May 09, 2005

Share My Perspective!

I don't know if many of you caught this story in the Star Tribune last week, but it definitely opened my eyes. It describes situations in which pharmisists have refused to fill birth control prescriptions because they are opposed to contraceptives.

This needs to be remedied. For those of you who don't know, I spent a few days in the hospital last year due to a nasty cyst. I lost nearly two units of blood after all was said and done and had to have (minor) surgery. After that, I had severe pains (resulting in much missed work) that turned out to be more cysts. So, I am now on "the pill" in order to prevent more cysts. That's right, world. I said it. I use the big BC.

And I resent the fact that a pharmacist can refuse to a) fill my prescription or b) transfer my prescription just because he/she thinks he/she knows what the prescription is for. Birth control is used to treat many health problems, including hormonal imbalances, that have nothing to do with preventing pregnancy. Aside from the fact that it is nobody else's business why you are taking a prescription, this refusal to fill prescriptions can be dangerous to those of us who are prescribed these drugs for other reasons.

Another reason this interests me is that this issue is so sensitive. Women don't usually like to talk about things like birth control in public forums, so issues like this get ignored because not enough people are comfortable enough to stand up and say something about them. Additionally, I can't even imagine how embarrassing it would be to stand in line at the pharmacy and have them say out loud that they refuse to fill your prescription because they don't believe in the use of contraceptives. I would be mortified. Not only that, but I was actually very nervous about renewing my prescription. There was a delay while the pharmacist authorized it, and I was sure that they were going to tell me they wouldn't fill it. For some people, this is enough to stop them from filling the prescription all together.

Finally, many religious people are against the use of drugs like Lexapro and Paxil, which treat anxiety and depression. There are many drugs that various religious organizations might be against. Are pharmacists going to be allowed to prevent any of them from being sold simply because they don't agree with the use of the drug prescribed?

I'm all for religious freedom and equal rights, but where do your rights end and my rights begin? I have as much right to be comfortable as you do. At what point does religious freedom begin to jeapordize health? Should that be allowed?

Posted by LoWriter at May 9, 2005 03:58 PM
Comments

I got into a discussion about this with my mom on Mother's Day (whoops). She tried to equate it to doctors having the right to not perform abortions or grocery stores and restaurants having the right to not sell alcohol if they don't want to. She doesn't want to force people who are against birth control to sell it to others, and doesn't see how you can just tell them they can't work in pharmacies if they don't want to do it.

It's kind of a sticky situation as there are human rights on both sides of the fence, and someone's rights are going to have to be compromised unless we fashion some sort of ThePill Dispensing robot apparatus that accepts orders over the intertron. In lieu of that I'd argue that the pharmacist's rights are less important than the patient's, particularly since there are uses for birth control beyond pregnancy prevention, something mom should have known as her own daughter was on it in high school for acne treatment.

Posted by: schdav at May 10, 2005 10:38 AM

schdav, your mom does have a good point about freedom of choice, BUT if it is ever to be applied, it needs to be consistant. you cant have one server in a restaurant who refuses to serve alcohol b/c it is against his/her beliefs. it doesnt work that way in food service, and it shouldnt work that way with pharmaceuticals. ANY pharmaceuticals.

Posted by: Dr. Gonzo at May 10, 2005 10:55 AM

In case I wasn't clear, I don't support my mom's argument at all, I was just listing her arguments for discussion purposes. I can understand where's she's coming from, but don't find her arguments strong enough to violate the patient's rights.

And if she'd ever been a server in a restaurant she probably would have refused to serve alcohol. And gotten fired. It took me awhile to realize it wasn't normal to grow up in a house like that. Weee! Fundamentalism is awesome.

Posted by: schdav at May 10, 2005 11:49 AM

I have heard that arguement before, but there's a significant difference: One is a physical operation where the physician takes an active role in aborting a baby and the other is dispensing a pill that may (or may not; it's been known to fail) prevent pregnancy. Really apples and oranges at best.

Fundamentalism is interesting, but your mom is pretty nice. I don't see her as being fundamentalist exactly.

On the other hand, I have to read lots of stuff that I don't agree with and help people improve it on a daily basis. If I didn't, I couldn't be a teacher. And waitstaff would get fired for not serving alcohol, but people can refuse to dispense medicine and that's OK. If they continue to allow this, I don't think that there should ever be a time where a pharmacist who won't dispense birth control is the only pharmacist on duty. That's the only acceptable compromise.

Posted by: Lo at May 10, 2005 02:43 PM

Yes my mom is nice. I probably made her sound awful, wasn't my intention. I suck at the writing.

And she isn't fully fundamental, but her parents really, really are. They are the sort who will leave wedding receptions if there is alcohol involved. The ones who we avoid telling about cousins getting divorced or if they lived together with someone of the opposite sex before marriage lest they be excommunicated. Example: my older sister once got spanked for eating a pickle before we blessed the meal.

But they are still people, and there are really good reasons (or at least kind of good reasons) for why they are the way they are, and really it probably isn't all that different from the modern day equivalent of "I'm a recovering alcoholic, been sober for X long" they just decided to bring the Jesus into it, which kind of adds a cultish element to it sometimes. Or makes it harder for them to realize that just because they don't drink others just might be able to do it responsibly. That and some people just tend to live on the extremes. They used to party like it was 1929, and then they didn't, and anything that was remotely similar to partying like 1929 was akin to satan worship, middle ground just didn't enter into the equation.

So I guess my mom might be a first generation recovering fundamental? And that would make me second gen? I wonder how many generations it takes to go away. Or maybe it's cyclical. Perhaps my kids will be afraid of living a balanced life, too.

I'm not sure how any of that relates to birth control, but it's a bagillion degrees in here and I already typed this so...

Posted by: schdav at May 10, 2005 04:23 PM

schdav, i dont think your mom sounds like a bad person at all. there is something to be said for good intentions. hell, i think my viewpoint is right 99% of the time too! :o)

Posted by: Dr. Gonzo at May 10, 2005 05:00 PM

No Dr Gonzo, I am right!! :-) hehe, but actually Dave I come from a similar situation but because my mom never drank she doesn't have a problem with me drinking, just as long as I don't do it in her company. She's the one who (this weekend) told me to drink at home to see how it made me feel (experimentation, always good).

But I think finding balance in everything is hard is some people's life and sometimes security (knowing that there is no other way) is what people use to substitute living here on earth where so much is not secure. That doesn't make them bad people, I would rather be able to buy into that than live like I do sometimes...

Posted by: 10lees at May 10, 2005 06:23 PM

sorry, I think finding balance is hard is everybody's lives, not just some...

Posted by: 10lees at May 10, 2005 06:24 PM

Hey all, the other issue at hand is that a pharmacist plays a particular role in his/her position within the medical field. That role is to dispense--not write prescriptions, not make medical decisions, and not to judge. If a pharmacist thinks dispensing certain medicines is wrong, then I guess he/she chose the wrong profession because it's just not his/her place to judge, like Lo has said. It's fine if those pharmacists want to advocate against BCPills in their off time, but when they're on the clock, it's time to turn their biases off. That's just part of what it means to be a professional.

Posted by: J at May 10, 2005 08:46 PM

I'd take the side of they're getting paid to dispense prescriptions. Pharmacists also are supposed to know about and explain interactions and side effects to the customer (that is why they go to school for 8-11 years, they don't need that much to find the bottles on the shelves and count pills, or if they do they won't pass the tests to become one). Their only objection should be if the drugs will cause problems due to interactions and stuff like that. If they can't figure out that many (most? They seem to be prescribed for a lot of things these days) people aren't using them for uses to which they have an objection, they probably should find a new job.

Posted by: Jeremy at May 10, 2005 11:51 PM

Frankly... I think that people are insane. Most and probably all. It's fine to have a cause... even a cause with questionable/cultish motives... but it doesn' t matter where they come down politically... there are always these fools that are like... "I'm going to pick a totally pointless and largely detrimental way to assert my activisms."

All they do is annoy people... of all leanings. I'm for the "smack around" approach... but I tend to be impatient.

Honestly... I don't think it jives with the constitution to force people to sell or not sell things... one would hope, however, as Lo said, that pharmacies would take something like this into consideration and have someone around that would sell them. You'd think that with the sheer number of women on birth control, they'd just quit going to those places, and their boycott would do the work. I'm such a free-market whore... I love it.

But really... it's just another bit of madness... people desperate to take a stand. I vote for hobbies instead.

Read a book, crazed pharmacists. You're boring us.

Posted by: Mardou at May 11, 2005 09:29 AM

Now I have to rephrase... since there are plenty of things that it's illegal to sell... but as far as forcing people to sell or not sell perfectly legal, non-detrimental (even helpful) substances or products...

What if some vegan refused to sell me cheese slices? I'd tell him or her to come off of it, complain to his or her boss, and leave without spending a red cent... but that's just me...

Posted by: Mardou at May 11, 2005 09:32 AM

now that's a good analogy! i've actually gotten dirty looks from employees for buying free-range lunchmeat at Whole Foods before, but no actual complaints. why is it that people dont look at analogies more often? everything is an exception to the rules nowadays. everyone/everything is special. do people understand that that makes no one/nothing special!!??

Posted by: Dr. Gonzo at May 11, 2005 09:59 AM

I, too, can see both sides of this issue. To some degree, I have to repect someone who stands up and refuses to participate in an action that they find unethical, but on the other hand I would be royally pissed if their beliefs interfered with the freedoms to live my life as I should be able to under the laws of the land.

What strikes me as odd is that pharmasist's with this belief wish to stay pharmasists, despite this aspect of the job. It's like an SS officer saying, "well, I really like the uniform, the pay is great and the benefits are awesome, I just don't want to deal with the killing or oppression" Well guess what, the positive aspects of your job are derived from activity that you view as unethical whether you actively participate in such activity or not. You're tacitly complicit anyway.

If you truly feel the availability of prescribed birth control is unethical, than you should quit being a pharmasist, because like it or not, it's legal.

Posted by: rhett at May 11, 2005 10:02 AM

Now I keep thinking about it...

I do realize that not all women are equally assertive, and that some may be too embarassed to argue or make a scene. It puts the situation in a strange place.

If a woman is, for whatever reason, ashamed of her BC, should the powers that be then pass a law that says pharmacists, essentially, must not aggravate said shame? At what point does legality/illegality exit the issue entirely? Is the bigger issue, then, that there are not enough women out there willing to make a scene?

I hope this isn't too contentious... I'll say it anyway, for arguement's sake:

I've been concerned for a long time that one of the biggest issues for women is that there are so few willing to speak for themselves. So many expect the feminist groups and watchdogs to do it for them. At what point is the onus on women to -- on an individual, day-to-day basis -- stick up for themselves? "Make a little scene" as it were?


Posted by: Mardou at May 11, 2005 10:06 AM

Like the scene from when Harry Met Sally... oh, wait were we on another topic?? hehe

Well I think that feminist groups are annoying most of the time because I feel like they are trying to make me something I'm not. Like if you stay at home you aren't really important - though they have tended to back away from that stance recently. However, in this case they definetly need to speak up. The pill prevents abortion and only catholics (or strict fundamentalists) are against the pill... But I would like to point out that when we have a period we waste a perfectly good egg (we should all repent of that too) and what about all those men out there that blow off steam??? That should be completely off limits, take all lotion off the market because it's used for that.

Also, I agree with the Vegan analogy - but I think a good point is that most Vegans wouldn't be caught dead working in a shop that sold cheese or meat - or at least wouldn't be serving it. And that's the point - if you can't deal with that part of the job QUIT!

Posted by: 10lees at May 11, 2005 01:58 PM

rhett makes an excellent point. Why work for a place that profits from drugs with which you disagree? Obviously you don't disagree with the pills enough to stop receiving the company's money, some of which came from the sale of birth control. The pharmacist doesn't want to have to feel unethical for working for a company that sells a product he/she doesn't agree with. So, instead, he/she makes it about the patients' ethics.

People are weird.

Also, I don't believe that women stand up for themselves enough.

Posted by: Lo at May 11, 2005 03:45 PM

It wasn't my intention to assert that feminist groups shouldn't ever "activate" so to speak, but to be frank, I think that there are many women in this world who are very willing to just let things happen to them; then they wait for someone else to stand up and say, "You can't treat her like that!"

Very strange situation there. I get a little worked up about this women stuff. Nothing more counterproductive than a woman going from "Men! Help me, help me!" to "Feminism! Help me, help me!"
Both tend to make women look pretty helpless.

I don't want anyone to misunderstand. I am ALL about organized efforts to move women forward in the world, but what's the point if the individual just sits there waiting to be dragged along?

Sorry. Had to get that out. And.... I'm done. I swear.

Posted by: Mardou at May 11, 2005 04:38 PM

i think you're in the right forum for women who stand up for themselves. it took me my whole life to realize that i'm a feminist in denial. society characterizes feminsts as pushy & overbearing bitches, and i of course, do not want to be one of those. but, i stand up for my rights and will firmly assert myself when necessary. we need to encourage each other intead of the stigma. wooo hooo!!

Posted by: Dr. Gonzo at May 12, 2005 10:56 AM

I've been a long-time believer in helping myself. Organize, yes, because you're stronger together, but don't expect anybody else to save you from your own stupidity. So yes, Mardou, you've come to the right place.

Posted by: Lo at May 12, 2005 12:13 PM