The state's Pharmacy Examining Board acted correctly when it limited the license of a pharmacist who refused to refill a young woman's prescription for birth control pills because of his religious beliefs, the 3rd District Court of Appeals ruled today.

However, the board needs to reconsider charging the pharmacist the full cost of the disciplinary action, the ruling says.

The Barron County case pitted an individual's religion-based right to conscientious objection against the statutory obligations of a medical professional and drew international attention.

On July 6, 2002, a young woman went to the K-mart in Menomonie to fill her prescription for birth control pills. The pharmacist, Neil Noesen, asked if she intended to use the pills for contraception. When she said she did, he told her that filling it was against his religious beliefs. He refused to tell her how or where she could get the prescription filled.

Noesen was the only pharmacist working, and his supervisor was unable to come in to fill the prescription.

The woman took the prescription to a Wal-Mart pharmacy but when Noesen was called, he refused to transfer the prescription, later saying it would constitute participating in contraception.

The woman filed a complaint with the Department of Regulation and Licensing's Pharmacy Examining Board, and an administrative law judge heard the complaint.

The judge found that ordinary standard of care "requires that a pharmacist who exercises a conscientious objection to dispensing of a prescription must ensure that there is an alternative mechanism for the patient to receive his or her medication, including informing the patient of their options to obtain their prescription."

The administrative law judge went on to find that his conduct constituted "a danger to the health, welfare, or safety of a patient and has practiced in a manner which substantially departs from the standard of care of ordinarily exercised by a pharmacist and which harmed or could have harmed a patient."

The administrative law judge ordered that Noesen be reprimanded and that his license be limited by a requirement that he notify any pharmacy in writing and in detail of any practices he would decline and how he would ensure patient access to medication.

"He prevented all the efforts (the woman) made to obtain her medication elsewhere when he refused to complete the transfer and gave her no options for obtaining her legally prescribed medication elsewhere," the appellate court ruled in a decision written by Judge Michael Hoover. "The Board could therefore properly conclude that he violated a standard of care applicable to pharmacists."

While the board had the right to assess all or part of the costs of the disciplinary action, it should have looked at all relevant facts and applied the law before making the assessment. The appellate decision ordered the board to conduct a hearing on the costs.