Washington board backs ‘refuse, refer’

OLYMPIA – Druggists who personally oppose morning-after birth control pills could refuse to sell them under a rule endorsed Thursday by state pharmacy regulators.

The Board of Pharmacy’s move mirrored the preference of the state pharmacy association, but angered abortion- and women’s-rights groups and defied the wishes of Gov. Chris Gregoire.

“The governor isn’t a pharmacist,” said board member Donna Dockter, a Seattle pharmacist who led the push to give her colleagues broader discretion in filling prescriptions.

The rule, endorsed by the board in a 5-0 vote, says pharmacists may not “obstruct a patient in obtaining a lawfully prescribed drug or device,” and adds druggists must provide timely alternatives if they “cannot dispense” a prescription.

It faces additional public scrutiny before taking effect and could be altered before final adoption, expected at the end of August.

C.J. Kahler, past president of the Washington State Pharmacy Association, said the rule endorsed Thursday properly respects the rights of both patients and drug providers.

“The patient needs to get the medication they need; the pharmacist needs to be able to practice within their conscience limits. This allows both,” he said.

Some women’s rights groups fear the rule could block access to emergency contraceptive pills, the morning-after birth control that dramatically cuts chances of pregnancy if taken within 72 hours of unprotected sex.

They believe abortion opponents might refuse to dispense the morning-after pill because it may prevent a fertilized egg from implanting in a woman’s uterus.

Nancy Sapiro, an attorney with the Northwest Women’s Law Center, called the board’s action “profoundly disappointing.”

“It specifically creates an out for pharmacists who choose to refuse to fill prescriptions on their personal beliefs,” she said.

The pharmacy association counters that instances of refused prescriptions appear to be extremely rare, and that emergency contraception is available at hospitals and without a prescription in Washington state.

The board’s endorsed rule does require pharmacists to “provide timely alternatives for the patient to obtain treatment.” That could include sending the patient to another pharmacy.

“If they don’t stand in the way of a patient getting appropriate therapy … that is an option that, in many cases, is very appropriate,” Dockter said.

But that “refuse and refer” policy is opposed by Gregoire, several key legislators, and the director of the state Human Rights Commission, who believe the approach illegally discriminates against women.

In a statement issued after the vote, Gregoire said the board’s decision would “fail to protect Washington families from pharmacists who refuse to dispense lawful prescriptions.”

Board member Rosemarie Duffy, a Spokane registered nurse, said those opinions made the rule endorsed Thursday “a difficult reconciliation.”

“I think we’ll have to see how it plays out. We may be coming back to this,” Duffy said.