[jasonsRX7]

I can not believe this. It's time for robot pharmacists now, I guess.

Lunatic pharmacists

An increasing number of pharmacists around the country are refusing to fill prescriptions for birth-control and morning-after pills, saying that dispensing the medications violates their personal moral or religious beliefs.

Edit: Don't know why my first post is showing up blank... so here it is again. Edit again, fixed link

[Goldfinger]

That moral and belief crap is going a bit out of control if you ask me.

If you did that here your right to sell medication would be taken away.

[DeathToWindows]

I'd be interested in finding out if such practices are merely unethical or illegal... if the customer has paid in advance, it'd be breaking an implicit contract, right?

[TETENAL]

If doing their job properly violates their religious believes than they should simply take another job.

[budster101]

Originally posted by Goldfinger:
That moral and belief crap is going a bit out of control if you ask me.

If you did that here your right to sell medication would be taken away.

I know OB/GYNE Doctors that do not prescribe birth control, for their moral beliefs.

Isn't Belgium like most of Europe, you don't need a prescription from a doctor? You just go to the pharmacy and ask for what you need... It isn't the same in the USA bub.

Birth control on general is not necessary for anyone. Only for some women who happen to have cysts on their ovaries, and need the medication for relief.

[jasonsRX7]

Originally posted by budster101:
Birth control on general is not necessary for anyone. Only for some women who happen to have cysts on their ovaries, and need the medication for relief.

Why does it have to be necessary? Tylenol isn't necessary, but it is nice to have when you don't want to have a headache. And birth control is nice to have if you want to have sex and not get pregnant.

[budster101]

Originally posted by jasonsRX7:
Why does it have to be necessary? Tylenol isn't necessary, but it is nice to have when you don't want to have a headache. And birth control is nice to have if you want to have sex and not get pregnant.

It isn't necessary, and preventing pregnancy is not the same as a headache medication. You don't take Tylenol to prevent a headache... you take it after you have one already.

You aren't suggesting that a day-after pill is necessary are you?

Preventing a life from being created is a bit beyond your presented argument's scope of comparing a headache to pregnancy.

Finally,

Tylenol is over-the-counter... not prescription.

[von Wrangell]

Originally posted by budster101:
I know OB/GYNE Doctors that do not prescribe birth control, for their moral beliefs.

Isn't Belgium like most of Europe, you don't need a prescription from a doctor? You just go to the pharmacy and ask for what you need... It isn't the same in the USA bub.

Birth control on general is not necessary for anyone. Only for some women who happen to have cysts on their ovaries, and need the medication for relief.

Those doctors would probably lose their license to practice medicine here in Europe.

And need a prescription for what? There are different categories towards what you need a prescription for, what you don't need one for and what you need to get a special licence for.

And birth control is absolutely necessary for most women. Even if it's just for women who are married but don't want to get kids at the moment or have enough kids.

[von Wrangell]

Originally posted by budster101:
You aren't suggesting that a day-after pill is necessary are you?

It can indeed be necessary. The woman might have forgotten to take the pill, the condom might have failed etc etc.

One question. Do you know how the day-after pill works?

[jasonsRX7]

Originally posted by budster101:
preventing pregnancy is not the same as a headache medication. (snip)
Preventing a life from being created is a bit beyond your presented argument's scope of comparing a headache to pregnancy.(snip)
Tylenol is over-the-counter... not prescription.

You're being more specific about the comparison than I was. Not all medicine that is available is necessary, but that doesn't stop it from being available.

If someone has a moral disagreement with the duties their job entails, shouldn't they quit that job? Wouldn't that be their moral obligation? Isn't that why animal rights activists don't go to work in slaughter houses?

[dcmacdaddy]

There is a similar article in today's Wasington Post. According to the article there is little if any state legislation outlining what a pharmacist can and cannot do in regards to refusing to fill a prescription due to personal moral/ethical objections.

So some states are passing laws giving pharmacists an "opt-out" option from filling prescriptions they find morally/ethically objectionable. While other states are passing legislation requiring pharmacists to fill all prescriptions regardless of their personal moral/ethical beliefs.

No doubt, there will be lawsuits on this topic in the near future.

From a business stand-point big chain pharmacies have a greater concern because they don't want to lose clients. So, they are making arrangements so that if a pharmacist has objections to filling a certain prescription they can have another pharmacist within their chain fill the order.

My concern is either a smaller regional pharmacy chain or a local pharmacy refusing to fill a prescription at all. If they are the only consumer option in smaller communities than the patient will not have other recourse to get their prescriptions.

And THAT possibility is very bothersome to me. It essentially allows a pharmacist to override the medical recommendations of a physician. Kinda scary if you ask me.


http://www.washingtonpost.com/wp-dyn...2005Mar27.html

Pharmacists' Rights at Front Of New Debate
Because of Beliefs, Some Refuse To Fill Birth Control Prescriptions
By Rob Stein
Washington Post Staff Writer
Monday, March 28, 2005; Page A01


Some pharmacists across the country are refusing to fill prescriptions for birth control and morning-after pills, saying that dispensing the medications violates their personal moral or religious beliefs.

The trend has opened a new front in the nation's battle over reproductive rights, sparking an intense debate over the competing rights of pharmacists to refuse to participate in something they consider repugnant and a woman's right to get medications her doctor has prescribed. It has also triggered pitched political battles in statehouses across the nation as politicians seek to pass laws either to protect pharmacists from being penalized -- or force them to carry out their duties.

"This is a very big issue that's just beginning to surface," said Steven H. Aden of the Christian Legal Society's Center for Law and Religious Freedom in Annandale, which defends pharmacists. "More and more pharmacists are becoming aware of their right to conscientiously refuse to pass objectionable medications across the counter. We are on the very front edge of a wave that's going to break not too far down the line."

An increasing number of clashes are occurring in drugstores across the country. Pharmacists often risk dismissal or other disciplinary action to stand up for their beliefs, while shaken teenage girls and women desperately call their doctors, frequently late at night, after being turned away by sometimes-lecturing men and women in white coats.

"There are pharmacists who will only give birth control pills to a woman if she's married. There are pharmacists who mistakenly believe contraception is a form of abortion and refuse to prescribe it to anyone," said Adam Sonfield of the Alan Guttmacher Institute in New York, which tracks reproductive issues. "There are even cases of pharmacists holding prescriptions hostage, where they won't even transfer it to another pharmacy when time is of the essence."

That is what happened to Kathleen Pulz and her husband, who panicked when the condom they were using broke. Their fear really spiked when the Walgreens pharmacy down the street from their home in Milwaukee refused to fill an emergency prescription for the morning-after pill.

"I couldn't believe it," said Pulz, 44, who with her husband had long ago decided they could not afford a fifth child. "How can they make that decision for us? I was outraged. At the same time, I was sad that we had to do this. But I was scared. I didn't know what we were going to do."

Supporters of pharmacists' rights see the trend as a welcome expression of personal belief. Women's groups see it as a major threat to reproductive rights and one of the latest manifestations of the religious right's growing political reach -- this time into the neighborhood pharmacy.

"This is another indication of the current political atmosphere and climate," said Rachel Laser of the National Women's Law Center in Washington. "It's outrageous. It's sex discrimination. It prevents access to a basic form of health care for women. We're going back in time."

The issue could intensify further if the Food and Drug Administration approves the sale of the Plan B morning-after pill without a prescription -- a controversial step that would likely make pharmacists the primary gatekeeper.

The question of health care workers refusing to provide certain services first emerged among doctors, nurses and other health care workers over abortions. The trend began to spread to pharmacists with the approval of the morning-after pill and physician-assisted suicide in Oregon, with support from such organizations as the U.S. Conference of Catholic Bishops and Pharmacists for Life International, which claims 1,600 members on six continents. Its members are primarily in the United States, Canada and Britain.

"Our group was founded with the idea of returning pharmacy to a healing-only profession. What's been going on is the use of medication to stop human life. That violates the ideal of the Hippocratic oath that medical practitioners should do no harm," said Karen L. Brauer, president of Pharmacists for Life, who was fired from a Kmart pharmacy in Delhi, Ohio, for refusing to fill birth control prescriptions.

No one knows exactly how often that is happening, but cases have been reported across the country, including in California, Washington, Georgia, Illinois, Louisiana, Massachusetts, Texas, New Hampshire, Ohio and North Carolina. Advocates on both sides say the refusals appear to be spreading, often surfacing only in the rare instances when women file complaints.

Pharmacists are regulated by state laws and can face disciplinary action from licensing boards. But the only case that has gotten that far involves Neil T. Noesen, who in 2002 refused to fill a University of Wisconsin student's birth control pill prescription at a Kmart in Menomonie, Wis., or transfer the prescription elsewhere. An administrative judge last month recommended Noesen be required to take ethics classes, alert future employers to his beliefs and pay what could be as much as $20,000 to cover the costs of the legal proceedings. The state pharmacy board will decide whether to impose that penalty next month.

"He's a devout Roman Catholic and believes participating in any action that inhibits or prohibits human life is a sin," said Aden of the Christian Legal Society. "The rights of pharmacists like him should be respected."

Wisconsin is one of at least 11 states considering "conscience clause" laws that would protect pharmacists such as Noesen. Four states already have laws that specifically allow pharmacists to refuse to fill prescriptions that violate their beliefs. At the same time, at least four states are considering laws that would explicitly require pharmacists to fill all prescriptions.

The American Pharmacists Association recently reaffirmed its policy that pharmacists can refuse to fill prescriptions as long as they make sure customers can get their medications some other way.

"We don't have a profession of robots. We have a profession of humans. We have to acknowledge that individual pharmacists have individual beliefs," said Susan C. Winckler, the association's vice president for policy and communications. "What we suggest is that they identify those situations ahead of time and have an alternative system set up so the patient has access to their therapy."

The alternative system can include making sure another pharmacist is on duty who can take over or making sure there is another pharmacy nearby willing to fill the prescription, Winckler said. "The key is that it should be seamless and avoids a conflict between the pharmacist's right to step away and the patient's right to obtain their medication," she said.

Brauer, of Pharmacists for Life, defends the right of pharmacists not only to decline to fill prescriptions themselves but also to refuse to refer customers elsewhere or transfer prescriptions.

"That's like saying, 'I don't kill people myself but let me tell you about the guy down the street who does.' What's that saying? 'I will not off your husband, but I know a buddy who will?' It's the same thing," said Brauer, who now works at a hospital pharmacy.

Large pharmacy chains, including Walgreens, Wal-Mart and CVS, have instituted similar policies that try to balance pharmacists' and customers' rights.

"We obviously do have pharmacists with individual moral and ethical beliefs. When it does happen, the pharmacist is asked to notify the manager that they have decided not to fill the prescription, and the manager has the obligation to make sure the customer has access to the prescription by another means," said Tiffany Bruce, a spokeswoman for Walgreens. "We have to respect the pharmacist, but we have to also respect the right of the person to receive the prescription."

Women's advocates say such policies are impractical, especially late at night in emergency situations involving the morning-after pill, which must be taken within 72 hours. Even in non-urgent cases, poor women have a hard time getting enough time off work or money to go from one pharmacy to another. Young women, who are often frightened and unsure of themselves, may simply give up when confronted by a judgmental pharmacist.

"What is a woman supposed to do in rural America, in places where there may only be one pharmacy?" asked Nancy Keenan, president of NARAL Pro-Choice America, which is launching a campaign today to counter the trend. "It's a slap in the face to women."

By the time Suzanne Richards, 21, finally got another pharmacy to fill her morning-after pill prescription -- after being rejected by a drive-through Brooks Pharmacy in Laconia, N.H., one late Saturday night in September -- the 72 hours had long passed.

"When he told me he wouldn't fill it, I just pulled over in the parking lot and started crying," said Richards, a single mother of a 3-year-old who runs her own cleaning service. "I just couldn't believe it. I was just trying to be responsible."

In the end, Richards turned out not to be pregnant, and Pulz was able to obtain her prescription last June directly from her doctor, though she does not think she was pregnant, either.

"I was lucky," Pulz said. "I can sympathize with someone who feels strongly and doesn't want to be involved. But they should just step out of the way and not interfere with someone else's decision. It's just not right."


� 2005 The Washington Post Company

[dcmacdaddy]

Originally posted by budster101:
It isn't necessary, and preventing pregnancy is not the same as a headache medication. You don't take Tylenol to prevent a headache... you take it after you have one already.

You aren't suggesting that a day-after pill is necessary are you?

Preventing a life from being created is a bit beyond your presented argument's scope of comparing a headache to pregnancy.

Finally,

Tylenol is over-the-counter... not prescription.

Whether or not birth-control pills are medically necessary is irrelevant. A doctor can prescribe them to a patient and the patient can get that prescription filled.

Are you trying to suggest/imply that doctors should not be allowed to prescribe birth-control pills? or that birth-control pills should not be medically permissible?

[OreoCookie]

Originally posted by budster101:
I know OB/GYNE Doctors that do not prescribe birth control, for their moral beliefs.

Isn't Belgium like most of Europe, you don't need a prescription from a doctor? You just go to the pharmacy and ask for what you need... It isn't the same in the USA bub.

Birth control on general is not necessary for anyone. Only for some women who happen to have cysts on their ovaries, and need the medication for relief.

No, in Germany, you need a prescription for most things. You can get things like Aspirin or something like that directly, but nothing `serious'.

[budster101]

Originally posted by dcmacdaddy:
Whether or not birth-control pills are medically necessary is irrelevant. A doctor can prescribe them to a patient and the patient can get that prescription filled.

Are you trying to suggest/imply that doctors should not be allowed to prescribe birth-control pills? or that birth-control pills should not be medically permissible?

I'm discussing the topic of the thread, about Pharmacists, and mentioned doctors I know who do not prescribe birth control on moral grounds.

I'm not implying or suggesting anything.

I even stated they would for MEDICAL reasons, (i.e., tubular cysts) My wife had them chronically, and were quite painful. The only way they would subside was to use BCP.

[dcmacdaddy]

Originally posted by budster101:
I'm discussing the topic of the thread, about Pharmacists, and mentioned doctors I know who do not prescribe birth control on moral grounds.

I'm not implying or suggesting anything.

I even stated they would for MEDICAL reasons, (i.e., tubular cysts) My wife had them chronically, and were quite painful. The only way they would subside was to use BCP.

Fair enough. I had a girlfriend with severe endometriosis who took birth control pills as medicine to minimize the effects of the endometriosis. I don't much about tubular cysts but it sounds just as painful and uncomfortable as endometriosis.

However, I still got questions.
Do you think doctors should be allowed to prescribe birth-control pills as a contraceptive (i.e.: to prevent pregnancy)?

[budster101]

Originally posted by dcmacdaddy:
Fair enough. I had a girlfriend with severe endometriosis who took birth control pills as medicine to minimize the effects of the endometriosis. I don't much about tubular cysts but it sounds just as painful and uncomfortable as endometriosis.

However, I still got questions.
Do you think doctors should be allowed to prescribe birth-control pills as a contraceptive (i.e.: to prevent pregnancy)?

Endometriosis *is* cysts on the ovaries.

They can prescribe what they feel is right for the patient's health as far as I am concerned, and that includes cutting edge medicines.

I can understand the doctors who do not wish to do so, but am not against their being prescribed.

We would then enter the realm of age, and notification of parents or guardians when the patient is then under 18.

[OreoCookie]

Originally posted by budster101:
...

I can understand the doctors who do not wish to do so, but am not against their being prescribed.

We would then enter the realm of age, and notification of parents or guardians when the patient is then under 18.

Ever heard of doctor-patient confidentiality?

[Severed Hand of Skywalker]

Totally idiotic, they should be charged and fired.

[budster101]

Originally posted by OreoCookie:
Ever heard of doctor-patient confidentiality?

Yeah,

When do minors have any rights when it comes to anything? As long as they are dependent on a parent or guardian, privacy is no issue. Their health is the responsibility of a guardian.

You must not have any kids, or are just a kid yourself.

[finboy]

Originally posted by Severed Hand of Skywalker:
Totally idiotic, they should be charged and fired.

The lack of sympathy from folks on this is telling. So, in other words, you should be told how your convictions and/or beliefs can be applied to your profession.

[jasonsRX7]

Originally posted by finboy:
The lack of sympathy from folks on this is telling. So, in other words, you should be told how your convictions and/or beliefs can be applied to your profession.

Well, you should evaluate a profession and the duties therein and if they conflict with your convictions and/or beliefs you should refrain from participating in that profession, rather than just singling out which aspects of the job you will refuse to do.

[dcmacdaddy]

Originally posted by finboy:
The lack of sympathy from folks on this is telling. So, in other words, you should be told how your convictions and/or beliefs can be applied to your profession.

If the owner of a pharmacy tells an employee that s/he must fill all prescriptions legally submitted, then the employee must do that as part of their job. An employee doesn't get to pick and choose which parts of their job they are willing to do, that is determined by the employer.

You can have all the convictions you want, but an employer has a right to determine what their employees can and cannot do on the job. I work for the Federal government. There is a HUGE list of activities I cannot do in my personal life--mostly relating to holding political office--because of my job.

That is one of the perquisites of the job. If I don't like it then I have to look for a job elsewhere. The same should hold for these pharmacists: If they don't like an aspect of their job, for whatever reason, they can either suck it up and do it anyway or look for a job elsewhere.

Now, a pharmacy owner is fully within their right to not fill certain prescriptions as they set policy, within the limits of the law, as to what their pharmacists can or cannot do. Now, if customers decide not to patronize them for their decision they have to be willing to accept that loss. They are not guaranteed to have a successful business.

[Detrius]

Originally posted by budster101:
Yeah,

When do minors have any rights when it comes to anything? As long as they are dependent on a parent or guardian, privacy is no issue. Their health is the responsibility of a guardian.

You must not have any kids, or are just a kid yourself.

Minors have rights when it comes to birth control. They should not need parental consent for birth control. If a 16 or 17 year old wants to have sex, but can't get the pill without permission, they just won't use the pill. They will find other less effective methods.

[Zimphire]

Originally posted by TETENAL:
If doing their job properly violates their religious believes than they should simply take another job.

I agree.

These people need to either get down from their horses, or quit.

[von Wrangell]

Originally posted by finboy:
The lack of sympathy from folks on this is telling. So, in other words, you should be told how your convictions and/or beliefs can be applied to your profession.

Would you apply the same argument for those who deserted from the military because of the war in Iraq? Or does it only apply when you agree with the decision?

[finboy]

Originally posted by von Wrangell:
Would you apply the same argument for those who deserted from the military because of the war in Iraq? Or does it only apply when you agree with the decision?

That's exactly my point. If it's OK for folks to leave the military because of the war, then it MUST BE OK for pharmacists to stop filling prescriptions that violate their personal beliefs.

I'd argue that the point of joining the military is to go to war, now or later, whereas pharmacists fill lots of prescriptions that may have nothing at odds with their chosen morality.

[galarneau]

I'm a family practice physician, and one part of my job is to evaluate whether or not a patient requires medication to treat illness. This is not a job exclusive to physicians. Nurse practitioners, PA's also have this job. Pharmacists do not. Period.

Now, I can see a pharmacist not wanting to fill a prescription for OCP's on moral grounds, but when they interfere with that patient getting the prescription filled by another pharmacist elsewhere, THEN they cross the line of what I feel is defensible behavior.

If you don't like the choices that a person is making by taking OCP's, then by all means, don't dispense them, but when you interfere with their getting a medication that has been legally prescribed, you're making a choice for them, one that you have absolutely no right to take part in.

I'm going to start stocking up on OCP samples and telling my patients to keep my number handy, so they can always have access to OCP's if they need it in an emergency. That's something I don't mind getting woken up at 3AM for. If I ever hear of a pharmacist doing that in my area, I'm going to go out of my way to make sure I never recommend that pharmacy to a patient.

I'm not a lawyer, so I don't know if what they're doing is against the law, but in my mind, it surely is unethical.


P.S.

Originally posted by budster101:
Endometriosis *is* cysts on the ovaries.

No it isn't. Ovarian cysts are something entirely different.

(Definition from NIH)
-------------------
Endometriosis occurs when tissue like that which lines the inside of uterus grows outside the uterus, usually on the surfaces of organs in the pelvic and abdominal areas, in places that it is not supposed to grow.

The word endometriosis comes from the word �endometrium��endo means �inside� and metrium (pronounced mee-tree-um) means �mother.� Health care providers call the tissue that lines the inside of the uterus (where a mother carries her baby) the endometrium.

[budster101]

Originally posted by Detrius:
Minors have rights when it comes to birth control. They should not need parental consent for birth control. If a 16 or 17 year old wants to have sex, but can't get the pill without permission, they just won't use the pill. They will find other less effective methods.

Most teen pregnancy is of teens who have parents that don't give a damn anyway, and most likely had their children at a young age. This has been my wife's experience working with women's health over the past 18 years.

Parental consent is absolutely necessary when they are minors. Minors do NOT have all the rights that adults do.

- No vote
- No driver's license (Permit, differes in states, and countries)
- No military service until 18 (17 if parental permission)
- No drinking until 21 (legally)

Limited rights, because, believe it or not, there is an area in the front of the brain in all teens that is underdeveloped until a later age (20's) that prevents risk taking.

This is a fact, and was demonstrated by statistics of automobile accidents in which a majority are teen driver related. (Under 20)

Link 1

Link 2

Link 3

Link 4

Link 5

Link 6

[OreoCookie]

Originally posted by budster101:
Yeah,

When do minors have any rights when it comes to anything? As long as they are dependent on a parent or guardian, privacy is no issue. Their health is the responsibility of a guardian.

You must not have any kids, or are just a kid yourself.

While your reasoning is cunning, I would advise you to ask a lawyer or a doctor about that.

[SimeyTheLimey]

Originally posted by jasonsRX7:
Well, you should evaluate a profession and the duties therein and if they conflict with your convictions and/or beliefs you should refrain from participating in that profession, rather than just singling out which aspects of the job you will refuse to do.

That isn't the general rule by any means. For example, lawyers have a general ethical duty to take on unpopular causes (for example, defending a notorious criminal). However, that rule is hortatory. No lawyer can be compelled to do work for a client that they find morally repugnant. For example, a couple of years ago, a number of Jewish associates of a major law firm in New York very publicly refused to do work for a Swiss client in connection to money and artwork stolen from Jews in the Holocaust. They acted according to their moral principles, and there is nothing unethical about that. In fact, I would go so far to say it would have been wrong for the law firm to have forced its employees to choose between the law firm's bottom line, and their sense of morality.

Try to think of this outside of what you personally think of their position to see whether you are really creating a general rule, or one tailored to your personal preferences. For example, if a restaurant hires a Muslim chef, would you force him to try the pork dishes? Must he choose between his religion, and the practice of his chosen profession? This is in principle not so different. Or what if he wants to not work the Friday night shift but is willing to work Sunday? Is it so awful to accommodate his religion?

Really, there are only three issues here. One is a duty imposed by state law. If the state has a statute saying that they must dispense these drugs, then that is controlling. Second, the pharmacists might be employees of the pharmacy, drug store, hospital, HMO, etc. If so, then the employer might have grounds for dismissal (as noxious as that step would be). Third, there may be a contractual relationship which not dispensing the drugs violates.

Other than that, I don't see any issue that would require them to decide between their moral and religious beliefs, and their job.

[Shaddim]

So, many of you feel that the state can tell a person how they can observe their religious/moral beliefs. Interesting. I'll remember this for later use.

I'll be curious to see if you have the ACLU working against you on this.

[OreoCookie]

Originally posted by SimeyTheLimey:
[snipped for brevity]

Other than that, I don't see any issue that would require them to decide between their moral and religious beliefs, and their job.

If the person involved is an employee, can he be forced by his employer to hand out the medication?

[Shaddim]

Originally posted by OreoCookie:
If the person involved is an employee, can he be forced by his employer to hand out the medication?

He can be told to fill out the perscription or have his employment terminated.

[SimeyTheLimey]

Originally posted by OreoCookie:
If the person involved is an employee, can he be forced by his employer to hand out the medication?

I'm afraid the answer is maybe.

The general rule in the US is at will employment, which means that the employer can fire for any reason at all (or no reason). However, there are many exceptions. It would depend on state law and the circumstances of this case. It's too complicated to generalize about. There are also potentially federal causes of action related to religious discrimination. Again, complicated. And on top of that there is state licensing of pharmacists. So more complications.

Leaving the legalities aside, though, there is still the moral question. Should an employer force an employee to do something minor connected to employment that it morally and religiously repugnant to the employee, such as the examples I gave -- forcing Muslim employees to tase pork dishes, miss their sabbath, or dispensing abortion pills?

[OreoCookie]

Originally posted by SimeyTheLimey:
I'm afraid the answer is maybe.

The general rule in the US is at will employment, which means that the employer can fire for any reason at all (or no reason). However, there are many exceptions. It would depend on state law and the circumstances of this case. It's too complicated to generalize about. There are also potentially federal causes of action related to religious discrimination. Again, complicated. And on top of that there is state licensing of pharmacists. So more complications.

Leaving the legalities aside, though, there is still the moral question. Should an employer force an employee to do something minor connected to employement that it morally and religiously repugnant to the employee, such as the examples I gave -- forcing Muslim employees to tase pork dishes, miss their sabbath, or dispensing abortion pills?

I thought you might say that (my father is a lawyer, too ...)

I was merely asking a legal question.

My own opinion on this case is that a pharmacist is not a regular profession, but one that is subject to special regulations (e. g. in Germany, you need to have studies pharmacy to own a pharmacie and touch certain types of medication, such as narcotics).

Also, in those cases, they do not decide on the medication (maybe the brand if generica do exist), similar to a nurse, but the doctor does. A nurse can't refuse to give certain types of treatment to a patient, too.

(And yes, I would be all for enforcing that rule, regardless if someone is Muslim, Jew, Christian or atheist).

[SimeyTheLimey]

Originally posted by OreoCookie:
I thought you might say that (my father is a lawyer, too ...)

You'll get me in trouble. I'm not a lawyer -- not yet at least. Even after the bar I won't be an employment lawyer (though I happen to be taking employment law now).

[OreoCookie]

Originally posted by SimeyTheLimey:
You'll get me in trouble. I'm not a lawyer -- not yet at least. Even after the bar I won't be an employment lawyer (though I happen to be taking employment law now).

My father is not practicing anymore, too, but still, the way of thinking is still that of a lawyer. My gf makes fun of me, because I start most explanations with `it depends ...'

[ReggieX]

Originally posted by MacNStein:
So, many of you feel that the state can tell a person how they can observe their religious/moral beliefs. Interesting. I'll remember this for later use.

I'll be curious to see if you have the ACLU working against you on this.

Would you rush to defend a pharmacist who refused to fill a prescription based on the patient's religion or skin colour? Or sexual orientation?

[SimeyTheLimey]

Originally posted by ReggieX:
Would you rush to defend a pharmacist who refused to fill a prescription based on the patient's religion or skin colour? Or sexual orientation?

This question wasn't directed to me, but I don't see how you think this is analogous. The pharmacists in this case aren't discriminating against anyone.

On the contrary, it is the pharmacists' religious and moral views that are under attack. How would you defend discriminating against them by forcing them to do something that they feel tramples their religious and moral beliefs?

And again, nobody seems to want to touch my question which is analogous. Would you support an employer who forces a Muslim chef to taste pork dishes?

[jasonsRX7]

Originally posted by SimeyTheLimey:
And again, nobody seems to want to touch my question which is analogous. Would you support an employer who forces a Muslim chef to taste pork dishes?

I'll touch it. I'd support an employer that forces his employees to cook the dishes that are on the menu. Regardless of faith. But that's really not what a pharmacist does, is it? The pharmacist isn't the chef, he's the waiter. Saftey and medical concerns aside, a pharmacists job really boils down to taking pills from one bottle and putting them in another, and then giving it to the customer.

So in that regard, I'd also support an employer forcing a waiter to deliver a customers order, if that is indeed what the waiter was hired to do.

[SimeyTheLimey]

Originally posted by jasonsRX7:
I'll touch it. I'd support an employer that forces his employees to cook the dishes that are on the menu. Regardless of faith.

You changed the question, and thus dodged it. I asked would you require the chef to taste pork dishes, not just cook them. (AFAIK, it is haram for a Muslim to eat pork, but not haram to observe non-Muslims doing so).

The question is not whether or not what the pharmacists are asked to do violates their religious consciences. You don't get to debate the theology. You don't get to tell them that their interpretation of their religious beliefs is wrong.

The question is whether or not you as an employer would tell them to do something that they tell you does violate their conscience. I'm putting you in a very precise situation where the secular needs of the employer and the religious conscience of the employee directly conflict. Don't dodge it by changing the question to one where they don't conflict.

So given that, would you make him eat the pork?

[dcmacdaddy]

Originally posted by SimeyTheLimey:
So given that, would you make him eat the pork?

Yup. Of course, if I was a restaurateur the chef wouldn't get hired by me if he wasn't willing to eat all the dishes he was hired to prepare. So, the employer has an obligation to let the prospective employee know ahead of time the requirements of the job. And the prospective employee has an obligation to let the prospective employer know ahead of time if the employee's religious faith or personal moreal/ethical convictions would prevent them from fulfilling all the requirements of the job. If they can't find an equitable middle ground on what is acceptable duties then the chef needs to look elsewhere for employment and the restaurateur needs to look at another candidate for chef.

Now, back to the pharmacists. If they have always refused to fill prescriptions for birth-control pills then they might be in a better position to argue their case. But it seems to me that if they just suddenly decide one day to stop doing it and want their employer to be OK with that, then they need to prepared to have the pharmacy owner say, "No, that is not acceptable" and be given the choice of doing their job as they previously did or looking elsewhere for employment.

For me it's quite simple. An employee decides one day that performing certain parts of his job is now in violation of his ethical/moral/religious principles. The question then becomes can the employer legally make the employee perform those tasks in opposition to said principles. I don't know the answer to that. I would imagine it varies from state to state. However, as an employer, I would hope that they are fully within their rights to reprimand, demote, or fire said employee for not fulfilling all the duties of their job regardless of the reasons for not fulfilling those duties.

Simey, are there general guidelines in labor law that distinguish the reasons *why* an employee might be allowed to refuse a task? In other words, if an employer fires a pharmacists for not filling prescriptions that they find morally offensive, does the law see it any differently from firing an employee who does not perform certain tasks for other non-moral, non-religious reasons.

[OreoCookie]

Originally posted by SimeyTheLimey:
You changed the question, and thus dodged it. I asked would you require the chef to taste pork dishes, not just cook them. (AFAIK, it is haram for a Muslim to eat pork, but not haram to observe non-Muslims doing so).

The question is not whether or not what the pharmacists are asked to do violates their religious consciences. You don't get to debate the theology. You don't get to tell them that their interpretation of their religious beliefs is wrong.

The question is whether or not you as an employer would tell them to do something that they tell you does violate their conscience. I'm putting you in a very precise situation where the secular needs of the employer and the religious conscience of the employee directly conflict. Don't dodge it by changing the question to one where they don't conflict.

So given that, would you make him eat the pork?

You cannot compare a chef to a pharmacist when it comes to his duties. (I've posted some about that above when I edited my last comment.)

A pharmacist is not a regular profession, but one that is subject to special regulations (e. g. in Germany, you need to have studies pharmacy to own a pharmacie and touch certain types of medication, such as narcotics, whereas for `regular' medication, you don't).

Also, in those cases, they do not decide on the medication (maybe the brand if generica do exist), similar to a nurse, but the doctor does. A nurse can't refuse to give certain types of treatment to a patient, too.

(And yes, I would be all for enforcing that rule, regardless if someone is Muslim, Jew, Christian or atheist).

[SimeyTheLimey]

Originally posted by dcmacdaddy:
Yup. Of course, if I was a restaurateur the chef wouldn't get hired by me if he wasn't willing to eat all the dishes he was hired to prepare. So, the employer has an obligation to let the prospective employee know ahead of time the requirements of the job. And the prospective employee has an obligation to let the prospective employer know ahead of time if the employee's religious faith or personal moreal/ethical convictions would prevent them from fulfilling all the requirements of the job. If they can't find an equitable middle ground on what is acceptable duties then the chef needs to look elsewhere for employment and the restaurateur needs to look at another candidate for chef.

OK, fair enough. However, I don't think that forcing a chef to eat pork when it is against his religion to do so is an equitable middle ground (this as just a moral question, not a legal one). It costs the employer a lot less than it costs the employee. Someone else could taste the dish, or someone else could fill the prescription. Or the loss of a single dish or prescription won't cost the employer his business, but the moral cost to the employee is huge.

I asked this question because I want you (and those who agree with you) to see that what you are in fact arguing for has nothing to do with the ethics and politics of abortion pills and whether or not you agree with the pharmacists' stance. It is basically whether the free exercise of religion extends to the workplace. You are basically saying that once someone steps foot in to an employer's premisis, his religious conscience is out the window. I don't think that is compatible with my sense of morality, but you are free to take that position.

Now, back to the pharmacists. If they have always refused to fill prescriptions for birth-control pills then they might be in a better position to argue their case.

My understanding is that this isn't about all birth control pills, but specifically about abortion pills (the morning after pill). Birth control pills have been on the market for years, but abortion pills are relatively new. So the situation is new.

In any case, it doesn't alter the question. If an employee converts to Islam (or any other religion), he doesn't have a lesser right to practice his religion. Just because he didn't object to eating pork yesterday, doesn't mean he can't object on perfectly valid religious grounds today.

The question then becomes can the employer legally make the employee perform those tasks in opposition to said principles.

The law here really isn't the issue. As I tried to point out above, there are a wide range of factual and legal questions that make the legal answer of whether or not an employer could fire for this without legal consequences a debatable one. The answer would vary so much from state to state and situation to situation that we really can't go there in the space of a general thread.

However, being legal and right aren't always the same thing. An employer can do all kinds of things that nevertheless make the employer a jerk. I'm more interested in the moral question than the outer boundaries of legally permissible behavior.

Simey, are there general guidelines in labor law that distinguish the reasons *why* an employee might be allowed to refuse a task? In other words, if an employer fires a pharmacists for not filling prescriptions that they find morally offensive, does the law see it any differently from firing an employee who does not perform certain tasks for other non-moral, non-religious reasons.

That is just a rephrasing of the same question of what the law is. In some places yes, it perhaps could make a difference, in other places, no it would not. It just depends. But remember, the law is just a floor. Employers don't have to sink that low (and most in fact do not).

[SimeyTheLimey]

Originally posted by OreoCookie:
You cannot compare a chef to a pharmacist when it comes to his duties. (I've posted some about that above when I edited my last comment.)

A pharmacist is not a regular profession, but one that is subject to special regulations (e. g. in Germany, you need to have studies pharmacy to own a pharmacie and touch certain types of medication, such as narcotics, whereas for `regular' medication, you don't).

Also, in those cases, they do not decide on the medication (maybe the brand if generica do exist), similar to a nurse, but the doctor does. A nurse can't refuse to give certain types of treatment to a patient, too.

(And yes, I would be all for enforcing that rule, regardless if someone is Muslim, Jew, Christian or atheist).

That is just another specific question about state law. You are making the assumption that the pharmacists' license requires them to fill all prescriptions. If that is the case, then this is an easy question.

However, you don't know that is the case and neither do I, and we can't really proceed on the basis of a blind assumption.

[dcmacdaddy]

Originally posted by SimeyTheLimey:
Nice thoughtful reply. But I want to focus on this one paragraph of yours.
I asked this question because I want you (and those who agree with you) to see that what you are in fact arguing for has nothing to do with the ethics and politics of abortion pills and whether or not you agree with the pharmacists' stance. It is basically whether the free exercise of religion extends to the workplace. You are basically saying that once someone steps foot in to an employer's premisis, his religious conscience is out the window. I don't think that is compatible with my sense of morality, but you are free to take that position.

Well, framing the argument in terms of "the free exercise of religion" is a nice way to narrowly define the argument in 1st Amendment terms but I am looking at it much more expansively.

An employee hold beliefs that don't permit them to fulfill part of the requirements of their job. For me, the reason why they can't fulfill the requirements is irrelevant. You seem to want to privilege only the religious apsect of this, but it could apply to numerous non-religious situations.

What if somoene refused to wait on black customers? What if an Indian pharmacist refused to serve Pakistani customers? What if a man refused to wait on women? These objections to a task are not based on religious differences (they could be, I will grant you that) but the outcome is the same: The employee is not doing the work they were hired to do.

Tell me, what is the difference betwen a pharmacist refusing to fill a prescription based on moral/religious reasons and one based on personal animosity towards a particular person or group of people? Does the law--more importantly, should the law--privilege one set of objections (religious) over another (personal animosity)? Would the law in fact be establishing a religious preference by granting employee's right to let their religious conscience supercede the employer's rights to have an employee fulfill all the tasks they were hired to do?

[SimeyTheLimey]

Originally posted by dcmacdaddy:
Well, framing the argument in terms of "the free exercise of religion" is a nice way to narrowly define the argument in 1st Amendment terms but I am looking at it much more expansively.

An employee hold beliefs that don't permit them to fulfill part of the requirements of their job. For me, the reason why they can't fulfill the requirements is irrelevant. You seem to want to privilege only the religious apsect of this, but it could apply to numerous non-religious situations.

What if somoene refused to wait on black customers? What if an Indian pharmacist refused to serve Pakistani customers? What if a man refused to wait on women? These objections to a task are not based on religious differences (they could be, I will grant you that) but the outcome is the same: The employee is not doing the work they were hired to do.

Tell me, what is the difference betwen a pharmacist refusing to fill a prescription based on moral/religious reasons and one based on personal animosity towards a particular person or group of people? Does the law--more importantly, should the law--privilege one set of objections (religious) over another (personal animosity)? Would the law in fact be establishing a religious preference by granting employee's right to let their religious conscience supercede the employer's rights to have an employee fulfill all the tasks they were hired to do?

I keep trying to tell you that this isn't a legal question without getting a lot more specific than any of us can do based on the information we have. Not all issues are defined by what the law says. For example, the First Amendment has virtually nothing to do with the issue because there is no state action. The First Amendment only restrains the state. (I suppose it could come in if there is a government license or statute involved telling pharmacists or their employers what to do, but we don't know that).

So leave the First Amendment out as a legal question. You can keep it in to the extent that the principle of respecting people's right to practice their religion extends well beyond the confines of the First Amendment. It's not that it is usually legally enforceable, it is that as a matter of respect between citizens, we do not approve of one group of citizens denigrating the religious beliefs of another and restricting the exercise of those beliefs even if they can do so legally.

Likewise, your analogy to racial discrimination. There is no constitutional reason that individuals can't discriminate against one another. The constitution only restrains the government.

However, there are specific statutes that apply to specific situations that can create legal liability for discrimination. Unless those statutes are triggered, the law simply has no say in the matter. But individual citizens can still make a moral judgement about whether a person (for example an employer) is behaving ethically.

Ethically, yes, I do think there is a difference between a pharmacist refusing to fill a prescription because it offends his religious beliefs from a pharmacist refusing to fill it because he is a racist. Generally and ethically, we view religion as something to protect, but not racial animus. Racial (and religious) animus is not something we should approve of (which is why I don't see how you can defend religious animus, which is basically what you are doing). I'd condemn the pharmacist who discriminates by race, but the employer who discriminates against his employee's religion. In either case, however, there may be nothing the law can do at all.

The effect is also different. A pharmacist who singles out customers by their race harms the customer in a way that a pharmacist who simply refuses to fill a prescription because of the content of the prescription does not. There is no hostility toward the customer here, but there is hostility toward the religious views of the pharmacist.

[OreoCookie]

Originally posted by SimeyTheLimey:
That is just another specific question about state law. You are making the assumption that the pharmacists' license requires them to fill all prescriptions. If that is the case, then this is an easy question.

However, you don't know that is the case and neither do I, and we can't really proceed on the basis of a blind assumption.

Well, law can certainly be shaped to make certain requirements to pharmacists. I actually don't know whether or not pharmacists in Germany are obliged to hand out medication, but on the other hand, I haven't heard of cases like this in the (German) media.

Even though we (meaning us two) don't know this specific case, we can still discuss whether or not those requirements should be made. And my point is that because of the peculiar nature of that job, such a requirement can be made obligatory by law (i. e. compliance would be a condition to hold a license). Like a nurse, their job is not to make the assessment whether or not birth control pills are (ethically or medically) appropriate, but the respective doctor does.

[SimeyTheLimey]

Originally posted by OreoCookie:
Well, law can certainly be shaped to make certain requirements to pharmacists. I actually don't know whether or not pharmacists in Germany are obliged to hand out medication, but on the other hand, I haven't heard of cases like this in the (German) media.

Even though we (meaning us two) don't know this specific case, we can still discuss whether or not those requirements should be made. And my point is that because of the peculiar nature of that job, such a requirement can be made obligatory by law (i. e. compliance would be a condition to hold a license). Like a nurse, their job is not to make the assessment whether or not birth control pills are (ethically or medically) appropriate, but the respective doctor does.

Or conversely, the license may say nothing or may specifically protect the pharmacists' right to conscience. I don't see where this would get us except to a legal morass that would invoke a complicated discussion of the First Amendment, heightened standards of review, etc (because licenses issued by the state are state action).

What's wrong with taking the law out of this and just asking the simpler question: Is it ethical for an employer to ask employees to do things that they know violate the religious conscience of the employee, or should the employer as an ethical matter accommodate the employee?

[OreoCookie]

Originally posted by SimeyTheLimey:
Or conversely, the license may say nothing or may specifically protect the pharmacists' right to conscience. I don't see where this would get us except to a legal morass that would invoke a complicated discussion of the First Amendment, heightened standards of review, etc (because licenses issued by the state are state action).

What's wrong with taking the law out of this and just asking the simpler question: Is it ethical for an employer to ask employees to do things that they know violate the religious conscience of the employee, or should the employer as an ethical matter accommodate the employee?

For me, the question is different: what is more important in this case: the personal belief of the employee of the pharmacy or the fulfillment of medical needs of a patient. I'm with the patient here. Especially in remote areas, a patient might have little choice in finding a pharmacy willing to hand out certain types of medication.