Marketing science now seems to be advancing at a pace cancer research can only envy.

Things are happening that I don't want to write about.. so I won't beyond this. I said a long time ago that I would always tell the truth but I may occasionally not be able to tell the whole truth... this is one of those times.

I called American Waterwell and told Randy what I had been told, he said that the line about the reading "being an indication that the well might be going dry" did not come from him or anyone that worked for him.

I was curious about where the quote I chose from today came from and looked it up, it was from an article on a singer named Courtney Love... a little profane but still an interesting comment on the:

It's sure true that sometimes quotes taken out of context can loose their original intended meaning and, sometimes, be even more profound...

It is not a lack of love, but a lack of friendship that makes unhappy marriages.

Well, the buyer really wants a lawn so she backed out, someone convinced her that the well was no good... crap...Back to the drawing board.

We are back on the market as of 1700 last night... there are still two potential buyers, one is a lady with cash... cross your fingers.

You never really understand a person until you consider things from his point of view.

Brett's here, work is being done again, my contribution during the week is so sporadic it's practically useless. Christy says that someone will be coming to see the house tomorrow, we are trying to get some molding up...

September 1, 2005

Prescription for Injustice

By FLORENCE A. RUDERMAN

THE current push by some pharmacists for a right not to fill certain prescriptions awakens memories of 1954, when my father was dying of cancer. I was a graduate student in New York, but I returned to my home in New Haven, Conn., to be with him. As the end drew near, his suffering became intense, the pain harder and harder to control. He was being cared for by an extraordinary doctor: Seymour Lipsky, then chief of hematology at Yale-New Haven Hospital. Dr. Lipsky did not have a private practice, but he had volunteered to take care of my father, telling us to call him whenever we felt we needed him. When we called, he came to the house.

My father's drug bills were being paid by the New Haven Cancer Society. We had long used a nearby pharmacy, but now the pharmacist grumbled whenever we came. Dr. Lipsky, new in the state, did not yet have a narcotics license, so he wrote his prescriptions and another doctor signed them. The pharmacist complained about this. But he complained even more about the Cancer Society's slowness in paying: several times he told us that he doubted that he would be paid at all.

One day, with my father in great and mounting pain, Dr. Lipsky came to the house. I remember the relief we felt when we saw him: his mere presence brought a measure of comfort. We always spoke freely with Dr. Lipsky, about many things. Now we told him about the difficulty at the pharmacy. He said he would stop in at the store and speak to the pharmacist.

He left a new prescription, for a considerable amount of morphine. Soon after, with my father suddenly in extreme pain, I took the prescription and hurried to the pharmacy.

Dr. Lipsky had been there. The pharmacist seemed to have said nothing to him. But when I appeared, he flew into a rage. I won't have anyone telling me my business! he stormed. This prescription is a fake! It's illegal to stock this much morphine! I haven't been paid in weeks! I won't have anything more to do with this! And he tossed the prescription over the counter onto the floor.

I was stunned. It had not occurred to me that he might simply, suddenly, refuse to fill a prescription. With a searing vision of my father's suffering before my eyes - conscious of what every minute meant - for a moment I felt lost. What should I do? Where could I go? But then I made a quick decision. My best chance, I felt, was with a major pharmacy, with more experience and larger supplies. Taft's Pharmacy, the city's largest, was in the center of town, some distance away. Clutching the prescription I ran downtown.

I arrived breathless. Picture it: A wild-looking girl bursts into the pharmacy. No one there has seen her before. She has a fishy-looking prescription, for a great quantity of a narcotic. And she says she can't pay for it.

The clerk stared at me, but took the prescription and disappeared. I waited anxiously. After a few minutes a pharmacist appeared, carrying packages of morphine. He spoke calmly and, I felt, sincerely. He had made some calls, as of course he should have. He knew the prescription was in order. He knew he would be paid. And, he went on, he was sorry we were having so much trouble. If there was anything else he could do to help, please let him know.

I don't remember whether or not I thanked him; I'm not sure that at the time I could speak. I scooped up the vials of morphine and ran. But I do remember that for years afterward I went to Taft's to buy items I could have bought more conveniently elsewhere.

For years I thought of that experience as a singular event, long ago and isolated. Recently, however, I have begun to see it in a new light.

There is now a growing movement of pharmacists who refuse to fill prescriptions to which they have moral or religious objections. One such organization is Pharmacists for Life International, which claims to have 1,600 members. Almost always the refused prescriptions are related to birth control. Many women have already met with these refusals. Some have been hectored and humiliated. And some refusals have involved women who have been raped, or whose lives or well-being would be endangered by a pregnancy. At least one lawsuit has already been filed; more are expected.

The pharmacists involved in this movement sometimes cite "business judgment" to justify their refusal to fill particular prescriptions. More often, however, they invoke "conscience." And now they are asking for state laws that not only recognize a right to refusal, but also shield them from lawsuits if that refusal results in harm.

This may sound simple. Shouldn't a democracy respect claims of conscience? In fact, such claims are not simple; they are highly problematic. And they should not wipe out competing claims or override consideration of wider social consequences.

From 1957 through the early 1960's, I conducted a study of doctors' views and behavior in clinical situations involving birth control. Here I found ample evidence of how complex claims of "conscience" can be. A doctor's decision to prescribe, or not prescribe, birth control depended not only on his personal moral or religious convictions, but also on a web of community and institutional pressures. Sometimes these pressures led doctors to act - to their own unhappiness - in ways that were contrary to their own beliefs.

For pharmacists to claim that they have a right to refuse to fill valid, lawful prescriptions based on their own moral or religious beliefs can amount to a claim that they have a right to determine how patients may care for their own health, and what doctors may or may not prescribe. In effect they claim the right to annul birth-control-related prescriptions. In some cases pharmacists have refused to provide information on other pharmacies where a prescription might be filled or have refused to return a prescription so that a woman might go elsewhere. These pharmacists are not simply "opting out" for themselves; they are making it impossible for certain prescriptions to be filled at all.

Allowing a pharmacist the right to refuse to fill a legal prescription, without simultaneous safeguards to ensure that the prescription can be filled promptly elsewhere or by someone else, surrenders the right of the majority to willful obstruction by a determined minority. It is important to realize that even with some legally specified safeguards for transfer or referral, a movement of this sort can have the effect of depriving many women of birth control. In small towns or rural areas, there may not be another pharmacy, or a woman may have no way to get to one that is far from her home. And other pharmacists may be unwilling to fill contested prescriptions, out of fear of becoming targets for boycotts or other hostile actions. This is a way to nullify the laws of the land - with a state-provided shield for doing so.

Clearly it is women who will be most directly and immediately affected. But the pharmacists' refusal movement threatens everyone. Similar tactics can be used to subvert or negate other laws and other rights that may be contrary to some individual's or group's moral or religious views. Bus drivers can refuse to stop near a fertility clinic; suppliers of ordinary products can refuse deliveries to such clinics; clerks can lose the registrations of civil unions. Such a movement in the name of individual conscience threatens democratic freedoms by encouraging small groups of zealots to impose their will on everyone else.

State legislatures should find the courage to resist these undemocratic tides. We should question nominees to federal courts and the Supreme Court about this issue - and we have a right to ask political leaders to speak out, now. If we don't, more of us may end up in the position I was in when the neighborhood pharmacy refused to fill my suffering father's prescription for morphine - desperately searching for options as a pharmacist righteously looks on.

Florence A. Ruderman, a professor emerita of sociology at Brooklyn College, is completing a book on medicine and steroids.

September 1, 2005

Prescription for Injustice

Banished Whistle-Blowers

United States of Shame