OLYMPIA, Wash. — After a yearlong effort to establish a conscience clause for state pharmacists, the Washington State Pharmacy Board unanimously adopted rules dismissing a pharmacist's right of conscience.

The rule states that a pharmacy must fill a patient’s lawful prescription, even if the pharmacist has a moral objection to complying. The only way to avoid the dilemma is if another pharmacist on staff is willing to dispense the drug.

Amy Luftig, deputy director of public policy for Planned Parenthood Network of Washington, said. “The rule means that a patient can be assured of receiving lawful medications without discrimination, harassment or delay.”

The issue revolves primarily around the availability of emergency contraceptives. Presently, nine states have pharmacists’ conscience clause rulings on the books, 17 states have proposed such legislation, and six states have proposals for “must-fill” requirements. Washington is the 10th state to rule in favor of “must-fill” requirements for pharmacies.

But beyond this denial of conscience rights for pharmacists, the push for accessibility to Plan B has greatly expanded.

Laws enacted in many states now require emergency contraception be made available in all hospital emergency rooms for rape victims. Several states, including Washington, have been allowing pharmacists to dispense Plan B without a doctor’s prescription. And recently, the FDA decided to offer Plan B over the counter. Universal accessibility is the apparent goal.

James Ramseth, a pharmacist and owner of a drugstore in Covington, who has refused to stock Plan B contraceptives, believes, “This is not an issue of emergency contraceptives but an issue of a pharmacist’s choice in their whole practice.”

A pharmacist’s job “is to impact a patient’s health by medication therapy management,” Ramseth stated. “The majority of pharmacists have no objection to emergency contraception sales” as it is a small part of the practice. Most pharmacists don’t realize the real implications of this ruling, he suggested, “If they did, there would be a huge resistance.”

Dominican Sister Sharon Park, executive director of the Washington State Catholic Conference, believes that the next step may come with a court challenge because it touches on the long American tradition of respecting a right of personal conscience.

Under Pressure

Illinois has had the most contentious battle over the issue, with Gov. Rod Blagojevich insisting that drugstores not only fill all prescriptions, but also stock emergency contraceptives, and display signs outlining patients’ rights. Four pharmacists there were fired for not dispensing emergency contraceptives. Other pharmacists lost jobs in Texas and Wisconsin, as well, for refusing to fill Plan B prescriptions.

Washington Governor Christine Gregoire, a practicing Catholic, reversed the course of the dispute by introducing the present rule when it appeared the previous pharmacy board was about to pass a conscience clause. The governor selects the board members, and new board seats filled in time for the vote on this recent rule change include a past member of the Board of Directors for Planned Parenthood of the Inland Empire (Eastern Washington), and a current member of the board of NARAL Pro-Choice Washington.

“The new pharmacy board … is more interested in legitimizing their profiteering from Plan B,” said Karen Brauer, president of Pharmacists for Life International, “than they are in the health and lives of patients.

“The legitimacy of Plan B is held sacred above all things, and any facts or opinions to the contrary are to be suppressed and purged. This converts an entire health profession to mere clerks for the pharmacy benefit managers,” she explained.

A Seattle Times editorial on the conscience clause outcome stated that the ruling “brings to a welcome end a political fight disguised as morality.”

It went on to say that: “The cadre of druggists arguing for … the right to refuse to fill prescriptions … were simply tools in the debate over abortion rights.” The editor stated: “The Plan B debate was a prime example of politics’ intrusion into medicine.”

An editorial cartoon showed a man wearing a Roman collar and pectoral cross scrutinizing a pill bottle. The editorial and the cartoon generated protests outside the Seattle Times’ office and a response from Seattle’s Archbishop Alex Brunett, printed in the next day’s edition.

“Opposition to the rule by believers and non-believers alike is based on the right of conscience, a right affirmed by our federal and state constitutions,” Archbishop Brunett wrote. He went on to say that the word “conscience” didn’t even appear in the editorial, leaving the impression that the newspaper’s board didn’t really understand the issue.

The archbishop was especially concerned by “the apparent religious bigotry” in using the cartoon that “trivializes the role of conscience in this debate, and … the role and voice of the Church and clergy in the public square.”

He said an apology was in order.

Catholic Perspective

In March, a statement was made by the Pontifical Academy for Life, following an assembly on Christian conscience, especially in defending the sacredness of human life. The academy stressed the obligation for Catholic health care professionals, including hospital administrators, to refuse to participate “in any medical intervention or research that foresees the destruction of human life.”

It is completely justified, it said, for individuals and health care institutions to declare their status as conscientious objectors in responding to such threats.

The document stated: “This need for continuing formation and a deepening of the conscience is very obvious” because of the cultural and social problems that “affect the right to life in the context of the family, in … duties proper to married couples and to parents, in the health-care profession and in political tasks.”

Elenor Schoen writes

from Shoreline, Washington.