If it wasn't bad enough that we have to deal with the anti-same sex marriage battles throughout the country I heard about a new debate brewing relating to pharmacists who would like to select which pills they are ethically comfortable providing to their customers.

Texas Considers 'Conscience Clause' for Phamacists
by Janet Heimlich All Things Considered, April 5, 2005 ·

A bill in Texas state legislature would protect pharmacists who refuse to fill
prescriptions based on their opposition to abortion. Most of the prescriptions
are for emergency contraceptives and birth control. Ten states are looking to
expand "conscience clauses" for pharmacists.

What this boils down to is the right to contraception or emergency morning after pills. The right to life pharmacists and lobbyists in states where the majority of people don’t want certain drugs legal in the first place believe that they should be required to fill prescriptions if they are ethically opposed to it.

Here is my take on it. A person who can decide whether a prescription is available to a patient or not is already available. That person is called a doctor. So if a prescription can only be obtained by a doctor it should only be deniable by a doctor. If a pharmacist wishes to go to medical school and become trained as a doctor then they would have a right to deny a prescription to a patient or to provide a prescription to a patient.

If a pharmacy claims to offer the service of filling prescriptions from doctors, is licensed by the state and employs licensed pharmacists, and an individual licensed pharmacist chooses to not provide the service then they should have their license revoked to provide the service. Why, because they are refusing to provide the licensed service and one that is specifically regulated through licensing in order to ensure that patients have their rights upheld and doctors prescriptions can be effectively and safely obtained with limited abuses.

This may get a little more complex when it comes to items that are over the counter at the pharmacist desk. There are items that are actually discretionary. I believe that certain forms of Tylenol containing codeine require the consumer to request the item from the pharmacist. This control is put into place to provide the consumer with adequate instructions on use of the product and potentially to log usage to monitor abuse. In the case of Tylenol with codeine the concern is that codeine is addictive and causes constipation in a large percentage of users. The consumer needs to be informed of this. But this does not give a pharmacist the new right to deny a consumer the items that have been placed behind the counter due to an ethical objection. If the pharmacist believes that ethically they believe that codeine causes evil spirits they shouldn’t have a sudden right to deny use by the over the counter consumer. They are licensed and trained to provide a specific service which is to manage public safety as mandated by the government for that drug. When they fail to do this they are not doing their job and should lose their license for not doing their job.

Unfortunately this is a states rights debate where the split is between the states with high religious backing and ones that are more secular and often less urban. It appears that two sets of laws will be appearing such that the same drug will be at the discretion of a pharmacist based on ethics in one state and will be available regardless of the pharmacist in other. The less urban areas are the ones where this will cause the biggest impact because people will be unable to conveniently avoid the proscription by the pharmacists.

I don't have a great recommendation to stop this nonsense other than a hope that the core of the US Constitution provides more rights for the consumer and equality than the individual providing the care. I don’t think this will bubble up to doctors since doctors tend to specialize and don’t provide procedures they are ethically opposed to like abortions, sex change operations, or plastic surgery.