Pharyngula

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Wednesday, July 07, 2004

Access Denied

Here is a troubling article from Prevention magazine.

In April, Julee Lacey, 33, a Fort Worth, TX, mother of two, went to her local CVS drugstore for a last-minute Pill refill. She had been getting her prescription filled there for a year, so she was astonished when the pharmacist told her, "I personally don't believe in birth control and therefore I'm not going to fill your prescription." Lacey, an elementary school teacher, was shocked. "The pharmacist had no idea why I was even taking the Pill. I might have needed it for a medical condition."

Melissa Kelley, 35, was just as stunned when her gynecologist told her she would not renew her prescription for birth control pills last fall.

"She told me she couldn't in good faith prescribe the Pill anymore," says Kelley, who lives with her husband and son in Allentown, PA. Then the gynecologist told Kelley she wouldn't be able to get a new prescription from her family doctor, either. "She said my primary care physician was the one who helped her make the decision."

Lacey's pharmacist and Kelley's doctors are among hundreds, perhaps thousands, of physicians and pharmacists who now adhere to a controversial belief that birth control pills and other forms of hormonal contraception--including the skin patch, the vaginal ring, and progesterone injections--cause tens of thousands of "silent" abortions every year. Consequently, they are refusing to prescribe or dispense them.

Scenarios like these--virtually unheard of 10 years ago--are happening with increasing frequency. However, until this spring, the issue received little attention outside the antiabortion community. It wasn't high on the agendas of reproductive rights advocates, who have been preoccupied with defending abortion rights and emergency contraception. But when Lacey's story was picked up by a Texas TV station and later made the national news, Planned Parenthood Federation of America and others took notice.

Limiting access to the Pill, these groups now say, threatens a basic aspect of women's health care. An estimated 12 million American women use hormonal contraceptives, the most popular form of birth control in the United States after sterilization. The Pill is also widely prescribed by gynecologists and family doctors for other uses, such as clearing up acne, shrinking fibroids, reducing ovarian cancer risk, and controlling endometriosis.

"Where will this all stop?" asks Lacey. "And what if these pharmacists decide they suddenly don't believe in a new lifesaving medicine? I don't think pharmacists should be in a position to decide these things."

This is just nuts. I can imagine the day I have a heart attack, I'm rushed to the hospital with sirens wailing and lights flashing, and am taken to the doctor who tells me, "I'm a Christian Scientist. It's against my religion to treat you. Please close your eyes and pray—your symptoms are entirely imaginary."

It's the same thing, after all: doctors who are trained and commissioned to treat our material, physical ills, yet allow their superstitions about immaterial, unevidenced supernatural forces to compromise the job they are supposed to do.

What I find particularly worrisome about this situation is that this isn't the product of a small number of reactionary nutcases who have acquired power and are trying to dictate their will to those below them. It's sewage, bubbling up from below; the product of a culture that accepts and encourages religious buffoonery. Given the legacy factor in med school admissions, it's also a problem that can perpetuate itself.

The one gleam of hope, though, is that these deluded doctors are still a minority, and now is the time to fight against them.

But what will you do if, like Kelley, Williams, and Lacey, you encounter a doctor who tells you no or a pharmacist who won't honor your prescription? "If your gynecologist won't prescribe the Pill, find a new doctor--and tell all your friends what has occurred," says Vanessa Cullins, vice president for medical affairs at Planned Parenthood Federation of America in New York City. The same goes for pharmacists who refuse to fill your prescription. The best defense against this grassroots movement, Cullins notes, is another one--in opposition.

Personally, I haven't had to ask a doctor for a prescription to the Pill...but I think it's a good idea for us guys to ask our doctors about their policies on such things, and if they are believers in such crap, to change providers. Their work may not affect us directly, but they sure do harm to the women in our families and communities.


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Comments:
#4328: — 07/11  at  08:13 PM
My advice: Only take a position if you will discharge the standard duties involved. Anything else is negligence.

Applying to be a tour guide at the ICR museum? Be ready to lie to spread the meme. Take a Playboy gig? You must strip for the camera. Refusing to do either is negligence of duty, making it ethically wrong.

Likewise, taking the position of ob-gyn or pharmacist in a mainstream hospital or pharmacy requires you to provide standard, legal reproductive care. If you cannot accept the responsibility, move to a conservative Roman Catholic hospital.



#5198: — 08/12  at  08:00 PM
Do yourselves a favor people - from now on carry a coat hanger, I promise it's less expensive than birth control pills, and no one can take away your right to a coat hanger. And hey, you'll also help keep population down! Score one for the pro-choice team huh?



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