"The doctor-patient relationship is private and must remain inviolate.” That statement comes from a Columbian editorial on July 10, 2009, and it is no less true now than it was then.Unfortunately, last week a federal judge announced that a third party may intrude on that private relationship and dramatically alter it solely at the whim of the intruder. U.S. District Judge Ronald Leighton ruled that pharmacists in Washington state may refuse to sell emergency contraceptives. Some pharmacists apparently forgetting they are merely conduits in the doctor-patient relationship and not participants argue that they should not be compelled to sell such contraceptives as the morning-after Plan B pill, if it is against their religious beliefs to do so.
Leighton’s ruling was incorrect, but not surprising. He made the same decision five years ago, but it was overruled by the 9th U.S. Circuit Court of Appeals, which returned the case to him. Now, after Leighton’s second ruling, doctors and women in Washington are left confused. That’s why we urge the state to appeal the ruling.
Gov. Chris Gregoire indicated last week that an appeal will be forthcoming. She said the “purpose of the Board of Pharmacy rule is to ensure safe and timely access to lawful and lawfully prescribed medications, with particular concern about time-sensitive medications. … Secretary of Health Mary Selecky, the Attorney General’s office and I will confer regarding the best path forward. … There are strong arguments to make on appeal from this lower court decision.”
We hope the state presents those arguments, so that pharmaceuticals can be delivered free from the disruptive personal biases of pharmacists or anyone else.
Let’s face facts, a prescription is not a suggestion. It is an order of delivery. It is non-negotiable beyond the doctor-patient partnership. And if a pharmacist is allowed to disobey that order, what is to stop him or her from refusing to fill any other prescription? Could a pharmacist refuse to fill a prescription for an HIV patient because of the pharmacist’s political beliefs? What if a pharmacist simply doesn’t like a particular patient, and declares religious objections?
When someone decides to become a pharmacist, it should be clearly understood that personal beliefs are trumped by state law. And as we pointed out in that editorial more than two years ago, this debate has been sidetracked by a misconception. Plan B is not an abortion pill. When taken within 72 hours of unprotected sex, Plan B reduces or prevents the chances of ovulation or fertilization of an egg.
One special concern in this issue pertains to rural areas, where Gregoire says patients “may have few alternatives and could suffer lengthy delays in receiving medication or go without (the medication) entirely.” Which brings us to this reality: All parties involved patients, doctors and pharmacists share the compelling interest in preventing unwanted pregnancies. Plan B does that, and its legal use should not be blocked.
The state should appeal the incorrect ruling and let doctors and patients resume their private relationship unimpeded by outsiders.