I think Mr. Saletan misses a key point here: Pharmacists don't know why a physician has prescribed the pill. There are medical conditions that are treated by birth control pills, and many women should not get pregnant for medical reasons. Moreover, it isn't their business, not even one little bit. In fact, when a pharmacist says "I won't sell you that drug," he's sticking himself right in the middle of the doctor-patient relationship. That's not the pharmacist's job.

Pharmacists are licensed by the state to dispense medication as prescribed by doctors. That's what they do. They're a little bit like railroads in that respect - a railroad doesn't get to ask whether you're taking the train to your job as a stockbroker or to meet your married lover in the city, and a pharmacist is not entitled to know why you've been prescribed a particular medication.

This is true even if the most common use of the drug is obvious. After all, even then you don't really know - I once was prescribed acyclovir, usually used to treat herpes, for something else entirely.

I'm happy for pharmacists to do their jobs. I'm glad someone is making sure the right pills go into the right bottles at the right dosages, and even happier that there's someone who is in a position to check to see if doctors have prescribed drugs that interact badly with each other. But it's a technical job, not a job in which you get to decide how to treat the patient. For that reason it's important that pharmacists don't interfere with the doctor-patient relationship by deciding what they'll dispense and what they won't.