Supreme Court Rejects Pharmacists' Refusal to Fill Appeal

The Supreme Court of the United States (SCOTUS) has rejected a case brought by Washington State pharmacists citing religion in refusing to fill prescriptions for emergency contraception.

SCOTUS’s refusal to consider the appeal leaves in place regulations adopted in 2007 by the Washington State Pharmacy Quality Assurance Commission specifying that pharmacies must dispense all FDA-approved drugs to customers regardless of religious or moral reasons.

In 2012, US District Court Judge Ronald B. Leighton ruled that the 2007 policies violated the religious freedom of pharmacy owners by requiring pharmacies to stock and dispense emergency contraceptives. However, the unanimous 3-judge federal appeals court panel overruled Leighton’s 2012 ruling on July 23, 2015.

The plaintiffs involved in the case in Washington State objected the use of emergency contraception, so they didn’t want to stock Plan B and Ella for religious reasons. The pharmacy involved in the matter is Ralph’s Thriftway in Olympia, Washington. The other 2 plaintiffs were Rhonda Mesler and Margo Thelen—pharmacists who work elsewhere but similarly believe that the morning-after pill is a form of abortion.

In the original decision, Judge Susan Graber, who authored the court opinion, maintained that pharmacies must stock and dispense products such as Plan B because of the time-sensitive needs of patients seeking emergency contraception.

“Speed is particularly important considering the time-sensitive nature of emergency contraception and of many other medications,” Graber wrote. “The time taken to travel to another pharmacy, especially in rural areas where pharmacies are sparse, may reduce the efficacy of those drugs.”

On behalf of the plaintiffs, a law firm called Alliance Defending Freedom filed a petition for a writ of certiorari in order to have SCOTUS review the federal appeals court's decision to prevent pharmacists in Washington from citing religion to refuse to fill a prescription.

Some of the petitioners’ arguments included:

• Pharmacies have traditionally been able to choose not to sell a drug for reasons related to business, economics, convenience, and conscience. If a pharmacy doesn’t have a product in stock or doesn’t want to keep a product in stock, it typically provides a referral to another pharmacy. These conscience clauses have been supported by the American Pharmacists Association and the other 49 states.
• There are more than 30 other pharmacies that carry Plan B within 5 miles of Ralph’s Thriftway.
• Patients have “never been denied timely access to any drug,” according to the petition.
• Dispensing drugs like Plan B “would make them guilty of destroying human life,” according to the petition.

SCOTUS’s decision to not hear the case has been lauded by many stakeholders as a victory for patients who deserve access to the medications they need without the interference of a pharmacist’s personal convictions.

“When a woman walks into a pharmacy, she should not fear being turned away of the religious beliefs of the owner or the person behind the counter,” stated Louise Melling, Deputy Legal Director of the American Civil Liberty Union, in a press release.

However, the decision came from a divided court.

In a scathing dissent, Justice Samuel Alito deemed the court’s refusal to consider the claim an “ominous sign” for the future of religious freedom claims.

Alito noted there’s evidence that the state’s regulation was adopted because of “hostility to pharmacists whose religious beliefs regarding abortion and contraception are out of step with prevailing opinion in the state” and was designed with the intent “to stamp out religious objectors.”

The SCOTUS decision comes as a growing number of states are passing or considering legislation to expand access to birth control, including California, Oregon, New Jersey, and Tennessee, among others. Meanwhile, a first-of-its-kind law that recently passed in Maryland requires health insurers to completely cover the cost of all forms of FDA-approved emergency contraception.

At the federal level, the “Access to Birth Control Act” (S. 2960) recently introduced in the US Senate would require pharmacists to provide “any drug or device approved by the [FDA] to prevent pregnancy…without delay.” Under the proposed legislation, pharmacists refusing to dispense emergency contraception would be fined $1000 per day until the prescription is filled, or up to $100,000 “for all violations adjudicated in a single proceeding.”

Another federal bill would compel the FDA to review contraceptive drug applications more quickly and make them available OTC.

Plan B has been available OTC for women of all ages nationwide since 2013. It can lower the risk of pregnancy by as much as 89% if taken within 72 hours of unprotected sex.