Lisa Pearlstein, Fellow
Truly disappointing news came out of Idaho this week. The Idaho Board of Pharmacy decided not to take action after Planned Parenthood of the Great Northwest (PPGNW) filed a complaint with the state pharmacy board alleging a Walgreens pharmacist refused to fill a prescription, which could have left the patient in grave danger.
As described in the complaint, a nurse practitioner from PPGNW attempted to call in a prescription for Methergine, which is commonly used to prevent bleeding from the uterus following childbirth or an abortion, as treatment for an enlarged uterus, for miscarriage management, to help deliver the placenta after childbirth, or as a migraine treatment. The pharmacist inquired whether the patient had undergone an elective abortion, and the nurse refused to answer, citing patient confidentiality. The pharmacist then stated that she would not fill the prescription if the patient had undergone an abortion. When asked if she would refer the nurse to another pharmacist who would fill the prescription, the pharmacist hung up.
PPGNW alleged that the pharmacist wrongly applied Idaho’s refusal law when she refused to dispense the medication. Idaho’s refusal law states that a health care professional is not “required to provide any health care service that violates his or her conscience,” and health care services are defined to include an abortion and dispensing an abortifacient drug. PPGNW argued that the pharmacist wrongly applied the refusal law because Methergine is not an abortifacient. In its decision to close the investigation and not initiate administrative proceedings, the Board of Pharmacy did not address PPGNW’s claim because it could not “confirm all of the allegations.” Rather, the Board stated that nothing in Idaho pharmacy law requires a pharmacist to fill a prescription.
The Board missed an opportunity to read Idaho’s refusal law for what it is—a limited law that allows pharmacists to refuse to dispense only a narrow class of health care services. The law was not applicable in this case, and absent the law’s protection, pharmacists should be required to meet the needs of their patients and respect the professional judgment of the health care providers who care for them.
This situation is just another example of why it is necessary to have laws that require pharmacies to dispense all medications, unless there is an actual medical reason not to, such as a contraindication or evidence of improper use or abuse. A pharmacist’s right to exercise his or her personal beliefs should not trump a woman’s right to access the medications she needs.
Pharmacy refusals can severely harm a woman’s health. Had the nurse not found another pharmacist to fill the prescription, the patient would have needed emergency care. Kudos to Walgreens for recognizing how important it is for patients to have access to all the medications they need and taking corrective action against the pharmacist.
We encourage state advocates to work with state pharmacy boards to pass proactive laws that ensure a patient’s access to medication.