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This blog is the work of an educated civilian, not of an expert in the fields discussed.

Saturday, February 25, 2006

Fill That Script!

Junior Senator from Il: "I think that the Democratic Party should stand for economic policies that give opportunity to all people, a foreign policy that's tough and smart and a vision for the future that combines individual responsibility with a sense of community."


I rented a DVD of House, the television show, and noticed the end of the opening montage has the "team" of doctors walking down the hospital hall in the same basic way they do in the court house in Law & Order. The show concerns the team basically solving medical mysteries, so there is a sort of a connection ... the similarity is surely not coincidental.

"Death and Wal-Mart: Pharmacists, physicians, and the right of conscience." And, now to reality. This Slate piece connects two facially related, but not quite the same, recent controversies. One involves California not being able to execute someone because they could find no medical personnel to take part in the protocol deemed necessary by law -- the AMA not surprisingly frowns upon this sort of thing. Meanwhile, Walmart and other pharmacies are claiming the right for conscience reasons not to sell RU-486 and so forth.

Timely, since an appellate decision just struck down as overboard a state's rejection of a protocol allowing its use past what the state law allows. It noted that the FDA does not deal with off-label use, since the state deals with medicine generally ... Congress should be reminded about that re partial birth abortion. Anyway, the pharmacy want not to sell "abortion drugs" because they think it kills (or their owners do) a person. The drug is allowed under this protocol up to 63 days, so the claim isn't laughable. It just clashes with a woman's right to health. Surely, to the degree the state can protect it.

And, the pharmacists aren't quite medical personnel directly killing adult death row inmates. Different degrees here, even putting aside the fact the law doesn't recognize the personhood of those embryos. Still, the claim is not trivial. The American Pharmacy Association "recognizes the individual pharmacist's right to exercise conscientious refusal and supports the establishment of systems to ensure [the] patient's access to legally prescribed therapy without compromising the pharmacist's right of conscientious refusal."

And, as the APA suggests, pharmacists are not just pill suppliers. Sometimes, there are reasons for them to not supply certain drugs, or at least, advise the customer not to use them. Yes, they don't have patient/client confidentiality or anywhere close of a relationship. So, in this case, sometimes the woman will be using emergency contraception while not even being pregnant or will need it for serious health problems.

[I find the APA's position as pretty relevant, but I do not recall it being included in various stories on this issue. It probably was somewhere, but it is telling all the same ... too often some news story lacks some significant fact that is important to me. In fact, one message board discussion of this issue implied pharmacists have an ethical obligation to dispense these drugs per their own bylaws. But, this is not true, apparently.]

But, as the APA testimony notes, it is not an all/nothing deal. A way can be set up where the woman still obtains the drugs ... just not there. If this is shown to be a risk for the patient/customer, adequate supply of medicine might require licensed pharmacists to be required to supply the drugs. This will be iffy though in large urban areas -- my own neck of the woods has plenty of suppliers, so why should one or two not be able to choose not to sell?

Direct involvement in execution is not the same as indirect involvement perhaps in a non-therapeutic abortion in early pregnancy. Clearly. But, conscience clauses are not backed up with nothing either. A pro-choice person can recognize a pro-life person has different views. So don't go into the pharmacy field, s/he says. Oh, where will that stop? Any number of fields will force people to go against their conscience now, even if a means can be set up to supply an exception.

After all, maybe that police officer will be needed on the Sabbath. Sure, ten others, and he is willing to work on Christmas. But, he has a stupid belief, and who knows, maybe someone will be stabbed. And, he is willing to work if their is a state emergency, right? No absolutist he ...

Poor example? Oh, there are others. Comparing lethal injection to dispensing RU-486 and morning after pills (especially the latter) is lame, but denouncing conscience clauses as totally dumb for the latter is a wee bit lame too.