Hearing: Freedom of Conscience for Small Pharmacies

House Small Business Committee
Washington, D.C. 25 July, 2005

Opening Statement of Chairman Donald A. Manzullo

Full Text

Good morning. It is my pleasure to welcome everyone to today's Small Business Committee hearing on the impact that "duty-to-fill" laws have on small pharmacies.

The subject before this Committee today deals with the negative impact on small pharmacies that operate under the strict law that requires pharmacists to fill all prescriptions - even if doing so violates their moral and professional beliefs. I also want to discuss alternatives that will ensure that women who want a certain prescription have access to it, while preserving the integrity of the pharmacist.

Many individuals become physicians, nurses, pharmacists, or other healthcare workers based on a deeply-held conviction of service to others.

Each of these individuals has a developed sense of conscience based on personal experience, individual ideology, religious beliefs, or cultural influences.

The primary debate surrounding this issue relates to a pharmacist's moral opposition to filling prescriptions for emergency contraception, also known as the "morning-after-pill." On April 1, 2005, Illinois Governor Rod Blagojevich issued an emergency rule that requires pharmacies in the state that sell contraceptives to fill all prescriptions for FDA-approved contraceptives "without delay." That rule is currently before the Joint Committee on Administrative Rules to determine whether it should become permanent. Several pharmacists have filed lawsuits challenging the rule, and one of those individuals is here today.

The right to refuse to participate in acts that conflict with an ethical or religious conviction is accepted as an essential element of a free society. But what happens when the government forces a business to violate those beliefs?

Many pharmacies in small communities may not have another pharmacist who can simply fill the prescription for the pharmacist with a moral objection. Nor can they easily transfer the prescription to another pharmacy nearby. Under the Illinois rule and proposed federal legislation, such pharmacy would be forced to order the product under their standard procedures for ordering other out-of-stock drugs, even if it violates their personal beliefs or professional standards.

This will not only violate the pharmacist's conscience, but may also be extremely costly for the business. Pharmacies do not stock every drug that is currently on the market for economic reasons. This rule could become very expensive for pharmacies that are forced to order the morning-after pill when they otherwise would not have.

So what happens if a pharmacy owner refuses to fill a prescription despite these new mandates? Many of the "duty-to-fill" requirements impose stiff penalties on pharmacies who continue to allow their pharmacists to exercise their conscience.

Pharmacies could be subject to fines or even suspension of their licenses. If a pharmacy shuts down, especially in a small community, such as Morrison, IL, and in many of the other rural areas I represent, other businesses will also be affected. If people have to go to the next town to pick up their prescriptions, they may fill up their gas tanks or buy groceries, as well. The entire community is affected if a pharmacy is forced to close its doors.

No one, least of all a health care provider, should be required to violate his or her conscience by participating in procedures that he or she deems harmful. The government should never force anyone to choose between his business or beliefs.

The purpose of this hearing is to explore the impacts that extreme "duty to fill" legislation will have on small pharmacies. I also hope to discuss alternatives that will ensure that women have access to medicine while preserving the beliefs of the pharmacist.

I look forward to the testimony of all of the witnesses this morning, and I turn to my colleague, the Ranking Member for her opening statement.

Witnesses

Mr. Luke Page Vander Bleek, R.Ph., Pharmacist,
Fitzgerald & Eggleston Pharmacies

Ms. Sheila Nix,
Senior Policy Advisor,
Office of Governor Blagojevich

Mr. J. Michael Patton,  M.S., CAE,
Executive Director,
Illinois Pharmacists Association

Ms. Linda Garrelts MacLean, R.Ph., CDE,
Clinical Assistant Professor of Pharmacotherapy,
Washington State University;

Ms. Megan Kelly