2012 IL App (4th) 110398
Ill. App. Ct.2012Background
- Plaintiffs, two pharmacists and three pharmacy-owning corporations, seek declaratory and injunctive relief against officials enforcing a rule requiring dispensing of emergency contraception.
- Plaintiffs contend emergency contraception may be abortifacient and conflicts with religious/conscience beliefs; corporate plaintiffs cite ethical guidelines against dispensing such drugs.
- The rule at issue, Current Rule, applies to all FDA-approved medications (not just emergency contraception) and does not list conscience-based exemptions.
- Plaintiffs allege the Current Rule violates the Conscience Act, the Religious Freedom Restoration Act, and the First Amendment free exercise clause.
- The circuit court found sincere religious beliefs and permanently enjoined enforcement of the rule against plaintiffs; defendants appeal as to breadth and constitutionality.
- Historical background: Emergency Rule (2005) and Second Permanent Rule (2008) preceded the Current Rule (2010), with later amendments addressing emergency contraception logistics.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does Current Rule violate the Conscience Act as applied to plaintiffs? | Vander Bleek and Kosirog contend the rule burdens conscience rights. | Quinn argues the Act does not bar enforcement against these plaintiffs. | Conscience Act prohibits enforcement against these plaintiffs. |
| Is the Conscience Act applicable to pharmacists and pharmacies as health-care facilities or personnel? | Act covers medication provision by pharmacies, not just physicians. | Act limits to health-care personnel or facilities as defined. | Act applies to pharmacies and pharmacists; they are health-care personnel/facilities. |
| Is the injunction against enforcement overly broad given the Conscience Act protections? | Injunction should be expansive to bars enforcement against all objecting entities. | Injunction should be limited to the named plaintiffs and conform to the Act. | Injunction is overly broad and modified to apply only to plaintiffs. |
| Do emergency contraceptives fall within emergency medical care under the Conscience Act? | Emergency contraception is urgent care and protected. | Emergency contraceptives do not constitute emergency medical care. | Emergency contraceptives do not constitute emergency medical care under the Act. |
| Does the Current Rule survive the Conscience Act and related religious freedom concerns on the merits? | Rule violates conscience-based rights and free exercise. | Rule is neutral and promotes broad access to medications. | Conscience Act prohibits enforcement against plaintiffs; merits reviewed but limited to that scope. |
Key Cases Cited
- Morr-Fitz, Inc. v. Blagojevich, 231 Ill. 2d 474 (Illinois Supreme Court 2008) (conscience and religious freedom challenges to pharmacy rule; ripeness and injunctive relief discussed)
- Vandersand v. Wal-Mart Stores, Inc., 525 F. Supp. 2d 1052 (C.D. Ill. 2007) (pharmacist protected by Conscience Act for refusing to dispense emergency contraception)
- Stormans, Inc. v. Selecky, 586 F.3d 1109 (9th Cir. 2009) (broad access rules against religious objections; context for injunctive relief standard)
- Gaffney v. Bd. of Trustees of Orland Fire Prot. Dist., 2012 IL 110012 (Illinois Supreme Court 2012) (defines 'emergency' for statutory interpretation under public safety benefits act)
- Holtkamp Trucking Co. v. David J. Fletcher, M.D., L.L.C., 402 Ill. App. 3d 1109 (Illinois App. Ct. 2010) (statutory conflict resolution when administrative rule conflicts with statute)