ALTOONA, Pa. — They're a crucial link in the healing of the sick, but in many places, pharmacists are finding it harder to escape being agents of the culture of death.

So-called emergency contraception, taken by women soon after sex when it is thought contraception has failed, may cause the abortion of a newly formed embryonic life more often than thought, three physicians assert in the March issue of The Annals of Pharmacotherapy. The article, by Drs. Chris Kahlenborn, Joseph Stanford and Walter Larimore, was published at www.theannals.com.

Kahlenborn, the lead author of the article, works in the internal medicine department at Bon Secours Hospital in Altoona, Pa.

“Catholic hospitals that … allow hormonal EC (emergency contraception, for rape victims) prior to ovulation may wish to reassess their policies given the findings that EC use does not consistently stop ovulation and has the potential of causing a post-fertilization effect (abortion) even when used prior to ovulation,” the authors wrote.

But attempts are increasing throughout the country to make emergency contraception more easily available and to force even Catholic hospitals to dispense it in emergency rooms. California began the year by allowing women to purchase emergency contraception without a prescription. Washington state already has such a law, and Virginia is considering similar legislation.

Pope John Paul II, in his message for World Day of the Sick on the feast of Our Lady of Lourdes, Feb. 11, wrote: “The Church insists on the principle that not all that is technologically feasible is morally admissible. The tremendous progress in medical science and skills in recent times places a supreme responsibility on us all with regard to God's gift of life — which always remains a gift in all its stages and conditions. We must be vigilant against every possible violation and suppression of life.”

The Pope said that on the annual celebration, which includes prayers for the sick, his thoughts would also go out to “the countless men and women who are active in the field of health care,” including pharmacists.

A growing number of pharmacists are facing disciplinary action for refusing to fill prescriptions for emergency contraception as well as for birth control pills.

“Pharmacists who still have a conscience are being harassed and getting fired,” said Bo Kuhar, executive director of Pharmacists for Life International. The organization wants state laws to allow objecting pharmacists to refrain from dispensing the medications without facing punishment.

Most states have some form of legislation providing for a conscientious opt-out for abortions. But, on the reasoning that a pregnancy begins when an early life is implanted in a woman's womb rather than at the moment of fertilization, abortifacient contraception would not be covered by many of those laws. (It should be noted that this reasoning is scientifically unwarranted. The new life, at this stage, is already a boy or girl.)

An exception is South Dakota, where no pharmacist may be required to provide medication if there is reason to believe that it would be used to cause an abortion, destroy an unborn child (defined as an organism of the species homo sapiens from fertilization until birth) or cause anyone's death by means of assisted suicide or euthanasia.

In Illinois all health care providers, including pharmacists, can refuse on the basis of conscience to provide any kind of service.

Michigan and Kentucky are considering conscience protection bills. The Kansas Pharmacists Association opposes that state's proposed bill because it lacks assurances that patients can still get legally prescribed drugs.

“We recognize the right to conscientious objection,” said Robert Williams, the Kansas Pharmacists Association's executive director, but “patients’ rights outweigh providers’ rights.” Every pharmacy should have a procedure in place for accommodating a patient when a pharmacist refuses to fill a prescription, he said, suggesting that the pharmacist in charge might have another pharmacist fill it or require the objecting pharmacist to offer a referral to a nearby pharmacy.

But referral would be material cooperation in the immoral act, Kuhar said. “That's like telling someone, ‘I'm not going to sell you this gun so you can go shoot your cousin Betty, but I'll tell you where you can buy one.’”

Added Kuhar, “Our approach is total protection of the [unborn] child.”

“He's entitled to his opinion,” Williams responded. “But the patient is not asking for an illegal product.”

Soul Searching

Pharmacists are objecting not only to so-called emergency contraceptives but also to birth control pills, which also can act as abortifacients. Manuel Rodriquez, a pharmacist for almost 35 years, ended up resigning from Albertson's Pharmacy in Albuquerque, N.M., part of a large supermarket chain, after some soulsearching following the events of Sept. 11.

Rodriguez was praying a novena to Our Lady of Lourdes and thinking about the 3,000 or so lives that were lost in the terrorist attacks two weeks earlier. “And I thought, ‘Well, I'm really no better because I've been dispensing birth control pills all these years.’ But I'm not going to do it any more.”

He informed his boss of his decision and proceeded to turn down patients who come with prescriptions for birth control pills and told them why. But he did not get too far. The first woman he turned down went to his supervisor, who suggested he speak to the pharmacy supervisor.

The pharmacy supervisor expressed support for Rodriguez, but questioned whether birth control pills were as bad as the morning after pill. He said he would speak to Rodriguez again, but in the meantime the pharmacist submitted his resignation.

Rodriguez is working part time at a pharmacy he says is more understanding of his position, and is spending more time helping families understand the Church's teaching that contraception is immoral. He has organized a retreat in his parish in Belen, N.M., with family issues such as this on the agenda.

Birth control pills use one of 72 combinations of artificial hormones, and “every one of them is hostile to the uterus,” Rodriguez said.

He has tried to provide medical information to women who were having prescriptions of the pill filled, but he found that in most cases the explanation of the hazards involved “was going over their heads.”

Lamented Rodriguez, “It's so ingrained [in society] that they don't see any other possibility.”