My Conscience Made Me Do It
So, over at The Corner this morning, K-Lo (who was obviously saving herself for the Pope and now realizes that her life is meaningless) pointed me to a defense of conscience clauses for pharmacists opposed to birth control in the LA Times today. Naturally, she thought it was great, which means it's pretty awful. The author is syndicated columnist Crispin Sartwell, who has written numerous books on philosophy, aesthetics and anarchy and teaches political philosophy at Dickinson College in Carlisle, PA. I do not know very much about Mr. Sartwell, and I do not profess to be a philosopher or even to have read his books (although I will admit that I wouldn't mind reading the Emma Goldman section in his book Extreme Virtue: Truth and Leadership in Five Great American Lives), but I strongly disagree with the premise of his column, i.e. that pharmacists should be permitted to refuse to dispense medication "at which their conscience balks" in the name of individual liberty. Here's his entire column (with helpful comments from yours truly):

I once worked in a philosophy department in which one of the professors was active in NAMBLA, the controversial North American Man/Boy Love Assn. The secretary, a deeply religious woman named Judy, was assigned the task of typing up his man-boy love book manuscript and sending it off to the publishers.

She came close to quitting, but she was the sole provider for three children. Finally, she held her nose and typed one-handed.

First, let's talk about the comparison here. Is it fair to compare a pharmacist being asked to dispense medicine legally prescribed by a doctor to a woman being asked to type up a manuscript advocating an illegal relationship frowned upon by the great majority of society? And what if the professor were simply writing a book advocating relationships between older men and teenage girls? Was it the sex itself that bothered Judy or the same-gender aspect of it? What if the professor was gay and had written a novel about his sexual experiences? Should Judy also have the right to refuse to complete the task assigned in that case? (We'll get to some options for Judy that seem to escape the author in a minute.) Professor Sartwell's comparison deliberately skews the argument and is an attempt to make the reader equate dispensation of birth control with advocacy of man/boy love.

I think of Judy when I think about the issue of whether pharmacists should be permitted to refuse to fill prescriptions at which their conscience balks. The conscience of some pharmacists balks at birth control and morning-after pills.

Illinois Gov. Rod Blagojevich on April 1 issued a 150-day emergency order requiring pharmacists to fill contraceptive prescriptions after a Chicago druggist refused to dispense birth control pills. Elsewhere, reproductive-rights groups are pressuring lawmakers to establish professional-duty laws for pharmacists.

If your conscience motivates you that strongly, shouldn't you be willing to live with the consequences of any decision (such as quitting a job or losing a license) that results from the dictates of conscience? Nonviolent protest often lands the protester in jail. That is a consequence of a decision to protest a policy or practice which goes against one's conscience. If you are unwilling to live with the consequences of following your conscience, don't complain to me about it.

I personally am no opponent of birth control of any sort or, for that matter, of abortion rights. But people whose jobs require them to violate their own deeply held convictions ought to refuse to do the job, and any politician who upholds freedom or dignity must uphold their right to do so.

Great. I don't object to a pharmacist's right to refuse to do the job, either. If you have a moral objection to dispensing specific medication, don't become a pharmacist. Presumably, when these individuals went to pharmacy school, they were taught that birth control is one of the most common medications prescribed in this country and that the likelihood they would be given a birth control prescription to fill would be very high. That was the time for them to experience their crisis of conscience, not after they accepted the responsibility for dispensing medication. For example, I am an attorney, which carries with it certain professional obligations. I could conceivably be directed by a court to accept the defense of a person charged with a particularly heinous crime who is unable to assume the cost of their own defense (as recently happened in the case of the BTK killer), and my duty as an officer of the court would be to defend that person to the best of my ability, regardless of my personal convictions regarding the crime. If I didn't want to face that possibility, then I should never have chosen to go to law school, take the Bar, and become an attorney. That seems simple, right?

What you should ask yourself in this case is not whether you think people should have access to birth control, but whether you should be required to do things that violate your deepest convictions.

Bullshit. The issue here is when the two rights (right to birth control and right to free exercise of religion) collide--which should take precedence? If they don't want to be responsible for dispensing birth control, they shouldn't be pharmacists. No one forced them to go to pharmacy school, and no way am I going to believe that they didn't know birth control would be part of the job description.

Should a soldier be required to torture prisoners, for example? Should he refuse to do so if ordered?

Another stellar comparison there. WTF?? Torturing prisoners is a violation of the Geneva Convention, and any soldier who refuses to do so if ordered by a superior officer would not only be complying with his conscience, but also with the Uniform Code of Military Justice. Soldiers have an obligation to refuse to follow illegal orders; all orders to commit war crimes are illegal.

Should a liberal corporate peon be required to contribute to the Republican Party?

Well, again, forcing someone to contribute to a particular political party against their wishes would also be illegal. Notice the pattern here? Let's say I work for a conservative law firm. If my boss ordered me to contribute to Bush-Cheney '08 (Slogan: Because Term Limits are Only for Pussies (and Democrats)!), I would refuse. It's possible I could lose my job over it. (It's also possible I'd sue the pants off them, but that is neither here nor there.) I would have to suffer the consequences of my decision. Here, the pharmacist is asking another person (or couple) to pay the price of his or her beliefs.

Should a Christian secretary have to assist in the advocacy of man-boy love?

Oh, dear, now we're back to poor Judy and her three children that will starve if she quits her job. But, reading this touching story, I have a few questions. Did Judy ever tell the professor that typing the manuscript made her uncomfortable? Did she complain to the administration? Did she inquire if there were other support personnel (such as students in a work-study program) unencumbered by Judy's religious beliefs and willing to take on the task? Were her only options, type, quit or get fired? Somehow I doubt it. And Judy's situation is light-years away from the pharmacists at issue here. This was probably not a job requirement that she anticipated when she took the job (although who knows, maybe the professor told Judy he was all for man/boy love and her job would require her to type documents advocating such relationships). And the refusal to do her job would only inconvenience the professor, not jeopardize his medical care.

Sadly, these sorts of questions cannot be answered according to whether the act involved is objectively right or wrong because, in every case, that's the heart of the dispute and irresolvable by organizational policy, legislation or court proceeding.

Wrong. Both the soldier and the campaign contribution examples have already been resolved with legislation.

They are questions that are answerable only for you as you face the decision, as you face yourself. It would be nice not to confront any moral dilemmas, to slough off all responsibilities onto bureaucracies, to be blameless and pure even as you do things that you find abominable. That's nice for individuals because it makes them blameless for any crime, as long as it appeared to follow from one's function or role in the bureaucracy.

Notice how the second to last sentence deals with things "you find abominable" and the next sentence is about "crime." Two different topics there, pal. Moral dilemmas are a part of life, and most people have to make compromises every day. But these pharmacists are dispensing birth control, birth control which has to be taken at the same time every day to be effective. If Sartwell and others have their way, it is not at all inconceivable, particularly in small towns with only one pharmacy, for a pharmacist to be able to control the sexual practices of women seeking to obtain legal birth control. And let us not forget the sacrifices women like Margaret Sanger made just to spread the news about birth control to American women desperate for a way to control their health (despite what the fundies would have you believe, birth control is about health, not just about sex). I, for one, am not going to let her legacy take a back step to the "conscience" of some religious freak who thinks women are nothing but baby factories. Somewhere in all this is an unwritten assumption that birth control is "optional" and so the pharmacist's right should trump the woman's right. These people have no right to allow their conscience to infringe upon my life.

Let's take another example. Professor Sartwell says he is not against abortion rights. Well, how about the conscience of Eric Rudolph? It led him to bomb abortion clinics. Is that okay, too? (Interestingly, in a previous LA Times column, Sartwell may have answered this question: "If there should be a law against anything, most Americans would agree, it's murder. Radical anarchists might differ — they might say that murder, and any other act, should be a matter merely of individual conscience and not of law." From the little I can gather from a cursory review of his texts and syndicated columns, Sartwell is a self-professed anarchist. So I guess murder is also okay, if your conscience made you do it.) Anyway, back to his current column:

But, of course, it is a disaster for human beings in general because when individuals have no responsibility, they start robbing, raping, pillaging and murdering. And why not? There's absolutely nothing wrong with that if it's part of your job.

The modern world of bureaucracy is intent on expunging every individual and making each a mere space on the flow chart. Human beings are liquidated into functions: secretary, pharmacist, police officer, fry cook. But you can't offload your beliefs that easily, and when your job requires you to do something that you regard as evil, it's you who does it, not your space on the flow chart. And in the attempt to reduce people to functions lurks the nightmare: It's been the justification for the worst things our species has ever done. It's the Nuremburg defense on a smaller scale.

If you claim the right to behave in accordance with your conscience, then you also must accord that right to all others, even pharmacists.

Nothing else is compatible with human dignity, decency, individuality and truth. So as I urged Judy not to type, I urge these pharmacists not to dispense.

As with just about every other moral question, where do you draw the line between individual conscience and the rights of others? This blogger draws the line on the side of the women whose legal right to birth control is being violated by a pharmacist's religious beliefs.

ps--There is also of course a separation of church and state issue here, since pharmacists are licensed and controlled by state boards. The power to dispense medication is a right granted by the State. Imposing your religious beliefs on individuals seeking medication is a clear violation of the separation of church and state doctrine (you know, that doctrine that the fundies say doesn't exist?).
- posted by TJ @ 9:51 PM