SCIENCE AND HEALTH
'Conscience clause' laws weigh moral values

STATE BY STATE
• The American Association of Colleges of Pharmacy web site allows a search by state to links for U.S. colleges and schools of pharmacy.

IN THE NORTHEAST
• Nicole Clegg is director of communications for The Family Planning Association of Maine. In 2004 Maine passed a law to allow pharmacists to dispense emergency contraception without a doctor's prescription. Pharmacists have the option of providing emergency contraception but aren't required to. Contact 207-772-3841, nclegg@pfam.org.
• Ken Baum, a lawyer and physician in New Haven, Conn., argued for a balance between meeting the needs of patients and honoring pharmacists' moral values in an article he co-wrote with his wife, Julie Cantor, also a lawyer and physician, for the Nov. 4, 2004, New England Journal of Medicine. Contact 203-623-7539, kbaum@wiggin.com.
• Daniel C. Robinson is dean of the School of Pharmacy at Bouvé College of Health Sciences at Northeastern University in Boston and a professor of pharmacy practice. He believes that pharmacists should not be required to participate in providing health care they find morally objectionable, but that health care professionals also should not interfere with a patient's right to obtain approved care. He suggests that pharmacists consider practicing in a setting that would avoid putting them in frequent conflict with their beliefs. Contact 617-373-3380, d.robinson@neu.edu.

IN THE EAST
• Anita L. Allen-Castellitto, a professor at the University of Pennsylvania Law School, has taught about contemporary ethics and bioethics and is the author of The New Ethics: A Guided Tour of the Twenty-First-Century Moral Landscape (Miramax Books, 2004). Contact 215-898-9035, aallen@law.upenn.edu.
• Paul Rosenzweig is a senior research fellow at the Heritage Foundation, a conservative Washington think tank. He wrote a commentary arguing that, from the Pilgrims on, American history has been founded on freedom of conscience and that a pharmacist shouldn't have to fill a prescription that violates his or her personal scruples, but should provide an alternate source for the patient to receive the medication. Contact 202-608-6190, Paul.Rosenzweig@heritage.org.
• David Luban is a professor of law and philosophy at the Georgetown University Law Center. He teaches about legal ethics and has written in an online blog that "pacifists should not join the Army, and people who do not wish to fill prescriptions should not become pharmacists." Contact 202-662-9806, luband@law.georgetown.edu.
• Amitai Etzioni, a sociologist, is University professor at the George Washington University in Washington, D.C., and the author of From Empire to Community: A New Approach to International Relations (Palgrave Macmillan, 2004). In his blog in July 2005, Etzioni initiated an online conversation about pharmacists not filling prescriptions. Contact 202-994-8190, etzioni@gwu.edu.
• James Trussell is a professor of economics and public affairs and director of the Office of Population Research at Princeton University in New Jersey. He advocates making emergency contraception widely available as a means of reducing unintended pregnancies and runs a web site on the topic. Contact 609-258-4946, trussell@princeton.edu.
• Nathan Diament is director of the Institute for Public Affairs with the Union of Orthodox Jewish Congregations of America, based in New York. He wrote an opinion piece, published in the New York Sun in May 2005, regarding conscience issues in the workplace. Contact 202-513-6484, ipadc@ou.org.

IN THE SOUTHEAST
• Leonard L. Edloe is president of Edloe's Professional Pharmacies in Richmond, Va., and an assistant clinical professor of pharmacy at Virginia Commonwealth University. He wrote a letter to the editor in the April 9, 2005 New York Times saying, "I am a professional and I also have a conscience." Contact 804-643-5721 or 804-304-7598, ledloe@edloespharmacy.com.
• Flynn Warren is assistant dean for student affairs and a clinical professor of pharmacy practice at the University of Georgia School of Pharmacy. He teaches pharmacy law and ethics and is a past president of the Georgia Pharmacy Association. He contends that pharmacists should be allowed out of conscience to decline to provide services, just as patients can refuse treatment. Contact 706-542-5273, fwarren@rx.uga.edu (email preferred).
• Paige Johnson is director of public affairs of Planned Parenthood of Central North Carolina. She wrote an opinion piece in October 2004 in the Raleigh News & Observer saying that a woman should not be refused access to legal birth control just because a health care provider doesn't believe in it. Contact 919-618-3899, paige.Johnson@ppfa.org.

IN THE SOUTH
• John Giles is president of Christian Coalition of Alabama, a state where some nurses quit their state health clinic jobs in 2004 after refusing to counsel women on a full range of reproductive services, including emergency contraception, or to dispense emergency contraception if patients requested it. The coalition wants the state clinics to stop dispensing emergency contraception. Contact 334-832-4688, cca@ccbama.org.
• Larry Rodick is president and CEO of Planned Parenthood of Alabama, which supports women's access to emergency contraception. Contact 205-322-2121 ext. 103, larry.rodick@ppfa.org.
• Joseph Fink is a lawyer and a professor of pharmacy at the University of Kentucky College of Pharmacy. He has written about pharmacy law and ethics and is a founder of the American Society of Pharmacy Law. Contact 859-257-2300 ext. 241, jfink@uky.edu.
• John Juergens is an associate professor of pharmacy administration and an associate research professor at the University of Mississippi School of Pharmacy. He has taught courses in professional and research ethics and can speak about a 2004 Mississippi law that allows health care providers to refuse to provide services on religious or ethical grounds. Contact 662-915-6957, phjuerg@olemiss.edu.

IN THE MIDWEST
• Amy M. Haddad is a professor and interim director of the Center for Health Policy and Ethics and a professor in the School of Pharmacy and Health Professions at Creighton University in Omaha, Neb. She writes a column, "Ethics in Action," for RN magazine and is past chairwoman of the ethics special interest group of the American Association of Colleges of Pharmacy. She contends that the proper approach is to find a way to preserve the pharmacist's conscience but also make sure the patient is not abandoned - for example, by finding another pharmacist to fill the prescription. Contact 402-280-2164, ahaddad@creighton.edu.
• R. Alta Charo teaches law and bioethics at the University of Wisconsin law and medical schools. She wrote an article about the implications of conscience clauses in the June 16, 2005, New England Journal of Medicine, saying "conscience is a tricky business." Contact 608-262-5015, racharo@wisc.edu.
• Matthew Murawski is an associate professor of pharmacy administration at Purdue University in Indiana. He says pharmacists can face ethical concerns that go well beyond dispensing birth control - involving, for example, end-of-life issues and what medications are appropriate for children. Contact 765-494-1470, murawski@pharmacy.purdue.edu.
• Sandra Johnson is the Tenet Endowed Chair in Health Law and Ethics at the Center for Health Care Ethics and the Center for Health Law Studies at St. Louis University. She has written about pain management, care of the dying and nursing homes, and can speak about the ethical challenges they present for health care workers. Contact 314-977-2791, johnsosh@slu.edu.
• Abby Ottenhoff is a spokeswoman for Illinois Gov. Rod Blagojevich. In April, Blagojevich filed an emergency order requiring drugstores that sell contraceptives to fill all valid prescriptions for them "without delay." He signed the order after two Chicago women complained that a pharmacy had refused to fill their prescriptions for the morning-after pill. Contact 312-814-3158, Abby_Ottenhoff@gov.state.il.us.

IN THE SOUTHWEST
• Lynn D. Wardle, a law professor at the J. Reuben Clark Law School at Brigham Young University, has written a proposed draft of a conscience protection law that states generally that no health care provider should have to provide services that violate his or her moral or religious convictions. Read the prepared testimony on conscience clause legislation that he gave in 2002 to a U.S. House of Representatives subcommittee. Contact 801-422-2617, wardlel@lawgate.byu.edu.
• Tom Van Hassel is the director of pharmacy at Yuma Regional Medical Center in Yuma, Ariz., and serves on the board of the Arizona Pharmacy Alliance and as a member of the Arizona Board of Pharmacy. In April 2005, Arizona Gov. Janet Napolitano vetoed a bill that would have allowed pharmacists to refuse services related to abortion and emergency contraception based on religious or moral grounds. The Arizona Pharmacy Alliance opposed that bill, arguing it would disrupt patient care. Contact 928-336-7815, tvanhassel@yumaregional.org.
• Cathi Herrod is director of policy for the Center for Arizona Policy. The center says it supports "pro-family laws and values" and pushed for passage of the pharmacists' right-of-conscience bill that Napolitano vetoed. Contact 480-922-3101, cathi@azpolicy.org.
• Texas state Rep. Frank Corte Jr., R-San Antonio, sponsored a bill in the Texas Legislature in 2005 that died in committee, but would have allowed pharmacists with moral objections to decline to provide emergency contraception. Contact through Kathi Seay, 512-463-0646, kathi.seay@house.state.tx.us.
• Sarah Wheat is executive director of NARAL Pro-Choice Texas, which opposed the conscience clause legislation in Texas, arguing that it would restrict reproductive choices for women. Contact 512-462-1661, sarah@prochoicetexas.org.
• In Colorado, Republican Gov. Bill Owens in April vetoed a bill that would have required all hospitals, including Catholic institutions, to inform rape victims about the availability of emergency contraception and refer them to clinics that could provide the medication. Owens said the bill could have forced health care providers to violate their moral beliefs.

• Against the bill: Timothy R. Dore is executive director of the Colorado Catholic Conference. Contact 303-894-8808, tdore@cocatholicconference.org. • For the bill: Tamika Payne is executive director of the Colorado Coalition Against Sexual Assault. Contact 303-861-7033, tamika@ccasa.org.

IN THE WEST/NORTHWEST
• Lorie G. Rice is associate dean for external affairs of the School of Pharmacy at the University of California at San Francisco, where she teaches courses in pharmacy law and ethics. She is also former executive officer of the California State Board of Pharmacy. Listen to an April 23, 2005, NPR interview in which Rice explains how she discusses ethical and moral issues with pharmacy students. Contact 415-476-1041, ricel@pharmacy.ucsf.edu.
• Valerie J. Vollmar is a law professor at Willamette University College of Law in Salem, Ore. She maintains a web site about physician-assisted suicide and can speak about how health professionals, including physicians and pharmacists, follow their consciences regarding that issue. Contact 503-370-6079, vvollmar@willamette.edu.
• Susan W. Tolle is director of the Center for Ethics in Health Care at Oregon Health & Science University in Portland. Tolle does research about end-of-life care in her state, including interviewing people who considered participating in Oregon's Death with Dignity Act but decided not to, and can speak about the ethical questions that end-of-life issues pose for health care professionals. Both Tolle and Oregon Health & Science University have maintained a neutral stance regarding the Death With Dignity Act. Contact through Jim Newman, 503-494-8231, newmanj@ohsu.edu.
• Don Downing is a clinical associate professor in the University of Washington School of Pharmacy. He has been involved with research about how pharmacists can improve women's access to public health services, including contraception, and has trained pharmacists in Washington and across the U.S. to voluntarily prescribe emergency contraception, in states which allow that. Contact 206-616-4587, dondown@u.washington.edu.