USA TODAY, November 09, 2004
to give out pill; Say their religion forbids
the use of contraceptives
BYLINE: Charisse Jones
For a year, Julee Lacey stopped in a CVS pharmacy
near her home in a Fort Worth suburb to get
refills of her birth-control pills. Then one
day last March, the pharmacist refused to fill
Lacey's prescription because she did not believe
in birth control.
"I was shocked," says Lacey, 33, who
was not able to get her prescription until
the next day and missed taking one of her pills.
"Their job is not to regulate what people
take or do. It's just to fill the prescription
that was ordered by my physician."
Some pharmacists, however, disagree and refuse
on moral grounds to fill prescriptions for
contraceptives. And states from Rhode Island
to Washington have proposed laws that would
protect such decisions.
Mississippi enacted a sweeping statute that went
into effect in July that allows health care
providers, including pharmacists, to not participate
in procedures that go against their conscience.
South Dakota and Arkansas already had laws
that protect a pharmacist's right to refuse
to dispense medicines. Ten other states considered
similar bills this year.
The American Pharmacists Association, with 50,000
members, has a policy that says druggists can
refuse to fill prescriptions if they object
on moral grounds, but they must make arrangements
so a patient can still get the pills. Yet some
pharmacists have refused to hand the prescription
to another druggist to fill.
In Madison, Wis., a pharmacist faces possible
disciplinary action by the state pharmacy board
for refusing to transfer a woman's prescription
for birth-control pills to another druggist
or to give the slip back to her. He would not
refill it because of his religious views.
Some advocates for women's reproductive rights
are worried that such actions by pharmacists
and legislatures are gaining momentum.
The U.S. House of Representatives passed a provision
in September that would block federal funds
from local, state and federal authorities if
they make health care workers perform, pay
for or make referrals for abortions.
"We have always understood that the battles
about abortion were just the tip of a larger
ideological iceberg, and that it's really birth
control that they're after also," says
Gloria Feldt, president of Planned Parenthood
Federation of America.
"The explosion in the number of legislative
initiatives and the number of individuals who
are just saying, 'We're not going to fill that
prescription for you because we don't believe
in it' is astonishing," she said.
Pharmacists have moved to the front of the debate
because of such drugs as the "morning-after"
pill, which is emergency contraception that
can prevent fertilization if taken within 120
hours of unprotected intercourse.
While some pharmacists cite religious reasons
for opposing birth control, others believe
life begins with fertilization and see hormonal
contraceptives, and the morning-after pill
in particular, as capable of causing an abortion.
"I refuse to dispense a drug with a significant
mechanism to stop human life," says Karen
Brauer, president of the 1,500-member Pharmacists
for Life International. Brauer was fired in
1996 after she refused to refill a prescription
for birth-control pills at a Kmart in the Cincinnati
suburb of Delhi Township.
Lacey, of North Richland Hills, Texas, filed
a complaint with the Texas Board of Pharmacy
after her prescription was refused in March.
In February, another Texas pharmacist at an
Eckerd drug store in Denton wouldn't give contraceptives
to a woman who was said to be a rape victim.
In the Madison case, pharmacist Neil Noesen,
30, after refusing to refill a birth-control
prescription, did not transfer it to another
pharmacist or return it to the woman. She was
able to get her prescription refilled two days
later at the same pharmacy, but she missed
a pill because of the delay.
She filed a complaint after the incident occurred
in the summer of 2002 in Menomonie, Wis. Christopher
Klein, spokesman for Wisconsin's Department
of Regulation and Licensing, says the issue
is that Noesen didn't transfer or return the
prescription. A hearing was held in October.
The most severe punishment would be revoking
Noesen's pharmacist license, but Klein says
that is unlikely.
Susan Winckler, spokeswoman and staff counsel
for the American Pharmacists Association, says
it is rare that pharmacists refuse to fill
a prescription for moral reasons. She says
it is even less common for a pharmacist to
refuse to provide a referral.
"The reality is every one of those instances
is one too many," Winckler says. "Our
policy supports stepping away but not obstructing."
In the 1970s, because of abortion and sterilization,
some states adopted refusal clauses to allow
certain health care professionals to opt out
of providing those services. The issue re-emerged
in the 1990s, says Adam Sonfield of the Alan
Guttmacher Institute, which researches reproductive
Sonfield says medical workers, insurers and employers
increasingly want the right to refuse certain
services because of medical developments, such
as the "morning-after" pill, embryonic
stem-cell research and assisted suicide.
"The more health care items you have that
people feel are controversial, some people
are going to object and want to opt out of
being a part of that," he says.
In Wisconsin, a petition drive is underway to
revive a proposed law that would protect pharmacists
who refuse to prescribe drugs they believe
could cause an abortion or be used for assisted
"It just recognizes that pharmacists should
not be forced to choose between their consciences
and their livelihoods," says Matt Sande
of Pro-Life Wisconsin. "They should not
be compelled to become parties to abortion."
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