Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude

Missouri Senate Bill 458 Threatens Pharmacists

Missouri, USA (February, 2005)

Sean Murphy*

The following bill introduced in the Missouri Senate would require pharmacists to notify employers in advance of prescriptions they would be unwilling to fill for reasons of conscience.  This is a reasonable expectation that is normally possible to fufil. Notifying an employer would be necessary in any event if a pharmacist were seeking accommodation of religious or moral convictions, and giving advance notice makes it possible to work out arrangements to accommodate pharmacists, avoid awkward or difficult situations and  minimize inconvenience for patients.  The additional requirement that pharmacists treat patients respectfully reflects what ought to be the norm in any situation.

However, the bill would also impose a default requirement that objecting pharmacists fill prescriptions for morally contested products, unless they can be accommodated "without undue hardship to the employer or customers."  This reverses the onus characteristic of such legislation, which typically makes accommodation the default position.  Further, the bill requires the meaning of "undue hardship" to be so broadly construed as to enable the suppression of freedom of conscience and religion by intolerant employers or customers.



Read 1st time February 28, 2005, and ordered printed.


To amend chapter 338, RSMo, by adding thereto one new section relating to the duty of a pharmacist to fill prescriptions.

Be it enacted by the General Assembly of the State of Missouri, as follows

Section A. Chapter 338, RSMo, is amended by adding thereto one new section, to be known as section 338.012, to read as follows

338.012. 1. Pharmacists have a duty to fill all lawful prescriptions properly. If a pharmacist holds sincere religious beliefs that are inconsistent with filling any lawful prescription, such pharmacist shall:

(1) Notify his or her employer or prospective employer in writing as soon as possible of the prescriptions he or she refuses to fill; and

(2) Fill the prescription unless his or her employer can accommodate the pharmacist's belief without undue hardship to the employer or customers.

2. For purposes of this section the following factors should be considered in determining what constitutes an undue hardship:

(1) The need of the customer to have the prescription filled in the equivalent time period as the pharmacy is filling other prescriptions of in-stock medications or devices at the time such an accommodation would be made;

(2) The financial cost of implementing such an accommodation; and

(3) The effect such an accommodation would have on an employer's reputation or good will in the community.

3. A pharmacist has a duty to treat each customer in a non-judgmental manner and ensure that each customer is not subjected to indignity, humiliation, breaches of confidentiality, or pressure to fill or not to fill the prescription, regardless of whether an accommodation has been implemented under subdivision (2) of subsection 1 of this section.

4. Violation of the provisions of this section shall subject the license of the pharmacist to disciplinary action under section 338.055.

5. A person or governmental entity who believes that a violation of this section exists may make an allegation of that fact to the board in writing.