What Pharmacy Denials in Missouri Would Mean for Me

Pamela Merritt

As more states debate legislation to protect pharmacists who refuse to fill prescriptions on "moral" grounds, many consumers may face debates, forced public disclosures or delay at the pharmacy counter.

Going to the pharmacy and picking up prescriptions is a part of most people’s regular routine.  Consumers go online or place a phone call, schedule a time to pick up their meds and then go get them.  But, as more states debate legislation designed to protect pharmacists who refuse to fill prescriptions on moral grounds, many consumers may be faced with a debate, forced public disclosures or delay at the pharmacy counter.  Missouri legislators have made filing legislation protecting pharmacists who refuse to fill prescriptions on moral grounds an annual event.  That trend has resulted in an annual reflection on what a refusal at the pharmacy would mean in my life and the lives of my fellow Missourians.

State Representative David Sater (R) has filed legislation that “specifies that no licensed pharmacy can be required to perform, assist, recommend, refer to, or participate in any act or service in connection with any drug or device that causes a pregnancy to end prematurely resulting in an abortion.”  Since individuals cannot purchase the pill approved for abortion (mifepristone) over the counter, that leaves us with a bill that would protect pharmacists should they refuse to dispense any other medication that they feel may have an adverse affect on a pregnancy.

The intent of this legislation is to mislead Missourians into thinking that emergency contraception, which is available over the counter, is an abortifacient.  It’s not, but that hasn’t stopped anti-choice advocates from saying otherwise.  One would think that State Representative David Sater, who was named Pharmacist of the Year in 1983, would know the difference. The legislation, HB 28, also seeks to accomplish its stated goal and protect pharmacists who refuse to fill prescriptions and cite moral grounds.  That protection would extend to a pharmacists’ refusal to refer consumers to another pharmacy.  Anti-choicers hope that this will create an environment where women seeking emergency contraception are delayed long enough to take that option to preventing pregnancy off the table.  For many women living in parts of Missouri where there may only be one pharmacy serving their community that is a very real possibility.

Beyond the goals behind this latest version of pharmacy denial legislation there is the potential reality – that consumers may or may not face a denial at the counter depending on which pharmacist is on duty and what their personal moral beliefs are.  I can’t help but take that possibility personally.  For over a decade I took birth control pills to treat endometriosis and uterine fibroids.  When I first heard of legislation protecting pharmacists who refuse to fill prescriptions I immediately thought of my own and what that would mean for me.  I live in St. Louis city and have a lot of options when it comes to getting a prescription filled, but that didn’t stop me from imagining the scene at my local pharmacy. 

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I visualized myself standing at the pharmacy counter thinking of the errands I still had to run only to have the pharmacist tell me that, because of her or his moral objection to birth control pills, my prescription would not be filled.  I could see myself standing there faced with the option of explaining to the pharmacist that I wasn’t taking the pill for birth control but rather for fibroid tumor growth control and hoping that disclosure of my medical history satisfied her or his moral standards.  Or I would have to ask that same pharmacist to send my prescription to another pharmacy, even though this latest version of pharmacy denial legislation would protect the pharmacist should she or he refuse to do that.  I would be stuck there unable to get the medicine my doctor prescribed and unprotected as a consumer because the Missouri legislature decided it was more important to protect a pharmacist who has a problem with birth control pills than the consumers and patients who need medication.

That’s the scenario Missourians face should pharmacy denial legislation move forward.  As a reproductive justice advocate, I know that this legislation is about denying women access to emergency contraception.  The implications could deny women in Missouri access to birth control.  But this vaguely worded bill could touch anyone for any reason.  The only requirement would be a personal moral conflict and a pharmacist willing to discard the section of the Oath of a Pharmacist that states “I will respect and protect all personal and health information entrusted to me.”

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