February 01, 2004
12 Comments

Morning-after pill and its detractors

Thanks to Ufez Jones for passing this article on to me:

The woman in this case, by the way, had been raped. A doctor at her rape exam wrote the prescription. The pharmacists knew this; they had been told so by a male friend of the woman (Buzz's tipster), who had ferried her to a number of drugstores in Denton looking for one that had the pills in stock. The Eckerd had it, but because of their own moral objections, pharmacists there refused to fill a lawful prescription for an innocent woman in dire need.
The morning-after pill has been in the news a lot lately, because Mexico is now selling it over the counter. Yet here in the US, pharmacists are allowed to refuse to fill such a prescription if they have ethical and moral objections to it. In fact, 44 states have a "conscience law" that protects medical practitioners from having to perform medical procedures they find objectionable, and so far, courts have sided with pharmacists who invoke this protection. Some retailers refuse to carry the morning after pill altogether.

What a worrisome series of precedents. A pharmacist who refuses to fill a morning-after pill prescription is acting with disregard for the customer, the doctor who wrote the prescription, and the pharmacy he or she works in. In a situation where one pharmacist's refusal could directly translate into an unwanted pregnancy--in a small town, for example--such a decision should be considered criminal.

Posted by Dana at 08:33 PM

Comments

Many pharmacists, outside of the large chains, are independant owner/operators and while disregard for your customers doesn't exactly lend itself to continued successful business venturing, they are allowed to reserve the right, as the ubiquitous sign says, to refuse service to anyone. Even, as it were, for really small-minded reasons.

Nevertheless, it's awfully silly. Would they prefer the young woman in question have an abortion? As that is almost certainly what will happen, should she continue to not be served.

*reads article*

"As for the woman in question, she finally got her pill from a Walgreens pharmacy across the street, her friend said."

Across the street! Possibly, then, this is less a incidence of widespread pharmaceutical industry idiocy, and more so an occurrence of all-too-frequent "single muttonhead with a mission." To which I say: all's well that ends well :)

Posted by: Fes at February 2, 2004 09:08 AM

Yes, but this incident *does* raise some disturbing implications. Emergency rooms aren't allowed to "deny service" or refuse treatment; why should pharmacies? As Dana points out, not every town has a Walgreen's across the street, and very real consequences could result. If a doctor has determined that a drug is medically necessary for you, and has certified that need by writing a prescription, why should the pharmacist stand in the doctor's way? Med school takes longer than pharma school, the doctor has personally examined you, and the doctor knows your medical history. The pharmacist hasn't...so it is flat-out wrong for them to potentially endanger your health and well-being by arbitrarily deciding that you shouldn't have a legally, legitimately prescribed medication.

Posted by: Vidiot at February 2, 2004 10:03 AM

I don't think anyone's denying she has a right to the medicine, or that she needs it, but pharmacies aren't emergency rooms. Pharmacies are often individually owned and operated, and while I too think that this pharmacist did his customer a disservice by not filling her prescription, can we demand that he or she does NOT have a right to serve - or not serve - whomever they want? Additionally, this was not life-threatening medication - important, to be sure, but realistically speaking it wasn't as if he was denying her a chemo prescription on the grounds that he feels that cancer is God's punishment.

And, there was a Walgreen's *across the street*, which the first pharmacist certainly knew was there, and which he would have known would make his moral stand less impactful to the woman. And yes, there could be an incident where the woman could be so far from another pharmacy (perhaps in the Alaskan wilderness, or in northern Montana or something) that this sort of situation might be of consequence, but that didn't happen here and, as far as anyone has reported, has not happened anywhere. And, should one live in a town where it is more than a half-day's drive to a compliant pharmacy (I'm guessing that the period of effectiveness for this particular drug is about a half-day or so), well, that person's porblems only begin at unwanted pregnancy.

Like I said before, it's rather silly for a pharmacist to refuse service in this, but there was little consequence, and there hasn't been any indication that this is a widespread practice, or that it may spin up to be. One can never protect against - or legislate against, for that matter - the proverbial Isolated Incident, and there's usually little reason to get too worked up about it.

It would be better, imo, to concentrate one's efforts on the apprehension and incarceration of the rapist, as he is the one true criminal in this case.

Posted by: Fes at February 2, 2004 10:37 AM

Fes, the pill is effective up to 72 hours after coitus.

While I think such 'conscience loopholes' are abhorrent, I find the possible alternatives to these mucky compromises (ie - no morning after pill) far from preferable. If some Papal dead-head thinks it's against his morals to prevent an unwanted pregnancy, fine. Just make sure I have access to it somewhere within a resonable distance.

That said, I love the delicious irony of getting the morning after pill with nary but a cheezily faked "Parla inglese? Morning After Pill? Condom went Boom?" from the pharmacy within literal spitting distance of St. Peter's square.

Posted by: romakimmy at February 2, 2004 12:04 PM

I'm technically pro-choice, although I'm uncomfortable with the idea of abortion. I say "idea," since I've never been in a position where I had to make a real decision on the subject. (Which I realize makes my opinion worthless, but I'll press on anyway).

Putting aside whether the morning after pill is an abortofacient or not, I am kind of ambivalent about all this.

On the one hand I object to someone making decisions about someone elses body, on the other hand I'm uncomfortable with the idea of forcing someone to break their personal ethical code.

Call me wishy-washy, but that's how I feel, it's just not that cut and dried to me. I realize this was a case of rape, where I have zero problem with abortion. I'm just extrapolating.

Posted by: jonmc at February 2, 2004 12:20 PM

I pretty much agree with Jonmc right down the line on what he says above. I think that the greater harm is being done to the woman in question than to the pharmacist, although the presence of a Walgreen's across the street mitigates that somewhat. (or makes it entirely moot.)

I know nothing about such things -- but is there some sort of oath for pharmacists, akin to the Hippocratic oath for doctors? I wonder if that addresses the issue of when the pharmacist's morals collide with the doctor's.

Posted by: Vidiot at February 2, 2004 02:43 PM

As I understand it, the introduction to the Hippocratic Oath is "First, do no harm." The pharmacist could easily, in light of his implied religious beliefs, see the filling of that prescription as *doing* harm, and thus feel he was entirely within the bounds of his Oath.

What he should have done is simply tell the woman that his particular pharmacy was out of the drug (or, better yet, just not carry it); his personal moral code doesn't enter into the conversation, the woman goes across the street and fills her prescription, and everyone is happy. But, as always, it is the apparently irrepressible desire to proselytize that always gets these sorts in the end.

Posted by: Fes at February 2, 2004 02:52 PM

Thats really a cop out to allow a pharmacy to deny service to someone solely based on moral grounds. Firstly, the "morning after pill" is legal. Second, it must be taken with 72 hrs after intercourse which is not much given that it must be prescribed by a doctor (not to mention the emotional circumstances). Thirdly, denying someone service based on moral objections is on par with all other types of discrimination in this country. Would it be legal to deny the customer solely based on the fact that they were Muslim? If Eckerds, as a company decided not to carry the pill based on moral objections that would be legally acceptable, albiet reprehensible(fuggin walmart). But granted that the company, and the pharmacy itself, decided to carry the pill but deny the prescription to someone is wrong.
I would go Johnny Cochran on dat ass.

Posted by: HSAN at February 2, 2004 02:53 PM

I'm pro choice. That said, like jonmc, I'm not pro abortion. If I got pregnant tomorrow (a medical miracle) I would have an abortion without reservation. But I'd feel pretty bad about it.

The morning after pill stops the egg from implantation in the whatchamacallit, so there is no conception to speak of when speaking of the morning after pill. Then again, to look at it in those purely scientific terms is to ignore the emotional reality of what one must go through to take the MAP. It's not just some scientific process; it's an emotional one. And it's emotional for everyone involved, whether we like it or not. To make pharmacists deny their emotional life is a little silly. She was able to get the prescription, and that's all that counts in this case. Laws can't be made to perfectly fit every situation.

Posted by: The Liminal Liberal at February 2, 2004 03:27 PM

The morning after pill stops the egg from implantation in the whatchamacallit,...

Cut it out with the technical jargon. Not all of us went to Harvard, you know.

Posted by: jonmc at February 2, 2004 04:08 PM

Morning-After Pill Over the Counter? Actions Target FDA.
Current rating: 0

by Members of MAP Conspiracy
Email: tummino1 (nospam) yahoo.com (unverified!)
05 Feb 2004

In the tradition of Margaret Sanger, who broke the law to give women birth control when it was illegal, feminists will gather on February 15th to give their friends the Morning-After Pill. With just three weeks until FDA Commissioner Mark McClellan-a right wing Bush appointee-decides whether this safe, effective, essential method of birth control will be sold over-the-counter, women across the country are putting pressure on the FDA and the White House to stop making women criminals for giving their friend the morning-after pill.

Over 300 women from around the country have sent Mark McClellan, commissioner of the U.S. Food and Drug Administration, a pledge that they will defy the prescription requirement for the Morning-After Pill (and the law) by giving a friend the pills on the day after Valentines Day.

Women all over the country routinely break the law by giving their friends the Morning-After Pill. Why is helping our friends illegal? Because this safe, easy-to-use form of contraception is still prescription-only. In more than 38 countries, women can walk into a store and get the Morning-After Pill without a prescription— yet women in THIS country have to jump through hoops to get it.

The Food and Drug Administration has a chance to change all this. Between now and Feb. 20, FDA Commissioner Mark McClellan will decide whether the Morning-After Pill will be made over the counter in the United States. Forty-nine conservatives in Congress are pressuring the White House to stop McClellan from making this backup birth control method more widely available in the U.S.

To show the FDA how important it is to change the status of the Morning-After Pill, feminists have signed a pledge to commit civil disobedience. On February 15, Susan B. Anthony's birthday, in the tradition of Margaret Sanger, who handed out birth control pills when it was illegal, and suffragists who fought for women's right to vote, we are breaking the law in order to change it. Over 300 from all over the country have pledged to give a friend the Morning-After Pill (MAP) on Feb. 15, or anytime they need it. Among those who have signed is Kim Gandy, the president of the National Organization for Women and Patricia Ireland, former president.

The pledge, which has been sent to the FDA with hundreds of signatures, states: “Women all over the country are already breaking the law to evade an unjust law. Now we are proudly going public with our actions to make clear that we will continue to increase women’s access to the Morning-After Pill, illegally, if necessary.�

On the morning after Valentine’s Day (Feb. 15), women in Gainesville and New York City (and possibly elsewhere) will gather to speak to the press about our experiences, and to give friends the Morning-After Pill.

In New York, we are meeting at Rockefeller Plaza at 5th Avenue between 48th and 49th Streets at 1pm. If you would like more information about the action, please contact Cecilia Traini at ctrain3 (at) hotmail.com or Annie Tummino at tummino1 (at) yahoo.com

On Dec. 16, two FDA advisory committees voted overwhelmingly (23-4) to recommend that the FDA change the MAP to over-the-counter status. More than 70 health groups, including the American Medical Association and the American College of
Obstetricians and Gynecologists, say MAP is safe for over-the-counter distribution. More than 60 U.S. newspapers have taken an editorial position saying that MAP should be available without a prescription.

MAP is a safe backup birth control method that can be taken up to 120 hours after unprotected sex to prevent pregnancy, but it’s most effective within the first 24 hours after sex. MAP is not the same as RU-486, the so-called “French Abortion Pill� (If you are already pregnant, MAP will not work). The Morning-After Pill has been made inaccessible to women for decades by its prescription requirement. This means women have to get a doctor's appointment every time they need MAP— making it expensive and difficult (if not impossible) to obtain in time. Even requiring only a pharmacist’s prescription (behind-the-counter status) still poses serious obstacles to women’s access, and still places this reproductive decision in pharmacists’ hands.

MAP meets the FDA’s requirements for an over-the-counter drug. Allowing women to have over-the-counter access to the Morning-After Pill brings us one step closer to full reproductive freedom for all women. So we challenge FDA Commissioner McClellan to base his decision on science, instead of anti-woman politics. We say to the FDA: Take away the unfair barriers that drive up the cost and block timely access to MAP! Free up our access to the Morning-After Pill by making it available over-the-counter— and stop making us criminals!

Posted by: Great Leader at February 6, 2004 10:55 AM

[Blah blah blah blah right-to-life rigamarole baloney, deleted because I am a MIGHTY and POWERFUL GOD! HA!

Also, you gots to be MUCH CRAZIER if you expect your comments to stick around.]

Posted by: nomap at February 10, 2004 02:01 PM