Back in 2007, pharmacists in Washington State brought a case to court asking that they be allowed to refuse to fill prescriptions or dispense medications they found morally objectionable based on their religious beliefs. Although Plan B (the "morning after pill") is the primary target of this ideology, there have been reports of other medications pharmacists have refused to dispense, including prescriptions for post-abortion antibiotics and birth control pills for hormonal (not contraceptive) reasons.
Despite substantive evidence that Plan B rarely if ever induces an abortion (the removal of an implanted embryo from the uterine lining) and instead acts to prevent implantation of the fertilized egg (blastocyst), prevent fertilization of the egg, and/or to suppress ovulation, these pharmacists insisted that they had a right to act or refuse to act in accordance with their religiously-inspired moral views.
Although Plan B is available without a prescription for adults (minors need a prescription still), a customer still has to go to the pharmacy counter to obtain it, making it a "behind-the-counter drug". The other most prominent behind-the-counter drug is pseudoephedrine, controlled because large amounts can be used to synthesize methamphetamine.
In the end, the injunction was lifted by the 9th Circuit Court of Appeals, and pharmacies were required to have someone on duty who was willing and able to dispense the medication. (PDF download of WSBP publication here) I posted my thoughts on the issue here.
~---end of backstory---~
But this issue, after being laid to rest for three years, has resurfaced like a stealthy viral infection, generating heated discussion once more.
At the end of June, the Board of Pharmacy (allegedly at a meeting) changed their position on this issue and quietly altered the rules governing these pharmacists and is now allowing them to refuse to fill these prescriptions. According to The Redheaded Pharmacist, the Board decided to do this to avoid a lengthy court battle.
The updated rules are posted here:
- WAC 246-869-010: Pharmacies' responsibilities
- WAC 246-863-095: Pharmacist's professional responsibilities
I'm still researching this issue and have some questions about the changes and the significance. One question that is still open (I am asking around) is that it appears that Plan B does not require a prescription to be dispensed, but all the sources I see currently talk about it as if it needs one.
While substantively there may not be a huge difference (pharmacists still decide whether the patient gets it), it could change some details of the debate since we're not longer talking about prescribed medications. Not only does this remove the prescribing physician as one gatekeeper, leaving the pharmacist as sole decider, but it also changes the classification of the medication and possibly distinguishes it from other medications like birth control pills and antibiotics.
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