Right or Wrong?

Moral (adj): of or relating to principles of right and wrong in behavior

As parents, we try and teach our children right from wrong, based on what our parents taught us. They, like their parents before them, served as the initial crafters of our moral compasses, and we in turn, start building that device for our children. As our children grow older, we hope that moral compass continues to point in the right, not wrong, direction.

Like with everything else, however, individuals still possess different notions of right and wrong. Some people think resistance in the face of law for a cause one supports is moral; others do not. Some people consider taxes immoral; others do not. Stealing is usually considered wrong; stealing to save one's child from starvation perhaps not. Sometimes the black and white of morality goes gray and one's definition of moral may take on a new layer.

And then there is the issue of abortion. In Arizona, a recently signed bill has tightened restrictions on access to abortion care and services. Many people applaud the provisions, many people do not. What some people see as a step in the right direction -- for example, notarized parental consent for girls under 18 -- others see as wrongly requiring these private decisions to become public in a notary's record book.

The word moral actually appears in one of the last provisions of this expanded statute:
A pharmacy, hospital or health professional, or any employee of a pharmacy, hospital or health professional, who states in writing an objection to abortion, abortion medication, emergency contraception or any medication or device intended to inhibit or prevent implantation of a fertilized ovum on moral or religious grounds is not required to facilitate or participate in the provision of an abortion, abortion medication, emergency contraception or any medication or device intended to inhibit or prevent implantation of a fertilized ovum. The pharmacy, hospital or health professional, or an employee of the pharmacy, hospital or health professional, shall return to the patient the patient's written prescription order.

In other words, a pharmacy technician can say no to a woman coming in with a prescription for emergency contraceptives. It would not take too large a stretch to apply this to regular oral contraceptive medicine, since a certain number of regular pills also can be used for emergency contraception. To refuse to provide the meds, all an employee of the pharmacy has to do is have signed a statement that he or she objects on moral grounds.

So not filling a prescription or perhaps sterilizing operating room equipment is now subject to moral grounds, to what is right and wrong. Or at least the practitioner's sense of right and wrong. The patient's sense of right and wrong seems lost in this equation.

In some ways, Arizona should have seen this one coming. According to the first definition in current law, the practice of pharmacy shall be interpreting, evaluating and dispensing prescription orders in the patient's best interests. Interpreting? The law already allows a pharmacist to "interpret" what is in a patient's best interests in regard to prescriptions? So what's next? A pharmacist who doesn't believe in antibiotics for children or who decides no one deserves oral chemotherapy agents?

Pharmacists undergo a great deal of training -- many obtain their doctorates -- and should be considered partners in health care. But while I expect a pharmacist to counsel me on drug interactions and side effects and work with my doctor to ensure these do not occur, I have a difficult time with a pharmacist denying a patient a legal prescription, just as I have with a technician refusing to touch instruments, on "moral" grounds. No matter how one feels about the specific application of this provision in this statute, we face a very slippery slope of interpretation as to how it could be expanded. One hopes those who make the laws will do the right thing, but we all know that things can go very wrong.