A step closer to letting pharmacists refuse to give morning-after pill

TUMWATER — The state Board of Pharmacy on Thursday took a step toward allowing pharmacists to refuse to dispense emergency contraceptives or other medication on moral grounds, provided they don't "obstruct" patients from getting that medication.

At the heart of the controversy is the emergency contraceptive pill, commonly called Plan B or morning-after pill, which some equate with abortion.

Some pharmacists called the newest proposal, which came after months of input from the public, a fair compromise on a sensitive topic. But women's-health advocates, including Planned Parenthood and the Northwest Women's Law Center, said the language was too vague to protect patients from discrimination. And Gov. Christine Gregoire immediately renewed her objections.

"I expect the board to develop rules that provide clear guidance and protection to the public," Gregoire said in a statement. "It is my hope that the board will develop rules that put patients first."

The proposal, which the pharmacy board approved unanimously for consideration, is slated for a public hearing Aug 31. Then the board will vote again, this time whether to adopt the rule.

The board is appointed by the governor but functions independently of any agency. It is made up of seven members: five pharmacists and two nonvoting public members.

Once the board acts, only the state Legislature could change the rule, or possibly a statewide initiative, the governor's office said.

Public meeting

The state Board of Pharmacy is accepting written comment on its proposal and will hold a public hearing Aug. 31 in Kent. For further information on the meeting, check the board's Web site, https://fortress.wa.gov/doh/hpqa1/
HPS4/Pharmacy/default.htm, closer to the date.

Across the country, states are considering similar "conscience clauses" for pharmacists.

C.J. Kahler, a retired pharmacist and former president of the Washington State Pharmacy Association, a private trade group, said the board's latest proposal would protect patients' ability to get medicine while allowing pharmacists to follow their consciences. "This is probably one I could live with," he said.

The proposal would require a pharmacist who refuses to fill a prescription to provide a timely alternative, such as a referral to another pharmacy. Pharmacists may not "obstruct" patients in getting legal drugs with a valid prescription.

The proposal is not specific about what constitutes obstruction, but board members said that language was designed to prevent pharmacists from tearing up prescriptions or otherwise discouraging patients. Planned Parenthood has reported several such incidents in Washington, though the board has not gotten any official complaints.

The debate over a new rule has been heated since January, when the private Pharmacy Association presented the pharmacy board with a proposal that would have allowed pharmacists to refuse to dispense medication on moral grounds. Since then, the board has heard from hundreds of citizens in public hearings in Tumwater and Yakima and has fielded about 6,600 letters, most opposed to the proposal.

One letter was signed by 71 groups, including the Governor's Council on HIV/AIDS and the American Academy of Pediatrics of Washington. Last month, women's-health advocates were encouraged when the board drafted a new proposal that said pharmacists "shall dispense" any lawful prescription unless there is another pharmacist on site to fill the prescription without delay.

But board member Donna Dockter, a Seattle pharmacist, urged the board at a meeting last month to draft an alternate proposal more similar to the one the Pharmacy Association originally offered.

On Thursday in Tumwater, as the board considered both proposals, Dockter listed several reasons a pharmacist might refuse to dispense medication, including suspecting the prescription would be sold to others or used in a harmful way.

She dismissed Gregoire's letters to the board on the subject.

"The governor is not a pharmacist," Dockter said.

The board finally took language from both rules to make the latest proposal.

The Associated Press contributed to this report. Cara Solomon: 206-464-2024 or csolomon@seattletimes.com