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When can druggists refuse to sell the Pill?


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MINNEAPOLIS, Minn. -- For the first time, the Minnesota Legislature is poised to give pharmacists the right to refuse to dispense birth-control pills on moral or religious grounds.

And legislators may have found a way to take that step without the kind of battle that has flared across the country over the issue.

A House committee approved a bill last week that would allow pharmacists to decline to fill prescriptions, but only if patients are assured "timely access" to their medications. Some details of the bill are in flux, but sponsors say it's likely to pass.

"This is an issue that is gaining momentum across the country," said Michael Barrett, a Long Prairie pharmacist who is pushing for the bill.

Barrett added: "I think we need to come up with a compromise."

The question of whether a pharmacist's moral views should ever limit a woman's reproductive rights is provoking national debate.

That's partly because of the growing use of emergency contraception commonly called the "morning-after" pill.

Some critics consider the pill a form of abortion because it may stop a fertilized egg from implanting in the uterus if taken within 72 hours of intercourse. Advocacy groups such as Pharmacists for Life say that pharmacists who object to it should not be forced to dispense the drug or even transfer such a prescription.

The American College of Obstetricians and Gynecologists, reflecting the consensus of the medical profession, does not consider the drug an abortion pill. Medical groups say the pill, which at times is confused with the abortion pill known as RU-486, cannot end a pregnancy.

So far, at least four states, including South Dakota, have passed what are called "pharmacist conscience clauses." They allow pharmacists to refuse to fill prescriptions for the morning-after pill or other contraceptives.

On the other side, Illinois Gov. Blagojevich issued an executive order last year requiring pharmacists to fill all prescriptions, regardless of their beliefs.

But in Minnesota, partisans on both sides of the issue say they prefer to carve out a middle ground. "I don't think either side is compromising their values or beliefs," said state Rep. Tom Emmer, R-Delano, a sponsor of the bill.

At this point, prominent advocacy groups on both sides of the abortion debate have remained neutral on the plan. Planned Parenthood and Minnesota Citizens Concerned for Life have said they do not support or oppose it.

"That tells you this is a good, reasonable bill," said Barrett, the pharmacist.

ROAD TO COMPROMISE

At first, there seemed little room for compromise.

Emmer decided to step into the fray when he was approached by Barrett, a Republican candidate for Congress, asking for his help.

Barrett, who manages a hospital pharmacy, said he was under pressure to stock the morning-after pill, known as Plan B.

"I didn't want to," he said, because he is morally opposed to it. "I believe there are other options. But this doesn't mean a woman shouldn't have access to Plan B. I just shouldn't have to provide it."

Emmer introduced a bill that would have guaranteed pharmacists the right to say no. Meanwhile, an opposing bill, also introduced this session, would have prohibited pharmacists from refusing care.

The Minnesota Pharmacists Association proposed a compromise.

"We saw the level of attention it was getting [nationally] and knew the different extremes that were out there, and felt that we needed to find a balance," said Liz Carpenter, a vice president of the pharmacists group.

The compromise allows pharmacists to refuse service on "ethical, moral or religious grounds." But they must notify their employers in writing, and avoid causing "undue hardship." Otherwise, they could be disciplined by the state Board of Pharmacy.

That doesn't satisfy everyone.

"We want to make sure that women are getting their prescriptions filled in the stores that they go to," said Erin Matson, president of Minnesota chapter of the National Organization for Women.

Sending women to another store, she said, isn't good enough because many don't have the means to travel. "In rural areas, this can be very serious," Matson said.

But Carpenter said pharmacists rarely refuse to serve customers.

State officials have only one complaint on record about a pharmacist refusing service, according to the Minnesota Pharmacy Board.

It was filed last year by Rebecca Polzin of Glencoe, who said a pharmacist at a Pamida Pharmacy refused to fill her prescription for birth-control pills last April. The pharmacy board decided not to take action and the complaint was dismissed. The pharmacy declined a request for comment from the Star Tribune.

Polzin, now 27, said she believes the problem is more common than many realize. "Since this happened I've had a lot of women come up to me ... who have had the same thing happen to them," she said. "A lot of women, I think, are scared or embarrassed or afraid to speak up."

Polzin called the proposed legislation "a fair compromise" and said it may help ensure "that the interests of both the pharmacist and the customer are being acknowledged, instead of it being so one-sided."

c.2006 Minneapolis Star Tribune

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