Thoughts on how a "Conscience Clause" will affect the rights of women and others to medical care.

Though CNN apparently considered Pharmacists for Life a significant enough organization to invite its president to appear on American Morning unopposed, the organization is rather obscure. Pharmacists for Life's most recent IRS filings indicate that the organization has no paid employees and raised and spent less than $30,000 in 2003 (the most recent year for which figures are available), with more than half going for "VIT, GLOVES, SUPPLIES."

Pharmacists for Life president Karen Brauer was fired by a Kmart pharmacy in Ohio for refusing to fill birth control prescriptions. As Brauer acknowledged during an April 16, 2001, appearance on Fox News' The O'Reilly Factor, Brauer didn't merely refuse to fill a patient's prescription, she lied to the patient, as well:

O'REILLY: I got you. Now, when the customer complained, what happened there? Did you refer that customer to somewhere else?

BRAUER: I asked -- I -- she did not complain to me. OK? What happened is, she came in for a refill. I informed her that we did not carry the drug at the time. And I offered to call a copy of her prescription to the pharmacy of her choice.

O'REILLY: And then she complained. But did you -- how -- why would she complain about that, if you didn't have the drug on hand?

BRAUER: Somehow she found out that this pharmacy actually did have the drug at the time.

O'REILLY: So you lied to her.

BRAUER: Yes, I did.

When a Wisconsin pharmacist was presented with a prescription for birth control pills, he not only refused to dispense the script or refer it to another pharmacy, he refused to give it back to the patient based on his religious beliefs. He is now facing a disciplinary hearing brought by the state board of pharmacy.

Last February, an Eckerd pharmacist in Denton, Texas, refused to dispense emergency contraception to a woman identified as a rape victim. The pharmacist was fired.

Last spring, a Raleigh man complained to the North Carolina pharmacy board that a pharmacist refused to dispense an emergency contraceptive to his wife and lectured her on religion. The pharmacist was reportedly fired.

In March, a CVS pharmacist in North Richland Hills, Texas, refused to refill a prescription for birth control pills because the drug violates her personal beliefs. CVS declined to comment on whether the pharmacist was fired.

The refusal of the CVS pharmacist to dispense birth control pills was a wake-up call to the Planned Parenthood Federation of America, which had been focusing on protecting abortion rights, not women's access to birth control pills. President Gloria Feldt fired off an angry letter to CVS, demanding that the drugstore chain's CEO personally promise that such a "completely inexcusable" incident would never happen again. Suddenly, Americans are waking up to the fact that women are being confronted at the counter by pharmacists asserting a religious or moral right to refuse to dispense hormonal contraceptives or emergency contraceptives. An estimated 12 million American women use hormonal contraceptives for birth control. But the drugs can also be prescribed for many other indications, including acne, fibroids, endometriosis, and to regulate menstrual periods.

Last week, Louisiana’s legislature passed what is known as a “conscience” bill, allowing medical professionals to refuse certain procedures if they violate religious or other beliefs. Often, conscience bills, like the midnight regulation passed in the final days of the Bush administration (Obama is expected to rescind the rule), specifically target abortion and contraception. Louisiana’s bill includes abortion and some types of emergency contraception, along with stem cell research and euthanasia. Gov. Bobby Jindal, who is anti-choice, is expected to sign the bill. But Louisiana isn’t alone in proposing such a measure; 12 other states have introduced such bills this legislative session, the most active of which were in Louisiana and Arizona.

...Esman, who testified before the state legislature three times on behalf of changing, said that the ACLU called the bill “discriminatory medicine.” The more sinister potential of the original bill could have expanded far beyond reproductive services, Esman said. “If you were anti-gay, you didn’t have to treat gay people. If you were a white supremacist and worked at a doctor’s office you could refuse to make appointments for people who are non-white.” It was by raising concerns of broader threats of the legislation that the ACLU was able to build a diverse coalition to work on the bill.

.....Still, conscience clauses are becoming an increasingly popular mode of anti-choice legislation, and not all states will result in the kind of compromise reached in Louisiana. Arizona’s bill combines a conscience clause, allowing pharmacists to refuse to dispense emergency contraception, with a 24-hour waiting period for abortions. The bill also increases penalties (from one year of prison to two years) for physicians that perform the already-illegal late abortion procedures erroneously and misleadingly termed "partial-birth abortions."

According to ProudParenting.com, the conscience clause laws that pharmacists have been using to deny women birth control and emergency contraception prescriptions could also be used by doctors to refuse treatment to gay and lesbian patients. Looks like these laws are just chock full of discrimination. Jeez.

The ProudParenting piece specifically discusses Michigan’s law, which Rep. Chris Kolb (D-Ann Arbor) notes “doesn't ban discrimination based on a person's sexual orientation.” The legislation prohibits racial discrimination.

An increasing number of clashes are occurring in drugstores across the country. Pharmacists often risk dismissal or other disciplinary action to stand up for their beliefs, while shaken teenage girls and women desperately call their doctors, frequently late at night, after being turned away by sometimes-lecturing men and women in white coats.

"There are pharmacists who will only give birth control pills to a woman if she's married. There are pharmacists who mistakenly believe contraception is a form of abortion and refuse to prescribe it to anyone," said Adam Sonfield of the Alan Guttmacher Institute in New York, which tracks reproductive issues. "There are even cases of pharmacists holding prescriptions hostage, where they won't even transfer it to another pharmacy when time is of the essence."

That is what happened to Kathleen Pulz and her husband, who panicked when the condom they were using broke. Their fear really spiked when the Walgreens pharmacy down the street from their home in Milwaukee refused to fill an emergency prescription for the morning-after pill.

"I couldn't believe it," said Pulz, 44, who with her husband had long ago decided they could not afford a fifth child. "How can they make that decision for us? I was outraged. At the same time, I was sad that we had to do this. But I was scared. I didn't know what we were going to do."

President Obama went a little farther today in saying that conscience clause protections on abortion coming from his White House will be strong and 'robust". He made the comments to Catholic reporters while discussing his upcoming meeting with the Pope next week in Italy. The Brody File has transcript. Read his comments below.

Q Many of the people who are providing aid through the church, both domestically and internationally, are very concerned about possible restrictions on churches' moral teachings in their work going away -- through the conscience clause -- I didn't articulate that very well. But they're very concerned about the conscience clauses that protect their ability to refuse to do certain kinds of services going away. And it's been a little unclear what direction this administration is going with some of those restrictions.

Can you talk a little bit about where you see the boundary lines between what -- how much the government can limit what happens according to people's consciences?

THE PRESIDENT: Well, I think that the only reason that my position may appear unclear is because it came in the wake of a last-minute, 11th-hour change in conscience clause provisions that were pushed forward by the previous administration that we chose to reverse. But my underlying position has always been consistent, which is I'm a believer in conscience clauses. I was a supporter of a robust conscience clause in Illinois for Catholic hospitals and health care providers. I discussed this with Cardinal George when he was here in the Oval Office, and I reiterated my support for an effective conscience clause in my speech at Notre Dame.

So I think that there have been some who keep on anticipating the worst from us, and it's not based on anything I've said or done, but is rather just a perception somehow that we have some hard-line agenda that we're seeking to push.

Let me start with an explanation of why I stand where I do on this issue: Doctors and pharmacists in the US are given a license to practice their profession by the state. They do not have the right to practice without a state-issued license (in other words, their church cannot issue them a license). Our constitutionally mandated separation of church and state therefore extends to that license IMO. Few people would hesitate to call it wholly unacceptable discrimination if a doctor or pharmacist's beliefs led them to refuse to treat a person because of their religion or race or gender, no matter how sincerely they felt their religion insisted that treating such people was repugnant.

Monica Goodling has a problem. As senior counsel to Attorney General Alberto Gonzales and Justice Department liaison to the White House, Goodling no longer seems to know what the truth is. She must also be increasingly unclear about who her superiors are. This didn't used to be a problem for Goodling, now on indefinite leave from the DoJ. Everything was once very certain: Her boss's truth was always the same as God's truth. Her boss was always either God or one of His staffers.

..... A 1995 graduate of an evangelical Christian school, Messiah College, and a 1999 graduate of Pat Robertson's Regent University School of Law..., Goodling's chief claim to professional fame appears to have been loyalty to the president and to the process of reshaping the Justice Department in his image (and thus, His image). A former career official there told the Washington Post that Goodling "forced many very talented, career people out of main Justice so she could replace them with junior people that were either loyal to the administration or would score her some points." And as she rose at Justice, according to a former classmate, Goodling "developed a very positive reputation for people coming from Christian schools into Washington looking for employment in government."

The school is not the first to approach the law from a Christian perspective, nor is it the only such institution to emerge in recent years. Legal organizations backed by evangelical Christians have been waging court battles over the last two decades.

But it represents the latest effort by the religious right to transform American society - on everything from the division between church and state to such social issues as abortion and same-sex marriage - from the inside out. And it's an indication of the alienation that many conservative Christians feel amid the larger secular culture.

"Christians are just now coming around to see the importance of law and legal institutions in terms of judges and government," said Michael P. Schutt, director of the Institute for Christian Legal Studies at Regent University in Virginia Beach, Va., whose law school takes a similar approach to Liberty's. "So Christians have begun to think about how we can influence these important perspectives."

It's a direction that has raised eyebrows among some civil libertarians and constitutional law scholars who fear that schools like Liberty are designed to preach, not teach.

"I don't believe that the understanding of Jerry Falwell about the history of America and of the American Constitution is remotely accurate, nor is it ethically responsibly," said the Rev. Barry W. Lynn, executive director of Americans United for Separation of Church and State and a longtime critic of Falwell. "It is designed to turn America into his view of a Christian nation&. When you get these insular institutions who believe they are right and fighting the entire world, you get extremists coming out as graduates."

Pharmacists are obliged to dispense the Plan B pill, even if they are personally opposed to the "morning after" contraceptive on religious grounds, a federal appeals court ruled Wednesday.

In a case that could affect policy across the Western states, a supermarket pharmacy owner in Olympia, Wash., failed in a bid to block 2007 changes to pharmacy regulations that required all Washington pharmacies to stock and dispense the contraceptive.

Family-owned Ralph's Thriftway and two women employed at other pharmacies sued Washington state officials over the requirement. The plaintiffs asserted that their Christian beliefs prevented them from dispensing the pills, which can prevent implantation of a recently fertilized egg. They said that the new regulations would force them to choose between keeping their jobs and heeding their religious objections to a medication they regard as a form of abortion.

Ralph's owners, Stormans Inc., and pharmacists Rhonda Mesler and Margo Thelen sought protection under the 1st Amendment right to free exercise of religion and won a temporary injunction from the U.S. District Court in Seattle pending trial on the constitutionality of the regulations. That order prevented state officials from penalizing pharmacists who refused to dispense Plan B as long as they referred consumers to a nearby pharmacy where they could get it.

On Wednesday, a three-judge panel of the U.S. 9th Circuit Court of Appeals lifted the injunction, saying the district court was wrong in issuing it based on an erroneous finding that the rules violate the Free Exercise Clause of the Constitution. Other constitutional challenges are pending with the district court, which had been waiting for the 9th Circuit ruling on the injunction, said Chad Allred, a Seattle lawyer whose firm represents the Stormans and the pharmacists. In anticipation of the injunction being vacated, Stormans and the two pharmacists secured an agreement with the state that it would not pursue sanctions against them until the other issues were decided at trial, Allred said.