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June 10, 2005



PAUL GIGOT: In Washington this week, a new development in the battle over abortion. Congressmen introduced legislation to prevent pharmacists from refusing to fill any legal prescription. That's what some pharmacists have been doing when women ask for birth control or morning-after pills. Our briefing is from correspondent Lisa Rudolph:

LISA RUDOLPH: If you're looking for small town USA -- homespun, all-American, Midwest values -- welcome to Troy, Illinois, official population 8600. Not much divides this conservative community. But lately, when you stop to talk to locals, whether it's the town newspaper or the "The Spot" diner you'll find opinions as strong as the coffee.

WOMAN: It's none of your business, no. It's totally up to that woman if she wants to take it or not.

MAN: Pharmacists has feelings just like anyone else. And I think it should be their discretion.

LISA RUDOLPH: 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.

RON STEPHENS: I believe that it's just like an abortion, the morning-after pill. And I don't want to participate in that.

LISA RUDOLPH: 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, 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.

ILLINOIS GOVERNOR: No lectures, just fill the prescriptions.

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

RON STEPHENS: A woman has a right to choose. And I'm saying as a practicing Christian, I have a right to choose too.

LISA RUDOLPH: But in fact, in Troy there are only two pharmacies. So it's certainly an inconvenience, if not a barrier to access for some women. Do you think that's fair?

RON STEPHENS: If it's a matter -- a question of your inconvenience versus my religious beliefs, and you're a state telling me that convenience wins out, I'm sorry. I'm going to maintain my religious belief.

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

KAREN ROMANO: I was absolutely mortified that this man was trying to delve into my most intimate and not to mention painful affairs to pursue his own moral agenda.

LISA RUDOLPH: The demand for emergency contraception is growing nationwide, from just over 17 thousand emergency contraception kits distributed in 1995 to nearly 775,000 in 2003. And with that increase, a growing number of women who are being turned away by morally opposed pharmacists.

STEPHANIE COX: Most of the time they just say, "Well, I'm not going to do it," or "It's not open for discussion." I have counterparts throughout the country, and they are all experiencing the same kind of situations.

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

STEPHANIE COX: Sometimes telling them erroneous information -- that it as causing an abortion or killing babies. And then the patient would call me back, hysterical, crying, because there is a short window of time when it's most effective.

LISA RUDOLPH: So if you don't get the pill in that window of time ...

STEPHANIE COX: It's not going to be as effective, no.

LISA RUDOLPH: 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.

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

LISA RUDOLPH: I think no one here is questioning your right to your beliefs and your religious freedom. The issue is, does that belong in the workplace.

RON STEPHENS: Absolutely. When we have to cower before the state when we are practicing our religious beliefs, then we've gone way in the wrong direction.

LISA RUDOLPH: 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.

STEPHANIE COX: What if a pharmacist doesn't think patients with AIDS should get their medication, because he views that as immoral sin? What if he doesn't think alcoholics should get medication, because they (quote) "brought it on themselves?" I mean where does it end?

LISA RUDOLPH: 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 patient's or the pharmacist's?


PAUL GIGOT: Some news this week, Dan. A third pharmacist in Illinois has sued to block the order on prescriptions, and a nurse sued Eastern Illinois University claiming that she was denied a promotion because she refused to prescribe the medication. As always in America, these disputes seem to end up in court.


PAUL GIGOT: Where do you come down on this issue of individual conscience for pharmacists versus reproductive rights?

DAN HENNINGER: Well, I'll tell you one place I come down. I would like to pose a question: is anyone other than me getting tired of these unending reproductive rights battles? I mean, Roe v. Wade was decided in 1973, and incessantly ever since this country has fought over abortion, over partial birth abortion, over parental notification. And here we are to fight and litigate over pharmacists and the morning-after pill.

And it seems to me that the ideas that the proponents of reproductive rights are going to use the law to coerce their opponents into complying is just not going to work. We'll be fighting about this. It will be a virtual Civil War for the next hundred years. They have to adopt another strategy, and I think there has to be a place in there somewhere for conscience of the sort these pharmacists are talking about, or we'll never get past this subject.

PAUL GIGOT: What's the precedent for other kinds of medical procedures, for example? We don't require doctors to do abortions, do we? I don't believe you do.

KIM STRASSEL: No. I mean, one of the reasons why they could have a difficult time compelling pharmacists to do this is because 47 states in this country have what are known as "right to conscience" laws. And what they say is that health workers do not have to provide medications, procedures, or services that go against their conscience. And it's one of the reasons why we can't demand doctors to perform abortions. But it also gets into far other issues, too, like whether or not you can compel a doctor to help in a capital punishment decision, for instance.

And this has been going on for a long time. The idea that anyone might read these laws to not include pharmacists seems a little far-fetched to me.

PAUL GIGOT: Can you compel somebody, a doctor, to participate in a capital punishment?

KIM STRASSEL: No, not in these states that have these rights-of-conscience laws. They're very much protected. And this is part of a much larger and very sort of intricate debate about medical ethics. This is not a new subject.

PAUL GIGOT: Bret, I want to get you to respond to a line from a NEW YORK TIMES editorial which takes the opposite point of view -- you may not be surprised to know. "This is an intolerable abuse of power by pharmacists, who have no business forcing their own moral or ethical views onto customers who may not share them." What's your reaction to that?

BRET STEPHENS: Well, I don't agree with them. Look, we have a system that is engineered to resolve these differences -- peacefully, if not amicably. And it's known as federalism. We never should have gone into the great national abortion debate to begin with, because we shouldn't have had national abortion laws. We should have had state legislatures deciding these things. It's the same thing that comes down to this microcosm with so-called pharmacists' rights versus the rights of their customers. Look, if you're a pharmacist and you don't want to dispense certain kinds of medication, I think that's your right. It's also the right of customers to go elsewhere. We make these sorts of decisions all the time in all other fields of life. We don't like restaurants because we don't like the menus they have, we go elsewhere. And pharmacies -- it's the capitalist system -- have to adapt or else they die.

Now, I think that it would strike me as bizarre to imagine that these women who have been denied their prescriptions by one pharmacy can't really go very far and get their prescriptions filled elsewhere. And it seems to me that's a perfectly normal solution to these kinds of problems in life.

PAUL GIGOT: Dan, there was a precedent here, was there not, in the case of AIDS? Because some doctors, for somewhat different reasons, did not want to treat AIDS patients. And yet the people who were part of the AIDS support network did go out and find a solution. How did that work?

DAN HENNINGER: Well, doctors who were willing to treat AIDS patients made that known, and I think it actually worked out pretty well because you didn't develop the expertise with a highly complex disease that allowed patients to get the treatment they needed.

This case, I think -- you know, in some ways it's a tempest in a teapot. This is an emergency pill. It's a high dose of contraceptive pill that's taken. It's a little two-pill kit that one can get if you're in an emergency of some sort -- which I guess either your protection didn't work or you weren't taking your contraception pills. So the incidence of people who find themselves in a situation like that has got to be relatively small, I would guess. And it hardly seems like the kind of issue that should be built into a great national legal battle over reproductive rights. There has got to be a better way to work this out.

PAUL GIGOT: There's a bill in Congress called the Workplace Religious Freedom Act, which would say that a pharmacist would not have to dispense a medication as long as there was another pharmacist who was able to do it. You know who the cosponsors of that bill are? Rick Santorum, a very conservative anti-abortion senator from Pennsylvania, and John Kerry of Massachusetts. That's what I call a broad coalition, on behalf of conscience. So I think that that's probably going to win.