When Is It Acceptable to Refuse to Fill a Prescription?
Recently, a pharmacist made national news after refusing to fill a prescription for a patient. In this particular situation, the drug in question was being used in lieu of a D&C to end a failed pregnancy. The physician, stating personal beliefs, refused to dispense the prescribed medication. In this particular case, he was within his rights in his state of employment and within the policies of his employer. The woman’s prescription was transferred to another location to be filled. This case has left a lot of people wondering when it is acceptable to refuse to fill a prescription. The answer to that question is a little complicated.
Personal Harm or Contraindications
There are many cases in which a physician will prescribe a medication that presents a conflict to another drug or supplement being used by a patient. This could be from their oversight, omitted information by the patient on intake, or a simple error in prescribing. It is not only acceptable for a pharmacist to refuse to fill a prescription that will cause harm to a patient or create the possibility for a poor interaction, but it is their responsibility to catch such errors and alert the patient and physician.
Some pharmacies have specific policies about the frequency and time limits on filling and refilling prescriptions. In some cases, there may be limitations on insurance claims for a specific prescription within a certain period of time. If the prescription is filled before the pharmacy can be reimbursed, they will be left holding the bag and selling expensive medications for the price of the co-pay. This is a scenario in which the pharmacist has little choice than to refuse to fill a prescription. In other cases, policies are put in place to help ward off drug-seeking behaviors and the abuse of prescriptions drugs.
Suspicion of Abuse
Beyond company policies, there are times when a pharmacist may see the need to refuse service to a person who they believe by actions or prescription history to refuse to fill their prescription. This most commonly would take place with an opioid prescription or other narcotic painkiller. This goes back to the pharmacist suspecting that a drug would cause a patient personal harm, so in turn, it is their responsibility to refuse them service. Pharmacists, however, should be careful not to unduly burden patients with chronic pain who have been in good standing with the pharmacy just because federal guidelines have become more stringent.
When it comes to refusing to fill a prescription based on personal or religious beliefs, things get a bit tricky. This issue most often comes into play with birth control, “morning after” contraception, or drugs that may induce a miscarriage. Only a handful of states protect the rights of a pharmacist to refuse to serve a patient based on their own personal beliefs. Pharmacists who have strong beliefs that may cause a conflict with their job should first understand their state laws, their company policies, and prepare a backup plan to allow someone else to fill the prescribed medication.
While there are some cases in which it is absolutely without question that a pharmacist should refuse to fill a prescription, the jury is still out on their rights to do so for their own beliefs. Everyone in the industry should take care to make informed, compassionate decisions any time they are presented a prescription by a patient.