Reconciling Principles and Prescriptions: Do Pharmacist Refusal Clauses Strike the Appropriate Balance Between Pharmacists’ and Patients’ Rights?

The U.S. Supreme Court has repeatedly held that all women, mar-ried or single, have a right to privacy when making family planning deci-sions, including the right to receive and use birth control. Nearly all sex-ually active women choose to use oral contraceptives, the most popular form of birth control, during their child-bearing years for a variety of medical and physical reasons. Because these contraceptives require a prescription, pharmacists play a critical role in the reproductive health of a majority of American women. However, a string of reported incidents in recent years reflects an alarming trend: pharmacists, despite legal and professional obligations, are refusing to dispense prescription contracep-tives because of their own moral and religious objections. Despite the established standard of care that places the patient as the focus of the pharmaceutical profession, four states have already passed “pharmacist refusal clauses,” laws or regulations that grant pharmacists the right to refuse to fill prescriptions based on personal beliefs. These laws explicit-ly allow pharmacists to circumvent their professional duties and protect pharmacists from adverse employment actions for doing so. In this note, the author argues that pharmacist refusal clauses fail to strike a proper balance between pharmacists’ rights to exercise their own conscience and patients’ rights to access legal prescriptions. Additionally, these regulations unreasonably expand the initial purpose of refusal laws, are sexually discriminatory, and violate pharmacists’ code of ethics. To ad-dress these problems, the author suggests that rather than enacting new pharmacist refusal clauses or adding transfer provisions to current laws, a variety of organizations—federal and state legislatures, state pharmacy boards, and the pharmaceutical community—must work together to adopt legislation and alternative policies that will balance the competing rights of pharmacists and patients, ultimately guaranteeing that women are never denied access to legally prescribed birth control.

The full text of this Note is available to download as a PDF.