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Thursday, June 1, 2006

The Pharmacy Board Ruling

Posted by on June 1 at 16:50 PM

Okay, so the Board was trying to strike a balance between the guaranteed right of employees not to face religious discrimination & the guaranteed right of women in Washington state to have access to contraception. (Here’s the language from Washington state lawRCW 9.02.100: “Every individual possesses a fundamental right of privacy with respect to personal reproductive decisions… every individual has the fundamental right to choose or refuse birth control.”)

One thing to add into this equation: There’s something known as a bonafide occupational requirement (BOQ), which means, while employers still have to make reasonable accommodations to respect an employee’s religion, they can force employees to do things that are essential to the joblike filling prescriptions.

Anyway, as I see it, the Pharmacy Board struck a balance by erring on the side of protecting someone’s feelings over protecting someone’s health.

Now, here’s a telling detail. Here’s some language that had initially been in the ruling (back when the ruling prohibited refusals), but was struck today. Check out 7C.

Again, this is language that was struck:

(1) A pharmacist’s primary responsibility is to ensure patients receive safe and appropriate medication therapy. Pharmacists shall dispense a lawfully prescribed drug or device or provide suitable therapeutic substitution in a timely manner consistent with reasonable expectations for filling these prescriptions except when:
(a) clinically contraindicated,
(b) potentially fraudulent, or
(c) another on-site pharmacist will fill the prescription without delay.

(7) Pharmacists and ancillary staff shall not:
(a) Destroy or refuse to return unfilled lawful prescriptions when requested to do so by patients or their agent,
(b) Violate a patient’s privacy, or
(c) Discriminate against patients or their agent in a manner prohibited by state or federal antidiscrimination laws.

Nancy Sapiro, of the Northwest Women’s Law Center, explains that the original languge, which had outlawed refusal clauses, made a point of re-stating the Pharmacy Board’s commitment to anti-discrimination…to make it clear that the board believed refusal clauses could be discriminatory. However, the new rule struck that language because, the board said, it was redundant with anti-discrimination law that’s already on the books…and so, it didn’t need to be re-stated here.

Or maybe it’s because the Board recognized that the rule they passed today is antithetical to anti-discrimination laws. Indeed, state law requires all public accommodations, like stores and pharmacies, to serve all people. Northwest Women’s Law Center argues that refusal clauses, like the one passed by the Pharmacy Board today, amounts to discrimination against women in a public place.

PS: The Board of Pharmacy hasn’t called me back yet.

More from Planned Parenthood and NWLC (part of the Alliance for Reproductive Choice in this case) linked below.

The Washington Alliance for Reproductive Choice (WARC) today announced its opposition to the Washington State Board of Pharmacy's proposed rule that would allow pharmacists to refuse to fill safe, valid and legal prescriptions.

The Board began the meeting by debating the first draft, which was supported by patient's rights advocates and women's groups. Some members, like Gary Harris, urged the Board to pass the draft, which of the two versions more strongly protected patients and ensured access medications. Others, like Donna Dockter and Susan Teil Boyer, said the draft rule did too much to regulate pharmacists, and said they would oppose it.

The draft was put to a vote by board members, but failed because it did not have the votes needed to pass.

The board then began amending the first draft, creating a third version which was ultimately passed by a unanimous vote. The version states that pharmacists may not obstruct a patient who is trying to obtain a drug, but also states that if a pharmacist "cannot dispense” a drug then their alternatives "may include--but are not limited to--returning the prescription or referring them to another pharmacy.

The third version also removed language that stated that a pharmacist may not destroy prescriptions, refuse to return prescriptions, or discriminate against patients.

The draft rule will now be filed with the code reviser where the public will have one more opportunity to comment before it becomes state law.


CommentsRSS icon

So we can hope that the guv'nr will step in and what?


It is so obvious to even the biggest twit that this is a right-to-discriminate law. Period. It is a conscience law. Period. Yes, it is the same fucking thing, twit. That jimmy-cricket voice that says don't trust fairies, fairies are bad. Keep fairies away. Bullshit to that and bullshit on those pharmacists. That's right, bullshit on you.

I don't like all pharmacists because all you pharmacists favor depriving medicine to those in need. Therefore, don't you buy groceries from my store, because as a matter of conscience, I can not sell you or your family and associates food. See my conscience says evil is around every turn and that to feed an evil is an evil act. I don't like evil acts and I certainly will not choose to sell you food. What does your conscience say about that? motherfuckers.

you see, that is why you should care.

So if you work in the guv'nr ladys office, feel free to print that off and put in on her chair.

I mean what the fuck? this seems like a good as place to as any to leave a message for her. Later cats...

Uhhh ... the gov. added to her two previous letters to the board with another today, which again spells out her opposition.

Another problem with this ruling is that it is, in essence, permitting the pharmacist to practice medicine without a license.

The legislature needs to enact criminal penalties. Prison time will seperate the real "crisis of conscience" pharmacists from the ones who just want to fuck with women's health because they can.

Time to start a site to track pharamacies that let their employees do this. A cashier who refused to scan meat would be fired. A mechanic who refused to work on an SUV would be fired. A waiter who refused to take orders for alcohol would be fired. Boycott pharmacies that allow this until they establish a policy to ensure that your prescriptions will be filled, period.
There's a big health expo downtown this weekend - maybe some picketing there?

Why is there no mention of this decision nor even something about the discussion searchable through either the Board of Pharmacy's website or the Department of Pharmacy's website? I can't find a single sentence about this specific topic in their published agenda. Am I looking in the wrong place? Am I smoking crack?

Unfortunately, there's also nothing about this decision in the times or the PI. Hopefully there will be a legal challenge to this "anti-choice" right of refusal for pharmacists.

Publicising the refuzniks would be a good idea.

if i were a pharmacist, i'd use this ruling to prohibit distribution of VIAGRA

Yeah, dicks get old and broke. The Puritians's God's Will Be DONE!! No viagra for you, until you go home and pray really hard on why a hard dick is important. Come back tomorrow, old man. BROOOHHAHAHAHAHA.

So what's next? Not being able to buy condoms when I'm out camping in E Washington, but being "referred" to the pharmacy in Spokane? Being a pharmacist has nothing to do with morality but should be about science and the law. I think that if this holds up, we have to demand the legislature have some balls and set the pharmacy board on its ear through some appropriate legislation. This crap has to stop.

To whom it may concern:

How about a honest discussion regarding this situation with facts not agenda politics!

I am not a pharmacist but I know 100's of them and I am somewhat informed on issues in front of The State Board of Pharmacy. With that in mind let me point out the following:

There are business, financial, and expertise related reasons that Pharmacist's and Pharmacies are not required to fill every legal prescription. Here are some examples:

1) It simply is not possible for every pharmacy to stock every drug. Go check out one of the 100's of small pharmacies in the area. Do you really think they have the space or the money to stock every single drug on the market today?

2) Some pharmacies have chosen to specialize in compounded medications. Pharmacies who don't compound medications simply don't stock the same types of medicines and therefore couldn't fill the prescription even if they wanted to.

3) Some pharmacies specialize in medication packaging for specific segments of the community ie retirement homes, assisted living, adult day care, etc. These patients have special requests and medical regimentations that pharmacists without experience in this area don't have time to do or in some cases the equipment or expertise to fill the prescription properly.

4) What about costs? Let's say you go to the pharmacy with a presription for an uncommon but expensive medication that comes in minimum quantities of 500 units. If the pharmacists knows there isn't a chance they will sell the rest of the medication should they be forced to order the medication. Would you be willing to purchase the remaining 470 units - knowing your insurance won't cover it.

The proposal originally put before The State Board of Pharmacy earlier this year basicaly would required the pharmacist to fill all prescriptions unless there was a contraindication or there was a chance of forgery. My examples obviously show why this statement was too broad. To that end, The State Board of Pharmacy adopted a more restrictive proposal as you have pointed out in your article.

The governor, special interest groups, and newspaper writers seem to be focusing in on "a women's right to contraceptive medication", in this case Plan B, instead of the much broader "right to fill" issue.

There is no question that women (AND MEN) have a right to legal medications. In our pharmacy we believe this and put it into practice. We'll give you the personal and professional respect that you deserve. And if we can't fill your prescription (for whatever reason) we'll do our professional best to provide you with an alternative that is agreeable to you.

TALK IS CHEAP - you know it and so do I. So I encourage you to come check us out, our pharmacy is on Sand Point Way NE two blocks from Children's Hospital. Better yet, hopefully you'll have a chance to read an article in "The Stranger" about their experience at our store on Saturday morning, June 3rd.

In the mean time, I encourage the State Board of Pharmacy to hold their ground against all the 1/2 truths, exagerations and inuendos put forth in print. Maybe with a little bit of their help the governor can get it right by August 31st.

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