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I then thought about the argument that the doctor is just giving the patient access to pharmaceuticals, and the patient's autonomy in making her own healthcare decisions removes any culpability from the physician. Can this situation be likened to, say, an employee at a book store? Is the sales clerk culpable when he rings up a patron's purchase of pornography? What about a sale of the latest Joel Osteen?
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In most situations, the roles are different - the doctor would most often be actively recommending or proposing the sinful thing, rather than merely ringing up a purchase of Osteen.
Yet, there are probably physicians who will not recommend or propose such pills, but would be willing to 'ring up the purchase' so to speak. This may apply more to pharmacists than GP's.
And in that case, I have a very strong immediate reaction that even that course is unacceptable, though I am having trouble being consistent in my reasoning.
I would (grudgingly) ring up an Osteen book, but refuse a purchase of pornography, and would not work at a store that carried such. Likewise, I would hope doctors refuse to prescribe the pill even a the direct insistence of the patient.
To be consistent, I would have to deny the Osteen purchase also. That doesn't really bother me all that much
, but I'd want to hear other opinions before actually taking that hard of a line.
An elder at our church has been a pharmacist for 30+ years, and has come very close to losing his job many times over this exact issue. He works at a major retail/drugstore chain, and has somehow managed not to budge an inch and have that respected.