Washington State Moves to Allow Pharmacies to Refuse to Dispense EC

In an unexpected move, the Washington State Board of Pharmacy moves to change a rule which prevents pharmacies from being able to refuse to dispense emergency contraception. But the public outcry, once again, may be too much to ignore.

In Washington State, a small group of pharmacists are putting on the pressure to allow pharmacies to refuse to dispense medication to which they object – and the State Board  of Pharmacy seems to be bending over backwards to do all they can to help them do so.

The Washington State Board of Pharmacy has voted 3-2, according to the News Tribune, to move ahead with a reversal of a 2007 rule that prevented pharmacies from refusing to dispense certain legal medication – including emergency contraception (EC) for the women of Washington State.

When the rule was first implemented (with the support of the state’s Governor Christine Gregoire) – to ensure that anyone who needed timely access to legal medication from a pharmacy could get it –  owners of a grocery store, Ralph’s Thriftway in Olympia, WA, responded with a lawsuit. The owners of the store refuse to carry Plan B (the brand name under which emergency contraception is sold) out of “moral opposition” to the drug. While the majority of pharmacists don’t have a problem with dispensing emergency contraception, there are some who seem to feel that that the medical community’s “evidence” that EC is actually contraception gets in the way of their personal opinion that it’s actually an abortifacient. Further, they feel that regardless of the safety, legality and FDA approval (PDF), women simply don’t deserve access to this medication.

The issue has been dragging on for years with public support firmly on the side of ensuring access to Plan B at pharmacies in the state, and a 2009 Ninth Circuit Court of Appeals decision in regards to an injunction against the rules, which held that the rules “do not aim to suppress, target, or single out in any way the practice of religion, but, rather, their objective was to increase access to all lawfully prescribed medications.”

But instead of allowing the case to go to court, where this small group of pharmacists attempting to stand in the way of women’s access to Plan B was likely to have lost, the state Attorney General stepped in to negotiate a settlement. The AG said that pharmacists should be able to “conscientiously object” to dispensing emergency contraception and refer women elsewhere. Yeah, it didn’t work for most of the residents of Washington State either.

What was at first a unanimous decision, on the part of the Washington State Pharmacy Board, to go ahead with the settlement has turned into an extremely divisive issue after thousands voiced their opposition to the Board’s consideration of changing the rule to meet the AG’s suggestion. The Board has received, so far, a total of 5,350 comments on the proposed rule change; 4,448 are in support of leaving the rule in place. An overwhelming number of those who have commented believe pharmacies should not be allowed to “opt out” of dispensing legal medication. 

To be clear, the existing rule already allows individual pharmacists to express their “moral opposition” by essentially passing a customer on to a co-worker, as long as the pharmacy fills the prescription by someone.  But a small group of pharmacists, led by Ralph’s Thriftway, aren’t satisfied. They want to be able to have an entire pharmacy say no to women in need of emergency contraception. It doesn’t stop there, of course. If they get their way, what would stop a pharmacist from deciding to opt out of providing a gay person with access to HIV medication, if they so chose? Or a diabetic person access to life-saving treatment?

The Pharmacy Board is now split with, interestingly, two of the three women on the board in support of keeping the rule as is (ie, ensuring that pharmacies cannot refuse to dispense medication) and three of the four men in support of changing it to allow pharmacies to refer women elsewhere. The third woman on the board was not present at the most recent meeting.

The one man on the board who does not support changing the rule is the Board chair, Gary Harris, who asks “What if a pharmacist believes “marriage is one man, one woman, and I have some gay men that come in.  (What if) I were to say ‘Gee, it’s against my religious background. You’ve brought this on yourself.’” Harris, however, does not have a vote unless there is a tie.

The rule-changing process is far from over. The public can comment on the proposed rule changes until November 30th, notes Planned Parenthood Votes! WA. When the board drafts final rules language, the public will then have another extended period in which to register comments and feedback. It should go without saying that a small group of pharmacists who have registered opposition to EC because they believe it “kills a fertilized egg,” as one pharmacist puts it, should not have the ability to enact barriers to safe, legal medication for the women of Washington State. If the rule change is allowed to go into effect, though, it means those pharmacists’ personal opinions about certain medications; patient populations; or individual choices, will take precedence over accessing timely, needed care.