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June 14, 2005
Update on emergency contraception refusals
The State of Wisconsin Pharmacy Board has disciplined a pharmacist for refusing to fill an oral contraceptive prescription and refusing to transfer it to another pharmacist. In this case, the woman in question was getting a last minute refill and because another pharmacist was not on hand she actually missed doses, so this was a fairly substantial inconvenience. This isn't exactly what you'd call an ideal test case. The pharmacist's contract explicitly specified that he would furnish "All services generally performed by a registered pharmacist in the customary manner and extent ordinarily performed at pharmacies." so he was pretty clearly in breach of contract. Moreover, he appears to have claimed that he would make alternate arrangements, but in practice he did not do so. Nevertheless, the case makes fairly interesting reading. At the very least, it should make clear that a generic right not to fill prescriptions without a requirement to transfer them to another pharmacist will likely result in substantial inconvenience—and potential harm—to patients.Posted by ekr at June 14, 2005 10:09 PM | Filed under:
Comments
Saying "I won't fill that" seems enormously different from saying "...and I won't let anyone else get the prescription to fill it, either."
--John
Posted by: John Kelsey at June 15, 2005 8:48 AM
Sorry, I don't see it. The woman in question is not experiencing "harm". Presuming that she was not raped, she willingly engaged in an activity whose well-established consequences she wished to avoid. Furthermore, she failed to avail herself of the means to avoid these consequences before engaging in the activity, even though these means are readily available.
Furthermore, the actions of the pharmacist are almost entirely moot unless the previously established "conseqence" materializes, and another member of our species now exists within the woman.
At that point, the one facing the greater prospect of harm is not the woman...
Posted by: Nathan Zook at June 17, 2005 8:55 AM
Huh?
The issue here isn't EC, it's simple use of oral contraceptives. Here we have someone who *is* attempting to avail herself of the means to avoid conception, but is blocked by a pharmacist. The result is that she is forced to use backup contraception, which is less effective. That's inconvenient, and at least arguably harmful. If she actually conceives as a result of that, pregnancy confers a substantial risk.
How, exactly, is that not harm?
Posted by: EKR at June 17, 2005 9:02 AM
It seems like the elegant solution here is to stop requiring prescriptions for contraceptives. An alternative (the solution I think I'd try in such a bizarre situation) is to call the on-call doctor from the office that prescribed the contraceptives, and ask for a new prescription.
--John
Posted by: John Kelsey at June 20, 2005 6:28 AM