Pharmacist Refuses to Fill Valid Prescription for Reasons of Personal Belief

It is a topic that keeps coming up – can a pharmacist decline to fill a valid prescription because of personal beliefs?  In August, this column covered the story of a pharmacist who lost his job after refusing to fill a prescription for hormones for a transgender woman. And in February, we discussed a Human Rights Act lawsuit filed against Walgreens after a pharmacist there refused to fill a prescription for misoprostol. Now the ACLU of Michigan has filed a complaint against Meijer Pharmacy and one of its pharmacists who refused to fill a prescription to treat a woman’s miscarriage.

Just the Facts

The patient, Mrs. P, and her husband were delighted when discovered that she was pregnant with their first child. However, complications soon ensued. Mrs. P first discovered that she was pregnant with twins but miscarried one. She still hoped for the second fetus to be viable, and it was, at least for a few more weeks. But one morning she woke up with no morning sickness or fatigue (as she had been having) and saw her obstetrician who did a viability scan and discovered that the fetus had died.

The physician gave the patient three options: wait and see if her body would expel the fetus without intervention; use the drug misoprostol to complete the process; or schedule a dilation and curettage to remove the fetal tissue. The patient chose the first option, but when that took longer than expected, the physician prescribed misoprostol to ensure the patient wouldn’t develop an infection.

The physician called the prescription into a Meijer Pharmacy in Petoskey, MI where Mrs. P and her husband were spending the weekend. An hour later, Mrs. P received a call from the pharmacist stating that he would not fill the prescription, nor would he transfer it to another pharmacist or pharmacy.

ACLU Complaint

According to the ACLU complaint, the pharmacist told Mrs. P that “as a good Catholic male” he could not “in good conscience” fill the prescription because he believed it was her intention to use it to end a pregnancy. When Mrs. P explained that the medication had been prescribed because the fetus was not viable, the pharmacist allegedly said that was just “her word.” Devastated, Mrs. P called her regular pharmacist, also at a Meijer Pharmacy, who said he would fill it, but had troubles getting it from the other pharmacy. Finally, after driving over three hours to get back home, she was able to have her prescription filled.

The ACLU filed a complaint against Meijer Pharmacy and the specific pharmacist, alleging the Mrs. P was discriminated against because of her sex, and had a man shown up with the same prescription to treat a stomach ulcer it would have been filled. The ACLU also alleged that the pharmacist violated ethics rules promulgated by the Michigan Pharmacists Association and the American Pharmacists Association in his treatment of Mrs. P.

Possible HIPAA Violation

In addition, a possible privacy violation also occurred. After Mrs. P’s encounter with the pharmacist, her outraged mother called to speak to him. When the pharmacist learned the caller was Mrs. P’s mother, he began disclosing details about the prescription to her, without asking consent from the patient or verifying that the person on the phone was actually Mrs. P’s mother.

The Takeaway

The pharmacist who would not fill the prescription is no longer employed by Meijer. A Meijer spokesperson has said that the company policy follows guidelines set out by the American Pharmacists Association. “We recognize the right of a pharmacist to abstain from filling a prescription based on his or her religious beliefs, but the pharmacist is required to have another Meijer pharmacist fill the prescription or, if no other pharmacist is available at that time, to transfer the script to another pharmacy convenient to the customer," said Christina Fecher, the Meijer spokeswoman. 

The pharmacist in this situation had other options rather than to just refuse to fill the prescription. He could have given it to another pharmacist. He could have transferred it to another pharmacy. He even could have checked with the ordering physician if he had a concern about the use of the medication. He made three major mistakes: 1) refusing to transfer the prescription to someone who would be willing to fill it; 2) making the patient who was already mourning her miscarriage feel even worse; and 3) speaking to a third party about the patient’s prescription without getting consent from the patient. 

If you feel that you cannot fill a legitimate prescription for personal reasons, be sure to treat the patient with respect and dignity, and follow your pharmacy’s guidelines for either transferring the prescription to another pharmacist or another pharmacy to fill.

Ann W. Latner, JD, is a freelance writer and attorney based in New York. She was formerly Director of Periodicals at the American Pharmacists Association.

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