Emergency plan overturned

An Illinois court has struck down a 2005 measure that would
force pharmacists to provide Plan B.

In 2005, the then-governor of Illinois, Rod Blagojevich,
enacted an “emergency” measure intended to force pharmacists to fill all
prescriptions for the Plan B morning after pill, regardless of their ethical or
moral beliefs. The state’s “right-of-conscience” law, he claimed, applied only
to physicians. Two pharmacists subsequently took the case to court, suing the
state to overturn the ruling, and, after six years, they succeeded.

On April 5th this year the court struck down the governor’s
measure on three counts: “as a violation of the Illinois Healthcare Right of
Conscience Act, the IL Religious Freedom Restoration Act, and the Free Exercise
Clause of the First Amendment.”

Imagine the horror now overtaking the state: women in the
wilds of Chicago frantically dashing about, unable to find a doctor or
pharmacist to give them this pill. Yes, time to call on the National Guard,
perhaps the Red Cross too -- surely they could navigate the treacherous byways of
Springfield to reach the panic-stricken women? But wait a minute -- perhaps
it’s the S.W.A.T. team we need…

Surely, the refusal by a handful of pharmacists to dispense one
small product is but a small inconvenience that does not warrant emergency

Strangely enough, the governor was not concerned that
healthcare professionals might refuse treatment to the needy or poor of his
state, as is happening amongst a growing number of physicians in the US who are
refusing new Medicare patients because of low government payments. A USA TODAY survey shows that 18 per cent of doctors in
Illinois restrict the number of Medicare patients in their practice.

It is interesting to speculate on what Mr. Blagojevich might
have done if some Illinois pharmacists refused to provide other types of drugs
or services when the customer could not pay. This has happened in Canada, where
British Columbia pharmacists threatened to withdraw provision of Methadone to First
Nations and Inuit peoples because of inadequate reimbursement by Health Canada.
Most recently, pharmacies in Ontario have made headlines for threatening closure and reduced patient
services over government cuts.

And things can always get worse. Imagine if the former
governor were faced with service-disrupting protests such as those in Islamabad where over 900 pharmacists took to the streets --
presumably halting services -- in protest over unfair treatment, and
threatening a countrywide movement if demands were not accepted; or if he were
confronted by angry pharmacists threatening to close shop over government
cutbacks, as in South
, in Ireland, or in Canada. What would he have done then?

Patients are inconvenienced for various reasons every day.
In Staten Island, New York, pharmacies are refusing to stock certain pain-killers because of the
area’s drug abuse problem, thus forcing legitimate users to go on frustrating
and sometimes fruitless hunts for their medication.

Was it more likely that Illinois women would be denied
access to Plan B than to other medications or health services? No. The judge in last month’s ruling said that the state provided
“no evidence of a single person who ever was unable to obtain emergency
contraception because of a religious objection. … Nor did the government
provide any evidence that anyone was having difficulties finding willing
sellers of over-the-counter Plan B, either at pharmacies or over the Internet.”

It seems that in enacting his emergency measure, Governor
Blagojevich was only concerned about one thing: appeasing the birth control
lobby at the expense of the conscience rights of a very small group of

Clearly, the state’s concept of “emergency” was fabricated
in order to justify the imposition of a moral ideology on unwilling citizens.
In this case, the target happened to be religious believers, or for that
matter, any pharmacist who believes that life begins at conception and is
worthy of respect, or any pharmacist who has come to realize that the morning after pill may in fact not be reducing the number
of unwanted pregnancies as it is purported to do. But such an attack on human
rights by state authorities can be turned against any group of believers.

There are those who firmly believe that vaccinations are
dangerous, but there is a trend in the United States as well as worldwide of
governments mandating vaccination for the public at large and strictly
limiting exemptions.

Again, there are those who believe that a woman has an
absolute right to an abortion, but there is now anti-abortion legislation in
some US states requiring that a woman be offered an ultrasound first. Last
month the governor of Texas signed a law requiring women to have the ultrasound (not just be
offered it), and then to have the option of seeing it and listening to the
fetal heartbeat.

Those who object to the Texas law as an intrusion into a
woman’s privacy should be able also to appreciate the resistance of some health
professionals to the mandating of certain services and procedures which would
violate their conscience.

As we have seen, the exercise of conscience rights in
Illinois had no discernable effect on access to Plan B. In Canada, too, women
have no problem accessing this drug, which is available at pharmacies across
the country without a doctor’s prescription. It is kept behind the counter in
Saskatchewan and is available under a prescription by pharmacists in Quebec. It
is available over the counter in Alberta, British Columbia, Manitoba, New
Brunswick, Newfoundland and Labrador, Nova Scotia, Nunavut, the Northwest
Territories, Ontario, Prince Edward Island, and the Yukon.

To date, five out of nine Canadian Anglophone pharmacy
jurisdictions enforce mandatory dispensing or referral for prescription items
or services that go against a pharmacist’s moral or ethical beliefs, but there
is no law mandating that a pharmacist must stock or offer a particular product.
And although when it comes to all other non-prescription items, there is no
specific requirement to refer, most pharmacists will tell a woman where to get
Plan B.

In other words, unlike those affected by the draconian
emergency measures of Blagojevich, pharmacists in Canada are free not to stock
Plan B. This is most certainly a sign of our political rulers’ superior

Alarcon is a Vancouver pharmacist and writer. She holds a Masters in Bioethics.


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