Prescription politics hard to swallow

April 22, 2005|By Clarence Page

WASHINGTON - I respect the feelings of pharmacists who, as a matter of conscience, refuse to sell the new "morning-after" emergency contraception pill. I also respectfully disagree with them. In fact, I wonder how many druggists who object to dispensing the morning-after pill have no objection to selling erectile-dysfunction drugs.

The issue of "conscientious objections," as the Ohio-based group Pharmacists for Life International calls them, has bubbled up in recent months with more than 100 reports of pharmacists who are just saying no to dispensing the morning-after pill, also known as Plan B.

Unlike the French drug RU-486, Plan B is not an abortion drug. Best taken within 24 hours of unprotected intercourse, the morning-after pill prevents ovulation or fertilization or blocks a fertilized egg from becoming implanted in the uterus.

About two dozen states have responded with a patchwork of legal and political actions.

For example, Illinois Gov. Rod R. Blagojevich recently made national headlines by ordering pharmacies, although not all pharmacists, in Illinois to fill Plan B prescriptions after an incident in which a pharmacist at a downtown Chicago drugstore refused to fill two. The Massachusetts legislature is considering a bill to let pharmacists dispense the pill without a doctor's prescription and require all hospitals to make it available to all rape victims. A bill in California would require objecting pharmacists to be prepared to make referrals to other drugstores.

Arkansas, South Dakota, Mississippi and Georgia have conscience-clause laws that allow pharmacists to refuse to dispense any drugs related to contraception or abortion on moral grounds. Legislatures in about a dozen other states are considering similar bills.

Who knows how many women and teen girls in distress already have been turned away and been too pained or embarrassed by the experience to go public. How many even would have the fortitude, in such circumstances, to object when a zealous pharmacist refuses, in an act of conscience, to refer them to another pharmacy or even to give them back their prescription?

Yes, that's the sort of control-freak action that Karen Brauer, president of Pharmacists for Life International, favors.

In interviews, Ms. Brauer has said that a pharmacist should not only refuse to dispense medication that offends her but also block all future access by that patient to that medication. Referrals, she says, would be like saying, "I don't kill people myself but let me tell you about the guy down the street who does." Is this the sort of information that major drugstores want their customers to hear when they come in with serious medical questions?

Of course, much of this Plan B dispute would become moot if the U.S. Food and Drug Administration were to approve the morning-after pill for over-the-counter sale. The agency's scientists and review panels support that move, but abortion politics are blocking it in Washington.

While we wait for common sense to invade the capital again, here's my suggestion: If druggists want to argue that they have the right to pick and choose which prescriptions to sell, they should be required to post their choices at the front door.

And, as a matter of gender equity, stores that refuse to sell Plan B on moral grounds, for example, should be prohibited from selling male-oriented sex aids. After all, selling sex-enhancement drugs to men while denying morning-after pills to women dodges moral responsibility too. It's sort of like sowing your wild oats on Saturday night, then praying on Sunday morning for crop failure.

Clarence Page is a columnist for the Chicago Tribune, a Tribune Publishing newspaper. His column appears Tuesdays and Fridays in The Sun.

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