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Jul 2018

A Miscarriage of Justice in Arizona?

What befell Nicole Arteaga of Arizona, as she stood at the mercy of a Walgreens pharmacist in late June, was anything but compassionate. But was it legal? The short answer, in Arizona, is yes.

Before entering into her local Walgreens, Arteaga had already done what any other expecting mother who had suffered a miscarriage would do – she had seen a doctor. The Arizona mother had been advised by her physician on June 19th that she had suffered a missed miscarriage due to her baby no longer having a life-sustaining heartbeat.

Going through a miscarriage is undoubtedly one of the most awful tragedies a mother can face. It is an extremely vulnerable time and one that is filled with confusion, loss, pain, guilt and immense heartache.

Arteaga’s doctor presented her with two options to end the pregnancy so that she could forego the very painful and emotionally taxing process of a natural miscarriage. Once her physician had determined that the fetus had deceased in utero, the next goal was to prevent further hemorrhaging and infection.

The first of two options given to Arteaga was performing a dilation and curettage procedure, which is a highly invasive method of scraping the dead tissue out of the womb and uterus. The alternative was a prescription medication called Misoprostol, which helps expedite the process of a natural miscarriage by allowing the uterus to contract in a way that would rid the body of the dead tissue. Both of these methods are not uncommon and are readily suggested treatments for mothers that have  experienced a missed miscarriage or have the misfortune of intrauterine fetal demise.

(There are several types of miscarriage, including complete miscarriage, incomplete miscarriage, ectopic miscarriage and more).

Given these set of options, Arteaga opted for the latter which would spare her from undergoing the painful curettage procedure. She left her doctor’s office that day, prescription in hand and reassured that she’d be putting this awful ordeal behind her soon.

Arizona Protections for Healthcare Workers

Little did Arteaga know that she would be prevented from filling her prescription at Walgreens because of an Arizona statute called ‘the conscience clause’. With her 7-year-old in tow, Arteaga discretely presented her prescription to the pharmacist on staff. The pharmacist proceeded to ask her if she was pregnant. When she replied ‘yes’, he refused to fill the prescription. So in front of her 7-year-old and several customers in line, embarrassment aside, she pleaded  with the pharmacist to fill her prescription.

In a statement to BuzzFeed, Arteaga recalled the reasoning.

“I asked him why he wouldn’t sell it to me, and he said, it was his ethics.”

“I stood at the mercy of this pharmacist explaining my situation in front of my 7-year-old, and five customers standing behind only to be denied because of his ethical beliefs,” Arteaga wrote on Facebook.

She left without her prescription. Humiliated, defeated and not knowing what her next move would be, Arteaga took to social media to share her story. Although she hadn’t previously planned on telling anyone other than her close family about her miscarriage, she decided it would be helpful to share her story in the hopes it would expose this metaphorical miscarriage of justice.

The Conscience Clause

“Conscience” or “Refusal” laws permit people and organizations, primarily healthcare providers and institutions, to refuse to provide certain types of healthcare services for various reasons, including religious freedom. Walgreens, as company policy, took it upon themselves to add a legal caveat in there. Their company policy states that if an employee so chooses to exercise their right to prevent a patient from receiving medications, then they are required to pass that request on to another willing pharmacy in a timely process.

Not only did Arizona pass faith-based refusal laws back in 2014, but now they have raised red flags by specifically allowing pharmacists the right to refuse medication if it goes against their religious beliefs. This law trumps any recommendation authorized by a trained medical professional or licensed physician.

Arizona is one of six states that have passed laws allowing pharmacists to deny filling emergency contraception based on moral grounds. Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Maine, Mississippi, South Dakota, Tennessee and Washington have all enacted conscience clause laws, while other states have adopted adaptations of the same approach.

Arteaga said she has filed a complaint to the Arizona Board of Pharmacy. “I share this story because I wish no other women have to go thru something like this at time when you are vulnerable and already suffering,” she wrote. “I am in left in disbelief on how this can happen? How is this okay?”

Diametrically Opposed Sides

While instances like this are absolutely legal under Arizona state law, it begs the debate of whether reproductive rights should be in the hands of anyone other than the female herself. The divide widens, and both sides are digging their heels in. Nicole Arteaga’s experience is growing all too common, and it isn’t just resigned to issues surrounding miscarriage medications. It balloons out to encompass a slew of other female reproductive services and medications, like Plan B (a one-step emergency contraceptive pill)  and legal abortion.

As tensions swell and religious advocacy groups lobby tirelessly to smudge out opposing policies, questions arise regarding the future of reproductive rights for all females. The questions are many: How far will the law go to limit or obstruct reproductive rights? Where does it end? Isn’t there supposed to be a division between church and state?

It is one thing if a single pharmacist has the right to refuse reproductive medicines to a patient. But it’s an entirely different Goliath if pharmacies and entire institutions work in unison, with the help of the government, to control  the rights of women across the country because of religious beliefs.

What should be paramount is protecting the health, welfare and rights of all mothers and females here in the US.  No one is suggesting that an individual’s right to exercise their religious beliefs shouldn’t be honored as well. But there needs to be appropriate legislation to protect both sides from falling victim to this growing fissure in our society, especially when the safety and mental well-being of the mother is at issue.

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