2005.04.27
Burkah on the Bus
Not too long ago there was some issue about pharmacologists pharmacists being allowed to deny prescriptions because what they were dispensing went against their personal moral code. Essentially this was allowed so that Pro-Life medication dispensers could deny folks getting The Pill.
This is setting an interesting trend. What if the guy behind the counter at McDonald’s says, “Sorry, it’s against my judgment to serve you. You’re too fat.” What if the guy at the theater says, “Sorry, it’s against my religion to allow babies into the theater.” What if the guy at the unemployment desk says, “Sorry, it is my conviction that people need to stand on their own feet. You are denied.” What if the guy teaching kids says, “Sorry kids, my moral convictions impel me to not teach you because Christ is coming any day now.” What if the local bus driver refuses to allow a woman on, “Because it’s against my conscience to allow women not completely covered in a burkah on the bus.”
It sounds ridiculous, but then again so is allowing a service technician who is fulfilling a doctor’s order to deny someone their legal prescription. These people serve that one single role as far as the customer is concerned. Not to pass judgment, not to contradict the doctor, and certainly not to deny service. If you don’t like it then get a new career.
UPDATE 2005.04.27. NHK pointed out that I probably meant a pharmacist and not a pharmacologist. He is correct, and I’ve struck out the bad use of terminology above. Thanks, NHK!
Categorized: thoughts
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7 Responses to “Burkah on the Bus”
- Uncle Roger says (April 27th, 2005 at 07:49:05 )
A complex issue
Having worked in the pharmacy industry for 10 years, I’ve encountered this issue before.
A couple of years ago, there was a case in the midwest (iirc) of a pharmacist who refused to fill a prescription for birth control. It’s not as simple as it sounds, though. In that case, the pharmacist was the only one on duty, and he refused to return the prescription to the patient (so she was unable to get it filled elsewhere).
Refusing to fill it is not so much of a problem — any vendor can decide what products they will or won’t sell. An independent pharmacist can make that choice on their own.
One who works for a chain (and I believe the aforementioned druggist worked for K-Mart or Wal-mart) has to work it out with his/her employer. The employer may say that there will always be another pharmacist on duty at the same time who can dispense the problem meds or they may simply say that selling birth control pills is a condition of employment.
The problem, however, lies in the last part. By refusing to return the prescription, he denied her the ability to have it filled elsewhere. That’s illegal and unethical.
I’m not sure that I have a problem with a pharmacist choosing not to sell birth control pills, if they want, or not dispensing them if they can work that out with their employer, but I do have (as does the pharmacy board) a problem with a pharmacist holding a prescription hostage.
As for the other issues, they’re not really analogous… Someone selecting a specific person to treat differently is not the same as simply not offering something for sale (or saying, “one moment, let me get my associate to help you.”) A better analogy would be if McDonald’s (or a franchisee) decides to stop selling fat-laden french fries and only offer carrot sticks instead. Or if a theatre owner refuses to show the Passion of Christ or Farenheit 9/11.
- NHK says (April 27th, 2005 at 10:14:29 )
Did the woman eventually sue? I can’t recall.
“By refusing to return the prescription, he denied her the ability to have it filled elsewhere. That’s illegal and unethical.”Exactly. That woman should have (and perhaps did - I dunno) calmly stepped away, called the police, and waited for them to show up and retrieve her Rx from behind the counter. I hope she filed a grievance with the state pharmacy board, too.
- dugh says (April 27th, 2005 at 11:27:35 )
I don’t see a difference
Perhaps I’m wrong in my perception of what a pharmacologist is but my understanding is that you get a perscription and you go to the pharmacist to get it filled. Their duty isn’t to do much more, from a customer’s perspective, than to take the prescription and fill it. Am I wrong?If I’m not wrong then the pharmacy is a service and while there are conditions under which service can be denied, I believe they have to be stated very clearly outside the building. “No shirt, no shoes, no service.” Honestly, I do see the similarity in the examples I give, even if they are a bit extreme.
The analogy to McDonalds deciding to stop selling fat-laden fries doesn’t apply because that is a corporate decision. If a pharmacy stocks The Pill then they should be obligated to sell it regardless of their moral convictions. They can charge thousands of dollars to fill the prescription, but they should not be denying the prescription.
Besides, there are many women who are on The Pill for perfectly valid medical reasons. How is our morally “convicted” pharmacist going to know that?
- NHK says (April 27th, 2005 at 15:07:53 )
Dugh: I think you are perhaps saying “pharmacologist” when you actually mean “pharmacist”.
There are several instances where a pharmacist may choose to decline to fill an Rx. The most widely known examples (I think) being potentially significant drug interactions and forgeries of prescrptions for scheduled or widely abused drugs (highly illegal). In the latter case, I’m almost sure the pharmacist *is* allowed to retain the paper - and call the cops - so as to prevent the “customer” from trying to bilk someone else. As well, I saw someone get turned down once at a Walgreens. He was told loudly and pointedly to take his business elsewhere; but I did notice he was handed back his Rx. Whatever…More relevant to your comment above is that some pharmacies *do* make a decision not to stock certain things. E.g.: Oxy-Contin in West Virginia or perhaps Ortho Tri-Cyclen (a particular brand/formulation of “The Pill”) in the Midwest. I’m not a pharmacist or a legislator, but my understanding is that the pharmacy owner decides what (or what not to) carry. Though I imagine there *may* be some things they have to stock. I see your point, though. If there’s no medical or legal justification to refuse to fill a prescription, I personally think it would be a very good idea to legally require the pharmacist to dispense if the drug/product is on hand. And for the record (being very pro-population control), I think all pharmacies should be required to stock birth control pills.
“Besides, there are many women who are on The Pill for perfectly valid medical reasons. How is our morally “convicted” pharmacist going to know that?” He’d probably just ask. And what a heap of well-deserved trouble I bet he’d be in if somebody was prescribed those hormones for say, something life-threatening and unrelated to birth control and he chose not to believe them or dispense.
- NHK says (April 28th, 2005 at 01:25:56 )
“What if the guy at the theater says, “Sorry, it’s against my religion to allow babies into the theater.”"
I’d probably:
1. Ask him what he was doing later and if he wanted to go get a beer.
2. Convert to his religion.
- Uncle Roger says (April 28th, 2005 at 04:40:31 )
Open an Rx of worms…
First off, let me say (what you probably already know) that I have no problem with the pill in particular or birth control in general. My theory is, no party hat, no party, but if the pill works for you, then great. That aside…
A pharmacist is nothing more than a specialty retailer whose products are controlled by the government. There might be any number of reasons for a pharmacy not to carry a specific product — pharmacies in parts of Arizona and New Mexico might choose not to carry birth control if their entire clientelle lives in retirement communities. (I haven’t asked, but I’d bet good money that the otherwise fully stocked pharmacy at the Jewish Home (www.jhsf.org) doesn’t stock much birth control.) One of the reasons a pharmacy might not carry birth control is because of religious beliefs.
Now you determine where that decision is made. Is it at the corporate level (such as at Wal-Mart)? At the local level (by the store manager)? Or is it an individual decision by an employee? In the first case, there’s nothing you can really say — how can you force a company to sell something? Should the Gap sell birth control pills? Certainly Victoria’s Secret should. At the local level, it becomes an issue between the manager and the head office. The Long’s drugs in Daly City carries virtually no snow gear; in Truckee they have sleds, clothes, and more. Local decisions on what to sell are not uncommon. And people come up with all kinds of reasons for their business decisions — would a pharmacy that made the decision not to sell birth control any different than Ben & Jerry’s that also makes company decisions based on personal beliefs?
When you get to the individual pharmacist who doesn’t want to dispense birth control pills, it becomes an issue between the pharmacist and his employer. A million years ago, I worked at the Opera House McDonald’s. One of the jobs I had was to keep the little buckets that the condiments were in full. This meant going to the big fridge at the back, getting a five gallon bucket of pickles, sticking my hand in, and dumping handfuls of pickles into the little bucket. Now, I don’t hate pickles. I loathe pickles. And that’s an understatement. If I had thought I could get away with it (instead being laughed out the door), I would have gone to my boss and said I don’t want to fill the pickle bucket, pickles are evil. A pharmacist could do the same. Depending on his employer, he might get laughed out the door, told that he had to dispense the pills, or only scheduled to work when there was another pharmacist who could fill such prescriptions.
Long and the short of it is that if it’s a corporate decision, then the only solution is to take your business to someone who will sell you what you want. If the issue is with a single employee of the pharmacy, then it is an issue between the pharmacist and the company. (Although, I will stipulate that the company would need to do some placating of the customer if it came up.)
This argument could be equally applicable to guns. There are legitimate reasons for owning a gun. I once got into a long e-mail discussion with a guy which started because he flew off the handle when someone inquired about the best way to carry a handgun on a mountain bike. I pointed out that perhaps the guy was a law enforcement officer of some sort, or had some other valid reason for packing while riding. Since there are indeed valid reasons for owning a gun, should stores be required to sell them? The Long’s Drugs in Reno carries them; stores in California don’t. Do you have a problem with that? What if the reason a store — say, a Big 5 sporting good — decided not to sell guns was because they didn’t believe people today should be owning guns? Is that a problem? What about someone who worked at the store who felt that way and so refused to work the gun counter?
How about alcohol? There’s a local corner liquor store in San Mateo that as of June must stop selling booze. I don’t know all the details, but it seems that the owner of the building has found religion and has declared that no alcohol is to be sold in any of his properties. So the liquor store people can either rent a storefront elsewhere or stop selling liquor. It’s the landlord’s perogerative.
Going back to McDonald’s, sure, corporate could decide to only sell healthy, low-fat, low-calorie food. Or, perhaps one person could say “Cows are sacred; I won’t serve them as food.” Either way, it’s an issue for the company to decide. So, while I’m fully in favor of people not having kids if they haven’t made a specific decision to do so, I also support a company’s right to pick and choose what products they want to sell, or an employee to try and negotiate for working conditions they can live with.
- Uncle Roger says (April 28th, 2005 at 04:52:50 )
Oops!
Sorry, I didn’t mean to talk so much…
