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gender & sexuality | health | human & civil rights

Druggists refuse to give out pill

For a year, Julee Lacey stopped in a CVS pharmacy near her home in a Fort Worth suburb to get refills of her birth-control pills. Then one day last March, the pharmacist refused to fill Lacey's prescription because she did not believe in birth control.
Back to the Comstock Era
Back to the Comstock Era
"I was shocked," says Lacey, 33, who was not able to get her prescription until the next day and missed taking one of her pills. "Their job is not to regulate what people take or do. It's just to fill the prescription that was ordered by my physician."

Some pharmacists, however, disagree and refuse on moral grounds to fill prescriptions for contraceptives. And states from Rhode Island to Washington have proposed laws that would protect such decisions.

Mississippi enacted a sweeping statute that went into effect in July that allows health care providers, including pharmacists, to not participate in procedures that go against their conscience. South Dakota and Arkansas already had laws that protect a pharmacist's right to refuse to dispense medicines. Ten other states considered similar bills this year.

The American Pharmacists Association, with 50,000 members, has a policy that says druggists can refuse to fill prescriptions if they object on moral grounds, but they must make arrangements so a patient can still get the pills. Yet some pharmacists have refused to hand the prescription to another druggist to fill.

In Madison, Wis., a pharmacist faces possible disciplinary action by the state pharmacy board for refusing to transfer a woman's prescription for birth-control pills to another druggist or to give the slip back to her. He would not refill it because of his religious views.

Some advocates for women's reproductive rights are worried that such actions by pharmacists and legislatures are gaining momentum.

The U.S. House of Representatives passed a provision in September that would block federal funds from local, state and federal authorities if they make health care workers perform, pay for or make referrals for abortions.

"We have always understood that the battles about abortion were just the tip of a larger ideological iceberg, and that it's really birth control that they're after also," says Gloria Feldt, president of Planned Parenthood Federation of America.

"The explosion in the number of legislative initiatives and the number of individuals who are just saying, 'We're not going to fill that prescription for you because we don't believe in it' is astonishing," she said.

Pharmacists have moved to the front of the debate because of such drugs as the "morning-after" pill, which is emergency contraception that can prevent fertilization if taken within 120 hours of unprotected intercourse.

While some pharmacists cite religious reasons for opposing birth control, others believe life begins with fertilization and see hormonal contraceptives, and the morning-after pill in particular, as capable of causing an abortion.

"I refuse to dispense a drug with a significant mechanism to stop human life," says Karen Brauer, president of the 1,500-member Pharmacists for Life International. Brauer was fired in 1996 after she refused to refill a prescription for birth-control pills at a Kmart in the Cincinnati suburb of Delhi Township.

Lacey, of North Richland Hills, Texas, filed a complaint with the Texas Board of Pharmacy after her prescription was refused in March. In February, another Texas pharmacist at an Eckerd drug store in Denton wouldn't give contraceptives to a woman who was said to be a rape victim.

In the Madison case, pharmacist Neil Noesen, 30, after refusing to refill a birth-control prescription, did not transfer it to another pharmacist or return it to the woman. She was able to get her prescription refilled two days later at the same pharmacy, but she missed a pill because of the delay.

She filed a complaint after the incident occurred in the summer of 2002 in Menomonie, Wis. Christopher Klein, spokesman for Wisconsin's Department of Regulation and Licensing, says the issue is that Noesen didn't transfer or return the prescription. A hearing was held in October. The most severe punishment would be revoking Noesen's pharmacist license, but Klein says that is unlikely.

Susan Winckler, spokeswoman and staff counsel for the American Pharmacists Association, says it is rare that pharmacists refuse to fill a prescription for moral reasons. She says it is even less common for a pharmacist to refuse to provide a referral.

"The reality is every one of those instances is one too many," Winckler says. "Our policy supports stepping away but not obstructing."

In the 1970s, because of abortion and sterilization, some states adopted refusal clauses to allow certain health care professionals to opt out of providing those services. The issue re-emerged in the 1990s, says Adam Sonfield of the Alan Guttmacher Institute, which researches reproductive issues.

Sonfield says medical workers, insurers and employers increasingly want the right to refuse certain services because of medical developments, such as the "morning-after" pill, embryonic stem-cell research and assisted suicide.

"The more health care items you have that people feel are controversial, some people are going to object and want to opt out of being a part of that," he says.

In Wisconsin, a petition drive is underway to revive a proposed law that would protect pharmacists who refuse to prescribe drugs they believe could cause an abortion or be used for assisted suicide.

"It just recognizes that pharmacists should not be forced to choose between their consciences and their livelihoods," says Matt Sande of Pro-Life Wisconsin. "They should not be compelled to become parties to abortion."

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Abstinence The Only Option Taught in Texas Schools 11.Nov.2004 08:31

Ellen Goodman

The religious insanity continues:

Ellen Goodman

Here it is just days after the red states gave their presidential seal of approval to the man from Texas, and we've already been treated to another skirmish in the culture wars. The Texas Board of Education has now given its educational seal of approval to what may soon be dubbed Red Sex Ed.

The big news is the state's successful demand that textbook publishers change the description of marriage between "two people" to marriage between "a man and a woman." They also ordered that marriage be defined as "a lifelong union between a husband and a wife."

Frankly, I found the "lifelong" description charming considering that the Long Star State has one of the highest divorce rates in the country. Massachusetts, by the way, has the lowest divorce rate in the country. We are so fond of marriage that we want everyone to do it.

But never mind all that. The real heart of the textbook controversy is whether Texas students should learn about contraception. And the answer is no.

Texas has now officially gone to abstinence-only texts. Students are learning the ABCs of sex ed without the C. And as Texas goes, so may go the nation.

Only one of the four approved books even mentions contraceptives. The altered lessons teach students how to avoid sexually transmitted diseases in many ways - including "getting plenty of rest" - but not using condoms. One actually suggests using latex gloves to avoid contact with blood but says nothing about using latex . . . you get the idea.

Ironically, the state curriculum for health education still mandates that students "analyze the effectiveness and ineffectiveness of barrier protection and other contraceptive methods." But the books have expunged the information they're required to learn.

In some ways, this Texas story is proof of how the abstinence-only lobby is flexing its muscle. But Americans are nowhere nearly as polarized over sex education as it appears in this public wrangling.

Americans have come to some sort of uneasy understanding that sex education is not just about health, but also about values. It's not just about biology, but also about relationships.

As Samantha Smoot, who heads the Texas Freedom Network that opposes textbook censorship says, "Everyone agrees that abstinence is the best choice for teenagers. And everyone thinks books should give kids real negotiation skills and information that helps them make responsible decisions. Last summer, about 90 perecent of Texans surveyed said they wanted teens to learn about both abstinence and contraception.

Americans, especially parents, believe that teenagers should delay sex, even if we have trouble answering the next question: until when? Some believe sex should be postponed until that mystical age called maturity and others until marriage. Everyone seems to hope that their own kids will wait till they're no longer under our roof.

But it turns out that most parents are pragmatic as well as worried. We have rules and fallback positions. We don't want our kids to drink, but we want them to call us for a ride home if they do. We don't want them to have sex, but we hope they'll use protection if they do. If that's a mixed message, it's a safety message. And it's working.

During the past decade, teen pregnancy and births are down by about 30 percent. As a Centers for Disease Control and Prevention scientist showed, just about half the decrease in pregnancy comes from abstinence and half from increased contraceptive use.

Yet in Texas, with the highest teen birth rate in the country, an ardent minority is pushing abstinence-only information, or lack of information.

Sarah Brown, who runs the National Campaign to Prevent Teen Pregnancy, says the public argument is out of step with private reality. "We know that young people spend more time engaged in the media than in school, let alone in Mrs. Schmidt's health-education class," she says.

So this is where we are. We have a shared agreement on the importance of teaching both abstinence and protection. We have as well a shared opposition to the culture that sells sex like doughnuts.

But in politics we see only the most polarized debate in which we're told that we have to choose between A for abstinence and C for contraception. In this class, Texas gets an incomplete.

Muddled Thinking 11.Nov.2004 08:33

Curious George

Do any of these dipwads realize that, in refusing to provide contraceptives, they may be indirectly responsible for an unwanted pregnancy and the subsequent abortion?

I'd call that worse than preventing conception in the first place.

"Red State, Blue State," my ass 11.Nov.2004 09:13


I'm so sick of hearing about this supposed "Red State" "Blue State" dichotomy, as if everyone in the Red States are ignorant bigots and those in the Blue enlightened and wordly. I mean, have you ever been to Gresham? Seriously, I grew up in Connecticut, and whenever I have to go back for I am constantly amazed by the square, reactionary viewpoints I get from the wealthy Kerry supporters in the southwestern part of the state. In general, they don't have much more of a clue what's going on in the world than reactionary types in Georgia(where I also lived). They're usually not as overtly racist as in parts of the South(though many still use words like "nigger" as a normal part of their speech), but still have their quiet methods of keeping their tony suburbs lilly white. Overall, it's a class issue. These are the same people that were against Vietnam only to protect their own precious kids; most never raised a peep on behalf of black kids from Bridgeport and blue collar white kids from Brass Valley who were doing most of the actual fighting (and dying).

Besides which, and the obvious election fraud aside, if State A went one extra percentage point for Bush, and State B one for Kerry, how different are they really? I find that a huge percentage of liberal Democrats in the Northeast are actually unenlightened elitists.

Relieved in Texas 11.Nov.2004 10:08

ranch hand

The state's redefinition of marriage is a great step forward - at least for me. The former definition of marriage as a union between "two people" has been changed to a union between "a man and a woman." Okay, I realize a lot of them weird homosatchels have a problem with that, but they've got serious mental problems. For me the new definition is like a breath of freedom. Under the old rules I had to live in the shadows, and constantly worry I'd be found out. Now that marriage is defined not between "two people" but simply between "a man and a woman" I can at last openly pursue a future with the love of my life, Ernestine. She's a three year old ewe, and the sweetest, most beautiful, most loving creature you ever laid eyes on. No man could ask for more. I couldn't be happier.

uh, ranch hand 11.Nov.2004 13:41

White Lilac

I think you want to keep working on that language--you want marriage between a "male and female," not "man & woman." Sheep still lose under the new rules.