Friday, November 09, 2007

Emergency Contraception and Pharmacists, Again

Skimming the Daily Star this morning...

Court: Washington State Druggists May Refuse to Prescribe "Morning-After" Pill
In an injunction signed Thursday, U.S. District Judge Ronald Leighton said pharmacists can refuse to sell the morning-after pill if they refer the customer to another nearby source. Pharmacists' employers also are protected by the order.

Two pharmacists and a drugstore owner sued the state in July over the new rule, saying it violates their civil rights. They asked the judge to halt forced Plan B sales while the lawsuit is in play.

Many critics consider the pill tantamount to abortion, although it is different from the abortion pill RU-486 and has no effect on women who are already pregnant.

In other words, many critics are fucking idiots. All together now, please. Emergency contraception. Does NOT. Cause. Abortion.

EC works, instead, by preventing ovulation. If you've already ovulated in the 72 or so hours prior to unprotected sex, EC will not help you, just as if you're already pregnant, EC will not terminate that pregnancy and will, in fact, probably give that pregnancy a helping hand by maintaining the richness of the uterine lining. If you have not ovulated, EC keeps your ovaries from releasing an egg into the hordes of sperm stampeding up your fallopian tubes for a few days until all the little buggers are dead.

That is not abortion. That is not the destruction of a fertilized egg. That is not even the frustration of an egg and sperm gazing at each other all moon-eyed through a veil of latex, because EC keeps the egg from being there in the first place. Sperm get to do their spermy thing, swimming in circles and snapping each other's butts with their flagellae and standing in the street looking wistfully up at the ovary and yelling yo, you coming down or what, but the egg stays snug up in the ovary reading Katha Pollitt with a cup of tea and says, no thanks, I'm busy tonight.

Not that it matters to the pharmacists trying to exercise what's pathetically titled a conscience clause. You know damn well they understand the physiological mechanism the EC pill triggers (considering that they got through pharmacy school and all), and that it's not even vaguely related to abortion. They are not attempting to escape being involved in an abortion. They're simply flexing a newly created muscle that allows them to intercede in a woman's life when she deigns to have sex in a context they disapprove of. That is, any context not precisely equal to married and desirous of producing children.

Pharmacy is not simply another service industry sector. The license required by state regulators does not simply indicate competence but grants pharmacists a quasi-monopoly on drug transactions. Because the only way people in this country can legally acquire the controlled medications they need is by (1) getting prescriptions from their doctors and then (2) having medications dispensed by a licensed pharmacist, pharmacists have an absolute duty to fill all prescriptions brought to them in a timely manner, and to stock all drugs that can be reasonably expected to be required by the populations they serve, particularly medications that respond to acute needs. Like nitroglycerine, or asthma inhalers, or emergency contraception.

The fact that EC may now be purchased without a prescription doesn't change this basic argument, because, while no prescription is needed, the drug still must be dispensed from behind the pharmacy counter.

The pharmacist's job is to check dosages and potential drug interactions the physician may have missed, and to make sure the patient is informed about use instructions and side effects. It is not to increasingly interfere in people's lives under the banner of morality, or to make value judgments predicated solely on the medication prescribed or sought without the context of the life of the person seeking the medication. RU-486 opened the gate to pharmacists who were able to make an accepted argument against being required to participate in abortion, and now that gate is in danger of being flung wide open by those who would us the RU-486 precendent as justification for refusing to dispense any medication to be used in circumstances that run afoul of their own personal standards of conduct. That alone is cause enough for concern. But when the focus is consistently narrowed down from any morally ambiguous circumstances to those specifically and exclusively relevant to sexually active women, and adjudicated on the basis of one particular strain of one religious sect, it's completely unacceptable and abhorrent.

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