Wal-Mart's initial refusal to stock
EC -- the "morning-after" Pill

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Overview about Wal-Mart in the U.S.

Wal-Mart is the largest retailer in the United States, and its fifth largest provider of pharmaceuticals. All but 22 Wal-Mart stores have pharmacy counters. In many cases, their 3,400 pharmacies ₁₉ have become the only source for prescription medication in their region. Small, independently owned competing pharmacies have difficulty surviving and are often driven out of business. Thus, Americans in rural areas of the country frequently have to choose between buying their medication at Wal-Mart or of driving a long distance to the next urban area where there is a non-Wal-Mart pharmacy.

According to an article in Christianity Today -- America's leading Evangelical Christian magazine --:

" 'Is Wal-Mart a Christian company? No,' said former Wal-Mart executive Don Soderquist at a recent prayer breakfast. 'But the basis of our decisions was the values of Scripture'." ₁₈

By the term "values of Scripture" it is unclear whether they mean values as interpreted by conservative Protestant theologians, or by religious liberals. They are often diametrically opposed. Christianity Today continues:

"Indeed, based in the Bible Belt town of Bentonville, Arkansas, Wal-Mart has a tradition of tailoring its service to churchgoing customers. It sells only the sanitized versions of hip-hop CDs bearing warnings of objectionable content. Responding to a campaign by the largest evangelical mutual fund group, The Timothy Plan, to keep Cosmopolitan magazine covers out of view of Wal-Mart customers, the company slapped plastic sheathes over suggestive women's periodicals and banned 'lad mags' such as Maxim." ₁₈

The company decided in mid 1999-APR that they would no longer sell Preven, a package of emergency contraceptive pills that is often called "the morning after pill" or "emergency contraceptive." (EC) ₂Their policy is to refer women to other pharmacies. They stated:

"At this time Wal-Mart has made the business decision not to sell Preven. However, in the interest of serving and meeting the needs of our customers, our pharmacists will refer any request for this product to a pharmacy that does carry it." ₁₄

The drug remains available at K-Mart, Rite Aid, Walgreens and other pharmacies in large chains.

This medication is taken by women who have had unprotected sex, to prevent pregnancy. Some sources stated that Wal-Mart did not give a reason for its refusal to sell the pills. One source stated that Wal-Mart had announced on 1999-APR-14 that the decision was not related to ethical concerns. They had simply concluded that the medication might not sell enough to make it economically worthwhile. ₅ However, Wal-Mart continues to fill prescriptions for regular birth control pills, even though these pills and emergency contraception pills are identical, except for dosage.

According to Planned Parenthood: "In a compromise reached a few months later, Wal-Mart instructed its pharmacists to fill prescriptions for birth control pills as ECPs or to refer customers to another store if they have an objection about dispensing a drug. Wal-Mart still refuses to sell Preven." (Morrow, 1999).

In 2006-FEB, a Massachusetts board ordered Wal-Mart to stock and dispense EC within the state. This meant that Massachusetts and Illinois were the only two states where Wal-Mart customers could obtain EC. In the latter case, a state directive also required Wal-Mart to stock EC.

On 2006-MAR-03, officials at Wal-Mart's head office announced that they will stock EC in all of its pharmacies starting 2006-MAR-30. ₂₁ Covenant News reported this development under the title: "Wal-Mart to kill babies nationwide." ₂₂ This headline was probably based on the now discredited belief that EC can prevent implantation of the pre-embryo in the wall of the uterus. Medical studies now show that EC only acts as a contraceptive by inhibiting ovulation or preventing fertilization.

Overview about Wal-Mart in Canada: 

The Canadian government approved the sale of Preven on 1999-NOV-5. This was the culmination of a 25 year campaign by pro-choice advocates to have "post-intercourse contraception widely available and reduce the number of abortions" The "emergency contraception kit" is sold with a home pregnancy test for use before the woman takes the pills. If the woman tests positive, then she is pregnant and the pills would have no effect. Preven was released for sale by the manufacturer on 1999-NOV-10. The 144 stores of Wal-Mart Canada initially did not stock Preven. However, they would order it on request. Since Preven must be taken within 72 hours of intercourse, it would be unlikely for the store to receive the medicaiton on tie. Thus, their decision had the same effect as their policy in the U.S. to not sell the pill at all. 

Their decision to back-order Preven on request may be a clever ploy to avoid a serious ethical problem. According to the Toronto Star newspaper, a pharmacists' code  of ethics (presumably formulated by the Canadian Pharmacists Association) ₁₅ requires "those who refuse to sell a drug on moral or religious grounds must refer customers requesting it to a store that does sell it." ₁₆ Wal-Mart might consider itself released from this requirement because:

	they may take the position that the decision to not stock Preven is a business not a moral or religious decision.
	they are not refusing to sell Preven; they are merely making it impossible for women to obtain the drug from them in time for it to be useable.

On 2005-APR-20, Health Canada reclassified Plan B to non-prescription status. The Wal-Mart in Kingston ON Canada now stocks Plan B; we assume that the entire Wal-Mart chain in Canada has it available as well.

How the pills work (as viewed by medical professionals, pro-choice groups, etc.)

Physicians and other medical professionals classify the "morning-after" pill as a contraceptive. This is because it prevents the start of pregnancy. (If it could terminate a pregnancy which was already in progress, then it would have been called an abortificant). Pregnancy is defined as beginning when the fertilized ovum attaches to the wall of the uterus - typically about 12 days after conception.

Emergency contraception was originally believed capable of working in one of three ways:

	If an ovum has not been recently released from an ovary, the medication will usually prevent it from being released.
	If an ovum has recently been released, the pill would usually prevent it from being fertilized.
	If the ovum has already been fertilized, it was originally believed that the pills will "alter the lining of the uterus inhibiting the implantation of the embryo." 3 This has since been shown to be very improbable or impossible.
	If the ovum has developed to the blastocyst stage and has already attached itself to the uterine wall, the pills will have no effect. The pregnancy had already begun and will continue normally.

How the pills work (as viewed by some pro-life groups):

All of the major pro-life groups define pregnancy as starting at conception, when the sperm fertilizes the ovum. They also regard this as the instant where life (in the form of an ovum and sperm) becomes a human person. To these groups, any termination of the process after conception has occurred, is considered murder of a little baby -- of a human person at its most vulnerable stage.

They believe that emergency contraception may work in one of three ways, as listed above. However, most reject the findings of research and believe that the pills can act as an abortificant, by causing the uterine wall to reject the blastocyst. They believe that the medication kill the baby at its earliest stage of life.

Some response by pro-life individuals and groups:

	On the basis of these definitions which are unique to the pro-life movement, the American Life League (A.L.L.) states that a morning-after pill "can act to kill a tiny baby in his or her first few hours of life." 4The medication (which A.L.L. calls "chemicals") "have the potential of killing tiny babies in the womb...Previn, [sic] [is] the abortion-causing 'morning-after' pill." 4
	Lloyd DuPlantis, president of Pharmacies for Life International (PLI) said: "We concur with Wal-Mart on that decision." 8 PLI, reportedly urges its members to refuse to fill most prescriptions for emergency contraceptives, the birth control pill, contraceptive implants, injections and intrauterine devices. 12
	In an interview during the TV program "Fox Report" pharmacist Jimmy DeFranco said: "These pills are actually an abortion type of situation, and we don't want to get involved in that. We're talking about killing babies or killing fetuses...There is a lot of controversy -- Exactly what is abortion? And we feel at the time the egg is fertilized by the sperm, that is conception." He operates an independent pharmacy in the Bronx, and refuses to fill prescriptions for Preven. 7

Gene Rigozzo, a New Jersey pharmacist stated: "Abortions have gone from being a medical procedure to being just a pharmaceutical procedure. I think the issue will actually become more debated and heated as more and more drugs that induce abortion hit the market." ₁₀

Since some pro-life agencies use unique definitions for the terms abortion, pregnancy, and personhood, no resolution appears possible between their position and that of the medical and pro-choice communities.

Reactions to the Wal-Mart decision:

Judie Brown of the American Life League stated: "They are to be congratulated for their decision and commended for sticking to it."  It "may save human lives." Brown said. On their web site, they also ask that Wal-Mart discontinue selling oral contraceptives.

The Planned Parenthood Federation of America said that Wal-Mart "deserts women faced with reproductive health emergencies." ₁₄

Marie Griffin, editor of Drug Store News commented that retailers have an obligation to not withhold drugs that doctors have decided that a woman needs: "They [Wal-Mart] should not get involved in the sacred relationship between a physician and patient." ₁₄

Mr. DuPlantis, president of Pharmacists for Life International agreed with Wal-Mart: "Regarding Preven, based on the way we feel that life begins at fertilization, it's an abortifacient mechanism." ₁₄

Results of the Wal-Mart decision (as viewed by some pro-life groups):

For those pro-life groups that believe that pregnancy and personhood begin at conception, and who also reject the findings of medical research and believe that the morning-after pills may inhibit implantation, EC can work as an abortifacient - i.e. medication that induces an abortion. Thus any restriction on their sale will reduce the number of abortions.

In many rural areas of the United States, the Wal-Mart decision will restrict women's access to emergency contraception. It is likely that more women will not make the necessary time and effort to travel to another town or city to obtain the morning-after pill. Thus, they conclude that there will be a decrease in the U.S. abortion rate.

Results of the Wal-Mart decision (as viewed by medical professionals, pro-choice groups, etc.):

As noted above, Wal-Mart is restricting women's access to emergency contraception. Fewer women who have had unprotected sex will be able to use the pill. The number of unwanted pregnancies will increase. This will, in turn, generate an increase in the U.S. abortion rate because about half of all unanticipated pregnancies end in abortion.

An abortion performed in a clinic or hospital is far safer than a continued pregnancy. However, infections can occur; this can cause sterility and (in very rare instances) death. In those states where parental notification or permission is required for teens to obtain an abortion, some young women are seeking illegal abortions, where risks are considerably higher. It is thus inevitable that restricting access to emergency contraception will result in deaths to women.

Further developments 1997 to 2006:

	1997-MAY: Wal-Mart boycott proposed: The Kaiser reproductive health report reported that Planned Parenthood of New York City "has informed Wal-Mart Stores Inc. that it may orchestrate a boycott of its pharmacies" because of its ban on Preven. Their president, Alexander Sanger wrote: "I strongly urge Wal-Mart to immediately re-evaluate and reverse its decision to not stock, order or dispense emergency contraception under the brand name Preven." 6 The threatened boycott never materialized.
	1997-APR: Kosovo refugees: The United Nations Population Fund (UNFPA) and Planned parenthood Federation of America announced that they had sent reproductive health supplies (including emergency contraceptives) to help Kosovo refugees who are frequently the victims of rape. Monsignor Elio Sgreccia, vice president of the Pontifical Academy for Life in the Vatican said that use of emergency contraception is "tantamount to abortion...it was important to distinguish between the act of violence suffered and the reality of new human beings who have begun their life" 9
	State laws: Bills have been initiated in Louisiana, New Jersey, and South Dakota to allow pharmacists to refuse to fill subscriptions if they conflict with their personal creed. The Louisiana bill defines personal creed as "a system of religious beliefs and precepts [that] a person holds with the strength of religious views and conviction."
	Pharmacist option: Dr. Leon Speroff wrote in an article in OB/GYN Clinical Alert: "I believe that most of us would agree that pharmacists should have the opportunity to remove themselves from an action they cannot morally support. But at the same time, the right of the patient to obtain legally approved medication must be protected."
	1999-MAY: Second boycott: Women Leaders Online suggest that people avoid buying stuff from Wal-Mart, to keep a record of how much money they have diverted from Wal-Mart, and then send them an Email at letters@wal-mart.com with a message such as:

"This week, I spent $134.23 at stores other than Wal-Mart. I made a business decision not to patronize Wal-Mart for these purchases, since your decision not to sell Emergency Contraception made it clear that you did not want my business, nor that of other women. If you change your minds and start providing the medicine women need, please let me know." ₁₃

	2006-FEB-14: MA: Pharmacy board orders Wal-Mart to honor Plan B prescriptions: Three women filed complaints with the Massachusetts Pharmacy Board, critical of Wal-Mart for failing to stock Plan B medication. It is the only emergency contraceptive approved by the FDA. The Board ordered Wal-Mart to fill prescriptions for Plan B. More details.
	2006-FEB-17: Connecticut: Comptroller asks Wal-Mart to honor Plan B prescriptions: Apparently triggered by the Massachusetts developments, Nancy Wyman, the state comptroller of Connecticut, has asked Wal-Mart to stock emergency contraceptive in its 20 pharmacies in the state. More details.

Should retailers have the right to not stock all products?

An editorial in the Opekika-Auburn News in east central Alabama expressed dismay at the 2006-FEB developments in Massachusetts. It states, in part:

"Pro-choice or pro-life is not the issue here. The issue here is the government dictating what we should consider as free enterprise. Wal-Mart, and any other retail store, should be able to carry any product it chooses just like it should be able to choose not to carry some products. The government should not be able to force a retailer to carry a product. When this happens, the government has a form of ownership, or control, over this retailer."

"Aren’t state-run industries signs of socialism or even communism? Is this what we want in America?"

"Imagine the government coming into your place of business and forcing you to sell certain products. It’s a form of socialism and it’s absurd to even think that the governing body of this nation that is supposed to be a free democracy would even consider such. How ironic it is that the pro-choice group would press to remove choice from a retailer."

"Wal-Mart is not denying women the ‘morning after’ pill. Wal-Mart is not restricting women from taking the pills. They just aren’t providing them at their locations. The pill can very well be purchased at many other retail stores that include pharmacy departments. Free enterprise is special. Let’s not begin to destroy it." ₂₀

Wal-mart reverses its decision; stores will stock Plan B pill across the U.S.:

A Wal-Mart spokesperson announced on 2006-MAR-03 that the company would start to stock EC in all its 3,700 pharmacies in the U.S. starting on MAR-20. Vice president Ron Chomiuk said: "We expect more states to require us to sell emergency contraceptives in the months ahead. Because of this, and the fact that this is an FDA-approved product, we feel it is difficult to justify being the country's only major pharmacy chain not selling it." They will continue their conscientious objection policy which allows any Wal-Mart or Sam's Club employee who feels uncomfortable dispensing this or any other prescription to refer customers to another pharmacy or pharmacist.

Andrew Grossman, executive director of union-backed campaign group WalMartWatch.com, said: "We commend Wal-Mart for taking an important first step towards allowing women access to safe and legal medication."

References:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. Wal-Mart receives letters from the public at: letters@wal-mart.com
2. Religion Today, Current News summary, 1999-MAY-17
3. A "Provider Attitudes towards ECPs" survey is at: http://www.path.org/
4. "Action Alert," American Life League, at: http://www.all.org/
5. "Maranatha Daywatch," daily summary of news headlines, 1999-MAY-5
6. News report, Reuters/Buffalo News, 1999-MAY-15; cited in "Preven: Planned Parenthood may boycott Wal-Mart." See:  http://report.kff.org/ *
7. Fox Report, 1999-APR-15, Fox News Channel. See: http://report.kff.org/ *
8. "Preven: Wal-Mart's decision not to dispense product outrages women's groups." See:  http://report.kff.org/ *
9. Article, Agence France Press, 1999-APR-13. See: http://report.kff.org/ *
10. "Conscience clause: New Jersey pharmacist bill in the works." See: http://report.kff.org/ *
11. Dr. Leon Speroff, Article, OB/GYN Clinical AlertOB/GYN Clinical Alert, 1998-DEC
12. "Emergency Contraception: crisis at the pharmacy counter," at: http://report.kff.org/ *
13. "Wal-Mart's Accounting," Women Leaders Online/Women Organizing for Change alert: 1999-MAY-28.
14. Quoted in an article, New York Times, 1999-APR-16.
15. The Canadian Pharmacists Association has a web site at: http://www.cdnpharm.ca/ 
16. Tanya Talaga, "Morning-after pill Preven goes on sale in Canada," Toronto Star, 1999-NOV-11, Page A2.
17. D.J. Morrow, "Policy on Prescription Orders at Wal-Mart Draws Praise." The New York Times, (1999-SEP-16), Page 10. as cited in "Fact sheet: Emergency contraception," Planned Parenthood, http://www.plannedparenthood.org/
18. Jeff Sellers, "Deliver Us from Wal-Mart? Christians are among those sounding the alarm about the ethics of this retail giant. Are the worries justified?," Christianity Today, 2005-MAY.
19. "Wal-Mart May Stock 'Emergency' Contraceptives," ConsumerAffairs.com, 2006-FEB-15, at: http://www.consumeraffairs.com/
20. "Retailers have right not to stock all products," Opekika-Auburn News, 2006-FEB-17, at: http://www.oanow.com/
21. "Wal-Mart decides to carry Plan B pill," Associated Press, 2006-MAR-05, at: http://www.usatoday.com
22. "Wal-Mart to kill babies nationwide," Covenant News, 2006-MAR-06, at:  http://www.covenantnews.com

* Cited in Kaiser reproductive health reports.

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Copyright © 1999 to 2010 by Ontario Consultants on Religious Tolerance
Latest update: 2010-JUN-20
Author: B.A. Robinson

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