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April 29, 2005

All About "Choice" and Tolerance

Debra Saunders has an interesting piece on choice and tolerance:

You know the world is changing when the left -- which used to believe in respecting choice and requiring businesses to accommodate workers' personal preferences -- opposes choice and letting individual workers say no to tasks they find morally abhorrent, while the right -- which used to stand for letting businesses choose policies that promote their bottom line -- supports laws that could force employers to accommodate workers whose personal scruples prevent them from selling a product.

Yet that's exactly what you get as Sen. Barbara Boxer, D-Calif., and other Democrats introduce bills that would force pharmacists to sell birth-control pills and emergency-contraception pills such as RU-486 and Plan B, even if the pharmacist is morally opposed to one of these forms of birth control.

The issue here isn't hypocrisy. The issue is that these laws can present serious consequences. Do Americans want the government to tell a business what it has to sell?

Interesting question. Do we only support choice and tolerance when people voluntarily make "choices" we agree with?

Posted by Cassandra at April 29, 2005 09:25 AM

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We had a family doctor who was a devout Catholic and when the pill came out in the mid 1960s, he refused to put single girls on it. He was dropped by three providers, but he stood his ground. It was noted in later years, about ten years after, that the incidence of STDs and unwanted pregnancies was lower among his patients. That man is no longer with us, but I remember his stand and his care of me and I would give anything to have a family doc like that again. He also served in a MASH unit. heh.

Posted by: La Femme Crickita [TypeKey Profile Page] at April 29, 2005 11:11 AM

First things first. This topic has shown up in a couple of places, and all of them seem to have been ignorant of a few basic facts.

1) A pharmacist's liscense gives them the legal right NOT to dispense medications to anyone (possibly for any reason - I'll have to confirm with the LG). This is usually done in cases of patient safety or fraudulent scripts (whether forged or pill pushing doctors).

Some heart medications cause allergy like side effects. Patients will then complain of allergy symptoms to their physician who will prescribe allergy meds.

Problem: some allergy meds interact with heart meds and render each useless. Patient at risk of heart failure.

2) Related to 1) is that doctors know very little pharmacology comparatively to pharmacists. Just because a doc gives you a prescription doesn't mean it's safe. MDs take one semester of pharmacology while PharmDs take 6 semesters. Not to mention the host of other pharmacy classes and rotations over the 4 year period.

Docs are very good at diagnosing diseases. They know the ins and outs of what a disease does to the body and what all is effected and interrelated with it. But they know squat about drugs.

The LG has saved many patients lives from (one particular example) physicians who prescribed drugs that are renally excreted to patients with kidney failure. I.e. Drugs that go in but don't come out lead to massive overdoses that can be fatal.

Both physician and pharmacist are needed, neither one is equipped to do the others job.

3) I very seriously doubt that any pharmacy in the country carries every single drug that is available. Don't believe me? Next time your doc prescribes a med that has to be compounded (Custom blended creams or syrups) take it to a Wal-Greens, CVS, or some other national chain. They'll (politely) tell you that you'll have to go somewhere else to get it. They probably lack the necessary equipment to even make it. It's just not economically feasable to spend 30 minutes making one prescription when they could sell 20 scripts in that same time period.

If you try to legislate "must carry" you'll only succeed in criminalizing stores that poorly manage their inventory. Sudden outbreak of disease in a small town that only responds to a certain rarely used antibiotic, too bad, it's off to court with you.

Well, you say, it has to be normally available.

Define "normally". Ninety percent of the time, 50%, 10%?

And don't tell me that just because the state liscenses pharmacists that they should be required to dispense any legally prescribed drug. Lawyers are liscensed by the state, we don't require them to accept all legal cases.

Pharmacies are businesses, they get to decide what they keep in stock for whatever reason they want, cost effeciency, revenue justification, drug rep pissed you off, personal atheistic or theistic morals, whatever. You don't like it, go somewhere else.

Posted by: Masked Menace [TypeKey Profile Page] at April 29, 2005 11:38 AM

I can tell you right now that what Menace is saying is true: my migraine meds are not stocked at lots of pharmacies and I live in the DC area. They had to special-order them for me.

You can order medication over the Internet, by phone, a plethora of different ways now. The refusal of a single pharmacist is not depriving anyone of the chance to get medication.

Posted by: Cassandra [TypeKey Profile Page] at April 29, 2005 11:50 AM

Not only that, if you need something compounded that is a controlled substance, or is a botanical, the pharmacist needs a special license from the FDA.

The old time pharms who could do that are retired or grandfathered.

Posted by: La Femme Crickita [TypeKey Profile Page] at April 29, 2005 12:15 PM

I need to pass this thread on to my sister. We discuss subjects like this a lot at home with her being a compounding pharmacy technician (she's the one that makes the special creams and pills that aren't normal stock)

Posted by: Ith [TypeKey Profile Page] at April 29, 2005 03:45 PM

Mrs. Purple here.
"Pro-choice" never was pro-choice. It was always pro-forced death, and the complete and total denial of choice. Where have you been for the past 30 years? Where were you when the so-called "pro-choice" movement has repeatedly prevented women from being provided the facts about abortion because, and I quote, "they might be to scared to 'get one'."
For several years now, students have not been allowed to become doctors unless they either perform abortions or refer patients to those who will. No woman is allowed to be counseled about the facts of abortion, and adoption agencies who advertise abortion alternatives are prosecuted for FRAUD. Have you not been paying ANY attention?
Well, better late than never.

Posted by: Purple Raider [TypeKey Profile Page] at April 29, 2005 09:06 PM

Mrs. Purple, I have no idea what has caused you to argue a point I haven't, by any stretch of the imagination, advanced in the 30-odd words of my own (including the title!) above.

You might stop to reflect that the word "choice" is twice included in quotes. You might even, in a quieter moment, ponder why I might have done that?

But even with wherever I have been (apparently with my head up some dark region of my anatomy) for the last 30 years, I am able to discern that at least one party involved has indeed made a choice: women who have abortions have chosen to end the lives of their unborn children.

There are other ironies inherent in the pro-choice moniker, but to say no choice has been made is to engage in willful blindness. The objection to abortion is that it takes the life of an innocent child who is too young to be offered any "choice" in the matter. But the mother does, indeed, have a choice that she did not have prior to Roe v. Wade.

Posted by: Cassandra [TypeKey Profile Page] at April 30, 2005 08:02 AM

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