Access to Prescription Drugs: A Normative Economic Approach to Pharmacist Conscience Clause Legislation

Over the past several years, many states introduced legislation that protects a pharmacist’s decision to refuse to fill a prescription. Termed “conscience clauses,” these pieces of legislation allow a pharmacist to refuse to fill a prescription because of moral or religious objections without fear of legal repercussions. In 2006, for example, twenty-one states considered legislation that permits pharmacists to refuse to fill prescriptions; some bills focus on contraception alone, while others are not specific to any one type of medication. Arkansas, Mississippi, Georgia, Florida, and South Dakota have state laws that provide legal protection to pharmacists who refuse to fill prescriptions. Alternatively, Illinois, Massachusetts, and North Carolina have duty-to-fill laws that do not afford legal protection to pharmacists that refuse to fill prescriptions due to personal beliefs. The goals of this Article are two-fold: (1) to explain that pharmacist conscience clause legislation may be expanded to areas concerning controversial biomedical research; and (2) to demonstrate that welfare economics can be applied to analyze pharmacist conscience clause legislation. Regarding the first goal, the broad language of existing and proposed conscience clause legislation creates an umbrella that allows a pharmacist to escape liability for refusing to fill a prescription for almost any type of medication. With respect to the second goal, this Article applies welfare economics to demonstrate that pharmacist conscience clauses are a part of tort law and can be analyzed as such to determine whether social welfare is maximized