one store it's going to be harder for the employer to prove "hardship" because they can just get Joe to fill the prescription and not Jan who has a religious objection.

But again, why be a pharmacist if you don't want to do your job? I'm not trying to be nasty, but this is what I want answered most. I've seen no good reason why anybody should be refused birth control or EC by their pharmacist.

If your job is to dispense prescriptions, refusing to dispense prescriptions would, I think, impose an undue hardship. Eyebrow piercings do not interfere with the stated job of a cashier, so, from that perspective, it doesn't cause an undue hardship. Not that the cashier won her lawsuit anyway. The court found that Costco's accommodation (covering it with a bandaid) was reasonable.

I'm 50 years old so I remember when condoms were ONLY purchased when someone marched up to the pharmacist and asked for them...and he could look over the counter at the sweating nervous 17 y/o guy and say "No."

I applaud that they are now hanging on display next to the pantyhose and shoe polish in the market aisles.

Our family doctor, GP, was a practicing Catholic. Wonderful doctor. But he would not write prescriptions for BC, even for married women including my mom. My mom still took us to him, but she saw another doctor in the practice for her bc.

Again...this is a balancing of issues here and it's not like this is something NEW!


And why would a Catholic become a medical doctor?

Should we have religious tests for these careers?


You're right as I said previously.

Costco won, but not because the girl's religious beliefs were found BOGUS.

Employers are precluded from questioning the sincerity of the religious beliefs of their employees.

Would you want to do it differently?

Our family doctor, GP, was a practicing Catholic. Wonderful doctor. But he would not write prescriptions for BC, even for married women including my mom. My mom still took us to him, but she saw another doctor in the practice for her bc.

I'd argue you're still missing the point. Not everybody is able to see another doctor. And still, the doctor wasn't doing his job.

As somebody else said, if a Jehovah's Witness is your doctor and doesn't want to give you a blood transfusion, you're screwed. Yes, you could conceivably go to a different doctor, but if he or she was the only doctor on call and this was an emergency...

Not to mention, not everybody lives in a big city with access to many different doctors. And with how big a mess insurance companies are these days...

A big reason I never went into veterinarian medicine was my squeamishness with putting down animals. So I was smart and stayed away. Now, if I had gone that route, then later whined when I was fired for not putting down an animal, I'd have nobody to blame but myself. Much like the pharmacists who were (I guess) fired who refusing to give out BC and EC.

If you don't do your job, you're fired. End of story. That's how it should be. No ifs ands or buts.

Should we have religious tests for these careers?

Darleen --

I don't think you should be disallowed from a profession based on your religion alone, no. BUT, if your beliefs interfere with your ability to do the job, then yes, it should be an issue.

Commandment 11:
You mustn't let anyone else sin if it is in your power to stop them... until they go to the CVS drug store across the street... f'ing heathens.

But you're assuming this gets limited to things like birth control pills. Fine, right now, that's the issue. But let's suppose, instead, that you get a Muslim pharmacist who, for religious reasons, refuses to dispense Iletin (a pork-based form of insulin) to a diabetic in an emergency. Even in a big city, if it's the middle of the night, this is a problem. Not all pharmacies are 24-hour pharmacies and those that are generally don't have more than one pharmacist on duty at 2 a.m.


as I said before, I think employers SHOULD be allowed to hire/fire as they see fit.

But that's not how the Law is written.

Even the article near the bottom admits there has to be a balancing of issues/needs.

This.is.not.new. And it's not some Xtian conspiracy either.

Would you want to do it differently?

No, of course not. I'm not suggesting at all that employers question the sincerity of their employees' religious beliefs. I'm suggesting that a pharmacist refusing to dispense prescriptions creates an undue hardship on a pharmacy. Just like a firm who has to meet a tight Friday night delivery schedule doesn't have to hire Orthodox Jews.

Lesley? From Michele's link:
The American Pharmacists Association recently reaffirmed its policy that pharmacists can refuse to fill prescriptions as long as they make sure customers can get their medications some other way.

The alternative system can include making sure another pharmacist is on duty who can take over or making sure another pharmacy nearby is willing to fill the prescription, said Susan Winckler, the association's vice president for policy and communications.

"The key is that it should be seamless and avoids a conflict between the pharmacist's right to step away and the patient's right to obtain their medication," she said.

I think this is much-ado-about very, very little.

I live in rural Pennsylvania (home address begins: Rural Route #nn). Party lines were still offered until about 3 years ago, ok?

Within 5 miles of my home I know of only two privately owned pharmacies. In that same radius there is a CVS, RiteAid, and Eckard, not to mention the 4 grocery stores with pharmacies inside (which may be considered 'privately owned', but not in this discussion).

With so many choices in a rural community, what are the odds that a person can't get their script filled?

And to answer Fed Law Title VII, how does that play in Right-to-work states, where anyone can be fired for any reason, at any time?

"The alternative system can include making sure another pharmacist is on duty who can take over or making sure another pharmacy nearby is willing to fill the prescription, said Susan Winckler, the association's vice president for policy and communications."

That's not really a fair alternative though if you're in a smaller town and your insurance provider/plan designates what pharmacy you have to get your prescriptions filled at in order for them to cover you to the maximum amount.

Also might encourage more ATM. Unintended consequences.


As I understand it (I'm not a employment lawyer) in RTW states you can still be fired for any reason that does NOT run afoul of Federal law (race, religion, etc).

Also might encourage more ATM.

ATM? Is this some sort of black market drugs thing?

I got the humorous mental image of somebody trying to get their meds from an ATM machine.


It's much more lewd than that. My apologies, I'm in a horrible mood today. I should probably ban myself.

It's much more lewd than that. My apologies, I'm in a horrible mood today. I should probably ban myself.

Oh, that. LOL. I thought about that for a second, then thought there might have been a nicer explanation. ;)


Yes, I read the entire article this morning before work. However, there are absolutely circumstances where that is not possible. Small towns. Late nights. If it can be worked out in a way that patients aren't affected, fine. But there are plenty of situations where that just won't be feasible.

Even in smaller areas where you might have a couple of pharmacies, it's possible that neither of them would want to dispense the prescription. What then? Who chooses which one gets the short straw? Do they alternate days? One day, pharmacist A gets to dispense "offensive" prescriptions, but the next day pharmacist B gets to do so? How does the market resolve this situation?


what then? I expect the APA to enforce their code.

But as it stands in other venues, Title VII is going to rule, unless you want to change the law.

The real question is: why is birth control still a prescription medication?"

Answers: politics, all the money for all those unnecessary checkups, and politics. And politics.

There's no need to change the law, and I have no desire to see it changed. The APA doesn't employ the pharmacists. I'm pretty certain that any pharmacy owner who wanted to argue that a refusal by an employee to dispense certain prescriptions on religious grounds was causing an undue hardship on his/her pharmacy would win that case under the current law. The pharmacy owner would be losing business as a result. Employers have to make reasonable accommodations. Losing business to a competitor goes beyond a reasonable accommodation. In fact, I wonder what the text of the statutes are in the 4 states that have laws explicitly allowing pharmacists to refuse to fill prescriptions that violate their beliefs. It occurs to me that if the law prohibits employers from firing such pharmacists, this might give them more rights than non-pharmacists in those states.

The point, to me, is that it shouldn't be possible to be state-certified to do a job you're unwilling to do. Whether or not these people get automatically fired is a separate issue, but once you intentionally and systematically violate the terms of your licensure, that licensure should be revoked.

For the pharmacists who are being actively coerced on this issue, the prospect of losing their licensure would provide a very strong defense to help them stand up to the people who trying to manipulate them.

I have a better idea. How about we explain to the Catholic Church, et al, how their fundamental perspective on birth control is based upon an inaccurate reading of the Bible? How about we show them that their dogmatic adherence to this principle is just plain stupid?

"I don't know about you, but I find that morally reprehensive. If your moral beliefs interfere with your ability to do your job correctly, find another line of work."


Sounds like a good rejoinder to a concentration camp guard having qualms about gassing the inmates.

Apparently, some pharmacists believe that my ovaries should slowly and painfully destroy themselves (from polycystic ovary syndrome, which the Pill controls) so that they can feel morally superior.

This is what I don't get- 40% of women take the Pill for medical reasons not related to contraception at some point in their lives. As much in favor as I am of standing up for one's principles, I still don't understand how pharmacists can justify assuming what the patient is taking the Pill for.


If those same ovaries became cancerous and the medicine you needed to fight the cancer made it impossible to keep your food down, it's too bad you couldn't take a widely available anti-nausea drug. After all, the dangerous side effects include potential weight gain and a fondness for reggae.

I wholly agree with you on that point too, jon. It's just separate from the point we're discussing. :)

I wonder if the "pharmacist" was wearing her mixed fabric lab coat or if she was working while menstruating? I wonder if, after refusing to do her job, she went to lunch during Red Lobster's shrimp fest?

I wonder.

add me to the list of women who take the bc pill not "just" for contraception (I went and got it, at age 16, with my mother's blessing - hell, she drove me to the doctor - because of a menstrual disorder).

I DO live in a small town.
It would be a headache if my pharmacist told me "you're not married, so I think it's evil for me to give you this." Still, I'd drive an hour to fill my 'script (or whatever it took) rather than deal every three months with some condescending jerk who wants to offer me a helping of his opinions along with the stuff I'm paying him to do.

Also: Isn't it possible to mail-order prescriptions, especially for things you take on a regular basis and know you will continue to take? I think I had a friend in college who was on meds for an anxiety disorder and she got them through the mail...That might be a way around the holier than thou pharmacists.

You could also get the Depi shot, as my gf has. Less hassle, and no period.

My Y chromosome just shook it's head at me.

That's Depo-Vera shot.

I don't think there's any point to trying to figure out all the possible repercussions of this, or the degree to which people may be harmed.

Pharmacology is not a religious endeavor. Anyone who wants to be licensed should have to agree up front to dispense legal medications as directed by a physician - period.


Do you think all Ob/Gyns should be required to (a) perform abortions or (b) refer women desiring said procedure to doctors who perform them?

Yes, of course there is a big difference between bc and abortion, but the professional dilemna is the same.

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