4.16.2006

Still think Pharmacists are all about saving lives?

So, my insurance company (the only HMO my employer offers) recently sent me a letter to inform me that they have decided to stop doing business with certain pharmacies, and won’t I please transfer my prescription to another pharmacy on this handy list we’ve provided? Unfortunately, not a single pharmacy on that list has a written policy demanding that their pharmacists fill all prescriptions as presented by their customers. Of course, I can press my luck with any number of drug stores which may or may not allow individual pharmacists to steal my prescription and call me a whore for daring to have irregular and painful menstrual periods which require an estrogen/progesterone combination commonly known as The Pill. Apparently, god gave me endometriosis to serve as a constant reminder of Jesus’ pain and suffering on the cross…or something like that. At any rate, in the last paragraph I have told you more information about my need for birth control than the average fundie pharmacist would have at their disposal when refusing to fill my prescription despite the fact that both my doctor and I have decided that this medication is the best course of action to preserve my physical health. Ironic, isn’t it?

But, of course, these pharmacists are not concerned about my painful cramps; their concern is for the fertilized egg that may or may not exist in my body (they don’t know if I’m sexually active, either) that this particular medication will prevent from implanting into my scarred endometrial lining. And if I don’t risk an ectopic pregnancy every time I fuck, the baby Jesus weeps. Allowing me to prevent a pregnancy that could potentially cost me my life (ectopic pregnancy is the second leading cause of maternal death—and we all know what the leading cause is, right?) is a secondary concern for the fundie pharmacists who are on a quest to save everyone’s life but my own.

And what better evidence for the fucked up priorities of the fundie-pharms than this:
Cedar River Clinics, a women's health and abortion provider with facilities in Renton, Tacoma, and Yakima, filed a complaint with the Washington State Department of Health this week alleging three instances where pharmacists raising moral objections refused to fill prescriptions for Cedar River clients. The complaint includes one incident at the Swedish Medical Center outpatient pharmacy in Seattle. According to the complaint, someone at the Swedish pharmacy said she was "morally unable" to fill a Cedar River patient's prescription for abortion-related antibiotics. Cedar River's complaint quotes its Renton clinic manager's May 17, 2005, e-mail account: "Today, one of our clients asked us to call in her prescription... to Swedish outpatient pharmacy. [We] called the prescription in... and spoke with an efficient staff person who took down the prescription. A few minutes later, this pharmacy person called us back and told us she had found out who we were and she morally was unable to fill the prescription." (Cedar River thinks their client eventually got her prescription filled.) [emphasis mine]

So, while the moral outrage sets in, let’s recap shall we? Woman had an abortion, meaning that whatever embryo/fetus/child (use the term of your choice) that existed in her body has been removed. Pharmacist receives prescription for antibiotics which will prevent infection from setting in the woman’s uterus. Pharmacist refuses to fill prescription, thus endangering woman’s health, because s/he does not approve of a prior act committed by the woman. Yep, sounds like actions of a person so consumed with the zeal to save lives that they are willing to allow women to die.

I am opposed to drinking and driving. My father was nearly killed by a drunk driver 20 years ago, and the thought that he would not have met any of his grandchildren had he not been lucky enough to survive the car accident is enough for me to never drink and drive, not allow my friends to drink and drive, and contribute time and money to organizations that work to educate people about the dangers of drinking and driving. The driver who caused my father’s accident died immediately, but had he survived I would not have supported any effort by EMS or the ER doctors to withhold treatment. I would expect that they would do everything they could to keep him alive, even if those medical personnel were as angered by his actions as I was. That is the reason we hold those in the medical establishment to a higher standard—you can believe whatever you would like, but to withhold medical treatment or services based on bigotries or prejudices is anathema to their profession. After all, where does it end? If women seeking post-abortion medical services can be turned away, what about smokers receiving Procrit to treat chemotherapy-related anemia? Can HIV+ patients have their prescriptions for protease inhibitors denied? Maybe men will have to submit a copy of their marriage license before picking up that Cialis? At what point to do we finally admit that one person’s morality simply cannot be a substitute for (or justification for denying) another’s medical treatment?

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annamaria at 10:15 PM

16 spoke

16 Comments

at Monday, April 17, 2006 10:01:00 AM Blogger Kurt said...

awesome job of articulating the dangers of assuming moral high ground without considering the ripples of one's actions.
many, many religous people's willingness to stand for their beliefs are admirable but misguided attempts to prove piety. they bring to mind the story of Jesus being confronted by a mob, eager to stone (to death) a woman caught in adultery. with no doubt about the "guilt" of the woman, Christ did not automatically condone her behavior and castigate the accusers. instead, He affirmed the proscribed punishment then required that the only ones qualified to administer it were those who had never been guilty of even one moral error.
after all the accusers found it necessary to disqualify themselves from the position of judge, then Christ judged her guilty. forgave her. and admonished her to "sin no more."
i agree with your question and rephrase it thusly - at what point do we realize that our own fallibilities make us unsuitable to administer another's moral "punishment"?

 
at Monday, April 17, 2006 11:10:00 AM Blogger ID said...

Wouldnt it be the best if men had to provide marriage licenses for their Cialis or Viagra?

I couldnt agree with you more. If they are going to label people and deny medication then it should be across the board. Right or wrong. See how long that lasts.

"Oh, sorry Mrs. Smith, we can't administer your Chemo today. Yeah, the doctor was against your actions and purported lifestyle, so, yeah..Good luck with that."

Like you said, medical personel are held to a higher standard where their loyalty to the Hippocratic oath is to come before their loyalty to any of the professed religions. They should require doctors to list their faith affiliations on the HMO websites so that we could choose the Athiest doctors who would have a medical opinion in place before they leveled a moral judgement.

Wasnt it Marx who claimed that all massive systems are bound to crumble due to internal collapse? I think our collective "check engine" light has come on and the motor is bound to start smoking any minute.

 
at Monday, April 17, 2006 12:58:00 PM Blogger Wake of the Flood said...

I am appalled by the actions of many people who share my beliefs. Especially when the action appears to give little or no consideration to the pain that another might bear because of such an action.

However, I fundamentally disagree with the underlying premise of your argument, which is that our religious beliefs are of secondary importance to the needs of a civil society. By your logic only those who are secularist or whose beliefs do not inform their worldview are appropriate candidates to deliver health services in the United States. Which means then, that a secularist worldview is deigned to be our civic religion, and the proponents of that religion are the only ones deemed morally acceptable to practice medicine.

Of course, if I extrapolate from your comments, that would be just fine in your world. For then only your "bias" or "superstition" would be the one receiving due consideration.

As much as we would like there to be, there is no such thing as a purely scientific and logical worldview rooted only in the empirical. Oh, such a worldview exists. It simply ignores or discounts the vast realm of our human experience that doesn't fit in the box.

The right to refuse to act against our beliefs is not just a fundie issue. When I was with Walgreen's one of my pharmicists really struggled with selling needles. She had no problem selling them to users -- well, she was concerned, but would never have thought of refusing to sell to them out of her desire that if they were using they would use clean needles. Where she struggled was in selling to the drug dealers who were buying needles not to provide clean needles and prevent the spread of HIV, but instead were using the availability of needles as a marketing device! And from the anecdotal evidence, they were having customers re-use dirty needles.

The law in CT says that it is legal for the dealer to purchase the needles. Is that pharmicist in the wrong in not wanting to participate in that sale with that dealer?

Yes, I know, there are many other related issues connected with my question: how does she know the needles are being sold to a dealer? how do we know they are being re-used? etc. By your logic however, those questions never come into play. Her moral position has no standing in the decision whether to sell the needles or not. She is licensed to dispense, dispensing is legal, and the client is legally entitled to the needles. End of story - the pharmicist must dispense. I happen to believe that is not the end of the story. And I believe the constitution upholds that understanding of our civil rights.

Have you ever read Stephen L. Carter's The Culture of Disbelief? His isn't the only book on the topic, but it's one of the best I've read. And of course, I'm partial to his Yale connections.

and I do like id's suggestion that we require men to provide proof of marriage (to a woman, of course!!!) before we fill that Viagra script.

 
at Monday, April 17, 2006 1:26:00 PM Blogger DrugMonkey, Master of Pharmacy said...

Just for the record.....not all pharmacists are right wing wackos. Take a look here to see what's on a left wing wacko pharmacists mind: www.drugnazi.blogspot.com

 
at Monday, April 17, 2006 3:39:00 PM Blogger ID said...

Oh, oh my.

"As much as we would like there to be, there is no such thing as a purely scientific and logical worldview rooted only in the empirical. Oh, such a worldview exists. It simply ignores or discounts the vast realm of our human experience that doesn't fit in the box."

Unless I'm sorely confused, which wouldn't be a first by far, this statement hurts.

Thinking in purely scientific and logical ways is a worldview? So what does account for our "human experiences" that don't fit into said box? God? Religion? Mysticism? Voodoo?

I don't understand much of what science, nor logic for that matter, has to offer. However, if the "worldview" it portrays doesnt fit into my experience, or the box its supposed to fit in, do I chalk it up to some mystical power that I dont understand either, or am supposed to understand via someone else's word through antiquity?

I guess my overall point was that morals are fine. People with morals often get their panties in a bunch when someone disagrees with them, then they claim its an "attack" on their way of life. Morals are supposed to be personal. It seems that folks with the strongest "morals" are those who are always trying to push them on other people. So, If I have morals, and you have morals, and they are subjectively different, who's set of morals are right?

Basing someone's medical care, or worldview, on rhetorical b.s. is in fact that, bullshit. If someone needs a certain drug to live, who is to stand in front of them and say they are wrong based on one's "morals?" Its a thinly veiled element of control that is protected by the morality curtain.

As for the conundrum of the pharmacist and her needles. Perhaps if CT wouldn't have banned the Needle Exchange programs that were in place, she wouldn't have to sell works to the local dealers. Harm reduction is another victim of the morals game. The users have a disease that we don't agree with, therefore let them stew in their misery and die.

Haters.

 
at Monday, April 17, 2006 7:03:00 PM Blogger Dane meets Simone said...

What about people who sell Big Macs to fat people? Where's the outcry??

 
at Tuesday, April 18, 2006 8:50:00 AM Blogger Dane meets Simone said...

However, I fundamentally disagree with the underlying premise of your argument, which is that our religious beliefs are of secondary importance to the needs of a civil society. By your logic only those who are secularist or whose beliefs do not inform their worldview are appropriate candidates to deliver health services in the United States. Which means then, that a secularist worldview is deigned to be our civic religion, and the proponents of that religion are the only ones deemed morally acceptable to practice medicine.

On a more serious note, I didn't get any of this from your post.

 
at Tuesday, April 18, 2006 9:06:00 AM Blogger Kurt said...

woot!woot!
annamaria was complaining last week about how there is "an inverse relationship between how serious I am when I blog something and the number of comments left?"
apparently this is an issue she doesn't take too seriously...
id and wake may be arguing the same side of the coin. both are arriving at this table with deep beliefs which they use to guide their behavior. wake is pointing out that often the "progressive" attitude is that the those who do not share their view must acquiesce to their view for the greater good or get out of the business of health service. hmmm. seems about as rigid as those on the far, far edge that would have less problem with allowing the suffering of another than the "compromise" of virtue.
balance and commonality are where we will find the ability to coexist.
i wish i knew how to get us there.

 
at Tuesday, April 18, 2006 9:31:00 AM Blogger Wake of the Flood said...

thanks for the clarifying comment Kurt. I guess I'm a little cranky with all this. Those who know me would never equate me with a right wing wacko or fundie. But I'm fed up with being told by the progressives I marched in the streets with that I'm still welcome at the table as long as I don't bring my faith with me. Well sorry folks, but if my faith doesn't come with me then I'm not there. My faith is such an integral part of who I am that if it is not welcome then I am not welcome. Why is it that my progressive compatriots believe that their "faith" -- and they do have a faith system -- believe that their's takes precedent over mine?

 
at Tuesday, April 18, 2006 10:19:00 AM Blogger ID said...

I hate to continue playing devils advocate here but. By subtly placing the word faith in parentheses when relating it to "progressives" implies that their faith is some how lesser than yours?

Having faith is fine. I have faith that the Chicago Cubs will someday end the 98 year drought and win the world series. I also have faith that the producers of Lost will reveal what the hell is happening on that island. But, I dont wear these faiths on my sleeve and force people to relate to me solely on the level of my faith.

And while these faiths may be feeble and shallow in the eyes of people with "actual" faith, all people are welcome to join me in having faith in these entities.

Faith/religion is like a ritzy nightclub. If you arent dressed the right way and attractive in the eyes of those who run the club, good luck getting in. And no, progressives aren't running the door.

So, to answer the question at hand. The faith that I choose to adhere to is no better or worse than yours. I just choose not to use it as my primary identifier in society. And if that makes me less than people with faith then so be it.

 
at Tuesday, April 18, 2006 10:50:00 AM Blogger Wake of the Flood said...

id, you are making my point for me. those who try to drive any faith based positions out of the discussion are as guilty of an orthodox rigidity as the fundies. the difference is in how that orthodoxy is defined. when you decide that it is wrong for me to establish my identity through my faith you are doing exactly what is done to those among the GLBT community who establish their core identity through their sexuality. Someone may think it a ludicrous way to define ones self but is it my right to deny someone's self-definition? That is a basic premise in many progressive positions -- and yet when confronted with ones whose means of identification they don't like they change the criteria. We can't have it both ways in this discussion.

And there is a faith position shaping your worldview whether you acknowledge it or not. A secularist view is not a neutral position. Neither is an atheistic one. Our cosmology shapes how we place ourselves and others within the universe. And we all have one. Some folks spend a great deal of time analyzing theirs while others simply take it as it is without much reflection. I am not trying to claim a higher value for one or another. I simply want it acknowledged as a legitimate part of the discussion on health policy.

In an earlier post you seemed to imply that faith and reason (logic) were mutually exclusive. I don't find them to be at all. They address differing facets of reality. You asked what would be outside of the empirical box. Love is but one item of a myriad. Yes, we are discovering lots and lots of physiological phenomena connected with love. But from my limited readings it appears that in this area, as in so many others, the empirical evidence takes us to a non-material world. One that is understood through our cosmology. And something that I find incredibly exciting is that, unlike the dogmatic fundies, I see the current discoveries in science as affirming my faith. I don't find science to be at odds with the Bible, but rather opening my reading of it.

 
at Tuesday, April 18, 2006 11:49:00 AM Blogger Dane meets Simone said...

There are some straw progressives being constructed here. Or maybe some real ones who we need to have speak for themselves in order to understand who it is Wake is reacting against. It's not Annamaria, as far as I can tell, as much as I'm supposed to think so.

but this:

when you decide that it is wrong for me to establish my identity through my faith you are doing exactly what is done to those among the GLBT community who establish their core identity through their sexuality. Someone may think it a ludicrous way to define ones self but is it my right to deny someone's self-definition?

Because I'm a lesbian, allow me to exploit my core identity for a moment and be all indignant.

Sexuality, if you're gay, is not just about who you fuck and please let me be free to. Not when who you fuck has so many cultural admonishments against it, not to mention barriers to civil liberties, so that claiming an identity around "sexuality" becomes claiming one's right to exist as more than just who one fucks, not the inverse. Blink and you'll miss the distinction, but only if you're wearing blinders.

This idea that gay people are out there forming core identities around their sexuality in some contrived or superficial or god help me trendy way misses the point that our sexuality is not just our sexuality--it's been made who we are. So if I claim something about being gay as central to my life, you might see me claiming my "sexuality" and thinking tsk tsk that's just who you fuck. And you'd be totally wrong. And probably totally straight. Because it will be a great day when my "sexuality" and "who I fuck" are the same thing.

AND, if I could rule the world according to my worldview, we'd stop selling Barbies to little girls, and guns to little boys, and packaged cowboys and indians to everyone. In fact, there's a lot of commerce that would be forbidden altogether. But I'll let that madness proceed if the Christians could all get together and please let us have our condoms and our birth control and our uteruses. You know, like a swap.

And btw, I also question this continual reference to "secularists." I don't call myself a secularist just because I think pharmacists should get out of the business if they don't want to sell legal birth control. In fact, isn't that what people of certain faiths call other people whom they perceive not to have any? And might that not be bullshit?

 
at Tuesday, April 18, 2006 12:22:00 PM Blogger Kurt said...

militancy in the form of fundamentalist rigidity (on the side of any argument), by its nature, opposes solution. its energy comes from the divisions it creates and as long as the focus remains on those extremists screaming the loudest, then the further peace seems.
consider the sectarian violence in iraq. to us outsiders, we see the need for them to work together in order "to form a more perfect union." there are probably a majority of regular people on the ground in Bagdad that would just like someone to agree on something that would make it safe for their kids to play outside.
i am old enough to remember when the balkans were breaking apart. suddenly, young men that had been the best of friends, inspirations to each other and teammates on the oold Yugoslavian basketball team were no longer able to speak - one was Croat and the other Serb.
all of us are the sum of our experiences and beings. it is time for us all to speak against those that would reduce us to particular sides instead of humans. it is especially important for those of us closest to one side to condemn the outrageousness of "our" side, instead of theirs.

 
at Tuesday, April 18, 2006 2:43:00 PM Blogger Dane meets Simone said...

it is time for us all to speak against those that would reduce us to particular sides instead of humans.

who are these people? i find, often, that i and others have to defend ourselves against universalist values that supposedly care about "human" life while trying to dispose of what others consider "human" rights. Sometimes we really are on different sides, at least politically.

it is especially important for those of us closest to one side to condemn the outrageousness of "our" side, instead of theirs.

Agreed. Which is why I think the more liberal Christians should be taking the fundies to task.

consider the sectarian violence in iraq. to us outsiders, we see the need for them to work together in order "to form a more perfect union."

But there is no "us"--not really. And no "we" that sees. I don't picture the problem as being the Iraqis or their ability to cooperate with one another. And even "sectarian violence" needs to be parsed, because a lot of Iraqis I've seen interviewed talk about how the sectarian divisions were not as discrete as they are now. I find the lack of postwar planning more constitutive of the problems that exist in Iraq than sectarian differences. Even the CIA got that part right.

And our union, at its founding, was rather uninclusive to say the least. Must have made working together a lot easier.

 
at Tuesday, April 18, 2006 5:14:00 PM Blogger Wake of the Flood said...

dane meets simone said: So if I claim something about being gay as central to my life, you might see me claiming my "sexuality" and thinking tsk tsk that's just who you fuck. And you'd be totally wrong.

This was in response to my comment about how some folks express their identity. And if that's what I meant I would be totally wrong. If if that's what my comment sounded like then I did a very poor job in expressing myself. In raising gayness as an example it was not to demean or moralize, but to show that our self understanding is part of our core being and comes to the table of discussion along with the rest our selves. I used the term sexuality not to define a person in terms of their physical actions, but as a shorthand, poorly chosen, to point away from the sense that a self identification as gay is "who you fuck" or some "trendy choice" and instead towards it being an integral part of how one sees ones self.

I think there's alot of folks in here arguing against straw men, myself included. Because I've raised faith as an issue in the debate I'm being held accountable for the idiocy of any person of faith, and especially the politically/socially noisy fundies. Hate to disappoint y'all, but they don't like me either.

This rant isn't against annamaria, nor those who've posted. It's about the way in which we've shut the door on allowing whole people into the policy discussions in our nation. As for using the term secularist, I find that people falsely think that somehow if we exclude references to faith we're being morally and religiously neutral. I don't buy it. What I hear is an automatic rejection of my input and the assumption that it is simply superstition and without any intellectual merit. There's an awful lot of folks who think they're super logical and being intelligent by dismissing religion as bunk who wouldn't be able to get through the first paragraph of a C.S. Lewis or J.R.R. Tolkien essay. As for beating up on the fundies -- they get both barrels from time to time. But they're not reading this blog so they're not the audience I address.

Now if I concede your argument, that if someone has deep fundamental disagreement with a legal element of medical practice then they should not be in practice, consider how many people would need to leave the profession. There are moral minefields all across the landscape when it comes to medical technology -- from euthanasia to being the attending physician at an execution...who is to decide which are the acceptable places for someone to opt out of and which ones are not? Who gets to be the god that reigns supreme over everyone else's god? Not I said the blind man....

 
at Tuesday, April 18, 2006 8:28:00 PM Blogger Dane meets Simone said...

It's about the way in which we've shut the door on allowing whole people into the policy discussions in our nation.

I guess I just don't see how this has happened. If Christians feel somehow marginalized these days, why must there be others to blame?

I find that people falsely think that somehow if we exclude references to faith we're being morally and religiously neutral.

I agree with this. Absolutely. But I do think a civil society has to ensure not only religious freedom, but freedom from impositions of religion. And I'd need more convincing that this country is one where religion is not infecting the state already. GWB invaded Iraq on God's orders if we believe the rumors out of his inner circle.

As for the sexuality issue, I'm happy I misunderstood.

 

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