Wisconsin Judge Recommends Reprimand for Pharmacist Who Refused To Refill Oral Contraception Prescription

Wisconsin Administrative Law Judge Colleen Baird on Monday recommended that the state... Pharmacy Examining Board reprimand and limit the license of a pharmacist who refused to refill a woman's oral contraceptive prescription because of moral objectives to birth control, the Milwaukee Journal Sentinel reports (Forster, Milwaukee Journal Sentinel, 2/28). Neil Noesen in July 2002 refused to fill university student Amanda Phiede's oral contraceptive prescription while he was working as a substitute pharmacist at a Kmart pharmacy in Menomonie, Wis. When Phiede confirmed that she was using the drug for birth control, Noesen told her that he would not fill the prescription. Phiede then asked him where else she could get the prescription filled, but Noesen refused to provide her with that information. Phiede later went to a Wal-Mart pharmacy, but when the Wal-Mart pharmacist called Noesen to have him transfer the prescription, Noesen refused, saying again that artificial contraception is against his personal beliefs. Noesen continued to refuse to fill the prescription even after two police officers and the Kmart assistant manager spoke with him. The police took no further action, and the managing pharmacist filled Phiede's prescription when he returned to work on Monday (Kaiser Daily Reproductive Health Report, 10/13/04).

Recommendations
Baird ruled that Noesen "fell far short of satisfying the standard of care" included in the state code of ethics for pharmacists and had not "done enough" to ensure that Phiede had another way to refill the prescription, according to the Journal Sentinel. "(Noesen's) testimony gave the distinct impression that satisfying his own moral code was his only concern," Baird wrote. In addition to recommending a reprimand, Baird recommended that in order to retain his license Noesen should have to prepare written notices five days before beginning work at a pharmacy specifying which practices he will not perform and the steps he would take to ensure that customers have access to "necessary medications," according to the Journal Sentinel. Baird also recommended that Noesen be required to attend six hours of ethics education and pay court costs (Milwaukee Journal Sentinel, 2/28). The Pharmacy Examining Board is scheduled to meet in April to decide whether to implement Baird's recommendations, according to the AP/Las Vegas Sun.

Reaction, 'Conscience Clause' Legislation
According to Krystal Williams-Oby, Noesen's attorney, Baird's recommendations are "unfair" because Wisconsin law and the board's rules do not address the issue, the AP/Sun reports. "What the state is doing is holding my client to a standard that does not exist," Williams-Oby said (Ross, AP/Las Vegas Sun, 2/28). Kelda Helen Roys, executive director of NARAL Pro-Choice Wisconsin, said that Noesen's case will "embolden" abortion-rights opponents to pass laws extending "conscience clauses" to pharmacists, according to the Journal Sentinel. "It's the next step because abortion has been so drastically restricted, that now (abortion opponents) are moving on to other goals," Roys said, adding, "This is the kind of thing where you have huge public outrage when you find out a pharmacist gets to inject personal morality into a relationship between doctor and patient" (Milwaukee Journal Sentinel, 2/28).


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