Who really wants to debate the morning-after pill?
"Moral battle rages in pharmacies," cries the front page of Sunday's Dallas Morning News. It must be true: Just a week ago, the front page of the New York Times warned, "Pharmacies Balk on After-Sex Pill and Widen Fight in Many States." A couple of weeks before that, the front page of the Washington Post declared, "Pharmacists' Rights at Front of New Debate." Supposedly, armies of pro-lifers are coming over the hills to fight for the right of pharmacists not to fill prescriptions for morning-after pills.
Don't count on it. This is a lousy issue for pro-lifers. That's why pro-choicers and the media are pumping it up and most pro-lifers are sitting it out.
The Times' front page touts "a growing battle" in "at least 23 states" that has "prompted much of the same intensity as the fight over abortion." But look at the fine print on page A16. At press time, only seven states were considering bills for pharmacists' rights, whereas 10 were considering bills to make hospitals offer morning-after pills to rape victims. Contrary to the headline, pro-choicers, not pharmacists, were trying hardest to widen the fight.
The Post's front page asserts, "An increasing number of clashes are occurring in drugstores across the country." Only if you follow the jump to page A10 do you learn nine paragraphs later, "No one knows exactly how often that is happening." According to the Post, "Advocates on both sides say the refusals appear to be spreading." But look at the quoted advocates. On the pro-choice side, it's NARAL Pro-Choice America and Planned Parenthood's Alan Guttmacher Institute. On the pro-life side, the Christian Legal Society and Pharmacists for Life. One team is fielding its first string. The other is fielding its third.
National pro-choice groups are clearly peddling this story, and journalists are buying it. They take at face value partisan assertions of a groundswell. "According to the National Women's Law Center, women across the country have run into problems getting prescriptions filled," the Post reports. The Christian Science Monitor features this quote about the fight: "Most observers seem to say it is picking up, and there seems to be a more organized campaign to allow pharmacists to refuse." The Monitor attributes the quote to a representative of the Guttmacher Institute, "which tracks reproductive health issues." Not until several paragraphs later does the article concede that "no hard numbers are available," and it never discloses the institute's Planned Parenthood affiliation. You need a magnifying glass to see that the Times' data on the explosion of pharmacist-rights battles come from Guttmacher. And the Los Angeles Times, having relied in an April 2 article on a Planned Parenthood quote that "we're hearing about it happening more and more frequently," admits three days later that the California Board of Pharmacy has received no such complaints.
Who's fighting hardest for pro-life pharmacists? Pharmacists for Life. Now, there's a shocker. According to the Post, the group "claims 1,600 members on six continents." Come on. That's less than 300 members per continent. Pharmacists for Life may be doing the Lord's work, but its Web site is politically insane—constantly referring to the Serbian-American governor of Illinois, for example, as "Slobodan" Blagojevich. The two other leading advocates for pro-life pharmacists are the Christian Legal Society and the American Center for Law and Justice. That's another sign of a losing issue: The legal purists are out front, while the political groups lie low.
Go to the Web sites of the major pro-life players, and run a search for anything related to pharmacists. I got three hits from the National Right to Life Committee, none since 2001. I got eight hits from Concerned Women for America, none on pharmacists' rights since 2002. Even the U.S. Conference of Catholic Bishops, characterized in some reports as a big campaigner for pharmacists' rights, hasn't touched the subject in four months. The Senate and House majority leaders haven't mentioned it. It's been raised at the White House just once—by a reporter—and the president's spokesman ducked it.
Why the silence? Because from a strategic standpoint, it's a stinker of an issue for pro-lifers. In recent years, they've gained the upper hand by focusing relentlessly on late-term fetuses that look like babies. Notice what's featured on NRLC's home page today: a Bush administration directive to protect "infants who had been born alive after unsuccessful abortions." A fight over morning-after pills would push the abortion debate backward, not just to the beginning of pregnancy, but beyond it, to the stage between conception and implantation. Pro-lifers can't even agree among themselves that a pre-implantation embryo is sacred—most such embryos spontaneously miscarry—and they'd have a hell of a time persuading people that this microscopic entity, which looks nothing like a baby, should be treated like one.
This is why the small groups willing to fight for pro-life pharmacists argue for choice, not life. They say pharmacists should be free to refuse prescriptions for pills they deem lethal to human life. It's a noble argument, and a doomed one. In this case, time is crucial. To work, the pill must be taken soon after sex. In a town with a single drug store, one pharmacist's refusal can effectively block a woman's choice. Furthermore, the pharmacist isn't defying just the woman; he's defying the doctor who prescribed the pill. This is why some state medical societies have come out against giving pharmacists the same freedom of conscience doctors demand. A couple of weeks ago, Arizona's governor vetoed a pharmacists'-rights bill, saying pharmacists "have no right to interfere with the lawful personal medical decisions made by patients and their doctors." Historically, doctors have sometimes supported abortion laws and sometimes opposed them. The only constant is that the doctors always win.
Even if you favor freedom of choice for pharmacists, the pro-lifers' position is weak. The bills and regulations they're fighting allow a pharmacist to refuse a prescription as long as she makes sure another pharmacist is on hand to fill it. (In Illinois, the central battleground, they're free not to stock contraceptives at all.) The American Pharmacists Association backs this policy as a reasonable compromise. Only the pro-life pharmacists and their legal advocates insist on the right to refuse even to refer a patient to an alternative supplier.
If pro-choicers and the media draw the public into this fight, pro-lifers will be in deep trouble. The most universally compelling petitioners for abortion rights are rape victims. Even by conservative standards, you can't say they deserve pregnancy as a "consequence for sex"—as a New Hampshire politician did three weeks ago during a fight over the morning-after pill—since they didn't choose sex in the first place. Such politicians look insensitive to crime victims, a deadly problem for a Republican in a general election. Already pro-choicers are working this angle, promoting the pill as post-rape treatment and spotlighting cases in which women turned away by pharmacists claim to be victims of sexual assault.
The other danger for pro-lifers is that the wall they've erected between abortion and contraception will collapse. Morning-after pills can prevent conception or implantation; in any given case, it's practically impossible to know which. If pro-lifers appear to oppose contraception, rather than abortion, they risk antagonizing and alarming most Americans. Five months ago, a CBS/New York Times poll asked, "Should pharmacists who personally oppose birth control for religious reasons be able to refuse to sell birth control pills to women who have a prescription for them, or shouldn't pharmacists be able to refuse to sell birth control pills?" Only 16 percent of respondents said yes. Seventy-eight percent said no.
Already pro-lifers are straying across this line. The president of Pharmacists for Life reportedly doesn't stock any contraceptives in her store. Three weeks ago, in a high-profile appeal to Gov. Blagojevich, a Catholic bishop protested that the Illinois regulation requiring pharmacies to fill prescriptions for morning-after pills violated the Catholic doctrine "that artificial contraception is morally wrong." Against this view, pro-choicers argue that a woman who requests a morning-after pill is trying, responsibly, to prevent a pregnancy so she won't have to abort it. If pro-lifers start to look like they care more about resisting contraception than avoiding abortions, look out.
Will Saletan covers science, technology, and politics for Slate and says a lot of things that get him in trouble.