Ethics Archives - Page 48 of 87 - Protection of Conscience Project Library

Rx for Drugstore Discrimination: Challenging Pharmacy Refusals to Dispense Prescription Contraceptives under State Public Accommodation Laws

Charu A Chandrasekhar

Extract
The problem of refusals to dispense prescription contraceptives in pharmacies is real and urgent. State public accommodations statutes offer an excellent vehicle in many states for challenging these discriminatory practices. State public accommodations lawsuits should ideally be brought solely against the pharmacy, not against the individual pharmacist who refuses to dispense a prescription. Pharmacies are best positioned to make institutional adjustments that ensure the filling of prescription contraceptives while accommodating the views and legal rights of their pharmacist employees. Moreover, a state public accommodations lawsuit will likely have a greater remedial and public relations impact if brought against a pharmacy as opposed to against an individual
pharmacist and will result in broader systemic change.

Chandrasekhar CA. Rx for Drugstore Discrimination: Challenging Pharmacy Refusals to Dispense Prescription Contraceptives under State Public Accommodation Laws. Albany Law Rev. 2006;70:55-115.

Scope Note 46: Pharmacists and Conscientious Objection

Richard M Anderson, Laura Jane Bishop, Martina Darragh, Harriet Hutson Gray, Anita Nolen,Susan Cartier Poland

Extract
The literature and online resources cited below include (1) policy statements and codes by professional organizations; (2) review essays on conscientious objection in health care and articles on the current debate regarding the field of pharmacy; and (3) legal perspectives and cases.

Anderson RM, Bishop LJ, Darragh M, Gray HH, Nolen A, Poland SC. Scope Note 46: Pharmacists and Conscientious Objection. Kennedy Inst Ethics J. 2006;16(4):379-396.

Equality, Justice, and Paternalism: Recentreing Debate about Physician-Assisted Suicide

Andrew Sneddon

Abstract
Debate about physician-assisted suicide has typically focused on the values of autonomy and patient well-being. This is understandable, even reasonable, given the importance of these values in bioethics. However, these are not the only moral values there are. The purpose of this paper is to examine physician-assisted suicide on the basis of the values of equality and justice. In particular, I will evaluate two arguments that invoke equality, one in favour of physician-assisted suicide, one against it, and I will eventually argue that a convincing equality-based argument in support of physician-assisted suicide is available. I will conclude by showing how an equality-based perspective transforms some secondary features of debate about this issue.

Sneddon A. Equality, Justice, and Paternalism: Recentreing Debate about Physician-Assisted Suicide. J Applied Phil. 2006 Nov;23(4):387-404.

Two Cheers for Conscience Exceptions

Adrienne Asch

Abstract
The pharmacist who wants her integrity and self-conception to be respected must accord respect to the woman whose views about sex, life processes, and parenthood differ from her own by courteously offering her own rationale and a referral.

Asch A. Two Cheers for Conscience Exceptions. Hastings Cent Rep. 2006;November-December):11-12.

Ethical misconduct by abuse of conscientious objection laws

Bernard M Dickens

Abstract
This paper addresses laws and practices urged by conservative religious organizations that invoke conscientious objection in order to deny patients access to lawful procedures. Many are reproductive health services, such as contraception, sterilization and abortion, on which women’s health depends. Religious institutions that historically served a mission to provide healthcare are now perverting this commitment in order to deny care. Physicians who followed their calling honourably in a spirit of self-sacrifice are being urged to sacrifice patients’ interests to promote their own, compromising their professional ethics by conflict of interest. The shield tolerant societies allowed to protect religious conscience is abused by religiously-influenced agencies that beat it into a sword to compel patients, particularly women, to comply with religious values they do not share. This is unethical unless accompanied by objectors’ duty of referral to non-objecting practitioners, and governmental responsibility to ensure supply of and patients’ access to such practitioners.

Dickens BM. Ethical misconduct by abuse of conscientious objection laws. Med Law. 2006 Sep;25(3):513-522.

The Oral Contraceptive as Abortifacient: An Analysis of the Evidence

Dennis M Sullivan

Abstract
Pro-life Christian ethicists and medical practitioners have been united in their opposition to abortion, but have sometimes been divided in their ethical approach to hormonal contraception. Even though many Christians believe that birth control may be a moral option, some claim that the “Pill” acts, at least some of the time, as an abortifacient. If true, Christians who hold that human personhood begins at conception would be morally opposed to the use of combined oral contraceptives. This article examines the scientific evidence for an abortifacient effect of such contraceptive agents, and concludes that such an effect is yet unproven. Some of the ethical arguments are also examined, and the author suggests that further research on early pregnancy factor (EPF) may help to resolve this controversial issue.

Sullivan DM. The Oral Contraceptive as Abortifacient: An Analysis of the Evidence. Perspectives on Science and Christian Faith. 2006;58(3):189-195. Available from:

Pharmacies, pharmacists, and conscientious objection

Mark R Wicclair

Abstract
This paper examines the obligations of pharmacy licensees and pharmacists in the context of conscience-based objections to filling lawful prescriptions for certain types of medications-e.g., standard and emergency contraceptives. Claims of conscience are analyzed as means to preserve or maintain an individual’s moral integrity. It is argued that pharmacy licensees have an obligation to dispense prescription medications that satisfy the health needs of the populations they serve, and this obligation can override claims of conscience. Although efforts should be made to respect the moral integrity of pharmacists and accommodate their claims of conscience, it is argued that the health needs of patients and the professional obligations of pharmacists limit the extent to which pharmacists may refuse to assist patients who have lawful prescriptions for medically indicated drugs.

Wicclair MR. Pharmacies, pharmacists, and conscientious objection. Kennedy Inst Ethics J. 2006;16(3):225-250.

Foreword: The Role of Religion in Health Law and Policy

William J Winslade, Ronald A Carson

Extract
This symposium issue explores several continuing controversies at the intersection of Law, Ethics, Healthcare, Politics, Health Policy and Religion: abortion, contraception, the status of embryos, stem cell research, IVF, personal and professional autonomy, end- of-life decisions, and religiously based health care systems. The multiple values associated with each of these topics strain and threaten to usurp the effectiveness of our legal system to regulate them.

Winslade WJ, Carson RA. Foreword: The Role of Religion in Health Law and Policy. Houston Journal of Health Law & Policy. 2006 Sep;6(2):245-248.

(Correspondence) Infertility Treatments for Gay Patients?

Anthony Charuvastra

Extract
We are entering an era where medicine is becoming more like engineering. The distinction between “treatment” and “enhancement” blurs as we are ever better at tinkering with the body. . .

Medical scientists will be able to modify and control an ever-expanding range of human bodily functions, from drugs that slow down aging to drugs that alter basic aspects of mood, anxiety, and cognition. Someday soon, the conflict between a physician’s idea of how people ought to live and how those people want to live will occur in fields far removed from reproductive technology. . .

Charuvastra A. (Correspondence) Infertility Treatments for Gay Patients?. Hastings Cent Rep. 2006 Sep;36(5):6-7.

“Who Should Survive?: One of the Choices on Our Conscience”: Mental Retardation and the History of Contemporary Bioethics

Armand H Matheny Antommaria

Abstract
The film “Who Should Survive?: One of the Choices on Our Conscience” contains a dramatization of the death of an infant with Down syndrome as the result of the parents’ decision not to have a congenital intestinal obstruction surgically corrected. The dramatization was based on two similar cases at The Johns Hopkins Hospital and was financed by the Joseph P. Kennedy, Jr., Foundation. When “Who Should Survive?” was exhibited in 1971, the public reaction was generally critical of the parents’ decision and the physicians’ inaction. Although technological developments in medicine were a necessary condition for the production of this film and its unanticipated reception, they were not a sufficient condition. The proximate cause was a changed understanding of the capabilities of individuals with Down syndrome. Part of the impetus for this change was data showing the adverse effects of institutionalization on normal children.

Antommaria AHM. “Who Should Survive?: One of the Choices on Our Conscience”: Mental Retardation and the History of Contemporary Bioethics. Kennedy Inst Ethics J. 2006;16(3):205-224.