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Wednesday, April 19, 2006

Emergency Contraception Emergency: Where’s Governor Gregoire?

Posted by on April 19 at 13:44 PM

An estimated 70 people testified this morning at a Board of Pharmacy hearing about pharmacists’ responsibilities to fill (or not fill) prescriptions.

About 65 of those 70 people—including state Sen. Pat Thibaudeau (D-43), and representatives from Lifelong AIDS Alliance, the League of Women Voters, the Washington Human Rights Commission, and Dr. Gordon Perkin (formerly of the Gates Foundation)—testified against allowing pharmacists to refuse to fill prescriptions based on moral grounds. (The 7-member pharmacy board is considering rules that may allow individual pharmacists to refuse to fill prescriptions based on moral objections.)

A crew from Bellingham showed up too (the hearing was south of Olympia in Tumwater) and handed off a petition signed by 1,000 people against Pharmacist “Refusals.”

A major theme for this morning’s speakers—mostly just regular citizens not affiliated with any organization—was that refusal clauses would hurt rape victims by preventing them from getting emergency contraception.

One major disappointment to women’s rights advocates, however, was this: No one from Governor Gregoire’s office was at the hearing. Activists who oppose refusal clauses for pharmacists feel that Gregoire is not using her office to frame this issue and pressure the Board of Pharmacy to do the right thing. To that end, over 70 groups—including NARAL Pro-Choice Washington, Northwest Women’s Law Center, Washington State Labor Council, the Governor’s Advisory Council on HIV/AIDS, Sid’s Professional Pharmacy in Pullman, WA., and the Yakima YWCA—delivered a petition to the governor after the hearing today stating:

We, the following undersigned organizations, urge you to do everything in your power to ensure that the Board does not adopt a rule that interferes with a patient’s ability to obtain the medications that they need. We strongly believe that while a pharmacist’s religious beliefs and personal values should be respected, it is unacceptable for pharmacists to impose their moral or ethical beliefs on the patients they serve.

Your help is needed to ensure that patients in Washington can access the drugs that they need, and that prescriptions are filled at the site where they are requested.

I’ve posted the whole petition to Gregoire and a complete list of those who signed the petition below.

We, the following undersigned organizations, urge you to do everything in your power to ensure that the Board does not adopt a rule that interferes with a patient's ability to obtain the medications that they need. We strongly believe that while a pharmacist's religious beliefs and personal values should be respected, it is unacceptable for pharmacists to impose their moral or ethical beliefs on the patients they serve.

Your help is needed to ensure that patients in Washington can access the drugs that they need, and that prescriptions are filled at the site where they are requested. Referring men and women to other pharmacies is not a satisfactory substitute -- many Washingtonians live in rural areas or small towns where there is no other pharmacy nearby. Men and women should not be sent out of the drugstore simply because the pharmacist does not wish to serve them.

We are a diverse group of organizations who work across the state to protect and promote the needs of women, men, youth, patients, minorities, rural areas and faith communities. This issue is of utmost importance to all of us, and the policy that is decided by the Pharmacy Board will affect all of us.

A pharmacist's foremost professional responsibility is to provide pharmaceutical care for his or her patients. While pharmacists have a fundamental right to their own religious and moral beliefs, those beliefs should not interfere with a patient's ability to obtain the health care that s/he needs.

Please do not adopt a policy that will make it more difficult for us, and for the individuals that we serve, to obtain the health care that patients need.


American Academy of Pediatrics, Washington Chapter
American Association of University Women
Aradia Women's Health Center
Aurora Medical Services
Blue Mountain Heart to Heart HIV/AIDS Organization
Cedar River Clinics-Tacoma, Renton, Yakima
Clergy Advisory Board of Planned Parenthood of Central Washington
CounterCrisis Northwest
Cowlitz Family Health Center
Ellensburg Bi-Mart
Equal Rights Washington
Family Planning Association of Chelan-Douglas Co.
Family Planning of Clallam County
Governor's Advisory Council on HIV/AIDS
Healthy Mothers, Healthy Babies Coalition of Washington
Interfaith Community Health Center, Bellingham WA
King County Coalition Against Domestic Violence
Lambda Legal
Law Students for Choice at the University of Washington
League of Women Voters of Washington
Lifelong AIDS Alliance
May Arkwright Hutton Democratic Women's Alliance/Agnes Kehoe Chapter, Spokane, WA
Medical Students for Choice at the University of Washington
Mother Baby Center, Bellingham WA
Mount Baker Planned Parenthood
NARAL Pro-Choice Washington
National Council of Jewish Women, Seattle Section
Northwest Health Law Advocates
Northwest Women's Law Center
Odyssey Youth Center
Okanogan Family Planning
Palouse HIV Coalition
Peace and Justice Action League of Spokane
People of Color Against AIDS Network
Pierce County AIDS Foundation
Planned Parenthood Network of Washington
Planned Parenthood of Central Washington
Planned Parenthood of the Columbia Willamette
Planned Parenthood of the Inland Northwest
Planned Parenthood of the Inland Northwest Faith in Action Committee
Planned Parenthood of Western Washington
Polylang Translation Services, Inc.
Pride Foundation
Pride Foundation/Inland Northwest
Program for Appropriate Technology in Health
Puyallup United Methodist Church Puyallup, WA
Radical Women
Real Change
Seattle Chapter Hadassah
Seattle Metropolitan Elections Committee
Sexual Assault Center of Pierce County
Sid's Professional Pharmacy, Pullman
Spokane AIDS Network
Spokane Chapter of Inland Northwest Older Women's League
Spokane Women's Coalition
VOX: Voices for Planned Parenthood at Washington State University
Walla Walla County Democrats
Walla Walla Friends Meeting (Quaker)
Washington Association of Churches
Washington Citizen Action
Washington Coalition of Sexual Assault Programs
Washington State Commission on Hispanic Affairs
Washington State Council on Family Planning
Washington State Labor Council
Washington State National Organization for Women
Washington State University Department of Women's Studies
Young Democrats of Whitworth College
YWCA of Bellingham
YWCA of Yakima


CommentsRSS icon

Hopefully common sense will rule the day with regards to this issue. Anyone who has a moral objection to dispensing a legitimate prescription should not become a pharmacist. That would be like a Hindu applying to work at McDonalds.

Gregoir got hit in the head with a coconut and now she believes that she's the Gov of S. Dakota. A "moderate" gov of S. Dakota. I'm worried I might get hit in the head with the same coconut and forget to vote for her.

Sid's Pharmecy in Pullman!? My hometown makes me proud!

If i was a pharmacist and they approved this, i would refuse to dispense perscriptions to republican voters on the moral grounds that i do not believe they deserve to get better. I say let them reap the full fury of whatever has stricken them.

That's a beautiful list. Thanks for showing it to us. I'm especially heartened to see people standing up in the red parts of the state; the freedom of choice in places like Okanogan County is on shakier ground than it is here in the big city.

Did supporters of the change bring a petition, or just random individual kooks?

I am employed at a public library and think it would be a grand idea for the staff to refuse to fill interlibrary loan requests for material we find objectionable. Should you need a copy of "Daddy Daycare", "My Big Fat Greek Wedding", Tom Arnold's autobiography or any selections from Peggy Noonan's ghastly oeuvre, I cannot be of service to you.

she was busy schmoozing with the Chinese Head of State, is my guess.

I am employed at a public library and think it would be a grand idea for the staff to refuse to fill interlibrary loan requests for material we find objectionable.

Betina, if you were employed at a private library you could do that. And if we had public pharmacies, surely they would not be allowed to choose which drugs to sell. But we don't have public pharmacies -- only private businesses that resell drugs. Should they all be required to sell every drug on the market?

I'm stongly in favor of pharmacists not getting in the way of patients acquiring medicine their doctors prescribe for them, but I'm not sure how we can reasonably achieve that without either having doctors dispense drugs directly or having state-run stores sell them.

What do people think of Washington State having liquor, wine, and birth control stores?

Phil,
In scuttling Bettina's analogy, you've set up an inaccurate scenario. These rules will be about pharmacists, not pharmacies. In other words, individual pharmacists want the right to trump what the private pharmacies (the owners) are telling them to do. Individual pharmacists want the right not to fill a prescription for Plan B even if the private pharmacy where they work stocks it. Yeah, there's certainly nothing the state can do if a private pharmacy doesn't stock for certain prescriptions. But this isn't about that.

But we don't have public pharmacies -- only private businesses that resell drugs. Should they all be required to sell every drug on the market?

Actually, we have businesses licensed by the state to resell drugs according to certain conditions. If they're unwilling to follow those conditions, then they'll simply be unable to legally sell.

If a pharmacist can *withhold* medication from a patient for "moral reasons", why can't they also *dispense* medication for "moral reasons"? Maybe I have a religious reason for needing so much vicodin... Stop oppressing my people!

It's a slippery slope once you start allowing people who are not medical doctors to start practicing medicine without a license.

Sorry, Josh, I hadn't read your article yet, just the Slog posts -- things available via RSS feed get read before anything that requires me to go browse a Web site or pick up a dead tree in order to read.

Now that I have read it:

How does the WSBP differentiate between actions of pharmacies and actions of pharmacists (who act as agents of pharmacies)? I mean, doesn't it make more sense to regulate whether or not a pharmacy has the right to refuse to fill a prescription and let the pharmacy deal with employee insubordination privately? Or do they simply license pharmacists and thus require pharmacies to hire pharmacists in order to dispense drugs?

Either way, how can we force a private business or salesperson working for that private business to sell something it or he does not want to sell? Is it possible because we've said, "These things are dangerous so they will be controlled by the state, which will license qualified individuals to act on its behalf by controlling access to them"?

Actually, we have businesses licensed by the state to resell drugs according to certain conditions. If they're unwilling to follow those conditions, then they'll simply be unable to legally sell.

Do those conditions include one that says in order to sell any drugs the state-licensed business must sell all legally prescribed drugs?

My previous comment was made in jest; I assure you I have no plans to righteously deny anyone access to Tom Arnold fare or even middling Kate Hudson thrillers. I was just trying to mock the dangerously sanctimonious.

I realize it was made in jest, but it brought to light a good point. If you had a strong moral objection to filling inter-library requests for crapola like Daddy Daycare, you would have the option of going to work at a private library where you and your employer could choose not to fill those requests. The pharmacists, however, already work for a private business.

Maybe our response to pharmacies should be, "Okay, if you want to let your pharmacists decide which medicines to dispense, go ahead. But in order to ensure that patients get the drugs their doctors prescribe we're going to sell drugs ourselves at state-run stores -- at cost."

Either way, how can we force a private business or salesperson working for that private business to sell something it or he does not want to sell?

Does this mean that a vegetarian cashier at Safeway can "opt out" of selling meat to customers? Well, certainly, they could take the issue to the Supreme Court if their vegetarianism were a tenet of their religion and ultimately call it religious discrimination to force them to sell meat. However, they probably understand that part of living in a multi-cultural, multi-religion, diverse society is having the respect for the amazingly beautiful variety of people in this country. Professionally, if they can find something that in no way, ever, ever, ever makes them participate in any way, shape or form in anything related to anything outside of their own personal, moral or religious belief system then fabulous. Likely, however, they'll need to understand that they don't live in a bubble.

Can a homophobic pharmacist "opt out" of filling a prescription for a gay man with AIDS? Lifelong AIDS Alliance was present at the public input session yesterday because they understand the implications a ruling like this could have. Why would this not fall under the domain of "conscience clause" - and please don't tell me it's because it would be discrimination. So far pharmacists have applied their refusals solely to women so discrimination would certainly be an appropriate charge here.

This is not, I assure you, in any way about a pharamacists "right of conscience." There is a small group, a very small group, of extremist religious folks who have decided that they do not believe women should be allowed emergency contraception, "the morning-after pill." And so they have brought it to the level of "conscience conflict" rather than having some balls and calling it is "an excuse to discriminate."

If a pharmacist believes strongly that the form of birth control we call emergency contraception should not be dispensed to women for safety reasons then there is a mechanism for this pharmacist to make his or her professional opinion known - contact the FDA. If this pharmacist feels morally that emergency contraception is "wrong" then that pharmacist has a mechanism for making his or her thoughts known - join Human Life of Washington or any other pro-life/anti-choice organization.

I work for Aradia Women's Health Center, a local nonprofit feminist women's health center. We are one of the co-signers of the letter to the Pharmacy Board. The issue is absurd - we have been prescribing "emergency contraception" in one form or another for over fifteen years. Not one single pro-life activist, not one pharmacist, no one has protested in any way shape or form. Emergency contraception is extremely safe.

When thousands were dying from Vioxx why weren't pharmacists up in arms demanding their right not to fill this prescription for this medication that was KILLING people?!

Now there are a handful of pro-life pharmacists who are telling us that they want the "right" to opt-out of filling prescriptons for birth control? Birth control?! The JOB of a pharmacist is to fill prescriptions If a pharmacist cannot do that then he or she needs to find another job.

Does this mean that a vegetarian cashier at Safeway can "opt out" of selling meat to customers?

Yes, he most certainly can. His employer may not like it, and he may lose his job if he's unwilling to perform it, but that's up to the employer, not us. Similarly, Safeway can "opt out" of selling meat to customers. It's just a retailer. It buys and sells some goods -- not all goods. The choice of what to sell is up to Safeway, not us.

Regardless of his stance on the burning of fossil fuels, a state Department of Licensing employee cannot "opt out" of issuing a vehicle license without losing his job. He works for us and we issue vehicle licenses to qualified individuals.

Where do pharmacists and pharmacies fit in? Why do we leave the regulation and control of medicine up to private business?

Exactly, Safeway can fire the vegetarian employee. What pharmacists want is protection from being fired if they refuse to fill a prescription. They claim that being forced to fill prescriptions, or facing the possibility of being fired if they refuse, violates their religious rights. It's a bullshit argument.

If a pharmacy refused to hire a pharmacist because of his or her religious beliefs, then that would be a violation of the pharmacist's rights. Firing someone for refusing to do their job is not discrimination.

Pumping irony: "(T)he freedom of choice in places like Okanogan County is on shakier ground than it is here in the big city. ..." - via Fnarf, above.

Suggestion for jesting Bettina, aka Conan the Librarian: Read Peggy Noonan's ouvre. You'll learn how to (1) write, and how to (2) think. Start with Noonan's superb bio of Reagan or her essays about 9/11.

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