"We Are a Patients' Rights Pharmacy"

The latest front in the battle over reproductive rights is the controversy over so-called "conscience clauses" for pharmacists. As summarized by Ellen Goodman in today's WaPo, there are bills in twelve states that would establish the right of pharamacists to refuse to fill prescriptions for contraceptives as well as, presumably, any other medication they object to on moral or religious grounds.

My sympathies in this debate are strongly against the aggrieved pharmacists (1,600 of whom supposedly have joined an organization called Pharmacists for Life). For one thing, there is no scriptural basis for banning or discouraging contraception. Churches that forbid birth control do so, it appears, from a combination of two motives: (1) their misguided, inconsistently-applied belief that "artificial interference" with natural processes is illegitimate and destructive, and (2) their desire to control women's sexuality and punish those who transgress their (extremely narrow) rules of sexual behavior. The latter motive is, I think, less fully conscious but probably more powerful.

There's no sound comparison between the "Pharmacists for Life" and the other kinds of conscientious objectors they like to claim as forebears. Thoreau, Gandhi, King, and the antiwar protestors of the Vietnam era were battling against governmental acts that oppressed or killed people--unjust wars, imperialist rule, Jim Crow. The phastidious, phinicky pharmacists want to prevent women from exercising a right that harms and oppresses no one.

Furthermore, classic "civil disobedience" as first practiced by Thoreau and later developed in theory and practice by Gandhi and King insists on the willingness of the practitioner to accept punishment (however unfair) at the hands of government authorities. Part of the strategy of civil disobedience is the idea that the public will eventually be repulsed by the spectacle of thousands of individuals submitting peacefully to punishment that is manifestly unjust, and will consequently demand changes in government policy. This strategy actually worked, to varying degrees, in Gandhi's India and King's Deep South, and it probably helped shift US opinion against the war in Vietnam in the late 1960s and early 1970s.

By contrast, the pharmacists are demanding the right to follow their consciences without suffering any punishment--"conscience without consequence," as Goodman puts it. Not only is this attitude wimpy in comparison to that of the true apostles of civil disobedience, it hardly seems to fit the spirit of the New Testament, with its many willing (even eager) martyrs.

Having said all this, we're left with the question: How should progressives respond to this latest challenge?

I don't think that it makes sense for us to mount a counter-offensive on the legal front--for example, by pushing for laws that would force pharmacists to fill prescriptions they find offensive. This would create sympathetic victims for the anti-birth-control movement and lead to distracting made-for-TV spectacles (druggists in handcuffs, weeping supporters with placards, posturing Congressmen, etc. etc.).

Furthermore, since pharmacists are professionally and ethically required to screen prescriptions for errors and medical dangers, it would be very hard to craft a law that defines the pharmacist's responsibilities sufficiently narrowly and accurately. Medical professionals who are morally opposed to birth control would find it easy to claim that they are refusing to provide it on the grounds that it is "dangerous" to women's health. (Like most medications, birth control pills have side effects, which a zealot can readily exaggerate.) So a law requiring pharmacists to fill all legal prescriptions as written is probably not a good solution to the problem.

Instead, I think that pharmacists and drug stores that don't support the anti-birth-control movement (surely a large majority of the industry) ought to begin marketing themselves as customer-friendly, non-judgmental service providers. Perhaps they can band together and develop a shared description of their policies that could be posted in the window of every subscribing pharmacy--something like this:

WE ARE A PATIENTS' RIGHTS PHARMACY

Our pharmacists have pledged to fill every legal prescription presented by any customer, after screening it for medical errors and possible interactions with other medicines you may be taking. We repect the privacy of every customer and will NOT impose our personal moral, religious, or political views on you. Thank you for your patronage.

I suspect that millions of customers would find this message reassuring and attractive. Those who don't--those who want to have their personal choices vetted by the guy behind the drugstore counter--would be free to seek out their local busy-body pharmacist and bring him their business.