Appeals court says pharmacists can’t refuse to dispense Plan B

Damn straight! On Wednesday, an appeals court ruled that despite two Washington pharmacists’ lawsuit saying that their religious beliefs should allow them to refuse to stock and provide emergency contraception to their customers, personal convictions doesn’t trump a patient’s right to timely medication.
This decision is huge as it could affect policy across the Western U.S. regarding the “right to conscience” nonsense that has been gaining momentum over the past few years, particularly with the help of Bush implementing the anti-choice HHS regulations before he left office (which we’re still waiting for Obama to rescind like he intended). But this ruling creates a precedent for future cases around the issue.
While the pharmacists won a temporary injunction by the U.S. District Court in Seattle under their claim that they should be protected under the First Amendment right to free exercise of religion, the U.S. 9th Circuit Court of Appeals wasn’t having it. They lifted the injunction, saying that a person’s religious beliefs “does not relieve an individual of the obligation to comply with a valid and neutral law of general applicability”:

“Any refusal to dispense — regardless of whether it is motivated by religion, morals, conscience, ethics, discriminatory prejudices, or personal distaste for a patient — violates the rules.”

Booya.

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123 Comments

  1. Alice
    Posted July 11, 2009 at 11:46 pm | Permalink

    I am aware of what the law says. I know that within the context of the statist precedent set by the American court system, this ruling is largely correct, but it is precisely that system, and its consequences such as this, that I am arguing against. I do not believe it is legitimate to infringe on people’s rights for the sake of “public policy,” for rights that have exceptions are not rights at all.

  2. kisekileia
    Posted July 12, 2009 at 1:29 am | Permalink

    Having read all Alice’s replies to this thread, I’m pretty sure she’s an extreme libertarian troll. I’ve dealt with this type before, and they don’t tend to respond to reasonable arguments, so I suggest not engaging her further.

  3. SirGrant
    Posted July 12, 2009 at 2:04 am | Permalink

    Ok well I have a few posts to reply too. Firstly as mentioned before I am a pharmacy Tech not a pharmacist. However I have done the research and I know the 3 mechanisms that plan B works on.
    1) Prevents ovulation
    2) prevents contact between sperm and egg
    3) In case of zygote formation (fertilized egg) it can prevent implantation in the uterus.
    Source: FDA (http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm109795.htm)
    As far as rights go here is the California Patient’s bill of rights from the board of pharmacy (http://www.pharmacy.ca.gov/consumers/bill_of_rights.shtml) and nowhere on it does it say people have a right to any medication be it planB or anything else.
    Now let me say this again before I’m attacked. I know how plan B works and I am pro planB and will continue to dispense it. However if you think free market is not a good way to handle healthcare I would urge you to write your members of congress and tell them that. Because that is the way it is now. If you think healthcare is a fundamental human right use your power of representation to argue for that. I am actually in agreement with you there.
    You also said that “It’s interesting that you seem to think the government should not be able to tell a doctor to do something, but that the government should be able to tell everyone else what they can and can not do.”
    I never once said the gov shouldn’t be able to tell MDs and pharmacists but they should be able to tell the regular public what to do. I don’t know where I said that and if you can point it out to me I’d appreciate it because that isn’t something I agree with.

  4. baddesignhurts
    Posted July 12, 2009 at 4:40 am | Permalink

    she may be an extreme libertarian, but i certainly don’t think she’s a troll.
    is having a dissenting opinion enough to earn the troll label now? groupthink much?

  5. aznemesis
    Posted July 12, 2009 at 5:28 am | Permalink

    So proud to be from Arizona. /sarcasm
    So, these people aren’t content with just trying to screw over the women of my state; they have to go looking for other states to screw with?

  6. aznemesis
    Posted July 12, 2009 at 5:39 am | Permalink

    There is really nothing forcing these people to go into this specific career field, is there? If you are going into a field that requires you to dispense legal medications, then you should uphold the requirements of that field. If you don’t wish to do so because they violate some ethical belief, then choose something else. For example, I would never enter the military because I believe that a good 99% of U.S. military actions are morally offensive. To go into a field that requires me to follow the orders of superior commanders, engaging in acts I believe to be morally wrong, then demanding that they adapt to my belief system would be the epitome of self-importance and delusional behavior. The acts of pharmacists who refuse to dispense legal medications is even worse, because it explicitly denies the rights of women to proper healthcare. If they are not going to be a partner in the proper healthcare of ALL patients, they are not only selfish, they are dangerous.

  7. kisekileia
    Posted July 12, 2009 at 2:55 pm | Permalink

    Okay, that’s fair criticism of my comment. I’m not generally a fan of enforcing groupthink; I suppose I overreacted to her. I don’t think Alice is trolling in the sense of expressing opinions she doesn’t actually believe in order to cause trouble. I thought she might be expressing opinions she actually does believe in order to cause trouble. I have had some bad experiences with people who share her beliefs, which may have prejudiced me unfairly towards her.
    I have found, though, that extreme libertarianism is social darwinist in practice, which is obviously not compatible with feminism or other anti-oppression beliefs.

  8. jellyleelips
    Posted July 12, 2009 at 3:00 pm | Permalink

    The problem is these pharmacists believe that Plan B is an abortifacient. Plan B works in three main ways: preventing ovulation, preventing fertilization of an egg, or preventing a fertilized egg from implanting. Even though Plan B will not affect an existing pregnancy, as every piece of literature about the drug states, some people believe that the prevention of implantation is enough to call Plan B an abortion. It’s seven kinds of stupid that medical professionals will use their religious beliefs (life begins at conception) to override ALL EXISTING MEDICAL LITERATURE on the topic of Plan B (preventing implantation of a united sperm and egg is not an abortion, because pregnancy starts at implantation). Therefore, in an astounding leap of logic, these people actually think that they are contributing to the abortion rate by PRESCRIBING Plan B. Pretty goddamn ridiculous, eh?

  9. Alice
    Posted July 12, 2009 at 4:08 pm | Permalink

    Extreme libertarianism consists entirely of the assertion that it is illegitimate to use violence against another’s person or property except in defense of your own. Certainly an idea most people would say they agree with, until you mention that all government action is ultimately backed by violence, including the collection of taxes.
    This is not at all incompatible with feminism or any other idea besides those that relate to the legitimate use of force. You can promote feminism without resorting to state force. In fact, much of feminism has consisted of repealing uses of state violence to oppress women, such as legal restrictions on abortion.

  10. Keliz
    Posted July 12, 2009 at 6:07 pm | Permalink

    Wow you are getting a lot of disrespect on this board. I am not as much of a fan of the bureaucratic state system as most of the people commenting here. At the same time, I do not share your certainty that abolishing those systems would necessarily result in a better world. I find the whole issue immensely complicated, and am surprised people find it so easy to dismiss your viewpoint. Thank you for challenging me and offering a different perspective.

  11. Keliz
    Posted July 12, 2009 at 6:22 pm | Permalink

    Clearly a lot of people here disagree with Alice, but you have to admit that she/he is responding to the issues everyone is raising in a thoughtful way. I would characterize that as stirring up thought – something I am in favor of – not stirring up “trouble”. I can’t point to anything Alice has said that has not been rational, and people are mainly attacking or immediately dismissing her/him instead of taking the time to pull apart the implications of those statements.

  12. Alice
    Posted July 12, 2009 at 9:39 pm | Permalink

    Whether the customer experience would be improved, I can see being debatable. But as for whether it would make the world as a whole better also depends on how much you value freedom from aggressive coercion. One thing that removing government controls would mean for certain is that mutually voluntary agreements and exchanges rather than collective violence would dictate the terms on which the medical industry is run, whatever those terms may be.
    I think that constitutes an improvement in and of itself.

  13. kisekileia
    Posted July 12, 2009 at 11:36 pm | Permalink

    That is true; she has provided thoughtful responses. I guess I’m just jaded for much the same reason that seasoned feminists are jaded about things like “what about teh menz” arguments: I’ve seen how libertarian vs. non-libertarian arguments tend to play out, and in my experience, there are not enough shared fundamental assumptions about reality for extreme libertarians and non-libertarians to have productive discourse.

  14. kisekileia
    Posted July 12, 2009 at 11:45 pm | Permalink

    However, much oppression against women originates from private citizens, and from private citizens acting in blocs such as corporations. When private citizens act en masse, in groups that hold power in society, to oppress other citizens, only government has the power to stop them from oppressing. For instance, anti-discrimination laws for employment have been necessary to protect women and other oppressed groups. Do you believe that government has the authority to enact and enforce such laws?

  15. Anathema
    Posted July 13, 2009 at 8:29 am | Permalink

    My concerns are that this is only the tip of the iceberg so to speak. If pharmacists are allowed to choose what medicines they dispense to what people (such as birth control only for medical reasons, or to married women only), what comes next?
    Will a doctor be allowed to deny a woman a life saving surgery because they are lesbian and the doctor does not agree with homosexuality? If that women dies will it be accepted as the doctor going by their moral beliefs? Will a therapist be allowed to deny psychological care to a rape victim because the victim is of another race? Will a fire-fighter be allowed to refuse to save a child because the family in danger are illegal immigrants? Could a pharmacist or care provider have the right to deny a cancer medication to a patient because they disagree with the use of the drug? Where will the line be drawn? These scenarios seem ludicrous but some are already occuring.
    We live in a nation with separation of church and state, under this alone, morals should not triumph career obligation. Also, this law means that a pharmacy must stock and sell Plan B, if a particular pharmacist does not agree with it than that person can step aside and have another employee dispense the medication. The health and well-being of the patient should be first priority.
    Taking morals and beliefs out of the argument, the facts are that women are being denied legal, safe, and doctor prescribed medications, which is just wrong no matter if it is Plan B, or a cough medicine. Emergency rooms are not allowed to deny any patient treatment regardless of their ability to pay, insurance, age, gender, or any other specification, so why should pharmacists be allowed to do just that?

  16. Anathema
    Posted July 13, 2009 at 9:00 am | Permalink

    Exactly, you cannot bring religion and morals into health care. That is so dangerous! These pharmacists certainly have every right to not agree with or take any kind of medication. No one is disputing that, which I think a lot of people are confused about. We dont all share the same religious beliefs, it is illegal to impose ones beliefs on another person, so why is this even an issue? For example, as a lesbian I am obviously for gay rights. I have every right to speak about my beliefs, educate others, and have access to every ammenity that heterosexuals have. Just as this is true, someone who is against my rights has every right to voice their own opinions and values. But they should NEVER be allowed to deny me care because they do not agree with who I am, whether the issue at hand being medical, or something of less importance (such as staying at a hotel, where many gay people have been denied rooms because they requested a single bed). This is discrimination and so is this controversy over Plan B. Everyone has a right to their own beliefs. But they cannot impose these beliefs on others.

  17. smiley
    Posted July 13, 2009 at 4:23 pm | Permalink

    Anathema,
    I won’t reply to all your questions (others might, and do it better than me).
    I do have a question though, addressed to you and others: can a pharmacist choose not to open a pharmacy in a town or neighbourhood? If he or she decides to close his or her pharmacy, or to not open one, thus removing the only pharmacy around, should he be forced to remain open (or to open one)? If you say ‘yes’, then how is that different from refusing to provide one type of medicine?

  18. Alice
    Posted July 13, 2009 at 5:36 pm | Permalink

    I doubt there is any problem in the world that doesn’t become a lot easier or at least a lot more straight forward to deal with if you have the option of using overwhelming violence against your opponents. That doesn’t make it a legitimate avenue for social change, though.
    It’s not even as though we have access to such an option. Once the state involves itself in that sort of thing, the political mechanisms behind it are equally accessible to either side. The state can, at best/worst, impose uniformity. There is no reason to expect that said uniformity would be an improvement, and if one accepts your idea that private sexist interests are so powerful that they are capable of oppressing half the population, there’s even less reason to expect that they couldn’t just as easily oppress by political means as well. In fact, that’s exactly what they have historically done. As Mises said, “If one rejects laissez faire capitalism on account of man’s fallibility and moral weakness, one must for the same reason reject every kind of government action.”

  19. Anathema
    Posted July 14, 2009 at 12:08 am | Permalink

    That is a good question. No I do not think that a pharmacy should, or could for that matter, be forced to stay open or to open in the first place. This is because that pharmacy could start providing improper care (emphasis on ‘could’, I am certianly not saying that that would happen, just that its possible because when someone is forced to do something against their will, they can lose the drive to do the job right).
    Again only possibly, but I wouldnt want to risk it no matter how small the chance is, because this is healthcare at stake. Also, I wouldnt want to go to any healthcare provider who didnt voluntarily wish to be in that job, I would want to seek out someone who loved their job and helping others, otherwise I wouldnt feel safe or secure.

  20. Alice
    Posted July 14, 2009 at 6:44 am | Permalink

    No I do not think that a pharmacy should, or could for that matter, be forced to stay open or to open in the first place. This is because that pharmacy could start providing improper care…
    Or how about because slavery is wrong?

  21. Anathema
    Posted July 14, 2009 at 6:49 am | Permalink

    Can you expand on that please?

  22. Alice
    Posted July 14, 2009 at 4:40 pm | Permalink

    What is there to expand on? Forcing a pharmacist to continue working despite their desire to stop would be slavery.

  23. Anathema
    Posted July 15, 2009 at 8:26 am | Permalink

    I just agreed that it would be wrong earlier. I see slavery as too harsh, but yes it would be wrong.

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