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Strategy Notes:
John Belisarius

The Appalling Elitism behind the Pharmacists' "Right of Conscience" Campaign

The current debate regarding whether individual pharmacists should have a "right of conscience" to refuse to sell birth control medications has been almost entirely composed of either straightforward arguments in support or opposition to the proposed "right" or the discussion of some compromise position that attempts to bridge the gap between customers' rights to buy legally prescribed medication and pharmacists' personal ethical views.

Yet, when one steps back for a moment to look beyond these limited terms of debate, an extraordinary fact quickly becomes apparent -- the proposed extensions of earlier "conscience" laws to cover pharmacists are profoundly and, in fact, grotesquely elitist. They actually propose nothing less then endowing a small group of Americans with a special class of new legal rights and privileges regarding moral/religious issues -- based essentially on their education -- while denying those same rights to everyone else. As a result, the proposed laws are not only basically unconstitutional in intent but also un-American in spirit and contrary to the egalitarian tenets of sincere Christian faith.

To see why this is so, it is only necessary to compare the proposed extension of the "right of conscience" to pharmacists with the purpose of the original "conscience" laws which were designed with doctors and operating room nurses in mind. It was not because doctors or nurses had advanced medical education or knowledge that special provisions were enacted for them, but because the nature of their work might obligate them to personally perform medical procedures they considered immoral, such as abortions or sterilizations, or to personally prescribe and administer abortion-inducing drugs. Granting a doctor or nurse with moral objections to these procedures the legal right to refuse to personally perform them was, as Ellen Goodman noted in a Boston Globe column, both "common decency" and "common sense".

Pharmacists in contrast, do not personally select medications, prescribe them or administer them. They dispense them in accordance with a doctor's instructions. Drug store pharmacists may have more specialized education and greater responsibilities then other retail salespeople, but when they package and sell a customer a product they personally consider ethically objectionable their individual moral involvement and responsibility - which is what we are talking about here -- is in absolutely no way greater or more direct then that of a ordinary convenience store cashier who sells condoms of which he or she morally disapproves or a supermarket, gas station or 7-11 cashier who sells cigarettes that he or she personally considers addictive and poisonous and therefore deeply immoral on ethical and religious grounds.

This is not an abstract issue. There are tens of thousands of retail sales workers who have lost husbands, wives and parents to lung cancer and who are deeply and sincerely disturbed and saddened every single day of their working lives by the moral implications of selling a product whose destructive long-term effects they know all too well. They feel serious moral guilt about selling cigarettes, but do it simply because it is part of their job.

Thus, any proposed individual "right of conscience" for retail sales employees cannot fairly or reasonably be limited to only the men and women behind the pharmacy counter. The people operating the cash register in the drug store may have less formal education then pharmacists and asking for age ID may be less complex then reviewing dosages and double-checking for allergies or incompatible drugs, but as human beings with personal moral and ethical standards, the cashier and the pharmacist are exactly and precisely equal and any new legal rights of conscience extended to one cannot properly be denied the other without violating the fundamental principle of every Americans' right to equality before the law.

In order to disguise this uncomfortable fact -- one which clearly makes the proposed laws constitutionally flawed -- the conservative activists managing the current campaign have resorted to elitist arguments that express a snobbery and contempt for ordinary Americans that can only be described as appalling.

Here, for example, is a statement published in USA Today by the legal council to the Health Care Right of Conscience Project of the Center for Law and Religious Freedom:

Forcing pharmacists to function like supermarket cashiers .will result only in fewer pharmacists for everyone as bright and talented young people decide against entering a profession that treats them like automated medicine dispensers.

And here is the conclusion of a letter published in the New York Times from a pastor of a church who is also the chief executive of a Pharmacy chain:

The last time I checked my license, the Commonwealth of Virginia stated that I am a professional. That means I have choices.

And a spokesperson for the American Pharmacists Association, (which is trying to find a compromise solution to this issue), admits that

Some people seem to say that a pharmacist is nothing more then a garbage man, and that's not what the average pharmacist wants to hear.

It is difficult to imagine more blatant and arrogant expressions of snobbish class elitism. "Bright" and "talented" pharmacists - "professionals", after all, not just "garbage men" -- have highly developed moral and ethical consciences regarding the products they sell and therefore deserve special legal rights of conscience. The illiterate morons who work at the cash register, on the other hand, aren't smart enough or good enough to deserve such special consideration.

This is so unfair, so un-American and indeed so contrary to the ethics of most sincere Christians as to be literally repulsive - and its time for the honest participants in this debate to start saying so. Either every single American retail employee who sells products to the public deserves to have a newly created "Right of Conscience" guaranteed by law or else we need to agree that existing laws covering the rights of retail employees, including retail pharmacists as well as cashiers, are appropriate as they are.

This is America. In this country we don't pass laws that say that pharmacists are more valuable and worthy as moral human beings then cashiers.