Target Corporation: Pharmacists' Acts of Conscience and the "Plan B" Pill
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06-11
Target Corporation:
Pharmacists’ Acts of Conscience and the “Plan B” Pill
On a humid and cloudy day in late September 2005, Rachel Pourchot entered a bright, clean, air-
conditioned Target store in Fenton, Missouri. She intended to fill prescriptions for Ortho Tri-
Cyclen, a common hormonal contraceptive, and for Levonorgestrel, an emergency contraceptive
otherwise known as the Plan B pill. Despite Target’s reputation for efficiency, diversity, and
friendly service, Pourchot told the Planned Parenthood Federation of America (PPF) that she left
the store without the emergency contraceptive. The Target pharmacist, she claims, had rudely
refused to fill her prescription on moral and religious grounds. PPF immediately contacted
Target Corporation for comment.1 A spokesperson initially denied Pourchot’s account of events,
and, according to PPF, declined to clearly state the company’s policy concerning pharmacists’
right to refuse. PPF launched a letter writing campaign that led over 60,000 supporters to contact
Target. For many, the incident cast doubt on the company’s reputation as a non-discriminatory,
impartial, and friendly company.2
Target Corporation
The Dayton Corporation opened the first Target store in Roseville, Minnesota in 1963. The
corporation had long been notable for its policy of giving five percent of its pretax profits back to
the community.3 In 1969, the Dayton Corporation merged with the J. L. Hudson Company. Over
the next four decades, Target stores would become the Dayton Hudson Corporation’s largest
source of revenue, allowing it to purchase Mervyn’s and Marshall Fields. By 1978, Target was
the nation’s 7th largest retailer.
In 2000, the Dayton Hudson Corporation was renamed the Target Corporation. It is currently
headquartered in Minnesota and has 1,300 stores in 47 states, including 140 SuperTarget stores,
which introduced upscale grocery shopping Target customers. In addition to the expansion into
This case was prepared by Research Assistants Joshua L. Cox and Katherine M. Berry under the direction of James
S. O’Rourke, Concurrent Professor of Management, as the basis for class discussion rather than to illustrate either
effective or ineffective handling of an administrative situation. Information was gathered from corporate as well as
public sources.
Copyright ©2006. Eugene D. Fanning Center for Business Communication. All rights reserved. No part of this
publication may be reproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form by any
means – electronic, mechanical, photocopying, recording, or otherwise – without permission.grocery goods, the company has matched growing consumer demand for convenience by
launching its bridal registry and gift card divisions. Besides one-stop-shop convenience, aisles
are well-organized, products are attractive and stores are always clean. Thus, as Target has
evolved, it has earned the reputation of being a no-hassle, friendly, and easy place to do everyday
shopping. It boasts the most rapid revenue growth in the industry and, with a market
capitalization of over $48 billion, provides Wal-Mart, the world’s largest retailer, with a
significant source of competition.
Plan B Pharmaceuticals
The Plan B pill is a large dose of the hormone Levonorgestrel (synthetic progestin).4 Progestin is
a naturally occurring hormone in the human body that plays an important role in regulating a
woman’s menstrual cycle and uterine environment. The hormone has been available for decades
in traditional birth control pills, though in smaller, more regular doses. The drug is manufactured
and distributed in the United States by Duramed, a division of Barr Pharmaceuticals, Inc.
When taken within 72 hours of sexual intercourse, Levonorgestrel will reduce the risk of
pregnancy by 89 percent by stopping ovulation, or, if ovulation has already occurred, by
preventing the implantation of a fertilized egg. Patients are normally instructed to take one .75
mg tablet as soon as possible, followed by a second tablet 12 hours later. It is important to note
that the drug is most effective when taken immediately, and becomes much less effective after
the first 72 hours.5
The Plan B pill is often confused with RU-486, or mifepristone, sometimes called the
“abortion pill.” Mifepristone was first made available to European women in 1988, though
political and scientific controversy delayed its approval for sale in the United States until 2000.6
Also a synthetic hormone, mifepristone is classified as an abortifacient rather than a
contraceptive. When taken during the first seven weeks of pregnancy, the drug is intended to
terminate pregnancy. In contrast to mifepristone, the Plan B pill will not terminate an established
pregnancy or cause any harm to a developing fetus.7
Not everyone involved in the nation’s abortion debate recognizes a distinction between
emergency contraceptives and abortifacients. The controversy came into focus on May 6, 2004,
when the FDA rejected Duramed’s application to make the drug available over-the-counter. Dr.
David Hager, a gynecologist from Lexington, Kentucky, testified before the FDA committee
considering the proposal. Dr. Hager refuses to prescribe the pill to his patients because he
believes that the drug’s effects constitute chemical abortion. Though he concurs with FDA
studies that no deaths, heart attacks, or strokes, associated with the drug, Dr. Hager expressed
concern that young girls would misuse the drug.8
For only the second time in 50 years, FDA administrators overruled its advisory panel’s
recommendation that the drug be approved for over-the-counter sale.9 An FDA spokesperson
stated that the application was rejected for scientific, not moral or religious reasons. Critics,
2however, pointed to a letter writing campaign by a group of conservative members of congress
that encouraged the FDA to oppose the application. On the other side of the aisle, senators who
support making Plan B more easily available have been delayed the confirmation of the FDA
Commissioner Lester Crawford.10 To contribute to the fury, the director of the FDA’s Office of
Women’s Health resigned in protest over the decision.11
Target Policy and Response
Provoked by outside players like Planned Parenthood, Target was forced to define and publicly
express a clear policy. Target announced that pharmacists have the right to refuse to fill a
prescription if doing so would be counter to their moral or religious convictions. Nonetheless,
the company stated, pharmacists must also sign a “conscience policy” that requires them to help
customers get their medications in a timely manner by referring them to another pharmacist on
duty or to another pharmacy.
Reaction to this policy was mixed. Planned Parenthood applauded Target’s commitment
to ensuring that prescriptions be filled, but expressed concern that refusals could cause delays
that would interfere with qualified medical treatment and possibly make the medication less
effective. This, critics argue, would be of particular concern in areas where there is no other
pharmacy nearby. “Timeliness,” in other words, was left open to interpretation. In a panel
interview on National Public Radio, a target spokeswoman responded to a Planned Parenthood
spokeswoman: “Most Targets are in metropolitan, suburban or urban areas, so, you know, there's
very likely to be another pharmacy very close by.”12
Target has also been pressed for clarification about how broadly applicable pharmacists’
right of refusal should be. While the corporation states that it is required by the 1964 Civil
Rights Act to make “reasonable accommodations for their employees' religious beliefs,” the
corporate policy applies only to the Plan B drug. Pharmacists are not allowed to refuse
prescriptions for any other medications.13
If strongly held moral beliefs and made this issue complicated for target to navigate,
differences in state laws have made the problem almost intractable. In fact, state law typically
determines the balance between pharmacists’ and consumers’ rights and some states take very
different approaches than others. Legislative directives about pharmacists’ rights in Missouri, for
example, were in many ways opposite those in neighboring Illinois. State laws complicate
Target’s response and its competitors’ responses.
Walgreen’s in Illinois
The American Center for Law and Justice (ACLJ) is currently representing 4 pharmacists who
were terminated at an Illinois Walgreen’s after failing to fill prescriptions for Plan B. Defending
the "Healthcare Right of Conscience Act", the ACLJ claims that the pharmacists have a right to
refuse based on moral grounds. While this law does support the pharmacists’ actions, it also
3stipulates that the pharmacy must ensure that prescriptions be filled in a timely manner through a
referral.14 At first glance the Missouri and Illinois laws appear identical, but they differ in their
definitions of “timely manner” and of “referral.”
In Missouri, the law allows a pharmacist to refer a customer to a different nearby
pharmacy.15 In Illinois, the pharmacist must refer the customer to another professional within
that pharmacy, unless the customer specifically requests a referral to a different pharmacy.
Furthermore, Illinois defines “timely” as about 45 minutes, the average time it takes to fill a
typical (not necessarily emergency contraception) prescription. Missouri law, on the other hand,
doesn’t specify a maximum delay. A pharmacist may refuse to fill a prescription without regard
to the delay it will cause the customer, and the pharmacy is not compelled to ensure that the
prescription is filled. In Illinois, the pharmacists’ rights are protected only insofar as they do not
exacerbate the time constraint for the customer.16
Wal-Mart in Massachusetts
Historically, Wal-Mart has managed to skirt the emergency contraception controversy by refusing
to stock the drug. Increased public attention to corporations’ policies on the matter, however, has
left few companies unprovoked. On February 1st, 3 women filed a lawsuit against Wal-Mart for
not stocking Plan B in its pharmacies. Technically, all Massachusetts pharmacies are required by
law to carry all “commonly prescribed medicine” that the community needs. Wal-Mart’s policy
was legally viable only if Plan B could be considered unnecessary or uncommonly prescribed.
However, on February 14th, the state addressed the legal technicality and required Wal-Mart to
stock Plan B in all pharmacies. Wal-Mart complied immediately and company officials say the
retailer is considering stocking the drug nationwide, though there is no indication that the policy
has changed yet.17
Current Situation
In a lawsuit unrelated to Rachel Pourchot’s case, Target is currently being sued by a Missouri
pharmacist, Heather Williams, under the Federal Equal Opportunity Employment Commision.
Williams refused to sign the company’s “conscience policy” and argues that her rights were
violated when she was fired. A Chicago-based anti-abortion group, Americans United for Life,
claims that the termination occurred because Planned Parenthood threatened a boycott of Target
stores. Planned Parenthood has vehemently denied any involvement in the matter and denies
having planned or threatened a boycott. As of January 26, 2006 Target had not returned calls to
the Associated Press.18
Target will continue to face public scrutiny as public expects the corporation to take a
side in the debate over pharmacists’ right to refuse and the consumers’ right to have a
prescription filled without delay. Complicating matters further, the corporate strategy will have
to differ across state lines, which will likely create issues over how accurately Target's corporate
values are portrayed in the media.
4Questions
1. Can Target craft and maintain an image of neutrality in this national debate? If not, how
should they decide their position?
2. How likely is Target to suffer significant loss of revenue because of Plan B? What
consumer group will be the most likely cause for revenue leakage?
3. How important is it to articulate a consistent, clear policy on accommodating
pharmacists’ beliefs?
4. Is a consistent policy even possible in the context of many contradictory state laws? How
can Target communicate this complexity without appearing indecisive?
5. What is the likely effect of the controversy on employees’ image of the company?
6. How should Target respond to Heather Williams’ Federal complaint?
5References
1
Stevens, Allison. “Target at Center of Battle Over Plan B,” Women’s eNews,
http://www.womensenews.org/article.cfm/dyn/aid/2602/context/cover/, January 15, 2006.
2
Planned Parenthood® Federation of America, Inc Press Release “Target's Pharmacist Refusal Policy,”
http://www.plannedparenthood.org/pp2/portal/files/portal/media/pressreleases/pr-051117-target.xml November 17,
2005. See also SaveRoe.com, a Planned Parenthood website, http://www.saveroe.com/node/1714.
3
Target Corporation., “Corporate History and Timeline,”
http://sites.target.com/images/corporate/about/pdfs/target_history_timeline.pdf
4
Plan B consumer homepage: http://www.go2planb.com/ForConsumers/Index.aspx
5
Ibid.
6
http://en.wikipedia.org/wiki/Mifepristone
7
Emergency Contraception, National Guideline Clearinghouse,
http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=8143&nbr=4536
8
60 Minutes, “The Debate over Plan B” CBS News.
http://www.cbsnews.com/stories/2005/11/22/60minutes/main1068924_page2.shtml, November 27, 2005
9
Kaufman, Mark. “Memo May Have Swayed Plan B Ruling, ” The Washington Post, May 12, 2005
http://www.washingtonpost.com/wp-dyn/content/article/2005/05/11/AR2005051101812.html
10
Schor, Elena. “Crawford nomination stalls in Senate over Plan B delay,” The Hill
http://www.hillnews.com/thehill/export/TheHill/News/TheExecutive/061605.html, June 16, 2005.
11
Rubin, Rita. “FDA official quits over Plan B pill delay”, USA Today
http://www.usatoday.com/news/washington/2005-08-31-fda-official-quits_x.htm, August 31, 2005.
12
National Public Radio, Day to Day, November 18, 2005
13
Ibid.
14
Pierce, Olga. “Plan B: W algreens pharmacist flap dissected,” United Press International,
http://www.upi.com/HealthBusiness/view.php?StoryID=20060201-033743-9067r, February 1, 2006.
15
State of Missouri W ebsite. “Healthcare Right of Conscience Act,”
http://www.house.mo.gov/bills061/bilsum/commit/sHB1539C.htm.
16
ABC News. “Pharmacists Suspended for Refusing to Dispense ‘Morning After Pill.’”
http://abcnews.go.com/Health/story?id=1391310, December 12, 2005.
17
CNN.com, “W omen sue W al-Mart over contraception,”
http://www.cnn.com/2006/LAW /02/01/walmart.contraception.ap/, February 1, 2006.
18
Salter, Jim. “Mo. pharmacist fired for refusing to dispense morning-after pill.” The Associated Press State & Local
Wire. January 26, 2006.
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