Physicians and pharmacists who refuse to participate in what they deem killing have more in common than many of us might like to admit. But the most important distinction between them has to do with their differing relationship with patients. The law recognizes that doctors' special relationships with their patients warrant a legal privilege: Their discussions are kept secret. You may like and trust your pharmacist. You may even trust him with intimate details about your yeast infection. But your pharmacist has neither the tools nor the right to probe details about rape and abuse, incest and health risks. Which is why pharmacists who interpose themselves between decisions made by a doctor and her patient are overstepping moral and ethical boundaries—and undermining another professional relationship that is fundamentally different from their own. You needn't believe that one relationship is more important than the other to recognize that neither relationship should be allowed to intrude upon the other.
The right of conscience, ultimately, is a subjective one. And no one disputes that a pharmacist's moral objection to dispensing certain drugs is as heartfelt or urgent as a physician's refusal to inject lethal doses of sodium thiopental. But as a legal or legislative matter, the inquiry should begin, not end, with that moral objection. Legal regimes that balance an individual's right to opt out against safeguards for patients (like making it the pharmacy's responsibility to provide timely alternatives) are good compromises. This is why, if physicians cannot supervise executions in accordance with their professional obligations, we will probably need to devise some new form of capital punishment that does not require a doctor's intervention to ensure against violent, painful death.
There should and will always be space in this county for conscientious objectors. But it cannot and should not follow that murder is murder is murder.
A version of this article also appears in the Outlook section of the Sunday Washington Post.