Why Plan B is wrong

Should doctors be made to perform abortions?

"Undermines attempts to turn America in contraceptive-free Utopia that is Africa"

BlahahahahahahhhahHHAA..

Anyone want to take bets on where Stein's question is leading?

That last comment about parents not wanting children is hilarious and also hits a home run on the core issue.

Gee, Stein, I don't know. Do you think pharmacists should have to do their fucking job? Because I do. And if pharmacists REFUSE to do their fucking job, they should find another job. That's another great thing about Plan B going over the counter: No one between the woman and the medication to stand in flawed moral judgment. The real question, Stein, is do you PREFER that doctors perform more abortions? Because barriers to abortion-limiting options like Plan-B are a guarantee that more abortions will be performed.

Should doctors be made to perform abortions?

...HUH?...

Should PIGMIES be allowed to date DWARVES?

Should policemen be made to make arrests?

Qualified doctors who go into reproductive medicine and work in women's health clinics should willingly do abortions for their patients. I am totally against forcing my orthopedist to do abortions.

"I am totally against forcing my orthopedist to do abortions."

For the win!

Is there a male version of Plan C? Just asking.

One of these days, I'm going to become a Christian Scientist, and get a job as a pharmacist. Then I can refuse to dispense every single prescription that people ask for. I'll et paid for sitting behind the counter, and, if I choose well, my employer will be amongst the huge crowds of people insisting on my right not to do the job I'm paid for.

Now, can someone remind me why I'm not already doing this?

Only prob with forcing doctors to do abortions is that wielding a coat hanger will become a lost art.

I'm so glad PYGMIES and DWARVES has made a comeback.

One of these days, I'm going to become a Christian Scientist, and get a job as a pharmacist.

I've had that same thought, but as a doctor instead of a pharmacist. You could refuse to prescribe antibiotics, give blood transfusions, or even do surgery.

I think Bitch, PhD has a great idea for promoting awareness:

http://www.goodstorm.com/stores/bitchphd

Now I just need to convince Hubby to buy me one for a (very) early Xmas present ...

Stein, I can't match PZ for wit, but doctors who treat women as family docs, as emregency room docs, and as OB/GYNs should absolutely be trained in performing D & Cs, one of the most common procedures performed on women. If they prefer not to perform abortions then they should avoid any of the specialties which might require it. To let doctors skip D & Cs as part of their training, because of moral qualms about abortions, should be considered medical malpractice.

Wait. It'll take up Twix space?? SAVE THE TWIX!!

Of course, what everyone seems to have missed is that Stein seems to be one of those half wits that believes Plan-B is an abortion pill, designed to prevent implantation, not prevent conception in the first place... His questions, if phrased properly **in the correct context of what Plan-B does** should have been something far more insane, like, "Should doctors be forced to provide condoms and diaframs to their patients when asked?"

I probably differ from some of the folks here in that I think pharmacists should be able to refuse to sell products. I think this is more a matter of corporate policy and employees sticking to it, be it "to sell or not to sell." I wouldn't agree with the "not sell" stores, and wouldn't patronize them, but still, I don't see why we should be focusing on the pharmacists. It seems to me the pharmacies are passing the responsibility onto the pharmacists, unless I'm missing something.

I think that's dodging the issue. Pharmacies and pharmacists are in the business of filling prescriptions - they have no business passing judgement on why someone is getting any particular medication and refusing to do it. Pharmacy corporate policy should be uniform: "Fill whatever prescription is given." The FDA is there to make sure that the drugs are safe and legal; beyond that point, they have no decision to make.

I think pharmacists should be allowed not to fill a prescription - as long as there's someone else in the same store, working at the same time, who will. At that point, though, what's the point of keeping Mr. Ethical Refuser on the payroll?

I wouldn't agree with the "not sell" stores, and wouldn't patronize them, but still,

Which part of remotest Montana do you inhabit? How many hours drive is it to the second-closest pharmacy?

Pharmacists should have to fill perscriptions because they shouldn't stand in the way of what someone's doctor has decided is the best course of treatment for their patient. Pharmacists aren't doctors, and shouldn't be allowed to decide what's best for patients, especially not on moral grounds. For example, many women are prescribed birth control pills to regulate monstrous periods (my very own sister, even!), or to help get acne under control. When pharmacists stand in the way of getting those scripts filled, they are undermining what the doctor and patient have decided is the best course of treatment.

I think pharmacists should be able to refuse to sell products

Why? What possible business is it of the pharmacist? Do you understand that there have been cases of pharmacists refusing to fill prescriptions for antibiotics after abortions? Do you really want to consider the possibility that it's a crapshoot when you had over a 'script whether you'll get your drugs? You want pharmacists to spend their time looking over your prescription and deciding whether or not they think you should have it? Is there any logical reason for having every doctor second-guessed by a pharmacist? Is that who you normally turn to for a second opinion?

And, last question, what if the pharmacist is making decisions based on race, or class, or sexual orientation, or really anything that's subjective?

I'm not sure I agree, though. I know a lot of this gets muddled, such as what sort of entity a corporation is, but I see it as requiring someone to take part in something they find reprehensible, and I'm uncomfortable doing so. The first response that comes to my mind is "don't choose that business/career then," but that bothers me, too, because things change.

I don't see this as an issue of race, class, sexual orientation, etc., of individual judgement being passed, though I certainly think such things also happen and are wrong. In this case, I see it as a conclusion that the product has no "good" purpose, and similar to requiring pacifists to sell handguns, or environmentalists to sell banned pesticides.

I don't want pharmacies or pharmacists actually trying to enforce a morality on others, such as humiliating or harassing those who purchase a certain product, and I understand that is what some think is going on here. Perhaps I'm just drawing the line a bit differently. Perhaps it shouldn't be drawn at all...as quork points out, one pharmacy's decision could be de facto law for a remote small town, and I don't want that happening, either. But again, that leaves me telling some guy in Montana that he must commit what he believes to be a sin or be fired.

To that, I say "oh, well." I feel bad he'll have to 'sin', or whatever, but hey, Jesus forgives you. It's all good.

"If I'm wrong, I'll recant on my death bed."

Please, you are elevating pharmacists beyond their station. They are business people and should be allowed to refuse to sell any product they desire. What right do we have to tell the pharmacy what to sell? It is a business; patronize it or don't.
I want to require religious bookstores to sell "Hustler" and condoms.
Get over yourselves. Wal-Mart elected not to sell adult literature, magazines and CDs. Where was the uproar? I don't go to Wal-Mart. Their corporate prudishness isn't the reason, but they have a right to refuse to sell and I have a right to refuse them my business. When, as Americans, did we develop a constitutional right not to be inconvenienced? You demand the right to OTC Plan B; win that fight and go where it's sold or find a Canadian pharmacy that will mail it to Montana. People in remote Montana should not be allowed to have sex anyway. The gene pool that convinced them that living there was a good idea should be allowed to die out.

Kaethe--I think rrt was proposing a compromise with which I agree: Any store with pharmacists who wants to go this route should make it clearly known before anyone opens their wallet.

My own version is that any pharmacist who wants to second-guess you and your doc should have no objection, and should be legally required, to put up a sign to that effect, clearly visible from the parking lot. It would save all parties time, anger and embarrassment. A woman can just drive by if she needs Plan B pills.

Or tampons. Or lipstick. Or batteries. Or toilet paper. Or magazines. Or nail clippers. Or vacuum cleaner bags. Or potato chips. Or shoe polish. Or ironing board pads. Or pencils. Or deodorant. Or pantihose. Or vitamins. Or candles. Or envelopes. Or toothpaste. Or diapers. Or emery boards. Or light bulbs. Or perfume. Or kitty litter. Or shampoo. Or aspirin. Or laundry detergent. Or paper towels. Or tea. Or glue. or fabric softener. Or saline. Or Twix.

They're big talkers when there are no consequences to them. Let's see how willing they--or their corporate enablers--are when women start looking for other places to shop.

No one has mentioned that the proposed rule that von Eschenbach (sp?, newly nominated to head the FDA) put forward requires that even though the FDA is now proposing that Plan B be offered over the counter (something Barr Labs suggested four years ago), in fact, they are also proposing that it be stored behind the pharmacy counter, available only on direct request. It won't be out there with the racks of condoms in 26 colors where anyone can pick them up.

Personally, I fully expect the entire argument over age will become moot since I suspect nearly every girl short of 18 who needs it (assuming the OTC plan is implemented) will have one or more friends who are 18 or over who will buy it for her. What's the drug store to do? Ask each buyer to sign a statement attesting to the age of woman who plans on taking it? Also will the FDA permit its sale to males? If so, will there be an age below which males cannot buy it? The entire episode is a farce in religious politics that illustrates what happens when fundies are in charge of the pharmacy! Madness.

Hey, maybe all pharmacies that don't want to sell Plan B (and many don't carry it now) should be required to put up a big sign next to their primary sign saying "Fundie Pharmacy."

Apropos of many pharmacies not carrying Plan B, everyone should ask their current pharmacy if they do. If they say "No" take your pharmacy business to a pharmacy that does. My wife and I are retired now, so we clearly don't need Plan B (but with insurance we buy about $5000/year of drugs), but we made the switch four months ago when our old pharmacy said they didn't and wouldn't carry it.

I'm not sure I agree, though. I know a lot of this gets muddled, such as what sort of entity a corporation is, but I see it as requiring someone to take part in something they find reprehensible, and I'm uncomfortable doing so. The first response that comes to my mind is "don't choose that business/career then," but that bothers me, too, because things change...

If Plan B were sold without prescription, then the whole question of pharmacist involvement would be moot. And why shouldn't it be? The FDA should be concerned with the safety and efficacy of drugs. It is not the Ministry of Vice.

Good for you, Keanus. I did something similar. In fact, I just found out that a particular pharmacy chain allowed its pharmacists to refuse to fill a script because of "conscience," and I haven't been back in that chain since. We frankly need to think in terms of a boycott if the laws aren't going to help. If pharmacists want to go into the ministry, they are welcome to attend seminary. No sympathy WHATEVER for retail pharmacists with a moral problem with a legal medication. If "things change" and they had no idea when they got into the Rx biz back pre-Griswold that they'd have to deal with reproductive health, they can teach or work in a hospital pharmacy or cook meth or something. But retail pharmacies are a crucial link in our health care and we cannot leave it to post-modern, biblical literal, pre-Socratic, or any other non-medical whim. Screw'em. I'm tired of this debate. There's no argument. Pharmacists must pharmatate.

But if Plan B is sold over the counter pharmacists will not have the opportunity to properly shame and oggle women who have had teh sex.

Could someone explain the american pharmacy system to me?

Is someone willing to mention which pharmacy chain, (especially in Washington State) will not sell Plan B? I will not spend my money there......

ou want pharmacists to spend their time looking over your prescription and deciding whether or not they think you should have it? Is there any logical reason for having every doctor second-guessed by a pharmacist?

That's exactly what the pharmacist is supposed to do, but not for the reason discussed here. Pharmacist check for possible drug interactions and often verify drugs with the doctor to see if certain alternatives might be better.

Molly: Yup, but as quork points out, sometimes "just driving by" isn't easy or even practical, especially when we're talking about an emergency contraceptive. There may be only one pharmacy remotely nearby, or several that ALL refuse to carry it.

Greg: This: "But retail pharmacies are a crucial link in our health care and we cannot leave it to post-modern, biblical literal, pre-Socratic, or any other non-medical whim" is, I think, the argument most likely to convince me to accept forcing pharmacists to sell.

Quork: I very much agree, though I think OTC sale will still leave us with the corporate policy problem. They could still refuse to carry it. Look at Walmart refusing to carry or sell certain products, such as music CDs, for blatantly moralistic reasons.

Archgoon: Not quite knowing what you don't understand about the US pharmacy system as compared to yours (UK resident?), I'll do my best, and please forgive if I go over things you already know. In the US, pharmacies are privately owned businesses freely selling a range of products much like any store, including convenience-store-like products and many drugs. But many drugs cannot be directly purchased...they require a doctor's prescription, ostensibly because the potential for harmful misuse is too great without a physician's supervision. You bring the prescription to the pharmacist's counter at the back of the store, he or she pulls the drug off his shelves, packages it, and gives it to you. As others have mentioned, he also doublechecks the prescription for any errors or conflicts. Apparently, part of the FDA's proposed Plan B approval will be requiring pharmacists to keep Plan B "behind the counter," so that even though no prescription is required, a customer must ask for it and (possibly) show identification to prove their age.

With no universal health care in the US, the customer pays the retail price for the drug, unless he has some form of insurance that pays for some or all of the prescription price. The insurance may be purchased directly by the customer, by his employer, or may be provided by the government if he qualifies.

Why can't American Hindu Mcdonalds employees refuse to sell all-beef patties without fear of dismissal?

I don't know why he can't. But it won't be because of a law.

The whole problem with pharmacists refusing to fill legitimate prescriptions based on their beliefs is they put the onus on the patient. If one is engaged in civil protest (after all the drugs are legal), the protester should bear the cost, not an innocent bystander. So if a pharmacist has ethical (not medical) issues with filling certain prescriptions, that pharmacist has the clear obligation to either find another line of work, or a job in the field that would not present this conflict. In no case does the pharmacist have the right to make someone else pay the price for the pharmacist's views. And if the pharmacist may end up with a less desirable or remunerative job, well, guess what? That's what the phrase "taking a principled stand" used to mean.

This is one area that I feel the public good far outweighs any religious belief. Require pharmacists to fill valid prescriptions or lose their license, RFRA be damned. It's obvious that there is a compelling state interest in providing medicine to those who need it, and doesn't seem burdensome to religion.

And don't give me no "short ride" crap, like Loserman.

RRT and Shyster:

Name me any situation where a person is allowed to take a job, refuse to perform the duties of the job for voluntary, personal reasons, and can expect to keep the job anyway. Just one.

That's what you're asking us to accept here.

Also, as for finding the next nearest place, not only may it be prohibitively far away, not only may a woman or girl have no way to get there, not only may the next nearest place also refuse to dispense it, but there has been at least one reported case where the pharmacist not only refused to fill the prescription, but refused to return it to the patient so she could get it filled elsewhere (lost the damn link, though, so if someone has it, please share x.x)!

If you want a compromise solution, pass legislation requiring any pharmacy that refuses to carry or dispense contraceptives to also not carry or dispense [goddamnit, the hard-on-restorer drug. Will someone PLEASE get a spam filter that wasn't scraped off the bottom of the bargain bin?] and such. It'll be interesting to see how their "moral objections" hold up when they're forced to be consistent, even in much more lucrative areas.

Its already available in 37 countries...come on people, get with the times.
In Australia, its behind the counter so you have to ask for it.
Getting the Morning After Pill has always been easy, just took longer and was cheaper via the Doctor.
In reality most women will never need it or very rarely so I don't see the fuss. It boogles me to think that some people think suddenly women will go out and have unprotected sex all over the shop because you can pay $30 the next day for some drugs.
The whole chemist refusing to sell it thing is stoopid to put it mildly, I guess those ones don't sell condoms either, which if they did may counter the problem of selling Plan B.

The Onion article is great and the discussion here is really interesting.....good stuff.

Azkyroth, You are arguing a corporate policy. If the boss says "you don't have to" then you don't. If the boss says "We ain't carrying Plan B." That should be his right. A pharmacist responds to and follows corporate policy or walks. If the law says that he can refuse to sell it as a matter of conscience then Walgreens can decide if carrying this drug is worth the hassle. The issue is: Can we force (or should we) Walgreens to carry Plan B? The answer is: NO!

I think Georgiana has the big point of it, pharmacists are refusing to fulfill an aspect of their jobs, namely filling contraceptive perscriptions. This differs from a store not carrying a product, this is like the store selling twix, but one clerk refusing to sell the twix to pregnant women. The clerk is depriving someone of a good or service base dupon thier own beliefs, they should be the ones to bear the cost of their beliefs.

Also Pharmacies are in a business of providing life saving and altering goods, ones that often need to be taken within a set amount of time (especially plan B). I can see where they would be required by law to make sure they stock all available drugs which can be obtained with a perscription. Its a medical service and thats what sets it apart from the supermarket or McDonalds down the street.

Are hospitals allowed to refuse treatment?

Pharmacists in the United States are as likely to be employees as businessmen. The discipline of the market goes both ways. In red states there may be a boycott of stores that carry Plan B, in blue states boycotts of those that don't.

I'm inclined to think that those who refuse to provide it should lose their licenses. Certainly any pharmacy which refused to fill a prescription should. This argument might be weakened if the drug is available over the counter.

However, should a woman who was refused this drug die as the result of her pregnancy, or bear a defective child, and should she or her family sue the pharmacy for damages, it might be expected that pharmacies refusing to offer it might eventually find insurance unavailable.

Azkyroth, I don't share Shyster's enthusiasm, but I agree with his point: You mischaracterize my statements, which I thought I adequately clarified above.

I do NOT need to "Name [you] any situation where a person is allowed to take a job, refuse to perform the duties of the job for voluntary, personal reasons, and can expect to keep the job anyway." That is NOT what I'm asking you to accept here. As I thought I'd explained in my response to pastor maker, I think McDonald's can refuse to hire/choose to fire a Hindu who refuses to sell beef. What I question is our right to pass a law explicitly forcing said Hindu to sell beef or quit his job.

As I've also stated quite clearly, I think the "next nearest place" situation is a real problem, and I've made it quite clear I detest the sorts of conduct such as pharmacists confiscating prescriptions as much as you do. I understand that makes you angry, it pisses me off too. That doesn't blind me to the crappiness of the law telling pharmacists "your drugs or your job!" I don't see all of these "religious conscientious objectors" as evil bastards, and I can't imagine you do.

As I have also clearly stated, I'm very open to the "critical part of the health care system" argument, but that doesn't change my discomfort with the solution. "Suck it up?" Yeah, maybe.

Pharmacies and pharmacists are in the business of filling prescriptions - they have no business passing judgement on why someone is getting any particular medication and refusing to do it. Pharmacy corporate policy should be uniform: "Fill whatever prescription is given." The FDA is there to make sure that the drugs are safe and legal; beyond that point, they have no decision to make.

I have to take exception to this comment by Charlie. Pharmacists are in the business of healthcare and patient safety. If you think that every perscription handed across the counter should be filled, then what about the typos, drug interactions, or incorrect dosages missed by doctors how have, typically, had only one course in pharmacology? These are licensed professionals who, in the past 10 years or so in the US, all have doctorate level medical degrees. That's not just fluff, it's training for patient safety.

There's a legitimate arguement for having pharcists be required to fill Plan-B perscriptions. 'Shut up and fill the 'script' has no place in that discussion.

Its a medical service and thats what sets it apart from the supermarket or McDonalds down the street.

Are hospitals allowed to refuse treatment?

For emergencies, not usually.

However, it's interesting to note that it's damned near impossible to find someone to provide an elective sterilization procedure (tubal ligation or vasectomy) if one is under 35 or has no children. I have first hand knowledge from the female side of the equation, but admit I'm only assuming it's the same for men. Haven't known very many men under 35 who've sought to get snipped ;-)

This whole argument against Plan B is pure political and religious bullshit. I'd like to see it on the rack next to the Midol where any woman of childbearing age can get it. For pete's sake, teenagers can buy OTC cold medicine and do FAR more damage to themselves than anything that'll happen from a high dose of birth control hormones, which is all Plan B really is.

Pharmacists should either commit to doing their jobs as chemists or change careers. Their primary function is to inform patients as to any side-effects of the meds they're taking, or if one Rx may affect another, or some combination is not recommended. They're not there to weigh in on the morality of medical decisions of doctors and patients.

The only way it could equitably be compromised on is that if one pharmacist refuses to dispense any particular drug, there has to be another pharmacist on duty at the same time who will. This would be fair to any patients coming in, because they would be assured of their prescription being filled, and would let the conscientious objector off the hook. Of course, what this would probably do is create a living nightmare for whatever manager has to do the scheduling, and perhaps make it much less likely that a pharmacy would hire/keep someone with that problem. It would just have to be done in such a way that said pharmacist has no grounds for filing a lawsuit about it...

I don't see all of these "religious conscientious objectors" as evil bastards, and I can't imagine you do.

I'd like to reiterate that I have no problem with someone being a conscientious objector, civil protestor, and so forth. There is a long, fine tradition of it here in the States, as in the civil rights movement, Quakers and military service, etc. BUT the principle is leadership through moral example, which means the objector challenges the law AND accepts the consequences. One may recall that has included jail time in the past. Instead, now we have pharmacists refusing to fill legal prescriptions, who want both job assurance and moral status as conscientious objectors. Bah. Denying someone else's healthcare for one's own beliefs is hardly ethical.

Now if a pharmacy is willing to pay two pharmacists to do one job to cover these situations, or if a pharmacist chooses employment in an area that doesn't involve Plan-B, all to the good. But in no case should the prescription holder be beholden to the moral beliefs of the pharmacist.

I'm with "suck it up". Pharmacists aren't in any old business; they're in the highly regulated field of health care, operating with government licenses. They're given a privilege to do a job, and have the responsibility to *do* the job. Yes, their freedom of conscience is (or should be) restricted. But the freedom of all of us as medical consumers is restricted, ostensibly for our safety. I have no sympathy for pharmacists trying to break the system at our expense.

This is one of the cases where a libertarian critique feels valid: having stepped in to solve one perceived problem (consumers having full liberty to buy medicines), the government has to step in again to patch problems caused by the first intervention (regulating pharmacists to do their jobs, which wouldn't be needed but for the first intervention.)