California
2023 California Code | Business and Professions Code - BPC | Division 2 - Healing Arts | Chapter 1 - General Provisions | Article 10.5 - Unprofessional Conduct § 733
Note: The law includes some protection for "licentiates" (presumably individual pharmacists employed in a pharmacy they do not own) who decline to fill a prescription for reasons of conscience, inasmuch as it exempts them from the requirement to fill the prescription if they have notified their employer in advance, in writing, and the employer arranges to accommodate their objections and patients' requests for service.
"Licentiates" (presumably pharmacy owners) who decline to stock some drugs or devices for reasons of conscience are required to ensure that prescriptions for them are returned to patients and that they make "a reasonable effort" to ensure that patients are "referred" to a nearby pharmacy where they can obtain the drugs or devices. Some owners may be unwilling to direct a patient to a specific known provider because of concern that they would thereby become morally culpable for assisting in what they believe to be wrongful activity. They might be willing to provide patients with addresses and contact information of all pharmacies in the immediate vicinity.
Note that the law grants absolute protection of the economic interests of pharmacists by allowing them to refuse to provide even the most necessary drugs or devices if they are not paid for them. [Administrator]
CA Bus & Prof Code § 733 (2023)
733. (a) A licentiate shall not obstruct a patient in obtaining a prescription drug or device that has been legally prescribed or ordered for that patient. A violation of this section constitutes unprofessional conduct by the licentiate and shall subject the licentiate to disciplinary or administrative action by his or her licensing agency.
(b) Notwithstanding any other law, a licentiate shall dispense drugs and devices, as described in subdivision (a) of Section 4024, pursuant to a lawful order or prescription unless one of the following circumstances exists:
(1) Based solely on the licentiate’s professional training and judgment, dispensing pursuant to the order or the prescription is contrary to law, or the licentiate determines that the prescribed drug or device would cause a harmful drug interaction or would otherwise adversely affect the patient’s medical condition.
(2) The prescription drug or device is not in stock. If an order, other than an order described in Section 4019, or prescription cannot be dispensed because the drug or device is not in stock, the licentiate shall take one of the following actions:
(A) Immediately notify the patient and arrange for the drug or device to be delivered to the site or directly to the patient in a timely manner.
(B) Promptly transfer the prescription to another pharmacy known to stock the prescription drug or device that is near enough to the site from which the prescription or order is transferred, to ensure the patient has timely access to the drug or device.
(C) Return the prescription to the patient and refer the patient. The licentiate shall make a reasonable effort to refer the patient to a pharmacy that stocks the prescription drug or device that is near enough to the referring site to ensure that the patient has timely access to the drug or device.
(3) The licentiate refuses on ethical, moral, or religious grounds to dispense a drug or device pursuant to an order or prescription. A licentiate may decline to dispense a prescription drug or device on this basis only if the licentiate has previously notified his or her employer, in writing, of the drug or class of drugs to which he or she objects, and the licentiate’s employer can, without creating undue hardship, provide a reasonable accommodation of the licentiate’s objection. The licentiate’s employer shall establish protocols that ensure that the patient has timely access to the prescribed drug or device despite the licentiate’s refusal to dispense the prescription or order. For purposes of this section, “reasonable accommodation” and “undue hardship” shall have the same meaning as applied to those terms pursuant to subdivision (l) of Section 12940 of the Government Code.
(c) For the purposes of this section, “prescription drug or device” has the same meaning as the definition in Section 4022.
(d) This section applies to emergency contraception drug therapy and self-administered hormonal contraceptives described in Section 4052.3.
(e) This section imposes no duty on a licentiate to dispense a drug or device pursuant to a prescription or order without payment for the drug or device, including payment directly by the patient or through a third-party payer accepted by the licentiate or payment of any required copayment by the patient.
(f) The notice to consumers required by Section 4122 shall include a statement that describes patients’ rights relative to the requirements of this section.