MYTHS & FACTS ABOUT PHARMACY IN WASHINGTON By C.J. Kahler, R.Ph. MYTH: There is a health crisis in Washington because patients are unable to get needed prescriptions filled if a pharmacist refuses to fill them for conscience reasons. FACT: There is no health crisis surrounding the issue of access to needed medication by citizens of Washington. The issue is politically motivated by certain advocacy groups that want to strengthen state regulation with the aim of increasing access to post-coital medical care and removing any barriers  perceived or real  that might limit that access. Of the over 75,000,000 annual prescriptions that Washington community pharmacists dispense, I have heard of only four instances in which a pharmacist refused to fill a prescription for a Washington resident  hardly a problem which demands that a new rule be added to the over 350 pages that already exist. MYTH: The pharmacists of Washington are placing their ethical beliefs ahead of their patients’ needs. FACT: To the contrary, the WSPA supports the ability of a pharmacist to excuse him/herself from certain activities, much the same way doctors, nurses and other health professionals excuse themselves. But in contrast to the approach taken by other healthcare professionals, the WSPA’s endorsement of the ability to 'step away' comes with an additional task  the establishment of alternative systems to ensure that the patient gets clinically safe, legally prescribed therapy. This duty is entirely in keeping with the Pharmacists’ Code of Ethics and forms the bedrock of our accountability to individual patients. MYTH: Washington law makes it clear that pharmacists must dispense contraceptives. FACT: There is NO law in Washington that requires a pharmacist to dispense contraceptives. On the contrary, Washington law clearly provides that "no individual health care provider. . .may be required by law or contract in any circumstances to participate in the provision of. . .a specific service if they object to so doing by reason of conscience or religion." These statutes were enacted by the legislature and are found in the Revised Code of Washington at 48.43.065(2) and at RCW 70.47.160(2). Pharmacists are regarded as "health care providers" under Washington law. Like other health care providers, pharmacists have the right to exercise their conscience, and may not be required to provide services to which they have a conscientious objection. Any rule adopted by the Washington State Board of Pharmacy must be consistent with Washington statutes and must therefore recognize a pharmacist’s conscience rights. MYTH: Pharmacists in Washington are robots and must dispense all prescriptions presented to them regardless of their belief system. FACT: Contemporary pharmacy practice has evolved to today’s practice standard that pharmacists fulfill a duty to their patients when providing prescription medications and medication therapy management services. Pharmacists take comprehensive medication histories, including the patient’s drug allergy and medication experience, and in some situations help the patient and their physician develop and implement a medication action plan. In more than 40 states, pharmacists and physicians collaborate to adjust and, in some cases, initiate medication therapy. In nine states, pharmacists are explicitly authorized to both prescribe and dispense emergency contraception in collaboration with a physician. Physicians expect pharmacists to intervene when prescriptions contain obvious dosing errors or pose a risk of interacting with other drugs. Pharmacists work with patients every day, helping them understand medications. A system that requires pharmacists to check their personal beliefs at the door compromises their ability to work with patients to make the best use of prescription and over-the-counter medications. In addition, the constitution of Washington Article 1, Section 11 reads " Absolute freedom of conscience in all matters of religious sentiment, belief and worship, shall be guaranteed to every individual, and no one shall be molested or disturbed in person or property on account of religion; …"