On July 6, 2002, Neil Noesen found himself on the front line of the culture wars. Less than three days after taking a job as a pharmacist at a Kmart in Menomonie, Wisconsin, he received a refill request from University of Wisconsin-Stout student Amanda Renz for the contraceptive Loestrin.

Noesen, a devout Catholic, had always refused to dispense birth control. For six years previous, he had been willing to refer patients seeking contraception to another pharmacist, but a recent trip to Calcutta—where he realized anew that health care is about helping the suffering—had convicted him that this was wrong. "Finally, my conscience caught up to me," Noesen told CT. "I couldn't do it anymore. I felt like I was being used by the system, that I was becoming part of the problem rather than part of the solution."

Now back home in Wisconsin, he faced the first real test of his new policy. He told Renz he could not provide Loestrin.

The store's head pharmacist, who knew Noesen's concerns, had agreed to personally fill such prescriptions, but he was out of town for the weekend. Renz asked where else she could get the prescription filled. Noesen declined to tell her. Renz went to the local Wal-Mart, but when the pharmacist there attempted to transfer her prescription over the phone, Noesen refused.

The resulting deadlock put Noesen's name in newspapers around the country and brought the case to the attention of the Wisconsin Department of Regulation and Licensing (DRL). Though Noesen had violated no state law or administrative code, DRL's Pharmacy Examining Board looked into the matter. They found that Noesen was within his rights when he refused to fill the prescription, but that he had not served the public in a "minimally competent ...

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