reasonable belief?

[martasfic]

Over at FB a friend posted a link:

http://www.addictinginfo.org/2012/05/15/kansas/

We all remember conscience clauses for a while ago; basically there's a new law in Kansas that sets up something similar for doctors and pharmacists. They can refuse to write or fill a prescription that "they 'reasonably believe' might result in the termination of a pregnancy."

Last night I got a call from my doctor, saying to call immediately - at home if necessary. Now, I'm fine. A biopsy of a cyst I had removed showed an infection, and the doc was out of the office the next day. He just needed me to start a special antibiotic. But for the hour it took me to get in touch with him, I was convinced it was something serious. Think cancer. And I knew I had dinky student insurance, so if it was something serious I wasn't sure if I would have to pay for it myself. I'm still shaken up from the whole experience emotionally, even though I'm fine physically and much better than I was yesterday. The thing is, I get how scary it is to not have control over your medical care. To have to trust in someone else's help to get the treatment you feel like you need - I don't know that it matters whether we're talking about your back or your uterus.

So I feel really bad that I'm not more empathetic here. I should be. I think I'm just worn out with all the talk over contraception coverage and access lately; it all seems unreal and remote, somehow. So what really got me was the "reasonable belief" thing. If we read that literally, it seems like it could actually help the situation, because - going by the dictionary definition of reason - you'd need a fact for why such-and-such a drug is likely to actually terminate a pregnancy. Now, maybe we can split hairs over whether a pregnancy just means having a conceived fetus inside you or whether it also requires that fetus is part of you (i.e. it's implanted). And maybe you can say that some emergency contraception prevents implantation (so a conceived fetus is essentially killed, or at least denied what it needs to live).

But there are many other pills that don't work that way. As you guys have explained to me on this very blog, there's some BC you can take after sex that prevents fertilization. That keeps the pregnancy from ever happening in the first place, even if you want to say pregnant means "there's a fertilized egg inside me."

But is that what the lawmakers mean? From past conversations I know this isn't how many people will read "reasonable." (I'm speaking generally, about students and fellow adults I've seen use the word time and time again - not necessarily the Kansas lawmakers.) The word reasonable literally means having evidence, having facts; but I suspect for a lot of people this will be read as "having followers." So if a certain % thinks the morning-after pill terminates a pregnancy, then that pill can be denied to women who want it. Facts be damned.

Which is a scary state of affairs, indeed.

Comments

[dreamflower]

The Mid-West is one of the most politically backward places I have *EVER* been-- it makes the Deep South look enlightened!

I have to say following the link, though, that some of the comments were hilarious-- a bit crude and more than a little bitter, but very funny anyhow!

The rationale behind a "conscience clause" seems reasonable, until you realize that it is weighted in favor of a person whose conscience is against helping women prevent unwanted pregnancies. What about the conscience of the person who believes that poor women should be entitled to have birth control? Is there a bill that would protect them if they decided to fill the prescriptions at a free or reduced cost in spite of what their employers thought? It would not be taking any more money out of their pockets than refusing to fill them at all!

Once someone compared making a person fill a prescription for contraceptives to making a person take a job as an executioner! But the truth is no one "makes" a person take a job. If a pharmacist objects to filling a prescription a doctor gives a patient, then maybe said pharmacist should find a new line of work.

As for these lawmakers, I cannot understand them or even begin to grasp how their minds work. I am so far from their POV that they might as well be Martians or something. I suppose most of them "mean well", but their definition of "well" is not something I can figure out.

[marta-bee.livejournal.com]

Interesting point re: conscience clauses. Here in New York it's quite common for restaurant franchises owned by Muslims to not sell pork products. There's a Subway sandwich shop here where all the salami, bacon, etc. uses turkey substitutes. I find myself wondering how they'd handle it in Topeka, if a Muslim worker insisted he not handle or sell pork products that were against his conscience? (Or even if businesses tried to set up similar rules based on the owners' part.)

Re: stereotypes - funny how that works out. I still see the "redneck" stereotype tossed around in the news about southerners, but going just by the legislation, the Midwest seems much more extreme than the South these days. Of course, I'm sure there are good, sensible people in both places.

[celandineb.livejournal.com]

If a pharmacist objects to filling a prescription a doctor gives a patient, then maybe said pharmacist should find a new line of work.

What dreamflower02 said. It is totally none of the pharmacist's business what the prescription is for; they have NO RIGHT to interfere in a legally given prescription.

There is no other line of work I can think of where such a "conscience clause" would be even remotely acceptable. Can I refuse to check out Bibles and theological tracts at my library because I think they are totally fiction, and potentially dangerous? Can a good Muslim or Mormon take a job at a liquor store, and then refuse to sell alcohol? No, and no; in either case the person whose conscience is (supposedly) violated by the normal activities of the job would simply be expected to get another job.

And "reasonable" in this instance is just going to be construed to mean "if that person doesn't like it", regardless of any evidence or reason. I can almost guarantee you that.

[mrowe.livejournal.com]

Ah... I do agree with you, but here in the Netherlands there is in fact a 'conscience clause' for civil servants performing marriages: if they object to same-sex marriages on religious (and afaik only christian denominations) grounds, they don't have to perform them. There is a clause that it must be possible for people to get married everywhere, so a colleague steps in in that case. Also, iirc, the get-out-of-equality-free-card is only available to people who had the job at the time the law changed.

[celandineb.livejournal.com]

Huh. I would disagree with that exemption, too; it's none of their effing business, and their sect doesn't have to recognize the marriage, so they should have to perform the ceremony. At least newer employees don't get to have their beliefs trump those of the people they are supposed to be serving, whose actions are totally legal.

The other thing about these pharmacist and doctor "conscience clauses" is that it is far too often not easy, sometimes not reasonably possible, for a person to get the prescription given or filled elsewhere. There's a heck of a lot of open space in the midwestern United States, and many little towns might have just one pharmacy (or none); the next closest could be 50 miles away.

[marta-bee.livejournal.com]

I think I'm more sympathetic to people with genuine moral objections to what their work requires of them than you seem to be. People on both side of the equation have moral considerations here. So I'm not going to say "it is totally none of the pharmacist's business what the prescription is for" - they do have an involvement in that decision because they have to fill it. Of course, as you say, the pharmacist chose to take a job as a pharmacist which makes things different. If you truly believed contraception was immoral, you need to not put yourself in a position where you have to fill those prescriptions. And that means giving up the job. You can't have your cake and eat it too.

The reason I can't get on board with what you say is it reduces the pharmacist as a means to fulfilling the patient's needs. The pharmacist has a moral decision to make, too, if this is a moral issue for her. Trouble is, the decision this bill wants to give her isn't a legitimate one.

[celandineb.livejournal.com]

I have no problem with folks having moral objections to certain prescriptions; I may think they are idiotic, but I certainly agree that they can have objections.

BUT then they have NO BUSINESS being a pharmacist. Because the job of a pharmacist is to fill any legitimate prescription with which s/he is presented. That is their purpose. If they refuse to fill a prescription, they are not doing their job and should take a different one. Otherwise their objections trump the patient's rights. Huh-uh. Not okay at all. The patient does not have options; s/he needs that medicine, stat. The pharmacist could have gone into many other occupations.

So I am not at all okay with "conscience clauses". I think anyone who would need to invoke such an exception ought instead to be required to find another job.

[ithilwen.livejournal.com]

I have no sympathy for those pharmacists and their precious, precious consciences. Either fish or cut bait. If they find filling a legal script so very morally difficult, they can get off their fucking fat asses and find another job. No one is required to go to pharmacy school; they knew what they were signing up for when they joined the profession.

Patients come first, always. If I can deal with that, so can a pharmacist. The ONLY legitimate reason for a pharmacist to refuse to fill a script is if the medication would directly endanger the patient; no other reason is acceptable. There's a cost to being a licensed professional.

[celandineb.livejournal.com]

Hear, hear.