‘Morning after’ morality

Earlier this month, Illinois Gov. Rod Blagojevich signed emergency

legislation requiring pharmacists around the state to fill

prescriptions for contraceptives, including those dubbed the “morning

after pill.” David Scimio, a pharmacist in Chicago, filed suit

against the state, saying the legislation violated his right to not

fill prescriptions for “emergency contraceptives,” in keeping with

his religious beliefs. According to Scimio’s attorneys, he previously

was able to refer patients seeking such contraceptives to another

pharmacy nearby. How much leeway should an employee have, regarding

actions that go against his beliefs (i.e. filling prescriptions for

contraceptives)?

No one should ever be forced to violate their conscience in order

to work, live, eat or exist. It is amazing to me that our culture

consistently awards people without conscience, but punishes people

with a conscience. Over and over again, it is the people of moral

conviction and conscience who are being marginalized as intolerant

and bigots.

Dr. Scimio is not forbidding people from getting the pill, nor is

he blocking their access. He is merely stating that he will not be

the conduit for prescriptions that violate his conscience. This is

not a medication that could potentially affect the new life, but is

designed specifically to destroy it. There is a big difference and

that difference is at the core of Dr. Scimio’s objection.

Gov. Blagojevich is forcing a hardworking American out of a job.

That kind of secular fundamentalism is what gives Christ-followers

the heebie-jeebies. That kind of fanaticism is seen as the beginning

of the persecution that will trumpet the arrival of the anti-Christ

and the end of time.

From a secular perspective, it is also very Orwellian. If we are

to remain the “land of the free,” then we must be free to abstain

from activities that violate our conscience. Corrie Ten Boom and her

family objected to the Nazi treatment of the Jews. Though not a Jew,

she was sent to a concentration camp with the Jews she protected. She

survived, but lost the rest of her family and their possessions. Many

others did the same.

Even today, our military allows for conscientious objectors. Why

should we require anything else of our civilians?

SENIOR ASSOCIATE

PASTOR RIC OLSEN

Harbor Trinity

Costa Mesa

“No delays, no hassles, no lectures.”

Using these words, the governor supported the rights of women to

get their prescriptions filled, over the claim of a pharmacist that

he did not have to fill the prescription for emergency contraception

because he disagrees with the morality of using it.

The pharmacist who has this belief should be the one to bear any

hardships caused by his personal ethical views, rather than shifting

the burden to the patient or consumer. I do not think that a woman

who wants this medication should hear one word of disapproval from

the pharmacist or be expected to go elsewhere, even two steps.

The “morning after pill” (also known as Levonorgestrel or Plan B)

is better termed “emergency contraception.” In emergency rooms, it is

standard operating procedure to offer it to rape victims. It is also

used where another form of contraception may have failed -- for

example, a condom that was not used at all, was not used properly, or

that broke.

Dr. Andre Lalonde, executive vice president of the Society of

Obstetricians and Gynecologists of Canada, has said, “Emergency

contraception has the potential to significantly reduce the incidence

of unintended pregnancy and the number of abortions performed.”

In many cases, the woman who needs emergency contraception is

already traumatized. She should not be subjected to treatment at a

pharmacy that humiliates or embarrasses her and which creates

barriers or causes delay.

Emergency contraception is most effective in preventing pregnancy

(95%) when used within 24 hours, so time is of the essence. It can be

effective up to 120 hours, but its success drops to 75%. It gives the

body a short, high burst of synthetic hormones that prevents

pregnancy by preventing ovulation, fertilization or implantation in

the uterine wall.

Regular birth control pills may also be used for emergency

contraception, with special dosage charts for using them for that

purpose available online. It is not practical as a regular

contraceptive method because it causes nausea and upset stomach, and

a woman would have to use it each time she had sex.

There is no teaching in Zen Buddhism that a woman must allow

ovulation, fertilization or implantation, or that taking

contraceptives or emergency contraceptives is immoral.

In Canada this week, the federal government approved regulatory

changes to allow emergency contraceptives to be dispensed from behind

the counter in pharmacies without a prescription. A further movement

is underway for emergency contraceptives to be available on the

shelf, rather than behind the counter.

If this happens in the U.S., the conscience issue for most

pharmacists would be moot. But it is not likely that we will see the

U.S. pharmacists who object to filling emergency contraceptive

prescriptions advocating this solution, because so many of them would

like these medications to be illegal or, failing that, try to make it

as difficult as possible for people to get them.

Last week, a bill was vetoed which would have required all

hospitals in Colorado, including Catholic facilities, to notify rape

victims of the availability of emergency contraception to avoid

pregnancy. A woman who is taken to a Catholic hospital in an

emergency should have the same treatment rights and options as

someone who is taken to a non-Catholic hospital.

In this case, the religious doctrine of the hospital is given a

priority over the quality of medical care given to the public, even

in emergencies where the patient was taken to the closest hospital.

Creating access barriers of any kind disproportionately impacts

people with low income, or who have language or literacy limitations.

Any woman who wants emergency contraceptives should be able to get

it, and the conscience of the pharmacist should not be used as a

reason to delay, hassle or lecture.

REV. DR. DEBORAH BARRETT

Zen Center of Orange County

Costa Mesa

Emergency contraception pills prevent pregnancy. They cannot

terminate an established pregnancy.

Pharmacists who reject a physician’s prescription for emergency

contraceptives claim the pill is an abortifacient (an agent that

causes abortion). But the Food and Drug Administration concluded,

“Emergency contraceptive pills are not effective if the woman is

pregnant.”

In fact, the “morning after pill” would prevent hundreds of

thousands of abortions from taking place. Any pharmacist so ignorant

of the reproductive system should be terminated, regardless of his

refusal to fill prescriptions.

Licensed by the state, pharmacists bear a public duty regardless

of their private morality. Should a pharmacist’s religious beliefs

trump a woman’s medical needs? Shall the pharmacist refuse

contraceptives to an unmarried woman for fear of abetting

fornication? Shall we return to the era of signs reading, “We reserve

the right to refuse service to anyone (anyone who is not the same as

we, that is)?”

The code of ethics for pharmacists reads in part: A pharmacist

promises to help individuals achieve optimum benefit from their

medications, to be committed to their welfare and to maintain their

trust. A pharmacist places concern for the well being of the patient

at the center of professional practice. A pharmacist promotes the

right of self-determination and recognizes individual self-worth ...

in all cases a pharmacist respects personal and cultural differences

among patients. A pharmacist acknowledges that colleagues and other

health professionals may differ in the beliefs and values they apply

to the care of the patient.

Arizona governor Janet Napolitano rightly vetoed a bill that

allowed pharmacists to refuse to provide emergency contraception, if

doing so conflicts with their moral or religious beliefs. She said

that pharmacies “have no right to interfere with the lawful personal

medical decisions made by patients and their doctors.”

A woman’s right to fulfill the directives of her physician

outweighs the pharmacist’s right to force his private morality into

her life. As healthcare professionals, pharmacists are responsible to

do what is medically best for each patient.

After all, you may seek relief from a migraine headache and bring

a prescription for Imitrex to a pharmacist. What if he holds a deep

religious belief that pain brings you closer to God?

RABBI MARK S. MILLER

Temple Bat Yahm

Newport Beach

Moral law and civil laws often collide. When they do, those of us

who prioritize moral law must determine whether or not we choose to

bear the consequences of violating civil law. Great efforts for

justice and peace spring immediately to mind.

Part of government’s business is, in ethical terms, “the greatest

good for the greatest number” of citizens. So this Christian

pharmacist in Illinois has great leeway in a variety of choices

including: pursuing his suit against the state, risking financial

losses; refusing to fill prescriptions which he feels violate his

religious beliefs, risking termination; moving into part-time

employment so that his pharmacy can hire another pharmacist who will

fill prescriptions he cannot, risking ridicule; continuing to refer

patients to another pharmacy nearby, risking both termination and

arrest.

I wonder if prescriptions for contraceptives are the only ones

that Mr. Scimio believes violate his Christian morals.

Personally, my conscience rebels every time I sign a “License and

Certificate of Marriage,” issued by the State of California. I ask

what a Christian minister is doing acting as an agent of the state. I

sign the licenses because consequences of not doing so would affect

me less than it would put the marriage partners at risk.

Sometimes collisions between civil laws and moral law are tempered

by pragmatism and by caring enough about others to prioritize their

needs.

(THE VERY REV’D CANON)

PETER D. HAYNES

Saint Michael & All Angels

Episcopal Church

Corona del Mar

This is a tricky question because I can see reasonable arguments

on both sides.

It would serve no purpose to force someone to do something that

violated their religious beliefs, and it would serve no purpose to

deny a customer something they are legally entitled to. On the other

hand, if a pharmacist believed that a certain drug like chemotherapy

was causing undo suffering and would not lead to a healing, would

they have the right to refuse that pharmaceutical request?

These and other questions are requiring more and more study in the

area of biomedical ethics.

My suggestion would be to employ a few biomedical ethicists and

see what kind of solutions they might be able to come up with. It

would also prove beneficial if the group of ethicists were joined by

some spiritual leaders for input and suggestions.

The issues here are not about denying a person’s spiritual

beliefs; they are about the possible violation of those beliefs. If,

however, the rhetoric heats up and people dig their heels in, it will

probably take longer to resolve and turn into a legal battle where it

will, more than likely, come down to how a judge or group of judges

interprets the law.

SENIOR PASTOR

JAMES TURRELL

Center for Spiritual Discovery

Costa Mesa