Across the nation, patients and pharmacists are increasingly butting heads over the filling of prescriptions for contraceptives and "morning after" pills. Some pharmacists object to filling such prescriptions on religious, moral, or ethical grounds. State governments have now entered the fray, producing legislation aimed at protecting either the pharmacist's right of refusal or the patient's "right" to have a prescription filled. In a truly free society, such legislation would be unwarranted; women would be free to choose to use contraceptives and pharmacists would be free to dispense the medications they choose.
Four states – Arkansas, Georgia, Mississippi, and South Dakota – currently have "conscience clauses" that protect the rights of pharmacists to refuse to fill prescriptions on moral or religious grounds. At least eight other states are considering similar legislation. Five states, however, have legislation pending that would make it illegal for pharmacists to refuse to fill prescriptions for ethical reasons, and two such bills – S. 809 and H.R. 1652 – are pending in Congress.
California currently has two similar anti-refusal bills pending, SB 644 and AB 121. SB 644 would allow pharmacists to refuse to dispense medication for moral or religious reasons only if they had previously presented their employers with written notification of their decision and the employer could "provide a reasonable accommodation of the pharmacist's objection" by ensuring that the patient can get the prescription from another pharmacist or pharmacy without too much trouble. Heaven forbid we inconvenience the patient to uphold the pharmacist's right to freely express his religion or conscience! The provision that pharmacists may invoke their right of refusal only if they (or their employers) can make alternative arrangements for the patient comes as little consolation to conscientious objectors. For pharmacists who consider the morning-after pill, for example, to be a form of abortion and do not wish to take part in the ending of an innocent life, this is akin to forcing them to say, "I'm not going to help you kill your baby, but I can give you the name of a guy down the street who will."
The second bill, AB 121, originally would have made it illegal for pharmacists to refuse to fill prescriptions for any reasons, though thankfully it was amended to at least allow pharmacists the modicum of rights contained in SB 644. AB 121 would additionally make it illegal to fire, or refuse to hire, a pharmacist based on his or her beliefs with regard to dispensing contraceptives. The bill would thus trample not only on the right of pharmacists to decide what medications to dispense (and what not to) but also on the right of employers to set their own business practices and decide what to sell or not sell.
One of the problems (among many) of occupational licensing is that it invites this politicization of personal beliefs and decisions. While the growth of stores like Wal-Mart has offered people increasing levels of convenience over the years, let us not forget that this added convenience is merely a byproduct and benefit of the free market, not a right.
Consumers do not have an inherent right to any particular product at any particular store. Should a store be forced to sell books or music or other products that the proprietor deems "objectionable" if a significant interest group can amass the political support to oppose his decision? Imagine the uproar if all large retail stores were forced by governmental action to sell guns. After all, we do have the right to bear arms. Using the logic of the anti-refusal crowd, stores (and their employees) who refuse to sell guns should be castigated for "discriminating against gun owners." Of course, guns are currently out of vogue on the political scene and contraceptives are not.
It is as convenient as ever for women to obtain contraceptives. Telephone and Internet mail orders, 24-hour pharmacies, and a rapidly expanding network of superstores containing pharmacies have all expanded consumers' options for birth control. In case this is not enough, many doctors write "just in case" prescriptions for the morning-after pill, giving patients ample time to obtain the pills – or locate a pharmacy/pharmacist that will fill the prescription for them in the future.
There is obviously a large market for contraceptives. The aforementioned objections to infringements on the rights of pharmacists and employers notwithstanding, the free market provides strong incentives (i.e., the profit motive) for businesses to satisfy consumers' demands. Thus, pharmacies tend to adopt policies to ensure that patients' prescriptions are filled, such as making available another pharmacist who does not object to filling the prescriptions or providing referrals to nearby pharmacies. Those that choose not to, however, should not be forced to do so.
"Pro choice" is a two-way street. Women are free to choose to use birth control and pharmacists (or doctors, for that matter) are free to choose whether or not to supply the medication. Likewise, businesses are free to set their own policies and business practices. Employers should be free to choose to sell or not sell products and to employ people who will adhere to their policies. Consumers and pharmacists who disagree with these policies are free to boycott or otherwise peacefully protest the employer's decisions. In a free society, all parties would be allowed to exercise their beliefs. The wonder of the free market is that it allows them to do so while also ensuring that consumers' demands will be satisfied – without government interference.
The Founding Fathers were rightly concerned about of the tyranny of the majority. Let us not discard the rights to freely pursue one's livelihood on his or her own terms and act in accordance with one's moral or religious beliefs because a temporary majority finds these rights inconvenient.
July 13, 2005
