Pharmacists Shouldn't Be Forced to Dispense Abortion Pill

"It rankles me when somebody tries to force somebody to do something." --John Wayne.

You can almost hear John Wayne's methodical drawl lumber over those words, can't you?

I like that quote because it's a simple, elegant remedy for just about all of the issues we waste time debating these days. It seems to me that a good remedy for most of today's contentious issues is to let everyone live his or her life as they please, so long as they do no harm to anyone else.

Most of the debate today arises from people who'd cross John Wayne. That is, they want to make everyone else live they way they do, too.

Wayne's quote rings in my head each time I read the latest in the ongoing debate over the "morning after pill," the "abortion pill," and your neighborhood pharmacist. To catch you up, it seems there are some pharmacists who have moral objections to dispensing medication they feel would make them party to an abortion, or at least to the taking of a potential human life. Anti-abortion groups have latched on to their cause, noting that the decision to become a pharmacist doesn't obligate one to facilitate treatments he or she finds morally abhorrent.

Fair enough.

On the other side of the debate are the abortion rights groups. They want widespread access to these medications, arguing that ending a pregnancy essentially before it has begun ought to be more acceptable to anti-abortion groups than ending one when the fetus is more fully developed. We can't allow rogue pharmacists to leave women in a lurch (some not only refuse to fill prescriptions, they sometimes destroy them), they say.

Again, fair enough.

There's a simple solution to all of this, and doesn't require a single new law. That solution? Don't force anyone to do anything.

Pharmacists should be free to fill only those prescriptions they feel comfortable filling. By the same token, pharmacies and drug store companies like Walgreens, Wal-Mart, and CVS should be free to set their own policies regarding controversial medications. They should also be permitted to fire any employee who doesn't conform to those policies.

The result would be a system where a pharmacist with moral qualms about some treatments and medications would avoid taking a job at a company with policies that undermine his values. He knows that the first time those values clash, he'll either comply, or he'll be fired. Pharmacies that want to distribute controversial medications would know not to hire employees with moral qualms to certain drugs, and pharmacies with objections to birth control, the abortion pill, or the morning after pill could go out of their way to hire pharmacists with similar values.

There is the possibility that this could raise questions about employment discrimination. But it shouldn't. No one should be forced to hire an employee who can't perform the job he's hired to do. For example, a pharmacy that chooses to distribute these should be free to ask potential employees if they're capable of upholding and maintaining company policy. If an applicant says he can't, for whatever reason, the company can and should look to someone else.

This scenario would be best for consumers, too. Soon enough, we'd know what stores offer what drugs, and we could shop accordingly. Women looking for the morning after pill wouldn't need to waste their time by going to Wal-Mart, for example, a chain that has largely refused to dispense the drug. Women with their own objections to the drug could go out of their way to patronize Wal-Mart as a store that reflects their principles.

The problem is that nobody wants this scenario. The players in this debate want to force everyone else to do as they do. Anti-abortion groups want laws that would allow a pharmacist to work for a company with explicit policies requiring prescriptions for controversial drugs to be filled, refuse to fill them, then be protected by law from termination or reprisals from his employer.

Supporters typically say such laws are necessary to protect the "religious freedom" or pharmacists. Nonsense. A hands-off approach to this issue wouldn't require anyone to do anything that conflicts with his or her own religious beliefs. An anti-abortion or anti-birth control pharmacist simply wouldn't be able to go to work for a company with views contrary to his own, assert his own views anyway, then use the force of law to insist that his employer continue to pay him.

But those on the other side of this issue aren't any better. Abortion-rights supporters are pushing for laws that would require every pharmacy to stock controversial medication (laws requiring the morning after pill to be on the shelves are already in place in Illinois and Massachusetts). They argue that because pharmacy is a heavily-regulated field in an area as important as health care, the state is obligated to ensure that everyone has access to all available treatments. Further, they argue, in some areas of the country, there may only be one pharmacy. Consumers don't have other options. If the only pharmacy in town won't stock birth control, they say, women in that town have effectively been denied their reproductive freedom.

This too is nonsense. The rights guaranteed to us in the Constitution are only guarantees against government trespasses. There is no "right" to goods, services, or care that someone else has to provide. Suppose, for example, that there is only one doctor in town. Would it also be acceptable to require him to perform abortions, even if he found them morally repugnant? What about breast augmentation? What if there were only one pharmacy in town, but it had to close for economic reasons? Could the town pass a law forcing its owners to operate the business at a loss, under the same justification that residents have a "right" to medication?

The solution is simple: If you don't like a particular pharmacy's policy regarding birth control or abortion-related medication, don't shop there. And if you're a pharmacist? Don't work there.

But stop using the law to force everyone else to think, act, and believe as you do.

It rankles me.

Radley Balko is a policy analyst for the Cato Institute specializing in "nanny state" and consumer choice issues, including alcohol and tobacco control, drug prohibition, obesity, and civil liberties. Separately, he maintains the The Agitator weblog. The opinions expressed in his column for are his own and are not to be associated with Cato unless otherwise indicated.

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