I have written rather extensively on Talk to Action regarding dominionists and reproductive health--one of the larger issues being the spread of so-called "moral refusal" clauses that do not just ban medical abortion but go towards banning the pill and even go so far as refusing reproductive health services to LGBT people and refusing prescriptions outright--including for antibiotics and prenatal vitamins--because they came from a women's clinic.
Now, in an end-run against "must dispense or refer" laws in several states, dominionists are now expanding the large "parallel economy" to a new area--namely, the dominionist-run pharmacy not providing contraceptives at all...and there are disturbing indications that a prediction I made re broad "moral refusal" clauses may have come to pass.
No reproductive health for you!
The Washington Post writes about the new hotness in the dominionist "parallel economy"--and right off the bat, reveals to us just how extensive the problem of "moral refusal" has become:
When DMC Pharmacy opens this summer on Route 50 in Chantilly, the shelves will be stocked with allergy remedies, pain relievers, antiseptic ointments and almost everything else sold in any drugstore. But anyone who wants condoms, birth control pills or the Plan B emergency contraceptive will be turned away.
That's because the drugstore, located in a typical shopping plaza featuring a Ruby Tuesday, a Papa John's and a Kmart, will be a "pro-life pharmacy" -- meaning, among other things, that it will eschew all contraceptives.
The pharmacy is one of a small but growing number of drugstores around the country that have become the latest front in a conflict pitting patients' rights against those of health-care workers who assert a "right of conscience" to refuse to provide care or products that they find objectionable.
"The United States was founded on the idea that people act on their conscience -- that they have a sense of right and wrong and do what they think is right and moral," said Tom Brejcha, president and chief counsel at the Thomas More Society, a Chicago public-interest law firm that is defending a pharmacist who was fined and reprimanded for refusing to fill prescriptions for birth control pills. "Every pharmacist has the right to do the same thing," Brejcha said.
Of course, there's a more ulterior reason why the trend is going towards setting up completely dominionist-run pharmacies (in a remarkably similar way to how attempts to promote young-earth creationism have morphed over the years as the courts shoot them down).
A number of states--California, New Jersey, Illinois and Washington State among them--have laws on the books requiring "must dispense or refer"--that is, if someone does have a "moral objection" to dispensing a drug, they either must dispense it, refer the prescription to another pharmacist on staff, or refer to the nearest drugstore that carries it--and if there are no other options, they must dispense. At least ten other states--thanks to the increasing awareness of the real healthcare costs of "moral refusal"--have bills in their state General Assemblies that would also mandate "must dispense or refer".
Unfortunately, many if not most of these laws and bills have a rather considerable loophole, as documented in the article:
California, New Jersey, Illinois and Washington state recently began requiring pharmacies to fill all prescriptions or help women fill them elsewhere, and at least another 10 states are considering such requirements. But some states exempt pharmacies that do not generally stock contraceptives, and it is unclear how other existing rules and laws and those being considered would apply to those pharmacies.
(Never let it be said that dominionist groups do not have a talent in finding the one loophole and managing to stick the camel's nose under the tent with it.)
In addition, many of these new dominionist "parallel economy" pharmacies--largely linked with a group called Pharmacists for Life International, which organises "moral refusal" campaigns and is seeking to get broad "moral refusal" clauses nationwide--will have de facto religious tests to work there (which in and of itself could be a violation of employment laws--unless they're run as divisions of churches). Often, these tend to be linked to an increasing number of "parallel economy" OB/GYN services:
The DMC Pharmacy opening in August marks an expansion by Divine Mercy Care in Fairfax, a nonprofit health-care organization that adheres to the teachings of the Catholic Church. The group runs the Tepeyac Family Center, an obstetrics-gynecology practice in Fairfax that offers "natural family planning" instead of contraceptives, sterilization or abortion.
"We're trying not to leave our faith at the door," said John Bruchalski, who chairs the group's board of directors, noting that one of the organization's major goals is helping needy, uninsured patients obtain health care. "We're trying to create an environment where belief and professionalism come together."
Like the doctors, nurses and other staff members at Tepeyac, Robert Semler, the pharmacist who will run DMC Pharmacy, plans to start each workday with a prayer with his staff, which at first will just be his wife, Pam, a nurse.
"Being a faith-based workplace, it's a logical thing to do," Semler said.
Real life consequences for women
The sad thing is, these sorts of "moral refusal" clauses--and the existence of loopholes that allow dominionist pharmacies to completely skirt around "must carry or refer"--do have very real consequences for women.
For starters, "the pill" is not just used for birth control. It turns out that "the pill" is used for many conditions where hormonal regulation is a must--PCOS (in which "the pill", longterm, can be both lifesaving and fertility-saving; the only treatment for PCOS other than "The Pill" or Depo-Provera is surgical removal of the ovaries, and untreated PCOS can lead to morbid obesity, type II diabetes, and certain forms of cancer), as well as other problems of hormonal regulation, are commonly treated with "The pill". Newer versions of "The Pill" such as Seasonale (that only have a "period cycle" once every three months) are also becoming frequently used for treatment of endometriosis.
Secondly, there are conditions where it would be very harmful--to the mother, to the fetus, or both--for her to become pregnant, and not having effective hormonal therapy could well deprive women of healthcare options unrelated to pregnancy. Among other things, prescriptions for a number of drugs including Thalomid (thalidomide, now used both in leprosy treatment and in clinical trials for various cancers) and Accutane and other retinoids (used in treatment of severe, disabling acne and certain types of psoriasis as well as basal cell carcinoma chemo) require you to be on at least two separate forms of birth control (one hormonal, one a barrier method) unless you have had a hysterectomy--and yes, documentation is required of this.
In fact, there have already been documented cases of "moral refusal" of Accutane based on the requirement persons using the drug use birth control (in order to prevent the horrific birth defects that inevitably result from taking Accutane during pregnancy--birth defects which tend to render even the tragedy of "Thalidomide babies" a spring picnic in comparison, with kids being born without brains, with extreme spina bifida with kids' brains being in sacs outside their skulls, and so forth):
Ms. M suffered for many years from severe disfiguring acne. After trying every other method available, she reluctantly agreed with her dermatologist to try a controversial acne drug. The treatment was known to be effective, but carried some significant side effects. Among them were a possible increased risk of suicide, and an established risk of birth defects so severe that female patients taking the drug were required to be on birth control. Ms. M went to her local pharmacy to get her prescription. Pharmacist Z refused to give her the medicine. He considered the drug unethical because of its side effects, and because using it forced women to take contraceptives.
Thirdly--and this has been less publicised--"moral refusal" goes far beyond just refusing to fill "the Pill" and Plan B. As I've written before, "moral refusal" of any prescription from women's clinics has been documented--even those prescriptions that are explicitly for support of a pregnancy to term such as pregnancy-related vitamins. In addition, refusal of antibiotics prescribed by women's clinics have been documented, as have refusals of medication that can be used for treatment of genital herpes (and also has applications of treatment of stuff NOT for genital herpes--like, oh, chickenpox in adults or immunosuppressed kids, or people exposed to simian herpes B virus--both of which can kill, and kill in particularly grotesque manner).
And in those cases where actual medically-necessary abortions are needed (part of tomorrow's subject, involving a particularly nasty form of "moral refusal" where a woman was refused ambulance transportation to a women's clinic for an abortion due to an obstetrical emergency), they're often next to impossible to get; in many places, there are no hospitals available to perform emergency abortion--many are owned by the Catholic or Southern Baptist healthcare systems, both of which refuse to perform abortions, and it is not uncommon for hospitals to refer women to women's clinics for even medically necessary abortions (and this primarily in "must provide or refer" states; in most states with "moral refusal" clauses, you're pretty well SOL as far as getting referrals).
In fact, in many states, abortion has literally been "ghetto-ised" into women's clinics by state law. It's not uncommon for situations to occur where women are required to have medically necessary and lifesaving abortions in doctor's offices and women's clinics because hospitals refuse to do so:
First the story. In 1994, I got a call from a very distraught doctor in Nebraska. He told me that a 19-year-old woman had been admitted through the emergency room of the hospital where he practiced. She had a blood clot in her lung. Tests revealed that she was 10 weeks pregnant. The clotting disorder was a rare complication of the pregnancy. Her treating physicians told her that she had two
alternatives. She could stay in the hospital for the remaining 6 1/2
months of her pregnancy, taking medications and undergoing surgery to reduce her risk of death or she could have first trimester abortion. She wanted to go home to her toddler so she decided to have an abortion. Four doctors certified that it was a life-saving procedure for her. On the morning surgery was scheduled, however, the hospital’s lawyer appeared in the operating room brandishing a State law that said that no hospital could be required to permit an abortion on its premises. The procedure was canceled. Ten days of dangerous delay followed. Although moving the patient greatly increased her medical risks, she was ultimately transferred 20 miles by ambulance to the office of her physician. He performed the abortion safely. Although his patient had survived the unconscionable risks to which she had been suggested, the doctor wanted to know whether what the hospital had done was legal. That is one of the questions presented here today.
(I'm sure William F. Harrison, our resident clinic doctor, will have much to say on this--being literally on the front lines of this.)
And it gets worse from here. Tomorrow, we discuss the deadliest "moral refusal" of all--refusing to transport ill women to have medically necessary abortions; we also discuss a possible fix to the issue of "moral refusal".