http://www.pharmacist.com/emergency-contraception-otc-or-not-pharmacists-are-important
This week’s topic is ethics and emergency contraception (EC). The main question posed here is, should ethics play a part in the dispensing of EC. Many questions arose in my last post regarding pharmacist’s ability to refuse to dispense an emergency contraceptive based on their personal beliefs. These “conscience clauses” were enacted in response to the Roe v. Wade case in 1973 (National Conference of State Legislators, 2012). These clauses were initially intended to protect those health care providers from performing abortions or abortion related services when they violated their religious or moral obligations. With the advent of emergency contraception, the clauses have been challenged and forced some states to enact specific laws and regulations relating to dispensing or not dispensing emergency contraception. In my opinion, this is absurd. A previous blogger brought up the point of dispensing HIV medications. Should a pharmacist be allowed to determine that the medication you are receiving does not fall in line with his/her religious or moral obligations, therefore, you should not be taking it? They certainly have the right to refuse, according to some laws, but if they do, they have to provide an alternative for customers. Unfortunately, conscience clauses lack federal legislation and are only maintained at a state level. There are several bills that have been introduced by Members of Congress to address this issue. Two acts were implemented in 2005 to protect consumers, the “Access to Legal Pharmaceuticals Act” and “Pharmacy Consumer Protection Act of 2005.” These two acts say basically the same thing, pharmacies must fill valid prescriptions presented by consumers. They do, however, allow for the refusal based on religious or moral obligations. If that is the case, the pharmacist must provide other methods for the patient to obtain the prescription. I have included the links to those bills at the end of this post.
Feder, J. (2010). Federal and state laws regarding pharmacists who refuse to dispense contraceptives. CRS Report for Congress. Retrieved at http://congressionalresearch.com/RS22293/document.php
National Conference of State Legislators. (2012). Pharmacist conscience clauses: Laws and information. Retrieved at http://www.ncsl.org/research/health/pharmacist-conscience-clauses-laws-and-information.aspx
Access to Legal Pharmaceuticals Act 2005:
S. 809–109th Congress: Access to Legal Pharmaceuticals Act. (2005). In http://www.GovTrack.us. Retrieved January 27, 2014, from http://www.govtrack.us/congress/bills/109/s809
http://thomas.loc.gov/cgi-bin/query/z?c109:H.R.1652.IH:
Pharmacy Consumer Protection Act of 2005:
http://www.gpo.gov/fdsys/search/pagedetails.action?packageId=BILLS-109s778is
Emergency Contraception 
In your post you mention that pharmacists must provide other methods to obtain the medication. I have recently read that some pharmacists are not stocking emergency contraception in their pharmacies. What does the patient do in this case? Can these medications be obtained through mail order pharmacies? I look forward to your future posts this semester. J Mar
Thanks for your comment! In a case where the emergency contraception is not readily available, the legislation says that the pharmacist must obtain the emergency contraception from another pharmacy, or give specific information to the patient on where he/she can obtain the medication at a nearby pharmacy. I don’t believe that emergency contraception can be obtained through mail order pharmacy.
Emergency contraception is available from other sources if the local pharmacy does not carry it. I did see that ella, which is available by Rx only, can be purchased from online pharmacies. Plan B, which is sold over the counter, is sold on Amazon. The limiting issue is cost, about $40-50 per pill. JMar
When I first heard about Plan B OTC, I went to a random pharmacy and asked about it. Awkward to say the least. I can see how a person seeking this with the added stress of unprotected sex and asking for a controversial possibly unavailable drug could quickly give up. Additionally the cost can be prohibiting at upwards of $50.
Unfortunately, politics play a role in the ease or difficulty in dispensing this OTC medication. Ultimately, this effects the acquisition of the product and appears to especially hinder those who may need it the most- poor or under-educated. If one doesn’t know their rights and seeks Plan B from a pharmacists who refuses to sell it or stock it, they may not receive accurate information on what to do next. They may receive information but not have transportation to another pharmacy. They may also not be able to pay the higher than expected cost. In my opinion, cost and dispensing should be regulated on a federal level and not left up to states.