Bloodless Coup

EC

Let's start with a definition:

Emergency contraception is a backup method for preventing pregnancy and is not for routine use. Plan B® can reduce your chance of pregnancy after unprotected sex. For example, if you were using a condom and it broke, if you forgot to take 2 or more of your birth control pills this month, or if you were sexually assaulted, Plan B® may be a good option for you. It is important to know that Plan B® is not RU-486 (the abortion pill). Because Plan B® is used to prevent pregnancy, it will not work if you are already pregnant, and it will not affect an existing pregnancy.

OK, so, birth control to prevent pregnancy. Not to induce abortion.

Remember that you have only a few days to prevent a pregnancy after unprotected sex. If it is taken within 3 days (72 hours) after unprotected sex, it will decrease the chance that you will get pregnant by 89%. That means 7 out of every 8 women who would have gotten pregnant will not get pregnant. And Plan B® works even better if you take it within the first 24 hours after unprotected sex.1 Unprotected sex might happen when your healthcare professional’s office may be closed, such as over a weekend. Getting a prescription for Plan B® in advance means that it will be there for you — in time — if you ever need it.

and

Take the first tablet as soon as possible within 3 days (72 hours) after unprotected sex.

So far, we have 1) birth control, and 2) limited window of opportunity.

Here we have the case of a rape victim, who was unable to get the birth control prescribed for her.

While calling dozens of Tucson pharmacies trying to fill a prescription for emergency contraception, she found that most did not stock the drug.

When she finally did find a pharmacy with it, she said she was told the pharmacist on duty would not dispense it because of religious and moral objections.

snip

"We have all kinds of compassion for a rape victim - in that case, Plan B is OK, the church has no problem with it," said Ron Johnson, with the Arizona Catholic Conference, which supports the right of any health-care worker to refuse to dispense emergency contraception and lobbied hard for passage of the Arizona law to allow it.

But the biggest roadblock to obtaining emergency contraception was that most pharmacies simply do not stock it, Fladness said. She said she called nearly 50, before finding two that had it and agreed to dispense it.

So, even though this woman was not seeking an abortion, she actually belongs in the category most people are willing to grant an abortion: the rape victim. This is even supported by the Church representative (which I find a little interesting, since, you know, contraception is sinful). The problem for this woman was that she did not report her rape to the police, only to her doctor, because she felt guilt and shame. We could digress into a long discussion about the symptoms women experience after rape, but I'm going to give you a little about.com site to note how common this is, and this link which includes FBI statements abouthow rape is the most underreported crime. To summarize, we have a woman who was raped, who had a pattern of reporting that fits the majority of most rape victims, and those rape victims make up the most cited "compassionate" argument for access to both EC and abortion.

Now, let's consider the refusal of pharmacies to stock and/or dispense EC as cowardly corporate policy.

Dear Target Guest,

Target places a high priority on our role as a community pharmacy and our obligation to meet the needs of the patients we serve. We expect all our team members, including our pharmacists, to provide respectful service to our guests, particularly when it comes to their health care needs.

Like many other retailers, Target has a policy that ensures a guest’s prescription for emergency contraception is filled, whether at Target or at a different pharmacy, in a timely and respectful manner. This policy meets the health care needs of our guests while respecting the diversity of our team members.

Your thoughts help us learn more about what our guests expect, so I’ll be sure to share your feedback with our pharmacy executives.

Thanks for taking the time to share your questions, thoughts and comments. I hope we’ll see you again soon at Target.

Sincerely,

Jennifer Hanson Target Executive Offices

Diversity of team members. I'm curious if that diversity also leads them to refuse to fill prescriptions for birth control pills, or to ring up packages of condoms, because those products have the same function as EC. If not, I think we are not talking about respecting diversity, but rather deliberately promoting false information and engaging in dishonest and deceptive manipulation of religious protections to discriminate against women seeking access to certain kinds of birth control.

Bitch, Ph.D. spotlights (rather pithily) the hypocrisy of the supposed religious opposition to EC:

Look, for the umpteenth time. Plan B is not an abortificant. It prevents conception. So there is no goddamn reason for anyone to refuse to provide it, period. Even the goddamn Catholic Church (I can get away with cursing it, I'm Catholic) allows contraceptive use in some circumstances, and has no position on non-Catholics using contraception.

Charlie at Big Brass Blog revisits and argument about why the talk about alternate pharmacies is a red herring, because of the very real situation in rural areas (or, say, in metropolitan Tuscon) where there are no alternatives.

Where does this leave rural areas? Shall we leave out the large percentage of people who live in small towns with only one pharmacy? When there is no competition, the free market is not a viable solution.

Nor is it a valid compromise. As Amanda at Pandagon points out, there is another aspect of small towns: those are the same women who are least able to fight for their rights without suffering social backlash. As Amanda says, "the gossip factory of small towns being what it is, the woman who first makes a stink about getting her pills faces a very high risk of getting tagged as a bitch or a screeching harpy at best, and sexually suspect and slutty at worst." Which is only natural considering that is exactly the opinion of any pharmacist who refuses to fill birth control.

Pharmacists shouldn't be compelled to do what they find repugnant.

I completely agree. But this statement is phrased in a way that obscures an important point: nobody is forced to become a pharmacist. If you find one aspect of any given profession morally repugnant, you shouldn't enter that profession. And let's not forget that there are many alternatives available for pharmacists to minimize their need to fill the medications they find morally questionable, such as positions as hospital pharmacists.

Laws protect physicians and nurses who oppose abortion from being penalized if they refuse to participate in the procedure. Oregon, the only state to allow physician-assisted suicide, cannot force an unwilling doctor to prescribe a lethal dose to a terminally ill patient.

The difference is that doctors and other health care professionals who refuse to participate in abortions are hired in capacities that do not require them to peform those tasks. If doctors routinely accepted jobs at abortion clinics and then refused to participate in abortions on moral grounds, then we would have a good analogy. As it is, we don't. And if this was happening, it wouldn't be a situation that called for compromise, either.

Note the bold that I have added. It's an important point, because there is a legitimate concern about excluding people from jobs they want to do on the basis of religious, gender, and other discrimination. We could also think about it if someone got a job with the TSA, but refused to let some people walk through the metal detector.

Ol Cranky also discusses the employment issue, specifically addressing other conflicts between religion and the provision of health care.

Healthcare workers are required to put the health of the patient first, if they can not do that for all patients they may serve they need to either avoid working in places where the possibility of being involved in the care in cases they can not participate in or ensure there is always someone else working on their team at the same time to fulfill those tasks they can not. A nurse who is a Jehova's witness can not force someone to find another facility or come back at another time if they need a transfusion of blood products (even if the need for transfusion is not emergent), to do so would be refusing to follow the doctor's orders and interfering with the physician prescribed action plan (nurses who are Jehovah's witnesses have another person on staff who is working at the same time do the transfusion). The same goes for a pharmacist, to refuse to fill a valid and legal medical prescription when the medication is in stock (or lie to say it is not in stock) is interefering with the medical care of a patient. A pharmacist who is a Scientologist is not allowed to refuse filling legal and valid prescriptions to patients because use of particular types of medications are proscribed by Scientology as that would be an imposition of Scientologist's personal views on a non-adherent. Similarly, there is no legitimate reason to allow adherents of any other religion to allow their personal views to interfere with the medical treatment of a patient by an appropriately licensed healthcare practitioner.

Pharmacists who have moral issues with certain medications have multiple legitimate alternatives to prevent them from interfering in medical care while continue to work as a pharmacist including: working at a pharmacy that makes it clear they do not stock or fill prescriptions for [insert type or class of medication here]; working at a mail order/internet pharmacy wherehouse with an agreement they will not be involved in filling prescriptions for medications they find offensive/immoral (while not interfering with those medications or the dispensation of them by another), or ensuring there is always another person on staff with them at the same time who will fill and dispense those prescriptions. If the pharmacist feels that compliance with the latter two alternatives and/or referring the patient to another pharmacy after ensuring that pharmacy has someone on duty to fill the offending prescription in a timely fashion when his/her pharmacy really is out of stock would make him/her a party to the sin of using the offending medication, the pharmacist should refrain from working at a pharmacy that stocks those medications (s)he finds morally objectionable.

We do not force people into professions that may require them to perform tasks they find morally objectionable by way of legislation. For all intents and purposes, those who enter the profession of pharmacist choose their course of study and how to utilize their education of their own volition. The only reason a pharmacist would work in a setting in which (s)he may be the only person on duty permitted to fill a prescription their pharmacy stocks is to intentionally set him/herself up in a position by which (s)he can become a barrier to filling those presciptions. This isn't about rape, sex or abortion, this is about the intentional interferance with medical treatment in an effort to impose one's religion on others, and is a direct violation of the first amendment.

Employers are in a difficult position. They should neither discriminate against their employees nor against their customers. They may also be the target of manipulative behavior by employees with an agenda, seeking to politicize the sale EC. John at America Blog does a nice job of explaining how Target is likely setting itself up for being taken advantage of in exactly this way, and how the company is caving to an incorrect interpretation of the law. [note: lawyers, here's your chance to chime in on the Civil Rights Act of 1964]:

Now, the 1964 Civil Rights Act certainly does protect religious folks against discrimination in the workplace. But the kind of discrimination it refers to would be, for example, Target saying "we're not going to hire Christ killers," or, "man we hate those Baptists, none of them get promoted at Target." Yes, that would be illegal under the '64 act.

But Target is now saying, outright, that the 1964 Act covers any action a Target employee takes so long as the employee claims the action is motivated by his or her religion. Though, then they turn around and say that their religious employees have no such rights at all (see further down).

snip

And even better, could a Target manager who is Baptist fire a gay employee simply for being gay, in violation of local civil rights laws protecting gays in employment, because such discrimination is religiously based and federal law protects such religiously-motivated discrimination, per Target's apparent interpretation of the law?

Target needs to come clean. Does Target or doesn't Target give its employees carte blanche to discriminate against its customers so long as the employee claims their religion is offended? And if Target doesn't give its employees carte blanche, then what IS Target's standard for determining when their employees get to play the religion card, and when they don't?

One final legal note to Target. You are going to get your asses sued by your religious employees, and you just gave them the document they need to nail your ass.

At the end of your email above you write the following:

In the unusual event that a Target pharmacist's sincerely held religious beliefs conflict with filling a guest's prescription for emergency contraception, Target policy requires our pharmacists to take responsibility for ensuring that the guest's prescription is filled in a timely and respectful manner. If it is not done in this manner, disciplinary action will be taken.

Well, here's your problem. Your employee thinks abortion is murder and refuses to fill prescriptions that "assist in a murder." You say that his or her refusal to assist in a murder is covered by the '64 Act since it's against their religion. But then you say that your employee is required to assist in the "murder" anyway by making sure the prescription is filled in a timely and respectful manner. So, you're mandating that your religious employees assist be accomplices to murder, something that clearly violates their religious beliefs, yet you previously claim that coercing your employees to take such actions is illegal under the 64 Act. I think you've got a problem here.

If it's assisting murder for your employee to put my pills in a plastic jar and hand them to me, then it's also assisting murder for your employee to pick up the phone and call another pharmacy to place my order for "murder pills." There's no difference. It's like saying it's against my religion for me to murder someone, but I have no problem handing a murderer a gun so that he can murder the pregnant woman standing in front of me.

While I think John could have been more clear that EC is not abortion, and that the hypothetical pharmacist's belief is factually wrong, he does a good job discussing the legal dilemma.

What it comes down to is that there is a conflict between the customer and the access to legal prescribed medication, on the one hand, and the religious beliefs of the employee, on the other. The problem is with the companies trying to weasel around without coming out and saying "we will always fill prescriptions for medicines" or "we stand with our employees in the belief that the use of some medicines is immoral and on those grounds will not guarantee access." In this situation, the behavior of the companies supports the pharmacist over the patient, the rape victim, the woman who is judged by some pharmacist to be more immoral than the "normal" customer seeking her regular birth control pills or his condoms. To some people, there are kinds of birth control that are more moral than others, just like some kinds of reproduction (yeah, that thread). And they are willing to prevent women from access to health care in a way that only guarantees more anxiety and real duress, and which potentially compounds the suffering of rape victims who most people in the US agree should have access not only to contraception, but to abortion.

I have no trouble calling that a radical agenda that is out of the mainstream of values in the United States.

Posted by binky at October 25, 2005 04:35 PM | TrackBack | Posted to Gender and Politics | Religion