Letter to the editor, Pharmacy Practice

Rosalyn Wosnick invites her readers to equate conscientious objection among pharmacists to the bigotry of a ‘deep south’ restauranteur, who argued that he had a right to deny service to blacks. (Editorial, Pharmacy Practice, July 2000) The analogy is misplaced, misrepresents the position of conscientious objectors, and is likely to engender prejudicial attitudes among their colleagues.

It would have been more accurate to compare pharmacists who have moral objections to dispensing a drug with a coffee shop owner who refuses to sell Brand X coffee to anyone, because it has been produced by child labour. The object, in both cases, is to avoid complicity in what the parties judge to be evil, regardless of the legalities involved.

However, Ms. Wosnick suggests that if a product is legal, and she wants it, other people should be made to give it to her, even if doing so would be contrary to their moral convictions. The product she is concerned about is Preven. Let’s consider a different product.

Ammunition, like Preven, is a legal product. Moreover, one has a legal right to defend one’s own home, even to the point of using deadly force, if need be. Suppose that a householder wants ammunition for defence against burglars, but a gun store clerk with moral objections to this type of crime prevention refuses to sell him ammunition. Applying Ms. Wosnick’s reasoning, the customer complains that the clerk is denying him his “right” to obtain a legal product. He demands that the clerk sell him the ammunition, or refer him to a more willing colleague, threatening to have him fired if he does not do so.

To say shotgun slugs are “legal”, however, means only that the customer is free to obtain and use them for legal purposes. It implies nothing about how gun store clerks should exercise their own freedom, even if licensed gun stores have a monopoly on the sale of ammunition as part of the state gun control system. Freedom to buy shotgun slugs – or drugs – does not mean that one is legally obliged to sell them, or to help others buy them.

If Ms. Wosnick asserts, instead, that there is a moral obligation to dispense a drug, and that this moral obligation is absolutely binding, she must identify the source of this morality. Moreover, since she would not dare to suppress the moral or ethical beliefs of others unless she was convinced that they were inferior to her own, she must explain why her moral views are superior to those that she seeks to suppress. Finally, in view of human rights jurisprudence that generally requires accommodation of belief rather than its suppression, she must explain why accommodation of those who disagree with her is impossible or undesirable.

Sean Murphy, Administrator
Protection of Conscience Project

Project letter to the editor, Pharmacy Practice

NAPRA, the Canadian Pharmacy Association and New Brunswick, Newfoundland, Prince Edward Island, Yukon and Alberta colleges or associations of pharmacy have stonewalled efforts from outside the profession to discuss freedom of conscience in pharmacy. Gordon Stueck’s invitation to serious, open dialogue on the subject is welcome (“Here we go again…” Pharmacy Practice, May 2000). One hopes it will encourage a change of attitude among those governing the profession. This is particularly important if, as Mr. Stueck states, a significant number of pharmacists object to dispensing Preven for reasons of conscience.

Mr. Stueck suggests that the proper context for such discussion is “the role of the pharmacist in today’s society”, and puts forward an argument against freedom of conscience based on economic self-interest. His primary concern is that the monopoly that pharmacists now enjoy in dispensing prescription drugs will be endangered if too many pharmacists refuse to dispense certain drugs for moral or religious reasons. What this amounts to is an assertion that economic self-interest is a greater good that should be protected at the expense of lesser goods – like freedom of conscience and religion.

Is economic self-interest a greater good than freedom of conscience and religion? Perhaps, in Mr. Stueck’s view, it is, but his view has not been dominant in the histories of liberal democracies, and it is not reflected in the Charter of Rights. The Charter guarantees freedom of conscience and religion- not economic self-interest.

Mr. Strueck’s assertion notwithstanding, public policy in Canada is rarely, in practice, determined by everyone in society, but by those in power. The rejection of the Charlottetown Accord in the nationwide referendum was a singular exception to the general rule. The results of other referenda have been ignored when they have conflicted with the views of public policy makers.

Whatever ‘public policy’ might be with respect to this drug or that, suppression of freedom of conscience and religion is not acknowledged by any authority to be a matter of public policy in Canada.

It should not become the policy of a professional association.

Sean Murphy, Administrator
Protection of Conscience Project

Project letter to the editor, The Standard

A number of health care professionals have moral or ethical objections to dispensing the ‘morning after pill’, so a recent article in The Standard (“Morning-after pill poses moral dilemma for some Mds”, 29 June 2000) is of interest beyond the community served by your paper. I would like to make two points.

First: though the drug in question was described as a ‘contraceptive’ that ‘prevents pregnancy’, many who are familiar with the action of the drug consider it an abortifacient, not a contraceptive, and object to dispensing it for that reason. Moreover, people attempting to understand the issues involved need to be aware that the words ‘abortion’, ‘pregnancy’, ‘conception’ and ‘contraception’ are often assigned completely different meanings by parties in the dispute about Preven.

Second: the good news in the story is almost too obvious for many to see. The woman obtained the drug that she wanted, and the physician was not forced to involve himself in something that he considered to be morally abhorrent. Arrangements at the hospital accommodated both her request for the drug, and his request not to have someone else’s morality imposed upon him.

This is the kind of common-sense accommodation that ought to be more widely practised.

Sean Murphy, Administrator
Protection of Conscience Project

Project letter to the editor, The Winnipeg Sun

As submitted

I am pleased to see that the Winnipeg Sun supports the principle that people should not have to dispense products that they find morally offensive. Your editorial (Pharmacological farce, 6 June, 2000) makes clear that conscientious objectors who refuse to sell cigarettes can count on your support, even though cigarettes are legal in Canada.

What remains unclear are the reasons why you insist on a two-tiered system of civil rights with respect to freedom of conscience: full rights for people who agree with you, like those who would refuse to sell cigarettes, and none for those who do not agree with you, like Concerned Pharmacists for Conscience.

However, the fact that you support the principle with respect to like-minded individuals suggests that a more tolerant and liberal attitude toward others may eventually prevail.

Contrary to the dismissive comment in your editorial, concerns that pharmacists may be forced to dispense drugs for assisted suicide and euthanasia are not misplaced. The College of Pharmacists of BC has put its members on notice about such possibilities. Legalization of assisted suicide, as well as execution by lethal injection, have led some pharmacists’ associations in the United States to adopt policies to protect conscientious objectors.

An attempt to force moral beliefs upon the populace? While that may be a fitting description of the Sun’s editorial, it is not the position of conscientious objectors. They simply do not wish to have the private morality of drug companies and newspaper editors forced upon them.

Sean Murphy, Administrator
Protection of Conscience Project


As Published

Objection sustained

I am pleased The Winnipeg Sun supports the principle that people should not have to dispense products they find morally offensive. Pharmacological Farce, June 6, makes clear that conscientious objectors who refuse to sell cigarettes can count on your support.

Why do you insist on full rights for people who agree with you, like those who won’t sell cigarettes, and none for those who do not agree with you, such as Concerned Pharmacists for Conscience.

The B.C. College of Pharmacists has warned members about the possibility of being forced to dispense drugs for assisted suicide and euthanasia. Legalizing assisted suicide and execution by lethal injection led U.S. pharmacist associations to protect conscientious objectors.

Conscientious objectors aren’t trying to force moral beliefs upon others. They simply do not wish to have the private morality of drug companies and newspaper editors forced upon them.

Letter to the editor, Globe and Mail

Reproduced with permission

Re: April 27, 2000: Don’t let drugstores become pulpits

An “inability to distinguish between emergency contraception and the abortion pill”, and “irresponsible and blatantly uninformed” actually describes Planned Parenthood, not educated pharmacists. Planned Parenthood eagerly wants women to ingest dangerous hormones, which in the case of the morning after pill, fails at least 25% of the time. Planned Parenthood, not pharmacists, makes the choice for women by withholding facts and “spreading misinformation” in the name of sexual freedom.

Let every woman exercise her right to make an informed decision: the scientific literature is clear and abundant that the morning after pill (post-coital interception) acts primarily to prevent implantation, not ovulation. Therefore, to call it a contraceptive is false and misleading. To argue that pregnancy is not already established is a minority viewpoint ignoring virtually all embryology, biology and genetics texts.

Dr. Albert Yuzpe invented the morning after pill, yet does not mention ovulation prevention in his Contemporary Obstetrics and Gynecology article in 1994. He does mention, however, structural changes in the endometrium might “represent a hostile or non-receptive site for implantation”.

Futhermore, Jennifer Kessell, spokewoman for the company making Preven, confirmed that “more often it would prevent implantation” (The Report, Dec 6, 1999).

Pharmacists are objecting to participate, not attempting to block patient access to products. Doctors cannot be forced to perform procedures that violate their consciences, why should pharmacists? By pushing their morality on health care workers, the public violates a pharmacist’s autonomy, integrity, and basic human rights in a country that protects its minorities

Maria Bizecki
Concerned Pharmacists for Conscience