In Good Conscience

CAN PHARMACISTS DECLINE TO FILL SOME PRESCRIPTIONS?

In the aftermath of Roe v. Wade came statutes allowing health-care providers to refuse to provide procedures, such as abortion or sterilization, to which they objected on moral or religious grounds. Today such “conscience clauses” exist in forty-five states, and potentially affect not merely abortion and other aspects of reproductive medicine, but end-of-life care, stem-cell-related technologies, and a host of other issues. Gradually the exemptions have expanded beyond physicians to include other individuals and entities involved in health care: nurses and counselors, insurers and hospitals. Should health-care workers be allowed to refuse to provide treatments they deem morally objectionable? When does professional obligation override the sense of moral responsibility? Such questions are playing out every day in hospitals and clinics across the country.

And now in drug stores. During the past year, several jurisdictions have passed laws extending the exemptions to pharmacists. The controversy has zeroed in on emergency contraception (EC), or the so-called morning-after pill. The FDA approved various drugs in 1998 and 1999 as emergency “contraceptives,” but not everyone finds that description accurate. In many cases, EC functions like other birth-control drugs: it prevents ovulation or fertilization. But it can also act as an abortifacient, preventing implantation of an already fertilized ovum. This is the...

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