Pharmacists' moral beliefs vs. women's legal rights

Store policies differ. CVS states that its pharmacists must ensure that "customers promptly receive all medications for which they have a lawfully written prescription."

At Wal-Mart, pharmacists do not stock the morning-after pill. Danette Thompson, a spokeswoman, calls the policy a business decision. "When we look at the number of prescriptions filled for a given drug and the frequency with which that's requested by a customer, those kinds of things are taken into consideration," she says.

Critics counter that Wal-Mart's dominance in rural areas leaves many women with few alternatives if they need emergency contraception in cases of rape or incest.

Also, "many rural communities only have one pharmacy," says Ms. Boyce, "so you have only one pharmacist. Or the next pharmacy is miles away.

Calling the recent refusals by pharmacists "very troubling," Kelda Helen Roys, executive director of NARAL Pro-Choice Wisconsin, says, "If we let pharmacists pick and choose which prescriptions they're going to honor, you basically invalidate that healthcare for large numbers of people in the state." More than 90 percent of women will use birth control at some point in their lives, according to Planned Parenthood.

Others see the issue differently. "This is a situation where certain people of certain faiths seem to be fair game for discrimination, which is egregious," says Peggy Hamill, director of Pro-Life Wisconsin in Brookfield. She tells of pharmacists who refused to fill prescriptions and have had to move from one place to another. Others have taken jobs in nursing homes.

Contraceptives are not the only moral and ethical issue some pharmacists face. Mr. Stewart says that in Oregon, where assisted suicide is legal, the American Pharmacists Association policy would support a pharmacist who does not want to dispense medication that would facilitate assisted suicide. And in other states, he adds, "Our policy supports pharmacists who do not want to dispense lethal injections as capital punishment."

As pharmacists and women's groups await the results of Noesen's hearing, some ethicists are considering the ramifications as well. Linda Rankin, a medical ethicist and philosophy professor at the University of Tennessee in Knoxville, calls this a complex issue.

"It's clearly legal that women are entitled to get morning-after pills," she says. "Morality is a lot slipperier. If we don't protect personal integrity, we would go down a dangerous avenue. By taking a professional license, you do in fact step out of your personal morality. You have taken on an additional responsibility, but that does not mean you have given up your integrity as a person.

"When people take on the life of a pharmacist, they have to realize what might be asked of them," Professor Rankin continues. "Would they be able to fill these prescriptions? If they can't, then they have a moral obligation not to practice at a place where they are the only pharmacist, and where not to do this would cause serious harm to other people."

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