## I L L I N O I S 

## O F F I C I A L 

## RE P O R T S Appellate Court

Morr-Fitz, I

nc. v. Quinn , 2012 IL App (4th) 110398

Appellate Court Caption MORR-FI TZ
, I NC., an I llinois Corporation, d/b/a FI TZ GER ALD PHARMACY, L icense d and Practicing in the State of I llinois as a Ph a r ma c y ; L

. D O Y L E, I

NC., an I llinois Corporation, d /b /a E G G E L ST O N PHARMACY, L icense d and Practicing in the State of I llinois as a Pharmac y ; KOSI ROG PHA RM A CY
, I N C.
, a n I llinois Corporation, d/b/a KOSI ROG REXAL L PHARMACY, L icense d and Practicing in the State of I llinois as a P h arma cy ; LUKE VANDE R BL EEK; and GL ENN KOSI ROG, Plaintiffs-Appellee s, v. PAT QUI NN, Gover

nor, The State of I llinois ; FERNAN DO E. GRI L L O, Secre tary , The Depa rtment of Financ ial and Professional Reg ulation; DANI EL E. BL UTHARDT, Acting Direc t o r, The Division of Professional Reg ulation; and THE MEMBERS OF THE S T AT E BO ARD OF PHARMACY, in Their Offic ial Capac ities, Defe ndants-Appe llants.

District & N o. Four th District Docke t No. 4-11-0398

Argued Filed August 7, 2012 September 20, 2012

Held (Note : Th is syl lab us

con st it ute s n o par t of the opi nio n of the cour t but has bee n pre

par ed b y the Repo rt er o

f D e c i s i o n s f

o r t h e

c o n v e n i e n c e o

f t h e

rea der

. ) T he injunction issued by the trial court prohibiting defe ndant p u b l i c officia ls from enfor cing the admini strative rule requiringpharma cies to dispense emer g ency contr ac ep t ion was aff irmed to the extent the trial

cour t found that the rule could not be enfor ced without violating the Conscience Act, but the injunction wa s reve rsed and modified to e njoin

en forcement of the rule ag ainst plaintiffs who have conscie nce- based objections to the rule.Dec ision Under

Review Appea l from the Circuit Court of Sang amon County
, No. 05-CH-495; the Hon. J ohn W. Belz, J udg e, pre siding.

J udg ment Affir med in part a s modified and re verse d in part.

Counsel on Appea l L isa Madig an, Attorney Gene ral, of C h i cago (Michae l A. Scodro, Solicitor Gene ral, and Carl J

. Elitz (ar g ued) and Nadine J

. Wichern, Assistant Attorney s Gene ral, of c ounsel), for appellants.

Duane D. Young
, of L aB arr e, Young & Be hnke, of Springf ield, Fr ancis J

. Manion, of New Hope, Kentucky
, and Carl Nichols, Steven L ehotsky
, Natalie Hurt, Thomas Dettore
, and Aly ssza DaCunha, all of Wil mer, Cutler, Pickering
, Hale & Dorr L L P, and M ark L

. Rienzi (ar g ued), of Catholic University of Americ a, Columbus School of L aw, both of Washington, D.C., for a

ppellees.

Panel J USTI CE KNECHT deliver ed the judg ment of the c ourt, with opinion.
J ustices Steigma

nn and Pope conc urre d in the judgme nt and opinion.

OP INION

¶ 1 Plaintiffs, two pharma cists and three corpor ations that own and operate pharma cies, filed suit seeking decla

ratory and injunctive relief ag ai n s t ce rt ain public officia ls who seek to enfor ce an administrative rule that require s pharma cies to dispense or aid in the dispensing of emer g ency co n t ra ce ption. The individual plaintiffs believe life beg ins at conce ption,

emer g ency contra ception may act as an abortifa cient, and the dispensing of such medication is ag ainst their relig ious beliefs. The corpor ate plaintiffs have ethical g uidelines that preve nt the phar macies the y

own and ope rate from dispensingemer g ency contra ception. ¶ 2 The administrative rule at issue (Curre nt Rule) does not specific ally identify “eme rg ency contra ception” but a

pplies to all medication appr oved by the United States F ood and Dr ug Administration (F DA). 68 I ll. Adm. Code 1330.500(e) (2010). Plaintiffs’ third amended complaint alleg es the Current Rule is inva lid as it violates the I llinois Hea lth Care Right of Conscience Act (Conscienc e Act) (745 I L CS 70/1 to 14 (West 2010)), the I llinois Religious Fr eedom Restoration Act (Relig ious Fr eedom Act) (775 I L CS 35/1 to 99 (West 2010)), and the first ame ndment’s fre e-e x erc ise clause (U.S. Const., amend. I ).

-2-¶ 3 The ci rc u i t co u rt found plaintiffs had sincere relig ious beliefs preve nting them from

disp e n s in g e merg ency contra ceptives. The court found the Current Rule unconstitutional and invalid under the Conscience Act and the Religi o u s Fr ee d o m Act and issued a perma nent injunction, enjoining defe ndants from enfor cing the Current Rule. Def endants appea l,
arguing (1) the injunction is overly broad in that it pr ohibits def endants from enfor cing the Current Rul e o n o th er FDA -appr oved medications and ag ainst nonobjecting pharma cies; and (2) the Curr ent Rule is constituti onal and doe s not violate either the Conscience Act or the Religious Fr eedom Act. We ag ree the injunction is overly broad but find the Conscience Act prohibits enfor ceme nt of the Current Rule on the issue of emer g ency contra ceptives ag ainst these plaintiffs. ¶ 4 We affir

m in part as modified a

nd reve rse in par

t.

¶ 5 I . BA CKGROUND ¶ 6 A. “Plan B ” or “ Emerg ency Contrace ptives” ¶ 7 In their opening brief, defe ndants identified four products marke ted in the United States and approve d for sale by pharma cies: Plan B One- Step, ella, Next Choice, and levonorg estrel tablets. Eac h of these products is used t o p re vent “pre g nancy in the few day s afte r sex.” http:// ec.pr in c e to n

. e d

u /q u e s ti o n s /d o s e

. htm l (visited Aug

. 30, 2012). The parties ref er to these medication s collectively as “Plan B” or “eme rg ency contra ceptives.” Plaintiffs’ exhibi ts, including product labeling approve d by the FDA
, show emer g ency contra ception may curta il
pregnancy by preve nting t h e re l ease of an eg g , preve nting fer tiliz ation, or preve nting a fer tiliz ed eg g from attaching

. The FDA ’s officia l Web site acknow ledg es Plan B may preve nt

a fer tiliz ed eg g from attaching

. See Morr-Fitz, Inc. v. Blagojevich
, 231 I ll. 2d 474, 480 n.1, 901 N.E.2d 373, 379 n.1 (200 8) (quoting ht tp://www.fda.g ov/CDER/drug/infopa g e/planB QandA.htm). The se contra ceptives w ill not work if a fe rtiliz ed eg g is impl anted.

¶ 8 B. Par ties in the L itigation ¶ 9 Plaintiffs in this litigation include two individual pharma cists and corpor ations that own “community pharma cies.” The plaintiff individua ls are Luke Vande r Ble ek and Glen Kosirog , licensed I llinois pharma cists. V ander Ble ek, a lifelong Roman Catholic, has been

a pharma cist for over 20 y ear s. Kosirog
, a Christian since ag e 17, has been a pharma cist for

over 25 y ear s. Both Vande r Ble ek and Kosirog have relig ious-based obj ec t i ons to participating in any way in dispensing emer g ency contra ceptives due to their beliefs these
contra ceptives may preve nt a fer t i l i z ed egg from attaching to a woman’s uterus. The individual plaintiffs were added to the c ase w ith the first amende d complaint. ¶ 10 Three corpor ate plaintiffs are in this case : Morr-F itz
, I n c., L

. Doyle, Inc., and Kosirog Pharmac y , Inc. Vande r Ble ek is the sole share holder of Morr-F itz
, whi ch operates a pharma cy in M o rr i s o n

. L

. Doyle, I nc., has two share holders. Vander Blee k is the m ajority share holder. L

. Doyle operates two pharma cies as Eg g elston Pharmac y

. One is located in Sy camor e and the other in Genoa

. Kosirog Pharmac y , Inc., has one share holder, Kosirog

. I t operates one pha

rmac y , KosirogRex all Pharmac y , in Chicag o.

-3-¶ 11 C. Defe ndants

¶ 12 Def

endants i n v olved in this appea l are the following : Pat Quinn, Gover nor of I llinois ; Br ent E. Adams, Secre tary of the I llinois Depa rtment of Financ ial and Professional Reg ulation (De partment); J ay Steward, Direc tor of the State Boa rd of Pharmac y ; and the State Boa rd of Pharmac y

. Throug h o ut the litigation, these defe ndants wer e substitut ed in place of other defe ndants who occupie d the same office s, in cl u d i ng Gover nor Rod Bla g ojevich, Secre tary Fe rnando Grillo, Secre tary Dea n Martinez, and Direc tor Daniel Bluthar dt.

¶ 13 D. “Eme rg ency Rule” and “ Permane nt Rule” ¶ 14 In April 2005, Gover nor Rod Bla g ojevi ch fi led an “Emer g ency Rule” amendingthensection 1330.91 of title 68 of the I llinois Administrative Code. 29 I ll. Reg

. 5586 (eme rg ency rule eff

. Apr. 1, 2005). In August 2005, the amendment beca me perma nent in the form of an administrative rule. This rule (Permane nt Ru l e) m an d ated the following of community pharma cies: “1) Upon rec eipt of a valid, lawful presc ription for a contra ceptive, a pharma cy must dispense the contra ceptive *** to the patient or the patient’s ag ent witho ut delay
, consistent with t h e normal timeframe [ sic ] for filling any other presc ription. I f the
contra ceptive *** is not in stock, the pharma cy must obtain the contra ceptive under the pharma cy ’s standard proce dures for order ing contra ceptive drug s not in stock, including the proce dures o f an y en t ity that is aff iliated with, owns, or fra

nchises the pharma cy

. Howeve r, if the patient pref ers, the presc ription must be transfe rre d to a local pharma cy of the patient’s choice under the pharma cy ’s standard proce dures fo r transfe rring
presc riptions for contra ceptive drug s, incl u d i ng the proce dures of any entity that is aff iliated with, owns, or fr anchise s the pharma cy

. Under any circ umstances an unfilled
presc ription for contra ceptive drug s must be returned t o t he patient if the patient so direc ts.” 29 I ll. Reg. 13639, 13663 ( eff . Aug . 25, 2005).
In section (j), the term “contr acep t i v e” ref ers to all FDA -appr oved drug s that preve nt pregnancy (29 I ll. Reg

. 13639, 13663 (ef f. Aug

. 25, 2 0 0 5 ) )
, in c luding medications commonly identified as “ emer g ency

contra ceptive pills” or “ emer g ency contra ception.” ¶ 15 When t h e E m erge ncy Rule was promulgate d, Gover nor Blag ojevich “publicly war ned that I llinois pharma cists who vi olate the rule face signific ant penaltie s, rang ing from fines
to the loss of profe ssional licenses

. ” Morr-Fitz
, 231 I ll. 2d at 481, 901 N.E.2d at 380. On April 13, 2005, Gover

nor Bla g ojevich issued a press rele ase stating, “ ‘I f a pharma cy wants to be in the business of dispensing contra ceptives, then it must fill presc riptions without making moral judgme nts.’ ” Morr-Fitz
, 231 I ll. 2d at 482, 901 N.E.2d at 380 (quoting press rele ase of Gover nor B lag ojevich, Apr il 13, 2005).

-4-¶ 16 E. The L itigation

¶ 17 In September 2005, plain t i ff s M o rr -F i t z , I nc., and Kosirog Pharmac y , Inc., filed a complaint for decla

ratory and inju n ct i v e relief ag ainst defe ndants. Plaintiffs, maintaining

emer g ency contr ac ep t i ves act as abortifa cients, asked the court to enjoin defe ndants from enfor cing the Permane nt Ru l e, ar guing the rule conflicts with I llinois law. Plaintiffs maintained the rule was void under the Conscience Act (745 I L CS 70/1 to 14 (West 2004)) and the Religious Free dom Act (775 I L CS 35/ 1 to 99 (West 2004)). Afte r the c ircuit court denied p l ai n t i ffs’ reque st for a temporar y restra ining order on g rounds of standing and ripene ss, plaintiffs sought lea ve in Octobe r 2005 to amend the complaint. ¶ 18 In the proposed first am en d ed co mplaint, plaintiffs added a claim the Permane nt Rule substantially burdene d plaintiffs’ first-ame ndment rig hts to fre e exercise of relig ion. Pla i ntiffs maintained the Permane nt Rule forc ed them to participate in abortions to which they wer e re ligiously

and consc ientiously

opposed. ¶ 19 In November 2005, the circ ui t co u rt gra n t ed p l ai n t i ffs leave to amend, as well as defe ndants’ motion to dismiss on g rounds of ripene ss, lack of standing
, and failure to exhaust administrative reme dies. Plaint i ff s appea led. By majority
, this court, in Morr-Fitz, Inc. v. Blagojevich
, 371 I ll. App. 3 d 1 175, 1184, 867 N.E.2d 1164, 1171 (2007), deter mined the issue was not ripe and aff

irmed the judgme nt. The majority conclude d the plaintiffs had not pleade d fac ts establishing they felt the eff ects of the rule in a concr ete way and would suffe r

a substantial hardship if they wer e not allowed to pursue their claim. Morr-Fitz
, 371 I ll. App. 3d at 1184, 867 N.E.2d at 1171. The majority further conclude d neither the Conscience Act

nor the Religious Fr eedom Act made the claim ripe. Morr-Fitz
, 371 I ll. App. 3d at 1184, 867 N.E.2d at 1171. J ustice Turner d is s e nte d
, f in d in g p la intiffs’ claims ripe and compelling under the Conscience Act and the Religious Fr eedom Act. Morr-Fitz
, 371 I ll. App. 3d at 1185-86, 867 N.E.2d at 1172-73 ( Turner , J ., dissenting) . Plaintiffs appea led. ¶ 20 Whil e plaintiffs’ petition fo r ap p eal to the Supreme Court of I llinois was pending , the Permane nt Rule espoused in subse ction (j) was amende d (Second Permane nt Rule) (32 I ll. Reg

. 7116, 7126-27 (ef

f. Apr. 1 6
, 2 0 0 8 )). The Depa rtment added “seve ral, more onerous provisions pertainingspecific ally to ‘emer g ency

contra ception.’ ” Morr-Fitz , 231 I ll. 2d at 486, 901 N.E.2d at 382. The Second Permane nt Rule mandated r etail phar macies use their “best eff orts to maintain adequate stock of emer g ency contra ception t o the extent that it continues to sell contra ception.” 32 I ll. Reg

. 7116, 7127 (ef f. Apr. 16, 2008). I t further mandated if a pharma cist o b j ected to the dispensing of emer g ency contra ception and no nonobjecting pharma cist was prese nt at the pharma cy , the “dispensing pharma cy” must sell the emer g ency contra ceptive throug h “ ‘re mote medication o rd er p roce ssing,’ ” which involved having a nonobjecting pharma cist at another location authorize a non p h ar m ac i st employ ee at the dispensing pharma cy to dispense the drug

. 32 I ll. Reg

. 7116, 7127 (ef f. Apr. 16, 2008). The Second Permane nt Rule further require d re t ail pharma cies ensure a nonobjecting p h armacist was schedule d when the pharma cy was open or a licensed pharma cist was available to perf orm the remote- medication-or der- proce ssing p ro ce dure when no nonobjecting pharma cist was available at the dispensing pharma cy

. 32 I ll. Reg

. 7116, 7132 (ef

f. Apr. 16, 2008)

.

-5-¶ 21 In Dec ember 2008, the Supreme Cour t o f I l l i nois reve rsed the majority ’s decision in

Morr-Fitz
, 371 I ll. App

. 3d at 1184, 867 N.E.2d at 1171, finding plaintiffs’ claims ripe. Morr-Fitz
, 231 I ll. 2d at 504-05, 901 N.E.2d at 392-93. The court fu rt h er deter mined plaintiffs wer e not require d to exhaust administrative reme dies and rema nded the cause for a hearing on plaintiffs’ mot ion for a preliminary

injunction and further

amendments to t he complaint. Morr-Fitz , 231 I ll. 2d at 504-05, 901 N.E.2d at 392- 93. ¶ 22 In August 2009, the circ uit court g rante d plaintiffs a preliminary injunction, prohibiti ng defe ndants from e nforc ing the Second Perma nent Rule ag ainst plaintiffs. ¶ 23 In April 2010, defe ndants issued the Current Ru l e, en t i t l ed “C ommunity Pharmac y Service s,” which repla ced the Second Permane nt Ru l e. See 68 I ll. Adm. Code 1330.500 (2010). Emerg ency contra ceptives are not mentioned i n t h e Current Rule. Section (e)
, howeve r, mandates “Pharma cies have a duty to deliver lawfully presc ribed drug s to patients and to distribute nonpresc ription drug s approve d by the [FDA] for restric ted distribution by pharma cies, or to substitut e a gen er i c drug *** in a timely manner , or to contac t the
presc riber to obtain authorization to dispense a differ ent drug that produce s a simil ar clinical eff ect in a timely manner ***.” 68 I ll. Adm. Code 1330.500 (e) (2010). The Current Rule includes exceptions to this requirem en t, but it does not list conscie nce- or relig ious-based objections. The listed exceptions includ e matters of profe ssional judgme nt, such as when drug -drug interac tions or drug -food inte ractions are indicated (68 I ll. Adm. Code 1330.500(e) (1) (2010)) and when emer g encie s aff ect drug av ai l ab i l ity (68 I ll. Adm. Code 133 0

. 5 0 0 ( e ) ( 2 ) ( 2 0 1 0 ) )

. Se c tion (g ) mandates if a lawfully presc ribed drug or nonpresc ription drug is not in stock or is o t h er wi s e unavailable
, the pharma cy must provide the patient a timely a lt e r

n a ti v e for appropr iate thera

py , which may include obtaining the drug

. 68 I ll. Adm. Code 1330.500(g ) (2010). Sugg ested alternatives include, if the patient re q u es ts it, transmitting the presc ription information to a pharma cy that will fill the presc ription. 68 I ll. Adm. Code 1330.500(g )(3) (2010). A pharma cy that fails to c omply with the Current Rule is subject to disciplinary action “or other enfor ceme nt actions

. ” 68 I ll. Adm. Code 1330.500(h) ( 2010). ¶ 24 In May 2010, plaintiffs f il e d a third amende d complaint and a summary -judg ment motion seeking relief ag ainst the Current Rule. In their third amende d complaint
, plaintiffs maintained the Curre nt Rule violated the Conscience Act, the Religious Fr eedom Act, and the first amendment. Be fore trial, the circ uit court g rante d the parties’ joint motion in which defe ndants ag ree d not to pursue disciplinary action for violations of the pre vious rules and plaintiffs ag ree d to voluntarily dismiss claims made under Title VI I of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000e to 2000e-17 (2006)) and the I llinois Human R ights Act (775 I L CS 5/ 1-101 to 10-104 (West 2010)). ¶ 25 I n M ar ch 2 0 1 1
, a t ri al was held. Plaintiffs Vande r Ble ek and Kosirog testif i ed fo r plaintiffs; Dr. Warre n Wallace a nd Secre tary

Adams testified for

defe ndants. ¶ 26 Plaintiff Vande r Ble ek, a pharma cist who resides i n M o rr i s o n, testified he had been a pharma cist since 1986. He owned three pharma cies, with locations in Morrison, Sy camor e, and Ge noa. Va

nder B leek is Roman Catholic and re g ularly attended c hurch. ¶ 27 Vande r Ble ek testified he was awa re of emer g ency contra ceptives. He believed his f aith

-6-preve nted him f rom participating in the sale of eme rg ency contra ception beca use it ha s the potential for terminating human life. Vande r Ble ek believed human life beg ins at conce ption, and the FDA -appr oved product literature on the Plan B products indicates such medication

m ay preve nt pregnancy afte r fer tiliz ation. Vande r Ble ek testified his faith preve n t ed h i m from selling emer g ency contra ception and also from permitting his stores to stock the drug s

or participating in a sy stem throug h which he would transfe r the presc ription to another store to be filled. ¶ 28 Acc ording to Vande r Ble ek, his pharmaci es h ad gu i d el i n es co n cerning emer g ency contra ception. In May 2005, by letter, he informed his staff of this p o l i cy

. Vande r Ble ek asked any pharma cist who worke d for him to sign the policy

. Since 2005 approximately three

or four women had asked for emer g ency contra ception in his Morrison store. About the same number ha d asked f

or those drug s in his other two stores combined. ¶ 29 Va n d er Bl ee k testified, upon hear ing Gover nor Bla g ojevich’s comments abo u t t h e chang e i n t h e law, he felt like he would have to choose betwee n violating the law or his conscie nce. Vande r Ble ek watche d an interview of Gover nor Bla g ojevich on television, when the g overnor said pharma cists unwilling to dispense emer g ency contra ception should find a ne w job. ¶ 30 Vande r Ble ek testified the near est location to his Morrison store wher e a woman could obtain emer g ency contra ception was approximately 3 1/2 blocks awa y

. This location was an inpatient pharma cy at a public hospital, which stocked Plan B in the emer g ency room. The

near est pharma cy , howeve r, was approximat el y 1 4 miles awa y

. More than 12 pharma cies

wer e within a 15-minute drive of the Morrison location. Reg arding the Sy camor e and Genoa locations, Vande r Ble ek testified a Walgr een’ s was approximat el y 1 0 m i nutes from his Genoa pharma cy and 5 minutes from his Sy camor e s t o re

. Prescr iption emer g ency contra ception wa s also available on the Interne t. ¶ 31 Glenn Kosirog
, a reg istered pharma cist for over 25 y ear s an d a re s i d ent of Wheaton, testified he was the sole share holder in a corpor atio n t h at owns Kosirog Pharmac y , a pharma cy that had been in his family over 50 y ear s. Kosirog testified he had been a Christian since he was 17 y ear s old. Kosirog believed emer g ency contra ceptives to be “abor tion pills,”
as emerg ency contra ception taken afte r unprotec ted sex could destroy an embry o. Kosirog believed life beg ins at conce ption. Kosirog
, beca use of his faith, could not have any thing to do with emerg ency

contra ceptives. ¶ 32 Kosirog testified his store, since 2006 or 2007, had an “abor tion pill policy .” This policy require s a pharma cist, if prese nted with a presc ription for emer g ency contra ception, to return the pre scription. Kosirogtestified one or two women eac h month e ntere d his store seeking

emer g ency contra ception. Over 12 pharma cies wer e within three or four miles of his Chicag o pharma cy

. ¶ 33 When Kosirog first lear ned of the require ment to sell emer g ency contra ception, he f

elt

coer ced and frig htened. He was conce rned the g overnme nt might c lo se his pharma cy beca use of his beliefs. Be cause of the uncer tainty surrounding the rules, he did n o t expand his business. ¶ 34 Warren Henr

y Wallace, a phy sicia

n a t N o r thwestern University Medica l School, testified

-7-as an expert witness for defe ndants. Dr. Wallace testified he prac ticed medicine for 35 y ear s.

When he presc ribed a medication for a patient, he expected the presc ription would be filled and the patient would take it. Dr. Wallace would not inform a pharma cist of the rea sons for the presc ription and descr ibed situations wher e a woman’s life an d h ea l th would be endang ere d by a pregnancy

. Dr. Wallace testified the failure to take emer g ency

co n t ra ce p t ives in a timely manner “may lead to incre ased risk that it will be ineffe ctive.” When asked about the optimal time frame for taking emer g ency contra ceptives, Dr. Wallace testified they wer e most eff ective when taken immediately afte r unprotec ted intercour se and “bec ome[ ] prog ressively less eff ective ove r the c ourse of

the next several da

y s.” ¶ 35 Dr

. W al l ace testified he hear d the term “dispensar y ” used to ref

er to a pharma cy . He
ag ree d phy sici an s we re fre e to ref use to enter into phy sician-patient relationships for conscie nce- based rea sons and pharma cists should have that same rig ht. Dr. Wallace testified until April 2010 there had not been a rule requiring ever y pharma cy to sell ever

y drug

. In his

own persona l experience
, he was not awa re of any instance in which a relig ious ref usal to sell

emer g ency

contra ceptives r esulted in the woman’ s failure to obtain the drug

. ¶ 36 Br ent Adams, the se cre tary of financ ial profe ssional r egulation f or the State of I llinois
, test i fi ed h e had been with the Depa rtment since J uly 2006. In October 2009, he was confirme d as secr etar

y

. In his role as s ec re t ary , Secre tary Adams helped deter mine the Depa rtment’s policy

initiatives and directives. ¶ 37 Secre tary Adams t estified he draf ted t he C urre nt Rule. Secre tary Adams ex plained the prior rules wer e re peale d as par t of “a compre hensive rewrite of the rules in the contex t of amendments to the Pharmac y Practice Act [(2 2 5 I L CS 85/1 to 41 (West 2010))].” Upon lear ning of the Ninth Circuit’s decision in Stormans, Inc. v. Selec ky
, 586 F.3d 1109 (9th Cir. 2009), in which rules broadly expanding acc es s to medications survived constitutional scrutiny
, he decide d to move in the same direc t i o n

. T h e C urre nt Rule was draf ted “to promote the health and well-be ing of residents” and “to establish a regulatory framework that would protec t acc ess to medications for all I llinois residents.” Secre tary Adams testified his

conce rn was with acc ess to medication in g ener al, but matters of Plan B contra ception wer e also discussed, as we re matters of postexposure prophy laxi s for human immunodeficienc y virus (HIV) infec tion and psy chotropic medications. Secre tary Adams was not awa re of any particula r instance when a patient was denied emer g ency cont raceptives beca use of a relig ious-based objection, but he “wa s awa re of g ener al controve rsy .” His “conc ern was that
at s ome future point, a patient in need o f t i m el y ac ce ss to one of those reme dies would be denied and *** the complaint proce ss via the Depa rtment would not redr ess that conce rn in an ade quate time fr ame.” ¶ 38 Secre tary Adams testified the duty to deliver applies to the pharma cy , not to pha rmac ists. The Depa rtment would lear

n of violations throug h consumer complaints. After a consumer filed a complaint, the Depa rtment would conduct an investigation a nd make a repor

t to the
prosec ution if nece ssary

. Pharmac ies wer e responsible for drug delivery beca use they wer e the frontline delivere rs of nece ssary medication. Pharmac ists, individually
, wer e not cover ed under the rule to addre ss relig ious objections. Secre tary Adams was unawa re of any customer

c o mp la in ts u n d e r th e p r e v io u s rules reg arding relig ious-based ref usals to dispense emerg e n c y contra ceptives.

-8-¶ 39 Secre tary Adams testified the Current Rule did not require doctors to write presc riptions

for drug s. He acknow ledg ed acc ess to medication could be denied if a doctor ref used to write

a presc ription. Secre tary Ad am s testified his Depa rtment had a varia

nce proce dure that allowed him to make individualiz ed assessments for parties seeking a varia nce. He could not fore see a situation in which he would g ive a va rianc e for a re ligious objec tion. ¶ 40 Secre tary Adams, in t h e p ro ce s s o f d ra ft i n g t he Current Rule, met with the Retail Merc hants Foundation, at least o n e pharma cist association, and Planned Parenthood. Secre tary Adams did not meet with relig ious objectors. Secre tary Adams testified he kept all of the materials related t o the C urre nt Rule in a file under the heading “Plan B.” S ecr etar y Adams could envision a health issue in which a patient is in need of medication and arr ives
at a pharma cy an d i s denied acc ess. Secre tary Adams ag ree d his rule did not require the pharma cy to stock the drug

. He ag ree d timely thera peutic equivalent in some instances might

mean the s am e day
, but timeliness would depend on the circ umstances. Secre tary Adams would not a g ree the public hospital’s selling the drug three blocks awa y was a n alterna tive for Vander Ble ek’s ref

usal to sell emer g ency contra ception at his pharma cy : “I find it

unrea sonable to expect a patient who is denied acc ess at a pharma cy to think to g o to the

emer g ency

room.” ¶ 41 The c ircuit court f ound plaintiffs Vande r B leek a nd Kosiroghad since re r elig ious- and conscie nce- based objections to participating in the distribution of the Plan B contra ceptives. The court conclude d t h e C u rr ent Rule is invalid on its fac e and as applied under the Conscience Act, the Religious Fr eedom Act, and the first amendment. The court enter ed judgme nt for plainti ff

s o n co u n ts I
, I V, and VI of the third amende d complaint and
perma nently enjoined defe ndants and “those acting in conce rt” with them from enfor cing the Current Rule. The court found no just rea son for delay ing the appea l. The court further issued

a stay on the enfor ceme nt of the judgme nt but found the preliminary injunction that had been previously

issued rema ined in eff

ect until the matter is fully litigated on a

ppeal. ¶ 42 This appea l followed.

¶ 43 I I . ANALYSI S ¶ 44 A. Injunctive Relief ¶ 45 On appea l, defe ndants first ask this court to find the injunction overly broad and vac ate it. De fenda

nts ma intain the injunction, a s written, preve nts the Depa rtment from enfor cing the Current Rule ag ainst pharma cies with no conscie nce- or relig ious-based objections to

emer g ency contra ceptives. Def endants, citing Stormans
, 586 F.3d at 1140, arg ue such an order is an abuse of

discretion and should be overturne d. ¶ 46 Plaintiffs disag ree

. Plaintiffs, ci t i n g Morr-Fitz
, 231 I ll. 2d at 498, 901 N.E.2d at 389,
argue if the Current Rule is fac ially illega l, then the circ uit court must void the enac tment in its entirety

. Plaintiffs further maintain b ec au s e the Current Rule does not contain an exemption fo r religious beliefs, it is also fac ially invalid and must be vacated. Plaintiffs conclude by arguing even if this court wer e to find the circ uit court’s injunction overbr oad, this court may modify the injunction to confor m with the leg al rig hts of those involved. See Stampede Tool W

arehouse, Inc. v. May
, 272 I ll. App. 3d 580, 591, 651 N.E.2d 209, 217-18

-9-(1995).

¶ 47 Resolution of t his argument ultimately depends upon the resolution of t he other issues in this case. We will return to this issue upon resolution of the other s.

¶ 48 B. Conscie nce A ct ¶ 49 In their opening brief, defe ndants next ask t he court to find the Current Rule does not violate the fr ee- exercise c lause of the first amendme nt. Defe ndants arg ue the Current Rule is fac ially neutra l, app l i es gen era lly
, and easily survives rational-ba sis revie w. I n the alternative, defe ndants contend the Current Rule s urvives a strict-scr utiny test beca

use t he State has a compelling i n t er es t i n establishing a uniform sy stem of eff icient local drug distribution and the Current Rule is narr owly tailored to satisfy

that interest. ¶ 50 We decline defe ndants’ invitation to beg in with this constitutional issue. W e s h o u l d avoid constitutional questions when the case may b e decide d on other g rounds. See InnovativeModular Solutions v. Hazel Crest School District 152.5
, 2012 I L112052, ¶ 38, 965 N.E.2d 414. We beg in with the question of whether the Current Rule violates statutory law, startingwith our consider ation of the Conscienc e Ac t. ¶ 51 In 1 977, the Gene ral Assembly enac ted the Conscience Act. See Pub. Act 80-616, § 2 (ef f. Sept. 13, 1977). In so doing, the Gene ral Assembly decla red, “It is the public policy of the State of I llinois to respec t and protec t the rig ht of conscie nce of all persons who r efuse
to obtain, rec eive or acc ept, or who are eng ag ed in, the deliv er y of, arr ang ement for, or pay ment of hea lth care service s and medica l car e whe ther a cting individually , corpor ately
, or in association with other persons ***.” 745 I L CS 70/ 2 (West 2010). ¶ 52 Consist ent wit h this policy
, the Genera l Assembly
, in the C o n s ci en ce Act, dete rmined “[n] o phy s i ci an or health care personne l shall be civill y or criminally liable t o any person, estate, public or private entit y o r p u b l i c o fficia l by rea son of hi s or her ref usal to perf

orm, assist, counsel, sugg est, rec ommend, ref er or participate i n any way i n any particula r form of h ea l t h car e service which is contra ry to the conscie nce of such phy sician or health car e personne l.” 745 I L CS 70/4 (West 2010). The Gene ral Assembly further made it unlawful for public officia ls to discriminate ag ainst any person, in a ny manner , in lice nsing “bec ause of such person’ s consci entious ref usal to rec eive, obtain, acc ept, perf orm, assist, counsel,
sug g est, rec ommend, ref

er or participate in any way in any particula r form of health car e service s contra

ry to hi s o r h er conscie nce.” 745 I L CS 70/5 (West 2010). “Conscienc e” is define d as “a s i n ce re l y h eld set of moral convictions arising from belief in and relation to God, or which, though not so derive d, arises from a place in the life of its possessor para llel to that filled by

God amongadher ents to relig ious faiths.” 745 I L CS 70/ 3(e) (West 2010). ¶ 53 The American Civi l L iberties Union (ACLU) of I l l i nois, in its amicus brief, urg es this
court to interpre t and apply the Conscience Act acc ording to the para meters of the Religious Fr eedom Act. ACLU rea sons the Religious Fr eedom Act was enac ted afte r the Conscience Act and is more specific and the Conscience Act provides no g uidelines that p er m i t t h e allowanc e of c ompeting inter ests. ¶ 54 W e fi n d these arg uments unconvincing

. Section 15 of the Religiou s Fr ee d o m Ac t provides the State “may not substantially burden a person’ s exercise of relig ion, even if the

-10-burden results from a rule of g ener al applicability
, unless it demonstrates that application of

the burden to the person (i) is in further ance of a compelling g overnme ntal interest and (ii) is the least restric tive means of further ing th a t compelling g overnme ntal interest.” (Emphasis added.) 775 I L CS 3 5 / 1 5 (W es t 2010). I t does not apply here

. The Gene ral Assembly
, in

enac ting the Conscience Act, did “not substantially burden a person’ s exercise of relig ion,” but instead bolstered it, by offe ring protec tions to those who seek not to act in the health-c are setting due to relig ious convictions. The Conscience Act is more specific than the Religious Fr eedom Act beca

use the Conscience Act deals s p ec ifically with the issue of health car e, while the Religious Fr eedom Act would apply to any g overnme ntal action that “substantially burden[s] a person’s exerc ise of re ligion” ( 775 I L CS 35/ 15 (West 2010)). ¶ 55 ACLU of I llinois contends, howeve r, the State must be permitted to weigh the intere sts of women who seek emer g ency contra ceptives ag ainst those of pharma cists whom the State should be able to command to dispense medications at the woman’s or phy sician’s reque st. We ag ree the S tate as a whole ha s this authority . Howeve r, we do not ag ree defe ndants, as part of the executive bra

nch of the State, nece ssarily have this authority here

. This is not a

case wher e the “State” has made one decision on the issue, but wher e the “State” has made
two decisions. The executive branc h decide d to make Plan B available over any pharma cist’s relig ious conce rns, while the leg islative branc h decide d to protec t health-c are personne l and health-c are fac iliti es from having to provide health car e ag ainst their conscie nce or relig ious beliefs. We must decide whether the two decisions ( i.e.
, the Current Rule and the Conscience Act) act in harmony

. I f n o t , t h e Conscience Act preva ils. See Holtkamp Trucking Co. v. David J. Fletche r, M.D., L.L.C

. , 402 I ll. App. 3d 1109
, 1126, 932 N.E.2d 34, 48 (2010) (“ ‘Wheneve r an administrative rule conflicts with a statute, the rule will be held invalid and the statute followed.’ ” (quoting Greane y v. Industrial Comm’n
, 358 I ll. App. 3d 1002, 1026, 832 N.E.2d 331, 352 (2005) )).

¶ 56 1. The ConscienceAct Applies to the Practiceof Pharmacy ¶ 57 D e f

e ndants arg

ue the Conscience Act does not apply in this case beca use pharma cists an d pharma cies are not protec ted by its provisions. Def endants maintain the words “phar macy” and “phar macist” do not appea

r in the statute and the Act define s “hea lth car e” as treatment rende red only by “phy sicians, nurses, para professionals or [a] health car e fac ility .” Def endants contend the issue of wheth e r p h a rmac ists are para

profe ssionals is ambig uous and
urg es this court to examine the leg islative history to resolve the ambiguity

. Whil e the terms “phar macy” and “phar

macist” do not appea

r in the text , plaintiffs contend the plain lang uag e of the Conscienc e Ac t establishes it applies to them and there is no ambiguity

. ¶ 58 The main “g oal of statutory interpre tation is t o as ce rt ai n an d gi v e ef fe ct t o t h e leg islature’s intent.” Lauer v. American Life Family Insurance Co.
, 199 I ll. 2d 384, 388, 769 N.E.2d 924, 926 (2002). The statutory languag e itself, g iven its plain and ordinary meaning
, is the best indication of leg islative intent. Lauer
, 199 I ll. 2d at 388, 769 N.E.2d at 926. When the statutory l an gu ag e is clea r, we will g ive it eff

ect without resor

ting to other aids of construction. Hadley v. Illinois Departme nt of Corrections
, 224 I ll. 2d 365, 371, 864 N.E.2d 162, 165 (2007).

-11-¶ 59 Section 3 of the Conscienc e Ac t defines “ health ca re” as follows:
“ ‘He alth car e’ means any phase of patient car e, including but not limit ed to, test i n g; diag nosis; prog nosis; ancillar y rese arc h; instruct i o ns; family planning
, counselling
, ref err als, or any other advice in connec tion with the use or procur ement of contra ceptives and sterilization or abortion proce dures; medication; or surg ery or other car e or treatment rende red by

a phy sician or phy sicians, nurses, para profe ssionals or health ca re f acility
, intended for the phy sical, emotional, and mental well-be ing of persons [

. ] ” 745 I L CS 70/3(a) ( West 2010). ¶ 60 A fede ral district c ourt, in Vandersand v. W al-Mart Stores, Inc.
, 525 F. Supp. 2d 1052, 1057 (C.D. I ll. 2007)
, reje cted the same argument made by defe ndants. In Vandersand
, the plaintiff, a licensed pharma cist in I l l i n ois, argued his employ er, Wal-Mart, wrong fully terminated his employ

ment afte r he refuse d to dispense an e merg ency contra ceptive ba sed

on his understanding the drug acte d “with a signific ant abortifa cie n t mecha nism” and his relig ious beliefs did not permit him to dispense the drug

. Vandersand
, 525 F. Supp. 2d at 1053, 1054-55. The plaintiff filed a complaint alleg ing, in part, his termination violated the Conscience Act. Vandersand
, 525 F. Supp. 2d at 1055. Wal-M ar t m o v ed to dismiss plaintiff’s complaint, arguing, as defe ndants do h er e, t he Conscience Act only protec ts treatment provided by phy sicians, nurses, para profe ssionals, or health-c are fac il i t i es

. Vandersand
, 525 F. Supp. 2d at 1057. The district court reje cted this argument upon concluding W al -M art took the limit ing languag e from the last clause of the “hea lth car e” definition in section 3 and that clause ref ers only to “surg ery or other car e or treatment,” and
not to the entire list of “hea lth car e” service s appea ring befor e it. Vandersand
, 525 F. Supp. 2d at 1057. The dist rict court found such languag e did n o t ap p l y to “fa mily planning ” and “medica tion” and anyone who ref

used to participate in providing medication beca use of his conscie nce is prote cted by the Conscience Act. Vandersand , 525 F. Supp. 2d at 1057. ¶ 61 We ag ree with the analy sis in Vandersand

. The statu t o ry l an gu age i s cl ea r and the limit ing languag e upon which defe ndants rely does not apply to “medication.” Section 5 of the Conscien ce Act prohibits discrimination in licensing ag ainst anyone “bec ause of such person’ s conscie ntious ref usal to rec eive
, obtain, acc ept, perform, assist
, counsel, sugg est,

rec ommend, ref

er or participa

te in any way in any particula r form of hea l t h ca re [ ( i.e.
, medication)] service s contrar y to his or her c onscienc e.” 745 I L CS 70/ 5 (West 2010). ¶ 62 W e fu rt h er find section 4 of the Conscience Act bars civil or criminal actions ag ainst plaintiffs for their ref

usal to dispense Plan B medication. Section 4, quoted above, protec ts “hea lth care personne l” from c ivil and criminal l iability when such personne l ref use t o act

acc ordingto their conscie nce. 745 I L CS 70/ 4 (West 2010)

. Section 3(c) of the Conscienc e Act define s “h ea l t h car e personne l” as “any nurse, nurses’ aide, medical school student, profe ssional, para

profe ssional or any other person who furnishes, or assists in the furnishing of, health care serv ices .” (Empha sis added.) 745 I L CS 70/3(c) (West 2010). A pha rmac ist is a person who furnishes or assists in furnishinghealth-c are service s, i.e. , the provision of medication. ¶ 63 Finding the statutory languag e clea rly applies to the provision of “medica tion” service s,

we need not attempt to interpre t the ter m “ p a r a p rofe ssionals.” We note defe ndants, in arguing

-12-t h e s t at u t e is ambiguous toward pharma cists, urg ed this court to find persua sive th e

comments of one repr esentative on the floor of the House of R ep resentatives, who stated pharma cists and pharma cies wer e specific ally ex cl u d ed
, on their own reque st, from the Conscience Act. Such statements might be minimally persua sive if we found this provision of the Conscience Act ambig uous and if the statement s wer e not made approximately 20
years after the Conscience Act was enac ted. See 90th I ll. Gen. Assem., House Procee dings, Apr. 14, 1997, at 40-41. ¶ 64 Plaintiffs next argue sections 9 and 10 of the Conscience Act (745 I L CS 70/9, 10 (West 2010)) simil arl y p ro tect the corpor ate plaintiffs, who manag e “hea lth car e fac iliti es” from
g overnme nt action under the Current Rule. Plaintiffs maintain pharma cies fall within the definition of “hea lth car e fac iliti es” as t h ey are “dispensaries” or, in the alternative, “location[ s] wher ein health car e service s are provided to any person.” Def endants maintain the term “ dispensarie s” re fer s to a part of a lar g er insti tution, such as a school, hospit al, or fac tory

. Def

endants further maintain there is ambig uity in the term “hea lth car e f a c il it ie s” and
urg es this court to follow the same leg islative history cited above

. ¶ 65 Section 9 provides, in part, no person or corpor ation that owns or operates a “hea lth c are fac ility ” shall be liable to a ny public entity

by rea son of the hea lth-car e fa cility ’s re fusal to provide any particular form of health-car e service that violates the facility ’s conscience as set forth in its ethical g uidelines or other g overning documents. 745 I L CS 70/9 (West 2010). Section 10, i n p ar t , m akes it unlawful for a public officia l to discriminate ag ainst any corpor ation who operates “an exis ting health car e fac ility ” in any way , including in licensing
, beca use the corpor ation ref

used to permit “any particula r form of health car e service which violates the h e alth car e fac ility ’s conscie nce as documented in its exis ting or proposed ethical
g uidelines” or othe r g overningdocuments. 745 I L CS 70/ 10 (West 2010). ¶ 66 Section 3(d) of the Conscience Act def

ines “he alth car e fa cility ” as f ollows: “any public or private hospital, clinic, cente r, medical school, medical training instit ution, laboratory or diag nostic fac ility
, phy sician’s office
, infirmary
, dispensary
, ambulatory surg ical trea

tment cente r or other instit ution or location wher ein health car e service s are provided to any person, including phy sician org anizations and associations, networks, joint ventur es, and all other combinations of those org anizations.” 745 I L CS 70/3(d) (West 2010). ¶ 67 Def

endants cite two definitions for “dispensar y ” to support their argument dispensarie s g ener ally ref

er to are as part of a larg er instit ution. The fi rs t i s from Webster’s Third New International D ictionary 653 (1993): “a place wher e medicines or medical or dental aid are dispensed to ambulant patients (a [di spensar y ] in an industrial plant).” The second definition

comes from Americ an Her itag e Dictionary : “[a]n office in a hos p i t al
, school, or other instit ution from which medical supplies and prepa rations are dispensed.” Americ an Her itag e Dictionary

406-07 (2d c oll. ed. 1985). ¶ 68 Plaintiffs emphasize the definitions for “dispensar y” and “phar

macy” prove the terms ar e sy nony mous. Plaintiffs, citing Webster’s Third New International Dictionary 653 and 1694 (1971), contend “dispensar y ” is define d as “a place wher e medicines *** are dispensed” and “phar macy” is define d as “a place wher e medicines are *** dispensed.” Plainti ff s point to

-13-defe ndants’ expert witness’s testimony
, in which Dr

. W allace acknow ledg ed he hear d the

term “dispensar

y ” used in ref

ere nce to a pharma cy

. Plaintiffs further cite s ec t i o n 3 o f the Pharm ac y P ra ct ice Act, which define s “phar macy” as a place wher e pharma cist car e is provided and wher e medicines are dispensed or wher e a sign is aff ix ed using words such as “ ‘Pharmac ist,’ ” “ ‘Pharmac y ,’ ” or “ ‘Dispensa ry .’ ” See Pub. Act 97-813, § 415 (ef f. J uly 13, 2012) (amending 225 I L CS 85/ 3(a) (West Supp. 2011)). ¶ 69 We find a “phar macy” is a “dispens ar y

. ” A d i spensar y is “a place wher e medicine or

m e d i c a l o r d e n t a l t r e a t m e n t i s d i s p e n s e d

. ” h t t p : / / w w w

. m e r r i a m

webster .com/dictionary

/dispensary (visi t ed Aug. 30, 2012). A pharma cy is “a place where

m e d i c i n e s a r e c o m p o u n d e d o r d i s p e n s e d

. ” h t t p : / / w w w

. m e r r i a m

webster .com / d i ctionary

/pharmac y (visited Aug

. 30, 2012). Given the languag e of the Conscience Act, the Gene ral Assembly plainly intended to protec t those instit u t i o n s or org anizations which dispense medication fro m h aving to act ag ainst their conscie nces. I t would be a tortured interpre tation to conclude individuals who dispense medicines inside a hospital or school are protec ted while i n d i v i d u als who dispense medicines outside the hospit al o r s chool are not. Pharmac ies and pharma cists fall within the protec tions of the Conscience Act. ¶ 70 We further find convincing the argument a pharma cy is a “location wher ein health ca re service s are provided to any person.” As we deter mined above, the definition of “hea lth car e” includes “medica

tion.” 745 I L CS 70/3(a) (West 2010). Be cause a pharma cy is a location wher e medication service s are provided, it i s a “hea lth car e fac ility ” as define d in the Conscience Act. See 745 I L CS 70/ 3(d) ( West 2010).

¶ 71 2. The Provision of “Emergency Contraceptives” Is Not “Emergenc

y Me dical Care” Cont emplated by the ConscienceAct ¶ 72 Def

endants argue, even if the Conscience Act applies to pharma cies and pharma cists, it does not permit them to ref use to provide emer g en cy -c o ntrac eptive car e. Def endants emphasize the C onscienc e Act specific ally states i n sections 6 and 9, “Nothing in this Act shall be construed so as to relieve a phy sician or other health car e personne l from obliga tions under the law of providing emer g ency medical car e.” 745 I L C S 70/6, 9 (West 2010). Def endants contend, beca

use “eve ry hour counts” in the eff ectivene ss of Plan B
contra ceptives, the provision of emer g ency contra ceptives f

alls within thi s exception. ¶ 73 Plaintiffs contend the la ng uag e in sec tions 6 and 9 does not permit the Curre nt Rule to stand. Plaintiffs contend the provisions mean the Conscience Act will not excuse health-c are personne l f

r om any independe nt leg al obligation they may otherwise have to provide medical

car e and defe ndants have failed to identify any independe nt leg al obligation on pharma cies

or pharma cists to provide such car e. Plaintiffs further contend a patient’s need to maxi miz e the drug ’s ef

fec tiveness within 72 hours is not proof of eme rg ency medical c are

. ¶ 74 We disag ree with plaintiffs’ first contention. The Current Rule itself, if the provision of

emer g ency contra ceptives is “eme rg ency medical car e,” would cre ate its own “oblig ation[ ] under the law of providing eme rgenc y medical car e.” The issue thus turns on whether “eme rg ency” contr ace ptives fall within the term “e merg ency medical c are .”

-14-¶ 75 The Conscience Act does not define the term “eme rg ency” in the context of “eme rg ency

medical car e.” Rece ntly
, howeve r, the Supreme Court of I llinois define d “eme rg ency ” as “an unfore seen circ umstance i n v o l ving imminent dang er to a person or proper ty requiring an urg ent response .” Gaffney v. Board of Trustees of the Orland Fire Protection District
, 2012 I L110012, ¶ 64, 969 N.E.2d 359. The c ourt arrived at this “plain and or dinary meaningof the term” when considering its context in section 10(b) of t h e P u b lic Safety Employ ee Be nefits Act (820 I L CS 320/ 10 (West 2006)). Gaffney
, 2012 I L 110012, ¶ 64, 969 N.E.2d 359

. S ec t i o n 10(b) sets forth the elig ibilit y require ments for firef ighte rs, among others, to have their employ er pay thei r h ea l t h -insuranc e premiums. One situation in which a firef ighte r’s health-insura

nce premiums will be paid is when an injury or death occur red when the firef

ighte r responde d “to wh at is rea sonably believed to be an emer g ency .” (Emphasis omitted.) (Interna l quotation marks omitted.) Gaffney
, 2012 I L 110012, ¶ 53, 969 N.E.2d 359. In considering the t erm’s meaning
, the Gaffney court quoted W ebster’ s Third New International Dictionary definition of the term: “ ‘a sudden bodily alteration such as is likely to require immediate medical attention (as a ruptured appendix or surg ical shock).’ ” Gaffney
, 2012 I L 110012, ¶ 62, 969 N.E.2d 359 (quoting Webster’s Third New International Dictionary 741 (1993))

. The Gaffney court found the term included “an element of urg ency and the ne ed for

immediate ac tion.” Gaffney , 2012 I L110012, ¶ 62, 969 N.E.2d 359. ¶ 76 W e fi n d t h e p l ai n and ordinary meaning of the term “eme rg ency ,” as define d by o u r supreme court in Gaffney
, is the meaning the Gene ral Assembly intended when it include d the term in sections 6 and 9. Emerg ency medical car e is medical car e with “an element of
urg ency and the n ee d for immediate action” ( Gaffney
, 2012 I L 110012, ¶ 62, 969 N.E.2d 359), such as “ ‘a ruptured appendix or surg ical shock’ ” ( Gaffney
, 2012 I L 110012, ¶ 62, 969 N.E.2d 359 (quotingWebster’s Third Ne w Interna tional Dictionary

741 (1993)) ). ¶ 77 Applying t h i s d ef i nition to the term, we find “eme rg ency contra ceptives” do not fall within the plain and ordinary meaning of the term “eme rg ency .” The Web site defe ndants cite for proof “eve ry hour counts” (see http://planbonestep.c om (visited Aug

. 30, 2012)) indicates if “Plan B One- Step®” i s “take n as di rec ted wit h i n 7 2 h o urs (3 day s) ***, it can

s i g n i f i c a n t l y d e c r e a s e t h e c h a n c e t h a t y o u w i l l b e c o m e p r e g n a n t

. ” http:// www.planbone step.com/plan-b- faq.a spx (pag e visited Aug . 30, 2012). The ne x t line
say s “[a]bout seven out of ever y eig ht women who would have go t t en pregnant will not become pregnant,” without making any distinction based on whether the emer g ency

c o n t r a c e p t i v e i s t a k e n i n t h e f i r s t h o u r o r t h e s e v e n t y

- f i r s t h o u r

. http:// www.planbone step.com/plan- b -f aq.aspx (pag e visited Aug

. 30, 2012). In addition, while Dr. Wallace test i fi ed emer g ency contra ceptives become progressively less eff ective

over the course of “seve ral day s,” he also testified the eff ectivene ss “ may lead to inc rea sed risk that it will be ineffe ctive” if a woman fails to take emer g ency contra ceptives in a timely

manner

. (Emphasis added.) Given the 72-hour window, even though the window may become narr ower

in that time frame, unpr otected se x does not pla ce a woman in imminent dang er requiring an urg ent response

. See Gaffney
, 20 1 2 I L 1 1 0 0 1 2, ¶ 64, 969 N.E.2d 359 (providingthe def

inition of “emerg ency”). ¶ 78 Our interpre tation and application of th e t er m “e m er gen cy ” m ay not be the same definition that would be applied by a w oman seeking the emer g ency contra ceptive. Howeve r,

-15-the evidenc e here does not sh o w t h er e wo u l d be an imminent dang er to the patient or the

need for immediate attention as co ntemplated by the Conscience Act (745 I L CS 70/6, 9 (West 2010)).

¶ 79 C. The Injunction ¶ 80 T h e C o n s ci en ce Ac t p ro t ec t s plaintiffs’ decisions not t o d i s p en s e em er gen cy contra ceptives due to their conscie nce beliefs. We need not decide whether the Religio us Fr eedom Act or the first amendment provides simil ar protec tions. We return to the question of whether the perma

nent i njunction issued by the circuit court is overly broad. W e find it is. ¶ 81 T h e C onscienc e Act does not prohibit g overnme ntal action that may ultimately fo rc e health-c are personne l or health-c are fac ili ti es to make a conscie ntious decision based on their beliefs not to comply with that g ove r nme n tal action. The Conscience Act, instead, states such
personne l or entities may not be discriminated ag ainst (745 I L CS 70/ 5, 7, 10 (West 2010))

or punished civilly or criminally (745 I L CS 70/4, 9 (West 2010)) if they make a conscie ncebased decision not to comply

. The Current Rule does not violate th e C o n s ci en ce Act; its enfor ceme nt ag ainst plaintiffs on the issue of e merg ency contra ceptives doe s. ¶ 82 We reve rse the perma nent i njunction g rante d by the circuit court and order def endants

are perma nently enjoined from enfor cing the Current Rule ag ainst plaintiffs in a manner inconsistent with the protections of the Conscie nce A ct.

¶ 83 I I I . CONCL USI ON ¶ 84 We aff

irm t h e ci rc u i t co u rt ’s fi ndings the Current Rule cannot be enfor ced a g ainst plaintiffs without violating the Conscience Act. We reve rse the court’s g ranti n g of a perma nent injunction a g ainst defe ndants’ enfor ceme nt of the Current Rule. We modify the injunction so it enjoins defe ndants from enfor cing the Current Rule ag ainst these plaintiffs, who have conscie nce- based obje ctions to the Current Rule.

¶ 85 Affir

med in part a s modified and re verse d in part.

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