Nevada Pharmacy Board delays decision on conscience clause

Friday, Oct. 28, 2005 | 6:54 a.m.

The proposal has sparked debate between board members and some health and women's advocates, who say it could limit access to birth control and AIDS drugs. They say any such guidelines should be drafted by the Legislature, not an appointed body.

"This was very hotly debated last (legislative) session. This is a true public policy question," state Sen. Maggie Carleton, D-Las Vegas, told the board. "Be cautious where you tread."

At issue is whether pharmacists can refuse to fill a prescription they find morally objectionable, and if so, what's the process for having that prescription filled. Nevada law and the pharmacy board's regulations are silent on the issue.

Two legislatures have taken up the "right to refuse" issue without reaching consensus.

Board executive director Larry Pinson said that while his panel hasn't received complaints about denied prescriptions, he wanted to be "proactive" in drafting a rule before it occurred.

"I can anticipate that someday it's going to happen," he said. "What do we do then? We really have nothing in place that takes care of that patient."

The board's proposal says a pharmacist may refuse to fill a prescription because it violates a "genuine principle or tenet of conscience." In that case, pharmacists should arrange "without delay" to have the prescription filled by another pharmacist and should not discuss their objections with the patient. A pharmacy could not discipline the pharmacist as long as it was alerted ahead of time of the pharmacist's beliefs.

Larry Matheis, executive director of the State Medical Association, argued the proposal allows pharmacists to interrupt a health care program designed by a doctor and a patient.

"A legal prescription has been issued. The pharmacist may or may not know ... why the prescription has been written. But that is a clinical judgment that if it's going to questioned, it can only be questioned, really, by another physician."

Law student Lisa Lynn Chapman told the board that as an 18-year-old she was denied birth control pills by a pharmacist who insisted on seeing a note from a parent. The pills had been prescribed to regulate her menstrual cycle.

"As I was driving to a different pharmacy I was furious, I was frustrated," she said. "It's not a pharmacist's job to pass judgment on me."

Pat Elzy, legislative affairs director for Planned Parenthood in Reno, told the board her group was largely concerned with accommodating the needs of patients.

"We would not be opposed to a policy that permits accommodation of a pharmacist's securely held religious beliefs provided that the patient received his medication in-store, without discrimination or delay," she said.

Board members said they did not think they were meddling in legislative business.

"Our job is to help the public. The regulations we draft affect public policy all the time. This is part of our job," member Michael Triolo said.

The board voted to extend debate on the proposal to its Dec. 8 meeting in Reno.