Thursday, April 18, 2013

Shiny new legal rulings

Did you see that a federal judge has ruled that emergency contraception should be legally available to any person of any age? How neat is that! It's also nice to see the authority of the FDA respected, since part of the ruling basically told off the Secretary of Health and Human Services for squashing the FDA's decision to let it be sold to any one of any age since it's safe.

I'm fairly excited about it because I think that fewer unwanted pregnancies is a good thing. Working in pharmacies, I've filled plenty of prescriptions for prenatal vitamins for 15 and 16 year old moms-to-be. Maybe a couple of them were excited or married, I didn't ask and I don't recall handing out the prescriptions to anyone but the patient. From when I was in high school, I knew of 6 girls who became parents (and one guy who would own up to it, and one husband who wasn't in school anymore). One of those pregnancies resulted in an adoption, 4 in parenting (one is a mystery as she was 8 months pregnant at graduation and left town). One of those couples is still together (they chose adoption) and has another 4 children and they seem relatively happy. I think that only 1 resulted in finishing high school in a timely manner.

I personally am pro-life. I personally get to make that choice about abortion for me. If someone asks me what I think about their choice on abortion, I'd tell them that it's between them, their doctor, and their Higher Power.

I take my job seriously as a future pharmacist. My job is to provide healthcare. Not healthcare that I agree with. Not healthcare that I am fond of. Not healthcare that I am happy about.

So I guess I get irritated with laws that allow healthcare providers to opt out of providing care they have personal opinions about. It makes some sense to me that if you own a pharmacy, you can opt not to carry some medications. This past summer when I had a sick kid while on vacation I went to three pharmacies before finding one that carried what she'd been prescribed because it was unusual strengths, only used in children. I get that. I strongly disapprove of entire chains getting to opt out of carrying birth control because it's against their corporate policy/feelings/they are afraid of loud boycotts if they do carry them (giant blue box retailer, looking at you). Why? Because sometimes there are no other options for hours. I recall again an injury while on vacation, where Giant Blue Box was the only pharmacy in town, and we drove 90 miles to the next nearest pharmacy because I don't shop there unless it's a serious emergency. Pain pills for a broken wrist weren't an emergency.

If we follow the logic of "I am morally opposed to your behavior/reason for needing a medication" means I don't have to dispense it, then do I not carry antibiotics used for gonorrhea? Do I ask why people are taking an antibiotic before I give it to them, in case it's for syphilis? Do I ask HOW someone got HIV before I let them have their HIV drugs? Can I refuse to carry medications for COPD because 90+% of COPD patients got it from smoking cigarettes, something I'm personally morally opposed to? It's a slippery slope. I don't like it.

I worry that if we take away reproductive rights from the fertile crowd, we may end up taking them away from those suffering from infertility and loss. What if the pharmacist in town says no drugs to induce a medically needed abortion (say for a molar or ectopic pregnancy) in addition to no emergency contraception? What if a woman is going to lose her much-wanted pregnancy but the fetus still has a heart beat and the only doctor around refuses to perform the abortion? Should she have to wait in the hospital and risk dying of complications like women have?

Yep, big rhetorical hypothetical scenarios. Except they happen, could happen again, could interfere with your life. That's why I hope we reform "personal conscience" laws that let healthcare providers opt out of procedures and dispensing that they personally have an opinion against for some reason. The oath that we take as pharmacists mirrors the Hippocratic oath, and one important point stands out to me: first do no harm. It harms women if they need the emergency contraception pill and no place within 90 miles sells it. They need to find a way to travel that distance or live without it and live with the possible pregnancy. In my view, that isn't cool. You knew what was coming when you signed up for being a pharmacist so no slacking. Do your job or find a niche where you won't be dispensing stuff you oppose (veterinary pharmacy is certainly an option).

I am excited that maybe, just maybe, it will be easier to prevent unwanted pregnancies. NO this medication doesn't cause abortions. That's another med entirely. It prevents ovulation and fertilization, but it MIGHT stop implantation (very big question mark there). Maybe. It doesn't stop implantation if it has started. #science!

Why am I excited about fewer unwanted pregnancies? I'm excited about fewer abortions, more high school graduations, more college degree completions. I'm hopeful that maybe we will turn a corner in the recent "squash women's rights to decide things about their bodies for themselves" trends going on in America. It needs to stop. Women are people and can decide things themselves. Abortion is icky and agonizing but I am not the boss of anyone else's morals. I personally don't like them for faith-based reasons. But I will fight for every woman's right to decide for herself, with her doctor, if one is right for her. Wonky personhood laws keep cropping up and threatening families who are using IVF. I sternly oppose these too because they aren't based in science but in fear.


  1. I love this and I absolutely agree with you. As a nurse, it always bothers me when other healthcare people refuse care or thrust their opinions on their patients. The story about driving an extra 90 miles to get to the right pharmacy made me laugh too. I will do almost anything to avoid that place as well.