Center for Policy Alternatives
CPA - Header Photo

Pharmacist Refusals

A growing number of pharmacists refuse to fill birth control prescriptions.
The anti-abortion group Pharmacists for Life International encourages pharmacists to refuse to dispense emergency contraceptive pills, commonly known as the “morning-after pill” or “Plan B.”1 Until very recently, pharmacist refusals were rare. But during a six month period in 2004, pharmacists refused contraceptives to at least 180 women.2 Examples of pharmacists refusing prescriptions for emergency contraception include:
  • In May 2005, a Wisconsin mother of six was berated in a crowded waiting area by a Walgreens pharmacist who called her a murderer when she tried to fill her prescription for emergency contraception.3
  • In April 2005, a woman at a Pennsylvania CVS was refused emergency contraceptive pills ordered by her gynecologist. First she was told that she could wait for the next pharmacist to come on duty, but was later told that the next pharmacist would also refuse to fill the prescription.4
  • In March 2004, a rape victim in Texas was denied emergency contraceptive pills by an Eckerd pharmacy.5
These pharmacists claim that birth control pills cause abortion—which is patently false.
Emergency contraception is the same medicine as the one-per-day birth control pills that 82 percent of American women have taken at some point in their lives.6 Emergency contraceptive pills “do not interfere with an established pregnancy.”7 An entirely different medicine known as RU-486 or Mifeprex does cause abortion.8 The anti-abortion movement has built opposition to emergency contraception by deliberately confusing it with Mifeprex—but licensed pharmacists should certainly know the difference. When pharmacists refuse to dispense contraceptive pills, they stand against birth control—not abortion.
This new movement focuses on emergency contraception, but some pharmacists deny other forms of contraception as well.
The idea that pharmacists have the right to refuse prescriptions has emboldened some to block access to traditional contraceptives. For example:
  • In April 2005, a Minnesota woman called a Snyders pharmacy to check on the status of a prescription order for a birth control patch. The pharmacist responded that he opposed birth control and would not fill the prescription.9
  • In December 2004, a Massachusetts woman was told by a CVS pharmacist that he did not want to fill her prescription for traditional birth control pills.10
  • In October 2004, a Walgreen pharmacist denied a Georgia woman her birth control prescription refill because, the pharmacist said, she did not believe in birth control.11
Ironically, by denying contraception, these pharmacists cause more abortions.
Emergency contraception pills work best when taken soon after unprotected sex, and are ineffective if not taken within a few days. Therefore, pharmacist refusals to fill prescriptions for emergency contraception inevitably cause unwanted pregnancies and unnecessary abortions.
Pharmacists are not qualified to overturn the medical judgment of physicians.
Whether a particular prescription is appropriate is a decision between a doctor and patient. States license pharmacists to fill legally-prescribed medicines, not to substitute their judgment for a doctor’s. Pharmacists have a professional and ethical obligation to serve their clients. If an individual doesn’t want to do the job of a pharmacist—to dispense legally-prescribed medicines—he or she should simply find another job.
Americans overwhelmingly oppose pharmacist refusals to fill birth control prescriptions.
A November 2004 poll conducted by CBS News and the New York Times found that eight out of ten Americans believe that pharmacists should not be permitted to refuse to dispense birth control pills. This opinion was consistent across all party affiliations—85 percent of Democrats and 70 percent of Republicans opposed pharmacist refusals.12
Some states have adopted laws that require pharmacists to fill birth control prescriptions.
In 2005, California enacted legislation that prohibits pharmacies from refusing to dispense contraceptives. Nevada enacted a version of the same legislation that only refers to refills. Illinois issued an administrative order requiring all pharmacies that stock at least one method of contraception to accept and fill prescriptions for contraceptives “without delay.” Pharmacy boards in Massachusetts, North Carolina and Wisconsin have advised pharmacists to fill any valid prescription. Four states (AR, GA, MS, SD) have laws that specifically allow pharmacists to refuse to fill prescriptions.

This policy summary relies in large part on information from NARAL Pro-Choice America.

Endnotes
  1. See www.pfli.org.
  2. “Moralists at the Pharmacy,” Editorial, New York Times, April 3, 2005.
  3. “Pharmacist Refuses to Fill Prescriptions for Moral Reasons: Walgreens Allows Pharmacists to Not Dispense Drugs They Object To,” MilwaukeeChannel.com, May 5, 2005.
  4. Planned Parenthood Federation of America, “Refusal Laws by State,” 2005.
  5. “Contraception: Pharmacist’s Refusal to Fill Emergency Contraception Script Raises Questions,” Women’s Health Weekly, March 18, 2004.
  6. Centers for Disease Control and Prevention, “Use of Contraception and Use of Family Planning Services in the United States: 1982-2002—A Fact Sheet for Advance Data No. 350,” 2004.
  7. Association of Reproductive Health Professionals, “What you need to know: The Facts about Emergency Contraception,” 2005; American College of Obstetricians & Gynecologists, “Statement on Contraceptive Methods,” 1998.
  8. Association of Reproductive Health Professionals, “What you need to know: Mifepristone Safety Overview,” 2005.
  9. Rene Sanchez, “New Arena for Birth-Control Battle,” Star Tribune (MN), May 3, 2005.
  10. Amy Grzybinski, “University Drive Pharmacist Denies a Student Birth Control,” Massachusetts Daily Collegian, December 13, 2004.
  11. “Pharmacists’ Ability to Reject Prescriptions on Personal Grounds Violates Consumers’ Rights,” Editorial, Atlanta Journal-Constitution, October 14, 2004.
  12. CBS News/New York Times poll, November 24, 2004.
Updates