State: Pharmacists Must Do Jobs

YAKIMA, W.A.— The state pharmacy board says pharmacists' moral objections should not allow them to deprive patients of a legal prescription.

Druggists could still refuse to dispense certain drugs under a proposed draft rule, but only if another pharmacist is on site to fill the prescription.

The draft rule, which requires several more steps before it could be enforced, was developed following a proposal to allow pharmacists to decline to fill prescriptions on religious, moral or ethical grounds. Supporters of that proposal included the Washington State Pharmacy Association.

The issue particularly centers on prescriptions for emergency contraception, commonly known as the morning-after pill or Plan B, which helps prevent a pregnancy if administered within 72 hours of sex.

Supporters say pharmacists have the right to a so-called ``conscience clause,'' while opponents argue that pharmacists are bound by state laws to dispense prescribed medications regardless of personal convictions.

Under the draft rule, pharmacies also would be allowed to refer patients to another business or recommend a timely alternative if they do not stock a certain drug.

Violations of the rule would be considered unprofessional conduct subject to disciplinary action, board Executive Director Steven Saxe said.

Under state law, a pharmacy must maintain a representative assortment of drugs in order to meet the pharmaceutical needs of its patients — but the only drug pharmacies are required to stock is Ipecac syrup, to treat accidental poisoning.
Saxe said the stocking provision isn't intended to give pharmacies an easy avenue to avoid filling certain contraceptive prescriptions by refusing to carry the drugs. Rather, it is intended to keep pharmacies from being disciplined simply because they have run out of a certain drug, he said.

"I think the intent is to make sure that when somebody legitimately has a shortage of product, that they are not brought up for discipline,'' he said. "I don't see that as the board looking at an out for not taking care of appropriate patient needs.''

Others at the Friday meeting declined immediate comment because of the uncertain effect of the proposal.

Amy Leftig, deputy director of public policy for the Planned Parenthood Network of Washington, said care of the patient must be the top priority.

Nancy Sapiro of the Northwest Women's Law Center agreed.

"At some point, we have to assess what these draft rules look like and figure out where to go from here,'' she said.

More than a dozen states have considered measures thathave"pharmacist refusal'' or "conscience clauses'' in them.
Pharmacy boards in Wyoming, Nevada, North Carolina and Massachusetts have already said pharmacists don't have such rights.

Gov. Chris Gregoire, a Democrat, sent the pharmacy board a letter opposing the proposal.

In Washington state, an estimated 1,000 pharmacists can dispense emergency contraception directly to a patient without a physician visit.

The exact wording of the rule and its potential effect remained unclear Friday, following a four-hour meeting in which pharmacy board members publicly avoided mentioning emergency contraception.

At one point, the board met behind closed doors for 40 minutes with a lawyer to discuss lawsuits that board members said were threatened by interests on both sides of the issue.

Board members discussed dozens of issues, questions and concerns during the meeting, with many written on nearly two dozen large sheets of paper on a wall.

But exactly which ideas were to be incorporated into the proposed rule was unclear because board members added parts to the proposal by choosing different options from a long list of suggestions not provided to the public or other observers.
The board scheduled another meeting for May 2 to further discuss the draft rule. The board held public meetings this week to gather comments about the proposal, and a final rule could be in effect by the end of August, Saxe said.

—The Associated Press