Access & Freedom of Conscience

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Will Truman

Will Truman is the Editor-in-Chief of Ordinary Times. He is also on Twitter.

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88 Responses

  1. Avatar greginak says:

    The only thing you haven’t mentioned, since it doesn’t seem directly germane, is one big reason why abortion services are so hard to find. While part of the reason is some medical professionals feel it is wrong to perform them there has also been a dedicated campaign to something that looks a lot like terrorising/threatening/harassing abortion providers.

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  2. Avatar Teacher says:

    The problem, well one of them at any rate, is that abortion and contraception are different ideas.  If you talk to any group of pro-life people, a large number (how large? no idea) will concede that during the first months it may be permissible.  Many will concede that the life of the mother (in the immediate, not the “if I have a baby I’ll be scarred for life”) makes it permissible.  Many will say that you really should only permit them before a clear and specific heart beat can be heard.  At any rate, suffice it to say that Abortion on the pro-life side is not bimodal.  It is a continum.

    But contraception is a different beast.  Yes it resides with a continum but is about, really, only two people:  Doctor and Patient.

    Abortion remains a thorny issue because when you look at the Pro-life arguments, if you are willing to respect them as arguments and not dismiss them out of hand, you see that for the most part it boils down to “the life of the unborn”.  Those are issues with 3 participants:  Woman, Doctor, Unborn.

    And maybe the unborn should not be considered a participant or a factor.  I’m not going to debate that on its merits.  But Contraception, for the most part, is based on something else.  It’s based on stopping that life from forming and thus being taken.  It’s based on choices between a doctor and a patient.

    The RCC (of which I am affiliated) made a horrible mistake in hitching their horse to this wagon and Obama did it one worse by throwing every woman in this country under the bus.  Here’s what should have happened if people had gotten their heads out of their anuses:

    RCC:  While we regret the choices of some of our employees and continue to encourage all who work for us to live a pious and just life, the reality is that we cannot force our beliefs on anyone else, nor is it proper for us to insert ourselves into the private affairs of the women in our employ.  We also recognize that “the pill” has many other medical benefits germane to women’s health and as such cannot deny it’s perscription because we find one such use objectionable.  While some will abuse certain medications, we cannot in good faith block the use of those within reasonable means.

    Obama:  While I respect each Catholic’s right to practice their faith as they wish, it remains that medical issues, such as the use of perscription medications to prevent pregenancy, can, and indeed ~must~ remain between a doctor and his or her patient.  There is no place for any employer to insert themselves into that conversation.  We are not prepared to usher in an era of insurers and employers making medical descisions for their employees.  That simply isn’t a place for their input.  It’s not a place for me.  It’s not a place for Speaker Bohner and it’s not a place for the RCC.

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    • Avatar Will Truman in reply to Teacher says:

      I agree with all of this. In my view, contraception and abortion are very different. But I also hear them talked about in the same way quite frequently, both under the rubric of “reproductive freedom” on the left and the Catholic Church bundling the two.Report

    • Avatar Kimsie in reply to Teacher says:

      Ten points for this!

      The unborn child MUST in any reasonable decision have a seat at the table. Maybe even a highchair.

      I believe that a woman should be free to make her own decisions… but I also believe strongly that people should be incentivized to “do the right thing” (which varies on a case by case basis, but is generally skewed toward have the child).Report

      • Avatar Morat20 in reply to Kimsie says:

        So if I’m in need of a kidney, and you have a match, the law should priortize taking it from you?

        You have two, after all. Sure, there’s a risk to you and your body will always bear the marks and maybe you’ll have healh problems down the line, but hey…

        Isn’t my life worth it? Shouldn’t the law give me a seat at the table? A priority even? it’s some discomfort and risk to you — but the bulk of it would be over in months!

        It’s life to me. In fact, I’m starting to wonder why you get a choice in it at all….Report

        • Avatar Patrick Cahalan in reply to Morat20 says:

          No, the law should not demand it of you.

          However, I may still have a moral obligation to give it to you.  That’s between me and my understanding of morality, not between you and me and the law.Report

        • Avatar greginak in reply to Morat20 says:

          Well the state can provide uni heath care so if someone needs a kidney and someone is willing to cough it up, so to speak, they can get life saving care.Report

        • Avatar Teacher in reply to Morat20 says:

          Maybe the state should.

          Of course, the difference between your kidney and abortion is that the person with the good kidney did nothing (generally) that had your need for a kidney transplant as a logical consequence.  There has only been one case in recorded history of someone becoming with child without having sex and even that’s debatable.  Now, there is also the Rape/ Incest qualifiers to consider (as a woman made no choices there) and I will grant that there are many in the Pro Life movement willing to make an exception there because of that.

          Also, I am not the only means you have to life.  There are many other matching kidneys.  However in the case of a fetus, it’s kinda where it’s going to be.

          But this goes to show the single most important point:

          Abortion is still a discussion about 3 people and where our priorities as a society should be.

          Contraception, however, is one between two people.  And neither of those people is Obama, the RCC or my employer.

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          • Avatar Murali in reply to Teacher says:

            Contraception, however, is one between two people.  And neither of those people is Obama, the RCC or my employer.

            Then, according to that measure, why should any of them have to pay for it. Remember, the exemption here is not about laws that prevent the sale of contraceptives. It is about forcing the RCC and other employers to fund contraceptives (specifically) even if they find such funding problematic.Report

            • Avatar Just John in reply to Murali says:

              Because there are a bunch of things we all pay for whether we agree with or use them because that’s the only way we as a society can have them: roads and highways, auto insurance, wars, clean water, clean air, national parks, prisons, rehab programs, space programs, foreign aid, mortgage interest deductions, tax-free churches.Report

              • Avatar Murali in reply to Just John says:

                There is a difference between paying taxes to a government which then spends it on things which I might find morally objectionable and being forced to spend money on things which I find objectionable. For example, I may pay taxes (if I were working) which might go to some people who cannot make ends meet who may then decide to spend it on things I morally disapprove of like meat. That’s fairly far removed and different from me paying for non-vegetarian food when I bring friends out for dinner. Where I am directly involved, I can reasonably take myself to be more directly involved than if it was through my taxes. Under such circumstances, my purchace of a non-vegetarian meal for my friends would be the kind of thing which would involve me aiding and abetting in the commission of some sin in a way that merely paying my taxes which are then received by someone who could then sin if they wanted to.

                Besides, contraception is not a public good. It is both rivalrous and excludable.Report

              • Avatar Patrick Cahalan in reply to Murali says:

                Where I am directly involved, I can reasonably take myself to be more directly involved than if it was through my taxes.

                Why?

                Aside from the fact that it’s psychologically easier.

                Is that enough?Report

              • Well, the psychological barrier is a big point right? With the mandate, the government may end up forcing me to do something that I feel really uncomfortable doing. That gives a strong prima-facie reason against the mandate.Report

            • Avatar Teacher in reply to Murali says:

              Because under the new laws if something is considered a medical nessecity, then there must be coverage for it.

              Insurance companies can’t say “we won’t cover heart surgery” and they can’t say “we won’t cover birth control”.  In short the laws, as I understand them, say that if you need it for general health, then it has to be covered, which is a specific answer to the problems of some policies being sold that had big gaps in coverage and people not ~reading~ these policies until after they realized they needed something in that gap.

              Realistically we could all just read what each policy covers and then buy the policy that best suits our own needs.  If we know we’re not going to have a baby, why pay for a policy that covers c-sections?  But, we are horrible about predicting our needs; a basic human flaw.  Likewise, everyone pays less on average if we all pay into the pot that covers all things that are “medically nessecary”.

              But the RCC can’t challenge the rulings that Birth Control is part of general women’s health.  That would mean arguing with too many honest to God experts.  So instead they’re playing the religion card and I’m profoundly embarassed by it.  Embarassed enough that Baby Teacher isn’t baptized yet and it’s possible that she might not be.

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              • Avatar Murali in reply to Teacher says:

                But it is a question of whether the new laws are reasonable in the first place right? The current RCC issue is a challenge to the reasonability of the new law. However, such a challenge cannot be answered by merely saying what the law requires. Such a response would pre-suppose precisely what is under dispute: Are the new laws reasonable?Report

  3. Avatar North says:

    This is all well in good Will. Since I don’t believe in positive rights I don’t believe in some kind of positive right to compel a medical professional to perform an abortion for you.

    But surely you’ll conceed that not only do abortion foes face zero possability of being compelled to perform abortions in the US; they also have their collective snouts driven very deep into the business of women who choose to have abortions and those medical professionals who choose to provide them. Whether it be via an endless series of creative mounting regulatory indignities, the constant drumbeat of total prohibition or the extralegal acts of intimidation or outright terror the pro-life forces in the US are very far from the meek minding their own business side of this subject.Report

    • Avatar Will Truman in reply to North says:

      But surely you’ll conceed that not only do abortion foes face zero possability of being compelled to perform abortions in the US;

      I believe that is true in the current political environment. In part because of the strength of the pro-life movement. Political environments are subject to change, though. I can’t find the story, but I recall movement actually being made to require it in specific circumstances (emergency care, when there are other lives at risk, something to that effect).

      If you want to argue that the medical community should do more to facilitate doctors that would so choose to be able to perform abortions (at least getting them training), efforts are being made to that end. Perhaps they will be successful. We’ll see.Report

      • Avatar North in reply to Will Truman says:

        I’m just reminding you (and myself) that one side of this affair would by and large be happy (ecstatic) to agree to never force anyone who objected to abortion to involve themselves with it in any way… so long as those who objected to abortion promised to not involve themselves with it in any way!Report

        • Avatar Teacher in reply to North says:

          The problem with the “Don’t like Abortions, don’t have one” argument is that no one polls the fetus about its opinion of the matter.  If we ever devise a way to ask a fetus how it feels about being aborted, my stance on the matter will radically change.

          Otherwise the analogy is quite akin to saying “Don’t like bank robberies?  Don’t rob a bank” or “Don’t like drunk drivers?  Stay off the roads!”Report

          • Nob Akimoto Nob Akimoto in reply to Teacher says:

            What about…”Don’t like abortions, then make them less likely”?Report

            • Avatar David in reply to Nob Akimoto says:

              I have the same feelings for those who protest abortion clinics as I do the idiots who stand outside a liquor store harassing poor thirsty gentlemen like myself who wish only to purchase a dram or two of brandy and go back home.Report

            • Avatar Teacher in reply to Nob Akimoto says:

              Hey.  Count me among the converted on that.  I totally support a lot of initiatives to discourage the circumstances that make abortions seem “nessecary”.

              And yes I think the RCC is full of crap with their denial of birth control to employees, partly for this various reason.  At the end of the day people are going to have sex and they’re going to get pregenant if they don’t do something to not get pregnant.  End of story.Report

              • Avatar James in reply to Teacher says:

                What you’re forgetting is that the Roamin’ Catholic Pedo Society is “consistent” in their demands.

                They demand that there be no sex out of wedlock – so the right of women to actually be, y’know, sexual without being shackled to a man is not a thought for them.

                They demand that sex within wedlock be “primarily for the purpose of procreation”, so even if a woman marries a guy she likes and they manage to keep up a sexual interest in each other over the years, she’s just stuck with the consequences of getting knocked up over and over like some deranged quiverfull lunatic unless she turns round and says enough is enough, either you get snipped or we say to heck with the demands of the church, protection it is.

                They’re “consistent.” Which is what you get from an organization whose pronouncements of the past at least 600 years have been the pronouncements of a bunch of cloistered homosexual and asexual males who have absolutely zero interest in treating women as equal human beings (and far too much interest in the behinds of prepubescent males) or ever existing in the real world.Report

  4. Avatar Snarky McSnarkSnark says:

    Holy crap.   You really wanted to wade into this?

    It is unfortunate in the long haul, but after WWII, we more or less established our national health-care system as employer-provided (thanks to a lack of a national health care system, a tight labor market, and a number of tax and other incentives provided by the government).   It doesn’t look like this will change any time soon–in fact, Obamacare pretty much locks in employer-provided care with a mandate for all but the smallest companies to provide it.

    For many, many reasons, this is not a very effective, efficient, or fair system.   But it is the system we have.   And until we change it, that’s the system we have to deal with.

    So I understand the contraception debate, and have sympathy for all sides.   But my personal judgement is that the Obama Administration has drawn the line in pretty much the right place.   Since health care is now mandated, and we are more closely tied to a system of employer-mandated care, any regulation has to be of that system, and not whatever other arrangement we might prefer.   And birth control is so central to health care, and to the general welfare, and–for that matter–modernity, that mandating it is, on balance, a positive public good.

    It would certainly be preferable (n an abstract sense, at least) if the government never had to compel us to do anything that offended our conscience.   But it does it all the time:   I had to help fund the Iraq war and the torturing of suspected terrorists.   Conservatives have to contribute to welfare programs that they find distasteful, and for the inauguration of a mulim, Kenyan socialist.    And allowing birth control to be part of mandated health plans strikes me as no more onerous than many of the other things that government compels me to do or pay for.

    Abortion is another matter.   I support abortion rights, and consider them fundamental to an advanced society:  without them, people can lose control over the course and outcome of their lives;  and unwanted children tend to live much crappier lives than those that were welcomed and planned for.

    Nevertheless, I have sympathy for much of the “pro-life” position.   I don’t believe that a just-fertilized zygote is a human being, or subject to all the rights and privileges of an actual person.   And I also believe that a fetus at the seventh month of development is much, much more than a mass of cells.    Unless you believe in ensoulment at the very moment of fertilization, the “humanity” of an embryo is something that exists on a continuum between fertilization and birth.    I don’t know that a heartbeat is where I would draw the line, but most Western countries draw it between the third and fourth month.   That seems about right for me, and I think it is a middle ground around which some consensus could be drawn.

    The way that “pro-choice” people frame their argument is pretty dim, and morally blind.   Yes, women should have the right to control their bodies as a general principal.   But when another human life is at stake, it seems to me to be inadequate.   There are tactical reasons, I suppose, that the “pro-choice” advocates never grant the growing “human-ness” of the developing embryo, but to address the issue of abortion without granting that central fact leads to some pretty chilling conclusions   (I have actually spoken with abortion advocates who aver that a woman has the right to terminate a pregnancy up until the moment that the entire baby has exited the womb, and the umbilical cord has been cut).

    I don’t think anyone in this fight except the bishops are conflating abortion and contraception.   One seems an unalloyed social good, and the other is fraught with moral dilemma, conflict, and arbitrary lines. And it is an absolute abuse of the “slippery slope” argument to assert that state-mandated availability of contraception will lead to a requirement that any individual must perform abortions.

    In general, Catholics object to contraception (to the degree that they do at all) because it is part of Catholic doctrine.   But even those supportive of abortion rights, like myself, will be forced to acknowledge that it’s fraught with moral hazard, and shaded lines.   So, if someone objects to contraception because it’s part of their doctrine, fine:   you don’t have to use it.   But to compel that choice upon others?   Nope.

    I cannot predict what our moral culture will look like in 100 or 200 years.   But, abortion has been with us since before we were a country, and has been legal for almost all of that time (with the fetal “quickening” being the point at which the line was drawn).   But given the culture and moral environment we have now, and will have for the rest of my life, I feel quite sure that no medical will be required to perform abortions as a condition of licenture.   No way.Report

  5. Avatar David says:

    Mr. Truman,

    while I recognize that you and your wife have deeply seated moral beliefs regarding abortion, I think your insistence (and hers) upon being aghast that she might have to perform one are simply unrealistic. Would you object if your wife identified a pregnancy with severe fetal deformities, severe risk to the mother’s life (such as a fetus whose deformed heart had failed and become a septic mass within her), and had to perform the necessary procedure?

    In a larger scope, someone who enters a field, attains gainful employment, but refuses to perform all of the duties (not because of physical incapability, but for religious reasons) is not performing their job. We would not expect leeway to be given to someone who entered a bank, took a position as a loan officer, and then after performing the duties of vetting loans for three years, suddenly insisted that they only work on “Islamic Finance” due to newly held or newly strengthened religious beliefs. They would be fired.

    Likewise if you had a medical surgeon who believed that organ transplants transferred a part of the soul, and refused to perform them; they would doubtless come across a point where they were the person on duty, required to do it, and they would either do it or be fired and de-licensed for dereliction of duty.

    Given news reports from the colonies, it would appear that upon the discussions of contraception and abortion, your national dialogue may revert soon to arguing over whether a man should be allowed to “spill his seed” outside of the vaginal passageway in any manner. I presume this will end with a witch hunt and spaghetti western-style round-up of all your pornographic actors who specialize in the proverbial “money shot”, followed by a mass lynching and reenactment of your avowedly illegal anti-sodomy laws, correct?Report

    • Avatar Will Truman in reply to David says:

      David, I do not believe it is unreasonable to expect the government not to force physicians to participate in things that they consider to be immoral if it’s either avoidable or not medically necessary. There are arguments pertaining to medically necessary circumstances in emergency rooms, but outside of that I believe that abortion falls into the category of either avoidable or not medically necessary.Report

      • Avatar David in reply to Will Truman says:

        I believe the considered American response, as related to me by my sister who has several co-workers who were denied the ability to take their religious holidays off of work, is “tough, you signed up for the job, you knew what it required when you took it.”

        In many senses I believe that it is a fallacy in that you Americans desire to have your cake, while making a banquet of it as well. Your laws are not supposed to enshrine religion, and yet you insist that “religious freedom” means you can ignore many laws on varying grounds if you can come up with a specious claim that they contradict your religious values.

        In the extremes, this means that an atheist humanist, who has a fully deep-seated aversion to the act of killing another human being formed by logic and reason, must be allowed to be drafted into your military while someone who claims their “religion” avers killing may be let off even if they six months earlier voted in a referendum to increase or expedite the process of putting persons convicted of various crimes to death.

        Again, I say this not to malign your beliefs as such, but I nevertheless find it specious and invalid to insist that a “religious” exception must at all times allow American citizens to fail to perform their contractual duties or to violate the laws passed by your government.Report

        • Avatar Jaybird in reply to David says:

          In the extremes, this means that an atheist humanist, who has a fully deep-seated aversion to the act of killing another human being formed by logic and reason, must be allowed to be drafted into your military …

          Hey, blame Oliver Wendell Holmes Jr (ptooey) for that one.Report

        • Avatar Will Truman in reply to David says:

          David,

          They could decide to stop doing obstetrical work altogether. With any specific job at any specific place, there are always requirements where “Hey, you took the job” is a valid response to the unpleasant aspects of any given job.

          Saying, on the other hand, “You chose to deliver babies” (which is in contrast to “you took a job at such-and-such hospital”) means “and therefore you must kill fetuses, too” (regardless of where you work, and for whom) is rather problematic. I struggle to think of many other professions where the law actually dictates your job description.

          And you talk of “ignoring the laws” but there are no laws requiring physicians to perform abortions. The question is whether or not we should make such a law. Thus far you are the only person (seemingly) supportive of the concept. I am heartened by this.Report

        • Avatar Will Truman in reply to David says:

          Also…

          “tough, you signed up for the job, you knew what it required when you took it.”

          doesn’t apply. Performing abortions has not, to date, been required when one decides to become a doctor. It would apply if they signed up to work at an abortion clinic or something, but that’s not what we’re talking about.Report

          • Avatar David in reply to Will Truman says:

            I believe part of the problem here is that you are insistent that these sorts of procedures only happen at specialized “abortion clinics.” And it seems that over the course of history the purpose for relegating the procedure to these clinics is so that your lesser-than-savory compatriots can do things like snap pictures of the women (or other identifying information such as license plates) or men who work in them, or who visit them, for the purpose of harassing them publicly and sometimes even murdering the workers at these clinics.

            And it seems to my sensibiities that much of the reticence to perform these procedures comes because these sorts of murders have happened in the colonies with a rather startling regularity, followed by your more insane right wing examples holding up the murderer of doctors as stellar human beings who supposedly “saved lives by killing a murderer”, if I am not mistaken.

            It would be better for all concerned if these procedures were to happen in the hospitals themselves, where full medical privacy laws actually meant something, rather than in specialized locations where the records themselves might be “private” but the patients and employees alike were required to give up their illusion of privacy to those insanely deranged individuals willing to stalk and harass anyone who visits the facility. Do you disagree?Report

          • Avatar Murali in reply to Will Truman says:

            Isnt there some part of the hippocratic oath that actually forbids the performance of abortions?Report

          • Avatar David in reply to Will Truman says:

            I had responded, but I see it’s once again caught in your misbegotten filter system. There must be a better solution.Report

            • Avatar Will Truman in reply to David says:

              I’m relatively certain the problem is the proxies you use. When I look up your IP address, I typically see what appear to be spammers. I don’t have a good solution for that on this end, but there isn’t much we can do about it over here without letting open the floodgates for spammers.Report

    • Avatar sonmi451 in reply to David says:

      Would you object if your wife identified a pregnancy with severe fetal deformities, severe risk to the mother’s life (such as a fetus whose deformed heart had failed and become a septic mass within her), and had to perform the necessary procedure?

      WHty the fuck is it his place to OBJECT? His wife is the doctor, it should be HER desision alone, based on HER moral objections or lack of moral obejctions.Report

  6. Avatar David says:

    It would appear my posts are once again filtered. Would someone mind…?Report

  7. Avatar David says:

    I really do wish you would get your spam filters addressed.

     Report

  8. Avatar James Hanley says:

    Will,

    This post was excellent.  Both sides should pause before responding and think about how it applies to them.  Sadly, I don’t think that will happen.  But their (our) failure does not diminish the thoughtfulness of your post.Report

  9. Avatar Robert Cheeks says:

    “..and, Jesus don’t like killin’ no matter what the reason’s for..”

                                                                                           John Prine

    leave ’em babies alone!Report

  10. Avatar Robert Cheeks says:

    As I understand it, you’re allowed to defend yourself, nation, etc.? I’m not sure how many dead Muslim’s that requires.Report

  11. I liked this post. I’m utterly exhausted from this debate, so I’m not going to comment on anything substantial. But you did a good job here.Report

  12. Avatar John Howard Griffin says:

    Freedom of Conscience. That’s a whole big can of worms there.

    I’d like to have the freedom of conscience to not be forced to use money that has child-like beliefs printed on it – I don’t want my money to say In Santa Claus God We Trust. Yet, I don’t have a choice.

    I’d like to have the freedom of conscience to not be forced to have the Pledge of Allegience affirm the child-like belief in The Easter Bunny God. Yet, I don’t have a choice.

    I’d like to have the freedom of conscience to not be forced to have some of the money I pay in taxes be used to kill brown people in our wars of aggression preemption. Yet, I don’t have a choice.

    I’d like to have the freedom of conscience to not have federal officials swear on a book of fiction Bible and affirm the child-like belief “so help me Cthulhu God”. Yet, I don’t have a choice.

    And, on and on…Report

    • And so the next time we invade someplace overseas or bomb somebody and when you say “we shouldn’t be doing this!”, can we just say “hey, I’m not a fan of the NEA but you don’t see me complain”?Report

      • Avatar John Howard Griffin in reply to Jaybird says:

        Sure. Absolutely.

        But, what do I do about money? No matter what I do, I’m forced to use money that affirms a child-like belief in a fictional character that is directly against my moral philosophy. You might even refer to my moral philosophy as a “religious belief”. Yet, I am forced to use something that is against those beliefs and repugnant to me – every day.

        I’m not holding my breath that anyone will be out there defending the beliefs, morality, and rights of Athiests any time soon. We live in a theocracy, but don’t want to admit it. It is impolite for me to even mention it.Report

  13. Avatar Michael Drew says:

    Will,

    I’m not sure if I can read here exactly where you stand on accessibility.  Clearly, you’re against any mandate that doctors must perform it, and rightly so, but I frankly think that you’re being overwrought on that, not because it would never happen (it wouldn’t), but because, to my knowledge, the most extreme abortion rights advocates have never suggested it would be desirable.  But that’s okay; as you say you have more reason than the average person to be concerned with it.

    You seem to suggest that the difficulty many women face getting an abortion is lamentable to some extent; on the other hand your statement that you want abortion to remain controversial suggests there is a limit to how accessible you would like them to become (a limit beyond there never being a mandate that any doctors must be trained and willing to perform them).  Perhaps I’m mistaken by that.

    But, especially given the kinds of concerns you express regarding expectations of physicians generally, I think there are two words missing from your piece that are really the first and last to be said on the topic of accessibility of abortion and reproductive health: Planned Parenthood.  I’ve come to believe that they are actually doing the equivalent in my worldview of God’s work.  if there were fewer Planned Parenthood clinics, which are federally funded, all the accessibility problems you discuss would be worse.  I leave it to you to consider then whether you think you might want to make working to secure and expand funding for Planned Parenthood clinics nationwide a part of any efforts you would consider pursuing to help ensure that there are never any abortion mandates that come down from future liberal governments.Report

    • MD,

      I’ve thought it through and while there are arguments both ways, I believe the likelihood of a mandate at the places my wife is most likely to work are actually made higher by decreased stigmatization versus more actors making such a mandate unnecessary. There is no shortage of pharmacists that will dispense birth control, and yet it is still a common argument that we should force pharmacies and pharmacists to dispense it.

      I suppose I could say “Fund Planned Parenthood and then let’s all hate them really loudly!” to cover both ends, both access and condemnation, but I don’t have the stomach for that kind of chessboard approach.

      Well, actually, I *do* support funding Planned Parenthood for their other activities despite their abortion activities. Not chessboard reasoning, though. More like… they do a lot of good stuff, and if anti-PP want that money to go to orgs that do good stuff but to not also do abortion, they need to actually establish such an entity.

      By and large, I do not support pulling funding for Planned Parenthood. Despite, rather than because of, their abortion activities. Namely, if PP’s critics don’t want funding to go to organizations that perform abortions, they need to form a parallel services that does the good stuff that PP does without the bad.Report

      • Avatar Michael Drew in reply to Will Truman says:

        Okay, so if I’ve got this straight, you yourself are morally opposed to abortion (you haven’t said this here, but I think you’ve said it elsewhere), but you want it to be legal.  But you want it to be stigmatized.  That is because you fear if it isn’t stigmatized, it’ll eventually become compulsory for physicians in the related specialty, or at least for some of them.  Is that the only reason for that preference?

        I’m still unclear where this leaves you in terms of access. Do you want abortion to… a) be less accessible than it currently is, b) be more accessible than it currently is, c) be as accessible as it now is, or d) you don’t care?Report

        • Philosophically opposed but legally pro-choice, check and check.

          However, I do not support stigmatizing it on the basis that it will make the likelihood of physician mandates less likely. I was just saying that I think it would have that effect rather than the more intuitive result of obviating any need for a mandate. Whether I am pro-stigma or anti-stigma depends on who are what we are stigmatizing. I believe in a stigma on the act, I guess, but not any sort of targeting any individuals involved in the act (I want to make sure that nobody is thinking I am pro-death threat or in favor of screaming ugly names at people). There’s a balance here that I am probably failing to articulate.

          On accessibility… I am not comfortable coming up with some specific determination on how accessible it should be. Let the doctors that want to do it get the training and such to do so. Don’t nudge doctors to do it who don’t want to. Let the chips fall where they may.Report

  14. Avatar Infuriating Pedant says:

    <i>There is no shortage of pharmacists that will dispense birth control, and yet it is still a common argument that we should force pharmacies and pharmacists to dispense it.</i>

    I would be one of those guys.

    A pharmacist’s sole job description is to dispense (and sometimes compound) drugs.   If they don’t care to do the job, they should not be licensed as a pharmacist.   If their problem with contraception goes that deep, they are in the wrong business:  it’s like an accountant that refuses to use the digit “7.”

    But I would never dream (or conceive) of a regime in which a physician was refused a license because he refused to perform an abortion.   A pharmacy fulfills a doctor’s orders:  a physician would be complicit in the abhorred act in a direct and substantial way.

    (BTW:  I would support allowing a pharmacist to refuse to fulfill birth control pills if the pharmacy is required to post a prominent sign in the font of the store stating that they are not a full-service pharmacy, and reserve the right to pass judgement on the patient’s prescriptions…)Report

    • Avatar Kimmi in reply to Infuriating Pedant says:

      still, there is the problem of the entire town deciding “no pharmacies that will prescribe birth control.” This is not a hypothetical.

      Now, I ask of thee, if, as is distressingly often the case, a case of fraternal incest arises, must the child have the baby? I believe that the girl should have access to contraception/abortion, and in a way that doesn’t involve having to tell other people (as that furthers the whole shame thing, and makes it more likely for her to be unable to follow her wishes).

      Many/most adolescents on the streets are because of abuse, sexual or otherwise. Are you willing to have a young mother bearing a malnourished baby in some horrid backalley (after being a prostitute), just because birth control wasn’t available?Report

    • Having a sign out front that says “Not a full-service pharmacy” (with perhaps a mention of contraception) would actually strike me as a fair compromise.

      I’m actually sympathetic to the distinctions between pharmacist and physician (and, for that matter, contraception and abortion). Part of the connection I draw is that historically, when I’ve said I fear that pharmacists and birth control would lead towards “standards of care” arguments that would apply to doctors (this was before I married one) and a lot of them said “It should.”

      I’m heartened to see what appears to be a lot of disagreement with that notion here.Report

      • Avatar Patrick Cahalan in reply to Will Truman says:

        Medicine isn’t quite like accounting.

        I might have triskadekaphobia, that would indeed make me a bad accountant.  However, there really isn’t an argument that can be made that you can do accounting without accounting for the number 13, when it crops up.  You can’t make a very credible argument that you want to be an accountant for the purpose of wanting to do accounting, but you don’t like 13 and this is something that is a problem with accounting, not a problem with your fear of 13.

        One can make the case that birth control isn’t actually therapeutic medicine*, and that one became a pharmacist to be in the business of providing therapy.  An abortion for the sake of convenience would fall into the same category, really, for a doctor with objections: “There’s nothing wrong with you, so I have no obligation to treat you.”  “Yes, there is something wrong with me, I’m pregnant and I don’t want to be.”  “I don’t think that’s a medical malady.  It might be a medical *condition*, but I’m not obligated to treat all medical conditions.  You can say you don’t like your right arm and it offends you and you want to have it removed (heck, maybe you have a sincere religious belief that this is the case); that doesn’t place me under an obligation to remove it for you.”

        Note: I don’t have the same problem with an *organization*.  If you’re a corporate entity, you’re incorporated under rules.  I don’t see a (justice) problem with the government saying, “If you want a license to operate a pharmaceutical business in this burg, you can either operate as a sole proprietorship and not carry birth control, or you can operate as an LLC and provide it.  If you have a pharmacist on staff that doesn’t want to provide birth control, hire someone who does.”

        (* when used for birth control, not for secondary therapeutic reasons, obviously)Report

        • Avatar Lucky in reply to Patrick Cahalan says:

          I appreciate the distinctions you draw but one of those distinctions gives me pause.  So, do we now have to differentiate between ‘good’ prescriptions for BCP and ‘bad’ ones?  Do I have to tell the pharmacist that it’s okay because I have, say endometriosis, and not because I just really like shagging?

          I also like the idea of posting ‘not a full service pharmacy: we don’t provide contraceptives’ and that would include condoms, right?

          It’s a bit tricky because the guy’s side of the equation doesn’t require a medical prescription but most of the gal’s side does (not sponges and spermicide which are less effective).  There are medical reasons (usually) for requiring prescriptions but prescription requirements have political consequences.  You have to see a doctor to get the most effective and least expensive options. Should we cite Comstock and require prescriptions for all contraceptives?

          So, can your conscientious pharmacist also refuse to sell OTC contraceptives?  I get real fuzzy at the point where medical care intersects with public policy.  It just seems odd the the mechanism of a medical prescription is the underpinning of a political right.Report

          • Avatar Infuriating Pedant in reply to Lucky says:

            Of course he can refuse to carry condoms–just as the Walgreens by my house refuses to carry veterinary tooth whitener.   Any retailer can choose to carry–or not carry–anything he wants.

            But a pharmacist’s job is to fill prescriptions written by doctors.   Medical decisions are between the doctor and patient.   If a pharmacist does not fill a valid prescription for a common medicine, that’s malpractice.

            I proposed the “notification” requirement because it would allow those that feel strongly about it to opt out, but they would have to stand fully by their convictions, and suffer all of the consequences for their stand:  many people might choose to no longer do business with them, of any kind.

            Otherwise, they are simply contravening the medical care of another because they choose to pass judgement;  and doing so in a way that causes them embarrassment, inconvenience, and loss of control over their lives.Report

            • Pedant,

              That strikes me as being an employer/employee issue, for the most part. If an employer wants to carry contraception but also wants to allow employees the ability not to hand them out, it is up the pharmacy to make it possible.

              Within the Truman household, prescriptions are my job. And so if I go to a pharmacy and they have a policy that allows employees not to hand out contraception, there are roughly three possibilities:

              1) One pharmacist can’t fill it out, but says “hold on” and hands me over to a pharmacist that can. I see this as no skin off my nose.

              2) One pharmacist can’t fill it out, and they can’t fill it out because the other pharmacist took the day off. Well, maybe I can live with that, or maybe I find a new pharmacy.

              3) The pharmacist won’t fill it out, and they can’t fill it out until another pharmacist comes on shift, but they can forward it to another pharmacy where I can go pick it up. Chances are, that other pharmacy (unless they have the same policy) has a new permanent customer. I don’t want to have to take multiple trips.

              4) The pharmacist won’t fill it out, and I have to come by when the other pharmacist is on duty. If I have to work around some internal schedule, I am going to find another pharmacy. Not just for contraception, but for everything. I doubt that I am alone in this regard because they are not a reliable provider of one of the prescriptions we need. They’re little different, in my eyes, from one that doesn’t do contraception at all.

              Because of the money involved, I feel relatively confident that few pharmacies would actually force customers to deal with their shift schedule and allow pharmacists that kind of latitude unless the law says they have to. I do not believe the law should say that they should have to.Report

              • Avatar Infuriating Pedant in reply to Will Truman says:

                Nothing clarifies an issue like a bad metaphor, so I’ll offer one up:

                A justice of the peace refuses to perform a marriage because he deems that interracial couples are against God’s plan.   (not theoretical:  it happened quite often in the 60s).   Can you get behind that?

                Filling prescriptions is pretty much a pharmacist’s job description.   If you read my post, you’ll see that I’m not proposing compulsion, but consequences.    It is a highly material to a customer whether a pharmacist thinks that filling a prescription is something that a pharmacist considers optional.   Therefore, the front window posting seems to be the solution that  preserves the most liberty–and transparency–for the most people.

                As for whether a pharmacy (company) allows its pharmacists (employee) to refuse:  if the customer is materially affected by the policy, they should know in advance of it.    If there are always three pharmacists on duty, and there is always at least on pharmacist on staff to fill birth control orders, then the customer is unaffected.   Otherwise, notice.

                But a pharmacist definitely should not be able to simply spring it on a customer when they present their prescription.   As long as the state licenses professionals, it has the right (and duty) to promulgate standards of service.   And one of those should definitely be:  “does their job.”Report

              • Pedant, I am not sure how much we disagree. I’m on board with the window posting.

                I don’t think the metaphor works, though, as JP’s are government officials. The rules are different there. I would argue that hospitals that are government-run would operate under different rules as well.Report

        • Patrick, on an individual pharmacist level and institutional level, I think that’s a question between employer and employee. Provided that there is no mandate on the employer (to be passed on to the employee), I am rather open to saying that an employer be able to say “Hey, if you want to be a pharmacist and work here, you have to handle contraception.

          However, if Catholic Bob’s Pharmacy doesn’t want to provide certain services, I am inclined to say that should be their right (though I am open to being convinced otherwise). Accountants may not be able to avoid the number 13, but they can avoid doing tax-work or do only tax-work. Likewise, a pharmacy that wants to do only reproductive medication or not do reproductive medication could receive the same leeway. I don’t have a problem with requiring that they help someone that walks in off the street make alternate arrangements (I’m sure pharmacies that do provide contraception would be happy with the referrals).

          The government is within its rights to require whatever it wants of pharmacists, within (broadly defined) reason. I think the same is true of physicians and abortion, though, which is why I am more concerned about that ever coming to pass than a lot of people.

          On an institutional level, outside very specific contexts, I believe that the vast majority of pharmacists will go out of their way to provide for what is perhaps the most-used set of prescriptions in the country. I can be convinced otherwise, but forcing everybody to do it seems like overkill. This is not something I would go to the hill for, though. And slippery-slopism might be coloring my thinking.Report

          • Avatar Patrick Cahalan in reply to Will Truman says:

            Well, if Catholic Bob’s Pharmacy is a sole proprietorship (or a LLP with all partners on the same page), I think you have a pretty strong case.

            If Catholic Bob’s Pharmacy is a publicly held LLC and it just happens that Catholic Bob was the founder and Catholic Bob’s daughter’s husband is the current CEO, I’m far less inclined to say they have a pretty strong case.

            The LLC is, by definition, a separate entity from Bob.  Since it’s a public company, it’s not out of bounds for the public to have some say in the rules under which it operates.

            But I’ll think more about this one.  We may need to argue it out over beer ‘n peanuts.Report

  15. Avatar Damon says:

     Different tack here:

    Since a woman “owns” her body, then by extension, so does a man own his body, but there are some legal inconsistencies.  Nobody can sell a kidney.  That’s illegal.  Why?  Under the same legal conclusion, I should be able to sell my organs. 

    Using that same theory, children (or potential children) are property.

    This is why this issue should never be addressed by the law.Report

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