Contraception, Duties and Rights

Ema is not happy:

The Missouri House on Tuesday [that is, 28.iv.09 – IB] voted 115-43 to approve HB 226, an amendment that [s]pecifies that no pharmacy can be required to perform, assist, recommend, refer to, or participate in any act or service resulting in an abortion and it will be immune from liability for refusing to do so.

The text of the Bill, incidentally, is available here; the news article quoted is here.

Ema continues:

By definition, when it comes to women of reproductive age, refusing to provide professional services to patients you deem undesirable is an inalienable right. As such, there’s nothing special about politicians enacting laws to shield medical professionals from liability. These politicians are just doing [insert deity of choice]’s work. (Hear that malpractice lawyers!)

What is remarkable about Missouri’s HB 226 is that it represents a quantum leap forward from the noble pursuit of playing games with your untouchable patients’ trust, dignity, and health without any professional or legal liability.

This law HB 226 allows pharmacies and pharmacists to take advantage of all the benefits of having a monopoly on the sale of drugs without any requirements to abide by those pesky professional duties and standards that are usually a condition of being granted a State monopoly.

Like so:

No licensed pharmacy in this state shall be required to perform, assist, recommend, refer to, or participate in any act or service…

No duty to dispense drugs, talk to or advise patients, refer them to another pharmacist, or refrain from stealing taking a patient’s prescription and refusing to return it to her.

…in connection with any drug or device that is an abortifacient, including but not limited to the RU486 drug and emergency contraception such as the Plan B drug…

No requirement to adhere to the professional standard of using science when dispensing drugs. (The medical definition of abortifacient is out, the personal definition is in.)

I think that contraception is a good thing; emergency contraception is a good thing; terminations of pregnancy are not good, but perfectly permissible and sometimes the best possible action. Having shown those cards, though, I think that Ema is wrong.

The nub of the thought here is that there’s a difference between a right to buy something, and a right to be sold it. I have every right to buy your house or stereo from you on the condition that you’re willing to sell it to me. Should noone want to sell their house, it won’t do for me to insist that someone ought to on pain of that right being violated; neither do I have the right, on learning that you won’t sell me your house, to insist that you point me in the direction of someone else who might.

The State monopoly thing is something of a red herring, too, on this reasoning.  If a right to access contraception exists, and if it doesn’t imply a right to have it provided, then the monopoly is neither here nor there.  Moreover, I can’t help but to think that a law that forced pharmacists to sell all possible treatments, or all treatments from a list, would not be a good law: there’s something to be said for the liberty not to sell stuff to which you object morally.  If every person who can sell it refuses… well, that’s bad luck: but it’s a spin-off of liberty that sometimes the best possible world is one in which we’re prepared to let suboptimal things happen.  Besides: pharmacists have commercial heads.  They’ll want to make sales – it’s unlikely that none of them would be prepared to hold his nose and sell Plan B.

So the challenge is this: though it might be bad, and undesirable, and – who knows? – downright thickheaded for a pharmacist to refuse to sell emergency contraception because of his moral beliefs, on what grounds ought he not to be exempt from liability?

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