Conscience clauses coming to Carolina?

Robert P pointed me to a proposed bit of legislation that would permit not only physicians, but also pharmacists to refuse to participate in any medical procedure or dispensing medicine relating to abortion. This is what's known as a "conscience clause," because the refusal is on moral or religious grounds, rather than scientific.

What started this all was a pair of pharmacists in Illinois who were suspended by Walgreens for refusing to dispense Plan B because they believe (note that word) it is abortion.

The problem is that science doesn't back them up, and belief has nothing to do with fact. Plan B is two doses 0.75 mg of levonorgestrel taken 12 hours apart, within 72 hours of unprotected sex. It works by preventing a fertilized egg from implanting into the uterus. If the fertilized egg has already implanted into the uterus, Plan B will not work. Medical science defines pregnancy as beginning with the implantation of the fertilized egg, and abortion as the termination of pregnancy. Clearly, preventing implantation is not the same as abortion.

However, when "belief" trumps fact, when you "believe" that pregnancy is defined as egg meeting sperm, you get people like Pharmacists for Life. (Google them if you want; I'm not linking. They're quacks.)

In my opinion, as a pro-choice pharmacist, the woman has a right to obtain medical treatment. When Plan B was still rx-only, she had to 1) decide it was what she wanted, then 2) go to her physician, then 3) talk to the MD, then 4) get the prescription. She's already made the decision that she wants to use this medication, and her doctor agreed that it would be best for her. It's nothing but rank paternalism to suggest that a stranger, someone uninvolved with her personally and unaware of the circumstances, to decide that he (and it's usually HE) knows better.


Pharmacists who refuse to dispense any medication prescribed by

a physician should lose their license. Period.

If something like this happens, I can only hope that progressive pharmacists all across the state will

Stop filling Viagra prescriptions
Stop filling any prescriptions when the patient is a Republican

If we're going to have "conscience clauses" let's have them for everyone. Doing anything to help keep Republicans alive violates my religion.

My conscience clause proposal...

I object to fertility-inducing drugs. I could attempt to refuse to fill them, but I'd be canned faster than I could say "goddamned insurance companies!"

Of course, in my pharmacy, we only stock birth control and STD treatments. We've got Plan B, and we gave one out this morning.

Tricky issue, here.

Part of being a pharmacist is making sure the doctor didn't write for something that'll kill the patient. They do that, periodically. New Drug B alters the metabolism of Older Drug A, which results in toxicity. So we call the doc and let him know, then either document that he said to do it anyway or take a phone order for a different drug. And since MDs are so busy, it may take 2 hours or 2 days for him to get back to you. Or the doctor wrote for a dose that's way too high.

That's not for moral reasons, however. That's for, well, not killing the patient. Then there's the issue of forged prescriptions for narcotics... legally, we shouldn't fill them (except if you're involved in a sting; apparently the DEA/SBI like having more charges to throw at people, so getting them for illegal possession adds to the list.)

Not killing someone

I'd say that's a moral reason. :)

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

OTC Viagra trial

I heard on NPR this morning that there will be a trial allowing Viagra to be dispensed Over-The-Counter.

Let's take a guess at how many of the Pharmacists who oppose BIRTH CONTROL (which is what Plan B is) will invoke a "conscience clause" on an OTC drug to give erections to the over-the-hill crowd.

This is me (not) holding my breath.

Larry Kissell is MY Congressman

Such a bad idea.

There is a variety of patient populations who really shouldn't take it.

Of course, they'd object to HIV patients taking it.

There is no rhyme or reason to their "Convictions"

because you see, it's ok to to devalue the rights and freedoms of women when they are making decisions about their lives and their bodies. If, however, someone, say like a taxi-cab drive, has convictions, maybe religious and decide not to allow someone in their cab because that potential passenger has an article that is against the cab driver's religion....well then this is what they say...

Tolerating this practice will only tend to encourage and expand such exclusionary behavior.

And who are the biggest group of people with exclusionary behavior?????

No matter that patriotism is too often the refuge of scoundrels. Dissent, rebellion, and all-around hell-raising remain the true duty of patriots.

Progressive Discussions My Blog at The Pilot online

Back-door ban on abortion

I think this is just another example of the Republicans trying to take away reproductive rights one sliver at a time.

Where are the candidates?

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

Front-door ban on contraception

Let's never spread their incorrect meme.

Plan B is contraception. It prevents pregnancy.

If someone objects to Plan B, they object to contraception.

Perhaps we should amend the "conscience clause" to say if a Pharmacist refuses to sell Plan B they can no longer sell any form of contraception. That may wake up consumers and business owners alike to the hypocrisy of this issue.

Larry Kissell is MY Congressman

Their Bottom Line would not love it

These so-called Pharmacists for Life may think such an "out" is the greatest thing ever, but Pharmacy Owners would take a big hit.

The last I heard, something like 90% of all women currently use or have at some point used contraception. Are Pharmacies going to turn away 90% of their female (and who know what % of male) customers?

And how will all of these contraceptive-using Consumers respond if they are turned away?

From a business perspective, it would be disastrous. And we all know that in America, business trumps ideology every time. (Well, except with Chick-fil-A. )

Larry Kissell is MY Congressman


It is most definitely that.

Where will it all end?

Why can't others demand conscience clauses on equal protection grounds? Teachers who don't believe in evolution, judges who don't believe in divorce?

Elected Congressmen who don't believe in the Constitution?

OOPS, sorry. We already have that one...

To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only UNPATRIOTIC and servile, but it is morally treasonable to the American public.

Politicians are like diapers. They should be changed frequently, and for the same reasons.

Good one

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

I have heard

of patients refusing treatment.

I have never heard of doctors refusing to treat. Sounds like a great precedent.

Draft Brad Miller -- NC Sen ActBlue :::Petition

"Keep the Faith"

Your license carries responsibilities

And even restaurant owners and shopkeepers aren't allowed to discriminate based on race. Your argument really doesn't cut it for pharmacists. Abortificants can be lifesaving in specific situations. Refusal to prescribe abortificants could cause women to die(in situations where women were unable to get them in time from another source).

The proposed law should be killed before people are.


And the whole point of this exercise is that Plan B is not one.

As for RU-486, pharmacies don't carry it, because it's only permitted to be dispensed from registered medical clinics (like Planned Parenthood.)

At the risk of sound like one of THEM

...if I am in private business, taking no guvmint money at all, do I not have the right to choose what I sell and to whom?

Don't get me wrong, I find the idea of refusing to serve a population or fill a particular prescription repugnant - but if we're going with the Constitution, we've got to go with it. If I'm a private merchant, no one can force me to carry a certain type of merchandise. Once I start accepting government funds, all bets are off, but until then, your rights end at my nose, yes?

"Be the change you wish to see in the world." - Gandhi

How Many Pharmacies -

- take no govt. money?

Tricare, Medicare, Medicaid,...

Any major pharmacy that wants to hire pharmacists who sign this better have some staff on board that don't. People vote with their feet. Can't fill it? See ya.

Well, yeah.

Of course. I feel the same way. I certainly would vote with my feet. But I don't think I want blanket legislation saying that X has to carry Y. That's all.

C.Diane's explanation below makes it a lot less - or a lot more - black and white, actually.

"Be the change you wish to see in the world." - Gandhi

they shouldn't have to carry it...but,

they should be required to 1) be honest - ie: it's contraception not an abortifascient

and 2) be consistent - you're either for contraception or not....carry or don't carry it...but don't dictate which one you'll sell me

Consumers, business owners, pharmaceutical reps and prescribing doctors will sort it out from there.

Larry Kissell is MY Congressman

NC Board of Pharmacy

From the NC Board of Pharmacy Rules

(a) A pharmacist or device and medical equipment dispenser may refuse to fill or refill a prescription order, if, in his professional judgment, it would be harmful to the recipient, is not in the recipient’s best interest or if there is a question as to its validity.
(b) A pharmacist shall not fill or refill a prescription order if the pharmacist actually knows or reasonably should know that the order was issued without a physical examination of the patient and in the absence of a prior prescriber-patient relationship, unless:
(1) the prescription order was issued for the patient by a psychiatrist;
(2) the prescription order was issued for the patient after discussion of the patient status with a treating psychologist, therapist, or physician;
(3) the prescription order was ordered by a physician for flu vaccinations for groups of patients or members of the public;
(4) the prescription order was for prophylactic purposes, such as the ordering of antibiotics by a pediatrician for members of a child's family when the child has a positive strep test;
(5) the prescription order was an emergency order for medication related to pregnancy prevention; and
(6) the prescription order was an order for medications to be taken by groups traveling to foreign countries.

Emphasis added. Technically that last "and" should probably be "or". The phrase "not in the recipient’s best interest" seems wide open to interpretation though.

Sort of what I was getting at to Ang above.

That section means that it's OK to dispense without a physical exam, under those conditions. So, essentially, a woman could call her doc, tell her story, and get a prescription for EC without having to get an exam.

What it basically says is Doctor X can't write for Patient Y unless Patient Y has been seen in his office before and has had a physical examination.

Pharmacy law is really weird. I think I couldn't pass the exam now if I had to.

The ambiguity in (b) is a problem

Doctors should and do prescribe meds in certain situations for ongoing patients that have not been to the office immediately before prescription for a specific complaint.

Not getting it.

The list of situations in (b) is a list of situations in which the doctor DOES NOT have to have seen the patient. A shrink, for example, doesn't do a physical exam, like, ever, but they can still prescribe antidepressants and call in refills.

Always hard to figure out where rights begin & end

I guess decisions of conscience do not include the Iraq War. A law of conscience does not protect soldiers. I would guess that many in this forum would support refusal to serve in Iraq on moral grounds, but not refusal to sell "Plan B" on moral grounds.
I am not able to tell clearly where one person's rights begin and end on this issue. I can see that refusal to sell may violate a woman's rights while selling may violate the Pharmacist's rights.


~ v e r e l s e

~ v e r e l s e

Look at it this way

If a man or woman refuses to serve as a soldier he or she is making a decision about his/her own life, when a pharmacist chooses not to serve a woman with a perscription he or she is making a decision about someone else's life.

Vote Democratic! The ass you save may be your own.


You shouldn't become a Pharmacist if you don't believe in dispensing pharmaceuticals just like you shouldn't join the armed forces if you don't believe in shooting people.

Larry Kissell is MY Congressman

I don't think the pharmacist has any rights

not in a technical sense about deciding moral issues. They are licensed by the state to perform certain responsibilities for the common good. If they don't want to prescribe legal medicine because of their belief system, they should find another job.

Southern Dem answers the other part of the question perfectly.