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Pharmacists Protest Prescribing Contraceptives on Grounds of Morality

June 30, 2005 at 12:00 AM EDT
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ELIZABETH BRACKETT: It’s a busy morning at Fitzgerald’s Pharmacy, the only pharmacy in Morrison, Illinois.

LUKE VANDER BLEEK: Fitzgerald’s pharmacy. This is Luke.

ELIZABETH BRACKETT: Pharmacist Luke Vander Bleek is busily filling prescriptions. But there is one prescription that he does not stock, and will not fill. Vander Bleek, along with an increasing number of pharmacists across the country, will not fill a prescription for the so-called “morning after pill,” for what he says are moral and religious reasons.

LUKE VANDER BLEEK: I’m opposed to all forms of abortion. And these abortifacients don’t belong in my pharmacy, and don’t belong under my watch because of my conscientious objection.

ELIZABETH BRACKETT: The morning after pill is an intense dosage of the original birth control pill that must be taken within 72 hours of unprotected sex in order to prevent a pregnancy.

Recent pharmacology graduate Matthew Thill told a Wisconsin legislative committee hearing that not only would he refuse to dispense the morning-after pill, he would not dispense birth control pills, either.

MATTHEW THILL: As a pharmacist who will conscientiously object, I would object to any medications that would be morally illicit in my mind, those that would end life early.

ELIZABETH BRACKETT: So, are there any birth control pills that you could dispense?

MATTHEW THILL: No.

ELIZABETH BRACKETT: Pharmacists like Vander Bleek and Thill say they merely want the same rights granted physicians and other healthcare workers in states across the country to not participate in what they believe are abortions.

LUKE VANDER BLEEK: I don’t know of any other instance where people are required to provide abortions, do you? I mean is there any other place in the United States where people don’t have the right of conscientious objection to that practice?

ELIZABETH BRACKETT: But those who favor women’s reproductive rights see this movement by pharmacists as very disturbing. Dr. Scott Spear runs the student health services at the University of Wisconsin.

DR. SCOTT SPEAR: This is a measured and well-planned and well-funded attack on birth control, and again, women’s right to make decisions about when to have a pregnancy and when to have their family.

ELIZABETH BRACKETT: Anti-abortion rights groups are pushing legislation with conscience clauses for pharmacists in state legislatures across the country. Four states have already passed bills that protect pharmacists from legal action for refusing to dispense birth control pills or the morning after pill. Eleven other states are considering similar legislation.

So far, no one knows how many of the 200,000 pharmacists around the country subscribe to this belief. But more than 3,000 pharmacists have formed a grassroots group, called Pharmacists for Life.

SPOKESPERSON: Healthcare for the rich and poor. Denying access no more!

ELIZABETH BRACKETT: Wisconsin is one of those states considering legislation to protect pharmacists. Last month, a protest was held outside a Milwaukee Walgreen’s where a pharmacist refused to fill a birth control prescription for contraceptives for a woman who was already the mother of six. She later became pregnant, and decided to abort the pregnancy. Chris Taylor of Planned Parenthood says many are upset.

CHRIS TAYLOR: There really is a level of outrage. There’s a level of disbelief, there’s a level of frustration that this possibly could be happening in 2005 when women are being denied access to birth control.

ELIZABETH BRACKETT: This suburban Milwaukee Walgreen’s refused to fill a prescription order for the morning after pill. The patient, who did not want to be identified, had gone to her doctor after panicking over a broken condom.

WOMAN: My husband and I and my doctor, we all agreed — and me especially agreed that I didn’t want to have another child, because I have four. And so she said, “Well, we’ll call in a prescription for you. Where do you want me to call it?” And I gave her the phone number, and about ten minutes later she called back to say — and she was outraged. She called the Walgreen’s, and they refused to fill my prescription.

ELIZABETH BRACKETT: What was your reaction?

WOMAN: I just couldn’t believe that somebody could do that, and take my right away.

TOM REYNOLDS: I’m sure it’s a contentious issue, but it is an important issue.

ELIZABETH BRACKETT: Last month the Wisconsin legislature started hearings on a bill that would protect pharmacists that refuse to fill a woman’s birth control prescription. The sponsor of the Conscience Clause for Pharmacists Bill, State Senator Tom Reynolds, says the bill is necessary because of the impact of the birth control pill, first approved in 1960. Today, an estimated 8.4 million women use the pill.

TOM REYNOLDS: There has been just a change sociologically or technologically that abortions have changed from surgical to chemical. So now we are in the situation where we are finding pharmacists that are in the situation where medical doctors used to be, where they are wanting to not to continue in their medical profession, but not be forced to, oh, do things that violate their conscience, their set of morals.

ELIZABETH BRACKETT: At the heart of the debate is whether the morning after pill, or birth control pills, cause an abortion. One medication, RU-486, or Mifepristone, does cause a medicated abortion. But it can be dispensed only by physicians, not pharmacists.

As a Roman Catholic ob-gyn, Dr. Julie Mickelson does not perform abortions. Nor does she prescribe birth control pills, because she believes that they, too, can occasionally cause an abortion by preventing implantation of the fertilized egg.

DR. JULIE MICKELSON: Life begins at the time of conception. We know that there’s a unique human being that has all the genetics components; it’s just has not implanted yet. So the idea of saying pregnancy doesn’t begin until implantation is really just a way of trying to brush away this whole idea of abortifacient action because it couldn’t be abortifacient if pregnancy doesn’t begin until implantation.

ELIZABETH BRACKETT: But Dr. Scott Spear says the very slim chance the pill could prevent implantation does not mean birth control pills cause abortions.

DR. SCOTT SPEAR: The medical opinion is that that’s just blatantly false. The general consensus in the medical field is that you don’t have a pregnancy until you have implantation of the embryo into the lining of the uterus. That’s when you get the hormones of pregnancy produced that you could detect an actual pregnancy.

ELIZABETH BRACKETT: The proposed Wisconsin bill does not require pharmacists who refuse to fill prescriptions on moral grounds to refer that prescription on to another pharmacist. Milwaukee pharmacist Jim Searles worries this is a slippery slope for his profession, one that will allow pharmacies to limit when a patient can get the pill.

JIM SEARLES: You’re stepping over a dangerous line and you’re getting into a religious philosophy. And in doing so, you’ll start to tear this profession apart. What’s good and what’s bad, and whose morals do you go by? And can one religion inflict their beliefs upon the next?

ELIZABETH BRACKETT: The lack of a referral requirement does not bother the legislative director of Pro-Life Wisconsin.

MATTHEW SANDE: Now, I will grant you, in some instances the women may be inconvenienced. She may have to wait a bit to have a prescription filled, because there may not be another pharmacist on staff that the pharmacist can hand the prescription to. But I will say that in this country, one person’s convenience should not trump another’s conscience.

SPOKESPERSON: Thank you very much for standing up for women’s reproductive health!

ELIZABETH BRACKETT: Supporters of universal access to birth control pills by women point to statistics showing that birth control reduces the abortion rate across the country. Planned Parenthood in Wisconsin says its services prevent over 35,000 unintended pregnancies and about 17,000 abortions every year.

It also estimates that almost 90 percent of the 25,000 pregnancies due to sexual assaults could be avoided with universal access to emergency contraception. Pharmacists’ conscience clause legislation would be devastating to women who have come to take contraceptive services for granted, says Planned Parenthood’s Chris Taylor.

CHRIS TAYLOR: Wisconsin is a rural state. There are many pharmacies or many communities that don’t have multiple pharmacies, where patients don’t have the option to go somewhere else, or have to drive a significant distance to get to another pharmacy.

ELIZABETH BRACKETT: While the trend has been to pass legislation to protect pharmacists, in Illinois, on April 1, Planned Parenthood rallied around Gov. Rod Blagojevich, who became the first governor to get involved in the fight.

GOV. ROD BLAGOJEVICH: This morning I issued an emergency regulation that requires pharmacies who sell contraceptives to fill prescriptions for birth control without delay. No hassles, no lectures, just fill the prescription.

ELIZABETH BRACKETT: The emergency order outraged Luke Vander Bleek. He says he is willing to stop stocking any oral contraceptives in order to avoid providing the morning after pill.

LUKE VANDER BLEEK: We’ll do that first, you know, before we go out of the pharmacy business. But it comes to, you know, where this aggressively gets enforced and the license becomes revoked as a result of it, we’ll stop the practice of pharmacy, because that’s not what I’m here to do.

ELIZABETH BRACKETT: Vander Bleek, along with five other pharmacists, have filed suit against the governor to rescind the order, and allow them to follow their conscience with no consequences.