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DIX HILLS, N.Y. -- Pathmark found itself on the front lines this week in a controversy over pharmarcists refusing to fill prescriptions on moral grounds. At a press conference held outside a Pathmark supermarket here, federal legislators said there ought to be a law requiring pharmacists to either fill all prescriptions, or refer customers to a colleague.
Local pols, House of Representatives members Steve Israel (D-Huntington) and Carolyn Maloney (D-Manhattan) held the press conference to introduce the bill, the Access to Legal Pharmaceuticals Act, which stipulates that a pharmacy could penalized up to $5,000 per violation per day, for refusing to fill a prescription or to give a customer a referral to another pharmacy.
The press event's location was no accident; Israel claimed an unidentified pharmacist at the Dix Hills Pathmark unit twice refused to fill prescriptions in March for emergency contraceptive pills, and failed to provide a referral.
Carteret, N.J.-based Pathmark, however, disputed the legislator's version of events. "Pathmark was never made aware of the alleged incident in Dix Hills, until [the] press conference," said Rich Savner, the chain's director of public affairs, in an interview with Progressive Grocer. "We were never contacted, and obviously not afforded the opportunity to present our side of the story."
Of the retailer's existing policy regarding pharmacists who have personal objections to filling certain prescriptions, Savner said, "Pathmark respects the fact that in certain circumstances, a pharmacist may have a moral reason for not filling a prescription. Our policy also requires that under such circumstances, the prescription be referred to another pharmacist or pharmacy.
"After discussing the alleged incident, which occurred nearly five months ago, with the pharmacist [in question], we have no evidence or reason to believe that this policy was not followed," Savner added. "While we have a neutral stance on the proposed legislation, it should be noted that our policy would be in compliance if this legislation became law in its current form."
Israel claimed that similar incidents have occurred in 14 states. Typically, refusals seem to be tied to prescriptions for birth control medicines, including the so-called "morning-after" pill. There is apparent disparity among state laws in dealing with the issue. Currently, laws in Arkansas and South Dakota allow pharmacists to decline to fill birth control prescriptions, while in Georgia and Mississippi a pharmacist can refuse any prescription he or she finds objectionable. Other states, such as Wisconsin, are considering "conscience-clause" laws that permit pharmacists to decline to fill prescriptions that go against their beliefs.
By contrast, in Illinois last week, Gov. Rod Blagojevic issued an edict requiring pharmacies that carry contraceptives to dispense them, or order contraceptives not in stock.
In the federal bill, penalties would not exceed $500,000; and a refused customer could sue within five years of an incident. In the Senate, the bill is being sponsored by Frank Lautenberg (D-N.J.).
The Washington-based American Pharmacists Association laid out its stance on the issue, in a letter written by the group's president, John A. Gans. "[A] pharmacist with personal objections to certain activity should not be mandated to participate, but should establish alternative systems to assure patient access to legally prescribed, clinically safe therapy," wrote Gans.
Later in the letter, Gans outlined what those alternatives would be. "There are many ways to navigate personal objections. Some pharmacists manage their objectives in choosing where to practice -- such as in a long-term care facility to avoid the prevalence of contraceptive prescriptions, or outside the state of Oregon to avoid prescriptions for physician-assisted suicide. Other successful approaches include proactively directing patients to designated practices, referring the patient to another pharmacy, or working with physicians and other prescribers to establish alternative dispensing methods."
Major pharmacy chains, among them Walgreens, Wal-Mart (which doesn't stock morning-after pills), and CVS, have similar policies in place that attempt to address both pharmacists' and customers' rights.
-- Bridget Goldschmidt