The Handmaid’s Tale: Not a Far Cry From Reality


Pharmaceutical Bans Prompt an Eery Look into Our Future

Ella Davis (PPS ‘25)

Ella Davis (PPS ‘25)

In The Handmaid’s Tale, written by Margaret Atwood and recently adapted into a hit Hulu series, Offred lives in a dystopian United States. She and all other fertile American women were forced into sexual slavery by a group of extremist conservative white men, who took over the government and slowly started disenfranchising women, non-Christians, people of color, and the LGBTQ+ community.

Offred’s life seems like a far cry from reality. But these men began by outlawing abortion. Then came women needing signatures to pick up prescriptions at their local pharmacy. Then, they needed a husband’s written consent to pick their own child up from daycare. Before they knew it, women weren’t allowed to read and were submitted to the control of men in power.

The real-life version of this sneaky spiral lives within states’ implementation of conscience clauses. Conscience clause legislation should end. Immediately.

These clauses are “federal statutes that protect health care provider conscience rights and prohibit recipients of certain federal funds from discriminating against health care providers who refuse to participate in certain services based on moral objections or religious beliefs.” In essence, if I walked into a Walgreens in a state that enacts a conscience clause, depending on who’s running the pharmacy that day, I could get denied access to any emergency contraceptive; most notably, this includes the widely known Plan B “morning after” pill.

The Handmaid’s Tale scares me, as it should scare any non-WASPM. In June 2022, almost one year ago, the Supreme Court ruling in Dobbs v. Jackson Women’s Health overturned the landmark ruling of Roe v. Wade, now stating that the Constitution does not confer a right to abortion. Because many right-leaning states anticipated this overturn, trigger laws — “laws passed by a legislative body but only go into effect once a certain thing happens” — had already been implemented, making it easy for participating states to quickly act on abortion prohibition with conscience clauses.

As scary as the idea is of someone taking away your right to bodily autonomy and just basic safety, what haunts me, even more so, are the effects of conscience clauses.

Take a look at what’s taking place in Arkansas; on June 24, 2022, they immediately enforced a trigger law that prohibited abortions at all stages of pregnancy and enacted a conscience clause, signed into law legislation in March 2021. Pharmacists across the entire state now have the right to discriminate against any patient on the grounds of morality, including religious reasons. So, once you get pregnant, you have no decision in the matter, even if you can’t support the child, and you are not guaranteed any treatment or preventative measures at your local pharmacy. In Arkansas, health professionals are also not required to provide an alternative location for treatment to their patients, and opponents of conscience clauses claim the law could be used to refuse filling birth control prescriptions and even overriding patient directives on end-of-life care.

Even further, conscience clauses directly target the LGBTQ+ community. If healthcare professionals “morally object” — presumably on the basis of Christianity — to treating these individuals, their refusal could include cutting off the “[maintenance] of hormone treatment for transgender patients needing in-patient care for an infection, or grief counseling for same-sex couples.” Even the initial effects of conscience clauses mean, for many minorities, an unsafe home, where basic needs are routinely unmet and groups of these individuals are less likely to seek care. It sets the precedent that non-cisgender people don’t deserve the same rights as other citizens.

Sound like The Handmaid’s Tale yet? There needs to be a collective federal effort to fully protect the rights of women, people of color, and LGBTQ+ members under our Constitution before more cracks can be filled with legislation like conscience clauses. Part of it means getting the right people into office. Part of it means sorting out exactly what “certain unalienable rights” truly mean — will previously protected rights start falling by the wayside? To me, Roe v. Wade was set in stone. Apparently not. So is gay marriage. Will that be next?

Conscience clauses being used by states like Arkansas dangerously push the boundaries of our country, creating a hostile environment for the minorities affected. Removing these clauses from legislation relies on putting pressure on state legislators. State residents must develop coalitions, watching for dangerously worded proposed bills and advocating for change in conscience clause vocabulary.

I hope with everything in me that we won’t turn into the next Offreds. But who’s to say?

Ella Davis (PPS ‘25) is from Norfolk, VA and an Undergraduate at Duke University’s Sanford School of Public Policy. This piece was submitted as an op-ed in the Spring ‘23 PUBPOL 301 course. This content does not represent the official or unofficial views of the Sanford School, Polis, Duke University, or any entity or individual other than the author.