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Plan B: Walgreens pharmacist flap dissected

By OLGA PIERCE, UPI Health Business Correspondent   |   Feb. 1, 2006 at 4:41 PM   |   Comments

WASHINGTON, Feb. 1 (UPI) -- Four Illinois pharmacists who say they were fired by the Walgreens drugstore chain because they refused to fill prescriptions for emergency contraception have filed suit against the company.

The suits claim that by firing the pharmacists, Walgreens violated the Illinois Health Care Right of Conscience Act, which prohibits employers from discriminating against employees who refuse to provide healthcare services because of moral objections.

"It couldn't be any clearer," said Francis Manion, senior council of The American Center for Law and Justice, a law firm founded by evangelist Pat Robertson that has filed the suit on the pharmacists' behalf. "In punishing these pharmacists for asserting a right protected by the Conscience Act, Walgreens broke the law."

Walgreens has said the company was only trying to comply with a 2004 executive order by Illinois Gov. Rod Blagojevich requiring pharmacies to fill prescriptions for contraceptives "without delay."

What that means, company spokesman Michael Polzin told United Press International, is that when the store is busy and it takes 45 minutes to fill other prescriptions, it must also take no more than 45 minutes to fill prescriptions for emergency contraception.

Likewise, late at night, when the wait is only five minutes, the pharmacy must be able to provide women with their contraception in five minutes -- but that's where difficulties arise, Polzin said, because often there is only one pharmacist working at night.

If that pharmacist refuses to fill the prescription, he said, the pharmacy is then in violation of state law.

"In order to comply with Illinois State Law," Polzin said, "pharmacists need to fill those prescriptions. Having two pharmacists working overnight is just not practical from a business perspective."

In other states without such time requirements, a pharmacist who morally objects to filling a prescription can either refer it to another pharmacist on duty or find another pharmacy nearby that will definitely fill the prescription, Polzin said.

"We want to be able to tell a patient exactly where to go and know the prescription will be there," Polzin said. "We don't want a situation where they leave and don't know where to go."

The four pharmacists, who all lived in the St. Louis metro area, were given the option of being transferred to stores on the Missouri side of the city, where no such stringent time requirement exists, he said, and also offered assistance getting their pharmacists' licenses in Missouri.

But attorneys for the pharmacists say Walgreens is using an unusually strict interpretation of the governor's order as an excuse.

"Walgreens has been trying to excuse its callous firing of these four pharmacists by blaming the governor and his unlawful executive order. But none of the other major retail pharmacies have interpreted the order the way Walgreens has," Manion said. "The others are doing what the law actually requires -- they're accommodating those pharmacists who object to dispensing these drugs while, at the same time, serving all of their customers. For whatever reason, Walgreens chose not to respect its pharmacists."

In issuing the order, however, Blagojevich emphasized the importance of prompt service at pharmacies.

"Our regulation says that if a woman goes into a pharmacy with a prescription for birth control, the pharmacy is not allowed to discriminate (regarding) who they sell it to and who they don't. The pharmacy will be expected to accept that prescription and fill it in the same way, and in the same period of time they would fill any other prescription. No delays. No hassles. No lecture. Just fill the prescription," Blagojevich said.

Arkansas, Georgia, Mississippi and South Dakota have passed laws allowing a pharmacist to refuse to dispense emergency contraception.

Illinois and California have rules in place requiring pharmacists to dispense emergency contraception under most circumstances. In 2006, 13 additional states are considering pharmacist-refusal clauses, which range in scope from specifically applying to pharmacists and contraception to covering all healthcare providers and services.

Emergency contraception is an oral medication taken in several doses that can prevent a fertilized egg from implanting in the uterus when taken as much as 120 hours after intercourse -- but with each passing hour its effectiveness in preventing pregnancy decreases.

Opponents of the medication -- sold under the brand name Plan B and also known as the morning-after pill -- believe it is tantamount to an abortion and that its availability will encourage promiscuity.

Advocates of its availability point to studies indicating it could prevent 1.5 million unintended pregnancies and 800,000 abortions each year.

Pharmacist refusals to sell emergency contraception have become widespread enough that the American Medical Association passed a resolution condemning them at its 2005 convention, and indicating doctors may seek permission to directly dispense the medications themselves.

The growing number of pharmacists who refuse to sell the medication has prevented women -- particularly those who are low-income and have limited access to transportation -- from getting their prescriptions filled, National Organization of Women President Kim Gandy told UPI.

The group has received many reports of women being denied their prescriptions, and in some cases even having them confiscated, Gandy said.

Organizations in favor of emergency contraception have filed lawsuits, launched state-level grassroots efforts and drafted legislation requiring pharmacists to fill the prescriptions.

"The idea that legislatures would decide that it's OK for pharmacists to substitute their judgment for a doctor's judgment is outrageous," she said.

"There clearly is an organized effort to convince pharmacists not to do their jobs," she said. "Contraception has been available since 1966, but 20 years ago, these things were unheard of."

However, ACLJ's Manion said the pharmacists in Illinois were just trying to act on their personal religious convictions.

© 2006 United Press International, Inc. All Rights Reserved. Any reproduction, republication, redistribution and/or modification of any UPI content is expressly prohibited without UPI's prior written consent.
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