The emergency contraceptive known as Plan B is back in the news again. Back in 2006, the state Board of Pharmacy took up rules under which a pharmacist could cite "conscientious, moral or religious reasons" in refusing to fill prescriptions for Plan B. Many people opposed the rule and in 2007 the board issued rules saying that pharmacists had to fill all lawfully prescribed drugs and devices. Later that year a US District Judge granted an injunction staying the rule for pharmacists who claimed it forced them to violate their religious beliefs. The Ninth Circuit Court of Appeals refused to lift the injunction and is scheduled to hear the case this coming April. We're sure to hear about that once they make their decision.
I was curious as to how Plan B works and found this excellent explanation. (Be warned that Paul Myers, associate professor of biology at the University of Minnesota, Morris, does not hold back while expressing what he thinks.) You could boil it down to one sentence. Plan B doesn't help if one is already pregnant, and it doesn't affect any implanted zygotes.
The FDA confirms this...
Plan B works like other birth control pills to prevent pregnancy. Plan B acts primarily by stopping the release of an egg from the ovary (ovulation).
... but then adds the "mays".
It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation). If a fertilized egg is implanted prior to taking Plan B, Plan B will not work. (emphasis added)
And the "mays" is what people with "conscientious, moral or religious reasons" are keying on, especially the second "may". It doesn't matter that many fertilized eggs do not attach to the womb anyway. Or that something like 20 per cent of all pregnancies end in miscarriage and most of those during the first two weeks. It'll be interesting to see if the FDA under the new administration changes that language.
Given all that the question for me is not, should pharmacists be allowed the option of not dispensing Plan B out of conscience or personal belief? The question is, should a pharmacist be allowed to practice if her beliefs about a particular medication defy or deny the science of that medication?
When you think about it, that's their argument. Unlike RU486 which does end a pregnancy, Plan B does not. But they believe differently.
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