Abortion rights on the line (continued)

THE MORALITY OF BIRTH CONTROL

A new front recently opened in the reproductive rights debate, as anecdotal accounts started to surface about pharmacists refusing to fill prescriptions for birth control or emergency contraception pills, due to "moral objections." In New Hampshire, a Brooks pharmacist refused to fill or transfer a prescription for emergency contraception last year, and other women have reported receiving lectures at pharmacies and hospitals, according to the Web site www.fillmypillsnow.com.

Perhaps it shouldn’t be surprising, given how the US Food and Drug Administration ignored the recommendation of its own experts in refusing last year to allow the over-the-counter sale of emergency contraception, marketed under the brand name Plan B. And Dr. W. David Hager, one of President Bush’s appointees to the FDA’s Reproductive Health Drugs Advisory Committee, the co-author of a book recommending scripture reading and prayer as a cure for premenstrual syndrome, has said that emergency contraception would encourage sexual promiscuity.

In what is being called a compromise, Senators John Kerry of Massachusetts and Rick Santorum of Pennsylvania — odd bedfellows, to be sure — have introduced the Workplace Religious Freedom Act, which would allow pharmacists to refuse to fill a prescription if there is another pharmacist available who would be willing to do so.

Illinois Governor Rod Blagojevich took a more absolute position, guaranteeing a woman’s right to have her prescriptions filled. After hearing of an incident in February in which a pharmacist at an Osco Drug in Chicago refused to fill two women’s prescriptions for a morning-after pill, Blagojevich issued an emergency order requiring all state pharmacists to fill such prescriptions.

In June, Woonsocket-based CVS — which has more than 5000 stores in 36 states — sent a letter to the Planned Parenthood Federation of America, stating that "CVS pharmacies fill prescriptions for all lawful, valid birth control medications, including emergency contraceptives," and that if an employee has a religious conflict with dispensing a certain medication, he or she must notify their supervisor before being asked to fill a prescription. In August, however, in the first such incident reported in Rhode Island, a pharmacist at a CVS in Coventry told a woman she would she would have to return the next morning, or visit another CVS, to get her emergency contraception. A CVS spokesman for CVS told the Providence Journal that the company must accommodate an employee’s "sincerely held religious conviction" or personal belief.

Planned Parenthood’s Kushnir characterizes this new focus on birth control and emergency contraception as "way into crazy-land," although it didn’t surprise her. "[This] goes so far beyond reasonable comprehension, that a pharmacist would refuse to do their job and be able to keep their job," she says. "It’s frustrating because people want to restrict access to abortion but also to [prescriptions that would prevent abortion] . . . . You have to wonder what their true intent is."

NOW’s Drnach identifies what she sees as the "true intent" — the continued control of women. She also notes that the debate has centered only on certain types of birth control. "The purpose of a condom is to prevent birth, to control birth, so it’s fascinating to me that you never hear about . . . pharmacists refusing to sell condoms," she says. "It’s about oppressing women, it’s about controlling women . . . through the control of their womb."

Parquette says the pro-life pharmacists have a right to refuse prescriptions they find objectionable. "They feel that their principles are being compromised and they shouldn’t have to give out something that they don’t feel is morally right," she says. "Their jobs shouldn’t be in jeopardy because they make a decision based on a moral position."

SUPREME STAKES

For pro-choice advocates, the scariest possibilities come with tracking the "what if" scenarios involving the landmark Roe v. Wade decision. Although Supreme Court Chief Justice William Rehnquist is expected to retire soon — perhaps within a month — he voted against Roe. The recent retirement of frequent swing voter Sandra Day O’Connor, however, has mobilized liberal and conservative groups across the country, with abortion being framed as perhaps the most decisive litmus test for John G. Roberts, her potential replacement.

O’Connor was a proponent of the court’s current position that states may restrict abortion rights as long as such restrictions do not place an "undue burden" on women. If she is replaced with an anti-choice justice, the court may approve such restrictions as parental notification laws, which it is scheduled to review in the fall, and so-called "partial birth abortion" bans.

Over the years, the rights guaranteed in the Roe decision have been steadily challenged, with anti-choice legislators placing a broad range of restrictions on abortion access at the state level, including parental notification, consent laws, and mandatory waiting periods. "I think that on the local level people believe that choice is a settled issue and that there isn’t any threat, and it has been a settled issue for over 30 years," Kushnir says. "[But] it has also been constantly under attack, constantly restricted. Those restrictions can certainly make it, in a practical way, completely an ineffectual right."

Answering the question of what will happen if Roe v. Wade is overturned is more complicated than it would seem, however. If it were to review the case — in itself a somewhat uncertain prospect — the Supreme Court could make a decision in a number of ways: it could uphold its earlier decision legalizing abortion; it could reverse its decision, criminalizing abortion nationwide; or it could return the matter to the states, allowing each legislature to make its own rules.

Parquette maintains that anti-choice advocates would still face a "fight" in trying to outlaw abortion at the state level if Roe were overturned. If the Supreme Court rules that abortion is illegal, however, pro-choice proponents would have no legal recourse. "Reversing Roe, what does that mean?" asks Kushnir. "It means what the court says, and the court can go part way, it can go a quarter, a half, three quarters, or it can go all the way to making abortion illegal."

THE LOCAL FIGHT CONTINUES

While the intense politicking around Roberts’s confirmation plays out on the national stage, the efforts of pro- and anti-choice advocates in Rhode Island remain largely focused on the state legislature, where a number of high-profile bills keep the issue front and center during each General Assembly session.

Drnach says the most important change is building more support for abortion rights in the overwhelmingly Democratic legislature. "It’s not a quick, easy process," she says, "[but] it’s clear what we need to do: we need to get a majority of state senators and state representatives who respect the right of privacy. It’s possible, it’s achievable, and it’s going to take a lot of work."

A large part of the challenge in Rhode Island is posed by how, as Planned Parenthood’s Burmeister says, "It’s such a heavily Democratic state that people just assume that, ‘Oh, we’re such a blue state, surely they’re supporting our right to choose at the State House,’ but that’s not the case."

Rhode Island Right to Life’s Parquette cites the last presidential election as evidence that an increasing number of Rhode Islanders are anti-choice. "In the last election, in this blue state of Rhode Island, 40 percent of the votes went to President Bush, which is huge in a state like this," Parquette says. "I think the reason this happened is because of moral issues like abortion."

Senator Rhoda Perry (D-Providence), a stout abortion rights supporter, characterizes the Senate as "quite conservative" despite the large Democratic majority, but she sees the potential for change if liberals find and support more diverse candidates. Senator Leo Blais (R-Coventry), an abortion opponent, agrees that the Senate is predominantly anti-abortion, but he characterizes the House of Representatives as pro-choice. During his 13-year tenure in the State House, he says, he has seen little change in the ideological makeup on this particular issue.

Besides lobbying at the State House, advocates on both sides say that a large part of their job is educating Rhode Islanders about the issues. At Planned Parenthood, this is done through an e-mail list serve and newsletters, and the group is part of the Rhode Island Choice Coalition, a network of about 30 organizations that advocate for reproductive rights. Rhode Island Right to Life and Rhode Island NOW also identify and campaign for candidates who support their particular message.

Meanwhile, as Americans gear up for the debate over the latest Supreme Court nominee, supporters and foes of abortion rights in Rhode Island each cite wider support for their views, with broader implications for the future.

Parquette says pro-choice groups have greater resources than Rhode Island Right to Life, but she thinks Americans have become more opposed to abortion since the Roe v. Wade decision. RI Now’s Drnach says that while there are many challenges to reproductive rights in Rhode Island, she thinks the climate is generally "progressive." "Rhode Islanders, I think, are pretty willing to let people live their life freely and with dignity," she says.

Rachael Scarborough King can be reached at rsk2021@columbia.edu.