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prescription-refusal-to-fill

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Handle a prescription you are not going to dispense — the professional judgement recorded, the patient conversation, the prescriber contact, and the continuity of care that stops a refusal becoming abandonment. Use when asked how to refuse to fill a prescription, decline to dispense, handle a suspected forgery or early refill, or document a corresponding-responsibility decision. Produces the decision record, the conversation script, the prescriber contact, the continuity step, and the escalation path. Legal obligations vary by jurisdiction; verify yours.

plugins/pm-pharmacy/skills/prescription-refusal-to-fill/SKILL.md

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# Declining to Dispense

Refusing to dispense is one of the few things a pharmacist does that is simultaneously a clinical act, a legal act, and a deeply personal moment for the patient standing at the counter. Done badly it is an accusation delivered in public. This separates the judgement from the delivery: what you decided and why, how you say it without humiliating anyone, and what you do next so the patient is not simply abandoned.

## What This Skill Produces

- **The decision record** — the basis for declining, stated as professional judgement rather than suspicion
- **The patient conversation** — wording that declines without accusing, in a setting that preserves privacy
- **The prescriber contact** — what to ask and what to record from the answer
- **The continuity-of-care step** — what happens to the patient next, which is the part most often skipped
- **The escalation path** — when this becomes a safeguarding, regulatory, or law-enforcement matter rather than a professional one
- **The internal record** — what the team needs so the next shift is not blindsided

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