Tuesday, September 26, 2006

Anti-contraception Movement... the Groundwork

On Monday I posted about the Christian Right’s coming battle against contraception (shorter version: none for anyone ever) and mentioned my grudging admiration for the morality brigades’ perseverance and dedication to to their mission, abhorrent as I personally find it. Part of the strategy has been to crank out the kids like bunnies, homeschool them, send them to evangelical colleges, and groom them to enter public life so as to influence legislation at every level, toward the ultimate goal of crafting laws reflecting conservative Christian values (or Biblical literalism, depending on how pessimistic you’re feeling at any given moment).

The articles in the Chicago Tribune and LA Times mentioned the intent to chip away at the availability of contraceptives, following the manner in which abortion access has been steadily constricted, in large part by enacting state laws giving pharmacists the right to refuse to dispense medications that violate their own personal consciences.

Four States (Arkansas, Georgia, Mississippi, and South Dakota) have passed laws allowing a pharmacist to refuse to dispense emergency contraception drugs. Illinois passed an emergency rule that requires a pharmacist to dispense FDA approved contraception. Colorado, Florida, Maine and Tennesee have broad refusal clauses that do not specifically mention pharmacists.

California pharmacists have a duty to dispense prescriptions and can only refuse to dispense a prescription, including contraceptives, when their employer approves the refusal and the woman can still access her prescription in a timely manner.

Given the increasing presence of evangelicals in legislatures of all levels over the past decade or so, I wondered if they might be stacking the pharmaceutical deck as well. So it came as little surprise that the Christian Pharmacists Fellowship International has established student chapters in 30 pharmacy schools out of the 89 or so institutions granting at least a B.S. in pharmacy across the country, including at major players such as Purdue, North Carolina, and Florida.

The CPFI position on the “conscience clause” is as follows (emphases mine):

Pharmacists have the moral and legal responsibility to refuse to dispense a prescription that, in the pharmacist's judgment might be harmful to the patient, either directly or indirectly. Therefore, the Board of Directors of CPFI supports the right of all pharmacists to refuse to dispense a prescription that goes against their moral conscience.

No regulatory authority should be allowed to force a pharmacist to dispense a prescription against his/her best judgment or refer a patient to another healthcare provider. Likewise, a pharmacist should not engage in any activity that impairs a patient from seeking care from another provider.

Furthermore, the Board acknowledges the responsibility of Christian pharmacists to follow Biblical principles including the sanctity of life and life begins at the time of conception. Therefore, CPFI supports the right of Christian pharmacists, based upon Biblical principles and their moral convictions, to exercise their conscience within the realm of professional practice.

The “either directly or indirectly” phrase is quite vague, and it’s difficult to think that was unintentional. Indirect harm to a patient covers a troublingly wide expanse of territory, including that nebulous realm of the patient’s eternal soul—presumably the target of the conscience clause refusals. The insistence that pharmacists shall not be compelled to refer the patient to the other, non-evangelical pharmacist at Walgreen’s or to the CVS down the street is troubling. And the “responsibility” of Christian pharmacists to insist that life begins at conception is the grand finale, the big cake topper.

To be fair, CPFI maintains chapters at only slightly more than a third of the major pharmacy schools in the US (I did not consider associate-degree-only colleges and technical schools in this compilation), and most of these schools support a variety of student organizations. The faculty advisors don’t mention CPFI prominently in their online profiles, if at all, and there is no evidence that the organization is exerting undue influence within the respective colleges of pharmacy. Nor are hard membership numbers readily available.

In that sense, this posting may reflect more paranoia than imminent threat to freely accessible contraception in the US. However, given the numbers of students in the programs where CPFI is present*, it is an unavoidable fact that pharmacists who are very likely to invoke a conscience clause (or push for such legislation in states where it has not yet been enacted) are being churned out at a steady rate. Additionally, ample anedotal evidence exists documenting instances in which individuals have encountered absurd, near-Atwoodian barriers to acquiring emergency contraception. It is imperative that we remain vigilant as one segment of this society seeks to impose its own version of morality on all people, regardless of their personal belief systems. Find out where the candidates in your local races stand on conscience clauses and keep their asses out of office if they are even remotely conciliatory to the idea.

* sample numbers of students:

University of Arizona: 77-81 admitted annually

University of Florida (Gainesville): 450 pharmacy students plus 100 graduate/postdocs enrolled annually

University of Iowa: 108 students admitted annually to six-year program

University of North Carolina (Chapel Hill): 500 professional students and 100 graduate students, postdocs, residents, and fellows enrolled annually.

Nationwide, 7,488 professional degrees were reported awarded in 2003.

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