Conscience clauses -- sometimes called "refusal laws" by their opponents -- stemmed not from abortion or contraception battles, but from Oregon's passage of the Death With Dignity Act, a law that allows physicians to prescribe a lethal dose of medications for their terminally ill patients under certain conditions.
The American Pharmacists Association supports pharmacists' right to deny specific prescriptions on moral or religious grounds, as long as patients' ability to obtain their medicine is protected. "Keep this in perspective. There are approximately 9 million prescriptions filled every day in this country. We would argue that the majority are being filled without problems," said the association's Kristina Lunner.
While the overwhelming majority of women have unimpeded access to their prescription birth control, there is concern that conscience clauses can be written so broadly as to affect a whole host of medications. Could conservative Christian pharmacists refuse to prescribe Viagra to single men, or gay men? Would a Scientologist pharmacist deny Paxil to a woman with post-partum depression?
"That's not even on the radar right now," said Lunner. "Viagra could be morally objectionable, for example, if the person had a history as a sexual predator, but beyond that I haven't heard any reports of pharmacists refusing to prescribe it."
Too often, Lunner said, we read examples of pharmacists refusing to dispense prescriptions in a way that the Pharmacists Association finds objectionable. "We support conscience clauses, but the clause must also support the establishment of a system that provides seamless care to the patient," she said.
Pharmacists' groups have also been active in ensuring access to emergency contraception, she noted. "There are efforts by pharmacists across the country working to enact laws that would allow pharmacists themselves to prescribe EC [emergency contraception] so patients could go to a participating pharmacy where a pharmacist can prescribe and dispense EC without a physician's prescription," she said.
While acknowledging that far-right activists have had some success in bringing contraception into the abortion debate, Planned Parenthood's Payne said the negative reaction to pharmacists' conscience clauses is a great opportunity to inform women and clear up confusion about emergency contraception and traditional birth control.
"We are making progress," she said.
Planned Parenthood is working with national pharmacies to develop policies that will accommodate both pharmacist and patient. "We focus on pharmacy as employer. Whatever they do behind the counter is their business. How they treat their customers is our business."