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The Idaho House voted 48-21 today to allow pharmacists -- but not pharmacist technicians or other staff members -- to refuse to dispense prescribed medication based on religious or moral objections, despite arguments that said the law would have major unintended consequences for the elderly and for employers. The bill, sponsored by Representative Thomas Loertscher, R-Iona, is widely believed to have been an attempt to limit the dispensation of medications such as the Plan B "morning-after" birth control pill, and received support from a number of conservative religious activists such as the Idaho Values Alliance and Idaho Chooses Life on that basis.

Idaho Pharmacists Allowed to Refuse to Dispense Medication

The Idaho House voted 48-21 today to allow pharmacists — but not pharmacist technicians or other staff members — to refuse to dispense prescribed medication based on religious or moral objections, despite arguments that said the law would have major unintended consequences for the elderly and for employers.

The bill, sponsored by Representative Thomas Loertscher, R-Iona, is widely believed to have been an attempt to limit the dispensation of medications such as the Plan B “morning-after” birth control pill, and received support from a number of conservative religious activists such as the Idaho Values Alliance and Idaho Chooses Life on that basis.

Debate on the bill was largely on a party-line basis, with Republicans such as Representative Erik Simpson, R-Idaho Falls, and Representative Russ Mathews, R-Idaho Falls, speaking in favor of the bill and a number of Democrats speaking against it, raising issues such as potential problems with a lack of medication, no requirement for a referral, no requirement for a 24-hour prescription to give the person a chance to find another pharmacist, and potential problems for employers.

Some arguments centered around the fact that pharmacists can already refuse to dispense based on conscience, according to the American Pharmacists Association; however, in that code of ethics, the pharmacist is also required to refer the patient to another pharmacist. The new law does not have any such provision, even if another pharmacist is on staff in the same facility, said Representative Grant Burgoyne, D-Boise. Loertscher noted, however, that the law did not prohibit pharmacists from making such a referral.

Potential medical issues brought up included men who couldn’t get Viagra, elderly and disabled people who couldn’t get medication to extend their lives, and diabetics who couldn’t get insulin because it is produced from animals. Assistant Minority Leader James Ruchti, D-Pocatello, noted that “age and disability” had been removed from a section of the bill, and asked Loertscher why that was; Loertscher responded that he couldn’t imagine a pharmacist making a decision on that basis.

Burgoyne, an employment attorney, also raised a number of other issues for employers, such as that pharmacists weren’t required to notify their employers of their decision, that they could make the decision on the spur of the moment, and that it would require employers to inquire about employees’ religious and ethical beliefs.

Representative John Rusche, D-Lewiston, who is a physician, also pointed out that because the bill protected pharmacists from being sued based on their decisions, that the next likely target for a lawsuit would be physicians themselves.

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25 comments

  1. I don’t get it. How does something like this actually get passed? Where does a woman go who wants basic birth control if she lives in a predominantly catholic area? Let alone legal “plan b” services. (I am pro-life, but put “Plan B” in the same category as birth control pills as ok.) As a federalist I support the states right to outlaw these medications as they choose, but laws like that should be stated and consistent, not up to the whims of a service provider.

  2. One of the arguments Representative Loertscher made is that one can get birth control pills anywhere, such as Planned Parenthood. Of course, that doesn’t help if one lives in a rural area.

    Ironically, Plan B doesn’t end up being covered by this, because it doesn’t require a pharmacist to dispense, according to Representative Anne Pasley-Stuart, D-Boise, who said you can even get it online.

  3. I should have addressed rural areas in my comment. This isn’t a problem if you live in large community. Which means that people who live in rural communities in that go against the mainstream ideology are even further behind the curve than they were before.

  4. Number one thing to get out: this is a right to work state.

    Fire any pharmacist that shows the slightest inclination to refuse to fill a prescription. Just don’t say it is because of that refusal.

    The lawsuits waiting for this decision are going to cost the state millions in defense. Idaho legislators must be some of the dumbest people in America, or at least the most misogynistic.

  5. Well, if people sue the doctors, it won’t cost the state anything. Whom in the state would they sue?

  6. Who are you calling a doctor? The pharmacist? Sorry, but no, they aren’t doctors. They don’t have the education or the experience that being a doctor requires.

    Sue the companies that hire the “moral” pharmacist. Sue the pharmacist. Sue the manager that kept a “moral” pharmacist on as an employee, with knowledge of their reckless behavior. Eventually, it will work its way up to the state that enabled this kind of dangerous practice.

  7. Within the first year I think an employee’s “at will” status will take care of the “moral” pharmacist. New hires will be subject to new scrutiny. There will be just as many birth control prescriptions filled. This law will accomplish nothing. And think the legislature will have spent time on this. Worse this is an intrusion into a private business and the employee/employer relationship.

  8. No, I’m not calling pharmacists doctors. I’m calling doctors doctors. John Rusche, who is a doctor, said that since pharmacists were protected by this bill, it was likely that the person a patient would sue would be the doctor.

    Pharmacists explicitly cannot be sued. I am not sure whether pharmacies themselves are protected.

  9. Wait until someone is harmed by this law, then tell me the “moral” pharmacist can’t be sued for a variety of things.

  10. Unfortunately, we live in a state run by morons who don’t get the importance of church and state separation. They might get it if they bother to visit a country where the church other than their church runs the state.

  11. Thank you for a helpful article. The headline is misleading, though, as the bill still has to go to the Senate and Governor.

  12. “Number one thing to get out: this is a right to work state.”

    And how exactly is that relevant? How does being illegal to fire someone for choosing not to join or pay dues to a labor union have anything to do with this issue?

  13. Sorry, meant “at-will employment”. My mistake.

  14. Mississippi of the Rockies.

  15. Another step backward for Idaho.

  16. This could go way beyond birth control drugs. What if a pharmacist refuses to dispense HIV/AIDS drugs ’cause of how they perceive someone contracted it? No cancer and/or pain drugs ’cause I don’t believe it smoking and that is what caused your illness? How about the pharmacist thinking obesity is a sin, so no drugs for the diabetic. The potential ramifications are immense.

  17. Why would anyone go into pharmacy if they didn’t plan to do their job, or felt that it was somehow immoral?

  18. I am a Pharmacy student 5th year from Miami out of a 7 year program.
    Seriously I can’t believe how the retrograde mentality of rural areas based on religious believes can interfere with providing medication of any type to a patient. If you start with Plan B what is next? Contraceptives? Addiction treatment drugs? …just to name a few or anything that affects the so called higher morality of people that proposes these bills.
    This line of thinking is what makes other Health care providers (HCP) to look down to us as pill counters despite the extensive training we endure to become pharmacists.
    To that person above that said pharmacists are not doctors I am sorry to disappoint you but we are. PhD stands for Pharmacy Doctor and our knowledge in pharmacology is way more extensive than that of a doctor. In addition, we do clinical rotations in hospitals as a part of our curriculum. Doctors are supposed to be experts in Pathophysiology but when it comes down to propose drugs for treatment based on a previous diagnosis… we rule. And this is a fact since doctors prescribe based on detailing and habit, with out even knowing many of the details and pharmacokinetics, pharmacodynamics, and mechanism of action of a drug.
    How can we call ourselves HCP when we are judging patients based on what they believe? We are missing the whole concept of a HCP and that is to provide aid to a patient based on our knowledge.
    i wonder why don’t they spend time in counseling these patients about family planning as a way to prevent contraception? or is it also immoral to just talk to them about the risks of unprotected sexual relations?
    With the training that new pharmacists are being exposed to i believe these ideas are bound to disappear if we ever want to be considered as serious HCP when we work out of the hospitals, MTM, and clinics that obviously would not tolerate this kind of prejudice from any of the HCP in practice. Thanks and best of lucks to those affected by this bill.

  19. Pharmacists who refuse to fill all legal and prescribed medications should lose their licenses.

  20. Sorry Patia but that is a very bold statement to make. Let me illustrate some facts that might help me get my point across.
    half the doctors (to be conservative) prescribe in a habit basis? detailing is one of the ways by which they are influenced? Drug companies invest more money in advertising (which includes detailing) than in anything else in a single round year?
    Many people i have counseled this past week that were taking medication that their doctors prescribed were taking it wrong!!!! thus having no clinical improvement from the medication because their doctors did not explain to them how to take it and at the same time increasing the risk of permanent side effects because the medication is only supposed to be taken for a certain amount of time. but since they were taking it wrong and they were not showing clinical improvement from the condition guess what the doctor prescribed? he increased the dose, he thought the if the patient is not getting better the dose most be wrong. Well like I said before the dose was right and the med was being taken wrong. I counseled the patient and told him how to take it correctly and alas, now the med is working wonders.
    This is just an example of many doctor’s mistakes that i see on an every day basis along with a lot more with all sorts of meds.
    We are the last door between the medication and the patient and in many cases we save lives. people might not see it but honestly it happens all the time. insurance companies (at this moment only Medicaid is doing it) are realizing that we can potentially reduce errors and decrease the amount of meds a patient is taking thus saving them money and they are paying pharmacists for these services.
    I am pretty sure that this mentality of refusing to sell meds is coming from old school pharmacists that got stuck on time and are not realizing of the important role that we can play as HCP. religion is what it is… saving or helping a person’s quality of life by expert knowledge and medication management is another thing that goes a long way if we are willing to accept the role that society demands from us as HCP.
    as a last comment i think we should be given prescribing rights, it is happening in Canada and in U.S is being done in MTM Clinics and in Veteran’s hospitals.
    I would go head to head with any MD/DO student in a medication contest about mechanism of action, side effects, pharmacokinetics etc etc of a drug and i know he wont beat me. I know my stuff they know theirs, we are here to help not to condemn. Just because 1 person or a group of people choose to behave against the logical path of a HCP is no reason to generalize trash us. Thanks again and sorry for the long reply, but if i don’t try to stir people’s minds on the right direction with facts who will? Peace and the best of luck

  21. This insane and absolutely mind boggling law is definely one for the supreme court. By the way, a pharacist is called a Doctor. Pharamacy school is a 4 year post graduate program, as is medical school.

  22. Hey Carlos, I appreciate all your input since you have personal insight into pharmacy. I, too, am pursuing this career and am doing research on the many aspects, including issues and ethical conduct. I totally agree that we will be specialists in medication in all efforts and doctors are specialists in physio/anatomy aspects with some medication background. I appreciate that you are helping the patients correct their way of use and are recognizing that this does NOT generalize all pharmacists, each individual has their own moral standards, but it is the ability to remain unbiased against other people’s moral standards and only making sure that they are getting better and we are being the best consultants as possible. It’s interesting on the topic you brought up about prescribing rights because people do bring this question up and I haven’t done much research on it yet, but it’s one thing to be able to have that opportunity, but probably not in independent pharmacies, more like those who have worked closely in hospitals and know the ins and outs of diagnoses and medical files. But then maybe it won’t create a homogeneous or uniforming all the pharmacists. (someone brought this up, so I can’t clarify lol) …. anyways good luck in your studies! help the patients!

  23. Hi Jane, thanks for the comment. i am now officially a P4 or P7 in some schools meaning i finished all my classes. I know that the new pharmacy mentality its pointing in a whole new direction of specialized clinical care with multidisciplinary teams, where a pharmacist is present.
    If you have any concerns or need help with anything please feel free to contact me. i added my email in case you want to exchange info. best of luck in your studies. Peace

  24. Wow, what an issue. However, as a born and raised Catholic who is studying to enter the health care field I take real issue with anyone who decides not to do the job they are hired to do. Even if I had an issue with filling out any doctor authorized perscription I would make damn sure there was at least one qualified person to handle this for me. If that person was unavailable for some reason, I would have to do it myself. I might not believe it is something I would do if I were the patient, however, I took the job knowing full well what was a certainty to happen at some time. Once you accept the job, you agree with the responsibilities that come with your decision.

  25. My understanding is that that’s what people are primarily requesting: that the law ensure that a person wanting to exercise a conscience provision be required to pass the patient on to someone else who can serve them, right then. Good luck in your career.