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BOB ABERNETHY: Several major decisions from the Supreme Court this week: Five of the nine justices voted to uphold President Obama’s health care law, saying the law’s individual mandate is legal. Religious groups were divided over the legislation. Some had called health care reform a moral imperative, while others worried the law would allow federally funded abortions. Faith communities had also lobbied hard around Arizona’s immigration law. On Monday, the court struck down three parts of that legislation, but it left in place the requirement that local police check the immigration status of people they believe could be in the country illegally. In another case, the justices ruled against mandatory sentences of life without parole for juveniles convicted of murder. They said courts should have discretion about imposing that punishment.

For more on the religious reaction to these decisions, Patricia Zapor of Catholic News Service is here, and so is Kim Lawton managing editor of this program. Welcome to you both.

PATRICIA ZAPOR (Catholic News Service): Thank you.

ABERNETHY: Pat, the health care decision: what do you hear?

ZAPOR: Well, I hear from some religious groups. Most mainstream religious groups are pleased with the outcome in general, although the Catholic bishops, for instance, cautioned that there are still a lot of parts of the health care law that are not quite perfect. It’s got issues for provision of contraceptives. It has not, what they consider inadequate protections for conscience for medical care providers. There are other things that they want to be addressed, but in general mainstream Christian groups are excited, because this is a way that the people who have been cut out of the health care system because they’re poor enough and they’re not rich enough might stand a chance of getting some decent health care.

KIM LAWTON: And a lot of the groups, Christian and Jewish groups and others, really lobbied hard to get this legislation passed as well so—

ZAPOR: Right. Some of them have been working at it for decades.

LAWTON: Yes. And so from them I’m hearing things like this is a victory for the common good and something that’s exercising the moral obligations to take care of people. But I’m also hearing a lot of concern from religious conservatives who see this as something terrible, the government reaching in violating peoples’ individual liberties. I’m hearing concerns about government funding of abortion and certainly the contraception mandate, which a lot of people feel does also violate religious liberty—the idea that religious groups have to provide free contraceptive services.

ABERNETHY: Even if they’re very strongly against contraception.

ZAPOR: Right, and that’s what the lawsuits were filed over

ABERNETHY: Summarize what that situation is now.

ZAPOR: Well, this is related to regulations from HHS and it’s actually at this point just proposed regulations from HHS about how the employer mandate, that employers provide health care plays out. And the Catholic Church and a bunch of churches, a bunch of religious groups in general, are worried that the way the possible provisions are currently written, they will be required to provide contraceptive coverage, which goes against their faith teachings, and they’ve sued over this. More than forty organizations filed lawsuits against the federal government challenging that a few weeks ago.

ABERNETHY: Go ahead.

LAWTON: Well, and there’s also—Well, I was just going to say, for some of the groups who support, who don’t oppose contraception, they’re worried about this notion of the government putting religious groups in different categories. So a worshiping institution would be exempt, but a faith based school would not or something like that.

ZAPOR: A hospital or school would not. And that’s another fight that they say has long since been settled, that religious organizations get to define themselves as religious organizations. The government doesn’t get to do that. That delves into First Amendment issues that nobody’s happy treading into.

LAWTON: And none of that was affected by this week’s decision.

ABERNETHY: Let me move on. Let me move on to the Arizona immigration decision. What have you heard about that in the way of reaction?

ZAPOR: Well, people are pleased with the parts that were overturned from the Arizona immigration law, the parts making it a state crime to be in the state illegally. The ruling was very clear in saying states don’t get to decide that this is a crime, and under federal law it is not. But they are worried about the provision, the “show me your papers” provision, that will allow law enforcement agencies to ask pretty much anyone who they think might possibly be in the country illegally for proof of residency, proof of legal status in the country.

ABERNETHY: But don’t they have to have some kind of other reason for stopping somebody, like speeding or something like that?

ZAPOR: That’s not clear, but they definitely have to have more than just “you look Latino.” There has to be more to it than that, and that was something that the ruling very narrowly said: We’re going to be watching this. You can’t be profiling people.

LAWTON: A lot of religious groups too are saying that this ruling—there was concern about this “show me your papers” provision, although some religious conservatives said, hey, it’s respect for the rule of law, and so there were some differences there. A lot of religious groups across the spectrum also said this shows the need for a federal immigration reform, comprehensive immigration reform at the federal level, and we’ve seen growing political activism on this, even from evangelicals who tend to be more politically conservative, but just saying that this shows that our country has an immigration problem that needs to be solved, and when you have these individual states coming up with differing laws, it makes the whole situation complicated.

ZAPOR: There was a large group of evangelical leaders who, a couple of weeks ago, came out with a statement just to that effect, and they reiterated that after this ruling.

ABERNETHY: Okay. Pat Zapor of Catholic News Service, Kim Lawton of Religion & Ethics NewsWeekly. Many thanks.

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BOB ABERRNETHY, host: In a coordinated effort, 43 Catholic institutions filed federal lawsuits to stop the Obama administration’s plan to require free coverage of contraceptive services. Among the plaintiffs were Catholic dioceses, hospitals, social service agencies, and universities, including Notre Dame. They say the requirement would infringe on their religious freedom. Supporters of the coverage plan say a proposed compromise would avoid religious liberty concerns, but the Catholic bishops reject that compromise. Meanwhile, a new Gallup Poll found that 82 percent of US Catholics believe birth control is morally acceptable. Fifteen percent said it was morally wrong.

Joining me now are Kim Lawton, managing editor of this program, and Kevin Eckstrom, editor-in-chief of Religion News Service. Kevin, Kim, welcome. Kevin, what do you make of this?

KEVIN ECKSTROM: Well, the Catholic institutions that filed suit are basically fighting over whether or not they have to provide birth control coverage to their employees in their insurance plans. That’s what the root of this is all about. The fact that they, 43 groups, came together and filed a dozen lawsuits shows that they are trying to come at this with the full weight of the church, to show that this is not just an isolated diocese or a small group, but that the whole range of the church is really upset about this. And it also signals, I think, that they don’t see any other alternative, that they don’t see a political compromise in the works with the White House. They, I think, in a lot of ways, feel like they have no other choice but to go to court.

KIM LAWTON: And they feel that the compromise that the White House has offered which some more progressive, liberal, moderate Catholics say that’s okay— these groups are saying no, it’s not okay. It doesn’t cover us, and for them it’s a matter of religious freedom, and they very clearly said, this is not about contraception, really. It’s about religious freedom and our ability to practice our beliefs and the government not telling us what to do, what we have to do, and the government not also saying who is a religious group that qualifies for an exemption from the policy.

ABERNETHY: And how representative do you think these groups are?

ECKSTROM: Well, they’re representative in that it’s a broad range. I mean, it’s schools, it’s groups, it’s dioceses, it’s big dioceses and small ones. But it’s only a handful of dioceses, I think, you know, less than 12 dioceses out of 200 or so in the country, so the vast majority of local dioceses did not join this suit.

ABERNETHY: But that doesn’t mean that they like, what’s going on.

ECKSTROM: Right. And a lot of them support what the bishops as a whole are trying to do, but there is some dissension in the ranks about what the best legal strategy is, and a lot of people, a lot of bishops, or some bishops think that this was a bit premature.

ABERNETHY: The fury of the opposition and the breadth of it suggest that the administration might have miscalculated when they presented this in the first place. Do you see that?

LAWTON: Well, the first policy, the first iteration of this policy got very widespread disapproval from a lot of Catholics, and we’ve heard that inside the administration there were people saying, warning the administration that this would not be popular. Now, more people, more Catholics have approved this, the compromise that the Obama administration tried to work out, but there are some suggestions that maybe they weren’t prepared for this and that the religious outreach wasn’t what it should have been in order to figure out how to maneuver this.

ABERNETHY: Quickly, you agree?

ECKSTROM: Yeah, and a lot of Catholic bishops said that they were basically blindsided by this. They were never consulted beforehand and say hey, this is what we’re planning to do, what do you think? Can we find something that works? Instead, they were just handed this and said take it or leave it, and the bishops basically have said no, we’re not going to take it.

ABERNETHY: Right in the middle of an election year.

ECKSTROM: Right. And there is some concern both within the bishops’ conference but also without that the bishops risk appearing to be anti-Obama or perhaps too Republican and that the timing on this needs to be very, very sensitive.

ABERNETHY: Kevin Eckstrom. Kim Lawton. Many thanks.

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KIM LAWTON, guest host: Now, more on religion and politics with Kevin Eckstrom, editor in chief of Religion News Service. Kevin, we’ve seen since the very beginning of this primary season that Mitt Romney has consistently done best among the Catholic voters in contrast to Rick Santorum, who is Catholic, and this really helped him out of course last week in Ohio, where about a third of the Republican voters were Catholics, and he got the majority of them and that helped him win. Why do you think that Catholics are really gravitating toward Romney as opposed to Santorum?

KEVIN ECKSTROM (Editor-in-Chief, Religion News Service): Well, I think it’s because Rick Santorum is sort of a very particular kind of Catholic that is a bit actually outside the mainstream of the American Catholic church. You know, the surveys indicate that the American Catholic church, or the American Catholics don’t buy the line that the contraception mandate, for example, is an attack on religious freedom, which is what Rick Santorum and the bishops have been saying. They don’t buy that. Americans Catholics by and large use contraception. Rick Santorum thinks it’s a moral evil, and so there is a disconnect. He is a particular kind of Catholic that I think is a little bit out step with the mainstream, rank-and-file Catholic church, and so I think when they look to him, a lot of them don’t see themselves in him, and a lot of people actually don’t even know that he’s Catholic. Most people assume he’s an evangelical.

LAWTON: And he also generated controversy when he criticized John F. Kennedy’s speech where he talked about the separation of church and state, and Santorum was very critical of that. He said that speech shows a philosophy that wants to keep religion out the public square. He wants to have more religion in the public square of all stripes, he says, and that also affected perhaps some of the Catholic views of him.

EKSTROM: Right. Again, you know, there are Rick Santorum Catholics and John F. Kennedy Catholics, and I think most Catholics, when they look at the two, they sort of identify with John F. Kennedy. They are fine with the separation of church and state. They actually think it’s a good thing. Rick Santorum thinks it’s kind of a bad thing. But what you see, I think, is Rick Santorum in a lot of ways is the Tea Party candidate in this race. I mean, he’s talking about issues of freedom and liberty and big, aggressive government, and that’s really not in line where most Catholics are, sort of the rank and file. They’re just of a different stripe, and so he’s going after the base of the party, and that’s really not where the Catholics are.

LAWTON: Rick Santorum has done extremely well among evangelicals. Of course, there are evangelicals who do support Mitt Romney, but by and large Santorum’s been getting the majority of those votes and especially in states where there are a large number of evangelicals. That’s made a big difference for him. We have a couple states coming up, Mississippi, Alabama, where that may be a factor for Santorum.

ECKSTROM: Right, and in a place like Tennessee, which Rick Santorum won, I mean, he won the evangelical vote decisively, and the thing to watch, I think, in the Southern primaries coming up, in Alabama and Mississippi, is how well he does among evangelicals and how well Newt Gingrich, who also has strong appeal among some evangelicals, how they do. And one of them is going to get that vote and I think if Santorum gets it, I think Newt Gingrich is pretty much done. But, you know, one of them is going to be the evangelical candidate, because clearly Mitt Romney is not, and I think the next coming week will tell us who that’s going to be.

LAWTON: And, of course, there’s been a lot of jockeying already, everybody calling on the other one to get out of the race, saying that if it were more of a two-man race that perhaps it would be a more interesting competition.

ECKSTROM: Right, and I think, as we’ve talked about, Newt Gingrich really has two roles he can play here. He can be a kingmaker and step aside and throw his support behind one candidate or the other. Or he can be a spoiler and prohibit, you know, drag out this contest among conservatives even longer.

LAWTON: Well, we’ll keep watching. Thank you so much, Kevin Eckstrom.

ECKSTROM: Thank you.

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BOB ABERNETHY, host: Familiar social issues led the religion news this week. In Washington, the Obama administration made a significant change in its policy on insurance coverage of contraception by religiously affiliated organizations. Any employer with a religious objection will not be required to offer or pay for contraceptive services but insurance companies would have to offer those services to women free of charge. This change follows a huge controversy over the administrations original plan which US Catholic bishops and several other religious groups said would have violated their constitutionally-guaranteed religious freedom. Republican candidates for president also weighed in on the controversy. Mitt Romney became the latest GOP candidate to accuse the president of waging “an assault on religion”. Newt Gingrich and Rick Santorum have launched similar attacks. On Tuesday, support from religious and social conservatives helped Santorum win the Missouri primary and caucuses in Minnesota and Colorado. Following those victories, Santorum traveled to Texas where he spoke to more than 100 Christian ministers about his Catholic faith.

We want to explore the contraception debate further. Kim Lawton our managing editor has been following the issue which produced for many people Kim, as you know, this terrible bind between having to obey the law on the one hand or follow their churches’ teachings and their own consciences on the other.

KIM LAWTON (Managing Editor): Well, that’s what the big debate was. The original policy allowed exemptions for most churches, but for these religiously affiliated institutions like hospitals or Catholic universities or charitable organizations—they felt like they were being forced to pay for something that their church says is wrong, and so they did feel that there was this bind, which is why there was this outcry.

ABERNETHY: And so what does the compromise say?

LAWTON: And with this solution, as the Obama administration calls it, they say they’re accommodating two core principles, the core principle of giving women access to affordable preventative health care, which they say includes contraceptive services. That was a core principle for the administration. But it also, they say, now accommodates religious liberty concerns so…

ABERNETHY: They also called it a public health issue.

LAWTON: Yes, and they say that, you know, they want women to have access to these contraceptive services as a matter of public health, so now the insurance companies will directly offer those to the employees, and the religiously affiliated institutions won’t have to provide those or pay for it.

ABERNETHY: Or refer?

LAWTON: Or refer people to it. It would be the responsibility of the insurance company, and so, you know, this is their way of getting around it. There were a lot of people in the religious community, especially in the mainline Protestant community that said they supported the original mandate, but for, you know, some people, including moderate to liberal Catholics, they had a problem with it.

ABERNETHY: And so is it all solved now? Is everybody happy?

LAWTON: Well, there were a lot of hard feelings that were generated in all of this—and again this notion that the Obama administration is in some way at war with religion or at war with the Catholic Church. That was the slogan that was out there. As we’ve reported, a lot of the Republican candidates certainly jumped on that some might say, the president says, you know, cynically for political gain. That issue’s still out there. Is there some sort of, you know, growing secularism or attack on religious exercise in this country? And so I think the administration does have, you know, some repairing to do. A lot of moderate and liberal Catholics who supported this president, who supported the health care bill when it was going through Congress, they felt a little betrayed. I’m hearing from people who say, you know, yeah, the majority of Catholic women may use birth control, and yeah, a lot of people disagree maybe with the church’s policy, but this issue is bigger than that in their view. And so, you know, for them they were pleased that the administration made this compromise, but there was some damage that was done.

ABERNETHY: And we will be hearing more about this as the campaign goes on.

LAWTON: Well. certainly I think a lot of the Republicans aren’t going to let this go. They are going to keep at it. They see it as a good issue, a good issue to battle the president with.

ABERNETHY: Kim Lawton, many thanks.

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LUCKY SEVERSON, correspondent: The protesters are here each weekday morning—not a lot of them, but they are not alone. What began in Sierra Vista, a town about 80 miles southeast of Tucson, as a quiet merger between the Sierra Vista Regional Health Center and the Catholic Carondelet Health Network has turned into a religious and ethical standoff over patients’ rights.

THERESE ERICKSON (Cochise Citizens for Patients Rights): The moral issue for me is that they wish to take my moral choice away. I think I’m very capable of making my moral choices, and I’ve done pretty good for 67 years.

SEVERSON: What the merger means is that Sierra Vista, a rural, secular hospital, must now abide by the Catholic ethical and religious directives which prohibit certain procedures. So physicians can no longer do abortions, even when the mother’s life is in danger, and they can no longer perform sterilizations or provide contraception.

DOTTI WELLMAN (Cochise Citizens for Patients Rights): This county has one of the highest teen pregnancy rates in the country, not just the county. Immediately when this arrangement went in there would be no talk of birth control. If we had two hospitals, we would not be here, because there would be a choice.

SEVERSON: One doctor has quit, and others who work at Sierra Vista, like Dr. Robert Holder, an ob-gyn, are very upset. .

DR. ROBERT HOLDER (Sierra Vista Regional Health Center): I would say that the majority of the medical staff is not really happy with the fact that this is occurring and the way it came about. It was hard for us, thinking long term, how this was going to work out practically.

SEVERSON: Dr. Bruce Silva, another ob-gyn at Sierra Vista, says Catholic directives often go against health care decisions he and his patient think are best.

DR. BRUCE SILVA (Sierra Vista Regional Health Center): The person who makes that decision is not me and the woman. We can make that decision, but then it has to be okay’d by someone else who puts their belief systems and their ethics on me and on my patients, which I just don’t think is right.

SEVERSON: Right or wrong, the Catholic Church takes its directives very seriously. Last year, Bishop Thomas Olmsted of the Catholic Diocese of Phoenix cracked down on this hospital, St. Joseph’s, after a doctor terminated the pregnancy of a mother who had developed pulmonary hypertension, which has a high mortality rate among pregnant women.

DR. HOLDER: It was not an either-or case. That baby was not going to survive because the mother was not going to survive, so the decision is that you let both die or you terminate the pregnancy so the mother can live, and to me that’s a no-brainer.

SEVERSON: But Bishop Olmsted disagreed with the doctors.

BISHOP THOMAS OLMSTED (speaking at Catholic Diocese of Phoenix December 21, 2010 Press Conference): In this case, the baby was healthy and there were no problems with the pregnancy. Rather, the mother had a disease that needed to be treated. But instead of treating the disease, St. Joseph’s medical staff and ethics committee decided that the healthy eleven-week-old baby should be directly killed.

SEVERSON: Bishop Olmsted stripped St., Joseph’s of its 116-year-long Catholic affiliation and excommunicated Sister Margaret McBride, the nun who had approved the abortion.

SEVERSON: Rev. Thomas Weinandy is the executive director for the Secretariat of Doctrine at the US Conference of Catholic Bishops. He and Richard Doerflinger, who handles bioethics issues for the conference, defended the church’s ethical and religious directives which, they say, are based on Gospel teachings about the dignity of life.

SEVERSON: So you support the Bishop Olmsted’s ruling with St. Joseph’s in Phoenix?

RICHARD DOERFLINGER (Associate Director, Secretariat of Pro-Life Activities, US Conference of Catholic Bishops): Bishop Olmsted has the authority to make the right decision. Personally, I support it.

REVEREND THOMAS WEINANDY (US Conference of Catholic Bishops): If you directly said the mother could not live unless we aborted the child then that would be contrary to Gospel values and the teaching of the church.

SEVERSON: So you would not perform an abortion on a child even if it meant saving the life of the mother?

DOERFLINGER: You would try everything else to save her life except directly kill someone else. There are times when the mother needs treatment to save her life or prevent some other terrible injury that is going to lead as a side effect to risking the child’s life, maybe ending the child’s life, and that’s acceptable in Catholic teaching, because you’re intent is not to take the child’s life. It’s to treat the woman’s life.

SEVERSON: You have a child that is conceived because of incest or rape. Same?

REV. WEINANDY: Well, sure. You don’t just kill somebody because of their—how it happened. That doesn’t make their life any less worthy of living.

SEVERSON: Dr. Holder tells of a mother who had miscarried one of her twins and was about to lose the other.

DR. HOLDER: We were advised to send that person 80 miles away to another hospital because there was a heartbeat, and that was a very difficult situation for me to manage.

DR. SILVA: Some people will define abortion if a baby has a heart rate, and you terminate that pregnancy—it’s an abortion. But there are times, for instance, with a pregnancy in the fallopian tube, where babies will have heart rates but that baby can’t survive there. It’s impossible. So there are some places where they do not allow you to terminate that baby. This is the real problem is that it’s defined differently by different bishops, who are the ones that decide how your hospital is going to run.

SEVERSON: Officials at the Sierra Vista Regional Health Center declined to be interviewed, but the circumstances here are not unique. Catholic hospitals have become the largest nonprofit health care provider in the US, with over 600 hospitals. This year, one in six patients will be cared for in a Catholic hospital.

DR. SILVA: I have worked at Catholic hospitals before, and I have no problems with that. I think Catholic hospitals do great care. But it was in a larger city where there was another hospital there, so women had a choice. Here we are very rural.

JESSICA GRAHAM: I’m Jessica Graham to see Dr. Silva, okay?

SEVERSON: Sierra Vista’s new directives posed a very real problem for Jessica Graham, who was going to have her second baby by c-section at Sierra Vista and then get a tubal ligation, or have her tubes tied. She and her husband didn’t want any more children.

GRAHAM: So I said, can you tie my tubes while I’m in surgery for a c-section? And when I got pregnant that was the option and that was the plan. Then it changed during my pregnancy when they did the merger here.

DR. SILVA: When I do a cesarean section, the woman is open already, and so if I do the tubal ligation it adds nothing to the risk that she has. But I can’t do them here.

SEVERSON: So Jessica was forced to have a second surgery in another city, which could have created problems.

DR. SILVA: People get infected, people can get bowel injuries. You can have a reaction to the anesthetic that can kill people. People die from tubal ligations every year—now very, very, very rarely, but why undergo that risk?

REV. WEINANDY: The fact that they can’t get, receive sterilization or abortions at a Catholic health care facility is not a form of suffering at all. It’s a matter of fact that we are protecting them from evil things that could happen to them.

SEVERSON: Doctor Silva says his Sierra Vista patients can’t get the standard of care they deserve and that some simply can’t afford a second operation at another hospital. He says when he worked at a Catholic Hospital 20 years ago, tubal ligations were permitted.

DR. SILVA: But politically things change. You get someone who is a little more conservative in, and they now stop you from doing that.

DOERFLINGER: I don’t think it has anything to do with politics. It has to do with the language of the directives, which are a reflection of Catholic teaching and the bishops’ theological understanding of what that requires.

SEVERSON: Another concern for the protesters outside Sierra Vista is what happens with their end-of-life wishes if the Catholic Church doesn’t agree with them.

CHARLES GORDON (Cochise Citizens for Patients Rights): If I’m in a bad place I want to be able to direct them, “Hey pull those tubes.” They won’t kill me, I know that.

DR. SILVA: They talk about the fact that all of your end-of-life wishes will be observed unless they go against Catholic teaching. The problem is what does that last line mean?

DOERFLINGER: They are not going to stand back and watch if you are doing something they think is basically just trying to make yourself dead, but they are also going to respect your decisions about how burdensome a treatment to accept, how far to go in terms of prolonging your life when you know that you are on a course toward the dying process.

SEVERSON: Dr. Holder says in these hard economic times he understands the need for smaller hospitals like Sierra Vista to hook up with a larger health care service. But he thinks there are more suitable non-Catholic partners out there, and he’s hopeful that one will come along.

DR. HOLDER: I don’t think they quite expected the push-back from the community, and I think it’s at least opened their eyes to think that maybe we need to re-look at this and look at some alternatives.

SEVERSON: The merger process is not completed and won’t be for months. Doctors hope for a compromise, but they realize that the Catholic Church won’t be changing its directives.

For Religion & Ethics NewsWeekly, I’m Lucky Severson in Sierra Vista, Arizona.

Editor’s Note: According to local media, on March 29, 2010 the president of Sierra Vista Regional Health Center announced that its agreement with the Catholic Carondelet Health Network is expected to be canceled in early April.

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BOB ABERNETHY, anchor (March 17, 2006): In Washington, renewed debate over access to the emergency contraception drug known as Plan B. Right now, the drug is available by prescription only. But the Food and Drug Administration has repeatedly delayed action on an FDA committee recommendation that Plan B should be made available over the counter. This week, two U.S. senators said they would block President Bush’s nominee as head of the FDA until the agency acts on the over-the-counter decision. Supporters of Plan B say it will reduce the number of unwanted pregnancies. Opponents say it can be a form of abortion when it blocks the implantation of a fertilized egg. Last year, Lucky Severson looked at the moral dimensions of prescribing emergency contraception.

LUCKY SEVERSON: A rally outside the Illinois State Capitol in Springfield. It’s against pharmacists who refuse to fill prescriptions for emergency contraceptives.

RALLY PROTESTORS: Stop discriminating against women, and keep your judgments to yourself. Just fill it. No hassles. Just fill it. No lectures. Just fill it.

SEVERSON: Their complaint is not new, but the chorus is growing.

Another rally, this one outside the Colorado State Capitol, is to ensure that hospitals provide emergency contraceptives to rape victims.

UNIDENTIFIED SPEAKER (At Rally): This bill would require hospitals to provide rape victims with information about emergency contraception which can prevent pregnancy when taken after an assault. On April 5, Governor Owens vetoed this bill.

SEVERSON: Forty-six states have what are known as “conscience clauses” that allow health care workers the right to refuse to perform abortions. What concerns many women and men is that several states are now debating legislation that would expand these clauses to include not only abortion but emergency contraceptives as well. Four states have similar laws in place.

QUIN HOSTETLER (Pharmacist): I’m a hard-line Catholic, so I believe that you shouldn’t use contraception and that you shouldn’t use the morning-after pill.

SEVERSON: Springfield pharmacist Quin Hostetler say his conscience would not allow him to fill an emergency contraceptive prescription.

(To Mr. Hostetler): You personally would not sell emergency contraceptives?

Mr. HOSTETLER: Not the morning-after pills, no; that I have a problem with.

SEVERSON: But he says he would not refuse to refer the patient to another pharmacist.

Mr. HOSTETLER: I don’t believe in forcing my morals down somebody else’s throat, and in return I don’t expect them to do the same to me. If I can help somebody in this instance get the medication that they need, I have no problem doing that, although I would not dispense it myself.

SEVERSON: Luciana Fortune-Bass says she is a churchgoing mother of three who got a call in the middle of the night from a traumatized friend. The young woman couldn’t get the pharmacist, also a woman, to fill her emergency contraceptive prescription.

LUCIANA FORTUNE-BASS (Speaking at Rally): The only thing I knew was that she had sex, the condom broke, and she was at a pharmacy, and the pharmacist refused to fill her prescription or even return it. I was livid.

When I got there, this lady was ridiculing her about the morality and the fact that her soul was in jeopardy and she was going to hell and she was a baby killer.

SEVERSON: The pharmacist eventually gave back the prescription, and Luciana drove her friend to a pharmacy 45 minutes away. Health experts say one of the problems with pharmacists refusing to fill prescriptions is that emergency contraceptives are most effective the sooner they are taken.

(To Ms. Fortune-Bass): What do you say to a pharmacist who says, “This is what I believe”?

MS. FORTUNE-BASS: I say, “You are entitled to your beliefs, but don’t infringe your beliefs on me.”

SEVERSON: It’s situations like that of Luciana’s friend that prompted Illinois Governor Blagojevich to issue an emergency order requiring pharmacists to fill prescriptions.

Governor ROD BLAGOJEVICH (At Press Conference): That if a woman goes to a pharmacist with a prescription for birth control, the pharmacy or the pharmacist is not allowed to discriminate or choose who he sells it to or who he doesn’t sell it to.

SEVERSON: The governor’s emergency decree may have endeared him to many people in Illinois, but not to religious organizations that oppose abortion.

PHILIP KARST (The Illinois Catholic Health Association): When a pharmacist, in their moral thinking, believes that this is an inappropriate activity, I have difficulty with the state or the governor just saying his moral judgment is more important than the moral judgment of some individual in the state.

SEVERSON: In Illinois, four out of 10 hospitals don’t or won’t stock emergency contraceptives. But the real impact is in rural Illinois, where there are fewer hospitals to begin with. The same is true with pharmacies. In neighboring Missouri, nine out of 10 pharmacies don’t stock emergency contraceptives, which can make a traumatic experience all the more traumatic.

LEE JACOBS (Rape Victim Advocate): Just another layer of trauma on top of the trauma of being a victim of sexual violence. If it’s an issue of racism and sexism and classism, people in rural areas have that much more difficult of a time: people who don’t speak the English language, people who don’t have easy transportation to go to another pharmacy. It’s very real for people.

SEVERSON: Recently, 14 states introduced conscience clauses that would cover not only contraceptive services but allow pharmacists to refuse filling any prescription that offends their moral convictions. Opponents say it could open a Pandora’s box.

TOI HUTCHINSON (Assistant to Illinois Majority Leader): Understand that if someone can refuse a prescription for this, they can refuse a prescription for something else. So if you have a child who has ADD, and the pharmacist doesn’t believe that that really exists, can you get your Ritalin prescription?

SEVERSON: Many pharmacists would like to have the same conscience clause as doctors, who are granted considerable latitude in what they can refuse. Emergency room physician Calvin Bell, a Catholic, would not perform an abortion, sterilization, or withdraw a feeding tube in cases like that of Terri Schiavo. His religious beliefs also affect the way he treats rape victims.

Dr. CALVIN BELL (Memorial Medical Center): This woman has at this point in time — she’s been victimized by someone, she’s been raped, she’s undergone a horrible trauma. But on the other hand, you’ve got a potential second life that is totally innocent, that’s done nothing wrong to anyone.

SEVERSON: Dr. Bell refuses to give rape victims emergency contraceptives, sometimes known as Plan B. In his opinion, life begins at fertilization, and the pill would prevent a fertilized egg from being implanted in the uterus.

Dr. BELL: Much of their action of these emergency “contraceptives” occurs actually after fertilization has occurred, so, in a sense, it’s an emergency abortifacient, is what we are talking about.

STEPHANI COX (Nurse Practitioner, Planned Parenthood, Springfield, IL): If the woman has a condom break, it comes off, she’s forgotten her pills, whatever the reason that she fears she may encounter an unplanned pregnancy, this gives her a second chance at preventing that pregnancy.

SEVERSON: Stephani Cox is a nurse practitioner with Planned Parenthood. She says Dr. Bell’s understanding of pregnancy goes against the accepted medical definition — that pregnancy begins only when the fertilized egg is implanted in the uterus.

Ms. COX: If a woman should happen to have an early pregnancy that she is totally unaware of and take Plan B, it will do nothing. It does not cause a pregnancy. It does not harm the fetus. The pregnancy will continue as normal.

SEVERSON (To Dr. Bell): You would advocate to a rape victim that they continue the pregnancy?

Dr. BELL: If one of my daughters or my wife tragically suffered a rape, what would my advice be? My advice would be for them to carry the pregnancy to termination and give the baby up for adoption.

Ms. COX: Plan B, an emergency contraception, can prevent 22,000 pregnancies as a result of rape that end in an abortion. It can prevent 800,000 abortions a year. So, you know, even people who are antichoice should be on board with this. It’s preventing unplanned pregnancies, preventing the need for abortion.

SEVERSON: You don’t think that pharmacists ought to be given a right-of-conscience clause?

Ms. COX: My feeling is that once a pharmacist puts on his lab coat and steps into the pharmacy, it is his professional responsibility to fill every valid, legal prescription.

Mr. HOSTETLER: We have the same right that anybody else does. Just because we are a merchant, we should have the right to refuse to fill different prescriptions if we don’t feel morally correct with that.

SEVERSON: Several states are debating laws that would expand Quin Hostetler’s legal and moral discretion. And a few others are now considering legislation that would restrict them. Pressure on lawmakers will be intense — from both sides.

For Religion & Ethics NewsWeekly, I’m Lucky Severson in Springfield, Illinois.

ABERNETHY (March 17, 2006): Since we produced that story, Wal-Mart has agreed to stock emergency contraceptives and will begin dispensing them on Monday (March 20, 2006). But Wal-Mart is also allowing their pharmacists to refuse to fill Plan B prescriptions if they want, so long as that doesn’t violate state law.

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