Wednesday, April 13, 2005

Drug Store Moralists

Ellen Goodman has some thoughts on the latest moral crusade.

To begin with, I don’t believe that anyone should be compelled to do work that they regard as unethical. History is full of heroes who rebelliously followed their consciences. It’s also full of people who shamefully followed orders.

I believe that companies and institutions should have a code of ethics. What is the alternative to corporate responsibility and public morality? Enron? So I approach the subject of conscience clauses rather gingerly.

The very first such laws offered an exemption for doctors in 47 states who don’t want to perform abortions on moral grounds. That seems to me a matter of common decency. Doctors are not automatons who leave their beliefs at the operating-room door. It also seems like common sense. Who would want their abortion performed by an opponent?

Gradually however, we have had the incredibly expanding conscience clause. In 10 states, healthcare professionals can conscientiously refuse to provide contraceptives. In 12 states, they can refuse to do sterilizations.

Indeed, last year the government decided that entire hospitals and HMOs had the right to deny these services without losing federal funding. Never mind that it is not clear who owns the conscience of a hospital: A church hierarchy? A board of directors? The doctors? The community? Or the taxpayers who foot the hospital bills?


It’s the pharmacists who are getting the most attention right now. In just six months, there were about 180 reports of pharmacists who said No. One refused to fill a college student’s birth-control prescription. Another refused medication to a woman who had suffered a miscarriage.

This has led to a counter bill in California that would make pharmacists tell employers of their objections in advance and be prepared to make referrals. It’s led to a rule by the Illinois governor that every pharmacy — though not every pharmacist — must fill prescriptions, “No delays. No hassles. No lectures.”

Karen Brauer, who heads a group called Pharmacists for Life that claims 1,600 members, compares them to “conscientious objectors.” But it isn’t that simple.

The pharmacist who refuses emergency contraception is not just following his moral code, he’s trumping the moral beliefs of the doctor and the patient.


Yes, we want people to have a strong moral compass. But they have to coexist with others whose compasses point in another direction. Frances Kissling, of Catholics for a Free Choice, says properly, “There is very little recognition that the conscience of the woman is as important, let alone more important, than the conscience of the provider.” There are other ways to exercise a private conscience clause. Indeed, in a conflict between your job and your ethics, you can quit. When Thoreau refused to pay taxes as a war protest, remember, he went to jail. What the pharmacists and others are asking for is conscience without consequence. The plea to protect their conscience is a thinly veiled ploy for conquest.

This is not easy stuff. But in the culture wars we have become awfully enamored of moral stances. Have we forgotten that what holds us together is the other lowly virtue: minding your own business? To each his own conscience. But the drugstore is not an altar. The last time I looked, the pharmacist’s license did not include the right to dispense morality.

There’s a funny scene in The Summer of ’42 where teenage boys try to buy rubbers from a suspicious druggist. Any boy of sixteen — straight or gay — can identify with it and the awkwardness of taking their first step into the adult world. But it’s only a movie.