“Whose Body Is It?”: Pharmacists Can’t Be Allowed To Deny Women Emergency Contraception
Women deserve the chance to prevent pregnancy after birth control failure, sexual assault, or unprotected sex. Emergency contraception, also known as the “morning-after pill,” is FDA-approved and prevents pregnancy after sexual intercourse. But it is time-sensitive; it only works if women are able to obtain it without delay or discrimination.
Unfortunately, healthcare providers are refusing to dispense emergency contraception based on their own religious or moral beliefs, thereby overriding women’s decisions about their bodies and lives. Pharmacists in at least 24 states have refused to sell birth control or emergency contraception to women. Some hospital emergency rooms refuse to provide emergency contraception to rape victims.
Some healthcare providers even lie to women—for example, by saying it will cause an abortion. In one case, a woman believed a Wisconsin pharmacist who called her a murderer. Although it will not work once a woman is pregnant, she did not fill her prescription and got pregnant. In a California incident, a couple with a newborn sought emergency contraception after birth control failure. The pharmacist called them irresponsible, refused to fill the prescription, and did not enter it into the system so that it could be transferred elsewhere.
Laws should require all hospitals and pharmacies to establish a system to ensure that women in need of birth control, including in emergency situations, receive it without discrimination and delay. Individual healthcare providers with religious objections may be accommodated—for example, by making sure two pharmacists are on duty—but not at the expense of patient access to critical healthcare. This approach is consistent with long-standing protections for individual religious beliefs in the workplace. Refusing providers must treat patients with respect and ensure that patients receive care from another provider. They cannot—as one Wisconsin pharmacist did—leave customers waiting indefinitely for assistance in the store and on the phone. A patient should not even know her healthcare professional objects.
Refusals often result in women feeling judged, shamed, angry, and vulnerable, and they reduce women’s trust in the healthcare system. Additionally, refusals violate informed consent, restricting women’s information and options. Delays or denials of emergency contraception can lead to pregnancy. For some women, pregnancy can entail severe health risks and even life endangerment. A refusal to provide emergency contraception can further traumatize an already traumatized woman—like a rape survivor. Refusals are most burdensome on people in rural areas, or those with low incomes and no job flexibility. For example, an Ohio woman refused emergency contraception at her local pharmacy had to drive 45 miles to find another pharmacy. And some women may be limited by their insurance plan to a particular pharmacy or provider.
Recognizing the harm of refusals, states, national professional associations, and pharmacy chains have acted to protect women’s access to emergency contraception. Twenty-three states and Washington, D.C., have laws and/or policies that improve women’s access to it, such as requiring hospitals to provide it to rape survivors. Major pharmacy chains have adopted policies ensuring that women leave the pharmacy with contraception in hand. Professional healthcare associations have issued guidance protective of patients’ right to receive care. The religious beliefs of pharmacists, doctors, nurses, or other healthcare providers should not trump a woman’s ability to make decisions about her reproductive health. Those decisions are personal, and they should stay that way.
By: Gretchen Borchett, U. S. News and World Report, October 15, 2012
A Progressive Defense Of The White House On Plan B
I get the reasons for liberal outrage at the Obama administration’s Plan B decision. But I can’t quite join in the indignation. I know that I am a man—a fact I’ve been aware of for some time—and so readers male and female can factor that in here as they wish. But it seems to me that to call this merely a case of politics cynically trumping science is way too dismissive of some concerns that parents with all kinds of political views might have about their teenage daughters buying this pill without their knowledge.
Much of the opposition to allowing underage girls to buy the pill over the counter amounts to straw-man arguments. There’s the line that taking the pill amounts to abortion. Watch this lurid ad by a right-to-life group and think about what sort of cacophony must be raging inside the mind that could even come up with such an egregious thing. Outside the realm of anti-abortion fanaticism, I don’t think most of us would equate the prevention of a pregnancy with the removal of an existing fetus. It’s called “emergency contraception” because it’s contraception, not abortion.
There’s also an argument about harmful effects on young girls of the pill’s heightened progesterone levels. I am far from being an expert on such matters, but unanimous view of the scientific community appears to be that the pill is safe for all females of child-bearing age, and that’s good enough for me.
Those are ideological issues, and ones that can be dismissed easily. But it seems to me that there is a fair issue here, and it has to do with parents having a right to know about and be involved in what their kids are up to. You simply don’t have to be a right-winger to have concerns about your 14- or 15-year-old daughter having easy access to such a pill.
That is not a political question per se. A parent’s view on that matter will be partially informed by politics, but only partially (and in some cases not at all, since lots of people have no political views to speak of). Parents’ opinions on this will be informed most of all by the parent-child relationship; by the parents’ views about sexuality and morality; by the parents’ feelings about their authority vis-a-vis their child’s autonomy. These areas might have a lot to do with a parent’s political views, but they might not. We all know people who are politically conservative but sexually libertine, or politically liberal and as chaste as Mother Teresa.
In other words, this is less about appeasing the right than acknowledging reality in all its complications out there in the country, where many people probably have mixed feelings. I’d be fascinated to see some polling on this, and I expect we will soon.
In an ideal world, parents would rationally support the idea of their daughters having every means available to them to correct an error (or, obviously, to override a violation) that happened a day or two prior. But parents don’t always think rationally about these things. That makes these issues sensitive by definition, and it’s hardly illegitimate for a government to take such matters into consideration. I’d have had more respect for Kathleen Sibelius in this situation if, instead of that blather about 11-year-old girls not being able to follow instructions and take the pill properly, she’d just said: “Look, I respect the science, but this raises ethical and moral questions about what is the proper age for access to emergency contraception, in addition to the scientific ones. And that’s a public debate we ought to have more of before we pull this trigger.”
Such pills are generally available in other advanced countries, but there are some limits. In England, you have to be at least 16 to buy them. In Finland, 15. In Quebec, you have to consult a pharmacist. In Italy, it requires a doctor’s prescription.
So advanced societies haven’t yet made an across-the-board decision that all girls from 11 up should be able to buy this pill, and the United States always lags behind in these things, for all the reasons we know.
I wouldn’t doubt that the administration feared the development of a narrative here. Newt Gingrich in particular is very adept at that sort of thing: This election, he’d have announced with his usual fanfare, is a contest between traditional values and 13-year-old girls having no-consequences sex. It’s hard to know the extent to which that would have taken off.
But I doubt this was just politics. It was only in August that this same “anti-woman” administration issued new standards requiring insurance companies to cover all government-approved contraceptives for women, without co-payments or other fees. That will take effect, under the new health-care law, in January 2013 and should go a long way toward lowering the cost barriers to birth-control services for insured women. If the administration so lives in fear of political fallout from the cultural right, then why did it do that?
So maybe there was something more going on here. Maybe we should have a longer debate about the appropriate age at which this pill should become available. And maybe the right answer, an answer that much, but not all, of the advanced world has agreed on, is that there shouldn’t be a limit. The science says it’s safe, and it will undoubtedly prevent unwanted pregnancies—and, in an irony that the anti-abortionists never grasp, it will prevent abortions, too. But it’s now the job of advocates to make the culture catch up to the science.
By: Michael Tomasky, The Daily Beast, December 9, 2011
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