The Journal Editorial Report | June 10, 2005 | PBS
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briefing and opinion
June 10, 2005

Stephani Cox and Ron Stephens
Stephani Cox of Springfield area Planned Parenthood says pharmacists are professionally obligated to dispense all medication, regardless of personal morality. Troy pharmacist Ron Stephens insists that he has a right to conscientiously object. Q&A with Cox and Stephens >

Troy, Illinois
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If you are looking for small town USA -- homespun, all American midwest values -- welcome to Troy, Illinois, official population 8,600. Not much divides this conservative community, but lately when you stop to talk to locals, whether it is the town newspaper or the "The Spot" diner, you will find opinions as strong as the coffee.

The debate is over whether pharmacists like Ron Stephens -- who owns one of only two pharmacies in town -- can say no to customers who have a legal prescription for emergency contraception known as Plan B or the morning-after pill. "I believe that it is just like an abortion, the morning-after pill, and I don't want to participate in that," says Stephens.

Ron Stephens and the people of Troy
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Stephens, devout Christian and father of five, has also served as a Republican state representative for the last 20 years. He is now fighting Illinois' Governor Rod Blagojevich, who became first in nation to issue an emergency ruling ordering the state's 14,000 pharmacists to fill morning-after prescriptions, regardless of personal views.

At least 15 states have laws in place or pending on pharmacists' and patients' rights -- and like the debate itself, they are divided on the issue with some states giving pharmacists the right to refuse and others requiring them to fill the morning-after prescriptions.

In Troy, there are only two pharmacies. So it is certainly an inconvenience, if not a barrier to access, for some women. "A woman has a right to choose," says pharmacist Stephens. "I'm saying as a practicing Christian, I have a right to choose too. If it is a question of your inconvenience versus my religious beliefs, I'm sorry, I am going to maintain my religious belief," says Stephens.

Plan B Legislation
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But for women like Karen Romano of California, having her pharmacist refuse to fill a prescription was far more than an inconvenience.

"I was absolutely mortified that this man was trying to delve into my most intimate and painful affairs to impose his own moral agenda," says Romano.

The demand for emergency contraception is growing nationwide, from just over 17,000 emergency contraception kits distributed in 1995 to nearly 775,000 in 2003 and with it, a growing number of women whose prescriptions are being turned away by morally-opposed pharmacists.

At this Planned Parenthood clinic in Springfield, Illinois, it has happened nearly two dozen times in the last year, with some pharmacists making this the latest battleground in the fight over abortion.

"I have counterparts that are patients services directors throughout the country, and they are all experiencing the same kind of situations," says Stephani Cox of the Springfield area Planned Parenthood. "Sometimes telling them erroneous information -- that it was causing an abortion or killing babies. Then the patient would call me back, hysterical most of the time, crying, because there is a short window of time when it is most effective."

Planned Parenthood
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The Springfield Planned Parenthood clinic says the number of abortions this year compared to the same time last year is down by two-thirds and they say Plan B has a lot to do with it. While Americans are deeply divided over abortion, according to a CBS News poll, 78 percent say they don't believe pharmacists should refuse to sell birth control pills. Perhaps for that reason, opponents like Ron Stephens are focusing on First Amendment rights rather than reproductive rights.

"I can tell you that the majority of the people in my district don't agree with me on my position of whether I should dispense this medication or not," he says. "But they do agree with me that, if it is my religious conviction, the state shouldn't force me to violate it."

No one here is questioning an individual's right to his or her beliefs, the issue is, does that belong on the workplace? "Absolutely," says Stephens. When we have to cower before the state when we are practicing our religious beliefs, then we have gone way in the wrong direction.

The American Pharmacists Association has a compromise position that pharmacists can refuse to dispense medications they oppose as long as they direct the customer to someone who can fill the prescription. They call it the "step away" option, but some fear it could set a dangerous precedent.

"What if a pharmacist doesn't think patients with AIDS should get their medication, because he views that as a moral sin?" says Stephani Cox. "What if he doesn't think alcoholics should get medication, because they 'brought it on themselves?' I mean where does it end?"

The controversy could end if the FDA decides to approve Plan B as an over-the-counter medication. But, for now, it remains the latest front in America's culture wars over reproductive rights, the rights of the unborn and ultimately, the question of whose rights come first: the pharmacist's or the patient's?