Pap Smear Ransom - Is It Ethical to Refuse to Refill a Patient's Birth Control Until They Come in for Their Annual Exam?

Int J Womens Health. 2020 Apr 8;12:265-267. doi: 10.2147/IJWH.S246220. eCollection 2020.


A review of the common but questionably ethical practice of refusing to refill a patient's birth control prescription until they are seen in office for, and presumably pay for, a yearly examination. This forced decision between making time for the appointment or risking an unintended pregnancy is comically referred to as "Pap Smear Ransom." This short review examines the limited data to support or decry this common practice.

Keywords: annual exam; birth control; contraception; office gynecology.