A Walgreens pharmacist in Arizona denied a woman medication to end an unviable pregnancy, stating that it was against his ethical beliefs to fill the prescription. "I get it, we all have our beliefs," Nicole Arteaga wrote of her experience on Facebook. "But what [the pharmacist] failed to understand is this isn’t the situation I had hoped for, this isn’t something I wanted. This is something I have zero control over."
When Arteaga reached week nine of her pregnancy, her doctor told her that there was no fetal heartbeat, and that she would miscarry. The doctor gave her two options: have a surgical procedure or take misoprostol, a medication used to end a failed pregnancy. Arteaga opted for misoprostal, but left the pharmacy in tears and "feeling humiliated by a man who knows nothing of my struggles, but feels it is his right to deny medication provided to me by my doctor," she wrote.
Unfortunately, this is an all too common scenario. Pharmacists in six states (including Arizona, where Arteaga is from) are protected by a "conscience clause," which states that they have the right to refuse to perform certain services that they feel violate their personal beliefs or values, explains Gretchen Borchelt, vice president for reproductive rights and health at the National Women's Law Center (NWLC). Often this includes birth control, emergency contraception, and medications intended for "medical abortions," like misoprostol. Eight states have gone the other way, and require pharmacies to give patients medications, and others have no laws at all, she says. "There's not one answer for everybody, it's going to depend where you are in your state," she says.
It can be tricky to navigate your state's laws when you're in this type of situation, so ahead are a few questions you may have about how to access medication once you've been refused:
How do I know what my state's laws are?
First of all, know that there are experts who are available to help you. For example, you might want to contact the NWLC and they can figure out what your state law specifically says, Borchelt says. "We can help you figure that out; you don’t have to do it alone," she says. Other organizations like the ACLU and Planned Parenthood can do the same sort of thing, so don't be afraid to ask.
How can I get the medication I need?
Again, it all depends on your state and the specific policies the pharmacy has in place, says Natalie DiPietro Mager, PharmD, MPH, associate professor of pharmacy practice at Ohio Northern University. If a pharmacist chooses not to fill your prescription, they typically will transfer the prescription to another pharmacist who can fill it, which is what happened to Arteaga. Or if there are no other pharmacists available (because there's only one pharmacist on call, for example), then they are may refer you to another pharmacy. In some cases, your pharmacist can refuse to provide contraception without taking further action, according to the ACLU. If you're in a bind, you may want to call your prescriber or an on-call doctor, Dr. Mager says.
This seems unfair. Can I do anything to complain?
Sure can. Each state has a pharmacy board that writes pharmacy laws, and you can file a complaint with them if a pharmacist is violating the law or practice or not giving you the medication they're supposed to, Borchelt says. "They can discipline the pharmacy, put sanctions into place, and it can change practice [which can] mean it doesn’t happen to someone else," she says.
If this happens to you, consider sharing your story on social media, because it can actually change things, Borchelt says. "Think about other ways to bring attention to this — certainly social media is a powerful tool to affect change and get people to notice," she says. You can speak directly to corporations through social media, which can push them to put policies and training in place. In Arteaga's case, Walgreens responded to her story saying that their policy allows pharmacists to step away from filling a prescription, but they're "required, to refer the prescription to another pharmacist or manager on duty to meet the patient's needs in a timely manner."
Also, you can use your story to talk to legislature and get them to pass a bill that will protect people if there's a pharmacist that wants to refuse, she says. "Be a citizen and demand action from representatives to make sure there are protections in place," she says.