Over the counter conscience vote

Every now and again, stories hit the media about pharmacists who refuse to stock condoms, dispense the contraceptive pill and, more recently, the morning-after pill. Contrary to what we are led to believe, this is not an irregular occurrence, nor is it a particularly surprising stance for a Christian pharmacist.

The most recent example is of one such pharmacist, Trevor Dal Broi of East Griffith, who, in recent weeks, removed condoms from his shelves; declared that he would no longer dispense contraception; and would not provide emergency contraception (the morning-after pill) to those who came in requesting it. He is not the first Catholic pharmacist to do so, and he will not be the last. Across Australia, a significant number of Catholic pharmacists have taken a similar stand.

Greg Turnbull of the Pharmacy Guild of Australia’s national secretariat told the Sydney Morning Herald that people were not forced to go to Mr Dal Broi’s pharmacy.

“As far as condoms are concerned, people can buy them almost anywhere - in supermarkets, in hotel rest rooms and in petrol stations - so, really, a pharmacist choosing not to sell them is no big deal.”

Regardless of personal views on the use of contraception, it is difficult to argue that pharmacist Trevor Dal Broi was in breach of his role as a pharmacist to refuse to sell certain products. Though one might ask the question, why he has removed contraceptives from his pharmacy only in recent times, it is a courageous move.

The refusal of organisations such as the well-known Body Shop to stock supplies tested on animals is a widely accepted fact. People can choose to shop there or they may prefer to purchase other cosmetic brands. Some consumers refuse to purchase sporting goods from companies such as Nike due to accusations of the use of sweat-shop labour. Others choose not to consume Nestle products because of previous alleged unethical practices regarding powdered milk. People vote with their feet, and act on their conscience.

Catholic hospitals in Australia choose not to provide abortions. This stance is consistent with the teaching of the church. There is no secret about this stance and there are plenty of publicly run hospitals which provide this service.

In commentaries on a Catholic News website in response to an article about this issue, one contributor defended the dignity and right of Dal Broi to answer to his personal conscience.

“The best part of Trevor Dal Broi's actions is the way in which he respects the dignity of the people who come to him as a client/customer. He very graciously tells them why he has taken the action. His actions have both religious and scientific backing.”

One could argue that pharmacists have a responsibility to provide products which prevent the spread of sexually transmitted disease. However, John Wilks of Seven Hills in Sydney has taken the stand not to provide condoms and contraceptives for many years, and articulately explains his reasons not by citing religious ideology, but by arguing the scientific facts. In this way, Wilks is convincing:

The criticism of Mr Dal Broi is based upon the assertion that condom and pill availability reduces the incidence of sexually transmitted diseases and unwanted pregnancies, and that therefore Mr Dal Broi's actions undermine this health ideal.

In the USA, the Centre for Disease Control reported that the cases of chlamydia increased from 887,478 in 2003 to 1,108,374 in 2007. Rates for gonorrhoea and syphilis have also increased.

In the UK, the rates of all sexually transmitted disease have increased every year since at least 1998, with chlamydia increasing by 150 per cent, and syphilis by 1,828 per cent, despite the widespread availability of condoms and in-school education programs on their use.

Also, the UK teenage pregnancy rate is the highest in Western Europe and has increased again in the last few years. In Australia on 17 September, 2009 a newspaper ran the following: "HIV, chlamydia and syphilis are cutting a swathe across Australia according to new national statistics which have disease experts calling for more testing and reinvigorated public health campaigns." Our teenage pregnancy rates are one of the highest in the OECD.

John Wilks’ argument is convincing, and it points out the flaws in how this situation was reported by the media. In reality, the less popular view is that of Mr Dal Broi, but the way it has been reported would suggest that he is personally responsible for a lack of availability of contraception in the town of Griffith. There are at least seven pharmacies in Griffith, meaning that although this could cause some personal inconvenience, it is certainly not impossible to obtain contraceptives elsewhere. Perhaps the story may be of more concern if it was a one-chemist town - but the argument still stands.

New South Wales Health Minister and Deputy Premier Carmel Tebbutt said, when interviewed by the SMH, that there is no legal requirement for pharmacists to stock any particular therapeutic device or treatment. While she was arguing against Trevor Dal Broi’s stance, this assertion is correct. People, if unable to access a particular medicine or treatment at one pharmacy, can always access it elsewhere. Not all pharmacies have access to vaccinations required for overseas travellers. This does not make them responsible if someone then becomes ill overseas, certainly not if there are a number of pharmacies in the area which could have provided these vaccinations. Similarly, a pharmacist’s refusal to stock the morning-after pill does not make him responsible for an unplanned pregnancy.

It is often simply not possible to stock every treatment available in every pharmacy. In the case of Mr Dal Broi, it is unlikely that if he was unable to stock some other variety of medication or treatment that such a fuss would have been made. Mr Dal Broi is not hiding his stance. It was reported by the SMH on October 11 that he is handing out a pamphlet to women with prescriptions for the pill stating his reasons for not supplying it. People have a choice. If this is not accordance with their beliefs, they have every right to go to another pharmacy.

The right to individual conscience seems to only be respected when the widely held view is at stake. Mr Dal Broi’s views are consistent with Catholic Church teaching and he makes no apology for that. He is serving his conscience and, as a health professional, he has as much right to live his moral beliefs in a free and democratic society as do those who choose to use contraception.