- BOSTON -- To begin with,
I don't believe that anyone should be compelled to do work they regard
as unethical. History is full of heroes who rebelliously followed their
consciences. It's also full of people who shamefully followed orders.
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- For that matter, I believe that companies and institutions
should have a code of ethics. What is the alternative to corporate responsibility
and public morality? Enron?
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- So I approach the subject of conscience clauses rather
gingerly.
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- The very first such laws offer an exemption for doctors
in 47 states who don't want to perform abortions on moral grounds. That
seems to me a matter of common decency. Doctors are not automatons who
leave their beliefs at the operating room door.
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- It also seems like common sense. Who would want their
abortion performed by an opponent?
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- Gradually, however, we have had the incredibly expanding
conscience clause. In 10 states health care professionals can conscientiously
refuse to provide contraceptives. In 12 states they can refuse to do sterilizations.
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- Indeed, last year the government decided that entire
hospitals and HMOs had the right to deny these services without losing
federal funding. Never mind that it is not clear who owns the conscience
of a hospital: A church hierarchy? A board of directors? The doctors? The
community? Or the taxpayers who foot the hospital bills?
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- Now, we have gone even further. Conscience clauses are
being proposed to protect professionals who refuse to follow end-of-life
directives and refuse to use treatments from stem cell research. Most notably,
we have bills in a dozen states to include pharmacists who won't fill a
prescription.
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- It's the pharmacists who are getting the most attention
right now. In just six months, there were about 180 reports of pharmacists
who said no. One refused to fill a college student's birth-control prescription.
Another refused medication to a woman who had suffered a miscarriage.
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- This has led to a counter-bill in California that would
make pharmacists tell employers of their objections in advance and be prepared
to make referrals. It's led to a rule by the Illinois governor that every
pharmacy -- though not every pharmacist -- must fill prescriptions, "No
delays. No hassles. No lectures."
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- Karen Brauer, who heads a group called Pharmacists for
Life that claims 1,600 members, compares them to "conscientious objectors."
But it isn't that simple.
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- The pharmacist who refuses emergency contraception is
not just following his moral code, he's trumping the moral beliefs of the
doctor and the patient.
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- "If you open the door to this, I don't see any place
to draw a line," says Anita Allen, law professor at the University
of Pennsylvania and author of "The New Ethics." If the pharmacist
is officially sanctioned as the moral arbiter of the drugstore, does he
then ask the customer whether the pills are for cramps or contraception?
If he's parsing his conscience with each prescription, can he ask if the
morning-after pill is for carelessness or rape? For that matter, can his
conscience be the guide to second-guessing Ritalin as well as Viagra?
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- How much further do we want to expand the reach of the
individual conscience? Does the person at the checkout counter have an
equal right to refuse to sell condoms? Does the bus driver have a right
to refuse to let off customers in front of a Planned Parenthood clinic?
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- Yes, we want people to have a strong moral compass. But
they have to coexist with others whose compasses point in another direction.
In the debate over conscience clauses, Frances Kissling of Catholics for
a Free Choice says properly, "There is very little recognition that
the conscience of the woman is as important, let alone more important,
than the conscience of the provider."
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- Pharmacists don't have the same claim to refuse filling
a prescription as a doctor has to refuse performing an abortion. But there
are other ways to exercise a private conscience clause. Indeed, in a conflict
between your job and your ethics, you can quit. It happens every day.
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- When Thoreau refused to pay taxes as a war protest, remember,
he went to jail. What the pharmacists and others are asking for is conscience
without consequence. The plea to protect their conscience is a thinly veiled
ploy for conquest.
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- This is not easy stuff. But in the culture wars we have
become awfully enamored of moral stances. Have we forgotten that what holds
us together is the other lowly virtue: minding your own business?
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- To each his own conscience. But the drugstore is not
an altar. The last time I looked, the pharmacist's license did not include
the right to dispense morality.
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- (c) 2005, Washington Post Writers Group
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- http://www.workingforchange.com/article.cfm?itemid=18859
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