Pharmacist faces discipline for refusal to transfer script

A Wisconsin judge has recommended a reprimand and remedial ethics classes for a pharmacist who refused to transfer a prescription for oral contraceptives based on his religious beliefs.

Administrative Law Judge Colleen Baird recommended that Neil Noesen be reprimanded and required to complete at least six hours of continuing education in pharmacy practice ethics for his refusal to dispense an OC refill or transfer the script for a University of Wisconsin coed (Drug Topics, Feb. 23, 2004). She also recommended that prior to providing services at any pharmacy, he must prepare a written notification spelling out in detail any services he would not provide and the steps he will take to ensure a patient's access to the prescribed medications. The notification must include a copy of her order. She also recommended that he pay the full cost of the proceedings, which included two days of hearings last fall.

"This case is about following professional standards in the exercise of one's conscience," wrote Baird in her 24-page proposed order. "This he failed to do. The discipline recommended in this order is a consequence of [Noesen's] failure to act as a professional. He is not being sanctioned for exercising his conscience. Rather, he is being held accountable, as would any other registered pharmacist, for engaging in a practice that departed from the standards of care that govern his profession. He did not even acknowledge that he had caused or could have caused harm to a patient."

Noesen, who has become a rallying point for anti-abortion groups supporting conscience-clause legislation, declined to comment on the judge's proposal. He referred all questions to his attorney, who did not respond to requests for comment.

The judge's proposal is "stupid," said Karen Brauer, hospital pharmacist and president of Pharmacists for Life International. "If this precedent were followed consistently, it would make every pharmacist financially liable even if no harm occurs from a decision. Neil would be effectively fined for the cost of proceedings outside his control for a decision that caused no harm to that woman. The judge is telling him that he has to see that a woman can get this drug. This is not a requirement for any other health professionals. I think this standard is never applied to drugs for healing but only to the sacred-cow birth control drugs. If the standard were applied to all drugs, no pharmacist could practice. It's the judge, not Neil Noesen, who needs ethics training."

At the other end of the spectrum, the judge's decision did not sit well with four Wisconsin legislators, who feel that the discipline proposed for Noesen "falls far short of the penalty that should be imposed." Expressing "outrage" over the pharmacist's behavior in a letter to the pharmacy board, they urged the members to consider suspending his license. "A pharmacist may object to filling a prescription as long as there are other options available for the seamless delivery of medication," the letter said. "The refusal to transfer the prescription in this case became an act of theft itself."