The NYCLU today filed complaints against three pharmacists who refused to fill patients' prescriptions for refill doses of Emergency Contraception ("EC"). The complaints argue that the pharmacists should be disciplined for putting moralistic judgments before professional responsibilities.
The NYCLU filed the complaints on behalf of health care providers in the Mohawk-Hudson region. In the two cases cited in the complaints, the providers had prescribed EC, also known as the "morning after pill" or "Plan B," to women who were their patients. When those women went to their local pharmacies to fill the prescriptions, the pharmacists filled the initial prescriptions but refused to recognize the refills that the prescribing providers had authorized.
The pharmacists refused to honor the prescription refills not because of medical or religious principles but simply because they objected to the idea that a woman might need EC more than once. One pharmacist told the prescribing provider that EC "should be inconvenient" for women and their doctors, and that women who needed EC were "irresponsible and should suffer the consequences."
"These pharmacists obstructed the patients' access to medication based on their own uninformed and biased opinions about the patients' sexual activity," said NYCLU Reproductive Rights Project Director Elisabeth Benjamin, a lawyer with a masters' degree in public health. "Pharmacists should be guided by sound medicine, not moralistic judgments."
EC consists of a concentrated dose of hormonal contraceptive used to prevent pregnancy after an act of unprotected sexual intercourse, including sexual assault and intercourse where the contraceptive used failed. If taken within 72 hours after unprotected sex, EC reduces the risk of pregnancy by approximately 89%. But the drug is most effective when taken within 24 hours, and its effectiveness decreases rapidly as the interval increases. Because women often need EC on evenings and weekends, when doctors' offices and clinics are closed, providers give women advance prescriptions so that they will be able to take the drug within the necessary timeframe.
Studies have shown that EC is safe and effective, that there is no risk of taking it on more than one occasion, and that having access to the drug does not cause an increase in sexual risk-taking behaviors. EC does not cause an abortion or interfere with an established pregnancy.
"Writing prescriptions for EC with refills is the standard of care," said Dr. Marc Heller, Medical Director of Planned Parenthood of Mohawk/Hudson, a licensed physician and board certified obstetrician and gynecologist, and a complainant in the case. "Because EC's effectiveness in preventing pregnancy decreases quickly over time, it is critical that women have access to EC as soon as they need it. These pharmacists had no medical reason not to uphold that standard."
The American College of Obstetricians and Gynecologists recently launched a campaign to encourage physicians to offer advance prescriptions for EC during routine gynecological visits. The American Medical Women's Association has also recommended that doctors provide preprinted prescriptions and instructions for use of EC, and the American Academy of Pediatrics recommends that pediatricians offer advance EC prescriptions for teens and young adults.
"Pharmacists are authorized to alter prescriptions based on health concerns, such as potentially harmful drug interactions -- but they don't get to make decisions about whether or not patients deserve the drugs their providers have prescribed," said Galen Sherwin, Staff Attorney with the NYCLU Reproductive Rights Project.
The NYCLU filed its complaints with the New York State Office of the Professions, which has the authority to discipline licensed pharmacists. The complaint charges that the pharmacists exceeded the scope of their authority, breached their duty of care to the patients, and committed professional misconduct under the Board of Regents prohibition against "abandoning or neglecting a patient or client under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care." The complaint also argues that failure to fill prescriptions for EC constitutes sex discrimination in violation of New York's Human Rights Law, which prohibits discrimination in places of public accommodation.