Pharmacist Sue over Morning After Pill

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As the title says, a couple of pharmacists are suing the State of Washington over a regulation that requires them to sell the emergency contraception commonly referred to as "Plan B" or "The Morning After Pill".

Full story here.

The plaintiffs that own a grocery store that contains a pharmacy claim that their civil rights are being violated because they view the Morning After Pill as tantamount to abortion.

I find two things about this troubling:

1. I think it is quite galling that because a pharmacist has made a personal choice that use of the Morning After Pill is immoral, that they feel they can withhold the use of this product from people who have come to a different conclusion.

2. However, in the favor of the pharmacy, I was under the impression that the Morning After Pill was now sold over the counter - that there was no need to have a prescription. If that is true, could they just opt to not carry it? If the store owner felt that the use of aspirin was immoral couldn't they chose to not stock any aspirin on the shelves? Does the law specifically require all pharmacies to carry a sufficient stock of the Morning After Pill and sell to anyone over 18 who requests it?

The other thing I don't know is do you actually have to get the Morning After Pill from the pharmacist? In other words, is it not out on a shelf somewhere that you can just pick it up and buy it - is it only behind the pharmacy counter? If so, why? Isn't the idea of selling something over the counter that you don't need a perscription and thus don't need the pharmacist to prepare the prescription?

As an aside, and something that is completely off-topic, but another odd pharmacy policy, is that when I went to a local pharmacy to buy the second level of nicotine patches today, they needed to see my license before selling them to me. Now, I understand that there are probably idiot kids that would purchase the nicotine patches to see if they could get a buzz from them, and that it probably is illegal to sell any nicotine product to someone under the age of 18. Carding me would make sense if I looked like I was around 18 years old, but the thing is - I'm 33. Wierd.

 

Aldeth, if a pharmacy does not wish to sell a legal product it is my opinion that they should not be forced to sell it. There are other pharmacists the client can go to, so it is not as if the pharmacist is withholding anyting from a client. I mean, if a product is legal we don't forbid its sale (unless under exeptional circumstances), so why would we mandate it?

The only reason I can see they might have a problem is maintaining their license. If they are a "full fledged pharmacy" that means that they are expected to supply all drugs a fully stocked pharmacy must have. If they refuse to carry something, the owners of their franchise might have something to say about that, and so might the Pharmacists Guild. But given my stated position above, I don't think they should be forced to sell something they are morally opposed to if the same product can be purchased elsewhere.

 

Ordinarily I would agree with the pharmacist. The government has no business forcing someone to carry and sell a product. However, in this case I believe the government does have a valid point. Since pharmacies and pharmacists are licensed by the state that gives them the power to regulate them. From a public policy point it would be a disaster for consumers if pharmacies could pick and chose what they want to stock. Forget about the abortion issues involved here, but can you imagine the inconvenience and hassle if you had to go to multiple pharmacies to get medecine.

 

I would side with the state at this point. Mostly because in smaller communities the pharmacist could easily decide not to provide this product and making it practically unavailable to those who'd want it. It would not be a problem if these pills could be sold in some grocery store, since in that case competition would probably see to it that the pills would be available but in smaller communities there very often is only one pharmacist and no markets for further competition, in which case the pharmacist would be a position to enforce his view on the people.

 

Right wing legal activism. This is part of America's culture war. It has everything to do with the pro-life movement. It is all about 'fighting back' against legislation they want repealed. And now there are two poor pharmacists forced to sell an the morning-after pill! Horrors! Injustice! Immorality!

The attorney representing them is one Kristen Waggoner, of the law firm Ellis, Li & McKinstry. I googled the name and she showed up on the BBC, in an article of a case brought against gay marriage, representing 'Allies for Marriage and Children', where she is quoted saying that "today is a triumph for marriage". Indeed! That Ms. Waggoner graduated from Regent University, Pat Robertson's law school, shouldn't come as a too great a surprise. Client and attorney are as if made for each other. I do not think it is an accident they met. It was probably divine intervention.

Of course, for the two plaintiffs and probably their attorney the moral question is indeed acute — that however, doesn't make the case any less political. Expect more cases like that. These folks are just getting warmed up.

 

I agree with LKD on this. A privately owned business should not be forced to sell something they don't wish to. If the morning after pill goes against morality of the proprietor then he should have the right not to sell it. It's not like he's refusing to sell some medicine that can have life or death consequences for a customer.

 

It is a profound misconception that you here deal with solely a private property. It is that only among other things. A pharmacy is not just a privately owned business. It is state licensed to provide a specific service. That means it is not up to the proprietor to decide what he offers.

If the pharmacist in question doesn't like it, he can open up a gun store. If he doesn't like the gun store's licensing and sales requirements, he can open up a bakery, or a bar, and if he doesn't like hygiene standards for whatever reason, well, too bad.... he can go do something else.

These people attempt to attack the morning-after-pill, and more general birth control, by making the morning after pill unavailable simply by not offering it. When they get through with it, they have established the case that nobody is forced to offer it, and can then build on that, and start fun like harassing pharmacists to drop that pill (or any other medication for that) through intimidation and harassment, err, legitimate public protest - think about rabid activists with posters in front of shop windows. That of course is a grass roots campaign by concerned or enraged private citizens. Honi soit qui mal y pense.

 

Well, to take on the 'over the counter' tangent, the term is rather vague. Literally it just means "medicine that may be sold without a prescription"; whether this medicine is located in a 'self-serve' location, or behind the counter where the pharmacist has to serve the product to the customer (over the counter, naturally) is up to the pharmacy.

Often this decision on location is the value of the item - not just intrinsic price (they keep those pricey diabetic glucose meters away from sticky fingers ), but also usability of it for other purposes (pseudoephedrine is 'watched' due to being used in the manufacture of 'meth')

Up to now, even, *I* had always thought of a pharmacy's wares in three categories: prescription - under lock and key and needs a doctor's note for dispensing, 'over the counter' - similarly guarded for any of the above reasons, but you don't need the note, and 'general merchandise' like pain relievers, cough drops, bandages, antibiotic ointment, toothpaste, etc. that just sits on 'self-service' shelves. I now see the latter two categories are actually BOTH 'O.T.C.'

As for the deeper issue, I'd leave it up to the courts; I see the point of the plaintiffs in being forced to provide something they disagree with, but at the same time there is the risk of essentially a few people controlling the behaviour of many others who disagree with their...ethics? morals? through this. All in all, I'm on the fence, but I'm leaning towards the government...

(and, if you're interested in looking further on the 'OTC' issue, I got some research from here.)


EDIT: Okay, just noticed Aldeth's tangent on being carded at 33. I have to ask: did the dispenser appear to either be a straight woman or gay man? Maybe they were trying to flatter you?

But don't worry; perceived age is VERY subjective and vague - I never got carded for things I *should* have been when I was 'under age' (didn't do it often, but when I did, I guess I had the right 'mature' vibe) yet now that I'm a few years your elder (and my mustache and temples are getting a fair bit of 'salt and pepper' gray hairs) I get carded more often...but still infrequently.

I could even just be that the pharmacist takes the stance of 'If I have to card some people, I'm just gonna play it safe and card EVERYONE.'

 

Don't "these people" have the right follow their conscience as Americans? Frankly your argument borders on paranoia toward the dreaded right-wing evangelical crowd and their schemes to make abortion illegal. I hardly think that that pharmacists are a hard line bloc of anti-abortion activists aiming to make this drug difficult to obtain. In fact, most pharmacies in this country are large chain stores. All they care about is profit so they'll sell anything that can make them some money. So a few pharmacies don't carry the pill. So what? Is this really going to snowball into some great nationwide anti-abortion campaign by pharmacists? Opinions on abortion are far too varied in this country for that to happen. Can't the customer simply go to a store that carries the desired product?

As far as I know we still don't have government run healthcare in this country. It follows, then that pharmacies are not government entities hence they are run by private citiziens/corporations. Until there are actual government run pharmacies, the government has no business telling a private company what products they have to stock. If the company loses the customer because they don't carry the product he or she wants then that is the their decision. As I said before this is not a life or death issue (although if one is a pro-lifer I guess in one sense it is). You're not going to die if you don't take this pill like you might if you couldn't get your heart medicine or your insulun.

 

I can understand how people might see it in those terms, BTA, but I don't think it's about stopping others from getting the pill. They just don't want to be a part of it -- I see no effort here to make the pill illegal or harass legitimate users of the pill, but rather a statement of personal conviction. As others have noted, if they don't try to stop other people from selling it, I can't see it as the insidious assault on the rights of others that Rags implies it is. Surely they can get an exemption to having to carry the pill and life can go on as those who need it simply go elsewhere -- there will always be others willing to sell it, I don't see it being made illegal from this incident.

 

It involves a human life - and if you don't agree it does, you must notice that it does from the point of view of the pharmacist.

Suppose you believe it's wrong to use post-coital contraception because it prevents something which should naturally happen and also blocks a little something's way to the place where it would normally lodge and start its way to birth and normal life. Then someone else beliefs it's not wrong to cut that and he wants the means to do it from you. How do you feel?

 

Like going in to medicine or pharmaceuticals is probably not a good idea. That's how I'd feel, anyway. I'm not a butcher and have never waited tables at a steak house because of my moral beliefs. My wife decided that maybe she didn't want to be a microbiologist because of hers. Dispensing medications and advising the customer on safety issues is a pharmacist's job. As a vegan and an environmentalist, I have chosen to avoid several industries and have passed on more than a few opportunities that have come my way. I can't refuse to serve steak at a steakhouse because I'm vegan. I can't refuse to process industrial waste because I'm an environmentalist. But I can (and have) decide that maybe processing chemical waste or working in the service industry isn't for me.

 

BTA put it well,

In my country you won't get the most medication without prescription of a doctor. The pharmacist then only sells this drug to you. As far as this is concerned a pharmacist is nothing but a highly qualified storage clerk. His leeway in respect of what drug a customer uses is near to zero, he can counsel his customer on which sort of drug A to use, but that's it.

The idea that my pharmacist would one day start to tell me that he won't sell me some drugs because they are against his religious beliefs is scary. It is not his choice to make. It's between patient, doctor and nobody else.

LKD,

Sorry to say that, but you are naive. To get that pill banned is high on their list of 'to-do's for US conservatives. Such lawsuits only complement their legislative efforts. Such legal proposals will return with the same predictability as the next round of lawsuits in case this one's lost. It'll then be some other pharmacist in some other state.

[ August 02, 2007, 07:44: Message edited by: Ragusa ]

 

Lots of democrats want to do that already along with socializing medicine.

 

Monty

Because this way there is sufficient market influence to keep up service to a high standard, while guaranteeing a couple of things.

It is a compromise to ensure that dangerous medication doesn't get into the wrong hands and that a steady supply to customers is guaranteed, that qualified counseling is guaranteed, and of course that you don't have to deal with pharmacists unwilling to sell you medication they don't like, be it for religious reasons, or because they have exclusive contracts with just one or two producers.

 

I totally understand that from the point of view of this pharmacist it involves a human life. I futher understand that the pharmacist has every right to decide never to use this product herself. However, the reason I called it galling was because the pharmacist says it is against her civil rights if she is forced to sell this product. However, I think it is against the customer's rights to be denied access to this legal product.

That's probably the best reason I've heard yet. The pharmacist is only the person who supplies the drug to the end user. To suggest that pharmacists have some say in what drugs they are willing to provide places you on a slippery slope. If a medication has potential severe negative side effects (and there are several that do) does the pharmacist have the right to not carry those drugs either? If we allow this, could a pharmacist cite "personal reasons" as a legimate means of not carrying any particular type of drug?

While I agree that in a perfect situation market forces would allow a person access to this pill even if certain pharmacists didn't carry it. If you lived in New York City, for example, even if one particular pharmacy didn't carry it there's probably another pharmacy a few blocks down the street that does carry it. But, if you live in Nowhereville, Montana (and I mean to offense to anyone living in Montana - just picking a state that has a low population density), where the town you live in only has one pharmacy, and the next closest town is 70 miles away, well that's pretty damn inconvenient!

The solution, of course, is to require any state licensed pharmacy to stock a long list of drugs. I also agree with BTA and Drew that if you have a problem giving certain drugs to people, then you made a very poor career choice in becoming a pharmacist.

 

I've never said that the conservatives don't want to ban the morning after pill -- of course they do. But THIS case, while it may strengthen that argument slightly as a side effect, is not about that. I'll try and put it differently.

The pharmacists in question (as near as I can tell) are not saying "we don't think ANYONE should have the skill and we are trying to stop all people from getting their sinful fingers on it". What they seem to be saying is more along the lines of "WE, personally, do not want to sell this product." It's not a matter of judging their customers, it's a matter of being involved in something they feel is immoral. What other people do is not their business, and it doesn't look to me that they are trying to stick their noses into the business of others. They just don't want to be forced to do it personally.

Even if they are nothing but jumped up storage clerks (which I think most pharmacists would disagree with, they are highly trained professionals) they are still involved in the deliver of something they morally disagree with. Even if yoyu believe them to be fools for their religious beliefs, my understanding was that they do have freedom of conscience, and THIS case does not involved them forcing those views on others as they are not in any way stopping their clients from taking a trip down to the pharmacy owned by the Democrat down the street.

When they became pharmacists maybe 20 years ago, this was not something they likely foresaw, so I don't think that saying they made a poor career choice is a fair argument, although anyone going into the field NOW should consdier this sort of thing.

All of that said, I should mention that I am 100 in favor of the morning after pill and don't see it as a form of abortion (that might surprise people given my known conservative tendencies.)

 

It is a fair arguement. While over the counter sale of the Morning After Pill is a relatively new development, it has been available by prescription only - meaning you absolutely HAD to get it through a pharmacy - for years now.

A quick Google search gave me the following information:

The morning after pill was first developed in France in 1980, and has been legal in many European countries since 1988. The U.S. legalized considerably later, and it was impossible to get it legally - even by prescription - prior to 1994. The FDA first considered legalization in 1983. The FDA insisted on doing their own testing, which is why it was legalized here so much later than much of Europe.

Therefore, I think it is unrealistic to think that anyone attending school to become a pharmacist would have no idea about the Morning After Pill at the time of their education unless they were already out of school by 1983. So even people who have been pharmacists for 20 years should know about this. The use of the morning after pill may not have been on the public's radar screen much in the 1980s, but I cannot imagine people in the field wouldn't have heard about it.

Granted, there are practicing pharmacists would did go to school before 1980, so I'm willing to cut them some slack. However, I would think that the majority of pharmacists today went to school after 1983.