Damn, how awesome is it that The Stranger is our local alternative paper? Last week there was a fantastic article about Club Z and this week The Stranger hits one over the fence on refusal clauses and pharmacists.

Here’s my take on the idea that pharmacists should be able to refuse to dispense things that go against their morality. This is a Right to Work Country which is basically an odd way of saying that people have the right to choose what jobs they want and employers have a right to choose what workers they want. We are not arbitrarily assigned some profession based on a central planning committee. We can choose what type of work we want to do as long as we are willing to accept the consequences of that choice. I could choose to be an artist as long as I was willing to accept that I won’t receive a regular paycheck, or I can choose to be a store clerk as long as I accept that I will have to follow the rules of the store.

Pharmacists don’t have to be pharmacists. They know going into the profession that they may be required to dispense things that they morally disagree with. I morally disagree with the military industrial complex- so I do not work for GE. I have a friend who also disagrees with it, but he likes the paycheck and the chance to live overseas that working for GE gives him, so he accepts the moral consequences. If he didn’t he would find work elsewhere.

But what about doctors? Doctors get a refusal clause because A) They perform the specific act resulting in life or death – pharmacists perform an auxiliary function but not the actual administration of either medications (doctors dispense RU486 in the office) or procedures that result in abortions and B) they physically risk their lives and families by choosing to perform abortions. No pharmacists have been killed to my knowledge for dispensing birth control- though that may change will the zealot of the wing nuts.

However, if it were up to me I would say there is enough specialization in medicine that if a doctor doesn’t want to perform abortions then he should not become a gynecologist- he can be a proctologist instead. Since specialization in not available for pharmacists (they are their own specialization within the medical field already) then they should choose another profession where their morals won’t be in conflict.

But why shouldn’t it be the patients that have to change pharmacies instead of the the pharmacists changing professions? Patients do have some choice of what pharmacy they go to, but it is in the interest of the greater good that patients in a crisis get the treatment they need in a timely manner rather than that pharmacists get to refuse service based on morality. We understand this with doctors, and doctors are not allowed to refuse treatment of a patient in a crisis. For example, if a woman came into the emergency room with an ectopic pregnancy a doctor could not refuse to perform a lifesaving operation even though he would be removing a fertilized egg. However, because doctors in hospitals are rarely there alone, the doctors usually have a backup if there is a procedure they are unwilling to do. But pharmacists generally work alone (or with clerks who do not have the same authorization as the pharmacist) and therefore a viable substitute cannot be utilized in a timely fashion. I would have no problems with a morality clause if pharmacies were required to keep 2 pharmacists on hand if one had objections to dispensing certain drugs. This would increase the cost of prescription drugs though, because of the necessity for redundant labor.