Editorial: What's in a job?

Pharmacists fill prescriptions. That's their job. And if someone doesn't want to do that, he or she shouldn't become a pharmacist.

Yet some Jewel-Osco pharmacists in Chicago are doing just that. Gov. Rod Blagojevich filed an emergency rule April 1, informing all Illinois pharmacies that if a store sells emergency contraceptives, its pharmacists must dispense them without delay. The action came in response to a Jewel-Osco pharmacist's refusal to fill prescriptions for emergency morning-after pills. The governor's department of Financial and Professional Regulation also filed an administrative complaint against the Jewel-Osco store in the Loop where an unidentified pharmacist declined to fill the women's prescriptions twice in February on moral grounds.

The governor and activist groups say there has been an increase across the country of pharmacists refusing to fill prescriptions for emergency contraception. Some pharmacists who oppose filling the prescriptions have said they feel the pills stop the life of an early human embryo.

Emergency contraception is used to prevent pregnancy after unprotected intercourse - such as when a contraceptive fails or when sex occurs without contraception. Two types of EC are available: emergency contraceptive pills, also known as the morning after pill, and emergency copper-bearing intra-uterine device insertion. According to the U.S. National Library of Medicine, emergency contraceptive drugs work primarily by preventing or delaying egg release from the ovaries. They may also slow egg or sperm transport in the fallopian tubes, and they may make the uterine lining less hospitable for implantation of a pregnancy. Pharmacies currently sell it in pill form such as Preven and Plan B, which can be used within a three-day window after unprotected sex.

First of all, if a doctor has already made a medical decision for a patient, it's not up to a pharmacist to overrule that decision. Imagine the kind of slippery-slope argument that would lead to. Pharmacists around the nation would claim all sorts of beliefs against various ingredients in medicines and refuse to fill them. A pharmacist shouldn't pick or choose what treatment to dispense based solely on their own views - it's their legal obligation to fill all legitimate prescriptions given to them, according to state law. But if pharmacists are covered by the Illinois Health Care Right of Conscience Act, which allows physicians not to perform abortions and other procedures they find repugnant, then pharmacists should refer the prescription to someone else that will fill it. Some might argue that those with moral objections to emergency contraception will not do a referral anyway, but this would be denial of access and potentially illegal.

The biggest problem with a situation such as emergency contraception is that there is only a 72-hour window. Patients do not have the time to be running all over the state trying to find a pharmacist that believes in emergency contraception. This means that pharmacists should not be in a job in which they feel their moral obligations supercede their pharmaceutical responsibilities. Some might argue that one shouldn't have to pick a job based on beliefs, but there is no difference between not joining the army to avoid killing people and not becoming a pharmacist to avoid filling an emergency contraception prescription.