Well, looks like I came across this one a bit late, but I sure would like to chime in.

We have said many, many times that, in the interest of nondiscrimination, sometimes people may not bring their personal beliefs into their professional lives. Denny's waitstaff may not act on a personal belief that whites should be served before blacks. DMV employees may not act on a personal belief that women should not be driving. Judges may not act on a personal belief that non-Christians should be sentenced more harshly then the "saved". Lawyers take cases all of the time for those they full-well know are guilty of serious crimes. And on it goes.

The public defender cannot say "That rat-bastard is a murderer, no way I'm going to give him a decent defense!" He is required, as a professional, to act dispassionately and without regard to his personal beliefs on the matter.

As to what's being discussed as to dangerous dosages/interactions, that's an entirely different story. It is part of a pharmacist's PROFESSIONAL duty to double-check that the medications patients are getting are safe, and to double-check anything that may be an error or cause harm. That is acting in a fully professional capacity and is part of his or her job.

On the other hand, it is not the place or business of any pharmacist (or any other professional, or even any other worker) to make moral judgments on those whom he or she serves. If you walk into 7-11 and ask for a pack of cigarettes, and you are of age and can show ID, the person behind the counter is expected to sell you your smokes, not tell you that he is anti-smoking and cannot in good conscience dispense cigarettes. If that's the case, he's working the wrong job and needs to find a job where that's not part of his duties.

If the waitress in a restaurant is a vegetarian and objects morally to bringing you your hamburger, same thing--she is in the wrong line of work, and needs to find a position in which serving or selling meat is not part of the job's duties.

If a pharmacist has a moral objection to dispensing any type of drug which the patient has been legally prescribed by a doctor, he or she is in the wrong line of work-and needs to either suck it up and act as a professional despite his or her personal views, or find a job where dispensing such medication is not part of his or her expected job duties.

As to abortion? Those who say that there is -any- clear-cut definition for when potential human life moves to actual human life are...well, to put it bluntly, wrong. That is not to say that people cannot have sincere, well-reasoned, and very clear-cut beliefs on the issue, but we must all recognize that your definition may not be mine, and neither of our definitions might be anywhere near the next guy's.

The Supreme Court did not find a "right to kill" in our right to privacy, and whoever said that is either totally unaware of how Roe was reasoned or deliberately ignoring it in order to use inflammatory language. What the Supremes did find is that carrying a pregnancy to term can be a major, life-altering decision, as can aborting a pregnancy. They thus decided that such a decision was properly made only by the woman who was pregnant, and that any "rights" a pre-viability fetus may have do not override a woman's right of sovereignty over her own body.

And what if it were not? How far would it go, then? Could a pregnant woman with a living will refusing heroic treatments be given such treatments against her will, by virtue of her fetus' "right to life"? What about a pregnant Jehovah's Witness who refuses a blood transfusion, though surely the refusal will mean she will die before her fetus is viable? After all, "right to live" does override religious freedom-if your religion calls for human sacrifices, you still possess no "right" to make them! Would a pregnant Christian Scientist who refused maternal care be guilty of child abuse? (Perhaps "fetus abuse")?

There are many important reasons why the Supreme Court decided that finding a fetus' rights trump those of an expectant mother's would be an unconscionable invasion of medical, bodily, and personal privacy. The right to abort is only the tip of that iceberg, and it would be only the most visible one to slip away should Roe be reversed.

I wouldn't want to see anyone forced to do something against his or her moral beliefs on the job. However, any pharmacist hired should know that he or she may be asked to dispense birth control, or other medications that may go against his or her values.

But if a pharamacist is truly uncomfortable with prescribing certain medications, why is he or she in that job in the first place? If it's a position that may have morally objectionable duties, then why take it? Why go into the pharmacy profession, if you are not willing to perform all duties required?

If a non-smoker or anti-smoking activist was hired at a convenience store, but refused to sell cigarettes on moral or health grounds, do you think that store is going to keep that employee on? Or a vegetarian waiter who refuses to serve meat in a steakhouse because he feels it's wrong to kill animals for food? What about the animal-rights activist who works in a shoe store, but will not sell leather shoes because he or she feels it's wrong to kill animals for leather?

Would the companies bend over backwards and allow these employees to continue what they're doing? No! Of course not! They would tell the employee: fulfil the duties, or go elsewhere.

Why should a pharmacist be allowed to stay, if he or she refuses to do his or her job? Why can't a company refuse to hire someone who will not perform all the duties required? Why should pharmacists be that special? If they can't or won't perform all requirements or duties in their chosen profession, they need to find another line of work, or find an environment more hospitable to their beliefs.

How far are you willing to go on demanding that professionals use their skill and training to violate their moral code? I don't know exactly what your job is, but I'm willing to bet your boss could ask you to do something that might be legal, but unethical, or might violate your personal values. Is your only alternative to resign, or do you have rights?

I was a librarian. Would I be morally obligated to provide addresses to elementary schools after I'd observed a male patron watching porn on the library computer while masterbating? It's not illegal to ask for school addresses, you know.

[Glenns' reply: Tricky scenario you paint because that gets into first amendment rights--librarians have special strictures when they work for government or schools because of this.

I don't reject the validity of your broader question. I have, in fact, been asked to perform unethical and sometimes illegal actions at previous jobs--I'm currently self-employed--and I have felt that I had few options other than resign. In one case, I was asked to commit software piracy. This is against the law, and against my ethical code. I refused, but didn't go so far as to report that the head of the company had authorized this. In retrospect, I should have said that if the piracy happened, I would report it. That's the benefit of growing up.

But you're asking about an individual decision made on one's own merits. A pharmacist, like a doctor, occupies a somewhat unique position in the world having to serve many masters: the law, the medical profession, and the patient, while wrestling with their own dilemmas.

Drug companies routinely promote products by paying doctors to write more prescriptions. It's illegal if carried out in certain ways, not in others. Should pharmacist who find this illegal and unethical try to prevent their customers from obtaining these drugs? It's just about as valid a question as the abortion/contraception one.

Fundamentally, we have to ask these questions--and I'm glad you are. I don't have a pat answer to it. I know that in the circumstance pharmacists find themselves in, it is critical that legally prescribed medications not be withheld from those who need them. That's got to be the basic issue here. How that works, I don't know. And if contraception or abortion becomes illegal, that changes the equation, too.

Remember that some pharmacists object to dispensing morning-after doses of contraceptive drugs which prevent conception. That's very different than dispensing drugs that cause spontaneous abortion without surgery.--gf]

If it's legal for people to deny prescriptions, we need a resource that gives people information on what businesses are enabling medical discrimination based on religious beliefs. That may be enough to create market pressure to get pharmacists to fulfill prescriptions.

I'm conflicted. Glenn, I agree with you, but I think we're putting pharmacists to a standard that we don't hold other medical professionals to.

If I walked into a doctor's office and demanded that I be prescribed a medicine that another doctor had provided for me a year ago, that doctor would be negligent if he did not examine me and arrive at his own evaluation. The doctor being a professional has a moral duty and obligation to arrive at his own diagnosis. He's not a machine.

That said a pharmacist's role is different that that of a doctor. Their job is to provide a service that someone else has ordered.

I wouldn't fault a pharmacist who refuses to dispense a medication, if they arrange for another pharmacist to dispense it where the patient would have easy, prompt access to it. (e.g. another pharmacist already in the same office, another pharmacist called in to fill the prescription, another pharmacy across the street, or delivery by courier to the patient's home.)

I think the key here is a pharmacist must fulfill their professional duties while balancing their own ethics. Taking a peek at the Pharmacists code of ethics a pharmacist could comply with their interpretation of the code, by refusing to dispense abortion causing medicines. (e.g. it is not in the welfare of humanity to cause abortions.)

I think the place I really get stuck up on is that I don't want more professions to be the equivalent of human machines, and running down the slope of requiring people to occasionally be required to perform an action against their moral beliefs is disturbing to me. I know in all my job I won't do something that I find against my morals, and I don't expect someone else to do so.

[Glenn's response: I agree that this is a thorny issue because I don't want pharamacists to be automatons, either. (In fact, I'd rather they paid closer attention to dispensing pain meds that are misused.) But I also see a conflict between what the law allows and requires and what personal morals do the same.

There's no reason someone shouldn't follow their moral system, but to do so, they may need to opt out of our framework of laws and jobs. Otherwise, it's a frictionless, not slippery slope.

I expect that if there's a good answer to some of the questions I posed that perhaps it would all work out. But unless you assume that all moral objections would be around certain drugs and by certain religions, then you have a giant can of worms.--gf]

Glenn, I agree that this has been a good discussion; I've really enjoyed it.

I have a busy week ahead, so I may not chime in again but I will check back to see if anyone else comments. The new questions you've added are good and interesting ones. Let's see if someone else has an insight.

But, I did want to add two things. First, I wanted to respond to your question about the druggist mentioned in the P-I who would not dispense drugs that were not aborifacients (if my recollection is correct, it was for antibiotics). I think that particular pharmacist was wrong; I'm sure he or she knew that the drug in question was not prescribed to perform an abortion; therefore, he or she should have had no difficulty filling the prescription. To refuse to fill the prescription just because it came from a family planning clinic is unethical, in my view. I'm sure we agree on that. Is it illegal? I doubt it; I don't think legislatures foresaw this coming. But, I'm no lawyer so perhaps I'm wrong.

Second, it is tough to find a good alternative example, but maybe I have one: What if assisted suicide became legal and someone like Dr. Kevorkian (i.e. a known suicide doctor) prescribed a massive dose of some killer drug? And the druggist could easily tell what the prescription was for because the instructions say, "Take in one dose, with water." Could we really fault a pharmacist for choosing not to fill that prescription? I don't think so; so it is with pharmacists and abortion drugs.

Thanks for doing such a great job engaging me in this discussion, Glenn!

Also, and this is totally off point, MT gives me a weird error message when I try to post my comments. Something about a template not being defined. So, perhaps something has gone wonky in the bowels of MT's software.

Your statement that "civil disobedience would be refusing to come to work" is like saying that Rosa Parks should have refused to ride the bus. That's one way out, I guess, but not a very powerful statement against a culture's immorality.

Now, your "atheist white supremicist" scenario is pretty weird and extreme, but I'll answer it. If such a person refused to prescribe (as a doctor) or fill the prescription (as a pharmacist) of a non-white, that would be a form of civil disobedience. There are laws against such discrimination though, and that person should be punished justly according to the penalties of those laws.

In this instance, however, there are no laws that require a pharmacy to fulfill any and every prescription. If there were, this discussion would be moot. Your position, though I understand it given your beliefs, presupposes an obligation that simply does not exist.

BTW: After reading those articles you linked to, it seems that there are a good number of pharmacists are against this. Do you really want them to refuse to work and picket? A lot of truly ill people would suffer needlessly, having to wait in long lines to have their prescriptions filled. I'd like to see your indignant remarks on that day! No, personally, I think the pharmacists are going about this the right way.

And, as to your point about how to change an unjust law in a civil society, I agree wholeheartedly with that. We should use the means of government that our system allows to change bad laws. And, believe me, Glenn, we're trying. We've been working at it for decades and we're almost there. But, here's the thing, we see the original Roe decision as a way that the law was changed--nationwide--in an improper way. The court found a right to kill under the right to privacy. It set aside tons of legislation and avoided the difficulty of a constitutional ammendment. Well, we think that was both improper and immoral, but we've been willing to do what it takes to legally and peacefully change the situation, even though it has taken a long time.

[Glenn's response: Rosa Park was arrested, and then people stopped riding the bus. They boycotted the bus lines. That's what provoked the change.

I'm not sure that I agree with you that there is no legal or regulatory framework in which pharmacists are required to fulfill legal prescriptions. I don't know every law in every state.

The white supremecist case isn't exotic at all, except if you believe that religion has a very specific definition that can be rigidly enforced. The Seattle Weekly wrote recently about how prisoners in Washington jails have "converted" to Judaism to receive special benefits. The way the statutes deal with religion are making it very hard to say that those white supremecists who claim Judaism as their religion aren't.

Fundamentally, I am opposed to the argument that the beginning of life can be defined in a particular way. Just as with Intelligent Design, the beginning of life has strong religious components, throwing away viability or other basic biological measures in favor of grafting the notion of a soul on top of the notion of the biological basis of life.

I am not comfortable imposing my specific ideas about the start of life on other people, and I don't believe there's a crisp line because I don't have the same set of religious beliefs as a minorty of people on the planet that drive this particular debate. It's a personal ethical decision in general that in certain religions is an imperative moral decision.

I don't pretend this is an easy problem, but I don't believe allowing pharmacists who oppose specific drugs because of the outcome of those drugs is a solution for it because it opens the door to every kind of religious or ethical right of refusal.

Brian, you don't mention the case cited in the P-I in which the pharmacist refused to fill a prescription written from an institution that performs abortions even though the prescription wasn't for a drug that would harm a fetus. That's part of the overall problem: if that's allowed, and it might be, then what's next?

I appreciate greatly your reasoned and reasonable tone even though I disagree with you. I am, in fact, anti-abortion, but I also contribute to Planned Parenthood, which is a leading organization for reducing the number of abortions through better contraception (which is immoral in some religions) and in aiding women in having children. I don't see a conflict: I'm neither pro-life nor pro-choice.--gf]

Glenn, given your beliefs, I can understand your indignation.

Can't you understand the convictions of those you're criticizing here? They believe that an unborn child is a human life. So to refuse to participate in an abortion by filling such a prescription--that IS civil disobedience, which you have already said is OK if you believe a law is unjust in a civil society.

Part of civil disobedience is accepting the penalties that may come down with such disobedience. So, these pharmacists should be willing to lose their jobs and/or do jail time if necessary. But to FORCE anyone to do something which they justifiably believe to be immoral�how is that a "civil" society, exactly?

And, I say "justifiably" because it it not merely a belief or opinion that the unborn are human life. It is a scientific fact. US law says it is OK to abort the unborn, but that does not in any way make it morally OK.

[Glenn's reply: I understand the feeling, but there's no good way out on this. It's not civil disobedience to refuse to dispense drugs. If you're not willing to dispense legal drugs, then you need to not be involved in the medical world. That's just a given, unfortunately. That's the way out. That's the disobedience. Staying within a commercial and medical system and stating that specific moral beliefs override a system of legal checks and balances is not civil disobedience. It's a kind of commercial/medical disobedience.

Civil disobedience would be refusing to come to work and staging protests against the ability to prescribe and dispense these drugs.

Let's reverse it. What if all birth-control pills (in any quantity) became illegal in the US ultimately affirmed by the Supreme Court. I wouldn't support the right of pharmacists to dispense these illegal drugs. I would suggest a Constitutional Amendment was needed. I would also support a woman's right to leave the country to obtain drugs.

I don't think I'm stating an inconsistent opinion. I just don't think that moral decisions made by an individual that contravene law can be carried out in the *context* of something like medical practice.

There's also the related issue. Please explain how an atheist white supremicist who finds it morally repugnant to prescribe drugs to people other than whites will not be swept into rules that allow pharmacists to make medical decisions about doctors' patients.--gf]