The Supreme Court’s Stormans ruling is a big deal.  Here’s why.

In June, bogus science and “religious freedom” claims—two of the Religious Right’s most powerful tools—got whomped by the Supreme Court in two separate cases, Whole Woman’s Health vs Hellerstadt and Stormans vs Weisman. Earlier you met Amy Hagstrom Miller, the Texas abortion provider who refused to roll over when Texas said she needed an operating room in order to hand women pills. Now, here is Lisa Stone, whose small but mighty non-profit legal organization spent a decade fighting for the right of pharmacy customers to get the drugs their doctors prescribe, even when religious drug store owners think God disapproves.

Stone is an attorney and the Executive Director of Legal Voice, where she heads a team of lawyers, advocates and interns who work to advance the rights of women and queer persons through the law. Why female and queer rights together?  As Julianna Gonen at the National Center for Lesbian Rights says, “The movements for LGBT equality and reproductive freedom share profoundly similar goals — to protect the fundamental right to bodily autonomy, challenge traditional gender norms, and secure the freedom of individuals to form families on their own terms.”

I might add that opposition to female and queer rights comes from the same Iron Age family script—handed down in Abrahamic religion—and that religious conservatives wield the same set of tools against us all. That’s what makes recent Supreme Court rulings so far-reaching.

Stone has been in the fight since 1988, and is proudest of Legal Voice’s role shutting down Operation Rescue clinic blockades and the marriage equality fight. Like the team at Whole Woman’s Health, the small cadre at Legal Voice has survived years of embattled uncertainty by forming deep bonds with each other and a shared sense of moral commitment to the values and the people they serve. “I have done none of this alone,” says Stone. “My colleagues have created a work environment that is feminist in behavior as well as beliefs.  It’s one of the most worker friendly places I’m aware of.”

Valerie Tarico: A lot of people spend ten years dedicated to a mission, but a decade on a single legal case is a long time. Why was this one so important to you and Legal Voice?

Lisa M Stone: The Stormans case was about the right of all patients to get their medications when they show up in a pharmacy without being harassed or delayed or turned away.  It came about because some pharmacists believed that they could impose their personal—not medical—beliefs and prevent patients from getting lawfully prescribed medications. In 2005, the WA Board of Pharmacy made rules that said pharmacies couldn’t “refuse to deliver a drug or device to a patient because its owner objects to delivery on religious, moral, or other personal grounds.” From there it escalated into a fight about alleged religious persecution.

VT:  That sounds familiar. As a former Evangelical, I can attest from personal experience that some people have a sincerely held religious belief that they should impose their own beliefs on others—or on society at large, that this is God’s will. They feel compelled by their beliefs to push it to the limits, even when it seems obvious from the outside that they are twisting facts or doing harm. Since laws are meant to promote the general welfare, when religious people fight for exceptions, they often are asking for the freedom to do harm. But in this case, couldn’t a religious pharmacy owner simply refer elsewhere? 

LMS: A lot of people ask that. The problem is that simply letting pharmacies refer out would work sometimes, but not always, which makes it bad medicine. Some medications are time-sensitive, emergency contraception and HIV medication being two examples. In a small town, there may be one pharmacy. Or, imagine if you are a person with mental illness and have a comfortable routine at a familiar store, and then a new person refuses to provide the medicine. Or imagine if a person speaks limited or no English and the person who speaks your language decides they don’t want to serve you.  The health care provider is imposing delays and additional costs on the patient – who should always be at the center of health care provision.

Also, consider potential embarrassment that may discourage patients from seeking services. When patients are subjected to scolding and embarrassment by pharmacists, that doesn’t engender confidence in the healthcare system and encourage people to get the care they need.  And since people whose lives are most precarious are most affected by barriers, adding hurdles and humiliations widens health disparities. Better medical care means reducing, not adding barriers.

VT:  Isn’t this just a bunch of hypotheticals? 

LMS: Not at all. One of our plaintiffs was a Western Washington University student taking a long holiday weekend on Camano Island with her boyfriend. Their birth control method failed, so she went to get Plan B at the local pharmacy. The pharmacist turned her away, brusquely refusing to dispense EC. She and her boyfriend cut short their vacation and drove back to Bellingham so they could get emergency contraception.

VT:  As a psychologist, I can’t help thinking about how humiliating that would have been—or how horrible the young couple must have felt as they drove home with their vacation ruined.

LMS: Yes. The risk of getting shamed and turned away fundamentally changes the relationship between a pharmacist and patient.  I rely on my pharmacist to tell me about possible interactions. I rely on my pharmacist, in the case of a possible error, to contact my doctor and say, “Are you sure you meant to prescribe this? Do you know she’s on this other med?” So pharmacists do need to use professional judgment and raise questions based on their knowledge of medicine and how drugs work. Pharmacists are part of a system of care, and they have access to very personal information. I want to trust that my pharmacist is watching out for me, not judging me.

But the stories get worse.

A married couple in Woodinville, north of Seattle, had a similar contraceptive failure.  The woman went to two pharmacies and was refused. She gave up and got pregnant and because of her personal values had the child. The wanted another child, and are happy, but the refusal meant they weren’t able to space their children according to what they had thought was best for their family.

VT: Good thing they wanted another kid. Even so, we’re learning more and more about the benefits of people being able to time their pregnancies. Zika is a huge example of that, but also, the CDC says that nutrient levels or toxic exposures like drugs or alcohol in the weeks right after a woman gets pregnant or even right before(!) can have long-term developmental affects. Forcing someone to go through with a surprise pregnancy looks like a worse idea all the time.

LMS:  As you might guess, medications used in abortion or for reproductive health care are prime targets for pharmacy refusals. One woman was prescribed misoprostol because she was going to have a uterine biopsy for cancer. She went to a pharmacy in Ballard. The pharmacist asked, “What do you want it for?” and the patient didn’t want to answer.  So the pharmacist said “I think you’re going to use it for an abortion and so, no, I won’t give it to you.” And she kept the prescription so the patient couldn’t even take it to another pharmacy. The woman went out to the parking lot and called her doctor, who called the pharmacist. And to the doctor the pharmacist said, “No I won’t dispense this drug and I don’t dispense regular contraception either.”

VT: Even after the doctor called!

LMS: I should say that the vast majority of pharmacists are not like this. Most pharmacists are scrupulous and careful and wouldn’t dream of imposing their personal beliefs on patients.

VT: Good reminder. Ok, I’ve heard of pharmacy refusals that aren’t about sexual and reproductive health—a diabetic being refused needles by a pharmacist who decides she’s an addict, for example, or other cases involving insulin, HIV meds, or Valium. But how much of this is about the religious right’s obsession with controlling sex, and the sexuality of women in particular?

LMS: Most interference by medical techs, pharmacists, or other health care providers is about women’s reproductive systems—It’s part of a broader pattern of infantilizing women and second guessing the judgment of women. If you don’t put the patient first, the system is failing.  A woman shouldn’t have to say to the pharmacist “I’m afraid I’m going to die of uterine cancer, give me my meds.”

VT: Last question. Talk to me for a moment about the broader implications of this case. From the standpoint of fending off harmful “religious freedom” claims, the precedent affects only state laws, not federal. Beyond the question of Washington residents being able to get prescriptions filled without fear of being humiliated or refused care, is the Stormans ruling a big deal, and if so why?  

LMS: Well, it shouldn’t be, because it actually fits well within established Supreme Court jurisprudence: a law or regulation that is neutral, and applicable to all, is constitutional under the 1^st Amendment even if it does have an impact on someone’s religious belief. But because of the climate around “religious liberty” in our country today, it matters immensely.

A number of commenters have highlighted the possible consequences if the Court had accepted the case and reversed the 9^th Circuit. The theory Justice Alito laid out in his dissent would roll back antidiscrimination protections for women and LGBT people across the country. If a for-profit business can refuse to serve a customer because of religious beliefs, where does it stop?

Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org.  Her articles about religion, reproductive health, and the role of women in society have been featured at sites including AlterNet, Salon, the Huffington Post, Grist, and Jezebel.  Subscribe at ValerieTarico.com.