Wednesday, June 18, 2008

SEX

SLATE has become a recent monopolist over my internet time, and I couldn't help but notice the well-argued defense of pharmacies that now will not dispense prescription contraceptives and Plan B, the "morning after" emergency contraceptive pill. I'll admit that William Saletan is fair and methodical in his arguments, but he too easily dismisses the inequality and sexism, and the hypocrisy of American society which celebrates sex in commercial, entertainment industries but will not recognize the gravity of the consequences of sex, which sometimes involves pregnancy. He also treats the situation lightly, and rightly so, since only about 7 pharmacies have signed the no-contraception pact, but the precedent that this sets puts many women in danger, as I will elaborate later. His arguments (counter-arguments, actually, to various criticisms of these pharmacies) are outlined below, with my responses are italicized.

1. In response to claims that this action "walls off" medical care to women, the author states that the additional burden of finding another pharmacy is not significant enough to consist of a serious threat to women's access to health.

This is fair, but as I will elaborate in #5, the additional burden of finding another pharmacy may be difficult in small towns and rural areas, where the next pharmacy is quite a distance away... And it presents unnecessary burdens and obligations to the woman, who is probably distressed, especially if she is seeking the emergency contraception pill after rape. Sure, if it's just prescription oral contraceptives, the woman might not be in such a hurry, but time is of the essence, as Saletan himself acknowledges, and he underestimates the potential (again, not a universal characteristic) magnitude of the additional stress of having to find another source of medical care.


2. In response to calls on inequality (Viagra is readily available when contraception is still taboo), he notes that Viagra has none of the ethical issues regarding the choice of human reproduction. He does point out that he doesn't necessarily buy into the pro-life argument 100%, but he can see why this would be an issue, while Viagra isn't. The inequality, therefore, simply exists because women's bodies carry the baby, men's bodies... well... don't.

I want to just have a rant here about what a sexist prick he is. But he brings up a slightly tangential, but still critical point. Regardless of the differences in the NATURE of the drugs mentioned - viagra and emergency contraception (since that, not necessarily regular oral contraception is the target of this new trend) - there are serious inequities in the treatment of male and female sexualities. I'd like to note that Viagra is often covered by health insurance. While similar drugs for women are not. Bush's policies also make contraceptives (the regular, monthly kind) much more expensive to some women. While this is part of a larger moral-social agenda, it targets specifically women, as the carriers of children, in a way that is unjust and simply disgusting. Many insurance companies don't carry the HPV vaccine, which I can tell you costs $135 (at least) per shot, repeat 3 times. It also hurts like hell...


3. In response to a doctor's claim that health care professionals are professionally obligated to dispense care, he cites that doctors are allowed to draw moral boundaries.

I concede in acknowledging a doctor or pharmacist's right to choose to dispense certain medical care, within reason. However, pharmacies are not people. Pharmacies, as institutions, do not have a common set of moral values. In effect, they are barring the pharmacists within to oblige by a standardized code of beliefs, which probably align with the individual beliefs of the pharmacists but may not always be the case. How is this any different than firing individual pharmacists for refusing to provide emergency contraception?

Also, his sources also mention that the general refusal to provide ANY prescriptive contraception (basically, stuff that allows women to take control over their reproductive functions, almost always to PREVENT pregnancies - and by extension, abortions) has to do with state regulations and such. If that is the case, pharmacies are also barring regular oral contraceptives, which almost all consider on par with condoms. They prevent pregnancies. Unless you're hardcore Catholic and believe that semen not used for procreation is a sin, this should not be roped into the deal just because of a DIFFERENT (though I'd like to point out they're both PREVENTATIVE drugs, and that Plan B is NOT abortion, though I can see why it could be construed as such) objection to a DIFFERENT drug. It would be like banning grape juice in an effort to also stop consumption of wine. Yeah, kind of like that. In that case, these health care "professionals" are denying reasonable care. And the fact that entire pharmacies are signing the pact also restricts individuals from having a nuanced position about female reproductive rights. Maybe some pharmacists do truly believe that contraceptives overall are evil, but this ban also effects many others who are not comfortable with Plan B but don't have much of a problem with regular contraception.


4. Such restrictions may create "humiliating" circumstances for women, but Saletan argues that this really isn't an issue and if anything, the person refusing to serve the patient should be the one humiliated. Just walk out and find another pharmacy, he suggests.

This is an extension of American culture that celebrates Super Bowl commercials with scantily-clad women, macho-culture where sexual conquests (female) are badges of honor, but that also scorns a girl who carries a condom. Americans love sex, but they aren't comfortable with it. It's an American-style burka placed on American women, who bear the burden of a nation's ambivalence towards sex.

Yes, the woman could walk out and find another pharmacy, but in a society that sexualizes women but fears sexual women, this IS humiliation. The pharmacy, as an institution that serves the greater PUBLIC, is making a morally based judgment and telling women that whatever they did (or had happen to them, in cases of rape and the like) are not mainstream and fall outside the moral boundaries of the institution. I find this repulsive, even if the author thinks it's a matter of some girl embarrassed about a one-night stand or something. It's more than that.


5. He rejects the idea that there could be regions where contraceptives will not be available. Mainly because only 7 pharmacies have signed the pact.

Saletan makes really good arguments based on facts, and I respect that. I only wished that he acknowledged the fears of those who wonder what kind of PRECEDENT such action by a group of pharmacies have. This makes it OKAY for pharmacies to refuse to serve sexual needs of women. Maybe it's only 7 pharmacies now, but the next pharmacy, which makes it #8, could be the only pharmacy in a rural town where the next pharmacy is hours away. Maybe #9 could be the neighboring pharmacy, making contraception simply nonexistent in a broad stretch of America. And let's consider the political orientation of America for a minute. It's the non-coastal, socially conservative, relatively more agrarian communities that are most likely to object to Plan B, thus the pharmacies in the region are more likely than pharmacies in NYC to ban contraception for women. You get my picture? I'm not expecting a league of hundreds of pharmacies across the country to follow suit, but a few clusters of pharmacies will be enough to condemn innocent women to make more drastic health and lifestyle choices.