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Austin Cline

Conscience Without Consequence

By April 15, 2005

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Politicians want to protect the conscience of doctors who don't want to follow end-of-life directives or don't want to use treatments derived from stem-cell research. They also want to protect pharmacists who don't want to fill prescriptions for things like contraceptives. What about the consciences of the patients?

Ellen Goodman writes:

In just six months, there were about 180 reports of pharmacists who said no. One refused to fill a college student's birth-control prescription. Another refused medication to a woman who had suffered a miscarriage. Karen Brauer, who heads a group called Pharmacists for Life that claims 1,600 members, compares them to ``conscientious objectors.'' But it isn't that simple. The pharmacist who refuses emergency contraception is not just following his moral code, he's trumping the moral beliefs of the doctor and the patient.

``If you open the door to this, I don't see any place to draw a line,'' says Anita Allen, law professor at the University of Pennsylvania and author of ``The New Ethics.'' If the pharmacist is officially sanctioned as the moral arbiter of the drugstore, does he then ask the customer whether the pills are for cramps or contraception? If he's parsing his conscience with each prescription, can he ask if the morning-after pill is for carelessness or rape? For that matter, can his conscience be the guide to second-guessing Ritalin as well as Viagra?

In the debate over conscience clauses, Frances Kissling of Catholics for a Free Choice says properly, ``There is very little recognition that the conscience of the woman is as important, let alone more important, than the conscience of the provider.'' ... When Thoreau refused to pay taxes as a war protest, remember, he went to jail. What the pharmacists and others are asking for is conscience without consequence. The plea to protect their conscience is a thinly veiled ploy for conquest.

Should an employee at McDonald's be allowed to refuse to make, serve, or otherwise be implicated in serving fatty foods? Should a clerk at a drug store be allowed to refuse to sell condoms? Should a cashier at Wal-Mart be allowed to refuse to sell guns or anything made with low-wage foreign labor? All of these have just as much right to legal protection as pharmacists who don't want to participate in someone's use of oral contraceptives.

In those cases, however, most people will readily see that the employees are only being asked to do what it standard for those jobs — and if the standard job description isn't something they can do in good conscience, then they should find a new job. A person who has an ethical problem with fatty foods shouldn’t work at McDonald's. A person who has an ethical problem with cheap merchandise made by low-wage foreign workers shouldn't work at Wal-Mart.

And someone who has a problem with contraceptive pills shouldn’t be a pharmacist.

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