Target still off -- and E.C. is just the tip of the "conscience" iceberg

Laws pending in 18 states could allow health workers to refuse a whole lot more than emergency contraception.

Published January 31, 2006 8:56PM (EST)

We adore Feministing, but we're afraid they're giving Target a little too much credit. Yesterday, Feministing reported that Target's firing of a St. Louis-area pharmacist who refused to dispense emergency contraception indicates that Target has changed its crappy opt-out "conscience" policy.

Not true! Target's policy, as Broadsheet reported here (and elsewhere), is -- and has been -- that pharmacists may refuse to dispense emergency contraception if they refer a customer elsewhere. Pharmacist Heather Williams refused even to do that. "I just can't be a link in the chain at all," she told the St. Louis Post-Dispatch. And, Planned Parenthood maintains, the option to refer is not good enough. (Try telling a woman who just schlepped on the bus through the snow with three kids that she has to go across town ... to another pharmacy on Planned Parenthood's thumbs-down list. Or try being a sexual assault victim in Arizona.) The only acceptable policy is one that allows pharmacists to opt out by, say, passing the prescription off to a colleague -- that is, in such a way that the customer is unaware of anything that happened behind the scenes. Result: The pharmacist follows his or her "conscience," and the customer gets her medication without delay or bonus shame.

And, from the Slippery Slope files, the Washington Post reports that 18 states are considering a total of 36 laws "to protect health workers who do not want to provide care that conflicts with their personal beliefs." Half of these proposals focus on emergency contraception, which is bad enough. And the other half? "Many are far broader measures that would shelter a doctor, nurse, aide, technician or other employee who objects to any therapy," says the Post. "That might include in-vitro fertilization, physician-assisted suicide, embryonic stem cell research and perhaps even providing treatment to gays and lesbians." Several bills would allow insurance companies to opt out of covering procedures they object to "for religious reasons."

Laws preventing disciplinary action against medical professionals who object to performing abortions, for example, are nothing new. But heightened attention to the emergency-contraception issue and the debate over Terri Schiavo's right to die -- along with complicated medical advances that chart new ethical territory -- seems to have sent legislators scrambling.

"This goes to the core of what it means to be an American," David Stevens, executive director of the Christian Medical & Dental Associations, told the Post. "Conscience is the most sacred of all property. Doctors, dentists, nurses and other health care workers should not be forced to violate their consciences."

More-liberal advocates counter that no, sorry, it goes to the heart of what it means to politicize healthcare and consolidate conservative power at the expense of average citizens who just need a doctor.

"The swell of propositions is raising alarm among advocates for abortion rights, family planning, AIDS prevention, the right to die, gays and lesbians, and others who see the push as the latest manifestation of the growing political power of social conservatives," says the Post.

"The so-called right-to-life movement in the United States has expanded its agenda way beyond the original focus on abortion," said Lois Uttley of the MergerWatch Project, which is working to plot a counterstrategy. "Given the political power of religious conservatives, the impact of a whole range of patient services could be in danger."

Doctors, for instance, could refuse to notify parents to inoculate their child for chickenpox because the vaccine was produced using fetal tissue cell cultures. Others worry that terminally ill patients' wishes to refuse resuscitation could be ignored, or that healthcare workers could refuse to provide birth control or sex ed because they believe in abstinence, or don't believe in homosexuality. An ambulance driver cited indirectly in the story had refused to drive a woman to the hospital for an abortion.

Just watch: Healthcare professionals who do their jobs will be criminalized, while those who refuse will go free. With a clear "conscience."

By Lynn Harris

Award-winning journalist Lynn Harris is author of the comic novel "Death by Chick Lit" and co-creator of She also writes for the New York Times, Glamour, and many others.

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