CHEYENNE - Victims of AIDS could face discrimination under a proposed rule that would allow Wyoming pharmacists to refuse to fill prescriptions amid moral objections, an advocate for HIV and AIDS patients said Tuesday.

"It is so broad, that any pharmacist with any personal belief that is contrary to any particular drug is allowed to refuse to fill a legal prescription," said Pamela Reamer Williams, director of the Casper-based Wyoming AIDS Project. "Health care professionals are supposed to help. They're not supposed to judge."

The proposed change will be discussed by the Wyoming Board of Pharmacy at 9 a.m. Oct. 5 at Teton Mountain Lodge in Teton Village.

A board official said the goal is to give the panel more clout to discipline pharmacists who refuse to help patients, but some lawmakers question whether the board is headed in the right direction.

Pharmacists are currently allowed to intervene if they think a prescription may harm a patient or if the patient is being overmedicated. But Wyoming law is silent on moral conflicts.

Some states require pharmacists to fill all valid prescriptions, while others allow refusal for personal reasons. About a dozen are considering legislation one way or the other.

The Wyoming rule would be amended to allow a pharmacist to refuse to dispense a drug based on moral beliefs providing other options are available such as transferring the prescription to another pharmacy.

Reamer Williams fears individuals seeking to fill prescriptions for AIDS may be turned away because of bias that the person may be gay or a drug abuser.

"It's no secret to any of us that there are people in this state who have religious and moral objections to homosexuality, and it's not just homosexuals in this state or anywhere else that are living with AIDS," she said. "Some of these are people who never shot drugs, never had sex outside of marriage, did absolutely everything that was the moral way to behave, and they still ended up with HIV."

In some states, pharmacists have refused to fill prescriptions for morning-after or birth-control pills. Reamer Williams said the list could include objections to dispensing Ritalin to hyperactive children, antabuse to alcoholics, anti-depressants, female hormones or numerous other controversial drugs.

She also said the change could cause problems in Wyoming's small towns - some which have only one pharmacy.

"If somebody in a small town is refused their medication and they have to drive 80 to 100 miles on bad tires in the snow, who's responsible for putting that person at risk?" she said.

Jim Carder, executive director of the pharmacy board, said the goal is to protect patients, not give pharmacists more leeway.

"If a pharmacist refused to fill the prescription, tore up the prescription or preached to the patient, there's really not a clear method for the board to deal with the situation," he said. "By drafting this rule, we're going to require steps be taken if they are going to refuse to fill the prescription."

He said he has received "a lot of comments, most of them negative" and acknowledged Wyoming's rural nature is "certainly an issue."

"I think we'll be able to protect those in a small town," he said.

Sen. Charles Scott, R-Casper, chairman of the Senate Labor, Health and Social Services Committee, said the board might be wading into rough waters.

"It strikes me that they best leave that one alone, because I suspect what it is aimed at in particular is some of the contraceptive drugs - and that's really none of their business," he said.

Allowing pharmacists to withhold drugs on moral grounds "has potential for some mischief," he said, such as not dispensing painkillers to terminally ill patients who may be strongly addicted to the drugs.

On the other hand, Scott said, it might be difficult to require pharmacists to dispense all medications because some pharmacists might not stock a drug because of a low volume of sales.

"How do you separate the business decisions from the ones based on religious beliefs?" he said. "You can't."

Rep. Jane Warren, D-Laramie, sent a letter to the board expressing her concerns, including that the rule might create a barrier to access. She is also concerned that some patients might be too embarrassed to visit another pharmacist.

"It puts a personal relationship between a pharmacist and a patient," she said. "It makes the personal relationship an issue."

Carder acknowledges that the proposal is "real touchy" but hopes the Legislature does not create a law mandating that every prescription be dispensed.

"That would take away the flexibility of the pharmacist to work with a patient," he said. For example, the pharmacist might want to contact the doctor to seek a different medication.

Addressing criticism about the location of the Oct. 5 meeting, Carder said it was scheduled in Teton Village to coincide with a district meeting involving other pharmacy boards and pharmacy college officials hosted by Wyoming.

Capital bureau reporter Robert W. Black can be reached at (307) 632-1244 or robert.black@casperstartribune.net.