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Monday, June 16, 2008

Pro-Life Pharmacies . . .

The Washington Post reports today on the opening in Virginia of a new pharmacy that will not carry contraceptive devices.  Rob Stein writes,

When DMC Pharmacy opens this summer on Route 50 in Chantilly, the shelves will be stocked with allergy remedies, pain relievers, antiseptic ointments and almost everything else sold in any drugstore. But anyone who wants condoms, birth control pills or the Plan B emergency contraceptive will be turned away.  That's because the drugstore, located in a typical shopping plaza featuring a Ruby Tuesday, a Papa John's and a Kmart, will be a "pro-life pharmacy" -- meaning, among other things, that it will eschew all contraceptives.   The pharmacy is one of a small but growing number of drugstores around the country that have become the latest front in a conflict pitting patients' rights against those of health-care workers who assert a "right of conscience" to refuse to provide care or products that they find objectionable.

"The United States was founded on the idea that people act on their conscience -- that they have a sense of right and wrong and do what they think is right and moral," said Tom Brejcha, president and chief counsel at the Thomas More Society, a Chicago public-interest law firm that is defending a pharmacist who was fined and reprimanded for refusing to fill prescriptions for birth control pills. "Every pharmacist has the right to do the same thing," Brejcha said.

But critics say the stores could create dangerous obstacles for women seeking legal, safe and widely used birth control methods.  "I'm very, very troubled by this," said Marcia Greenberger of the National Women's Law Center, a Washington advocacy group. "Contraception is essential for women's health. A pharmacy like this is walling off an essential part of health care. That could endanger women's health.". . . .

Some pro-life pharmacies are identical to typical drugstores except that they do not stock some or all forms of contraception. Others also refuse to sell tobacco, rolling papers or pornography. Many offer "alternative" products, including individually compounded prescription drugs, as well as vitamins and homeopathic and herbal remedies.  "We try to practice pharmacy in a way that we feel is best to help our community and promote healthy lifestyles," said Lloyd Duplantis, who owns Lloyd's Remedies in Gray, La., and is a deacon in his Catholic church. "After researching the science behind steroidal contraceptives, I decided they could hurt the woman and possibly hurt her unborn child. I decided to opt out."

Some critics question how such pharmacies justify carrying drugs, such as Viagra, for male reproductive issues, but not those for women.   "Why do you care about the sexual health of men but not women?" asked Anita L. Nelson, a professor of obstetrics and gynecology at the David Geffen School of Medicine at UCLA. "If he gets his Viagra, why can't she get her contraception?" . . . 

Bioethicists disagree about the pharmacies. Some argue that they are consistent with national values that accommodate a spectrum of beliefs.  "In general, I think product differentiation expressive of differing values is a very good thing for a free, pluralistic society," said Loren E. Lomasky, a bioethicist at the University of Virginia in Charlottesville. "If we can have 20 different brands of toothpaste, why not a few different conceptions of how pharmacies ought to operate?"

Others maintain that pharmacists, like other professionals, have a responsibility to put their patients' needs ahead of their personal beliefs.  "If you are a health-care professional, you are bound by professional obligations," said Nancy Berlinger, deputy director of the Hastings Center, a bioethics think tank in Garrison, N.Y. "You can't say you won't do part of that profession." . . . 

Pharmacists at eight pro-life drugstores contacted by The Washington Post said they would not actively interfere with a woman trying to fill a prescription elsewhere, but none posts signs announcing restrictions or offers to help women get what they need elsewhere.  "If I don't believe something is right, the last thing I want to do is refer to someone else," said Michael G. Koelzer, who owns Kay Pharmacy in Grand Rapids, Mich. "It's up to that person to be able to find it." . . . 

But others worry about what will happen if such pharmacies proliferate, especially in rural areas.  "We may find ourselves with whole regions of the country where virtually every pharmacy follows these limiting, discriminatory policies and women are unable to access legal, physician-prescribed medications," said R. Alta Charo, a University of Wisconsin lawyer and bioethicist. "We're talking about creating a separate universe of pharmacies that puts women at a disadvantage."

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