A federal district court judge ruled last week in the case of Stormans Inc. v. Selecky, regarding pharmacy owners’ legal duty to fill prescriptions and the right of conscience. The judge found the state Board of Pharmacy’s rules in question to be unconstitutional and concluded that the board’s goal in implementing them was to suppress conscientious objections by pharmacies and pharmacists.
This case is often described as being about Ralph’s Thriftway Pharmacy and the emergency contraceptive Plan B. As a state senator and practicing pharmacist, I am keenly aware that it has always been about much more than just one drug, one pharmacy or one community.
This issue rose to prominence several years ago when the Pharmacy Board released a draft rule that would have formally enacted a “refuse and refer” approach – meaning a pharmacist could refuse to fill a prescription as long as he or she referred the patient to another pharmacy that would fill it. After the governor expressed strong objections, the board switched its position and issued a “duty to dispense” rule, requiring pharmacies to essentially stock every drug and allowing pharmacists to opt out of filling a prescription only if there was an available co-worker willing to step in.
For pharmacies with only one pharmacist on duty, this effectively meant that this pharmacist would be required to dispense every drug – regardless of his or her feelings of conscience. The Stormans company – owner of Ralph’s Thriftway – sued, contending it was illegal for the state to force a pharmacist to dispense a drug if doing so directly contradicted his or her religious convictions.
As a pharmacist, I personally have no objections to dispensing Plan B, and will continue to do so. Some of my colleagues, however, feel differently – and their rights should be respected. I believe most of my fellow lawmakers would agree, as indicated by the recently passed same-sex marriage bill that specifically exempts clergy from performing marriages if they object due to their religious convictions. Legislators on both sides of the aisle agreed it was important to allow these individuals to follow their conscience. I agree, and think it’s also important to consider why the state would require pharmacists to do something that violates the same right.
In a case like this one, it is also important to look beyond today. For example, what if a pharmacist was required to dispense a drug for an assisted suicide? Under a ruling where pharmacists would be required to dispense every drug, many may simply choose to stop practicing. That would have a huge impact on the people who need their services – especially in our smaller communities.
In 2008 I sponsored legislation that would have put into law a practice that pharmacists already follow. Under the measure, which did not receive a hearing, pharmacists would have been required to fill the prescription, or, if the needed medicines were unavailable or they wished not to dispense the drug, refer the patient to another pharmacy. It would also have required the pharmacist to contact another pharmacy of the patient’s choice, confirm that the drug or device is available, and transfer the prescription to that pharmacy.
Enacting this facilitated referral approach would put into statute what is common practice. Patients would be guaranteed access to the prescriptions they need while at the same time laying out for pharmacists exactly what needs to be done to fulfill their professional obligations.
The Stormans case may be appealed. In the meantime, putting into statute what is common practice for registered pharmacists would provide the type of clarity and guarantee that all on both sides of the issue are seeking.
Sen. Linda Evans Parlette, R-Wenatchee, is Republican Caucus Chair. She is a graduate of the WSU School of Pharmacy and between legislative sessions works as a pharmacist in Wenatchee. She can be reached at Linda.Parlette@leg.wa.gov.