Protection of Conscience Project News
Service, not Servitude
The State of Washington has announced that it will appeal a decision by a U.S. District Court Judge that held that a state regulation was deliberately intended to deny freedom of conscience to pharmacists, and therefore unconstititional. [Yakima Herald]
Judge Robert B. Leighton of the United States District Court has ruled against the Washington State Department of Health. The case may be summarized by quoting the judge’s opening and concluding paragraphs:
This case presents a novel question: can the State compel licensed pharmacies and pharmacists to dispense lawfully prescribed emergency contraceptives over their sincere religious belief that doing so terminates a human life? In 2007, under pressure from the Governor, Planned Parenthood, and the Northwest Women’s Law Center, the Washington State Board of Pharmacy enacted regulations designed to do just that. . .
. . . The Board of Pharmacy’s 2007 rules are not neutral, and they are not generally applicable. They were designed instead to force religious objectors to dispense Plan B, and they sought to do so despite the fact that refusals to deliver for all sorts of secular reasons were permitted. The rules are unconstitutional as applied to Plaintiffs. The Court will therefore permanently enjoin their enforcement against Plaintiffs.
Polly Thompson asserts that religious tolerance is “a bedrock value of our democracy, and it goes both ways,” but then claims that “the onus is on the health professional to respect the religious beliefs of the patient, not the other way around,” a most peculiar form of tolerant reciprocity. The balance of the editorial demonstrates a troubling ignorance of the legal requirements to accommodate conscientious objectors[1] and de facto contempt of the “bedrock value” she purports to respect in theory. (The Public Trust and Access to Medication, Canadian Pharmaceutical Journal, October, 2004, Vol. 137, No. 8).
Patients and pharmacists have equal claims to freedom of conscience and expression, but one looks in vain in the editorial for a thoughtful analysis of how to deal fairly with conflicts of conscience in health care. A principled approach to conscientious objection would, among other things, distinguish between life-threatening injuries or conditions, and non-emergent situations. To equate the provision of blood transfusions for accident victims with dispensing contraceptives or post-coital interceptives suggests a disappointing editorial interest in polemics, not principle.
Thompson is mistaken when she claims that some pharmacists raise religious objections to her access to medication. Their concerns are not with her access, but with their own moral culpability should they facilitate harmful conduct or other wrongdoing by someone else.
The fact that a drug is legal does not determine this issue. By way of comparison, mouthwash is a legal product commonly sold in pharmacies. It can also be an intoxicant when consumed as a beverage. A conscientious pharmacist might well refuse to sell mouthwash to an alcoholic known to consume it for that purpose, whether or not the product could be accessed elsewhere.
Similarly, the practice of law is a self-regulated profession, and, like pharmacists, lawyers are expected to serve the interests of their clients. But a client cannot force a lawyer to facilitate what the lawyer considers to be a wrongful act – even if the act is legal.
Ms. Thompson’s fierce determination to adhere to her own moral views is not surprising, but she has failed to demonstrate that her morality is so superior that it should be imposed upon those who disagree with her. Indeed, she did not even attempt such a demonstration before calling for the elimination of “troubling holes” and “wiggle room” that make grudging allowance for freedom of conscience in pharmacy. Her message to those unwilling to go along with her is uncompromising; get out of the profession. Given this totalitarian mindset, Ms. Thompson’s complaint that ‘fundamentalist extremists’ dictate policy in the United States invites the waggish response that in Canada they write editorials for professional journals.
Pharmacy regulatory authorities can, with some imagination and good will, find ways to ensure “timely access to legal medication” without suppressing of freedom of conscience in the profession. The Canadian Pharmaceutical Journal can contribute to this kind of fruitful accommodation. But the profession and the public are not well served by the kind of incoherence, intolerance, polemics and ignorance of human rights jurisprudence displayed in its October editorial.
Sean Murphy, Administrator
Protection of Conscience Project
Notes
1. Benson I. “Autonomy”, “Justice” and the Legal Requirement to Accommodate the Conscience and Religious Beliefs of Professionals in Health Care [Internet]. Powell River (BC): Protection of Conscience Project; 2001 Mar. The Canadian Pharmaceutical Journal declined to publish the essay, which was a response to an article by Frank Archer that had appeared in an earlier number of the Journal. See also Murphy S. In Defence of the New Heretics: A Response to Frank Archer [Internet]. Powell River (BC): Protection of Conscience Project; 2000 Jul – also declined by the CPJ.
The Canadian Pharmacists Association has been asked by the Canadian Organization for Life and Family to ensure that pharmacists disclose to patients the fact that the morning-after pill can cause the death of the early embryo by preventing implantation. COLF, which addresses life issues for the Canadian Conference of Catholic Bishops, also asked the Association about its policy on freedom of conscience for pharmacists who do not wish to dispense the morning-after pill. [COLF letter]
© Copyright 2004 Calgary Herald
Reproduced with permission
A few years ago, a customer asked Co-op pharmacist Maria Bizecki to fill a prescription for an abortion drug. For Bizecki, a Roman Catholic and active pro-lifer, this was akin to being invited to become an accessory to murder. She declined.
It was a risky stand against the prevailing view of pharmaceutical professional associations, and employers retailing drugs. Yet, ultimately it led to a small step forward for Albertans’ religious freedom.
The Alberta College of Pharmacists (ACP), for instance, her profession’s ethics watchdog, emphasizes a client’s right to have pharmaceutical needs met. It grants conscience leeway to its members, though this did not save Bizecki from facing complaints about her stand.
More particularly, the conscience clause is little help to pharmacists dealing with unsympathetic employers.
The letter one Pro-Life Ontario pharmacist got from his boss (quoted in the Pro-Life paper, Interim) eloquently expresses the all-business perspective: “You are not employed by the company to make moral or philosophical decisions about whether birth control is appropriate for the customer . . . we are engaged in a retail activity.”
The letter concluded with a threat of termination, noting that if the pharmacist couldn’t separate his beliefs from his job, he should “think long and hard about whether you could continue in your capacity.”
Co-op was comparatively gentle. Bizecki had been straightforward with them about her views, and was known in the community as a pro-life activist. She was suspended with pay.
She doesn’t talk about the complaints which led to her being investigated by the ACP; the details are subject to her duty of confidentiality. Still, when in 2000, a pro-choice website challenged the conscience rights of pharmacists, the prompt arrival of the first complaint was no surprise.
The situation was a pickle of contending rights and obligations.
Obviously, if a prescribed drug is legal, a client has a right to buy it, and a druggist to sell it. But, only the wilfully blind wouldn’t admit honest people can sincerely disagree over abortion. As employees are not mere instruments of an employer’s will, but have a right of conscience, even an obligation, how does one loosen the tangle?
One way is to choose. When human rights commissions do so, religious freedoms sometimes lose. The case of a Catholic school board
compelled to allow a gay student to bring his boyfriend to a prom, is illustrative.
The other way is negotiation. It took nearly three years for Bizecki’s lawyer, Gerry Chipeur, the college and Co-op to work it out, but there was a happy ending. That is, something which worked for everybody, and it serves as a useful template.
The reasonable accommodation of Bizecki’s principles was a written agreement in which she recognized the public’s right to have a prescription filled by a pharmacist, and that she could not and should not obstruct it. But, employers have a duty to reasonably accommodate employee scruples, and Co-op agreed not to demand she fill prescriptions for drugs which effect abortions. Thus, with the college’s blessing, she would always be part of a two-person dispensary.
Chipeur adds this might not be a reasonable accommodation for a one- person pharmacy: “However, in Canada employers have always had a duty to be reasonable, so long as there’s no undue burden. This is the first time that I’m aware, that there has been such an accommodation. If there’s a similar breakdown in Alberta in the future, it would be unwise for any health employer to not accommodate a pro-life position. I’d just say this to pro-lifers: Don’t take a job in an abortion clinic and then say you don’t want to do abortions.”
What distinguishes this case from some of the head-on rights collisions we’ve seen in Canada, is that the parties would accept a solution, not hold out for a victory. Canada aspires to be a tolerant country.
This is what tolerance looks like.
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