Pharmacists can refuse to dispense emergency contraception pills
By Sue Vorenberg
Tribune Reporter
December 16, 2005
The condom broke. It was Sunday morning. The woman grabbed the phone in a panic.
FIND A PHARMACIST
These groups list pharmacists who provide emergency contraception prescriptions in New Mexico:
NARAL Pro-Choice New-Mexico hotline: (877) 324-6673
Online: www.ec-help.org
She dialed the number of several pharmacies, hoping to find a pharmacist who could prescribe Plan B, a pill to take her worries away.
All she got was referrals, and more referrals, all of which led nowhere, she said.
"I had to wait till the weekend was over to go to Planned Parenthood," said Gwyneth Doland, 33, a local writer. "The efficacy drops every hour you don't take it."
Deciding to take a day-after contraceptive pill is a hard choice for many women.
Running into the ethical dilemmas of their pharmacists can make it even harder, said Giovanna Rossi, executive director of NARAL Pro-Choice New Mexico.
New Mexico is one of eight states that allows pharmacists to prescribe Plan B. At the same time, pharmacists aren't required to fill emergency contraception prescriptions if they have ethical objections.
And different stores have different policies on the issue, which likely contributed to Doland's problem that Sunday morning, Rossi said.
About a year ago, the state instituted regulations requiring pharmacists to refer patients to another store if they opt out of providing the drug, Rossi said.
But that doesn't always happen in a timely manner, she said.
"The problem is that we're finding that referrals are not being given on a consistent basis," Rossi said. "We're finding problems with the process, and we're looking into different ways we can address that."
Time is critical for emergency contraception like Plan B, which should be taken as soon as possible in the 72 hours after unprotected sex, according to the manufacturer's Web site.
If a patient can't find the drug after being turned down by a pharmacist, it could cause serious problems, Rossi said.
"There are all kinds of women that have been intimidated by this process," Rossi said.
Manuel Rodriguez, the local representative of Pharmacists for Life International, refused to comment on the issue. The group's Web site, www.pfli.org, has a lengthy discussion of the moral issues surrounding emergency contraception.
"The (rules allowing pharmacists to opt out) is a pharmacist professional judgment issue and not simply a `pro-life' issue," the site says. "Pharmacy as a profession needs to decide are pharmacists critically thinking individuals who integrate their values into their work life or are they `mind-numbed' robots that are glorified order-takers for physicians?"
Still, their response to patients should be nonjudgmental, Doland said.
"A lot of them give you an attitude like you're asking for an abortion," Doland said.
New Mexico is one of eight states in which pharmacists can get special training to write prescriptions for emergency contraception. About 180 pharmacists in the state have taken that training, said Dale Tinker, executive director of the New Mexico Pharmacists Association.
"There are still some pharmacists that don't agree with that," Tinker said.
Michel Disco, an assistant dean at the University of New Mexico College of Pharmacy, provides the three-hour training classes for pharmacists who want to write emergency contraception prescriptions. She says she often bumps into the problem when talking to her students.
"It's an interesting ethical issue," Disco said. "I have prescribed it. I have filled it without any problems, but I also feel it's a pharmacist's right to make that decision."
The obligation of a pharmacist is to provide patient care, which means the patient should be able to get their prescription filled either way, Tinker added.
"It is the intent of our association to assist patients in getting appropriate health care and not hinder that," he said.
Some companies have two pharmacists working at the same time, so if one refuses to provide the prescription the other can fill it. But smaller businesses often only have one pharmacist working at a time. If they refuse it can create a hassle for customers, Rossi said.
NARAL Pro-Choice New Mexico is investigating a requirement that pharmacists who won't fill the prescription place signs in their windows with directions to the nearest pharmacy that will, Rossi said.
Such a rule would still have to make it through the Legislature, she added.
A better solution would be to take the pharmacist out of the picture by allowing the Plan B pill to be sold without a prescription, but that hasn't yet been approved by the Food and Drug Administration, Rossi added.
"We're very much in favor of it going over the counter," Rossi said.
Doland said she'd be extremely happy if that happened.
"The condom broke. It happens," she said. "You think about how many times that's happened to the average person. Really, what are you going to do?"
