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	Related links The Pharmacy Access Partnership These four sites are clearinghouses for political and medical updates on birth control and pharmacists. They also offer information and assistance to women trying to access contraception through local pharmacies. Each has its own niche: Go2EC offers comprehensive facts, figures, and state profiles on EC access; EC-Help offers direct connections with pharmacies that dispense EC; Pharmacy Access is geared toward professionals hoping to learn more; Health Step is specifically for women who use Depo Provera, the "birth-control shot." Planned Parenthood and Planned Parenthood League of Massachusetts At these sites, you can get involved in women’s-health activism, read about reproductive rights and family-planning options, find the nearest Planned Parenthood clinic, or order birth control or emergency contraception online (if you’re a PP client). NARAL Pro-Choice Massachusetts Check here for updates on Massachusetts’s fight for expanded EC access in local pharmacies. Catholics for a Free Choice Here, and at the Web sites for the Religious Coalition for Reproductive Choice and its Massachusetts affiliate, learn more about those who have reconciled their faith with their support for women’s reproductive rights. Pharmacists for Life International PFLI wouldn’t talk to the Phoenix for this story, so visit their Web site to learn more about this organization — the "only pharmacy association which is exclusively pro-life, something no other pharmacy organization can say (or would have the courage to say!)"

Of course, these are isolated incidents in a state with 9940 state-licensed pharmacists who work in 1044 pharmacies. In fact, most of the industry — including the Massachusetts Pharmacists Association and the Massachusetts Independent Pharmacists Association — is on record as supporting expanded access to EC. Extreme pharmacists’ refusals have been "raised to such a high level of visibility, and I think it really represents a very small fraction of pharmacists that are practicing," says Doctor of Pharmacy Daniel Robinson, dean of Northeastern’s Bouvé College of Pharmacy and Health Sciences.

But the more legislative support they have, the more bold anti-choice pharmacists might become. One tool they could soon have at their disposal is the proposed Workplace Religious Freedom Act, a federal bill co-sponsored by Massachusetts senator John Kerry. The bill would reinforce existing protections offered by Title XII of the Civil Rights Act of 1964, by ensuring freedom of religious expression on the job — concerning such matters as religiously appropriate clothing and leave time during religious holidays — as long as it doesn’t affect the employer’s bottom line. Combined with its bizarre and unpalatable co-sponsor (Pennsylvania’s homophobic senator Rick Santorum), the bill worries some women’s-rights advocates, who fear it could give pharmacists greater legal latitude to refuse to fill birth-control prescriptions.

"The bill is broad and vague," Judy Waxman says. "It maybe could be interpreted to allow a pharmacist to actually obstruct a woman’s ability to get the drug." The National Women’s Law Center has shared its concerns with the bill’s co-sponsors and "they have been listening to us," Waxman says. The bill is certainly one to watch as it moves forward.

Meanwhile, Senators Barbara Boxer, of California, and Frank Lautenberg, of New Jersey, have proposed bills that would ensure contraceptive access at pharmacies across the nation. They acknowledge individual decisions of conscience, while placing the burden on pharmacies to make sure a woman gets served in a timely manner.

Women’s-rights advocates like to illustrate how absurd pharmacist refusals would sound under different circumstances. What if a pharmacist decided to stop filling prescriptions for diabetes medications, asks Aaron Payson, a Unitarian Universalist minister in Worcester who served as president of the Religious Coalition for Reproductive Choice. Or scrips for Viagra, Rowland asks. Or those for Retin-A, offers Shapiro: "Does the pharmacist say, ‘Gee, I don’t approve of women who want to get rid of their wrinkles?’ Where do you draw the line?"

LOCALLY, THE controversy will continue to boil if the state legislature passes a popular measure (known as the "EC Bill") that would increase EC access in Massachusetts hospitals and pharmacies. In addition to requiring all hospital emergency rooms, including those in Catholic hospitals, to offer information about EC to sexual-assault victims, the EC Bill would also facilitate voluntary, collaborative agreements between pharmacists and physicians, allowing patients to obtain EC without a prescription. (Maine, California, Alaska, Washington, New Mexico, and Hawaii have enacted similar legislation.)

It’s a good step for women, Robinson says. "Every one of them, in their community, have access and are served by a pharmacy 365 days a year — and that’s the beauty of getting a pharmacy involved. They’re already there, they’re available, they’re strategically located, and they’re there holidays, weekends, anytime that would be needed by a woman in need of EC."

To that end, Planned Parenthood and other experts are training pharmacists across the state to dispense EC. "I can’t tell a pharmacist what to believe, but I can sit them down and talk to them and educate them," says Kristyn Napoli, a Neponset Health Center pharmacist who leads continuing-education EC programs for colleagues. "We don’t know where that patient is coming from. We’re not there to judge her, we’re there to give her timely access to health care."

Because the arrangements would be voluntary, any pharmacist uncomfortable with dispensing the contraception would not have to do so. But that doesn’t placate the Massachusetts Catholic Conference (MCC). They have seized on the emergency-room portion of the bill, claiming that it violates their religious freedom.

"It would mandate certain actions in Catholic hospitals which we could be opposed to," says Maria Parker of the MCC. "It’s kind of a nuanced thing. Contraceptives can act as a true contraceptive or as an abortifacient. And when it acts as an abortifacient, that is problematic, because now you are jeopardizing the life of a human being. And that is opposed to our Catholic position."

(Nuanced indeed. If a woman is pregnant, EC doesn’t have an effect. It cannot induce abortions, and is entirely separate from RU-486, the medical-abortion drug. Their so-called abortion objection, therefore, refers only to the few cases in which EC prevents a fertilized egg from implanting in the uterus.)

Of the state’s nine Catholic hospitals, some already dispense EC to rape victims, according to a 2004 NARAL Pro-Choice Massachusetts study. An informal Phoenix survey, conducted by calling Catholic emergency rooms and asking, "Do you dispense emergency contraception?", found only one hospital, Holy Family in Methuen, that offers EC to rape victims. Two phone operators, at Caritas Good Samaritan Medical Center in Brockton, and Mercy Hospital in Springfield, offered referrals without being asked (to Brockton and Bay State Hospitals, respectively). St. Vincent Hospital in Worcester suggested Planned Parenthood, and St. Elizabeth’s Medical Center in Boston advised going to "any ER that doesn’t have a Catholic affiliation." At Caritas Norwood Hospital, Carney Hospital in Dorchester, Saints Memorial Medical in Lowell, and St. Anne’s Hospital in Fall River, the answer was a simple "No," followed in two cases by the explanation, "We’re a Catholic hospital." When pressed, they did not offer referrals.

Yet all these institutions take public money, employ people of all religions, and accept patients from all faiths, the ACLU’s Shapiro points out. While they have Catholic roots, "they’re not religious institutions," she says, and don’t have the right to act like them.

In any event, the problem runs deeper than simple mixed-up facts about how the drug functions, says Payson, of the Religious Coalition for Reproductive Choice. Payson’s religious philosophy is one that embraces women’s freedom and liberty to care for their own bodies. However, his argument concentrates on institutional hypocrisy. "Conscience is one thing," he says. "But these are institutions that say they want to forego carrying this medication and yet accept federal funds. I understand individual conscience; I don’t understand institutional conscience."

Deirdre Fulton can be reached at dfulton[a]phx.com