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.