Medicine Blinded by Sex

CONFRONTATION AT THE COUNTER - Drug Topics

Suddenly, Americans are waking up to the fact that women are being confronted at the counter by pharmacists asserting a religious or moral right to refuse to dispense hormonal contraceptives or emergency contraceptives. An estimated 12 million American women use hormonal contraceptives for birth control. But the drugs can also be prescribed for many other indications, including acne, fibroids, endometriosis, and to regulate menstrual periods.

The crux of the current conflict is the question of when pregnancy begins. The long-standing medical definition held by the American College of Obstetricians and Gynecologists is that pregnancy begins when the fertilized egg is implanted in the uterine lining. But pharmacists who refuse to dispense hormonal contraceptives believe that pregnancy begins at fertilization. In the event that birth control pills do not suppress ovulation and an egg is fertilized, these R.Ph.s believe the drugs cause a chemical abortion. And some pharmacists believe that referring the patient to another pharmacist or pharmacy makes them unwilling parties to abortion.

You have heard the stories, I'm sure. Pharmacists fired for refusing to dispense hormonal contraceptives. I'm sure you have also heard the opinions. The topic even came up in my masters level English class, where pharmacists who exercised their conscience were labeled "draconian" and "abusers of power." The article referenced above is actually one of the more balanced treatments of this issue that I have seen. My wife is a pharmacist, so I happen to have personal stake in this issue. As a moral theology teacher I also have a lot to say about it.

I have to wonder why this issue is framed as an issue of religious rights. In a modernist culture, anything labeled as a religious argument is immediate written off as irrational emotional opinion. My wife will tell you that the main reason for a pharmacist to object to dispensing contraception is professional and medical, not religious. Personally speaking, religious motivations are the highest ranking motivations for doing anything. Bringing glory to God is the most important goal I can have in life. However, when we are engaging a modernist culture, perhaps religious motivations are not best in the forefront.

What are the medical reasons for refusing to dispense hormonal contraceptives? First of all, the primary action of hormonal contraceptives is to shut down a healthy body part. One of the first tenants of medical ethics, under the credo, "Do no harm," is that the body must be kept whole unless the damage done to a body part of physical function threatens the health of the individual. I often use the ridiculous example with students of asking a doctor for an amputation just because you don't like your arm or your leg. No doctor who respects his profession would do it. Yet, they willingly shut down a woman's fertility system so that the patients can have sex without consequence. That's not right. The erosion of this medical ethic is already apparent. I just read that a doctor in Great Britain amputates the legs of clients who claim to be turned on by the site of leg stubs. In addition to the primary function of the drug, hormonal contraceptives also have a lot of horrendous side effects. In fact, in the clinical trials of the first hormonal contraceptives, two women apparently died. The pill was approved anyway. Users of hormonal contraceptives put themselves at risk for blood clots, heart problems, strokes, and infertility in addition to a plethora of other potential problems. Considering the potential side effects, there are better and safer treatments for fibroids, endometriosis, and acne as well. For heaven's sake! Who would prescribe a medication with such side effects for acne? A pharmacist who knows about the primary and secondary effects has the right and the obligation to deny such dangerous medication to a client. That's what pharmacists are trained to do!

But the FDA approved oral contraceptives and doctors prescribe them, so they must be safe and ethical, right? The truth is that the medical community has its head in the sand when it comes to sexual health. A wonderful example of the medical community's denial of the truth when it comes to sexuality is the practice of sex change operations. A study by Johns Hopkins showed that people who get trans-sexual surgery do not become psychologically balanced and contented. Yet, despite this scientific finding, most psychiatrists and doctors continue to recommend such surgery for people with sexual ambiguity or gender identity disorder. The medical community is guilty of bad medicine when it comes to sexual health. They pander to politicians and cultural powers that want to see sexuality become free of consequences. Pharmacists and doctors who refuse to deal out contraception are the last defenders of good medicine. They may also be motivated by religious conviction, but the first argument they should make comes from good medical practice, not from their faith.

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