In my discussion of Sean Faircloth's new atheist strategy, I am at the third of ten policy objectives - that pharmacists and doctors do their job and not use their religion as an excuse to do refuse legal medical help to others.
Faircloth has in mind the case of a rape victim. After enduring the rape, and reporting it to the police, and going through a rape exam, she gets a prescription for a "morning after pill." She goes to a local pharmacist - and he refuses to fill the prescription. Where this happens once, it can happen two or three times. In a more rural part of the country, once is enough.
Faircloth's policy objective is for the law to declare that these jobs come with certain duties and responsibilities, which includes filling legal prescriptions that customers may come in with.
If your religion prohibits you from doing the job, find a different job.
Imagine taking your child to the hospital with a severe bleeding wound and being told, "We do not do blood transfusions here. If you want a blood transfusion, you will have to go elsewhere." And the next nearest hospital is 60 miles away.
However, I do not think that this issue is quite as simple as some wish it to be.
Let's consider conscientious objector status. Here is a case of people who, for religious reasons, refuse to kill. Are we going to advocate putting a gun in their hand and forcing them to kill people? Or are we going to allow them to use their religion as a legitimate reason not to kill?
My next step will be to ask whether or not the pharmacist can use religion as a reason not to kill.
I hold that an fetus has to have a brain capable of having desires before it can have moral standing. You cannot violate the interests of a being that has no interests. And while the being has potential future interests, that only speaks to the possibility of potential future harm if and when those potential interests become actual interests. Therefore, I deny that abortion or the use of a morning-after pill violates any moral prescription. However, the question here is whether and to what degree I may impose those beliefs upon others.
The argument for freedom is substantially an argument against arrogance. It is an argument that says that we are going to allow each competent adult the opportunity to look around and decide his own place in the world. Each of us thinks we are right. However, we are going to require enough humility to require that we use words to convince others of the error of their ways - not guns. We will presume in favor of freedom and the power of non-violent forms of persuasion, and give up freedom only when the arguments for doing so are compelling.
When religion commands somebody to kill others, the argument for finding this freedom intolerable is compelling. When it tells somebody not to kill - as in the case of the conscientious objector - the weight of the argument remains with the presumption of freedom.
However, in the case of the conscientious objector, freedom means that we are not going to compel them to kill. We still leave it to them not to choose the profession of soldier, where killing is potentially required.
We say, Fine. If you do not wish to kill - which is one of the potential duties of a soldier - then do not enlist. Do not go through basic training, get assigned to a squad, get into a battle, and decide at that point not to pull the trigger because you have religious objections to killing. Make your decision before you sign up that this career opportunity is not for you. In addition, do not demand that you be able keep your job as the heavy weapons specialist after you have decided not to do perform the duties that this job requires - because removing you from that position violates your "freedom of religion". Your freedom of religion is exercised in the freedom to not be a soldier.
We can take the same position with respect to the pharmacist. If you object to handing out any legally prescribed drugs, stay out of the pharmacy business. Do not go into training, get yourself a job, take the Sunday shift, and then refuse to do your duty when a customer comes in with a valid prescription for a morning after pill. Make your decision before you start training. This career opportunity is not for you. Do not say that requiring you to sell a legal prescription drug violates your freedom of religion. Your freedom of religion is exercised in the freedom to not be a pharmacist.
Individuals are still given freedom of conscience. We are not going to force people into jobs that are not compatible with their religious beliefs.
We are not going to force the conscientious objector to become a soldier.
We are not going to force that devout Jew or Muslim to become a sausage taster.
We are not going to force the devout animal-rights advocate to become a rancher.
We are not going to require religious fundamentalists to become pharmacists.
We will trust them to take jobs that are compatible with their religious beliefs.
13 comments:
My next step will be to ask whether or not the pharmacist can use religion as a reason not to kill. I hold that an fetus has to have a brain capable of having desires before it can have moral standing. You cannot violate the interests of a being that has no interests.
The earliest that a given infant can have any sort of conscious experiences at all is around 25 weeks (I'm counting age from conception here, obviously). From what I've been able to gather, infants as young as seventeen weeks' gestation have survived the birth process and lived for short periods of time outside of the womb, and those as young as 21 weeks and 6 days have been born prematurely and survived their infancy. Since these infants are not old enough to have any sort of conscious experiences, they have no desires at all. But surely they have the same moral standing as you and I. It follows from this that your claim according to which "a fetus has to have a brain capable of having desires before it can have moral standing" is false.
The case of these prematurely born infants proves the claim that one must have "interests" in order to have moral standing to be plainly false, at least when the term "interests" is defined in a way that requires that some desires be thwarted in order for one to be harmed in terms of one's interests.
But as far as I am concerned, the most interesting implication of your argument is that an infant born prematurely at 24 weeks and a newly conceived infant (a "zygote") have the same moral status. Of course, you would say that neither of them have any moral standing, and I would say that they both have the same moral status as you and I. The bottom line here, at least as I see it, is that we both agree in principle that there are no morally relevant differences between killing infants born prematurely at 24 weeks and killing, say, a 3-day-old infant (an "embryo") for medical research.
You are going to run into some serious problems if your side tries to win the public debate with these arguments.
Alonzo:
There are also good reasons for society to require that pharmacists in particular be capable of doing their jobs. A person's access to prescribed medications is vitally important for their mental and physical health. Pharmacists need to be capable of filling any legal prescription for the same reason that firefighters need to be strong enough to carry an unconscious person out of a burning building.
Incidentally, I was pleased to learn that conscientious objector status can be obtained for non-religious reasons in the US.
Austin:
Since these infants are not old enough to have any sort of conscious experiences, they have no desires at all. But surely they have the same moral standing as you and I.
Not only is it not assured that premature infants and zygotes have the same moral standing as adults, it seems obviously wrong. There are many things that make human lives valuable, and (in my view) adults have them all in equal or greater proportion to infants, let alone zygotes. Prefacing your beliefs with "surely" does not constitute an argument for them.
In any case, your entire line of argument is beside the point. The issue at hand is not whether RU-486 is morally legitimate; it is whether the actions of a pharmacist who refuses to honor a legal prescription for RU-486 are legitimate.
Austin
First, desires do not require consciousness. Desires motivate action - but not always consciously. Many individuals have been tripped up by unconscious desires. Everybody has likes and dislikes they do not know about until they try something new.
Second, there is no such thing as intrinsic value. You can claim that some particular state has value. However, as a matter of fact, nobody has a reason to do anything other than that which fulfills their desires. Other types of value - God's wishes, instrinsic values, categorical imperatives - they are all myth. They do not exist. The only thing that you are noticing when you discover some situation that you do not like are your own likes and dislikes. Asserting that they have intrinsic merit is a fallacy of projecting your interests on the real world. If zygote has no desires - no interests - it certainly cannot have an interest in living or dying.
Third, as Jesse pointed out, this is a post about the duty to perform the tasks of the job one has signed up for. It is not meant to contain a full defense of my position on abortion. Pursuing an abortion debate here would be a red herring.
In any case, your entire line of argument is beside the point. The issue at hand is not whether RU-486 is morally legitimate; it is whether the actions of a pharmacist who refuses to honor a legal prescription for RU-486 are legitimate.
I guess I don't really see the difference.
First, desires do not require consciousness. Desires motivate action - but not always consciously. Many individuals have been tripped up by unconscious desires. Everybody has likes and dislikes they do not know about until they try something new.
A being who is not conscious, has never been conscious, and will never be conscious, obviously has no desires. How could someone like that possibly be said to have any desires? I agree that being presently conscious is not necessary in order to have desires, any more than being presently conscious is a prerequisite for having beliefs; the statement "Austin Nedved believes that two and two are four and he desires to pursue higher education" is true even while I am sleeping. But someone who is not now conscious and never will be, such as your typical living infant born prematurely at 22 weeks who will live for several hours after being born and then die, indisputably has no desires. This is because having desires depends on having conscious experiences at some point during one's existence.
...as Jesse pointed out, this is a post about the duty to perform the tasks of the job one has signed up for. It is not meant to contain a full defense of my position on abortion. Pursuing an abortion debate here would be a red herring.
How is it not relevant to our discussion? If pre-conscious infants do indeed have the same rights as you and I, and prescribing the morning-after pill or RU-486 is therefore analogous to killing someone like you or me, then one can never have a duty to do so. Since the topic of this post is whether doctors have a duty to prescribe the morning-after pill and RU-486, and since if what I am saying here is true it would follow that no doctor could ever have such a duty, I don't understand how what I'm saying could possibly be irrelevant.
If [a] zygote has no desires - no interests - it certainly cannot have an interest in living or dying.
Again, I think that living infants born prematurely at, say, 23 weeks, who will live for several hours and then die, have the same moral status and "right to life" that you and I possess. So even if they have no "interest" in living in the sense of the term by which they have no desires that would be thwarted by being killed, it is plainly no less wrong to murder them than it is to murder someone like you or me. You aren't, uh, actually denying that it would be as seriously wrong to kill these desireless infants as it would be to kill you and me, are you?
Austin:
Alice is a police officer. She believes that marijuana is an effective medicine and that it is immoral to deny people access to effective medicines. However, the laws of her state are clear that possession, distribution, and use of marijuana is a crime. Is it legitimate for Alice to refuse to enforce those laws?
Bob is a paramedic, responsible for giving people emergency medical treatment. Bob's religion dictates that it is immoral for a man to touch a woman who is not his wife or in his immediate family. Is it legitimate for Bob to give treatment to men only?
Clyde is a doctor and a mohel. He believes that for a Jewish boy to go uncircumcised is a breach of God's covenant. Is it legitimate for Clyde to circumcise infants in his care, regardless of the parents' wishes?
In all three cases, the answer is "no." Alice, Bob, and Clyde are free to have their moral beliefs, to advocate them publically, and to organize their personal lives around them (within the law). Nevertheless, in their professional lives, they must abide by their professional obligations.
Can you see how the question "Should Alice, Bob, and Clyde abide by their professional obligations?" is distinct from the question of whether their moral beliefs are legitimate?
Alice is a police officer. She believes that marijuana is an effective medicine and that it is immoral to deny people access to effective medicines. However, the laws of her state are clear that possession, distribution, and use of marijuana is a crime. Is it legitimate for Alice to refuse to enforce those laws?
Assuming that her belief is correct, then yes, she would not only be justified in refusing to take any part in the enforcement of this law, she would have a duty to refrain from doing so. If cancer patients do in fact have a right to use marijuana, and this right does exist independently of the law, then no one could ever be justified in participating in the law's execution.
Bob is a paramedic, responsible for giving people emergency medical treatment. Bob's religion dictates that it is immoral for a man to touch a woman who is not his wife or in his immediate family. Is it legitimate for Bob to give treatment to men only?
No, it is not. If he refuses to give treatment to a woman, and that woman dies as a result, then he has violated her rights. He has no right to impose his moral beliefs on others not because doing so is in principle unjust, but because his moral beliefs are false.
Clyde is a doctor and a mohel. He believes that for a Jewish boy to go uncircumcised is a breach of God's covenant. Is it legitimate for Clyde to circumcise infants in his care, regardless of the parents' wishes?
Given that it is impermissible to circumcise infants even with the permission of their parents, I'm going to say "no" to this one too. And once again, this is a case of it being wrong for him to impose his moral beliefs on others not because it is necessarily impermissible to ever force other people to conform to the morality of others (as is evidenced by the fact that our government prohibits theft uncontroversially), but because his moral beliefs are false. When the mohel claims "it is right and just for me to circumcise infants", his beliefs are simply incorrect, and so he has no right to impose them on others.
I think that our discussion illustrates quite well the fact that we can't really have an argument about whether the law should require physicians to prescribe these drugs unless we can decide whether it is permissible for doctors to administer them at all. If the pro-choice side is correct, and there is nothing objectively unjust about using the morning-after pill and RU-486, then it is impermissible for pro-lifers to impose their false beliefs on anyone. And if the pro-life side is correct, it is impermissible for anyone to be prescribing these drugs in the first place, so obviously doctors cannot have any sort of duty to do so.
This is why Alonzo was dead wrong when he said that "Pursuing an abortion debate here would be a red herring."
So, I guess the answer to my question is "no." You've missed the point of both Alonzo's post and my comment.
Here it is, then: when you become a police officer, or a paramedic, or a doctor, you take on certain professional responsibilities, even when those responsibilities conflict with your personal beliefs. It is not the role of a police officer to decide what laws should be enforced, or a paramedic to decide who should be elegible for emergency medical treatment, or a pharmacist to decide what prescriptions should be filled. As private citizens, Alice, Bob, and Clyde are free to advocate and organize their personal lives around their beliefs, but in the course of their professions, they are obliged to fulfill their duty.
Instead of addressing this issue, you give a different standard for whether Alice, Bob, and Clyde's actions are legitimate: whether they are "right" or "wrong." Of course, all three of them sincerely believe that they are "right," but according to you, Bob and Clyde are "wrong." You haven't given any moral basis for your decision that Alice is "right" and Bob and Clyde are "wrong," and it's not supported by law. So the standard you offer simplifies to "right or wrong according to Austin Nedved."
This is exactly the kind of arrogance that Alonzo warns about in the post itself. But I'll emphasize again, so you don't miss the point a third time: the important question is not whether Alice, Bob, Clyde, or you, Austin Nedved, are "right" or "wrong." It is: do any of you have the right to decide for yourself what laws you are obliged to follow, or which of your freely assumed duties you are obliged to fulfill?
i think this goes a little far. the analogies don't quite match in an important way.
the soldiers job is obviously involves killing or assisting to kill in some way. it is obvious what they are getting into and it has been obvious for a long time.
the pharmicist's job is to hand out medicine to people who need that medicine; which is not as cut an dry. the morning after pill has not been around for 80 years. someone who under went training to be a pharmicist did not necessarily know that handing out this particular drug would be a part of their job. someone could have had a career as a pharmicist for 50 years and now you say she should quit or be fired because their religion now conflicts with their job.
another way the analogy diverges is that handing out the monrning after pill is not all that a pharmicist does. or even the main thing that a pharmicist does. that is probably a minor part of her job. for the soldier on the other hand. it would be a major breach of his responsibilities to refuse to pull the trigger in a fire fight. you need every soldier in a platoon willing to fire their weapon
you don't need every pharmicist in a pharmacy willing to fill any subscription. you only need one on duty pharmicist (or some combination that is) willing to fill every possible subscription. Pharmicists should be allowed to be concientious objectors. it should instead by the pharmicist company that is forced to hire and staff their buissness with some combination of people that will fullfill the obligations of handing out all legal medicine. and if a pharmicist has a perscription that they refuse to fullfill they need to tell their company so that their work hours can always be paired with someone who will perform the part that they will not.
the company should be required to fullfill this service but an individual pharmicist need not be forced to do so against their will. (perhaps they would become less likely to be hired but they have to live with the consequences of their decisions)
the soldiers job is obviously involves killing or assisting to kill in some way. it is obvious what they are getting into and it has been obvious for a long time.
Tell that to the National Guard units deployed overseas. But now we're digressing.
someone could have had a career as a pharmicist for 50 years and now you say she should quit or be fired because their religion now conflicts with their job.
No, not at all. I say she should give out the morning-after pill to anyone with a prescription for it. If she's willing to do her job, then by all means she should keep it. Would you let a police officer keep her job if she refused to enforce a law-- even if it wasn't on the books when she was hired?
I don't know anything about the day-to-day workings of a pharmacy. If it's practical to organize a schedule so that someone is on duty to fill any prescription, and a pharmacy is willing to do so, that'd be fine with me.
@Kristopher
All good points, but what if it is a small town with only one pharmacist?
I would leave each individual business with the option of organizing their shop as they see fit - as long as it is transparent to the customer. That is to say, if the pharmacy is open during regular hours, and somebody brings in a prescription, they get it filled.
@ alonzo
i completely agree. it is the responsibilty of the buisness to ensure that they provide access to legal perscriptions, and if they do not they deserve to be sued. but i think suing the individual pharmicist is the wrong target.
@ anon
small towns and mom and pop pharmacies should be held to he same standard as any other buisness. if they only have one pharmacist on duty and that pharmacist does not perform their job the buisness deserves to be sued. if that forces a buisness to hire additional staff, then so be it. if that forces a mom and pop shop out of buisness it was their own fault.
what happened to that rape victim is wrong and she deserves legal redress but we need to make sure we take aim at the correct targets.
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