Pharmacists upholds Catholic values

This is a piece I wrote a couple months ago, which was just published in today's paper here in the diocese.

When a Catholic person becomes a pharmacist – or when a pharmacist becomes Catholic – he or she must eventually grapple with the disparity between Catholic teaching and legally available prescriptions: namely, artificial birth control and abortion-inducing drugs like RU-487 or “Plan B.”

Like physicians, pharmacists adhere to a strict code of ethics, beginning with “Do no harm.” Dilemmas for Catholic pharmacists arise due to the difference between the generally accepted idea of “harm” and what the Church teaches is “harm.”

There is no question that drugs like RU-487 were created and are dispensed with the sole purpose of causing abortions. In contrast, artificial hormones can be administered for several different reasons, which clouds the issues. For example, the same item that is used as contraception can be prescribed to control abnormal bleeding or to help ease a woman through menopause.

Most people consider hormonal contraception “safe,” even though scientific research proves that hormone-based birth control – pills, patches or injections – are all potentially harmful to both women and any baby who may be conceived despite the prescription. The Church further instructs that artificial contraception is harmful to marriages and “intrinsically evil” (See Catechism of the Catholic Church, 1652, 2363, 2370).

It can be difficult for a pharmacist who is Catholic to determine how to deal with legal prescriptions for morally problematic drugs. Several Catholic pharmacists in the Diocese of Lincoln have spent years working through the issues, at times risking their livelihood to stand up for their convictions.

Change of Heart

When Lane Hawley decided that his business, Superior Pharmacy, would no longer fill prescriptions for artificial contraception, it occurred to him that he might be out of business within six months.

“I had to rely heavily on my faith,” admitted Mr. Hawley, who converted to Catholicism while still in pharmacy school.

He had been employed at the same pharmacy, which is located in Superior, first as a student intern and then as a licensed pharmacist until he and his wife, Anna, purchased the store in 2003. The whole time, artificial contraception was stocked and dispensed.

Mr. Hawley remembered, “2004 rolled around, and I was seeing the side effects in my customers – the cancers, failed marriages, fertility problems. I got to the point where I’d seen enough.”

With the decision made, he developed a policy statement to hand out, composed letters to physicians and customers, and made the announcement to his employees. Even though these prescriptions comprised only 1-1.5% of the pharmacy’s total business, the staff was shocked. They all feared the repercussions, but their concerns did not dissuade Mr. Hawley from making the change.

“For the most part,” Mr. Hawley reported, “people handled it well. I had people come in and thank me because they didn’t know about the side effects.”

Nearly two years later, business is improving at his full-service pharmacy. A few customers protested the decision by taking their business elsewhere, but most have now returned.

Taking a stand

Dan Dailey, co-owner of both Daily’s Pharmacy Clinic and Coleman Clinic Pharmacy in Wahoo, took a similar journey nearly 15 years ago. There were differing opinions among Mr. Dailey’s team as well, along with the fear of losing customers. Still, he knew he had to persevere.

Initially, he chose to refrain from dispensing the drugs himself, allowing one of the other pharmacists on staff to handle those prescriptions. “I eventually hit a point where being co-owner, I was uncomfortable with that.” He conferred with his partner, and the pair soon agreed to stop dispensing hormonal contraception altogether.

“I honestly don’t think it hurt our business at all, financially,” Mr. Dailey emphasized. “In fact, we have some people who are supporting us because we are pro-life.”

Like Mr. Hawley, Mr. Dailey notified his customers of the change with a very carefully worded letter, so as not to offend anyone who may have held a different stance on the issue. His letter frankly detailed the abortifacient aspects of hormonal birth control, explained his moral opposition to it, and recommended Natural Family Planning instruction at a local hospital.

“It is not my intention to judge any one else’s moral beliefs,” he wrote, “I hope by the same token, you will respect mine.”

Reaction, he said, was “generally good…We have a really good relationship with all our patients. People were understanding.”

Starting from scratch

When he became a pharmacist, Scott Kirkegaard took a job at the Hastings Regional Center, where artificial contraception was rarely a concern. He spent his days helping physicians pick medications for treatment regimens and consulting with patients.

Faced with the regional center’s closing, Mr. Kirkegaard had to determine the next stage of his career. He and his family are fond of Hastings and didn’t want to leave. But he knew that working in a regular pharmacy would test his Catholic convictions.

“I didn’t want to work for a Walgreen’s or Wal-Mart where those issues do come up,” he said.

Mr. Kirkegaard had another idea – opening a pro-life pharmacy. Though there are many other pharmacies in Hastings, none of them advertised as “pro-life.”

Coincidentally, a Catholic bookstore was moving out of Hastings to another city. So, the Kirkegaards decided to augment the traditional drug store offerings with Catholic gift items like rosaries, Bibles, statues and the like.

Mr. Kirkegaard’s investors agreed his plan was viable, and Crosier Park Pharmacy opened nearly a year ago. It’s situated next to a doctor’s office that also advertises as pro-life. The first year hasn’t been easy, but Mr. Kirkegaard hopes his clientele will continue to grow as more people become aware of his store

“I think in the long run, we will be blessed that we did it,” he said.

Differing views

While Catholics who own their own pharmacies can choose not to stock or dispense hormonal contraception, those who work for owners who do not share the same moral beliefs must negotiate a compromise.

James Polk and Jeff Rademacker both work for a SunMart pharmacy in Lincoln. SunMart, a large chain of grocery stores and pharmacies within grocery stores, requires every location to stock artificial contraception.

In such a situation, a Catholic pharmacist might defer such prescriptions to another pharmacist on staff who doesn’t have a problem with the drugs. For Mr. Polk and Mr. Rademacker, who share the same view, that isn’t an option.

“We struggle with dispensing them,” Mr. Rademacker said.

In fact, before he even finished pharmacy school, Mr. Rademacker consulted a priest about the issue. He was told that as long as the drugs could be prescribed for a morally acceptable reason (such as alleviating severe symptoms during menopause), and as long as he wasn’t helping a couple make a decision to contracept, he would not be sinning by filling the prescriptions.

Ethically, there is little that the pair can do to reduce the number of prescriptions for artificial contraception that are presented to them. Education is their best course of action.

“We encourage customers to ask the questions about the prescription,” explained Mr. Rademacker. “That leaves the door open so we can tell them the truth about the side effects and offer extensive counseling.”

He continued, “We try not to be judgmental, but we both feel they are unsafe and can cause abortions. People don’t know that, and they need to know.”

It’s a different story when it comes to Plan B, or the so-called, “Morning After Pill.” Even though the item is approved by the Food and Drug Administration (FDA), neither Mr. Rademacker nor Mr. Polk will dispense such a prescription – ever.

“I have talked to my district manager, and I’ve made it quite clear as long as I’m the pharmacy manager here, we won’t stock those products,” stated Mr. Polk. So far, his employer has acquiesced, which, Mr. Polk said, “is kind of nice, because some other companies are not that supportive.”

Legal Considerations

For now, pharmacists in most parts of the United States are not required to dispense either hormonal contraception or abortion-inducing drugs, even though they are legal. Late last year, however, the situation changed in Illinois.

After a pharmacist refused to dispense the abortion drug in an Illinois city, the state legislature passed a mandate requiring all pharmacists to fill such prescriptions, even if they had a moral opposition to the drugs. Many Catholic pharmacists in that state have been forced to either move or change professions.

Mr. Dailey considers that law outrageous. “It’s not fair to tell a pharmacist that he has to participate in an abortion by selling the Pill or the Morning-After Pill or RU487,” he said. “They can’t make a physician write a prescription for it, so they shouldn’t make a pharmacist dispense it.”

Each of the men is keeping an eye out to make sure that a similar situation doesn’t happen in Nebraska. “I don’t really have time to fight it,” Mr. Hawley said, “but I would have to make the time if the issue came up.”

One of Mr. Rademacker’s sons is currently studying to be a pharmacist at Creighton University. When he thinks about the pressure his son may face to dispense these drugs, Mr. Rademacker sighs.

“I think it’s going to get worse,” he said. “Plan B is making its way into the states, and depending on the government and Planned Parenthood and groups like that putting pressure on the voters, I really think unless we stand up, it’s going to get even worse.”

And here is the accompanying sidebar...

Assessing the risk of artificial contraception

When it comes to hormonal birth control, many pharmacists agree that couples often do not have a firm understanding of how much risk the drugs carry. The public generally accepts FDA approval as a sign of safety, but that might not be the wisest conclusion.

The University of Nebraska Medical Center instructor who taught Lane Hawley’s course on artificial contraception and other hormonal therapy clearly believed these items were not safe.

“It made an impression on me,” Mr. Hawley recalled.

That course as also where it became evident to Mr. Hawley that the birth control pill is abortifacient, meaning it causes the death of unborn humans.

Mr. Hawley, James Polk and Jeff Rademacker all agreed that patients are not educated enough about the potential danger of hormonal contraception.

“They’re not getting the full story,” Mr. Rademacker said. He believes that artificial contraception was approved by the FDA because people wanted convenience, not because the drugs are safe.

Mr. Polk explained that during the developmental phase in the early 1960s, researchers were studying contraception for men as well. After a minor side effect showed up in men, they stopped progress on that drug. However, when three female patients in the first study died, they simply reformulated the dose.

“That just shows the hostility that society has toward women,” he said. He recommends the tape and book series, Contraception: Why Not, by Dr. Janet Smith, for more details.

Mr. Polk also compared the use of hormonal birth control with certain arthritis medications. “You got a medication that millions of people are using for arthritis. A half-dozen people die, then eight to ten more, and the FDA pulls it from the market. How many thousands die from contraception, and yet the public demands it.”

Each of the pharmacists recommend that a woman who is currently taking hormonal birth control consult her doctor or pharmacist about her potential risks. These risks include*:

• High Blood Pressure
• Blood Clots
• Strokes
• Heart Attacks
• Migraine Headaches
• Menstrual Problems
• Vaginal Infections
• Abortion
• Infertility
• Gallbladder Disease
• Liver Tumors
• Breast Cancer

*Source: Jose M. Fernandez, M.D., www.omsoul.com