,font size=1>12-01-05, 8:48 am

The retailer Target recently announced that it would allow pharmacists at its stores to refuse to fill prescriptions for emergency contraception (EC), if dispensing it would violate their religious beliefs. When taken within 72 hours of sexual intercourse EC can prevent pregnancy. The retailer will require pharmacists who refuse to fill the order to ask another pharmacist at their location to fill the prescription, or confirm for the patient that it can be obtained elsewhere. Target joined Kmart and Costco in allowing pharmacists to refuse to fill a prescription for EC.

There has been an ongoing struggle this year between pharmacists who refuse to fill prescriptions for EC and birth control pills, and various state governments who either support or oppose these actions. In April, Illinois Governor Rod Blagojevich issued an administrative order that allows pharmacies not to sell contraceptives of any kind. But if they do, they are required to fill prescriptions for EC or risk loosing their license. Illinois is the first state to do so. At least 10 pharmacists have sued the state on the grounds that the order forces them to violate their religious beliefs. And the state has moved to revoke the licenses of two Walgreens pharmacies and an Osco pharmacy for refusing to fill the prescriptions.

The Arizona legislature has chosen to side with pharmacists who have religious objections to EC. The Arizona House and Senate have introduced legislation that would permit pharmacists to refuse to fill prescriptions for any contraception if they are morally opposed to it. And pharmacists would not be required to assist the patient in filling the prescription elsewhere. Michigan’s legislature is considering a similar bill. The California Assembly has taken a much wider approach. It is considering legislation that would allow a pharmacist to refuse to fill any prescription for religious reasons. The pharmacist would only have to inform their employer in writing in advance.

The University of Wisconsin at Madison ran an advertisement in the campus newspaper advising students to take EC to avoid unwanted pregnancies. This so incensed conservative members of the state legislature that they introduced a bill that would prevent the University of Wisconsin health system from distributing or advocating the use of EC. These types of actions prompted Senators Rick Santorum (R-PA) and John Kerry (D-MA) to introduce The Workplace Religious Freedom Act in the Senate. The act would allow a pharmacist to refuse to fill a prescription for religious reasons as long as another pharmacist is available to serve the patient.

Allowing pharmacists to refuse to fill an EC prescription on religious grounds is poor health policy. And it sets a dangerous legal precedent. If a pharmacist can decline to dispense EC there would be little grounds to prevent them from declining to fill other prescriptions owing to their religious beliefs. In fact, this seems likely to occur.

Many Christians believe that homosexuality violates their religious convictions. The Vatican just released a document that characterizes homosexuals as 'intrinsically disordered' and prone to 'evil tendencies.' The highest church court for the Methodist denomination ruled last month that homosexuals could be barred from joining the church. Given the strong convictions of many Christians, what would prevent a pharmacist from refusing to dispense AZT, the drug used to treat AIDS patients, on the grounds that the patient may be a homosexual and this violates their religious beliefs?

In June the Food and Drug Administration approved the use of the heart medication BiDil, but only for black patients. Although the drug has proved effective in treating heart disease in black people, it does not appear to have a beneficial effect on other racial groups. It’s the first drug approved by the FDA for a specific racial group. Could a pharmacist refuse to fill a prescription for BiDil on religious grounds?

This isn’t far fetched. According to the Southern Poverty Law Center there are at least 28 white supremacist Christian churches and organizations in 18 states. They are united in their belief that whites are the descendants of the Old Testament Israelites and that people of color, whom they regard as 'beasts' and as 'Satanic,' do not biblically merit equal treatment. Couldn’t a pharmacist belonging to one of these churches decline to fill a prescription for BiDil as a result of their religious beliefs?

Pharmacists, of course, have a right to their personal religious beliefs. But they shouldn’t be allowed to act on them in their capacity as healthcare professionals. While the slippery slope argument is often overused in moral and legal arguments, in this case it’s entirely appropriate. Granting pharmacists the legal right to decline one medication opens the door to decline any drug due to religious convictions.