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HB 16: Pharmacists don't need it, Texans don't want it

It's bad enough that most health insurance will only allow a woman to buy a month's worth of birth control at a time, but now, if Representative Frank Corte has his way, a pharmacist will be able to tell her she can't have it at all. This month, women's health advocates expect the House Committee on State Affairs to review the Pharmacist Discrimination Act, House Bill 16, which allows pharmacists to refuse to fill emergency contraception prescriptions and enables them to sue an employer if they feel they have been discriminated against for doing so. Representative Corte, R-San Antonio, was unavailable to comment on the bill he authored, which defines emergency contraception as "a prescription drug containing an elevated dose of hormones that is used to prevent pregnancy," which means it would also permit pharmacists to refuse to dispense birth control.

"This bill sets a dangerous precedent," says Sara Wheat, director of public affairs at NARAL Pro-Choice Texas. "It lets pharmacists second guess a physicians' recommendation without any knowledge of the woman's health. Whether she is a rape victim or a busy mom trying to plan her next child, the pharmacist can refuse to fill the prescription for any reason."

If HB 16 passes, a pharmacist will be able to deny a prescription even if a woman has been raped or has been prescribed birth control by her doctor to help prevent heart disease, stroke, endometrial cancer, ovarian cancer, or pelvic inflammatory disease. Furthermore, says Wheat, "the pharmacist can refuse to fill the prescription with no responsibility to refer the patient to another pharmacy." Nor does the bill oblige the pharmacist to, at a minimum, return the prescription to the patient.

"This bill sets a dangerous precedent. It lets pharmacists second guess a physicians' recommendation without any knowledge of the woman's health. Whether she is a rape victim or a busy mom trying to plan her next child, the pharmacist can refuse to fill the prescription for any reason."

— Sara Wheat

In Texas, some pharmacists are already refusing to fill prescriptions. A pharmacist at an Eckerd Drugs in Denton refused to fill a prescription for emergency contraception for a rape victim on the basis of conscientious objection. The owner of the only private pharmacy in Fabens, Texas, does not dispense birth control or EC unless he believes it is being used for other reasons than contraception. And in Fort Worth, a pharmacist not only refused to dispense birth control to a first-grade teacher and mother of two, but kept her prescription as well.

"We don't need legislation," says Laurence McCullough, professor of medicine and medical ethics at Baylor College of Medicine in Houston. "because these things have already been worked out."

According to McCullough, the code of ethics under which pharmacies function has always given pharmacists the right to live by their individual conscience, as long as their personal values do not compromise patient care. "The manager of the pharmacy has to make sure that all the patients' prescriptions are filled and, where it is possible, accommodate individual conscience objectors," he says. "If it isn't possible - if you are the only provider in a small town, for example - then you have to risk your conscience and do your duty as a pharmacist or seek employment in a pharmacy where your objections can be accommodated."

What if the bill were to pass and that resulted in a woman not getting a prescription filled? "That would be a legal endorsement of undermining professional integrity," asserts McCullough. "I doubt that was the legislature's intention, they have a public policy duty to protect professional integrity. So it's a bad bill, it's unnecessary and its effect could be deleterious."

According to a poll conducted by the Scripps Research Institute, Texans agree with McCullough: Eighty-seven percent of respondents do not believe pharmacists should be able to override a physician's order and refuse to fill prescriptions based on their personal views, and 80 percent believe that, if a pharmacist refuses to fill a prescription, it is the pharmacy's duty to make sure another pharmacist dispenses the medication without undue delay.

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By Susan Pagani

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