Prescriptions must be filled under newly adopted rule

A pharmacist who personally objects to a legal prescription, such as emergency contraception, would be required to fill it if it's in stock, or face sanctions, under a proposed rule adopted Thursday by the state Board of Pharmacy.

But the board's decision is by no means the end to the long-running controversy. Public hearings now must be held on the latest rule proposal. And chances are that many pharmacists will line up against it.

This latest proposal in the debate over the so-called Plan B emergency contraceptive was offered by Gov. Christine Gregoire's office as a carefully negotiated "compromise" and was lauded by women's-rights groups. But a last-minute word change Thursday left no compromise on the most controversial issue: whether pharmacists can refuse to fill a legal prescription for reasons of conscience or religion.

"I think the Board of Pharmacy has gone against my constitutional rights to exercise my conscience," said C.J. Kahler, a former president of the Washington State Pharmacy Association (WSPA).

The controversy over the rule has been raging since January, when the pharmacy association, a private trade group, proposed that the pharmacy board, a state regulatory body, specify the responsibilities for so-called conscientious objectors — pharmacists who decline to fill prescriptions on moral or personal grounds.

Many, if not most, pharmacists believed they already had the right to refuse under state laws.

Though there are other issues the rule would address, the primary controversy stems from the fight over Plan B, which some people believe is a form of abortion.

But reproductive-rights groups have been fighting for a rule that improves access to the contraception, which the Food and Drug Administration recently approved for limited over-the-counter sales.

The board Thursday took up the proposal from Gregoire's office, which said pharmacies had a "duty to dispense lawfully prescribed" drugs, except in certain listed situations such as drug interactions or fraudulent prescriptions.

Many pharmacists accepted that wording, saying it would allow an individual pharmacist to avoid filling a prescription, although the pharmacy would still have to find a way to provide the drug to the patient.

But the board changed the wording to put the duty squarely on the individual pharmacist, not the pharmacy. Steve Saxe, former executive director of the pharmacy board, said that change was necessary because the board does not regulate pharmacies, only pharmacists.

But Tim Lynch, current president of the WSPA, said the rule, as adopted, is more restrictive and not what the organization had supported.

"Compelling a pharmacist to dispense a medication is not in agreement with our stated policy," he said.

Donna Dockter, the only board member to vote against the latest proposed rule, said it doesn't offer pharmacists enough guidance.

"I don't see that we have accomplished a thing," said Dockter, a pharmacy owner. "What do pharmacists think we're telling them? I would like an answer."

Women's advocacy groups, however, clearly were delighted. The rule ensures that when patients go to the pharmacy, they'll get their prescriptions filled, said Blythe Chandler, deputy director of NARAL Pro-Choice Washington.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com