(CN) – Washington can enforce new rules barring pharmacies from refusing to fill legal prescriptions for certain drugs, including the controversial emergency contraceptive Plan B, even if the drugs clash with pharmacists’ religious beliefs.
The 9th Circuit lifted an injunction against the state, saying the lower court had “abused its discretion in applying an erroneous legal standard of review, failing to properly consider the balance of hardships and public interest, and entering an overbroad injunction.”
The Washington State Board of Pharmacy passed the new rules to address a growing concern over the availability of certain prescription drugs and medical devices, including syringes, prenatal vitamins, oral contraceptives and AIDS medications.
During a period of public input, most people commented on whether pharmacists should be allowed to refuse to fill prescriptions for Plan B, an emergency contraceptive that prevents a fertilized egg from implanting in a woman’s uterus. Plan B is sold over-the-counter to adults 18 and over, but requires a prescription for minors.
Seventy-seven percent of Washington pharmacies typically stock Plan B, according to a survey of 121 pharmacies, taken before the board adopted the new rules. The others cited low demand or the availability of an easy alternative source, with only 2 percent of pharmacies refusing to stock the drug based on personal convictions.
In April 2007, the board voted to adopt two rules barring pharmacies and pharmacists from refusing to fill a legal prescription, violating a patient’s privacy, discriminating against patients, and harassing or intimidating them.
The regulations took effect on July 26, 2007.
Ralph’s Thriftway in Olympia, Wash., and pharmacists Rhonda Mesler and Margo Thelen said the rules violated their constitutional right to freely exercise their Christian belief that life begins at fertilization.
U.S. District Judge Ronald Leighton ordered the state to stop enforcing the new rules against pharmacies or pharmacists who refuse to provide Plan B and instead refer patients to a nearby source.
Judge Wardlaw of the San Francisco-based appeals court overturned that ruling, saying the district judge had applied too strict a standard of review in deciding that the rules were neither justified by a compelling interest nor narrowly tailored.
A “neutral law of general applicability,” like the new rules at issue, need not have a compelling governmental interest, Wardlaw wrote.
The rules weren’t meant to target religious objections, the judge added, but were crafted “to eliminate all objections that do not ensure patient health, safety, and access to medication.”
Because the wrong standard of review was applied, the 9th Circuit concluded, the district court must reweigh the balance of hardships and reconsider the interests at stake.