The pharmacist debate raises broader questions about how individuals with conflicting moral beliefs interact in a pluralistic society. What standards should be mandated by government, and what should be worked out by communities? What role should Christians play in the public sphere?

"In a pluralistic society you tolerate a lot of things you don't agree with, but at the same time you need to be a voice for change," says David Stevens of the Christian Medical and Dental Associations. "The Bible tells us very clearly to protect life, widows, orphans, all those who cannot defend themselves. Therefore, we have an obligation to speak out as a voice of righteousness in our culture."

Dr. Rob Vischer, a law professor at the University of St. Thomas, notes that while some Christians "are a little skeptical about this whole pluralism thing," pluralism does have an upside. He argues that in the current debate over conscience in health care, Christians need to be careful about seeking legislative remedies.

"The state either is going to elevate the pharmacist as all-powerful in terms of their moral decisions, where there's no consequence for what they do," he says, "or, if that view loses, the state is going to say that the pharmacist is also irrelevant—you just do what the prescription says." In either case, the battle becomes a political one.

Vischer believes that leaving the issue up to market forces is the best method for maintaining pluralism. Buyers will vote with their feet, he says; in this way, pharmacy chains might better represent the cultural makeup of America.

Stevens disagrees, seeing a legitimate role for legal challenges. In fact, he would like to see current court cases on the subject go even further.

"I would think ...