There has recently been a great push in the world of women's health to consider prescription birth control (oral contraceptives, IUD, DepoProvera, etc.) not only a "right" but indeed a necessity – the "standard of care," if you will. The fact that ever-growing numbers of registered pharmacists are refusing to fill legal prescriptions for such birth control has caught the attention of quite a few powerful pro-choice and "feminist" groups, who have made it their goal to force such professionals by law to fill all such prescriptions with no questions asked. As a practicing pharmacist, I would like to try to address this issue.
First of all, I am one such pharmacist – I choose not to participate in any type of abortion, be it a physical or a chemical abortion. Let me start, then, by stating reasons why many consider birth control to be an abortifacient. The basic mechanism of most chemical birth control is three-fold: 1) to prevent ovulation 2) to thin the cervical fluid 3) to harden the uterine wall. Obviously, if a woman does not ovulate she cannot get pregnant, and since this is the primary mechanism of action, many would argue that abortion does not occur. However, no person or drug is perfect. Therefore, if and when ovulation does occur (a patient may forget to take it one or more days in the cycle, the dose may be too low for her body type, other medications/herbals may interfere, etc.) the other two mechanisms become important. The thinned cervical fluid makes it difficult for the sperm to reach the egg so that fertilization is unlikely. But should fertilization occur, the womb is now a hostile environment in which the fertilized egg is not likely to be able to implant. Now, this may be an area of dispute, but to me, life begins at fertilization (new DNA = new person), so when the fertilized egg is flushed out with the next period, an abortion occurs.
In my opinion, the two greatest pieces of evidence to prove that this is not so rare an occurence as we would like to believe are the number of pregnancies that occur while women are on birth control (we all know someone who got pregnant on the pill, and how many embryos were lost before that hearty one beat the odds?) and the fact that the so-called "morning after" pill is just a higher dose of the same hormone combination, given with specific intention of removing any fertilized eggs. It is impossible to know how compliant anyone is with her medications and therefore how likely she is to have one (or many) of these "silent abortions." I will not risk being a part of any of them – it is still killing and blood would be on my hands.
The groups that are pushing for pharmacists like me to "shut up and fill the prescription" argue that no matter what I believe about birth control, the decision occurs between a woman and her physician and I should not push my "morality" into the situation. I should not councel any patient about how this drug works (by the way, when was the last time your doctor told you how any drug works?) so that she can reconsider her decision, I should not warn her that birth control has been linked to an increased risk of breast cancer or can cause life-threatening thromboembolic events (blood clots) including stroke, I should not tell her about other side effects such as peripheral edema (swelling mainly of the ankles), severe nausea, decreased glucose tolerance (which can lead to diabetes), depression, anxiety, etc., and I most certainly should NOT be able to refuse to fill it. To me this is the same as forcing an OB/GYN to perform an abortion.
Why, then, does my profession exist? Why did I spend six years earning a doctorate in order to be told I play no part in the decision of what is appropriate drug therapy? Let me turn the situation around. Let's say a young woman is trying to get pregnant and succeeds but is not yet aware of the pregnancy. Unfortunately, she comes down with pneumonia. When she goes to the doctor, she tells him/her that she is allergic to penicillins. Said doctor prescribes doxycycline, but in haste forgets to ask if she may be pregnant and/or give the simple urine test to confirm such diagnosis. She brings me a prescription which is the right dose, duration and frequency, is perfectly legal, and seems to make sense for her infection. According to the above mentality, I should be required to fill it with no questions asked, since this treatment decision was already finalized between her and her physician. Indeed, I should not even bother mentioning whether the prescription was appropriate or not since it was legal – after all, that's all that counts, right? However, doxycycline is listed as pregnancy category D, meaning that it is known to be harmful to developing fetuses, and her baby is born with severe birth defects, or worse yet, does not survive. When her lawyer is making the list of health professionals to sue for malpractice, my name will be on it and I will have my license suspended if not revoked.
It is a horrible double standard to expect pharmacists to be on guard for honest mistakes in prescriptions, allergies and sensitivities, drug-drug and drug-food interactions, side effects, and other drug therapy problems that can cause illness or death, and yet to turn a blind eye to what they feel is murder. It is insulting that I am expected to only use my training and conscience to their full extent when it serves the whim of the masses and expected to act like a candy dispenser when the same training and conscience interfere with someone's comfort or lifestyle. It is discouraging that "freedom of choice" does not include the freedom of a licensed professional to practice the way that she chooses.
“The problem here is with #1. We’re not talking about a fetus. We’re not even talking about an implanted embryo. We’re talking about a pre-implantation zygote. I’m sorry, but I don’t believe there’s any evidence, scientific, ethical, or otherwise, that leads to the conclusion that a pre-implantation zygote is a human person or even a human being.”
It seems that you think there’s evidence that a developing zygote/fetus/embryo becomes a human person at another point, because you deny that there’s evidence of its human personhood at conception. So, to be consistent, your standard of evidence must be as high for another point during pregnancy or birth. Can you cite evidence that personhood is achieved at a point other than conception? If you can’t provide evidence for your position that personhood is attained at another point, then that means you’ve come at the issue with a very closed mind, and you decided that what you believe would be just that independent of your ability to provide an argument for it.
“And I don’t feel that I have to respect someone else’s belief that it is.”
Why not? If you don’t respect someone else’s beliefs here, why should anyone respect your beliefs anywhere?
Thanks for writing that bit Stuff. I certainly understand the moral dilemma you find yourself in.
What I don’t like is the end result. I think a woman looking to buy the morning after pill shouldn’t be walking into a roulette game when she walks in to a pharmacy. I don?t think any pharmacy can be forced to sell anything the owner does not want to sell, but I don?t think the availability of drugs should not depend on who is on shift at the time.
I also have a little trouble with your argument about abortion. I’ve heard that 2/3rds of fertilized eggs pass out of the vagina and do not result in pregnancy under normal circumstances (you or Jerry can correct me on that if I?m wrong). Taking a pill that increases the chance of that happening from about 66% to 95% (I guessing here) just does not seem that bad to me.
Final point about you being a professional and not a clerk. I can make my own decisions. Sometimes I seek the advice professionals, but I still want to make my own decision. More and more I see all medical professionals as obstacles. Dispense your damn advice, then get out of my way.
All that being said, I’m still uncertain where I stand on this issue. I agree with almost every logical point made on the different sides of this.
Steve,
I just had to chime in – because I couldn’t help myself – to say that condoms are allowed when used to keep medical devices sanitary (i.e. sonogram wands) as well as for sperm collection in moral medical testing provided that it is perforated prior to marital intercourse. The condom itself is amoral. It is the use to which you put it that carries morality.
Don’t know about the suggestive balloons though. 🙂
Hm, I cant agree with you in this particular case.
It’s time people woke up to the fact that the pro life movement is not just after abortion they want to ban contraception too.
This isn’t about saving babies, this is about putting women in their place!
Gloria Feldt, the former president of Planned Parenthood got it so very right when she said:
“When you peel back the layers of the anti-choice motivation, it always comes back to two things: What is the nature and purpose of human sexuality? And second, what is the role of women in the world?” Sex and the role of women are inextricably linked, because “if you can separate sex from procreation, you have given women the ability to participate in society on an equal basis with men.”
Can you smell what you’re shovelling? I don’t have time for a full rebuttal, but I can quickly point out that the author of this post is a woman who has a doctoral pharmacy degree, three beautiful, well-raised, homeschooled children, and does not see a contradiction in that nor does she feel “put in her place”.
When you peel back the layers of the modern feminist motivation, you find a sad delusion that in order to be treated equally by men, women must become like them and shed every vestige of their natural feminine attributes. What ever happened to the noble idea that women should be treated with equal dignity as human beings? Women are wonderous creations because of their womanhood, and should not be forced to become masculine in order to gain respect. Rejecting your nature to become what you are not is not equality. It is a form of slavery.
[Mary sent this response via email, but I didn’t see any good reason why it shouldn’t be seen publicly. – Funky]
Are you defining women by their reproductive functions?
Are women merely a means to an end?
Bear in mind that the average woman spends over three decades of her life being fertile. Should she be having a baby every year during that time so that she would fulfil her “god-given role”?
Wouldn’t that be a form of slavery, keeping women in perpetual childbearing not unlike battery hens who spend their whole lives producing eggs?
WHO estimates that throughout the developing 68.000 women die every year due to illegal abortion complications. Yet, people like you wish to deny them contraceptives which would go a long way to reduce abortion.
If your pharmacy was the only one around and you refused my prescription for contraceptive pills, my next stop would be the abortion clinic – legal or otherwise!
Actually, the Church wouldn’t deny or disagree with the first thing, except in how the question is answered. However, the Church would say that the second thing should be a matter of identity as a woman. That is, the roles women/men play are not nearly so important as what it means to be a woman/man. C.f. John Paul II’s “Theology of the Body”.
I don’t know if you knew about Chris West’s website. It has some good answers to these questions at http://www.christopherwest.com/works.asp .
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