Facebook complaint fuels controversy over pharmacists' authority

In a widely shared Facebook post, Brittany Cartrett describes how a Wal-Mart pharmacy in Milledgeville refused to fill her prescription for a drug called misoprostol. The medicine is often taken alongside the drug mifepristone, known as the abortion pill.

Cartrett, who miscarried six weeks into her pregnancy, planned to use the drug as a less invasive alternative to a surgical procedure to end the pregnancy, she wrote. Cartrett reported that the pharmacist told her there was no valid reason for her to take the drug.

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ATLANTA - Reports of a pharmacist's refusal to fill a prescription for a drug associated with abortion are stirring debate over an obscure rule that gives pharmacies discretion to turn away patients.

In a widely shared Facebook post, Brittany Cartrett describes how a Wal-Mart pharmacy in Milledgeville refused to fill her prescription for a drug called misoprostol. The medicine is often taken alongside the drug mifepristone, known as the abortion pill.

Cartrett, who miscarried six weeks into her pregnancy, planned to use the drug as a less invasive alternative to a surgical procedure to end the pregnancy, she wrote. Cartrett reported that the pharmacist told her there was no valid reason for her to take the drug.

Efforts to reach Cartrett for this story were unsuccessful, though she has also described the encounter in a television interview. As of Thursday, her Facebook post had been shared more than 1,800 times.

Cartrett wrote that she filled the prescription elsewhere, but the confrontation she described has fueled a debate over how much leeway pharmacists should have.

The state Board of Pharmacy gives them wide discretion in a broadly worded rule: “It shall not be considered unprofessional conduct for any pharmacist to refuse to fill any prescription based on his/her professional judgment or ethical or moral beliefs."

Greg Reybold, attorney for the Georgia Pharmacy Association, said such judgment calls happen frequently and are a "material part of the practice."

Those decisions may involve suspected drug abuse or concern about a patient's health, said Rep. Bruce Broadrick, R-Dalton, who is also a Walgreens pharmacist.

“It’s pretty complicated but certainly professional judgment and safety for the patient are always at the forefront,” Broadrick said.

Reybold said refusals to fill prescriptions based on moral beliefs are uncommon, as far as he knows.

Wal-Mart did not respond to questions about this incident, but a company spokesman told MSNBC that the pharmacist’s decision was “not a conscientious objection.”

Rather the pharmacist refused to fill a prescription for a drug not approved by the Food and Drug Administration to manage miscarriages.

Reybold said declining a prescription written for an off-label purpose – such as this one, apparently – is an example of a pharmacist using professional judgment.

Amy Mortion, chairwoman of an advocacy group called Better Georgia, said the basis for the pharmacist's action is irrelevant.

“Regardless of the reason this pharmacist refused to fill the prescription, women in Georgia should have access to the prescription that their doctors order for them, without having to prove to a pharmacist that it’s necessary,” Morton said.

“Certainly the last thing a woman who’s just been told she miscarried a baby needs to be forced to do is to argue with a pharmacist at a counter about that.”

In addition to the board's rule, a provision of the state’s abortion law protects pharmacists who refuse to assist an abortion based on moral or religious grounds.

Those pharmacists are still expected to help the patient find another who is willing to fill the prescription.

Broadrick and Reybold said they were not aware of any pharmacists who have recused themselves under that law.

But Broadrick said these protections, even if used infrequently, are important because pharmacists should not be compelled to do something that violates their convictions.

Jill Nolin covers the Statehouse for CNHI's Georgia newspapers. She can be reached at jnolin@cnhi.com.

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