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Austin Cline

Costs of Conscience Clauses

By October 18, 2005

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Religious conservatives have been working overtime to push the idea that people should be permitted to refuse to do routine aspects of their job if their religious forbids it. The primary target is getting pharmacists to be able to refuse to dispense whatever medication they want, but this won't be the last profession.

George J. Bryjak writes:

To date, the greatest number of refusals occurs among the ranks of pharmacists who deny oral contraceptive pills and emergency contraception pills to women. There were 180 reported prescription denials over a six-month period in 2004, and according to the Alan Guttmacher Institute, which tracks reproductive heath issues, “There seems to be a more organized campaign to allow pharmacists to refuse.”

It’s unlikely that refusing to dispense prescriptions will remain limited to contraceptives. If your child has a diagnosed eating disorder and the individual dispensing drugs does not believe this condition is a legitimate malady, he or she could decline to fill the legal prescription of a licensed physician. A pharmacist of the opinion that sexual intercourse is for the sole purpose of procreation may reject the Viagra prescription of an elderly man.

The clash between the religious convictions of some health professionals and the rights of their patients/customers raise important questions. Should medical professionals have the legal right to decide what medications and services they will dispense and what medications and services they will withhold from patients? Are we moving toward a patchwork healthcare system wherein some physicians and pharmacists will provide all legal drugs and services while others render only medicine and care that is in line with their religious convictions?

The best description of this was coined by Ellen Goodman: conscience without consequence. Refusing to do something because your conscience won’t allow it may be laudable in some cases, but it stops being laudable when you refuse to accept the consequences of your refusal. Society cannot function as a society if people are able to ignore whatever rules, regulations, standards, or laws they want on the basis of “conscience” or religious desire.

Doctors prescribe medication to someone because it is their professional medical opinion that the person will benefit from it. Pharmacists have a professional obligation to refuse to dispense that medication if, in their professional opinion, there are medical reasons to think that the patient may be harmed. They do not have a personal right to refuse to dispense medication because they have a religious opinion against the use of the medication. If they are unable to do their job, they should find another profession — that’s the consequence of following one’s conscience instead of the standards and regulations of one’s profession.


Quick Poll: Should pharmacists and other health care professionals be required to dispense medication like contraceptives and 'morning-after' pills, even if they have religious objections?

  1. Yes. If they can't dispense legal medications prescribed by a doctor, they should find a different profession
  2. No. A person should be able to refuse to dispense medication if their religion doesn't allow it
  3. I don't know / don't care
Click an option to vote, or View Current Poll Results


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