Jun 16 2008
“Pro-Life” Drugstores
Folks, I’m a big believer in individual rights. I think if you have the resources to start a business, you should be allowed to. But I think a pro-life drugstore is a dangerous machination intended to prevent women from taking care of themselves. Let me tell you why.
I’ve mentioned before that women are often prescribed birth control to help with physical problems. My mother was on birth control when she had ovarian cysts (PCOS is increasingly common these days, and birth control helps relieve the symptoms for some women). I myself have been on birth control to relieve emotional symptoms associated with menstruation (PMDD - again, increasingly common, many birth controls advertise themselves as a means to relieve symptoms).
Therefore, women are prescribed birth control for a variety of reasons that have NOTHING to do with preventing pregnancy. That’s why I think it should be illegal for a pharmacist to refuse to dole out the medication and for an insurer to refuse coverage for those medications, WITHOUT EVEN TOUCHING THE MORAL ISSUES.
Secondly, I think it’s idiotic to intend to go into medicine, into nursing, into filling prescriptions with the intention of forcing your morals onto someone else. You know what, I applied for a job at Whole Foods once, when I was vegan. They told me they could put me in the deli, would I have a moral issue with that. And I said, nope, I wouldn’t.
Did I think eating meat, cheese, etc was morally wrong at that point? You bet your sweet monkey butt I did. Would I have refused to slice that meat and sell it to someone? Hell no. You know why? Because I respect individual rights, and also because I am not contributing to the problem by slicing meat that’s already been processed and selling it to you. You’re going to eat meat no matter what. And the store will sell it so long as there is a demand for it. So what would my refusal to participate do?
I didn’t take the job because it was in a bad location and they wouldn’t up my pay and also because they tried to strong-arm me into signing a contract. But my point is - I would have taken that job, moral issues aside, because everyone deserves a choice about their lifestyles.
What bugs me more than the fact that these places exist is that they don’t feel as though they have any responsibility to help out the potential customers who come in by sending them to another store. This is a shitty business practice, and a crappy way to treat another human being. Apparently, their morals justify being a douche-bag.
When someone came into Butler’s Orchard and asked me about picking peaches, I didn’t say “We don’t pick peaches here. Fuck off.” I said, “We don’t pick peaches here, but here’s a list of other local places that do and what they charge.” You know what that’s called? It’s called customer service, and when you’re interested in doing business with people, you learn it well.
Maybe some consumers will like going to a store and not having to glimpse a condom. Maybe some pharmacists will like not having to dole out birth control. Maybe what they’ll like more than anything is not having to deal with someone with differing morals.
My personal hope is that someone starts a chain of pharmacy/sex shops. Now that would be a convenient stop.
The pro-lifers don’t believe this is a lifestyle issue. They believe it’s an issue of murder, and that a woman who has to choose between murdering countless unborn babies and treating a disease should just have to suffer with her disease. Simple as that.
This is why I find it funny when pro-life people accuse pro-choice people of being just as dogmatic as they are. Or when creationists accuse evolutionary scientists of being dogmatic. People honestly can’t tell the difference between a nuanced argument and “So there.”
OK, when free enterprise is the issue, I’m a little to the right of Genghis Khan. I think the right to be stupid ought to be #11 in the bill of rights. If I own an independent drug store, what I choose to sell is my business. If you don’t want to shop there, that’s your business. But since it’s my capital, it’s my right to be stupid. Maybe my drug store is next door to the Vatican embassy. Maybe this fits my strange, convoluted marketing plan. As long as we have a market place choice, and we do, since there are 43,993 other drug stores that are willing to sell contraceptives, I think those seven independent druggists ought to be allowed to be stupid.
In theory, I agree with your point. But I think painting any issue as strictly one of free enterprise misses the point, too. Unchecked free enterprise is a crappy idea, it hurts us all. One or two or seven of these independent druggists might not be a big deal. But what happens when a state like, oh, Oklahoma has hundreds of independent druggists who refuse to fill a birth control prescription for a woman in Pawhuska, who then has to drive to Tulsa, or Oklahoma City to get a prescription filled? Can she do that every month? Would her insurance (if she has it) cover her to get a prescription filled online?
And I think these pharmacies should have to advertise. They don’t have to paint it as a negative thing. But they should clearly say they will not sell contraceptives. They could call it a family friendly pharmacy or something equally stupid and convoluted and alliterated. But they should be clearly marked.
Not clearly marking it makes it seem like they don’t want people to know how special and different their business plan is. It reeks of the “clinics” that paint themselves like planned parenthood when in fact they will not perform abortions and attempt to corner women on stirrups and then proselytize.
In short, I believe in free market so long as it is also a transparent market.
So men who murder countless babies by masturbating shouldn’t do that either? Should I cry every month over the menstrual blood and unfertilized egg in my toilet? Should I pull out a cat o’ nine tails and whip myself when I don’t get pregnant every month?
If I’m sterile, and all of my little eggs go to waste, am I an awful human being? Should I be praying every night for forgiveness? If I adopt a million hungry Asian babies from the Christian Children’s Fund, will He forgive me? And by He, I don’t mean God, just the fat man from the commercials.
It’s just funny to me, because something like, oh, contraceptives, simply prevents fertilization from occurring. If that’s wrong then every month since I was 13 that I haven’t gotten pregnant is a month when I’ve been being an awful Christian.
And if they’re really against unfertilized eggs, then why is something like the rhythm method acceptable? Because the effectiveness rate is so low that if you don’t get pregnant, God must have willed it?
That’s not being dogmatic. That’s hypocrisy and idiocy, all wrapped up in one neat package.
Can’t speak for Kara, but I don’t disagree with Dad in principle. That’s the beauty of the free market. If I walked into a pharmacy and found that they made a big deal of pushing their morals on everybody else, I would walk right out of there and find somewhere else to take my trade. Free market.
There is one situation in which this sort of thing becomes dangerous though, and that’s in areas where one specific set of morals abounds. Travel isn’t free, and I’m going to go to a crazy liberal extreme here and state that every pharmacy within a certain radius refusing to sell birth control constitutes de facto discrimination against the poor. Even if you don’t care about the disproportionate effect on the poor, consider the socioeconomic impact à la Freakonomics.
What happens in a small town in the Midwest, say fifteen miles from the next town, if the two pharmacists in that small town both decide they’re not going to sell contraceptives anymore? Unlikely, maybe1, but nothing actually prevents it from happening. Maybe both pharmacists happen to be observant Catholics. Perhaps there will be enough public backlash that someone will open a competing pharmacy, but I don’t think so. What I think will happen is that the people who can afford to will drive to the next town to buy contraceptives. In other words, the people who are screwed in this situation are young people and the very poor, who are–surprise–the people most likely to make stupid sexual choices and create children who rapidly become society’s problem.
I’m fine with a free market, but I also don’t think we should permit a situation in which a small number of individuals can effectively strip a much larger number of individuals of their ability to make responsible choices for themselves, especially when it’s to the potential detriment of society as a
whole.
EDIT: Kara beat me to it, and we pretty much said the same thing.
1 - Insert Graham Chapman explaining what it means to be a Protestant here.
Also, Kara: I wasn’t saying it wasn’t stupid, I was just saying that’s what some of those people really believe.
And don’t make me quote The Meaning of Life again.
Husband: Look at them, bloody Catholics filling up the bloody world full of bloody people they can’t afford to bloody feed.
Wife: What are we dear?
Husband: Protestant! And fiercely proud of it.
Wife: Why do they have so many children?
Husband: Because, every time they have sexual intercourse, they have to have a baby.
Wife: But it’s the same with us Harry.
Husband: What do you mean?
Wife: Well I mean we have two children, and we’ve had sexual intercourse twice.
Husband: That’s not the point, we could have it any time we wanted.
Wife: Really?
Husband: Oh yes, and once more since we don’t believe in all that papist clap-trap, we can take precautions.
Wife: What do you mean? Lock the door?
Husband: No, no, I mean because we are members of the protestant reformed church, which successfully challenged the autocratic power of the papacy in the mid 16th century, we can wear little rubber devices to prevent issue.
Wife: What do you mean?
Husband: I could if I wanted have sexual intercourse with you…
Wife: …oh yes Harry…
Husband: …and by wearing a rubber sheath over my old-fella, I could insure that when I came up, you would not be impregnated.
Wife: Ohh!
Husband: That’s what being a protestant is all about, that’s why it’s the church for me, that’s why it’s the church for anyone who respects the individual, and the individual’s rights to decide for him or her self. When Martin Luther nailed his protest up to the church door in 1517, he may not have realized the full significance of what he was doing. BUT 400 years later thanks to him my dear, I can wear what ever I want to on my John Thomas, and prodo- stantism doesn’t stop with a simple condom, oh no, I can wear French Ticklers if I want.
Wife: You what?
Husband: French Ticklers, Black Mambos, Crocodile Ribs, sheaths that are not only designed to protect, but also to enhance the stimulation of sexual congress.
Wife: Have you got one?
Husband: Have I got one, well.. no, but I can go down the road anytime I want and walk into Harry’s and hold my head up high and say in a loud and steady voice, “Harry, I want you to sell me a condom, in fact today I think I’ll have a French Tickler for I am a protestant.”
Wife: Well why don’t you?!
Husband: But they, they cannot, because their church never made the great leap out of the middle ages and the domination of alien Episcopal supremacy.
You guys are just nasty.
Let’s worry about the right things. For the record, there are very, very few independent druggists left. Pawhuska Oklahoma is served by an one independent druggist, and an Alco and Wal-Mart with pharmacies. I think the last two are scary ones.
The fundamentalist goofball pharmacist who decides the Hallmark cards have subliminal messages so he won’t carry them will auger in eventually. Somebody else will take his business. Most likely, that somebody will be Wal-Mart. So what happens when Wal-Mart pulls the rubber diddies off the shelves? No choice and no competition. It’s hard to imagine Wal-Mart passing up the revenue, but I suppose it’s possible.
I wanted to quote a shocking large dollar number here to show how large the market is, but a Google search of “contraceptive market size”, seems to ignore the middle term and returns very embarrassing data.
But that is the concern. If Wal-Mart sees independent druggists doing well while not selling contraceptives, maybe they’ll start taking them off shelves. And they wouldn’t take them off shelves in cities, they’d start by taking them off shelves in small towns, where Wal-Mart may be the only pharmacies within 20 miles.
That being said, Wal-Mart’s selection of birth control is not great, and there are very few oral contraceptives on their list of reduced cost pharmaceuticals, most of which are $30 a month, certainly not cheap (one is $10 a month). Of course, they’ve only recently added oral contraceptives to that list, anyway.
So maybe I’m worrying for nothing, but the idea that this could become a trend means that Wal-Mart could one day follow suit. And they wouldn’t take the contraceptives off the shelves in Germantown, Maryland, but they might do it in Pawhuska, Oklahoma.
Personally, while I’d like to believe free market could settle this issue - I’d rather not risk women suffering with physical ailments because some morally-minded folk decided that they and Wal-Mart ought not sell contraceptives as a result of some seriously illogical dogma.
What is it with you guys and Pawhuska?
I don’t buy the free market pressure argument when it comes to contraceptives for the simple reason that people don’t like to talk about them. If a pharmacist in small-town Oklahoma decides he’s not comfortable selling birth control, which of these scenarios is more likely?
A. Townspeople crowd around his place of business with signs reading “BRING BACK THE RUBBERS”
B. People discreetly travel to another pharmacy or town to buy contraceptives
How many people are actually going to be willing/able to vote with their wallets and stop doing business with their local pharmacist entirely?
With regard to oral contraceptives and Plan B, which I think are the bigger issue here: Some chain stores are taking steps to make sure their pharmacists are allowed not to dispense products they disagree with. It doesn’t have to be an independent druggist to be an issue of a single person imposing their morals on a town.
Ten states currently have some form of “conscience clause” that protects the right of pharmacists to refuse to dispense medication that they morally disagree with. There are measures under consideration in many more states. Only California and New Jersey place restrictions on a pharmacist’s ability to refuse (as of 2007, the most current data I could find).
It doesn’t matter whether you go to Wal-Mart, because the individual pharmacist still has the final say in whether or not you get the drugs you were prescribed. In ten states, he has near-absolute authority to impose his moral standards on you. In several of those states, he has no obligation to let you know where you can get your prescription filled or to help transfer your prescription to a different pharmacy.
I can’t help but see this as a women’s rights issue.
I wanted to mention that but I thought it was an entirely different point, and one that should in fact, be illegal. If you don’t want to fill a prescription that a doctor wrote for someone, don’t be a goddamn pharmacist. End of the story. I tried to hit at this with my explanation about Whole Foods. I do not have the moral authority to refuse to serve someone if my JOB DEMANDS IT. As a pharmacist, you don’t have the right to question prescriptions, shut up and fill them. Don’t like it? Get a new job.
Honestly, again, on the transparency issue - pharmacists who will not fill prescriptions for contraceptives or plan B should let doctors (who call in prescriptions) and customers know PUBLICLY - so they can take their business elsewhere. Doctors offices should be the first people they let know - so a doctor can direct a patient to a pharmacy that will fill their prescription with a minimum of effort required by the patient.
If there is not a database of these pharmacists and where they work somewhere, there should be.
My point was that a single crazy pharmacist can effectively make any small drugstore (with only one pharmacist on the clock) into a “pro-life drugstore.”
I don’t think that’s an entirely different issue from what you were talking about in your post.
I know this is late in the conversation, but I just read this entry, and as a person who has worked in various types of Pharmacies and am currently a Pharmacy Educator, I felt I had to comment.
A pharmacy may be a privately-owned, for-profit business (like many hospitals and ambulance companies), but ultimately each of these institutions has a responsibility to provide for the public good that trumps any sort of moral ideology. Just as the power company cannot turn off the juice to a pornography store simply because they disagree with what that store is legally doing, a pharmacist should not alter or deny a prescription without consulting the physician (and while there are valid reasons for doing this, moral outrage is not one of them).
A pharmacist would probably get fired if they tried to pull a stunt like this in a hospital or other institutional setting, but somehow it becomes okay when done in a retail setting is completely nonsensical. A hospital cannot deny treatment to a person who has overdosed on heroin because it feels that drug users are somehow “bad.”
It also seems funny to me that Plan B and related medications are the only ones that this seems to apply to. A pharmacy would probably get sued (and loose) if they had a pharmacist on staff who was Christian Scientist that would refuse to fill any antibiotic prescriptions because the patient should be praying instead. One never hears about pharmacists displaying moral outrage over having to dispense Viagra or other lifestyle medications.
The fact of the matter is that pharmacies are businesses that operate for the public good, and which just happen to also make money. In many small towns, there is only one pharmacy and no alternatives for the local residents. No pharmacist should have the power to make what is essentially a public-health decision that affects that whole community on the basis of a personal whim. In fact, a pharmacist should not interfere with the medical choices made between a patient and their physician except when a medication’s use would be adverse to the health of the patient.