Judge rules pharmacists can refuse to sell emergency contraception

In yet another victory for “religious conscience” at the expense of women’s health, a federal judge struck down Washington State’s law requiring pharmacies to stock emergency contraception. The AP reports:

Washington state cannot force pharmacies to sell Plan B or other emergency contraceptives, a federal judge ruled Wednesday, saying the state’s true goal was to suppress religious objections by druggists–not to promote timely access to the medicines for people who need them.

U.S. District Judge Ronald Leighton heard closing arguments earlier this month in a lawsuit that claimed state rules violate the constitutional rights of pharmacists by requiring them to dispense such medicine. The state requires pharmacies to dispense any medication for which there is a community need and to stock a representative assortment of drugs needed by their patients.

This is bullshit. The state had a very compelling reason for the requirement: As we all know, EC gets less effective over time and in rural areas there may not be another pharmacy for miles. And pharmacists who don’t believe in birth control or erroneously think that EC is an abortifacient were free to pass the prescription off to coworker who would fill it. As the Seattle Times wrote in an editorial calling on the state to appeal the ruling, this decision “sends a message that pharmacists’ personal views can take priority over patients’ rights.”

It’s a message we’re seeing all over the place these days. Roy Blunt’s amendment that would basically allow employers to decide what kind of health care coverage you get based on their own “moral convictions” is expected to come up for a vote next week–and we already have a hint of what that would mean. Meanwhile, seven states have filed a lawsuit claiming that the no-cost birth control coverage mandate violates the rights of religious employers.

Remember: The Obama administration already accommodated those concerns by shifting the cost of the coverage from the employer to the insurance companies. One more time: religious employers are not required to pay for birth control coverage for their employees. Yet seven states have rushed to defend their “right” to prevent their employees from receiving that benefit from an insurance company. As Digby noted recently, religious conscience protections used to be about defending individual rights. Now they’re being wielded to allow religious institutions to force their own beliefs upon individuals.

It’s an upside-down world where pharmacists’ refusal rights supersede patients’ rights to timely care and the conscience of religious institutions trumps the rights of the individuals–religious or not–to access the health care coverage they need, overwhelming want, and are entitled to under federal law.

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27 Comments

  1. Posted February 24, 2012 at 1:50 pm | Permalink

    I remember when this first came up in WA state. At the time I never thought it would pass. Some days I hate being proven wrong. What’s worse is that this logic becomes (even more clearly) downright ludicrous when applied to just about ANY OTHER FIELD. This is a fun party game, examples follow:

    “I wonder if I could get a judge to rule that economists don’t need to perform economic projections if it is against their moral convictions to do so. I know I went to school for economics, but I became a born-again basicmathian, and now I feel it’s against my religion to use math not found on a basic calculator.”

    “I wonder if I could get a judge to rule that chef’s don’t have to prepare any food if it is against their moral convictions to do so. I know I went to school to cook food, but I became a born-again foodcatchian, and now the only way anyone should eat food is by catching it with their own two hands and devouring it on the spot.”

    “I wonder if I could get a judge to rule that engineers don’t need to stress test things if it’s against their moral convictions to do to. I know I went to school for engineering, but I became a born-again hopeitworksian and now I believe in just spakling everything together, and if it falls apart it was meant to fall apart by divine will.”

    • Posted February 24, 2012 at 3:15 pm | Permalink

      But, generally, as I understand it, that is the way our society works: I can say that I am an economist who is unwilling to perform projections, or I am a chef who is unwilling to prepare food, and the government does not, and is not able to, step in to stop me.

      In a non-command economy, the way this is supposed to work is that people will be unwilling to pay me for my services as an economist/chef/engineer if I am unwilling to provide a full range of services, and other people who are willing to do so, and are willing to spend their lives doing so, will step in to fill the need.

      I mean I think any businessperson who owns the pharmacy where pharmacists are not willing to dispense emergency contraception should fire the crap out of those people for not doing their jobs, but unless the government runs the pharmacy (which is not out of the question as a possibility if it is a public good that market forces can’t satisfactorily provide in certain rural areas, e.g., the post office) I’m not sure it has the power to interfere.

      Is there a way we can make sure everyone has access to emergency contraception even when there is no local provider? Is something like (subsidized?) internet ordering & overnight shipping biologically & economically viable?

    • Posted February 24, 2012 at 3:27 pm | Permalink

      Matt, this is full of so much win. I love it.

    • k
      Posted February 24, 2012 at 3:39 pm | Permalink

      You could get a judge to rule the first two. There are no laws requiring economists to perform projections or chefs to make certain types of food, they’d probably just get fired. Public works are regulated so no, a judge wouldn’t say an engineer doesn’t have to stress test things.
      I honestly don’t think its problematic to let certain pharmacies distribute which drugs they want as long as there’s not a community need. For example, like the author says, if you are the only pharmacy on the island or there’s not another one for 50 miles in any direction, you should have plan B. But, if you’re in Seattle, and there’s a CVS two blocks away that stocks plan B, and a Walgreens 4 blocks in the other direction that stocks it, why should a pharmacist be forced to stock it if its against his beliefs? If there’s no need (but just a matter of convenience), the government shouldn’t force him to stock certain things. Surely people don’t think the Muslim 7-11 owner should be required to sell beer, or the Orthodox Jewish grocer pork. As long as there’s no public health need, as in my example, there’s no benefit to forcing people to violate their beliefs and curtailing their rights.

      • Posted February 24, 2012 at 5:23 pm | Permalink

        Beer and pork are not generally considered medication by the medical field. Plan B is. No one’s rights are violated when they can’t find a rump roast.

        It might feel more practical to say that you are allowed to not carry a drug if someone else has it within X miles, but how do you regulate that? If you’re in the deep south and no pharmacy in the state wants to carry it, how do you pick which one must have it?

      • Posted February 24, 2012 at 7:47 pm | Permalink

        “But, if you’re in Seattle, and there’s a CVS two blocks away that stocks plan B, and a Walgreens 4 blocks in the other direction that stocks it, why should a pharmacist be forced to stock it if its against his beliefs?”

        Because there’s no one damn reason religion should fact0r into having a Pharmaceutical license.

  2. Posted February 24, 2012 at 2:05 pm | Permalink

    Is it generally within the power of government to force particular businesses to sell a particular product? Like, could the state government of Utah pass a law saying that all bookstores must offer Mitt Romney’s latest book for sale, and that would be legally binding on some hypothetical independent feminist bookstore, or would that also be outside the power of government and get overturned by a court?

    Naturally I think we all agree that the desired outcome is that everyone should be able to get access to the medicine & health supplies they need, but the legal case here seems like a shaky one to (not-a-lawyer) me.

    • k
      Posted February 24, 2012 at 3:28 pm | Permalink

      It depends. When the federal government passes that type of legislation Congress is theoretically authorized to do it based on “the commerce clause,” which has been read fairly broadly but still provides some restraint. Basically either you have to show some type of activityis part of interstate commerce or affects an industry spread over several states/ the national economy. A lot of how the SCOTUS would decide such an issue is based on what’s being regulated and the makeup of the court at the time

      • Posted February 24, 2012 at 4:57 pm | Permalink

        But this is a state law, not a federal law, I believe?

        I 100% agree with Wagatwe below that there is clearly and absolutely a valid governmental cause for ensuring that all its citizens have access to medical care, but (as we can see by it being overturned) this method of doing it seems potentially legally muddy. Maybe we need to brainstorm other methods, or see how other countries achieve the same goal and emulate them.

      • Posted February 24, 2012 at 7:04 pm | Permalink

        So are we saying that a federal law, not a state law, could require pharmacies to stock certain things?

    • Posted February 24, 2012 at 3:53 pm | Permalink

      I don’t think you can compare selling books to providing medical health care. Is there a conscious clause for viagra or other sexual-performance drugs? What if the person doesn’t agree with sex or medically enhancing sexual performance? Medical access is already limited for many; this is no where along the lines of book selection at the local Barnes and Noble.

      • Posted February 25, 2012 at 10:55 am | Permalink

        I would be very interested to see how it would play out if pharmacists suddenly refused to fill prescriptions for ED drugs. Say a pharmacist wanted to protest the fact that these drugs are covered by insurance but birth control wasn’t. Would anyone sue the government on their behalf?

    • Posted February 24, 2012 at 4:57 pm | Permalink

      Is it generally within the power of government to force particular businesses to sell a particular product? Like, could the state government of Utah pass a law saying that all bookstores must offer Mitt Romney’s latest book for sale, and that would be legally binding on some hypothetical independent feminist bookstore, or would that also be outside the power of government and get overturned by a court?

      Probably not, but the state government of Utah could almost certainly rule that it’s not legal for an individual bookstore employee to say, “I refuse to sell YOU, a consenting adult, this PARTICULAR book because I think YOU, specifically, should not read it.”

      Not to mention that this isn’t about choices in reading. This is about a pharmacist saying, “I have more right than a patient and her doctor to decide what medical care she receives.”

      • Posted February 24, 2012 at 5:19 pm | Permalink

        So, what about the owner of a pharmacy saying “we don’t stock that medication”?

        • Posted February 24, 2012 at 8:36 pm | Permalink

          They should be required to order it as medically necessary.

          • Posted February 25, 2012 at 5:26 pm | Permalink

            Or close the pharmacy? There’s a blow for public health- if you don’t want to provide all forms of healthcare, you can’t provide any. Are pharmacies public utilities now?

            Should doctors be mandated to perform all procedures requested by the patient? Or is birth control different from every other aspect of healthcare, because it is “women’s rights”?

  3. Posted February 24, 2012 at 4:03 pm | Permalink

    Oh my God, this is so horrible. A pharmacist’s job is to give people their prescription medications, not make their medical decisions for them, based on their own religious beliefs. We keep going backwards as a society, especially when it comes to women’s rights.

  4. Posted February 24, 2012 at 7:14 pm | Permalink

    How about requiring pharmacies to post a notice outside of their doors if they do not stock emergency contraception?

    That would save time for women. It would also help those of us that disagree with the such pharmacy’s decision to take all of our business somewhere else.

    Even if it is not possible to force pharmacies to post notices outside their doors if the do not stock EC, those that do should post it to get a competitive advantage (in communities where it would be so, of course).

    • Posted February 24, 2012 at 7:16 pm | Permalink

      Sorry, typos:

      How about requiring pharmacies to post a notice outside of their doors if they do not stock emergency contraception?

      That would save time for women. It would also help those of us that disagree with such pharmacies’ decision to take all of our business somewhere else.

      Even if it is not possible to force pharmacies to post notices outside their doors if they do not stock EC, those that do should post it to get a competitive advantage (in communities where it would be so, of course).

  5. Posted February 25, 2012 at 2:20 am | Permalink

    This really pisses me off. All the more reason to move away from this backward country.

    • Posted February 25, 2012 at 6:41 am | Permalink

      Man I always get a kick out of people saying they want to leave this country. Where do you plan on moving to? LOL I know it sucks here sometimes but we have a lot more freedom than the overwhelming majority of the world. Have you traveled anywhere to make a comparison? I’ve been to Canada, Mexico, the Caribbean, Asia, and Europe. Some countries have free healthcare but their healthcare sucks and isn’t any better than taking Tylenol. We got the top medical professionals in the world because of how much money they make here. We also have more residential space for the money, much less racism here (I know first hand being colored) and way less weight discrimination since not everyone is here is thin like they are in Europe (minus the UK) and Canada. Every time I come back from vacation I am reminded of how good we have it.

      • Posted February 25, 2012 at 2:18 pm | Permalink

        hahahahahahahaha oh, you’re a riot! i can’t tell if you’re serious, or just trolling. our health care isn’t better than tylenol? my my, i guess us canadians are all just dropping dead in front of the hospital because we don’t have the money to pay for our treatment…wait, that’s not canada. that’s just south of our border! and there is LESS racism in the states? are we talking about the same country that consistently has politicians and media outlets clamouring for proof of Barack Obama’s citizenship status? or calling him a muslim? jeez, i guess that’s just evidence of equal treatment. i mean, it’s happened to all of the white presidents, right? (no.)

        • Posted February 25, 2012 at 5:30 pm | Permalink

          Lilu I’ll admit that of all the countries I’ve been to I experienced less racism in Toronto and Montreal than anywhere in Europe. I did get a bad vibe from the French in Montreal though, it was more of a nationality thing though than racial. One question for you, if Canada’s healthcare is so great why do Canadians come to the US for major surgeries?

          I know people questioned Barrack Obama’s citizenship but…..we got a black president! How many traditionally white countries can say that??? When I was in Stockholm they wouldn’t let blacks into certain clubs (this is well documented btw). My Irish buddies admitted to avoiding blacks. In Paris I stayed in one of the lower income areas (Gare Du Nord) and it was nothing but minorities. You should youtube a video called “racism in Europe” that shows what colored soccer players go through over there. You would NEVER see that treatment in the US. According to the short documentary, “this is because there has never been a civil rights movement in Europe, what is considered taboo in the US simply isn’t in Europe”. Players actually leave the field crying from the racial abuse. There is no equivalent to Martin Luther King or Malcom X over there.

          • Posted February 26, 2012 at 4:25 pm | Permalink

            i agree with your comments, but find fault with america being characterized as traditionally white. it isn’t. blacks, native americans and whites were at the very birth of this country. native americans even earlier. this isn’t sweden. the idea that america is fundamentally white, with colored outliers is what fuels the whole obama birth certificate nonsense and why santorum can spew such garbage even those his parents were immigrants. he feels being white gives him more stake in america than the president.

  6. Posted February 29, 2012 at 4:54 pm | Permalink

    When did it become their job to tell me what I should and shouldn’t take? That’s what’s unconstitutional, not them having to sell me a medication they don’t agree with because of their morals.

  7. Posted February 29, 2012 at 9:16 pm | Permalink

    Personhood. Transvaginal ultrasounds. Birth control for low-income women. Abortions for active-duty military women. None of these are topics for Congress to decide. I am heart-sick that our elected leaders are debating these topics instead of tackling the economy or international affairs. It is time to remind the national and state law-makers that women are valued citizens, not just the wombs of women. We need a symbol to validate the fact that women have a right to control their bodies and that Congress does not have a choice about prescriptions that will be filled or what medical procedures women will undergo. I want a way to remind our Congressional representatives that they do in fact represent women. It seems so ridiculous to me that, in 2012, I have to remind them that women vote, that women have influence over a majority of family’s budgets. I want to remind Congress that women exist, that women count, that women are important regardless of their fertility.

    I propose that we start using the Sacagawea dollar coins to visually remind the world that American women are more than wombs. Why use this method to speak out in support of women? These gold coins, arguably an attempt to honor women, are unwanted. They are so unwanted that the bank teller told me that they haven’t had those coins in more than three years because no one wanted them. I had to take a roll of $25 because the bank teller didn’t want to open a roll! Society doesn’t honor this beautiful coin, and they don’t value women. A manager in my office didn’t even realize that there was a gold one-dollar coin featuring a woman. As I researched the history of Sacagawea on the U.S. Mint website, I learned some interesting facts.

    At about the age of 11, Sacagawea was captured by a Hidatsa raiding party and taken from her tribe. She was later sold into slavery. Then her new owners gave her away in a bet to a French-Canadian fur trader, who made her his wife. She had no choice in where she would live, if she would marry, or what course her life would take.

    According to the CDC, the largest demographic for women who have had abortions is women under the age of 15? Sacagawea was only 15 years old and already six-months pregnant when the Lewis and Clark expedition started. In today’s society we are still fighting for the right to keep our jobs when we are pregnant and still fighting for the right to feed our infants in public without being shamed.

    Sacagawea is a perfect symbol for our struggles today, with her infant son bound to her back. Technically she wasn’t a U.S. Citizen. Our law-makers call vote after vote on whether or not Planned Parenthood and free clinics should be funded – which is where women without health care can go for birth control and pap smears and mammograms. Regardless of income or immigration status women across the country juggle work and family. Women contribute to society in addition to, and in spite of, their status as a parent or a spouse.

    Sacagawea and her son served as a “white flag” of peace for the expedition, which was as much a military expedition as a scientific one. They entered potentially hostile territory, but not a single member of the party was lost to hostile action because no war party was ever accompanied by a woman and infant. And today, military women are still struggling to have access to the same reproductive rights given to civilian women.

    Not all of us are comfortable carrying signs or calling Senators, but we can all use these coins. It doesn’t matter if you are a man or a woman, if you are rich or poor – everyone can join in this reminder to honor women. It doesn’t even really matter what you think about Roe v. Wade; the only thing that matters is that you know that women and their health-care providers are the ones to make a decision about all health matters including reproductive choices. If you think that family decisions belong with a family, and not with Congress, please use the Sacagawea dollars. Just for the month of March, women’s history month – please use the Sacagawea dollars.

  8. Posted March 3, 2012 at 2:41 am | Permalink

    I have a religious objection to providing heart medication to patients who come to my pharmacy. Thanks to Judge Ronald, I have the right to deny patients this medication in the State of Wisconsin.

    …or, wait, do I?

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