A federal case involving a pharmacy refusing to dispense Plan B–aka the “morning after pill”–based on religious objection also has disturbing implications for assisted suicide in that state. A three panel Court of Appeals panel reversed an injunction and sent the case back to the trial court for further consideration. But in finding that Washington regulations requiring pharmacists to carry and dispense all legal drugs and medications is a rule of general applicability–thus precluding religious conscience-based exemptions–it also means that all pharmacists in the state must dispense death to terminally ill patients in Washington who receive lethal prescriptions. From the case Stormans v. Salecky:
The new rules do not aim to suppress, target, or single out in any way the practice of any religion because of its religious content. Though the procedural posture presents a sparse record, that record sufficiently reflects that the object of the rules was to ensure safe and timely patient access to lawful and lawfully prescribed medications…
That the new rules prohibit all improper reasons for refusal to dispense medication—permitting only refusals for reasons enumerated in the narrow class of exemptions—suggests that the purpose of the new rules was not to eliminate religious objections to delivery of lawful medicines, but to eliminate all objections that do not ensure patient health, safety, and access to medication. Thus, the rules do not target practices because of their religious motivation.
Ah, you say, “But Wesley: Under the Washington assisted suicide law, “providers” are not required to “participate.” True, but the law does a tricky thing. It narrowly defines the meaning of participation so that it does not include dispensing the drugs. From 2(d)(ii) of RCW 70.245.190, the immunities section of the assisted suicide law:
“Participate in chapter 1, Laws of 2009″ means to perform the duties of an attending physician under RCW 70.245.040, the consulting physician function under RCW 70.245.050, or the counseling function under RCW 70.245.060.
Oops. That very narrow definition trickily takes away the non participation protection from pharmacists, since to “participate” only means to perform the duties of the attending (prescribing) physician, the consulting physician, or the mental health professional who consults in the case. It does not mean dispensing the lethal prescription or filling out the forms required of pharmacists.
Thus, under the reasoning of the court ruling, not only will pharmacists in WA have to dispense an overdose to patients knowing it is intended for use in suicide, even if they have a religious objection, but they will also have to perform the required bureaucratic functions. Ironically, one professional role pharmacists are supposed to play–which is why they do far more than merely count pills into bottles–is to protect patients from receiving prescriptions that could conflict with other prescribed drugs, resulting in their deaths.
No one should have to participate in the intentional killing of a human being. The law must be changed to exempt pharmacists from participating in assisted suicide–in essence a conscience clause. Otherwise, pharmacists who don’t want the figurative blood of suicidal patients on their own hands will be forced to leave the profession, or at least, leave the state. Of course, that is precisely what assisted suicide advocates would like.
July 9th, 2009 | 2:19 pm
Well it’s about time someone insisted that pharmacists do their jobs instead of trying to “make statements.” Frankly, dear” (as Rhett would say) “I don’t give a damn” what my pharmacist thinks. He’s getting paid to fill the prescriptions my doctor writes, and if he can’t do that he ought to try being a plumber instead.
July 9th, 2009 | 3:08 pm
HistoryWriter, if you want to kill yourself that badly, at least there are ways that don’t force objecting third parties to be complicit. If you should have a choice, so should they.
July 9th, 2009 | 4:38 pm
HistoryWriter, you’re paying your pharmacist to make sure you don’t die. If he gives you the drugs to kill yourself, then he’s not doing his job.
July 9th, 2009 | 5:46 pm
There is a great new item making the rounds called The Congressional Spending Psalm. It starts like this; Big Government is our shepherd, the bigger it gets the more we lack. You can find this gem at SpendingPsalm.com. God Bless !!
July 9th, 2009 | 5:49 pm
A pharmacist is not paid to fill a prescription. If that were the case, he would not need to go to school for six years and his job would be done by a vending machine. A pharmacist is paid to ensure that the right drug is provided to the right patient at the right time. Somehow I doubt that intentionally killing the patient is in line with this profession.
July 9th, 2009 | 8:14 pm
John L’s vending machine comment is so good that, if I end up having time to blog this myself, I will include a reference to it.
July 9th, 2009 | 9:26 pm
HW-how would you like it if, say, someone was forcing you to participate in someone’s campaign to get rid of contraception entirely? Or, say, make abortion illegal? I don’t think you’d like that. I think you’d think that your rights of conscience had been violated. But you have no problem stuffing your personal beliefs about the perimissability of euthanasia down the throats of dissenting pharmacists. I suggest you go live in some authoritarian country that doesn’t let it’s citizens have any conscience rights.
July 10th, 2009 | 3:42 am
I have long wondered why the advocates of such things as abortion rights or euthanasia/assisted suicide react so violently to anyone who for conscience’s sake declines to particpate in such procedures, even when there are plenty of service providers who have no objection.
I think I have finally figured it out:
Deep down, these folks know that what they are advocating is morally wrong, but they have seared their conscience to no longer bother them about it. However, everyone who declines to participate in these things stands as a reproach to their position, reminding them, as their own conscience no longer does, of the immorality and sinfulness of their stance.
July 10th, 2009 | 7:36 am
I think you’re all missing the point. It’s not just that it’s none of the pharmacist’s business to question the doctor’s judgment in prescribing a lawful drug. Once a “conscience exception” is in place where are the limits? What prevents a pharmacist from refusing to fill a prescription for contraceptive drugs because he’s Catholic or, for that matter, his refusing to serve entire groups of people whose “lifestyles” he deems “offensive to his deeply held moral or religious beliefs”? Suppose the pharmacist has a deeply-held belief that Caucasians shouldn’t have to serve African-Americans in business establishments? And if you’re willing to extend “conscience exceptions” to pharmacists, why not also to other professionals? Why should public school science teachers be forced to teach students Darwinian evolution if it offends their religious sensitivities? Why shouldn’t a funeral director be able to refuse service if the deceased was a homosexual? Why should airline pilots be required to fly passengers to “sinful” places like Las Vegas, when we all know how big a problem compulsive gambling is? And so on, and on, and on. Face it, the “conscience exception” is a solution that’s potentially worse than the problem.
July 10th, 2009 | 11:07 am
Wolf N. Paul: Thanks for dropping by. I think it is ideological and a sense of entitlement to have “whatever I want,” and if you won’t give it to me, somehow it is oppression. I hope you are right, though, because it could presage a change of heart.
P.S. I edited your comment to keep the issues focused on matters of concern to SHS. That would have taken us down a discussion that is beyond our scope. Thanks for understanding.
July 10th, 2009 | 12:11 pm
[...] J. Smith writing at Secondhand Smoke (First Things): “A three panel Court of Appeals panel reversed an injunction and sent the [...]
July 10th, 2009 | 3:46 pm
HistoryWriter, you are simply wrong about the pharmacist’s right to question a prescription. Experienced physicians are nevertheless human beings capable of making mistakes. A quick Google search reveals that a young man suffered “potentially fatal complications” after being given clozapine instead of olanzapine. Another man died days after being given Librium instead of lithium. This is what happens when pharmacists are ill-trained or accept everything without question.
I wouldn’t worry about your flights to Las Vegas, and I’m not naive enough to think that no one will still succeed in killing himself. Where there’s a demand for something, you’ll almost always find somebody willing to fill it, legally or not. What I suspect folks really want is legitimacy, to have society’s seal of approval. But — and this is the big point — neither the government nor any private individual is obligated to grant that.
July 10th, 2009 | 8:07 pm
College Goyl: I admit that a pharmacist CAN be a safety mechanism where physician malpractice is concerned, but in the examples you cite there’s no indication that the pharmacist knew anything about the patient, but that he simply filled the prescription as written by the doctor. My local pharmacist maintains a data base of all my meds as well as my allergies, but if I decided to go to, say, Wal-Mart where I’ve never had a prescription filled in my life, their pharmacist would learn only what he thought to inquire about, or what I remembered to tell him.
BTW, you didn’t respond to my argument about the “slippery slope” of conscience exception. Do you not see that as a possibility, even if you’re personally not worried about it?
July 10th, 2009 | 8:20 pm
John Lewandowski wrote: “A pharmacist is paid to ensure that the right drug is provided to the right patient at the right time.” Sorry, but I believe it’s the PHYSICIAN’S responsibility to prescribe “the right drug at the right time” and the PHARMACIST’S responsibility to dispense it to “the right person.”
Pharmacy has come a long way (perhaps the wrong way) from the days when pharmacists actually compounded medicines from bulk materials. In those days they had to know something about chemistry, neurology, biology and physiology. Unfortunately, today’s pharmacist is essentially a pill-counter, a dispenser of manufactured pharmaceuticals whose responsibilities are being taken over, more and more, by “pharmacy technicians.” I do not say this to denigrate pharmacists, but rather to question the level of professional development and education that you feel entitles them to second-guess a licensed physician. I don’t believe it’s unreasonable to expect my pharmacist to fill my doctor’s prescriptions as the doctor has written them, and not as he’d like them to be.
July 10th, 2009 | 9:09 pm
SafePres: You ask how I would like it if someone was forcing me to participate in someone’s campaign to get rid of contraception entirely, or make abortion illegal. The question is totally irrelevant to the matter under discussion. Compelling someone to do something that he has a legal right NOT to do is in no way comparable to compelling someone to perform an act that he is obligated to perform as part of his job licensure. I refer you to the Dictionary of Occupational Titles: Occupation 074.161-010 “TITLE(s): PHARMACIST (medical ser.): druggist: Compounds and dispenses prescribed medications, drugs, and other pharmaceuticals for patient care, according to professional standards and state and federal legal requirements.” There is nothing in that definition that suggests he can dispense only those drugs he feels like dispensing to those to whom he feels like providing service. Like College Goyl, you also fail to address the argument that a “conscience exception” is a slippery slope. So let me ask you, where do you draw the line with respect to conscience? My own feeling is if one can’t abide the requirements of a specific kind of employment, then they ought to seek some other kind. Such is the beauty of living in a free country, that nobody may force anyone to pursue pharmacy or any other career. On the other hand, it is not unreasonable to require that a job, once undertaken, be performed competently, completely and without excuse. I therefore expect the mortician to embalm AIDS victims, the merchant to serve all customers regardless of race, color, religion or national origin, and the teacher to follow the approved syllabi and lesson plans for Biology 1.1 regardless of his or her opinion of Charles Darwin. And I expect my pharmacist to fill prescriptions as written. These are certainly not unreasonable expectations.
July 11th, 2009 | 5:49 pm
HW, nowhere in that statement are pharmacists REQUIRED to dispense anything they may see as harmful to their clients, either.
I believe MOST regulations on all professions should be withdrawn, as should licensure. There are plenty of quacks with legitimate licenses out there, and the licenses don’t make them less a quack. On the other hand, there are plenty of unlicensed competents who should be allowed to practice.
Legitimacy should be based on competence and results, not on some state-granted license.
There are plenty of druggists who will gladly fulfill any prescription. We should all have the freedom to go to them, and they should all have the freedom to service whom they will.
No business person should EVER be required by law to service ANYONE, for WHATEVER reason.
If we truly lived in a free society, such laws and regulations would not exist.
Everyone should be free to take or reject clients/business they choose. No mortician should be forced to take corpses they don’t want to; no photographer should be forced to shoot an event or person they don’t want to; no one should be forced to deal with anyone they do not want to.
Surely there are choices outside of forcing someone to do your bidding. Therefore, go to that someone and let the others be, as is their right under true freedom and liberty.
If that someone isn’t convenient to you, too bad. No one should be forced to conform to your convenience.
Otherwise, as we are, you create an artificial society, a society based on force, coercion; a society of slaves to absolute masters.
Who gave you the right to be a slave master?
If you want freedom, then grant it to everyone else, too. Anything else is hypocritical.
July 11th, 2009 | 6:00 pm
Forgive me for a couple of confusing paragraphs; they should better read:
“Surely there are choices outside of forcing someone to do your bidding. Go to those who are available and willing to do your bidding, and let the others be, as is their right under true freedom and liberty.
“If those willing to do your bidding aren’t convenient to you, too bad. . . . “
July 11th, 2009 | 6:49 pm
Cathy,
Most people draw the line at embracing the Libertarian agenda. BTW, do you really believe it’s appropriate to practice racial discrimination at the lunch counter, or to have restrictive covenants against Jews in real estate contracts? I thought we had settled this back in the last century.
July 11th, 2009 | 8:35 pm
HW, “appropriate” is absolutely subjective and maleable. It should have no place in issues of true liberty and freedom.
If there were true liberty and freedom, there would be no institutionalized racism, because there could be no laws or regulations either way.
People will ALWAYS have preferences. All people should have the right to those preferences, which in turn they may not impose on others who differ from them. Hence, there is no place for the State to dictate preferences.
Freedom means the ability to associate with whomever you choose, and no one else has a right to interfere with that freedom. This means neither the KKK has a right to impose its views, nor the Southern Poverty Law Center has the right to impose theirs.
“Most people” have never examined what the true libertarian agenda is, let alone considered that just like the Democrat and Republican Parties, there are opposing factions within. A blanket judgment without knowing the particulars is the lazy person’s way out of taking responsibility for his/her own thinking and actions.
True freedom and liberty, encompassing granting others the true freedom and liberty you yourself want, means accepting that there will undoubtedly be some actors who will exercise those rights contrary to what you might prefer.
But as long as they don’t force you to adhere to them, either by physical force and threats or by threat and force of law, that is their right. You have a right to not associate/deal with them; you have a right to go elsewhere.
Bad thinking is not solved by forcing people to do what you would prefer.
That only breeds either dangerous ignoramuses willing to kill for the “noble” causes of the State they unquestioningly serve, or violent opposition to that attempted usurpation of others’ rights.
I believe that is where we find ourselves today: the false choice being foisted on us between a “benevolent” all-encompassing government that permits no questioning of its policies, or a scary scenario of free people free to govern themselves. And they may not choose to associate with you and your preferences.
Practicing racial discrimination at the lunch counter and restrictive covenants against Jews in real estate contracts are very emotional and distracting red herrings.
Under both those supposed results of freedom is exactly demanding freedom: there can be no LAWS requiring lunch counter racism, as there were in SOME places in the South (and as there were in some other places as well), or legal contracts requiring the exclusion of any ethnic group. Martin Luther King, Jr. was a lover and proponent of freedom, who wanted illegitimate government sanctions granting racial discrimination abolished. He never advocated for forcing anyone to serve anyone. He wanted the freedom for everyone to go anywhere and be treated legally as a human being with full rights, dignity, freedom, and liberty.
If someone chooses not to serve you, go elsewhere. You do not have the right to demand a law to force him to serve you, especially when you CAN — you DO have the freedom to — go elsewhere.
And that is the way it should be.
“Settled this back in the last century.” It was supposedly settled in the last quarter of the 18th century.
Have you ever checked out the Mises Institute, and LewRockwell.com? You might be surprised at what the libertarian “agenda” really is.
But then, many people find the idea of freedom and personal responsibility scary. Too bad. If their supposed convictions were really what they are purported to be, they should be the first and firmest to support individual freedom and self-government. They have nothing to lose — except unjust control and power over others.
Which shows they’re not really lovers of freedom and equality at all. They are lovers of power who somehow count themselves as those very few who they presume are somehow “qualified” to govern others.
Yeah. Good luck with that.
July 11th, 2009 | 9:32 pm
Some interesting reading about individuals and freedom and rights:
http://www.lewrockwell.com/decoster/decoster74.html
http://www.lewrockwell.com/blog/lewrw/archives/029272.html
http://www.lewrockwell.com/long/long11.html
http://lewrockwell.com/rozeff/rozeff300.html
It’s a start, if you’re truly interested in justice and freedom.
July 11th, 2009 | 11:41 pm
How’s this for the “libertarian agenda”:
Libertarians are against aggression, and thus also against institutionalized aggression; the “state” opposed by libertarians is the agency of organized or institutionalized aggression. In Power and Market, Rothbard quotes Oppenheimer from his The State:
There are two fundamentally opposed means whereby man, requiring sustenance, is impelled to obtain the necessary means for satisfying his desires. These are work and robbery, one’s own labor and the forcible appropriation of the labor of others. … I propose … to call one’s own labor and the equivalent exchange of one’s own labor for the labor of others “the economic means” for the satisfaction of needs, while the unrequited appropriation of the labor of others will be called the “political means.” … The state is an organization of the political means [emphasis added].
Or, as Oppenheimer defined it in his introduction to The State: “I mean by [the 'State'] that summation of privileges and dominating positions which are brought into being by extra economic power. And in contrast to this, I mean by Society, the totality of concepts of all purely natural relations and institutions between man and man …. ” (See also Rothbard’s classic The Anatomy of the State.)
Here, by the way, we see the genius of Hoppe’s essentialist definition of socialism not merely as centralized control of the means of production, but as “an institutionalized interference with or aggression against private property and private property claims” (A Theory of Socialism and Capitalism, p. 2; also see pp. 12). To those who would object that this means all states are socialist, and all socialism is statist–yes. Exactly; and this is why libertarians are anti-state. It is because we are anti-aggression; and all states (in our sense) employ aggression; and this is what is also wrong with socialism: it is merely institutionalized aggression. Thus Hoppe explicitly writes:
There can be no socialism without a state, and as long as there is a state there is socialism. The state, then, is the very institution that puts socialism into action; and as socialism rests on aggressive violence directed against innocent victims, aggressive violence is the nature of any state.
(A Theory of Socialism and Capitalism, pp. 148-49; emphasis added)
Found at:
http://www.lewrockwell.com/blog/lewrw/archives/029218.html
Now: are you for the State, to enforce your preferences over others, “for their own good,” or “for the common good,” or are you not?
Personally, I am for a free society, as against the State and its inevitable aggression. No druggist should ever be threatened for merely refusing to do harm to another, to provide for the killing of another human being, unborn or at the end of natural life, for refusing to bend to the dictatorial tyranny of others who would have him or her kill for them or participate in killing. No just laws can ever be made to enforce that.
Just laws prohibit state aggression against the citizenry. Anything else is unjust.
Ever read Orwell’s 1984? Or The Minority Report? Can’t happen here? Isn’t happening now? Take your blindfold off, please. What else are “hate crimes,” and what else is this whole flap about pharmacists following their conscience?
It’s not an issue of conscience — except insofar as some would presume control over every other person’s conscience, never questioning whether their own beliefs and actions are right or wrong, their own lack of conscience, of obvious necessity, never bothering them. And under no circumstances should sociopathic lack of conscience be elevated to power.
It’s an issue of freedom and liberty and personal property rights. It’s an issue of whether freedom of thought should be surrendered to thought control. We know it as “political correctness.” THAT’s the “slippery slope.”
And we’re way past slipping; we’re careening straight down into the abyss, and some people think we’re not going fast enough yet!
They fail to realize that every law they enact to control “undesirable” behavior or beliefs in others will eventually turn on them. It is the nature of the beast. Someone else always has a complaint; someone else always wants someone stopped from doing or thinking something. Someone always wants control over the life and death of someone else. And if you’re not one of the string-pullers behind the curtain, you’re blithely signing over your own life as well.
And I guarantee you, you’re NOT one of those string-pullers. Sooner or later, you’re going to be the target of the string-pullers. And who will stand up for you then? What argument will you bring to protect yourself? You will have no authorized freedoms, except to obey the State or die. What then?
July 13th, 2009 | 3:51 pm
Thanks, Cathy, but anarchy’s not my bag. You go on believing that you can have heaven on earth without any laws to regulate people’s conduct, if that what makes you and other Libertarians feel good. I’ll stick with the Constitution.
July 13th, 2009 | 4:14 pm
Cathy,
I actually DID read all that stuff, which left me more than ever convinced that Libertarians seriously believe they can build castles in the air AND live in them. BTW, what are “justice and freedom” to which you refer? Can you provide a workable, objective definition of either? If not, then tell me this: how is one Libertarian able to respect the rights and of other Libertarians when all he can depend on is his own interpretation?
July 13th, 2009 | 10:28 pm
[...] uphold your profession’s proper ethical practices could be the end game. Time will tell. But as Wesley Smith, expert attorney and noted physician-assisted suicide opponent, has pointed out, there is more [...]
August 8th, 2009 | 2:39 pm
Hi there,
Thank you! I would now go on this blog every day!
Thank you
Nadine
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