Letter from William J. Perez, MD, MA to Washington State Board of Pharmacy

March 8, 2006

Washington State Board of Pharmacy
c/o Steve Saxe, Executive Director & Asaad Awan, Board Chair
Department of Health
P.O. Box 47863
Olympia, WA 98504

Subject: Conscience Clause

Dear Board Members,

I write to support the pharmacists of the State of Washington and their right to retain a meaningful conscience clause in order to protect themselves and their patients. It is my understanding that after much debate, the State Pharmacy Association crafted just such a clause and approved it, only to now have it challenged by Planned Parenthood and other advocates of abortion.

I work with pharmacists on a daily basis, and have done so for many years. There are few professions for which I have more respect. Pharmacists as a group are extremely intelligent people who make a big difference to both doctors and patients in improving health care and making it safe. Naturally, they come from all walks of life and have varying positions on issues, such as abortion, that divide our entire culture.

Pharmacists are also called upon to make judgments on a constant basis. They must clarify, interpret, instruct and counsel. They are an invaluable resource to our community. Pharmacists are not simply “medication dispensers” or human vending machines. As much as any other, this is a profession which requires clear thinking, integrity, and indeed, a strong moral compass. Sadly, there are those who would crush this moral compass in our pharmacists in order to promote their favored policies.

Make no mistake: Despite what you may hear from lobbyists, this issue is about the rights of pharmacists versus the dictates of powerful special interests. Planned Parenthood would have you believe it to be an access issue. This is a red herring. The issue before you is a pharmacist’s right of conscience. The pharmacists I know are as fine a group of patient advocates as I know. To lecture them on “putting the needs of patients ahead of themselves” is condescending and insulting. If a pharmacist refuses to fill a prescription, it is because he or she is convinced great harm could be done by doing so. This is true whether Planned Parenthood agrees or not.

I understand that there has been an organized letter-writing campaign to your board as well as the governor in order to prevent pharmacists from exercising their right of conscience. A statewide group of professionals is to lose a right of conscience statement they crafted themselves after careful deliberation. This will be in order to placate those purportedly concerned with a hypothetical scenario about which you are sure to hear: This will probably be a rape victim in a one-horse, one-pharmacy town, who has no car, no phone, and no hope on this earth but to force a pharmacist to violate his or her conscience. I ask you to not allow yourselves to be manipulated by an organized lobby that has a much louder political voice than its support in the general public would justify.

Much of this debate boils down to one’s views on abortion. People can play games with words, but the fact remains that if a drug prevents implantation of an embryo, that embryo will die. Many people consider this to be a grave moral evil. Some of these people are pharmacists. Why do so-called “pro-choice” people wish to deny a principled choice to pharmacists? They are trampling on the rights of pharmacists for a political agenda. Are we becoming so beholden to the sacred rite of abortion that we are willing to force men and women to cooperate with it, even if they consider it gravely immoral, all so that a patient won’t have to drive to the next pharmacy? This would be draconian indeed, and an unconscionable imposition of a highly divisive world-view on people of good will.

With such an important issue, it is important that the board hear from both sides and decide your course of action in a fair manner. I respectfully urge you to allow the pro-conscience side to have an equal say, and to excuse any board members with ties to Planned Parenthood or similar organizations from voting on this issue, as they will clearly have a skewed viewpoint.
I wish to make a point here that I believe is extremely important; one that goes well beyond this particular issue. If we require pharmacists to violate their consciences on issues of grave importance in order to keep their jobs, we guarantee a group of pharmacists who have become comfortable violating an important code of ethics. I ask you, is this really a quality we want to ensure in our pharmacists?

Let’s be realistic. If there is a conscience clause (Scenario A), a woman seeking an abortifacient may, rarely, run into a pharmacist who cannot in good conscience fill the prescription. She might then have to go to another pharmacist in the same or a different location. In Scenario B, the pharmacist is coerced into filling the prescription against his or her conscience. In both cases, the woman gets the medication, but in Scenario A the pharmacist is protected as well. Why would we prefer Scenario B? Hyperbole aside, in the real world people will get the medications they want. The only issue is whether we will force the pharmacist to comply over and against all objections.

The talking points at the Planned Parenthood website make clear that they view pharmacists as drug dispensers, and that any exercise of judgment “interferes with the doctor-patient relationship.” As a physician, I can tell you that this is sheer rubbish. Pharmacists are capable professionals who must refuse to fill certain prescriptions.

If we are to consider unlikely, hypothetical scenarios, consider this one: A man comes in with a prescription for a drug known to be used for date rape, and the pharmacist has reason to believe that is exactly what he plans to do with it. Should she fill the prescription? Most of us would agree she should refuse, yet the position of those who oppose this conscience clause clearly states that she should suspend all thought, get out of the way of the “doctor-patient relationship”, and send him out the door with the drug. The only difference is the particular issue to which the pharmacist conscientiously objects.

Our nation’s founders recognized certain inalienable rights and our constitution reflects this. Wishing to sidestep these rights, and often the will of the people as well, abortion purveyors use well-funded lobbying efforts and the courts to impose their will on others. They are attempting to strong-arm and intimidate you. The Pharmacy Association worked hard and came up with a good policy. I urge you not to allow yourselves to be bullied into stripping their right to protect themselves and their patients.

We live in times that are both exciting and frightening on the biomedical front. Arriving on our doorstep (or already entering the building) are cloning, embryonic stem cell research, and euthanasia among other things. It is entirely possible that we may see fetal farms for organ transplants, experiments on prisoners or the disabled, human-animal hybrids, etc. Are you willing to let others dictate that pharmacists must buy into and cooperate with any and all biomedical technologies, or will you stand with the pharmacists for a sensible and reasonable conscience clause in order to protect them from the selfish interests of others?
As for me, I stand with the pharmacists.

With Respect and Gratitude,
William J. Perez, MD, MA
Staff Anesthesiologist, St. Clare Hospital, Lakewood, WA
Vice President, Washington State Catholic Medical Association