Monday, October 25, 2004

Right Livelihood

I'll be watching this case pretty closely: Pharmacist says he feared 'spiritual pain': Hearing considers refusal to fill birth control pill prescription.

"MADISON, Wisconsin. (AP) -- A former pharmacist said Monday he refused to fill a college student's prescription for birth control pills or transfer it to another pharmacy because he did not want to commit a sin."

I've ranted about this before, but mostly in regards to proposed bills that would allow physicians & other health care professionals to "opt out" of providing any kind of abortion services. But what I wasn't really clear about is that it's already perfectly legal in some states, appparently for pharmacists to "opt out" of providing other prescriptions, too. There have been a rash of cases in recent years of pharmacists refusing to fill birth control Rx's. Besides the above-linked cases, there was a case in Texas last March. And one in New Hampshire last month. There are more - just google "pharmacy refuses to fill birth control" and you'll find more examples than you can count.

I could really get into a frenzy about the assumption that someone else's right to practice their religion somehow legally trumps a woman's right to basic healthcare. Or the ridiculous notion that if a sexually active woman gets pregnant it's her divine "punishment" for her sins. And I could wonder if they refuse to fill HIV medication or antibiotics for other STD's to men on the same grounds. But I won't.

Instead, I want to discuss the moral dilemma facing these pharmacists based on a tenet of Buddhism that really resonated with Curt & I when we began studying it. It's called "Right Livelihood" and it's one of the central precepts of the Eight Fold Path. Now in the simplest terms, "Right livelihood means that one should earn one's living in a righteous way and that wealth should be gained legally and peacefully. The Buddha mentions four specific activities that harm other beings and that one should avoid for this reason: 1. dealing in weapons, 2. dealing in living beings (including raising animals for slaughter as well as slave trade and prostitution), 3. working in meat production and butchery, and 4. selling intoxicants and poisons, such as alcohol and drugs. Furthermore any other occupation that would violate the principles of right speech and right action should be avoided."

Generally, pharmacists and other medical professions are definitely considered one of the "Right" and probably most noble of livelihoods. But if you use that profession to violate any of the other precepts of Buddhism, well, that would rack up bad karma in a hurry. What constitutes violations of those other precepts, and whether a particular act creates good or bad karma is, as always up to the individual circumstances and intent of the individuals involved. This ambiguity extends to the issue of abortion, as well. I might go into the logic around that issue in Buddhism but not right now. For the sake of this argument, let's just state that while abortion is generally frowned upon, birth control is not - since it prevents pregnancy to begin with (and thereby avoids the messy abortion dilemma). For that matter, consensual sex is not frowned upon either (so long as it is, in fact entirely consensual, nobody is profiting from it, nobody is addicted to it and nobody is getting hurt by it) and marriage is considered an entirely secular, and NOT a sacred institution.

But that's really besides my point. What I want to address is the more subtle meaning of the "Right Livelihood" precept as our Reverend Master explained it to us. Namely, that "Right Livelihood" not only means it is wrong to profit from someone else's suffering, it also means you should not profit from your own suffering. This is where the primary truth of Buddhism comes into play: that we are all the cause of our own suffering. This is why, not only is it wrong to prostitute others, it is wrong to prostitute your self. So from this standpoint, even though being a healthcare worker is usually considered a noble livelihood - if the requirements of that job cause you mental anguish, or places you in a position where you are violating your personal ethics, then you are intentionally causing your own suffering, and that makes your chosen livelihood wrong.

As I've mentioned before. I've quit jobs in the past because I had an ethical disagreement with the business culture of my workplace, or the requirements for the job. So has my husband. So have millions of other people. Your right to practice your religion does NOT in any way, shape or form give you the right to FORCE your religious beliefs on someone else - especially using the power of your profession. If I were Orthodox Jew or Muslim and I went to work in a pig slaughterhouse, my empoloyer would be totally within their rights to fire my ass for refusing to kill swine. Or if I were a diehard Vegan and I went to work in a steakhouse and I refused to serve T-bone to the customers. Or even give them the menu. I shouldn't have placed myself in that situation to begin with. Let alone make someone *else* suffer beecause of my doing so.

And that's exactly what these pharmacists are doing. They're not only making someone else pay the price for THEIR bad professional decisions, they're hurting themselves as well. Are you ethically uncomfortable working for a pharmacy that dispenses b/c (including the morning after pill?) Then feel free to quit and go to work for a privately-owned pharmacy run by Christian Scientists or some such where it won't be an issue. Or find a new profession. In every other situation in good old Capitalist U.S. of A - employees are reminded they do NOT have a constitutional right to a job. If the state isn't responsible for providing a job - it sure as hell isn't responsible for providing one that guarantees the employee a guilt-free conscience.

And if they manage to get legislation through that does give employees that right regarding b/c and abortion - they sure as hell better give the same right based on other moral issues or be prepared to fight it all the way to the Supreme Court. I don't see this having a Constitutional leg to stand on.

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