Imagine walking into your pharmacy, handing over your prescription and having it denied. Now imagine that the reason is not insufficient insurance coverage or the wrong dose, but a pharmacist who personally objects to your medication. What right does a pharmacist have to make moral decisions for their patients?

Lawmakers have wrestled with this question for decades. It reemerged in August 2025 when two pharmacists sued Walgreens and the Minnesota Board of Pharmacy, saying they had been punished after refusing to dispense gender-affirming care medications that go against their religious beliefs.

According to the pharmacists, Walgreens refused their requests for a formal religious accommodation, citing state law. One pharmacist had her hours reduced; the other was let go. If Minnesota law does not allow such an accommodation, their lawsuit argues, it violates religious freedom rights.

As a sociologist of law and medicine, I’ve spent the past 20 years studying how pharmacists grapple with tensions between their personal beliefs and employers’ demands. Framing the problem as a tension between religious freedom and patients’ rights is only one approach. Debates about pharmacists’ discretion over what they dispense also raise bigger questions about professional rights – and responsibilities.

The most famous controversy, perhaps, dealt with contraception. In the early 2000s, some pharmacists refused to dispense Plan B, also known as “emergency contraception” or the “morning-after pill.” Their refusal stemmed from a belief that it caused an abortion.

That is inaccurate, according to medical authorities. When Plan B first became available in 1999, the label said the medication might work by expelling an egg that had already been fertilized. In 2022, the Food and Drug Administration relabeled Plan B to say that it acts before fertilization. From a medical perspective, both mechanisms are contraception, not abortion.

States responded to pharmacists’........

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