A Win for Patients’ Rights on Contraception
The U.S. 9th Circuit Court of Appeals in Seattle overturned a District Court decision today, with the result that pharmacies cannot legally refuse to fill prescriptions for Plan B contraception — also called “emergency contraception” or the “morning after pill.”
Pharmacists are obliged to dispense the Plan B pill, even if they are personally opposed to the “morning after” contraceptive on religious grounds, a federal appeals court ruled Wednesday.In a case that could affect policy across the western U.S., a supermarket pharmacy owner in Olympia, Wash., failed in a bid to block 2007 regulations that required all Washington pharmacies to stock and dispense the pills.
Family-owned Ralph’s Thriftway and two pharmacists employed elsewhere sued Washington state officials over the requirement. The plaintiffs asserted that their Christian beliefs prevented them from dispensing the pills, which can prevent implantation of a recently fertilized egg. They said that the new regulations would force them to choose between keeping their jobs and heeding their religious objections to a medication they regard as a form of abortion.Ralph’s owners, Stormans Inc., and pharmacists Rhonda Mesler and Margo Thelen sought protection under the 1st Amendment right to free exercise of religion and won a temporary injunction from the U.S. District Court in Seattle pending trial on the constitutionality of the regulations. That order prevented state officials from penalizing pharmacists who refused to dispense Plan B as long as they referred consumers to a nearby pharmacy where it was available.
On Wednesday, a three-judge panel of the U.S. 9th Circuit Court of Appeals lifted the injunction, saying the district court was wrong in issuing it based on an erroneous finding that the rules violated the free exercise of religion clause of the U.S. Constitution.
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The 9th Circuit ruling … means that the requirement that pharmacies stock and dispense Plan B takes immediate effect, said Joyce Roper, an assistant attorney general for Washington state.
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Although the courts have yet to pronounce judgment on other aspects of the lawsuit, the unanimous ruling on the free-exercise clause could portend further judgments, as the case moves forward, that a patient’s right to timely medication supersedes a pharmacist’s personal convictions.
The three 9th Circuit judges found common ground despite differing outlooks: Two conservatives named to the court by President George W. Bush and a liberal named by President Clinton made up the panel.
The right to freely exercise one’s religion “does not relieve an individual of the obligation to comply with a valid and neutral law of general applicability,” the 9th Circuit panel wrote.
“Any refusal to dispense — regardless of whether it is motivated by religion, morals, conscience, ethics, discriminatory prejudices, or personal distaste for a patient — violates the rules,” the panel said.
Melissa McEwan correctly points out that
seeking permission to break those rules, to get on-the-job exemptions from primary duties based on religious beliefs, is … nothing less than the “special rights” conservatives are incessantly accusing the LGBTQI community, women, and/or people of color of seeking, despite the reality that members of those groups just want baseline equality. Christians who want to use their individualistic interpretation of the Bible to rewrite their job descriptions want an inequality that caters to their personal whims.
Exactly. The claim that dispensing Plan B contraception — or any form of contraception — violates the First Amendment rights of pharmacists who object to contraception on religious grounds has always been a complete and utter canard.
As Rachel Maddow explains, it’s the “Amish bus driver rule.”
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31 Responses to “A Win for Patients’ Rights on Contraception”
If you have a problem with filling prescriptions, pharmacy is not for you.
Yep. That's the Amish bus driver rule.
Not as simple as that. There are still mom-and-pop pharmacies around that have been in business for years, well before this was an issue. It's a bit too glib to say they should have chosen a different field.
The other obvious problem is it's not the government's place to tell private businesses what inventory they must stock and sell. If I were one of these pharmacies I would just not stock the Plan B and tell patients I'd have to special order it, but if they want it now to go over to Walgreen's or wherever.
Personally I am pro-choice and don't have a problem with Plan B contraception, but respect the views of those that disagree with me.
If it is a state wide rule that all pharms must carry and dispense that medication then I would say that your religion is not a reason to refuse. The same way I don't feel Islamic cabby's should deny service to someone who is carrying a bottle of wine. I would be concerned why the state had decided that medication must be stocked in all pharmacies and what other medications have those same requirements. The morning after pill shouldn't be granted special conditions that are not there with other meds for the single purpose of “making” people dispense it.
The Plan B pill will help reduce the problem of population growth and particularly growth in populations that we don’t want to have too many of.
You're absolutely right jwest, this is nothing more than an attempt to keep the darkies from taking over. Well done.
Ryan,
You seem to be the only one who thinks the remark is racist. Perhaps you’re a little too sensitive.
“Personally I am pro-choice and don't have a problem with Plan B contraception, but respect the views of those that disagree with me.”
and
“it's not the government's place to tell private businesses what inventory they must stock and sell … The morning after pill shouldn't be granted special conditions that are not there with other meds for the single purpose of 'making' people dispense it.”
That's the difference between so many of us and the extremists.
“it's not the government's place to tell private businesses what inventory they must stock and sell … The morning after pill shouldn't be granted special conditions that are not there with other meds for the single purpose of 'making' people dispense it.”
If you think the blatant politicization of medicine (as with science, in the case of global warming, for example) by lefties is bad now, just want until after the lib Dems make “progress” on health care “reform.”
Ryan,
I had hoped to suck Kathy into commenting on the “populations we don’t want too many off” quote, but I guess she’s not biting.
That quote comes from Ruth Bader Ginsburg, commenting on Roe v Wade.
http://newsbusters.org/blogs/tom-blumer/2009/07…
Provider Conscience’s legislation and policies, such as this one and the ill-advised Bush Administration HHS regulations that were recently overturned, allows personal religious beliefs to be put over what is best and right for the patient. This not only is an assault on patient’s rights, but it places certain patients at more of a disadvantage than others. It assumes that rural patients will have second or third options; it assumes often that pharmacists will return the prescriptions in due time; and it allows pharmacists to make personal, moral decisions and place them on others. Since this law specifically targets emergency contraception, a prescription that allows rape victims to avoid an unwanted pregnancy, one must also ask if these policies placed victims of sexual assault at a higher risk and further traumatized them. As a member of the Republican Majority for Choice, I hope that more policies favoring the patient’s health, needs, and rights are considered over the religiously-based opinions and judgments held by pharmacists and other medical professionals who forget that their job is to put the patients first.
This is being portrayed as a “patients rights” issue, but really gets into the old question of can something be a right when it requires a service from another citizen? The government should not be able to compel citizens to provide services they have no wish to provide. Additionally the government should not be able to compel private businesses to stock inventory they don't want to stock.
“[C]an something be a right when it requires a service [or anything else] from another citizen?”
No, obviously. But many on the left say their demands, wishes, claims on others are “rights” [sic].
Even if they are touching, such as the sign I saw yesterday saying “Health Care is Not A Privilege!”
Note that this common misuse of “right” has some of us concerned that the Ninth Amendment might be subject someday to judicial activism featuring such misuse as part of the bogus rationalization.
“I asked Emily Bazelon about it, and she said:
The main thing I'd say about this is that it was clear that when Justice Ginsburg said “we,” when she was talking about populations that we don't want to have too many of (you can get the exact quote from the piece), she meant some people in the world, not herself or a group that she feels a part of. That's not how she sees the world, as you I'm sure know. Her point was about other people's conception of who they thought should be encouraged to have children and who shouldn't be, not her own.
In other words, Bazelon is saying the we should have been in quotes, like this:
Frankly I had thought that at the time Roe was decided, there was concern about population growth and particularly growth in populations that “we” don't want to have too many of.
This, of course, hasn't stopped any right-wingers from assuming that Ginsburg was admitting the pro-choice movement was all about eugenics or others who were convinced that her use of the word “we” was something more nefarious than a reference to “some people.”"
http://jezebel.com/5311192/justice-ginsburg-eug…
“This is being portrayed as a 'patients rights' issue”
The real rights at issue here are those of the pharmacies and of the pharmacists as individuals.
Even in 2009, someone has the (real) right to defend what he or she honestly believes as propriety. On the other hand, the closest analogue, the position of those theoretically seeking contraceptives under what are controversial circumstances, in no way is a “right” in a radical-left, developmentally-reversed sense in that anyone has the “right” to whatever one wants, to whatever behavior one wants to enjoy.
“I can do whatever I want!” is accompanied by “Gimme! — it's my 'right'!”
Related:
It's no different in practice than restrictions on alcohol sales or drug sales or drug use, including the cases where sales are legal but are still refused for one reason or another. The only difference is in matter of degree.
“It's funny in a way to see conservatives accusing their opponents of being racist… civil rights have finally made enough progress that even the right wing is OK with it now.”
Yes, we’re making progress.
I’ve even heard of a few liberals who don’t hate our country, who’ve stopped spitting on military people and who are now unsure whether they want a total communist government. I suppose in 50 years we can look back on all of this and see how silly our preconceived ideas were.
Ryan,
I read that tortured explanation you linked to.
(sigh)
You might want to consider that sometimes people slip up and tell the truth. The eugenics movement was a very legitimate part of left wing politics and must have had some influence on Ginsburg. At the time, you were considered to be anti-science and anti-intellectual if you questioned the logic of the eugenics movement.
Perhaps she meant it not so much concerning race, but maybe genetic defectives. As liberals recoiled recently from the thought of Palin having a less-than-perfect child, Ginsberg’s thinking process was coming into its own when these anomalies were prime candidates for the selective culling promoted by the enlightened thinkers of the left.
Ginsberg has been a strong advocate of retaining the right to dispose of the wrong kind of babies at will, so her statement isn’t too far out of the realm of possibilities to simply take at face value.
Either way, I’m sure you would extend the same level of deference if Scalia had said the same thing.
Eugenics was a very legitimate part of politics in the Before Time. This has somewhat changed over the last century. Considering Roe was decided while the President thought that having a 'black and a white' was grounds for abortion, you're going to have to do a lot better than “she accidentally told the truth” to negate the slightly more straightforward interpretation of her comment as a notoriously-liberal judge criticizing the “states' rights” racists.
Ryan,
As all of us conservatives know, the “Before Time” was when people rode dinosaurs to the drive-in.
My point about Ginsberg is that her formative years (when she was eating her Wonder Bread) was a time when the people she would look up to believed in eugenics.
“From its inception eugenics was supported by prominent people, including Margaret Sanger, Marie Stopes, H. G. Wells, Woodrow Wilson, Theodore Roosevelt, Emile Zola, George Bernard Shaw, John Maynard Keynes, John Harvey Kellogg, Winston Churchill, Linus Pauling[11] and Sidney Webb.”
As you can see, everyone young Ruth would aspire to be like was a promoter of eugenics. Don’t feel bad if the influences of her youth instilled the desire to rid the planet of undesirables, such as “the poor, mentally ill, blind, “promiscuous” women, homosexuals and entire “racial” groups…”.
It’s not as if she hated these groups of people – no liberal hates just because someone is in a special group (except for conservatives) – she simply wanted to help all of humanity by eliminating the oxygen and food that would be wasted maintaining these people so that more deserving groups could live.
There are still mom-and-pop pharmacies around that have been in business for years, well before this was an issue.
There are lots of medicines prescribed now that did not exist 20 or 30 or 40 years ago, DaGoat. Pharmacists — mom-and-pop or not — are professionally obligated to carry any legal medication for which a patient might bring in a prescription. They accept that obligation when they decide to go into this field. They cannot pick and choose which prescriptions they will fill and which they will not based on their personal views or whether the product was around when they first became pharmacists. Also, your point, if it were valid, would be just as valid for chain pharmacies as for mom-and-pop pharmacies. There are lots of pharmacists working at places like CVS and Wal-Mart who got into the profession “before this was an issue.” That is a bogus argument.
The other obvious problem is it's not the government's place to tell private businesses what inventory they must stock and sell.
Another bogus argument. It's the government's place to protect the rights of consumers against unsafe, unscrupulous, and/or unprofessional business practices. The government has a legitimate — indeed, a constitutionally mandated — interest in defending both public safety *and* the right of individuals to live their lives and make choices for their lives as they see fit, within the law. If a particular individual cannot bring themselves to fill a prescription for Plan B contraception, they should not have to — but they should also not be hired or be allowed to remain in a job that requires them to do exactly that. People cannot have both their individual rights and the individual rights of others.
jwest,
No, Ryan is not the only one who thinks your remark is racist.
Kathy,
That was Ruth Bader Ginsberg’s quote.
Try to keep up with the conversation.
Stupid decision on the part of the 9th Circuit. Would they force a vegetarian restaurant to serve meat? Different product, same principle.
jwest,
I saw your comment about that after I posted mine.
Would they force a vegetarian restaurant to serve meat? Different product, same principle.
It's not the same principle at all. Restaurants serve specific types of food and not others by definition. That's what a restaurant IS. Thai restaurants don't serve burgers and fries.McDonald's doesn't serve coq au vin.People go into restaurants knowing and expecting that they will be offered specific types of food; they don't expect to be shown a menu that features every type of food in existence.
This is in addition to the fact that restaurants serve a discretionary/entertainment/leisure-related purpose. Nobody has to eat in a restaurant for health reasons.The professional mandate is completely different from that of a pharmacy that fills doctors' prescriptions.
This is a very interesting case because it touches on the validity of rights versus civic responsibility. Pharmacists are the only profession licensed by a state to dispense medication. Want meds? You have to go to a pharmacist. No one else can dispense that medication for you. Now people have a 1st amendment right to freedom of religious expression and the supreme and district courts have upheld that freedom, even in regards to reasonable accomodation from employers. The courts use the test of whether an expression of religion is Valid and Neutral in regards to accomodation. In these cases, does a pharmacist's decision to exercise their religious beliefs on the job conform to being a valid belief? Probably, since many mainstream religions feel that preventing pregnancy is a sin. In terms of neutral, the test will fail because the exercise of that right directly impacts the health and welfare of another person. Your religious expression is fair game until it hurts me, and not just because I don't share your beliefs. We dont allow polygamy or animal sacrifice in this country, even though we can see that they are actual religious beliefs and practices in some cultures.
This ruling only applies to pharmacy owners and not individual pharmacists. If a pharmacy can reasonably accomodate a pharmacist who has a jesus issue with certain medications, then they can do so and still not be out of compliance with the law. The value of an employee who can't fulfill their job duties becomes a personnel issue.
I think we will see other rulings regarding this, as republican dominated state legislatures are passing laws to defend the right of medical personnel to withhold treatment based on religious grounds. In the case of this law, it was a ruling that pharmacies had to dispense a particular medication, which is a pretty narrow ruling.
Kathy made a comment that pharmacists “are professionally obligated to carry any legal medication for which a patient might bring in a prescription. They accept that obligation when they decide to go into this field. They cannot pick and choose which prescriptions they will fill and which they will not based on their personal views or whether the product was around when they first became pharmacists”
The law in many states (6) is you are not allowed to refuse to dispense because of personal feelings nowhere does it indicate the Pharmacy must carry every drug known to man that someone may get a prescription for. Kathy's view of a Pharmacies professional obligation is not a universal one. Even in Cali a individual can refuse to dispense particular drugs, it's the pharmacy that must provide access to drugs they carry.
More states allow refusals than require drugs to be dispensed. 6 states have must dispense laws. % states have no obstruction must transfer laws and 4 states have the right to refuse without referral. Right now the count stands 6 to 9 for being able to refuse to dispense. And in one of the 6 a pharmacist can refuse to dispense as long as the “Pharmacy” dispenses. Basically it's the stores responsibility not the individual pharmacist.
So much for claim of a universal standard.
Pharmacists — mom-and-pop or not — are professionally obligated to carry any legal medication for which a patient might bring in a prescription.
This is just not true. It's fairly common in my town for a patient to have to call around to different pharmacies to find a certain medication if it's not prescribed that often, and often the pharmacy will have to order a medication overnight from it's supplier if they don't have it in stock. There is no way a pharmacy can stock all meds that someone “might bring in” a prescription for. Where do you find these claims? Do you have any documentation that supports your contention pharmacies must stock all meds someone might come in for?
Pharmacies stock things they think they can sell, which is appropriate.
People cannot have both their individual rights and the individual rights of others.
I'm not sure what you're trying to say here.
Do you have any documentation that supports your contention pharmacies must stock all meds someone might come in for?
I see your point. I should have used the word “fill” — iow, Pharmacists are professionally obligated to fill any prescription…. Not carry.
I'm not sure what you're trying to say here.
Pharmacists who refuse to fill certain prescriptions on the grounds that they find the product morally objectionable are prioritizing their right of conscience above the patients' right to make her own health care decisions. As a practical matter, if a prescription can be handed off to another pharmacist to fill, I'm fine with that, and I'm sure anyone else would be, as well. But if there is no other pharmacist there who will fill the prescription, then refusing to fill the prescription is a violation of that patient's rights.
I am saying that a pharmacist who does not approve of contraception should not be forced to fill a prescription for contraception, but if there is no one else there who *can* and *will* fill the prescription, then that anti-contraception pharmacist should not be allowed to remain in that position, because then he or she is privileging his or her own rights over the rights of the patient — or, put another way, that pharmacist is then trying to have her own rights *and* the rights of the patient (confiscating the latter's rights, iow).
Thanks for the clarification, Kathy. I see what you're saying – that because the pharmacist is in a service role he should subjugate his own rights for the rights of the patient. That's a very gray area and I think the variety of ways different states handle this issue reflects that.