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Pharmacists Allowed to Deny Drugs to Patients Based Solely on Personal Beliefs

02.01.11

In Idaho, the pharmacy can simply choose to not fill your medicine even if you have a valid prescription from your doctor.

It’s called the conscience clause, meaning that if you go to a Walgreen’s with an Rx for Methergine – a medicine used to prevent or stop the bleeding in the uterus after childbirth or an abortion – that pharmacist is not required by law to fill the prescription.

This is exactly what happened to a Planned Parenthood nurse in Nampa, Idaho, who took it to the Board of Idaho Pharmacy and found that the pharmacy did nothing wrong:

But according to the Board of Pharmacy’s response, the Idaho Pharmacy Act does not require a pharmacist to fill a prescription. Even if the conscience law was used incorrectly, the pharmacist did not violate the Idaho Pharmacy Act by refusing to fill the prescription, the board found.

My emphasis. I’m sure there is a good reason to have that clause in the books. For example, if a patient has multiple doctors for many different ailments and they all prescribe drugs that, combined, could cause significant harm to the patient, the pharmacy should have the power to not fill prescription. But, in that sense, it’s for the sake of aiding the patient, preventing harm to them, not fulfilling some judgmental opinion on behalf of the pharmacist.

Quite the contrary. If the woman for whom the Methergine was prescribed needed the drug desperately to prevent massive bleeding, this ability to deny prescriptions to people would be doing the exact opposite: putting someone’s life into danger. Also, since the medicine is also used for situations of childbirth, it’s not certain that it was being used on a woman who had even had an abortion. How would that affect someone’s conscience knowing that they denied needed medicine to a woman who just gave birth?

It turns out that this particular pharmacist asked the nurse if the drug was being used for post-abortion care, to which the nurse denied a response since it would violate the patient’s privacy rights.

According to the Board of Pharmacy’s response, Planned Parenthood alleged the pharmacist’s inquiry violated privacy provisions of the federal Health Insurance Portability and Accountability Act, which the board is not entitled to enforce. Under the Idaho Pharmacy Act, releasing such information would be a violation, but requesting it is not, the response states.

The danger in this type of questioning is that even though the nurse is bound by law to not respond, her denial could be interpreted by the pharmacist as a “no comment” type answer, essentially known as a “yes, but I don’t have to tell you so I’m not going to” response. Leading someone perhaps into feeling guilty about being a part of something they don’t want to be even if it’s not the case. Even now in this article, it’s never revealed why the woman needed the drug.

In response to Planned Parenthood’s assertion that denying the prescription could have placed the patient in grave danger, the board said no such danger was realized because the medicine was obtained elsewhere.

Well, that sure is easy to say now in hindsight since the woman apparently did get the drug. But, what happens when all of the pharmacies in the area cite the Conscience Clause, denying the medicine being filled, and the woman hemorrhages and dies? Would the board have found that last point differently?

Also, how is that even allowed to be a defense when there’s no way that pharmacist can know for certain that the patient would be able to obtain the medicine elsewhere in a timely manner enough to avoid any further complications? The only way to know if the patient would’ve been placed in grave danger would be after the pharmacist had already denied the prescription.

I find the whole conscience clause in general rather revolting. The notion that someone whose chosen profession it is to fill prescriptions can decide for themselves whether or not to then fill those legitimately ordered scripts based on their own personal beliefs infuriates me.  And why is this only limited to feelings about abortions and end-of-life care?

Why not about criminals? Or drug addicts?

Both are living lifestyles that some – or many, even – find wrong, immoral, unacceptable. What if a prescription came in for Methadone and the pharmacist refused to fill it because they didn’t think that it was right to give drugs to a drug addict even if it was to help them get off drugs? Or how about this: a gunman gets shot while in a gang fight and, while it’s not life-threatening at the moment, needs a blood-clotting agent to help his situation, but the pharmacist doesn’t agree with gang violence and doesn’t want to be part of helping a known criminal so denies the prescription. Why is that not allowed? Why would that be ridiculous? How is it so different?

Filling a prescription no more endorses the behavior associated with the treatment for whatever ailment necessitates that medicine than working at the local Walgreens endorses the behavior associated with whatever movie people decide to rent from the Redbox out front. When I go to rent a movie, I might want a recommendation from the guy behind the counter, but I surely don’t want to be judged for what I choose to watch by some stranger who thinks they’re so high and mighty when it’s perfectly legal for me to rent that R-rated flick no matter how trashy it looks.

Unless I’m breaking the law: just do your job, know that you had no part in my life choices, and let me do what I have my right to do.

Photo courtesy of Curtis Gregory Perry’s Flickr Photostream.

2 comments

  1. What an outrageously harmful law. Is this Idaho-only?


    • I agree. And, no, sadly I believe many states have similar conscience clause laws on the books. I just can’t imagine going into a pharmacy with a valid prescription from my licensed doctor and not being able to get my drug filled because of that pharmacists topical judgment of who I am and the strength of my character and moral makeup. Disgusting.



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