A sensible compromise.

Byline: The Register-Guard

Political and religious obstruction of women's access to emergency contraception has become so disgraceful that it's important to applaud every reasonable compromise.

A round of polite, tempered applause, please, for the Oregon Board of Pharmacy for sensibly dealing with something that, in the best of worlds, would never come up.

Unlike the outrageously overbroad refusal rights being proposed by the Washington Board of Pharmacy, the Oregon board has clarified pharmacists' responsibilities when presented with prescriptions for emergency contraception. Last week the pharmacy board took steps to ensure that Oregon pharmacy supervisors develop written policies and procedures that govern the behavior of pharmacists who object on religious or moral grounds to dispensing any drug, including emergency contraception.

Such policies would require pharmacists to inform their supervisors ahead of time of any religious or moral concerns and to allow another pharmacist on site to dispense the prescription. In all cases, the policies must ensure that a patient's prescription needs are ultimately met.

The most crucial requirement is that a pharmacist who won't fill a prescription must refer the patient to another pharmacy nearby where the patient can get the prescription filled. No lectures or Bible study lessons are allowed. That's unprofessional, and it violates patients' privacy rights.

Here's where Oregon's rule blows the Washington policy out of the water: In the event of a referral, the Oregon pharmacist is responsible for identifying another pharmacy that has the medication in stock and will dispense the prescription. The Washington board's policy contains vague language that simply says pharmacists must "provide timely alternatives for the patient to obtain treatment." The pharmacist is under no obligation to ensure that the patient's prescription will be filled at another pharmacy.

Oregon pharmacists aren't required by law to fill every prescription. In addition to their right to refuse to dispense a prescription if they have medical questions, they are not obligated to "participate in activities they find morally or ethically objectionable." Most other health care professionals also are protected by these so-called "conscience clauses."

The problem with pharmacists refusing to fill prescriptions on moral or religious grounds is that their role in the U.S. health care system, legally and professionally, makes them a mandatory partner in the drug treatments prescribed by doctors. Patients can't obtain their prescribed treatment without the participation of pharmacists.

When pharmacists refuse to participate, it intrudes on the doctor-patient relationship and interferes with patients' legal right to drug therapy as prescribed by their doctors. In the case of emergency contraception, the refusal can have the effect of denying access to treatment and even forcing an unwanted pregnancy, because the effectiveness of emergency contraception is time-sensitive.

Ideally, pharmacists wouldn't be allowed to refuse to honor lawful prescriptions on moral or religious grounds. Most never do, anyway. Those who make such radical intrusions into the doctor-patient relationship ought to find another line of work more accommodating to their religious convictions and less damaging to the nonjudgmental practice of medicine.