Pharmacy Board on a Slippery Slope

Russell Sadler

A growing number of pharmacists are refusing to fill prescriptions for Plan B. This contraceptive has a good record of preventing pregnancies if taken within 72 hours of unprotected sexual relations.

The protesting pharmacists insist prescribing Plan B offends their religious or moral sensibilities and they should not be forced to violate their consciences.

Oregon’s State Board of Pharmacy, struggling to resolve acts of conscience with the need of consumers for lawful prescription drugs, recently approved a policy statement that makes it a duty of licensed pharmacists who refuse to fill a prescription as a matter of conscience to refer consumers to another pharmacist who will. The policy statement also requires each pharmacy to draft procedures outlining a pharmacist’s ethical, moral and professional responsibilities.

More interested in a political statement than a policy statement, Gayle Atteberry of Oregon Right to Life complained it may violate the conscience of some pharmacists to even refer requests for Plan B to another pharmacist.

The Board of Pharmacy is out on a slippery slope without a safety harness because they are reacting to a deliberately contrived political issue by trying to regulate individuals rather than businesses.

For the sake of argument, let’s agree with two principles: (1) No person should be required by law to violate their conscience; (2) every consumer who goes to a pharmacy has a right to have their prescription for any lawful drug filled promptly and without moralizing. A pharmacy already, by law, must make sure the consumer has received the correct prescription, understands the possible side effects and interaction with other drugs and knows whether a generic drug may be as effective and less expensive.

The Board of Pharmacy’s position statement forbids pharmacists from discussing their religious or moral beliefs with consumers.

That probably violates the Oregon Constitution. Article I, Section 8 unambiguously states, “No law shall be passed restraining the free expression of opinion, or restricting the right to speak, write or print freely on any subject whatever; but every person shall be responsible for the abuse of this right.” But employers are under no such restrictions. They can forbid pharmacists from moralizing at customers and may do so as a condition of employment.

The Board of Pharmacy is on firmer ground describing confiscating, destroying or tampering with a prescription as unprofessional behavior.

The problem with writing rules for regulating pharmacists’ behavior is that we don’t know what prescription which religious group might deem immoral tomorrow. Religious objections to long-standing methods of contraception are resurfacing. At the present rate of medical and pharmaceutical innovation it is certain that new drugs will offend some pharmacists’ moral or religious sensibilities.

But that is largely irrelevant.

The State of Oregon’s responsibility is to assure that any legal prescription will be promptly filled. That means laws or rules making the pharmacy, not the pharmacist, responsible for filling prescriptions. If one pharmacist has moral or religious objections, the consumer must be able to promptly turn to another pharmacist to fill the prescription and not rely on the protesting pharmacist to refer the consumer to some other pharmacist. It should be the “duty” of the pharmacy to have sufficient employees on hand to fill any lawful prescription any time the business is open.

There will be staffing problems in smaller towns where Mom and Pop pharmacies are often the only pharmacy. But family-owned pharmacies are dwindling as large corporations and internet sales take over the job of dispensing prescription drugs. The problems of small pharmacies should not become an excuse for inaction or exemption. Large pharmacies can afford to have enough staff on hand to fill lawful prescriptions even if some pharmacists have moral objections.

Pharmacists who accumulate many moral objections or who want to use the dispensing of lawful prescription drugs as a soapbox for political statements, will have some trouble maintaining employment. But the state’s responsibility is not to assure convenient employment for the conscience-stricken or the crusader. The State’s responsibility is merely to assure that no one is compelled to violate their conscience as a condition of employment.

That is why it makes sense to give pharmacies the duty to fill any lawful prescription and the responsibility of hiring pharmacists who will help them comply with that duty instead of trying to regulate the behavior of the individual pharmacist.

By Russell Sadler June 17, 2006