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Spokane, Washington  Est. May 19, 1883

Pharmacists want right to refuse

Associated Press The Spokesman-Review

SEATTLE – The Washington State Board of Pharmacy is considering a proposal that would allow pharmacists to refuse to fill prescriptions like emergency contraception on moral, religious or ethical grounds.

Backers including Rod Shafer, executive director of the Washington State Pharmacy Association, argue that pharmacists should have the right to decline work that conflicts with their beliefs as long as they respect the patient.

“We are not dispensing machines,” Shafer said. “We are professionals who have as many rights as anybody else.”

Abortion rights advocates counter that pharmacists are bound by state laws to dispense prescribed medications regardless of their personal convictions. The only legal alternative would be if another pharmacist at the same facility could take over, said Nancy Sapiro, with the Northwest Women’s Law Center.

“We don’t believe saying ‘Sorry, we won’t dispense that here. Go somewhere else,’ is an adequate response,” Sapiro said. She added that asking patients to find another pharmacy is especially problematic in rural areas where options are limited.

Gov. Chris Gregoire, a Democrat, has sent the pharmacy board a letter opposing the proposal. At a public hearing in Kent last Friday, most of the more than 100 people who showed up spoke out in favor of it.

Seventeen states are currently considering measures that have “pharmacist refusal” or “conscience clauses” in them, according to the National Conference of State Legislatures.

Pharmacy boards in Wyoming, Nevada, North Carolina and Massachusetts have already said pharmacists don’t have such rights.

The national debate was inspired by the emergency contraceptive, commonly called Plan B, that the Food and Drug Administration approved in 1999. Opponents consider it a form of abortion. Some pharmacists have refused to dispense it.

Emergency contraception – essentially a high-dose birth control pill – works by preventing the ovaries from releasing an egg, blocking fertilization, or stopping a fertilized egg from implanting in the uterus.

When the first dose is taken within 72 hours of unprotected intercourse, the morning-after pill is 89 percent effective at preventing pregnancy.

Some argue that delays caused by women being forced to hunt down a willing pharmacist could result in unwanted pregnancies, because the pills are most effective within 24 hours.

The FDA is still considering whether to make the medication available over the counter.

The state Board of Pharmacy has received dozens of calls from pharmacists about the guidelines for dispensing emergency contraception in the past year.

“There’s not real clarity on it,” said Steven Saxe, the board’s executive director.

As the debate heated up elsewhere, the board began to discuss what the policy should be in Washington.

In January, the state Pharmacy Association presented a draft of its policy on the issue to the seven-member board, made up of five pharmacists and two members of the public. The board plans to hold public hearings around the state in the coming months.

The Pharmacy Association’s latest draft says a pharmacist “must act in accord with his or her moral, ethical, or religious principles, which may include conscientious objection to performing certain pharmacy care services.”

Pharmacies should inform customers of their options if a pharmacist declines to fill their prescription and “to always hold the autonomy, dignity and confidentiality of his or her patients in the highest regard,” according to the draft.

No formal complaints have been filed with Washington’s pharmacy board, though Planned Parenthood has received reports from women around the state who say pharmacists have refused to fill their prescriptions, said Amy Luftig, a lobbyist for the organization.

Emergency contraception is not the only medication pharmacists are withholding, Luftig said.

In May, she said one pharmacist at a Seattle hospital refused to fill a woman’s prescription for antibiotics because it came from a facility that provides abortions. The pharmacist cited religious objections.

Though the debate often centers on emergency contraception, the Pharmacy Association said its proposal is also meant to anticipate other issues. Some pharmacists, for example, worry that if assisted suicide is legalized, they could be forced to dispense drugs used to end someone’s life.