Nothing for the weekend
Terry Sanderson warns that conscience chemists are coming your way
Thanks to the ascent of a belligerent religious constituency in America and its success in getting George W Bush re-elected last autumn, the issue of 'conscience clauses' has become almost as totemic as gay marriage. Julee Lacey, a mother of two, had been using the Pill for nine years when a pharmacist at her local chemist in Texas refused her prescription. 'She [the pharmacist] began to tell me she personally does not believe in birth control,' Ms Lacey told the BBC. 'I was a little caught off-guard and shocked... I asked her again. She said: 'No, ma'am, I don't believe in birth control. I can't help you.''
The rationale behind this was provided by Dr Cynthia Jones-Nosacek ' a family doctor in Milwaukee ' who now refuses to prescribe the Pill. She opposes it on moral grounds, arguing: 'The contraceptive pill doesn't always prevent ovulation. As often as 30 per cent of the time, ovulation may occur and if that happens, fertilisation may occur. The hormonal conditions created by the Pill mean that any egg fertilised in these circumstances could not be implanted or survive. It's called a chemical abortion.'
Mainstream medicine does not accept the case being made by some religiously-motivated pharmacists that the birth control pill itself could cause 'abortions'. Even so, this reasoning is being cited by more and more pharmacists in the States who as a consequence are refusing to dispense contraceptive pills of any description. In some instances, the pharmacists have actually 'confiscated' the woman's prescription. For her own good, of course.
The situation has become so bad that the Democrat Governor of Illinois has introduced an emergency order making it illegal for pharmacists to turn away any woman with a birth-control prescription. 'Our regulation says that if a woman goes to a pharmacy with a prescription for birth control, the pharmacy or the pharmacist is not allowed to discriminate or to choose who he sells it to or who he doesn't sell it to,' said Governor Rod R Blagojevich. 'No delays. No hassles. No lectures,' he added.
Governor Blagojevich said he suspected the pattern of complaints over the past year was no coincidence but part of a concerted effort to prevent women from getting the birth control they wanted.
In response to this new ruling, religious activists in pharmacies have begun to employ a new tactic: they loudly berate and criticise women who bring in contraceptive prescriptions and try to embarrass them out of the store.
As is usual in the United States, there will be a court challenge. The Illinois Department for Financial and Professional Regulation says it is planning legal action against the Osco pharmacy chain for 'failureto provide appropriate pharmaceutical care to a patient'.
Similar action may have to follow in other states if the increasingly militant religious lobby is not to make it all but impossible to obtain contraceptives in some parts of America.
Wal Mart, the giant supermarket chain, with 3,750 megastores throughout the US (which is also the parent company of Asda in the UK), refuses to stock the morning after pill in any of its outlets. Challenging that policy will be a mammoth task.
In Britain, a growing religious right ' particularly the increasingly assertive 'pro-life' movement ' is watching carefully what is happening across the Atlantic, and taking note of how the arguments are developing. Like so many debates, it could reach these shores sooner than you might think.
Despite recent opinion polls showing that the British public has little taste for a big debate over abortion, it is already the case that if Britons go to their local chemist to obtain contraceptives that are perfectly legal to buy over the counter, the pharmacist can refuse to supply them on 'moral grounds'.
If you happen to live outside the urban areas, say in a small country village, where pharmacies are thin on the ground, and your chemist just happens to be an enthusiastic Catholic or Muslim who considers emergency contraception to be tantamount to abortion, you may have a problem. To be effective, the 'morning after pill' needs to be taken within 72 hours of intercourse. And there is evidence that confrontations over the supply of contraceptives in pharmacies are becoming more common here.
Take Kerrie Gooch, for example, who is a 24-year old mother of two. She is in a long-term relationship with her boyfriend, but has decided she doesn't want any more children at the moment. Unfortunately, one day last year, the condom she and her partner were using split, and Kerrie got anxious.
The following morning she went to the local Lloyd's pharmacy in Swindon, Wiltshire, to buy the morning after pill. She was met by a pharmacist who said his Catholic faith precluded his dispensing the pill. Kerrie was taken aback and shocked by the pharmacist's intransigence, but despite her pleas he would not be moved.
She was, fortunately, able to get her pill elsewhere, but Kerrie was understandably outraged. She went public in the press, which made her feel better, but ultimately got her nowhere, because the pharmacist was acting well within his rights.
And Kerrie is not alone. A pharmacist at an Asda store in Stockport similarly refused on religious grounds to supply a woman with an emergency contraceptive. Then it happened in Sheffield. And after that, reports surfaced of a similar incident at a Boots' pharmacy in East London, where a Muslim pharmacist told a customer who wanted the contraceptive: 'I'm sorry, I can't sell you that, it's against my beliefs.'
The National Secular Society, sharing the widespread outrage at these incidents, protested to the Royal Pharmaceutical Society (RPS). Why, NSS Executive Director Keith Porteous Wood wanted to know, were pharmacists permitted to behave in this way without any apparent comeback for the customer?
The answer is that the RPS has a conscience clause in its code of practice that permits pharmacists not to do anything that is 'against their personal convictions'.
David Pruce, Director of Practice and Quality at the RPS, wrote to Keith Porteous Wood: 'There have been some press reports of problems obtaining emergency hormonal contraception due to pharmacists refusing to supply for reasons of conscience. On investigation, these appear to be instances where the pharmacist has correctly followed the Society's guidelines and has advised the patient of alternative sources for the service requested.'
But this was not the case in February this year, when the Daily Mail reported that a 39-year old woman had been denied emergency contraception in another Asda store by an employee who said he wouldn't supply it because of his 'devout Christianity'. The customer denied that the chemist had told her of an alternative supplier in the area, although there was dispute over this.
Asda stood by their employee, saying: 'We are sorry if we have caused upset, but we cannot force a colleague to sell a product that goes against their moral or religious beliefs.'
Wood suggested to the RPS that if a pharmacist was on duty who might have moral objections to supplying contraceptives, then a notice should be prominently displayed saying so, with the address of the nearest alternative supplier given. The RPS, though, was not receptive to this idea.
These, of course, are just the cases that have made it into the public domain. The complaints were made by self-confident women who were shocked by their treatment and were prepared to speak out about it. How many other unreported cases are there, of insecure young women and girls who are desperate to obtain these contraceptives, but are mortified to be told by the pharmacist that they are, in effect, 'immoral' for asking for them? And what implications could the wider use of the 'conscience clause' in pharmacies have? Will chemists be able to refuse contraceptives to unmarried customers, dispensing morality rather than medication?
As religious groups around the world lurch rightwards, and increasingly employ guerrilla tactics to try to force their 'values' on to an unwilling society, it is time for liberals to wake up to the danger. The spate of religious activism in British pharmacies over the past year or so should serve as a warning that religious conservatism is on the march, and will make its presence felt over many more issues than simply Jerry Springer ' The Opera.
Terry Sanderson is vice president of the National Secular Society. If you or someone you know has been refused treatment or service by a health professional in Britain on 'moral or religious grounds', pleased contact us: [email]firstname.lastname@example.org[/email] or 020 7436 1151