Fixing Pharmacies

It's an interesting question: to what extent should pharmacists be allowed to exercise their own judgment when filling legal prescriptions for their customers? The Times has a good discussion on this issue today, and it includes several quotes from pharmacists who insist upon their "right of conscience" to decide what drugs to dispense. The American Pharmacists Association, it is noted, supports that position. And while recent consideration of this question centers on Plan B, the article reports that many pharmacists have been refusing to fill prescriptions for birth control products for years.

The current legislative battle here seems to be between bills that exempt pharmacists from having to dispense certain classes of drugs, like birth control and "morning after" pills, verses bills that require pharmacists to fill every legal prescription. However, as we know from the aftermath of the Terri Schiavo case, narrowly-tailored bills that propose to speak to broad moral issues rarely stay narrowly-tailored for long.

The real, underlying question, then, isn't where to draw the line, but whether to have a line at all. If some pharmacists are demanding the right to consult their consciences, it isn't necessarily the case that all such consultation will involve specific drugs we can name in advance. Will a pharmacist opposed to birth control refuse to dispense drugs with "serious sexual side effects"? Will another not fill some prescriptions for antibiotics, believing that your case of the clap is God's punishment for sin? And should something be done about the strict Freudian who opposes the use of anti-depressants, and instead recommends some time on the couch?

Or how about these cases: Should a fire fighter be allowed to opt out of responding to the fire at the mosque because he believes that all Muslims are terrorists who hate America? Should a police officer be able to pass on investigating a certain crime (for example, marital rape) if he doesn't believe that it is "really" a crime?

There is no end to these sorts of troubling questions, and the only way to provide order to this moral mess is to draw the line, and draw it brightly: all pharmacies must be required to fill any legal prescription without delay. Once a legal prescription is written, pharmacists don't get to second-guess the doctor or the patient, in the same way that fire fighters don't get to choose which alarms they will respond to. If a particular pharmacist has moral qualms about filling certain prescriptions, he or she is free to work that out with the employer (e.g. arrange to always work with another pharmacist who can fill those problematic scripts). But no pharmacy should have the right to deny lawful medical care to anyone — the rights of the patient must take priority.