Cashiers for Life

William Saletan, the Slate columnist who's made a career of claiming to be pro-choice while justifying attacks on reproductive rights, has had yet another epiphany: We should all support the rights of pharmacists to refuse to fill our doctor's prescriptions for birth control. According to Saletan, who defends pharmacy refusals in his June 19 piece "Drugstore Choirboy,"

You bring your scrip to the pharmacy, and the guy at the counter says, "Sorry, we don't stock contraceptives." That's annoying and, in my view, stupid. But nobody's walling you in. Your burden consists of finding another pharmacy.

William Saletan, one assumes, has not had to drive twenty-five miles to a second pharmacy – the case in a large swath of rural America – because a pharmacist imposed his moral beliefs on him. But then Saletan, one assumes, has never filled a prescription for birth control, has he? (Condoms are available at every 7-11 -- though William should be advised that the people he finds it provocative to defend would like to see the condom banned too.)

Saletan's proposed solution is to post a polite sign explaining the pharmacy does not fill birth control prescriptions. Saletan apparently thinks indulging extremists and, indeed, inviting them to take charge of our health care, to, in effect, supersede our doctors' recommendations is a minor inconvenience. If, however, we're going to let everyone's political beliefs or religious enthusiasms govern our important life decisions, then we must allow that any political or religious convictions can hold sway.

In this case, why not permit a Muslim fundamentalist pharmacist to simply put up a sign politely explaining that his religious beliefs require him to deny a woman's prescription for any medication? No doubt Aryan pharmacists have a belief system too. Why should they be forced to violate their dearly held beliefs and serve blacks? (It's worth pointing out that not filling birth control prescriptions is not merely discrimination by product category, is it? The pharmacist is discriminating against women.) By Saletan's lights, it seems that a "We don't fill prescriptions for black people" sign should not be a violation of black people's rights as long as it's accompanied by a 24 hour hotline, as Saletan proposed for those denied birth control, directing them to the nearest pharmacy that will serve them.

And, then to follow Saletan's thought line further, why should ethical concerns be limited to pharmacists? Why should only "pharmacists for life" get the perk of refusing to do their jobs? Why not, say, cashiers who just can't bear the thought of violating their ethical beliefs by ringing up birth control pills? If we follow Saletan's advice, isn't it just a matter of time before we'll have Cashiers for Life too? The pack of condoms and case of beer that provide hundreds of thousands of Americans with fulfilling Friday nights must first pass the approval of the cashier who, by Saletan's logic, has a right to deny those purchases. As for the rights of the rest of us, all we'll have to do is swallow our rage and find ourselves another 7-11.

Saletan's argument rests on the smug and dangerously uninformed notion that anti-family planning acts are fringe acts, and so are best ignored. He underestimates the scope, commitment, and resources of the anti-abortion/anti-contraception movement. He fails also to acknowledge that contraception is life-saving medication too.

Most American families want (and have) two children meaning women spend about seven years, on average, getting and being pregnant and about 23 years preventing pregnancy. Planning a pregnancy leads to dramatic declines in both maternal mortality and infant mortality. Indeed, the countries on earth with the lowest maternal and infant mortality rates are those with the greatest access to and use of contraception. Those with the highest death rates are countries that deny women and families access to family planning—many are nations that took Saletan's route and simply ignored the fanatics into power.

The best way to move beyond the abortion debate is to make preventing unwanted pregnancy, planning a family and protection against disease a top priority. Instead, we have witnessed in just the last few years a dramatic increase in activity aimed at rolling back American's right to use contraception and protection. Pro-life pharmacists are just this movement's warm-up act. This year Colorado is considering a ballot measure that would define life as beginning at conception, an unknown biological moment. Rejiggering the science has as its ultimate goal not only banning abortion, but all hormonal forms of birth control. These same forces have successfully de-funded the US portion to UNFPA, the contraception provider to the most desperate regions on earth.

Bush, no doubt a supporter of "pro-life" pharmacists, has worked closely with the anti-contraception movement throughout his presidency. One of his first acts in office was his attempt to strip federal employees and soldiers of contraceptive coverage. Another was to place at the head of the nation's contraception program for the poor an anti-contraception activist. In fact, he has delivered these activists many more anti-contraception successes than anti-abortion ones.

Now presidential-contender McCain is playing footsie with the anti-contraception movement, coyly refusing to answer reporters' questions on whether he supports contraception.

Saletan is no doubt under pressure to think provocative thoughts several times a week. What he doesn't see is that if we allow extremists to intercede in our medical lives by simply putting up a sign then the writing is, as they say, already on the wall.