Know Your Rights at the Drug Counter
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Know Your Rights at the Drug Counter

As the debate rages over whether pharmacists should be required to fulfill all prescriptions, what's a woman who is turned away to do?

A Slippery Slope

Kathleen O'Leary* and her husband already had four children and were using birth control to prevent a fifth pregnancy. But one night, when the condom they were using broke, O'Leary called her doctor in a panic. The couple got another shock when the pharmacy near their home, in Milwaukee, Wisconsin, refused to fill an emergency prescription for the morning-after pill. "It's a pharmacist's job to give people their medicine. It blows me away that they could refuse to dispense it," says O'Leary, 44, whose doctor ultimately gave her the medication herself.

Women like O'Leary are being turned away at drugstores across the country, as some pharmacists are refusing to fill prescriptions -- typically for birth control pills or emergency contraception -- that conflict with their moral or religious beliefs. Since January, as many as 14 states have introduced "conscience clauses" that explicitly grant pharmacists this right to refuse, while Arkansas, Georgia, Mississippi, and South Dakota already had such laws in place.

"There are pharmacists who object to all forms of birth control, and others who refuse only emergency contraceptives," says Adam Sonfield, public policy associate at the Alan Guttmacher Institute, in Washington, D.C., which researches reproductive issues. He adds that many people mistakenly believe that the morning-after pill works like the abortion pill RU-486 and causes the body to expel an implanted embryo. The morning-after pill is "actually the same medication as hormonal birth control pills, just a higher dose, which, if taken within 72 hours of intercourse, blocks ovulation, fertilization, or the implanting of a fertilized egg in the uterus. But not everyone understands that, including some pharmacists."

But the average consumer may not realize that the American Pharmacists Association's policy states that druggists can refuse to fill prescriptions they object to as long as they make sure customers can get their medication elsewhere. Despite these guidelines, anecdotal evidence suggests that some pharmacists aren't making referrals or are even confiscating the prescription. "Some won't transfer prescriptions, because even that level of involvement goes against their values," says Casey Mattox, litigation counsel for the Center for Law and Religious Freedom, in Annandale, Virginia.

No one knows exactly how often women are being refused, but cases have been reported across the country. "We hear only about the instances when women come forward," says Rachel Laser, senior counsel at the National Women's Law Center, in Washington, D.C. "But it's a threat that we're watching closely. Denying women such basic forms of healthcare as birth control, including emergency contraception, is sex discrimination."

Meanwhile, other states -- California, Missouri, West Virginia, and New Jersey -- are weighing legislation that would require pharmacies to fill any legal prescription. In April, Governor Rod Blagojevich signed an emergency rule in Illinois ordering pharmacies that stock the pill and the morning-after pill to dispense them without delay. Also that month, legislation was introduced in both the House and Senate protecting the right of an individual pharmacist to refuse to fill a prescription, but only under the condition that the pharmacy will dispense the medication through another druggist on duty.

This debate may become even more heated if the FDA approves the morning-after pill for over-the-counter sale to women 16 and older. Canada recently made the drug, sold under the name Plan B, available without a prescription. There's no word on when the FDA, which missed its January deadline to rule on Plan B, will make its decision.

For now, if your pharmacist refuses to honor a prescription for an emergency contraceptive, you can call 888-668-2528 for another pharmacist or healthcare provider in your area who can fill your prescription. Also talk to your doctor about filling an advance prescription for the morning-after pill to keep on hand. If your prescription for birth control pills is denied, call 800-230-7526 to find a Planned Parenthood near you that will dispense the pill, or try ordering it from an online pharmacy like Drugstore.com.

*Name has been changed.

Originally published in Ladies' Home Journal magazine, July 2005.

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