Pharmacists' Rights at Front Of New Debate

Karen L. Brauer, Pharmacists for Life president, defends the right of pharmacists to refuse medicine. (Courtesy of Karen L. Bauer)

"He's a devout Roman Catholic and believes participating in any action that inhibits or prohibits human life is a sin," said Aden of the Christian Legal Society. "The rights of pharmacists like him should be respected."

Wisconsin is one of at least 11 states considering "conscience clause" laws that would protect pharmacists such as Noesen. Four states already have laws that specifically allow pharmacists to refuse to fill prescriptions that violate their beliefs. At the same time, at least four states are considering laws that would explicitly require pharmacists to fill all prescriptions.

The American Pharmacists Association recently reaffirmed its policy that pharmacists can refuse to fill prescriptions as long as they make sure customers can get their medications some other way.

"We don't have a profession of robots. We have a profession of humans. We have to acknowledge that individual pharmacists have individual beliefs," said Susan C. Winckler, the association's vice president for policy and communications. "What we suggest is that they identify those situations ahead of time and have an alternative system set up so the patient has access to their therapy."

The alternative system can include making sure another pharmacist is on duty who can take over or making sure there is another pharmacy nearby willing to fill the prescription, Winckler said. "The key is that it should be seamless and avoids a conflict between the pharmacist's right to step away and the patient's right to obtain their medication," she said.

Brauer, of Pharmacists for Life, defends the right of pharmacists not only to decline to fill prescriptions themselves but also to refuse to refer customers elsewhere or transfer prescriptions.

"That's like saying, 'I don't kill people myself but let me tell you about the guy down the street who does.' What's that saying? 'I will not off your husband, but I know a buddy who will?' It's the same thing," said Brauer, who now works at a hospital pharmacy.

Large pharmacy chains, including Walgreens, Wal-Mart and CVS, have instituted similar policies that try to balance pharmacists' and customers' rights.

"We obviously do have pharmacists with individual moral and ethical beliefs. When it does happen, the pharmacist is asked to notify the manager that they have decided not to fill the prescription, and the manager has the obligation to make sure the customer has access to the prescription by another means," said Tiffany Bruce, a spokeswoman for Walgreens. "We have to respect the pharmacist, but we have to also respect the right of the person to receive the prescription."

Women's advocates say such policies are impractical, especially late at night in emergency situations involving the morning-after pill, which must be taken within 72 hours. Even in non-urgent cases, poor women have a hard time getting enough time off work or money to go from one pharmacy to another. Young women, who are often frightened and unsure of themselves, may simply give up when confronted by a judgmental pharmacist.

"What is a woman supposed to do in rural America, in places where there may only be one pharmacy?" asked Nancy Keenan, president of NARAL Pro-Choice America, which is launching a campaign today to counter the trend. "It's a slap in the face to women."

By the time Suzanne Richards, 21, finally got another pharmacy to fill her morning-after pill prescription -- after being rejected by a drive-through Brooks Pharmacy in Laconia, N.H., one late Saturday night in September -- the 72 hours had long passed.

"When he told me he wouldn't fill it, I just pulled over in the parking lot and started crying," said Richards, a single mother of a 3-year-old who runs her own cleaning service. "I just couldn't believe it. I was just trying to be responsible."

In the end, Richards turned out not to be pregnant, and Pulz was able to obtain her prescription last June directly from her doctor, though she does not think she was pregnant, either.

"I was lucky," Pulz said. "I can sympathize with someone who feels strongly and doesn't want to be involved. But they should just step out of the way and not interfere with someone else's decision. It's just not right."