A Citizen's Opinion Regarding

Pharmacist Conscience Clause Legislation

Senate Bill 21, Assembly Bill 63

5 March 2003

Ladies and Gentlemen:

I will not pretend to be familiar with the text of the proposed legislation. My purpose today is to speak of the merit of the proposed legislation solely on broader philosophical and moral grounds, that is to speak to the question of its apparent intent rather than to matters of implementation.

The matter in question is whether or not pharmacists who have objections arising from conscience to the practice of dispensing drugs which he or she thinks may be used, for example, as an abortifacient, for chemical abortion, suicide, or euthanasia, will be protected from discrimination in employment and from disciplinary action resulting from a refusal to dispense drugs in such cases.

This is not an abstract matter for me. I have friends who are pharmacists. One of them is even now undergoing a disciplinary investigation resulting from his refusal to participate -- in any way -- in processing a prescription for such substances.

It seems to me that the problem is twofold:

The first has to do with what constitutes medical care and the role of the pharmacist in delivering same.

The second has to do with the matter of conscience directly. When is it permissible to compel or attempt to compel someone to do something they find morally reprehensible?

The first problem results, I think, from certain societal pressures which seek to change the definition of words so that people will "feel" more comfortable with themselves. Witness the recent and ongoing debate as to whether or not health insurers should be compelled to cover contraceptive devices and substances. Attempts were and are made to paint this as a discrimination issue because, apparently, some plans covered Viagra. Lost in this attempt to play the discrimination card was the simple fact that the logical test for discrimination was not whether a plan covered Viagra treatment or not, but whether it covered, for example, vasectomies. "Medical care" is traditionally and, I think, properly defined as care given with the intent of restoring lost bodily function or appearance (such as treating an injury or illness), or of facilitating normal and natural bodily functions (such as child birth) which are not illnesses in themselves, but may often be accompanied by complications. The attempts to broaden "medical care" to include things such as contraceptives and abortifacients represent a sea-change in thinking, and I think a logical failure. The term "medical care" should not be used to describe steps taken to interfere with and frustrate normally bodily operations, as contraceptives, abortifacients, chemical abortives, et cetera, do. This partially successful attempt to change the meaning of "heath care" has had the effect of pulling health care professionals and those who aspire to be involved in a healing profession into a political and ideological maëlstrom with which they should not have to deal.

The second problem is related. It is important to bear in mind that a pharmacist, male or female, is a man, not a machine. Machines do not have a conscience; Homo Sapiens do. Those who would demand that pharmacists simply dispense drugs without having regard to the moral problem posed by some of them are, in effect, denying the right of the pharmacist to exercise his humanity. They are demanding that he simply be a highly sophisticated vending machine, an automaton, a device for producing the desired pills, powders, and devices on demand.

As a society we are properly very sensitive to matters of conscience. We have a process whereby those who can demonstrate a conscientious objection to the military draft can be excused or choose alternate service. We try accommodate people's religious duties and restrictions in our public and private institutions. We worry about the coercing children into doing things contrary to their consciences in school. Our health care professionals deserve no less. One should not have to check one's conscience at the door when you choose to enter a school of pharmacy, or work for the great bulk of employers, especially in matters which are in such a state of flux. A man should not have to choose between acting like a man or acting like a vending machine.

Thank you for your attention.

Richard Bonomo (some contact information deleted before web posting)