A Pharmacist's Good Will and Conscience


and the Vocabulary of Life Issues Debates

Copyright 2005 by Richard Bonomo.  This essay may be freely republished in newpapers and non-profit publications provided it is published in its entirety and as written.  Publication in commercial books,  or any publication of incomplete or modified text is only by the permission of the author.

What appears below is a guest editorial I submitted to the Wisconsin State Journal on Thursday, April 14, 2005. It was published the next day, slightly edited. Here I reproduce the editorial as submitted, except that I have broken the texts into smaller paragraphs. (The WSJ did the same when they published it.)

This piece was occasioned by a number of nasty commentaries which appeared in the press, including the Wisconsin State Journal. I hope to write and post a full-length essay on the matter. There is only so much that can be said in 500 words.

Neil Noesen, a pharmacist recently disciplined by the Pharmacy Examining Board, is a friend of mine. While Neil is far from perfect, I know him to be a very good and principled man with a generous heart, who practices Pharmacy to be of service to mankind. He has donated his services to a Presbyterian mission hospital in Africa (Malawi), traveling there more than once despite not being financially established himself.

His good will stands in stark contrast to the nastiness directed at him in the media (including this newspaper ), and to the just plain evil assaults directed against him by ideologues, and by certain radical state assemblymen who would deprive him of his livelihood.

The occasion for this? His refusal to handle -- in any way -- a contraceptive refill request. (For the record: he had made his conscientious objection known to his employer beforehand, he never capitulated, and the young woman got her prescription refilled some days later by another pharmacist.) Neil's judgement is that artificial contraception is neither good medicine nor moral. He knows that many "contraceptives" also have abortifacient properties. Wanting to avoid participating in the evil, he declines to get involved.

He is not alone in this (hence proposed legislation to give other health care professionals the same kind of protection of conscience that physicians have).

To hear the screaming coming from certain quarters one would think that he had refused insulin to a diabetic.

However, supplying contraceptives is not of the essence of being a pharmacist (in fact it was ILLEGAL not long ago) as, say, selling meat is to being a butcher. Giving or prescribing drugs for direct contraceptive use is not engaging in health care. It is facilitating recreational drug use . (What disease or dysfunction is being treated by the bulk of those engaging in deliberate contraception?)

Discussion of this is further muddled by vocabulary: different groups use the same words in different ways. The word "conception" in common parlance and in much of the medical community is identified with "fertilization" -- the union of sperm and ovum. "Pregnancy," similarly, is identified with the state of "being with child," which is immediately upon fertilization.

Those with a gyne-centric viewpoint (represented by many but not all medical dictionaries) view "pregnancy" in terms of the physical condition of the mother, and thus say that "pregnancy" does not begin until implantation, when the embryo chemically signals his presence and initiates a change in his mother's physical condition. "Conception" in this framework refers to implantation, NOT to the beginning of the mother's child's life which precedes it.

Consequently, people who employ this set of definitions include under the category of "contraceptives" drugs which prevent implantation in addition to or instead of inhibiting ovulation.

In common (not gyne-centric) parlance, drugs which act to prevent implantation are called "abortifacients."

Regardless of which convention one uses, drugs which act to prevent implantation directly cause the death of the developing individual.

The question is not why some pharmacists, such as Neil, decline to be involved, but why so very many go along with this.

-- Richard Bonomo