Kansas doctors not required to provide drugs that could end pregnancy

A new state law could imperil access not only to abortion-inducing medications but contraception as well, critics say.

By Alicia Gallegos — Posted May 28, 2012

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A new Kansas law will allow physicians and pharmacists to refuse to prescribe, dispense and make referrals for drugs they “reasonably believe” could terminate a pregnancy. Critics said the law restricts doctors’ ability to prescribe reliably for their patients and prevents women from obtaining such medications as conventional birth control and the morning-after pill. Supporters argued that the law is in line with past state statutes affording health professionals the right not to participate in abortions.

Kansans for Life, an anti-abortion organization that pushed for the measure, said the law means that physicians and pharmacists no longer have to fear discipline for acting in accordance with their religious and ethical beliefs.

“Kansans for Life targeted passage of the bill as a top priority, especially since the current federal climate is showing increased hostility to religious liberty and is pushing health care to include abortion without exclusions,” the group said on its website. At this article’s deadline, the organization had not returned messages seeking comment.

The law will be a detriment to women’s access to care in the largely rural state, said Peter Brownlie, president and CEO of Planned Parenthood, Kansas & Mid-Missouri.

Allowing a professional to refuse a referral to another who will help the patient “is a particularly problematic part of this law,” he said. “In some areas there are one or two pharmacists, and in some parts there is a shortage of doctors. Physicians have always had the ethical obligation not to participate in a medical treatment that they don’t feel comfortable about, but physicians have always had an obligation to refer someone to that service.”

The law also means physicians cannot be sure their patients receive the drugs they have prescribed, Brownlie added. “The perception is, if a person has a prescription from a licensed physician, that prescription will be honored by pharmacists.”

The law, which will go into effect in July, was signed by Kansas Gov. Sam Brownback in May. At this article’s deadline, Brownback’s office had not returned messages seeking comment.

The Kansas Medical Society did not take a formal position on the law, but the measure does not seem much different from existing statute, said Jerry Slaughter, the society’s executive director. “It doesn’t appear to change the underlying law that’s been in place for 25 years,” he said. “It’s not a ban on referrals. It just says you can’t be compelled to do it. That’s basically been our law.”

At least seven other states have similar measures. Arkansas, Georgia, Mississippi and South Dakota give pharmacists the right to refuse dispensing emergency contraceptives. Florida, Maine and Tennessee provide similar refusal measures to health professionals and do not specifically single out pharmacists.

The Kansas law states: “No person shall be required to perform, refer for or participate in medical procedures or in the prescription or administration of any device or drug which result in the termination of a pregnancy or an effect of which the person reasonably believes may result in the termination of a pregnancy.” No medical care facility or administrator may discipline a health professional because he or she refuses to perform or participate in a pregnancy’s termination, according to the law.

Brownlie, of Planned Parenthood, said the organization is considering its legal options against the measure.

Meanwhile, an Oklahoma judge on May 11 struck down a state law that would have limited medication-induced abortions. That measure, which was enacted in 2011, required facilities that perform abortions to use only abortion-inducing medication that was tested and approved by the Food and Drug Administration.

Critics said the Oklahoma law would have restricted access to care because it prevented off-label uses of drugs such as misoprostol. The ulcer medication is commonly used in combination with mifepristone — an abortion-inducing drug — to end a pregnancy, according to the Center for Reproductive Rights, which advocates for abortion rights and was a plaintiff in the lawsuit. As part of the law, prescribing misoprostol for different conditions than those for which the drug initially was approved would have been illegal.

In his opinion, Oklahoma County District Judge Donald Worthington called the law unconstitutional and said it violates the privacy and bodily integrity of women. Enforcement of the law, set to go into effect in November 2011, had been halted by an injunction since October 2011.

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