should wal mart be forced to sell emergency contraception?
Some of you who've been reading for a while probably know by now that I like Planned Parenthood, and that my affinity is at least partly connected to the fact that my mother works for the well-known non-profit. But despite my ardent admiration for its dedication to providing important health services to millions of women in the U.S. and beyond, I found myself cringing at a PPFA-related online poll that my mom forwarded to me a few days ago, asking me to submit my vote. This time, I thought, they've gone too far. (more in expanded post)
Those who follow news on reproductive choice are probably familiar with the recent controversies over whether individual pharmacists should be allowed to refuse to fill people's emergency contraception prescriptions on personal moral grounds. In addition to individual employees exercising discretion over which prescriptions to fill, some pharmacies have opted, for similar philosophical reasons, not to stock certain kinds of birth control at all. Notable among these pharmacies is Wal Mart. So while I wasn't surprised at the poll soliciting my vote on the Wal Mart contraceptive issue, I was dumbfounded by the specific question it posed, and the way the email summarized the issue at hand:
A lawsuit has been brought against Walmart for failure to stock and dispense emergency contraception.Hold on, back up a minute. Should Wal Mart be required, by the government, to stock a medicine to which it objects on moral principles?
Walmart pharmacies serve primarily mid-to-low-income people. In many communities, Walmart is the only pharmacy in the local area. Low-income women have few choices when it comes to accessing emergency contraception. Please indicate your support for requiring Walmart to stock emergency contraception.
Because of the publicity around the lawsuit, CNN is polling on whether WalMart should stock EC. The poll is now in the "QuickVote" box on: http://www.cnn.com/2006/LAW/02/01/walmart.contraception.ap/index.html
Here’s where the poll currently stands:
Should Wal-Mart be required to stock the "morning after pill"?
Yes -- 47% -- 51895 votes
No -- 53% -- 58999 votes
Total: 110894 votes
Should Wal Mart be required to stock anything it doesn't want to stock? It it the government's job to tell private retailers what to sell?
This one really had me confused. That is, until I actually clicked on the link and read the corresponding article.
As it turns out, we're not just talking about any old merchandise here. The government can't butt its nose into Wal Mart's decision, for instance, not to sell Jon Stewart's book "America" (not that it would want to, I guess). But in Massachusetts, where the lawsuit was filed on behalf of three women plaintiffs, it comes down to a question of whether or not emergency contraception is legally considered a commonly prescribed medicine. If it is, then according to state law, all pharmacies must supply it. If it's not, then businesses can decide for themselves whether to stock it. From the CNN article:
A new state law that took effect late last year following heated debate among lawmakers requires all hospitals to provide the morning-after pill to rape victims. It also allows pharmacists to dispense the pill without a prescription, but does not require it.
The lawsuit, backed by abortion rights groups Planned Parenthood of Massachusetts, NARAL Pro-Choice Massachusetts and Jane Doe Inc., argues Wal-Mart is violating a state policy that requires pharmacies to provide all "commonly prescribed medicines." They are suing to force compliance with the regulation through the Massachusetts Consumer Protection Act.In a letter to a lawyer for the three women plaintiffs, "Wal-Mart attorney John W. Delaney wrote that Wal-Mart has 'long had the corporate policy of declining to make available EC (emergency contraception) medication, based on, among other things, a view that EC medication is not 'commonly prescribed' and within the 'usual needs of the community,'" the article says.
If the poll question had asked me whether I think emergency contraception satisfies the criteria in question, I would have answered yes. The FDA's research committee has reccommended that EC be granted over-the-counter status, and many prominent physicians' groups support EC as an important option for preventing unplanned pregnancies. According to Planned Parenthood's website, "Widespread use of emergency contraception could potentially prevent an estimated 1.5 million unintended pregnancies and 800,000 abortions each year in the United States (Glasier & Baird, 1998; Stewart, et al., 2004). In 2000, an estimated 51,000 abortions were prevented through the use of emergency contraception; moreover, ECPs were responsible for approximately 43 percent of the decrease in total abortions between 1994 and 2000 (Boonstra, 2003)."
On January 19, the American Public Health Association adopted 19 new policies, including this one:
Access to contraceptive prescriptions: Supports many provisions to ensure women are able to have contraceptive prescriptions filled without interference or delay, including collaboration between pharmacist associations, pharmacies and schools of pharmacy to work with reproductive and public health professionals to conduct ongoing educational programs for pharmacists about the dispensing of contraception and emergency contraception. Continues to urge the U.S. Food and Drug Administration to make emergency contraception available over the counter.It will certainly be interesting to see how this case plays out. Now that I understand what it was really trying to ask, I would vote yes on the initially baffling poll question ("should Wal Mart be required to stock 'morning after pills?'") since I think the availability of emergency contraception is very important for many people--including individuals, couples, and families--and thus for a community. How would you vote on CNN's question, and, if you see an important distinction between the two questions, how would you vote on EC's qualification as a commonly prescribed medicine that fills the usual needs of a community?