An Illinois state court granted a preliminary injunction the other day in the case of two pharmacy owners who are trying to claim that no pharmacist in their stores has to dispense any form of emergency contraception, such as the so-called Plan B pill. (See link to news story at the end of this post.) Although not a final ruling, this decision does not bode well for those concerned about the rights of patients to obtain access to prescribed medication. A preliminary injunction is granted only when the court believes the party seeking the injunction is likely to prevail when the case goes to trial.
Claims of conscientious objection by health care professionals have proliferated in recent years. Pursuant to these claims, health care workers — nurses, pharmacists, technicians and others, not just physicians — demand the right to refuse to participate in any medical procedure to which they object, typically on religious grounds. For the most part, I believe these claims should be rejected.
The United States has long recognized conscientious objector status for those who are drafted into the military. For example, a Quaker cannot be forced to bear arms. But the situation of the pacifist Quaker cannot be compared to that of the pharmacist who wants to pick and choose what health care services she will provide. To begin, no one is forced to become a pharmacist or nurse. Unlike a conscripted Quaker, these individuals have chosen to place themselves in a situation where they may be required to provide services to which they object.
Moreover, not only have health care workers volunteered to provide services to the public, but many categories of health care workers also have successfully lobbied the State to grant them monopolistic privileges over these services. If you are not a pharmacist, you cannot dispense medication. "Conscientious" pharmacists want to exercise control over our access to health care and have the right to deny us health care when they see fit. Allowing a pharmacist to have exclusive control over the dispensing of medication while simultaneously retaining the right to deny medication to patients based on her personal religious beliefs is analogous to allowing critical military command positions to be staffed by Quakers and then leaving it to their discretion to decide, without penalty, whether their units will be deployed for combat.
In addition, the underlying premise of the argument for conscientious objection by health care workers is flawed. Their refusal is based on an alleged violation of their religious beliefs/personal integrity if they dispense drugs they find objectionable. Granted, a decision about whether to take a drug is a highly personal one, and should be left to the discretion of the individual. But pharmacists are not taking the pills; the patient is. Effectively, the objecting pharmacist wants to decide for others what treatment should be available. This exaggerated sense of personal responsibility for the decisions of others would lead to absurd consequences if workers in other areas could refuse to provide services on similar grounds: a librarian could refuse to stock books by noted atheists because she would be "complicit" in the immoral conduct of those who choose to read such books; a flight attendant could refuse to serve kosher meals on the plane because this constitutes "active cooperation" with anti-Christian beliefs; and Muslim taxicab drivers could refuse to transport passengers who are carrying alcohol.
Question: if a pharmacist has responsibility for my choice of medication, will she agree to pay for it?
Pharmacists who can decide if and when they will dispense drugs based on their religious beliefs are about as useful as an empty lab coat.