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Should Pharmacists Be Allowed to Refuse Dispensing Birth Control Pills on Moral Grounds?

At the end of last week's article, Should Pharmacists Be Allowed to Refuse Dispensing Birth Control Pills on Moral Grounds?, we asked you to submit your own views on this issue.

And wow, did we ever get your views!

With the amount of responses we received, we could have filled a book ... and if we did fill a book, it is obvious we'd have to call it "What Divides America, What Unites America."

The responses reflect many of the most serious schisms dividing the American people today. Due to the volume of responses we could not reprint them all, but you are highly encouraged to review the selected responses below as you'll see the differing viewpoints are really commentaries on some of the biggest and most important questions facing our society (or any society), such as:

  • What is morality? Who defines it?

  • What is choice? Where should it begin and end?

  • To what extent are professionals bound by the codes and expectations of their position versus their own personal codes and expectations?

  • What is "medicine," and who gets to decide?

Interestingly as you'll discover by reading some responses below, those who said pharmacists should be allowed to and those who said they should not be allowed to often used very similar arguments to support their different conclusions.

Consider these excerpts of two different responses:

Excerpt of One Response: "Yes, a pharmacist should have the right to refuse if they prefer. The customer has the right to buy where they prefer. This is not a communist or socialist country and I am angered at the push in that direction."

Excerpt of a Different Response: "NO! Maybe those pharmacists would be happier in a communist country or a country where women have no rights. Who are they to force their beliefs on someone else."

Another good example of using the same argument to make opposing viewpoints is the comparison of those in other careers making a choice similar to the pharmacists:

Excerpt of One Response: "I totally agree with pharmacists not dispensing birth control pills if they are against it. It would be sort of like forcing a doctor to perform an abortion if he did not believe in it."

Excerpt of a Different Response: What if a police officer personally believes that stealing from the rich to give to the poor like Robin Hood is "moral," the right thing to do - and therefore lets some poor criminal break into a well-to-do person's home?

You'll find multiple other such examples below. You'll also find a range of emotions. No matter what your personal views or emotions on this issue may be, though, we ask you to remember these three important points before reading (and granted, these are just our own opinions, as well):

  1. Perhaps the key tenet of Christ - and a central tenet to every other major world religion (and every major philosophic school, for that matter) - is the supreme importance of compassion, understanding and forgiveness ... it is easy to achieve this for those who are like us, but the challenge is in achieving this for those who aren't like us.

  2. We live in a nation where we are fortunate enough to be able to present our opinions out loud, in a public forum like, without fear of very serious reprisal that people in many other countries could face.

  3. If you care deeply about this or any issue, you can do something about it! This starts with personal responsibility, meaning "practicing what you preach." But it also entails spreading the message - meaning, for example, forwarding this article page on to others with your own opinion atop the article. Finally, of course, it also means telling your elected officials how you feel, including how you want them to vote (as a bill on this issue will be coming up soon - see this article)

For these three reasons - and despite the apparent differences, often extreme, you'll see below - we remain very much united.

Do You Think Pharmacists Should Be Allowed to
Refuse Dispensing Birth Control Pills on Moral Grounds?

Select SixWise Reader Responses

Yes, pharmacists should be allowed to refuse dispensing birth control pills on moral grounds. Without morals, our people will perish.
-- Anonymous

I am sure a number of people will respond that pharmacists should have the right to decide whether or not to dispense birth control on "moral" grounds. But usually the people supporting that "right" tend to mean only if it agrees with their own personal morality, as in "I support your right to say and do what your feel is right ... as long as it agrees with what I think is right!"

What if a physician believes that euthanasia is "moral" and therefore - because they believe it is right - euthanizes an unconscious and dying patient though they have no idea whether that person or their loved ones would have made the same choice?

What if a police officer personally believes that stealing from the rich to give to the poor like Robin Hood is "moral," the right thing to do - and therefore lets some poor criminal break into a well-to-do person's home?

What if a school principal personally believes that marijuana should be legal, and therefore routinely lets the students smoke it in the back of the school?

Professionals in all fields abide by certain established codes and public expectations. If they do not personally believe in those codes, they have two choices: 1) they can work to effect a change in the code through the professional organizations and businesses that represent them (while still performing their duties as required under that code); 2) as a citizen of their country, state, county, etc., they can work to effect a change in the overriding law (for example, working to make birth control illegal or marijuana legal), which would then force a change in the professional code.

But the one thing they cannot do - and they should lose their jobs if they do - is by their actions violate the codes and established expectations of their professional position. Because then they are violating the public trust and security, and that is a first serious step toward the breakdown of a society.

Or in other words, do you want to trust that your police will uphold the law, whether or not they personally agree with it? Your firemen? Your banker? Your airline pilot?
-- Gina H., Des Moines, IA

I totally agree with pharmacists not dispensing birth control pills if they are against it. It would be sort of like forcing a doctor to perform an abortion if he did not believe in it. We have pharmacy groups in our very Catholic south Louisiana town that don't dispense those items. We also have one doctor that I know of in town who does not write prescriptions for birth control pills. Instead he teaches Natural Family Planning and travels nationwide educating others on the Catholic churches teachings on the subject.
-- Dana Normand, LA

I go to a pharmacist to get prescriptions filled, not moral guidance. If a pharmacist has "moral" objections to dispensing legally prescribed drugs, they are in the wrong business. I resent the conservative politics behind legislation such as this.

Actually, I don't think I should have much opinion in this as I am not a woman. It is a woman's choice whether or not to use birth control methods. Her body, her choice.
-- Justin Stephens, TX

YES! Pharmacists should be allowed to run their businesses according to their consciences, values, and with the freedom that all responsible businessmen and women should be allowed according to the U.S. Constitution.

Customers and doctors who think otherwise forget that not all pharmacies have the space for every drug which has come out in the past 50 yrs. So, like it or not, customers always have to shop around to find some drugs. I know, I've had to do so --example, Timely-T3, a thyroid medication by prescription. In a 2 county vicinity, only one store carried it, the Walgreen's which is an inconvenient 50 mile round trip by car. No buses available.
--Ms. Reed, FL

I applaud anyone who knows who they are and has a strong belief system. It is the foundation for self determination and an expression of what is right and wrong for ourselves. But, if history is any indication of what is right or wrong for humanity than we must heed its cautionary tale.

Judging others through the filter of our own beliefs is extremely dangerous. The world's worst atrocities have taken place on moral ground: black slavery, the extermination of the first American people, Rwanda, Bosnia, the killing fields of Cambodia, the Salem Witch trials, the Holocaust and Inquisition, the eradication of peoples, cultures, species (plant and animal) happened because some one held their beliefs as a priority to all other living things. We too often convict with our convictions when the only things we need be convicted to is empathy compassion and tolerance. These are the true convictions to LIFE.
-- Maria Gillem, Washington DC

I find the act of refusing to fill a prescription based on moral grounds extremely reprehensible. A pharmacist is bound to provide services to anyone with a prescription, as long as they feel the script is not fraudulent. I personally feel that Ritalin should not be given to children under any circumstances because it may interfere with their brain development. I also find the wholesale prescribing anti-depressants to be disturbing given the clinical studies that indicate their health risks. That would not give me the right to withhold Ritalin of Zoloft or any other drug from an adult presenting a prescription if I were the dispensing pharmacist.

It is a slippery slope wherein I can approve or disapprove at random what medication I think is appropriate or to whom I will give it. It seems like thinly veiled prejudice at the very least and unethical. Would I have the right to withhold services to a group of people based on their gender, ethnicity or religious beliefs? Last time I checked, birth control pills were legal with a prescription.

I am very curious to see how others view this.
-- Karen

Yes, I most certainly do believe that pharmacists should be allowed to refuse dispensing birth control pills on moral grounds. Some birth controls are abortificants and therefore are murder of the unborn.
-- Jeanette Kremer, Epworth, IA

I once worked for a medical practice of 2 doctors. One would not give an Rx for birth control pills to his patients because of his Catholic beliefs, BUT he simply sent them down the hall to his partner who wrote the Rx. It sounds hypocritical to me, but at least it worked for his patients.
-- Anonymous

Absolutely....We live in a country where there should be that kind of freedom... Come on, there are thousands of pharmacies. However, it might make sense for a pharmacy to state their beliefs upfront...or a pharmacist to work somewhere where their beliefs would be respected. If a pharmacist works where a pharmacy supplies the drug, then another employee should do it. But the freedom to act on your moral conscience is key.
-- Anonymous

I think they should just do their job accurately and professionally without moralizing.

Should paramedics, doctors, nurses, firefighters and others be allowed to judge which fires to put out??? Where does it end?
-- Chris

YES, everyone should have the right to refuse to participate what causes the killing of an unborn child. The Pill makes the womb a hostile environment for a child, and many do not survive (some do though!). Perhaps they can use the opportunity to empower women by giving them information on Natural Family Planning, which is more effective than the Pill, and does not have any side effects!
-- Janet B. Cook, dJM Mesa, AZ

No, they should not get into the pharmacy business if they have moral objections to some medications. What if a pharmacist had a moral dilemma to antibiotics? (That is not so far off as over use of antibiotics creates chaos with resistant bacteria)
-- Anonymous

Absolutely. No one can be forced to act against right conscience. The Pill used as birth control is not "medicine".
-- Anonymous

Pharmacies may be private businesses but they function as essential providers of medical services. The public has little choice but to use their services if they subscribe to allopathic treatment. As such, these pharmacies have an obligation to fulfill the prescriptions presented to them. It is not as if women can go to another vendor, for example, a clothing or hardware store to get their prescriptions filled. So, as a monopolistic medical vendor, pharmacies have an obligation to meet their license requirements as vendors of prescribed substances.

In other professions, people usually have to make a choice. They tend to quit their profession if there are things that are abhorrent to them, or they make peace with themselves that they must accept performing in ways that they may not personally prefer. As to moralizing to customers--well that is the height of hubris. Why is it that radical fanatics always feel they have the answers for everyone. What arrogance! What disrespect for others. And what incredible lack of human sensitivity or compassion. Hmmm...maybe there should be some ethical requirement attached to the licensing of pharmacists, just as there is with other professions.
-- Anonymous

Yes I think Pharmacists should be allowed to refuse dispensing Birth Control pills and any other pill that potentially could kill another human being. This issue has clouded the FACT that some of these pills are killing unborn babies. Do people really want murder to go on unchallenged? Passing a bill to prevent this is unconstitutional. These patients who find their pharmacist refusing to dispense the pill on moral grounds should thank God that someone made them think about their choice and behavior. Our society has reached a point where no one wants to be told they can not do whatever feels good.
-- Starr, GA

Absolutely! It is wrong, morally, socially, politically and legally to force someone to commit an act that they feel is violative of their moral convictions. Compare this: Do you think women should be allowed to refuse sex with any man or moral grounds? I would hope that you would say yes, absolutely. But the two are different, you might exclaim. But, in essence, they are not. If we are to consider that a person should not be compelled to violate a personal moral in one case, we must continue that same thought to another. Any pharmacist who has a moral objection to doing something has a right to refuse to participate in that objectionable act, based on his/her moral ground.
-- Richard A. Marks, Libertarian

ABSOLUTLEY NO!!! Should a Catholic mechanic be allowed to refuse service to a Protestant car owner?
-- Brian Kearney, Wilmington NC

To anyone who believes that pharmacist have a moral right to choose not to fill a prescription for birth control, I would like to remark that all pharmaceuticals intercede in life's cycle. How many drug addicts do you father with the prescriptions you fill? How many suicides have occurred, intentional or induced by side affects of the drugs you dispense? How many elderly are living in substandard conditions because they cannot afford to live after they purchase their prescriptions? If you want to stand on moral ground, knowing what we all know about the business of Pharmaceuticals today, your battle should be with what the drug companies and their morality.
-- Maria Gillem, Washington DC

Absolutely, they should be able to refuse to dispense birth control pills (morning after pills). They must answer to God for their actions, not to the state. The customer can go to another pharmacist.
-- Anonymous

No. It is not their job to judge the morality of the RX. If they want to preach, they can go to a seminary and learn to be a minister.
-- Anonymous

It is a fact that some pills are abortificiants. I believe a pharmacist should be allowed that decision, if another pharmacist is there and can comply.
-- Anonymous

No I do not. Not all birth control pills are prescribed for "birth control". It certainly should not be up to a pharmacist to determine if the medication is what the woman needs. It is up to her physician to decide what medication in needed.
-- Anonymous

They should not be forced to do anything that counters their religious beliefs. Last I remember we have a thing call the Constitution which protects people who exercise their religious beliefs. Unfortunately the religious beliefs of people are being pushed aside and we are told we have to embrace and allow immorality. There are more and laws mandating we permit immorality for sexual deviations, redefining families and marriage, permitting premarital sex and hiding it from the parents.
-- Francine Razny, New Lenox, IL

No. Their job is to fill medications, not to make judgments as to what the medication is going to and for. Once again this we have people pushing their opinions and beliefs on the rest of us. It is our personal decision to put any form of medicine in our own bodies, not theirs.
-- Hanida Watertown, NY

Do OB/Gyn doctors have to perform abortions? Do we live in a free enterprise society? Obviously the owner of the pharmacy should have the right to refuse on religious grounds...remember the 2nd amendment.
-- Anonymous

Never. They are not God. They are not the doctor. They cannot decide what is moral for a woman who chooses not to become pregnant. This is an appalling trend. And this is America? Beyond belief.
-- Anonymous

I believe that everyone should be able to honor their conscience. In some cases this might mean a change of employment. Doctors, nurses, and pharmacists, as agents of healing should be able to refuse to perform tasks which violate that very purpose, causing physical harm or potential harm to another.
-- Anonymous

I am appalled that a pharmacist is allowed to have "rights." I believe that if they cannot dispense a drug based on their beliefs that they should seek a new profession. They should have to pay child support for every baby they bring into the world this way.
-- Anonymous

Absolutely! Birth control pills do not always prevent ovulation so additionally they are designed to dry the uterus to prevent implantation of the fertilized egg. The newly created human, in its earliest stages of development, is sloughed off with the mom's next menstrual cycle; the woman never knowing of her conception. Pharmacists should have a right to refuse to dispense drugs that will aid in the taking of a human life. Into what depravity are we sliding down this 'slippery slope'? What would be so horrific that society would say, "ENOUGH!"? If not with an abortifacient, where would the line be drawn?
-- Annonymous

Pharmacists are there to serve, not to judge or make moral decisions about others. Which one person is godly enough to have that ability...nobody I know. We are all human, just human. The answers to what is right and wrong are much more complicated than any of us can may things to look at.
-- Beth Hoxie, Birmingham, MI

Yes, they should be able to live out their beliefs and not have to dispense birth control pills. The pharmacies should have others who could do it.
-- Nancy, Brookfield, IL

There are many reasons for taking BCP. It is not the right of the pharmacist to know these reasons, especially since HIPAA went into effect. However, if a pharmacist feels s/he cannot in true conscience fill such a prescription, this information should be made public so the patients and physicians are not misled and treatments are not delayed.

I wonder if any pharmacist ever refused to fill a prescription for a large number of pain pills since they could allow someone to commit suicide if taken all at once. Two things: 1. The pharmacists of this belief might consider opening their own pharmacy and publicize that they do not stock BCP...the "Holier Than Thou" pharmacy. 2. If a pharmacist can exercise the right to choose which prescriptions s/he fills, the boss should be able to exercise the right to terminate, without hesitation, since the pharmacist is potentially holding up the healing of a patient. This practice could generate many lawsuits, and the nightmare fallout from that is not a good thing.
-- Anonymous

Yes, a Pharmacist should have the right to refuse if they prefer. The customer has the right to buy where they prefer. This is not a communist or socialist country and I am angered at the push in that direction. Stand up for our freedom. God bless America.
-- Anonymous

NO! Maybe those pharmacists would be happier in a communist country or a country where women have no rights. Who are they to force their beliefs on someone else.
-- Barbara Loxahatchee, FL, USA

Yes. Pharmacists have every right to follow their conscience. The government has no legitimate right to force these men and women to act against what they believe from the depths of their hearts.
-- Matthew Ryan, Chicago, IL

No. What a bunch of Baloney! I bet none of these pharmacistx thought twice about passing out Vioxx and many other drugs that have killed thousands of adults. They should seek out another possibly less-adult profession in which they can put there pious self-moralizing to good use. Pharmacists know what their job entails before they enter the profession. How dare they assume they have the right to meddle in another's individuals rights!
-- Jeff Walling, Foster City, CA

Yes. There are many pharmacists who would provide them, for those who want them. Perhaps an analogous situation is the case of Conscientious Objectors in the military. They are allowed to serve in other capacities, e.g. medical orderlies.
-- Anonymous

No, because abortion of a live baby is even worse -- and unfortunately that would be the birth control method they would choose. It would be best if our animalistic, sex-craving population would practice abstinence, then HIV, birth control, etc. would not be an issue. BUT that is just a pipe dream because of the moral decay of our society. Birth control pills help prevent unwanted pregnancies.
-- Anonymous

If conception has already taken place, the morning after pill is the same as an abortion, in the very early stages. The drug companies give us no choices with their ridiculously high priced medications, now they want to take away our morals and beliefs. Yes, the pharmacists should be allowed to refuse. After all, their profession is based on saving lives not destroying.
-- C.A. Tuskan, Highland, Indiana

When someone chooses a profession, they should be prepared to carry out the duties of that profession. If a task is legal, they have an obligation to fulfill those duties. Prevention of conception is NOT abortion. They are NOT our moral policemen. I would be curious to know if those who are so offended, dispense Viagra to an unmarried man? Some of us believe one should not have sex outside of marriage. Do they ask for proof of marriage?
-- Anonymous

Yes, I think they have a right to protect thier customers from something they understand as harmful or immoral. If all of us based our morals on that of the laws passed by the government they would be some very poor morals; such as abortion.
-- Sharon, TN, USA

Absolutely NOT! It is not their job to decide what is moral or immoral for anyone but themselves. Their job is to fill prescriptions accurately, not to make moral judgements!
-- Martha Case, Winlock, WA.

A doctor has the right to refuse to write for a drug and the fellow professional pharmacist should have that same right.
-- Sara Reynolds, M.D.

No, no and NO! I think it is "morally wrong" to smoke and drink but I would never refuse medical service to someone because they got a disease because of their vice.
-- Barbara Farren, Rancho Palos Verdes, CA

Yes, I do think pharmacists should be able to refuse to dispense these pills for whatever reason they have. Why would we, as women, not want the pharmacist to have the right to choose? Would we actually fight to be able to make a choice for ourselves and then deny another their right to a choice of their own?
-- Shelley, Edgewater, FL

Of course they may not refuse. Human beings must have the information necessary to make choices and then be allowed to exercise their choice. The pharmacist as a servant of the public has no business making choices for the persons he is serving.
--S. Woolley, Nassau, NY

Yes. The USA and Canada were built on strong moral (Christian) values. More and more people have no clue what Christian values are. They should not be the ones to set the standard for everyone else. People should get back to the Bible and learn what God has to say on the subject.
-- Anonymous

On moral grounds, can I, as a Buddhist, refuse to fill your prescription for any medication made with animal-based products? If I cannot, yet another pharmacist may refuse to fill certain prescriptions based on like-reasoning, I have grounds to sue for discrimination. In short, it is not a pharmacist's job to dispense their personal moral beliefs. Their job is filling prescriptions. Do it, or get another job.
-- Ahnaryn Becker, Venice, California

Yes - it is their ethical and self duty to live their moral convictions. I would trust someone that would refuse me more than someone who robotically dispenses whatever the doctor ordered without thought and care about the health and welfare of others.
-- Anonymous

No! This is still a free country, and your Dr. and you are the only people who have the right to control what you are taking. We can not force our views on everyone in the world, or everyone in our own country.
-- Ellen Norris, FL

Absolutely! (They) should promote and encourage health and healing ... not murder
-- Anonymous

My daughter takes birth control to help with her horrible periods..... It is ridiculous that anyone would look at what a doctor prescribed and comment on it!
-- Anonymous

Yes, it has been proved that contraceptive pills can cause abortion and breast cancer so if a pharmacy and/or pharmacist choose to not participate in the dispensing of these pills due to their personal belief systems, it should be their right to make this choice. There will always be pharmacists who will dispense them as long as it is lawful to do so. Find one of these pharmacies and/or pharmacists to take your business to. It is your right to choose which pharmacy you patronize.
-- Janet, AZ

No, because if they can do that then they would have to refuse to fill prescriptions for Vioxx, Lipitor etc. because some of the side effects are death. Consistency is important with beliefs otherwise hypocrisy runs rampant.
-- Helen Palmer, Kirkland, WA

I think they should be allowed to refuse to dispense the morning after pill. That is equivalent to selling someone a loaded gun knowing they are taking it to kill someone.
-- Anonymous

No. When it comes down to a matter of public health (which is the case in any medical situation), pharmacists have no right to fill a legitimate medical prescription. If a pharmacist is allowed to not fill a prescription for birth control pills, then would they also have the right to not fill prescriptions for cholesterol lowering drugs? Or anti-depressants? Could they then rationalize a way to not fill an order for any drug with which they have personal qualms? The law is clear that birth control is legal and no pharmacist, whatever their beliefs, has a right to refuse service of a legitimate drug.
-- Anonymous

I support the concept of the newly-proposed bill, as it seems like a decent compromise between the obligations of a pharmacy to provide all legal medicines and the right of each individual to act according to their conscience. I hope that the bill also includes some additional protections for the patient, as in the right to purchase birth control without being subjected to moral "counseling" from any pharmacist, contingency plans for providing the medicine if the pharmacist who CAN dispense is not available at that time, etc.
-- Sherilyn Wells, Bellingham, WA

Yes the pharmacists should be allowed to refuse dispensing any drug that is designed to kill.
-- Anonymous

Was there no moral issue in filling Vioxx prescriptions that killed thousands? Is their excuse that they didn't read nor heed the early warnings about the cardiovascular dangers; or is this a case of just doing what the doctor told them to do?

Or is this a case of situational ethics; e.g., my beliefs support my 'ethical' decisions therefore I am not to blame. Maybe the pharmacists and pharmacies that prescribed Vioxx should be named in the law suits and be liable also. After all they are the drug experts. They do read all of the drug information before selling the drug, correct? Without liability they are not accountable for withholding a prescribed drug by a liable doctor. Don't we all wish that we could act without consequence for our actions and base these decisions on moral grounds? Or wait, isn't that what attorneys do? Show me the money.
-- Dr. Rick Seim, Bedford, TX

Absolutely! They should have the freedom to follow their conscience. Doctors also should be able to refuse to do procedures or prescribe anything against their personal beliefs.

Pharmacists have a specific job to do - FILL PRESCRIPTIONS! And, that should be with no questions asked, and no personal interference. If they want to abide by their personal feelings AND do their job, they should work at specific places where this is possible - if these places exist, and these places are known as such to customers. Otherwise, they should get over themselves, and just do their job. Simple as that.
-- Sherry Karl

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