August 2, 2007
Have you ever worked at a job where you got to decide who you wanted to deal with? With the exception of attorneys, consultants and lobbyists, I can't think of many other jobs which allow you to pick and choose who you want to serve. Wouldn't it be nice if we could all decide who are customers would be? I know I would.

This scenario is now being played out across the country by various pharamacists who are refusing to fill prescriptions for emergency contraceptives, also known as the "morning-after pill". In fact, a recently filed case in Federal court will test whether a Washington state law, which requires pharmacists to sell the emergency contraceptives over their religious objections, violates the pharmacists civil rights.

The claim by these particular pharmacists, but also among others, is that the use of the morning-after pill is tantamount to abortion and as such, their religious beliefs prohibit them from filling the prescriptions.

The Washington law says that pharmacists may opt out of filling the prescription by allowing a co-worker to fill the prescription BUT, and this is the key part, this rule only applies if the patient is able to get the presciption filled in the same visit. If the person must come back at a later time, the pharmacist must fill the prescription even if they morally object to doing so.

I fully realize that there are people, myself included, who would refuse to do a job for whatever reason. A vegetarian being told they have to kill an animal for instance. In most cases, accomodations can be made for the person so the job can be done.

However, the medical profession is unique in that its core principle is to provide goods and services which can have a direct effect on a person's life. Not providing those goods or services is never acceptable except in extreme circumstances.

If certain pharmacists object to providing what are essentially birth control pills because their religious beliefs supposedly prevent them from doing so, why are they working in a pharmacy? Their job requires them to dispense medication as prescribed by a doctor or, in this case, an over-the-counter medication which does not require a doctor's script (but only for adults).

If birth control pills are objected to, what about condoms? Certainly they prevent pregnancies. Do the pharmacists object to having to process purchases of these items? What about spermicides? Do they fall into the same category as birth control pills? If not, why? The sole purpose of a spermicide is to kill sperm before it reaches an egg, thus preventing pregnancy. What about medications for STDs such as herpes? Do the pharmacists have an objection to filling prescriptions for these medicines for people who may have been having sex out of marriage?

How about we take these examples one step further. What if doctors were allowed to refuse to provide care to someone for religious reasons. How about a doctor, who is Catholic, refusing to perform surgery on a pregnant, single woman? Is that acceptable? How about if a person of the Jewish faith refuses to operate on a person of the Muslim faith because that doctor believes that muslims are terrorists and don't deserve to be helped? What about the opposite situation? What about a doctor of any faith who refuses to perform an operation on a person because that person is an atheist? Again, what about the reverse situation?

Am I being foolish in my examples? Hardly. These are perfectly, logical questions that need to be asked to find out what is acceptable for a doctor or pharmacist to refuse to do based upon their religious beliefs and what is not.

I'm certain there are those who will say that by forcing them to fill prescriptions which they believe violates their religious beliefs, their civil rights are being violated. To be honest, they probably. But, like so many other things in life, these people chose to pursue (or sometimes fell into) this position. They knew, or should have known, that there might come a day when their beliefs would clash with some aspect of their job. Just because that realization has now set in does not abrogate them from fulfilling their duties.

Article 1, Section 11 of the Washington State Constitution states:

Absolute freedom of conscience in all matters of religious sentiment, belief and worship, shall be guaranteed to every individual, and no one shall be molested or disturbed in person or property on account of religion; but the liberty of conscience hereby secured shall not be so construed as to excuse acts of licentiousness or justify practices inconsistent with the peace and safety of the state. No public money or property shall be appropriated for or applied to any religious worship, exercise or instruction, or the support of any religious establishment: PROVIDED, HOWEVER, That this article shall not be so construed as to forbid the employment by the state of a chaplain for such of the state custodial, correctional, and mental institutions, or by a county's or public hospital district's hospital, health care facility, or hospice, as in the discretion of the legislature may seem justified. No religious qualification shall be required for any public office or employment, nor shall any person be incompetent as a witness or juror, in consequence of his opinion on matters of religion, nor be questioned in any court of justice touching his religious belief to affect the weight of his testimony. [AMENDMENT 88, 1993 House Joint Resolution No. 4200, p 3062. Approved November 2, 1993.]

A reading of the Article would seem to indicate that religious freedom is granted in Washington but note the exception. Acts of licentiousness shall not be excused. What exactly is licentiousness? Using my favorite online dictionary,, I find the following three definitions:

1. sexually unrestrained; lascivious; libertine; lewd.
2. unrestrained by law or general morality; lawless; immoral.
3. going beyond customary or proper bounds or limits; disregarding rules.

A bit further down on that same page, the American Heritage Dictionary definitions are:

1. Lacking moral discipline or ignoring legal restraint, especially in sexual conduct.
2. Having no regard for accepted rules or standards.

Obviously, we are not talking about lewd sexual behavior in the current case so that definition does not apply. It is the third definition (or second in the case of the American Heritage Dictionary) that applies. Specifically, disregarding rules.

The rule is, a pharmacist must dispense the morning-after pill, regardless of their moral objections, unless they can find someone else to do so during the person's current visit.

The rule is reasonable in that it does allow a pharmacist who has an objection to filling a morning-after prescription a way of not going against their moral compass, but it also makes clear that if they cannot find someone to fill the prescription, they are obligated to fulfill their duties as a pharmacist regardless of their moral objections.

Which is what this case, and others like it, boils down to. Doing your job. As I said earlier, these people chose to pursue a career as a pharmacist. They would be dealing with all kinds of personal, private information which most people wouldn't want others to know about. By overtly objecting to filling a prescription for a morning-after pill, they are drawing attention to someone who probably doesn't want the people around them knowing what is going on.

The right of people to worship as they please is an inalienable right. All persons are, or should be, free to worship, or not worship, as they see fit. However, when ones religious views conflict with a law, the person has two choices: either quit their job or follow the law and do their job. In the current case, the law trumps ones religious views. Pharmacists are in the business of dispensing medication. Either dispense the medication or quit.