Pharmacists and Contraceptives

Over the past few years, the issue of whether pharmacists should be required to dispense so-called "morning after" birth control pills has been debated widely in Washington State. Today, the Pharmacy Board, after a substantial amount of discussion, consideration, and re-consideration of proposed rules, unanimously voted to require drug stores to dispense lawful prescriptions while allowing individual pharmacists only the discretion to have another pharmacist on-site fill the prescription instead. I find this to be an eminently sensible decision. Without rehashing the entire debate, here is why.

This issue presents a conflict of interests: (1) that of the patient, who has an interest in having a prescription filled and (2) that of the pharmacist, who may harbor moral objections to the particular prescription.

The interests of the patient have been through at least one level of review with a doctor, who wrote the given prescription. This, to me, serves to enhance the validity of the patient's interests. Given that refusals to fill prescriptions have often centered upon prescriptions preventing conception, the interest in avoiding an unwanted pregnancy is generally a very serious one. We must, of course, balance this against the interests of the pharmacist who objects.

The pharmacist's interest, on first blush, is also a fairly strong one - the right to behave in accordance with one's moral, religious, and ethical beliefs. This interest is, however, undermined in that being a pharmacist is a profession licensed by the state. Such licensing creates responsibilities. One such responsibility is to fulfill lawful prescriptions, regardless of personal convictions. The pharmacist is, of course free to seek other lines of work involving no such professional responsibility to the public (working in the pharmaceutical industry, for instance).

Weighing the competing interests, then, the balance seems to fall decidedly in favor of the patient's interest. Were doctors able to both create and fill prescriptions this would be a closer call, but currently, the only way to meet the patient's needs in every case is to require pharmacists to dispense all lawful prescriptions. As such, I applaud the Pharmacy Board's decision.