Pharmacists Refusing to Fill Spark National Controversy

A woman walks into a pharmacy to fill her birth control prescription and is turned away. This may sound like the start of a bad joke, but it is the reality at some pharmacies in the United States.

Pharmacists’ refusal to fill prescriptions for birth control and emergency contraception has sparked national controversy.

Such reports have surfaced in at least 25 states, according to the National Women’s Law Center (NWLC), a legal advocacy group focused on women’s issues. Many of these refusals are based on personal beliefs, rather than medical or professional concerns.

Although some pharmacists refuse to dispense birth control or emergency contraception even though it is in stock, other pharmacies refuse to even carry these medications.

In several cases, 1 type of emergency contraception available without a prescription was stored in a locked pharmacy case, forcing those seeking the drug to interact with pharmacy employees who then refused to dispense the medication. In other cases, men, who are legally permitted to purchase nonprescription emergency contraception under FDA rules, have been denied access.

Because of the time-sensitive nature of birth control and emergency contraception, delays in dispensing can result in improper use or reduce the medication’s effectiveness.

Legal experts say that a pharmacy refusing to provide birth control is a challenging issue complicated by the fact that the laws governing pharmacies differ by state. Most state laws do not specifically address refusals to dispense based on personal beliefs or judgments, thus limiting the grounds to professional or medical concerns such as drug interactions or misuse.

Only 8 states (California, Illinois, Nevada, Maine, Massachusetts, New Jersey, Washington, and Wisconsin) have laws explicitly prohibiting medication refusals. Six states (Arizona, Arkansas, Georgia, Idaho, Mississippi, and South Dakota) have laws that specifically allow pharmacists to refuse to provide medications for religious or moral reasons.

None of the laws in the 6 states that allow medication refusals include provisions requiring pharmacists to refer patients or transfer prescriptions to another pharmacy.

Pharmacy industry associations such as the American Pharmacists Association have issued policies stating that pharmacists should fill all valid prescriptions or transfer them to a pharmacist who can, according to the NWLC. Although these policies encourage pharmacists to check their personal beliefs at the door, the policies are not legally binding and are nothing more than recommendations.

Many major pharmacy chains also have policies in place that prohibit pharmacists from refusing to fill prescriptions for birth control, but some stores have “refuse and refer” policies. Like other retail store policies, a pharmacist’s failure to comply could result in discipline or, at worst, termination.

Birth control access advocates are urging supporters to petition their legislators and state pharmacy boards to pass laws that prohibit medication refusals. Pharmacists’ rights advocates, however, say that they should not be required to dispense drugs that they find morally or religiously objectionable.

Regardless of where you stand on this issue, it has caused a national debate and resulted in lots of media coverage. It could eventually make its way to a pharmacy near you.