Can Pharmacists Withhold Birth Control?

When Julee Lacey, a married mother of two, tried to get her birth control pill prescription refilled at a CVS near her home in suburban Dallas, the pharmacist refused.

"She began to tell me that she personally does not believe in birth control, and that therefore she would not fill my prescription," said Lacey, who attends church regularly and is a former teacher of the year.

Lacey's situation could happen with increasing frequency, since many conservatives are seeking laws that would protect pharmacists' jobs if they refuse to fill any prescription they oppose on religious or moral grounds.

"Pharmacists should not be forced to do anything," said Karen Brauer, president of Pharmacists for Life International. "Pharmacists should be practicing pharmacy for the purpose and benefit of enhancing human health and human life."

Brauer and other conservative pharmacists do not believe birth control pills enhance human life — in fact, they see them as doing quite the opposite.

The Food and Drug Administration and American College of Obstetrics and Gynecology have defined pregnancy as beginning at the moment a fertilized egg is implanted in the uterine wall. But many conservatives believe pregnancy — and therefore life — begins at the moment of fertilization, up to a week before implantation. Since the pill, the so-called morning-after pill, and other hormonal contraceptives can take effect after fertilization, they see these medications as ending human life.

Currently, only two states — Arkansas and South Dakota — have laws protecting pharmacists from having to dispense medications they oppose, which supporters call "conscience clauses" and opponents call "refusal laws." Ten other states — Indiana, Michigan, Minnesota, Mississippi, Missouri, Ohio, Rhode Island, Vermont, Washington and Wisconsin — are considering such legislation.

Fierce Debate

"These so-called conscience laws are unconscionable," said Terry O'Neill, vice president of membership for the National Organization for Women. "Any pharmacist who is not willing to care for a woman's total health should not be a pharmacist. Central to a woman's reproductive health is her ability to get birth control."

The controversy over the legality of hormonal birth control often only pops up during debates over abortion, even though the numbers of women who use birth control vastly outnumber those who have sought abortions. Often the same sides are represented; those opposed to abortion rights often oppose such birth control methods.

"I will not be supportive of covering medications that would lead to a fertilized egg not implanted in the uterus," Sen. Rick Santorum, R-Pa., said during the March 2003 Senate debate over what opponents call partial-birth abortion. "I believe life begins at conception. I would not support drugs that would prevent a conceived embryo to be implanted."

Sen. Dick Durbin, D-Ill., a supporter of abortion rights, said he "was stunned when I came to Congress many years ago to find that the people most vehemently opposed to abortion were equally opposed to contraception. How can that make sense?

"If you don't offer to a woman — a wife, for example, in a family situation — an option to plan her pregnancies, then you are just inviting an unplanned or unwanted pregnancy, inviting the possibility of abortion," he said.

But to many conservatives, some forms of birth control and abortion are essentially the same thing: the ending of a human life.

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