The Illinois plan for Plan B and reluctant pharmacists

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If a proposed settlement in Illinois is approved, pharmacists in the state who oppose filing Plan B or other emergency contraceptive prescriptions on religious grounds would not be forced to do so. The settlement comes as a response to a series of lawsuits filed by disgruntled pharmacists against Wal-Mart and Walgreens pharmacies as well as the state of Illinois, complaining of religious discrimination.

Under a law passed in the state two years ago, pharmacists have a duty to stock and fill any lawful prescription for contraceptive. The rule was passed in order to ensure women would have immediate access to the morning-after pill, therefore avoiding the need for abortions. Several pharmacists opposed this prescription for religious reasons, claiming that by preventing implantation of a fertilized egg to the uterus, the pill itself acts as an abortion. After refusing to fill patients prescriptions for the emergency contraceptives, the pharmacists were subject to disciplinary actions by their respective employers. The resulting lawsuits claim the pharmacists are protected by the First Amendment (free exercise of religion) as well as Title VII (employment discrimination based on religion).

If approved, the settlement would allow an objecting pharmacist to relay the prescription to an off-site pharmacist, who would then process the emergency contraceptive prescription instead. As with all settlements, however, parties on both sides remain unsatisfied. Those who religiously oppose Plan B are still unsatisfied that pharmacies would be required to stock the prescription, even though the pharmacists would no longer be required to dispense it. And proponents of the current law have a right to be concerned with the potential ramifications the settlement may have on patient care. What if, for example, the off-site pharmacist also refused to fill the prescription based on moral grounds?

The implication of this settlement also raises interesting questions about other prescriptions linked with strong religious beliefs. Aside from emergency contraceptives, could the argument similar to ones filed currently against Walgreens and Wal-Mart be stretched to include more traditional forms of birth control? Or taking the slippery-slope, would a pharmacist religiously opposed to premarital sex be justified in denying an unmarried individual a prescription, of, say, Valtrex? Those who worship at the temple of Big Pharma shudder at the thought, but perhaps consumers should also be concerned. Moral judgment, perhaps, is better suited for church than it is the local Walgreens.

-Roopali Malhotra

Earlier on blog.bioethics.net:
+ Federalism and Bioethics — the Case of Emergency Contraception

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