Emergency contraception a flawed choice

London Free Press
March 19, 2002

Reproduced with permission

Sharon  Osvald

Tomorrow, the first day of spring, a coalition of American national, state and local organizations will take Walt Disney’s Bambi’s notion of “being twitter pated” to a new level.

March 20 is the kick-off to their first annual “back up your birth control” campaign. On that day, women all over the U.S. will be asked, regardless of their need, to request emergency contraceptives (EC) from their doctors. Doctors will promise to tell their patients about EC; pharmacists will talk to their customers about it and activists will lobby both state and federal legislatures in favour of more access and awareness of EC.

Similar campaigns to support what many call the morning pill have been taking place for a couple of years with radio ads, billboards picturing a broken condom and other literature. The Web site has an image of a young working woman flexing her bicep with a heart-shaped tattoo saying EC.

Preven and Plan B are the two emergency contraceptives approved in Canada, but according to pharmacists I’ve talked to, many doctors have been prescribing concentrated birth-control hormones within 72 hours of sex since the 1970s. If taken in time, it prevents fertilized eggs from implanting on the uterine wall. Advocates for EC call it “a  safe, effective back-up birth control method that can prevent pregnancy after unprotected intercourse or contraceptive failure.” Opponents, however, call it an “abortifacient,” believing conception begins at fertilization and the idea of contraception after the fact is nothing more than wishful thinking.

I am certain the intentions of the majority involved in this initiative are good. After all, even the most pro-choice person knows the fewer full-fledged abortions that take place, the better for everyone. Consider the horrible state of the 15-year-old Brampton girl recently charged with second-degree murder after hiding her pregnancy and injuring her baby girl in an unassisted home birth. In contrast, EC pills seem such a neat little compromise. More radical feminists embrace EC as a tool to empower women against the evil oppressor, men, who make us pregnant in the first place and get off scot-free.
However, aside from my personal convictions about when life begins, this campaign and others like it give me the willies. This is because, in the words of Canadian organization, The Protection of Conscience Project, they are so “well-organized, well-connected and well-funded” and “may directly impact some conscientious objectors, especially if activists decide to target objectors or objecting facilities in order to get media coverage or to initiate complaints of professional misconduct.” In short, these groups bully those who don’t see the world from their point of view and trample on objectors’ rights and freedoms.

Secondly, it seems to me the message of emergency back-up plans is cheap. I mean, if a group is going to take time, energy and resources to imprint a message into the psyche of young women, is this the best message we have to give them? Why not teach them to respect themselves, to be responsible for their actions (even mistakes) and how to form monogamous, lasting accountable relationships, instead of ones that create an emergency if you become pregnant when pre-intercourse birth control fails? Why don’t we hand out planned parenting post cards that say, “Don’t waste yourself on a one-night stand,” instead of, “You have 72 hours to erase last night.” Rather than simply empowering women to be in charge of their bodies, why not teach men and women what a wonderful thing sex can be in the right context? Maybe even, heaven forbid, encourage  them to wait? Then we might not only have less unwanted pregnancies, but also women who are emotionally healthy and truly empowered.

Letter to the editor, Pharmacy Practice

Rosalyn Wosnick invites her readers to equate conscientious objection among pharmacists to the bigotry of a ‘deep south’ restauranteur, who argued that he had a right to deny service to blacks. (Editorial, Pharmacy Practice, July 2000) The analogy is misplaced, misrepresents the position of conscientious objectors, and is likely to engender prejudicial attitudes among their colleagues.

It would have been more accurate to compare pharmacists who have moral objections to dispensing a drug with a coffee shop owner who refuses to sell Brand X coffee to anyone, because it has been produced by child labour. The object, in both cases, is to avoid complicity in what the parties judge to be evil, regardless of the legalities involved.

However, Ms. Wosnick suggests that if a product is legal, and she wants it, other people should be made to give it to her, even if doing so would be contrary to their moral convictions. The product she is concerned about is Preven. Let’s consider a different product.

Ammunition, like Preven, is a legal product. Moreover, one has a legal right to defend one’s own home, even to the point of using deadly force, if need be. Suppose that a householder wants ammunition for defence against burglars, but a gun store clerk with moral objections to this type of crime prevention refuses to sell him ammunition. Applying Ms. Wosnick’s reasoning, the customer complains that the clerk is denying him his “right” to obtain a legal product. He demands that the clerk sell him the ammunition, or refer him to a more willing colleague, threatening to have him fired if he does not do so.

To say shotgun slugs are “legal”, however, means only that the customer is free to obtain and use them for legal purposes. It implies nothing about how gun store clerks should exercise their own freedom, even if licensed gun stores have a monopoly on the sale of ammunition as part of the state gun control system. Freedom to buy shotgun slugs – or drugs – does not mean that one is legally obliged to sell them, or to help others buy them.

If Ms. Wosnick asserts, instead, that there is a moral obligation to dispense a drug, and that this moral obligation is absolutely binding, she must identify the source of this morality. Moreover, since she would not dare to suppress the moral or ethical beliefs of others unless she was convinced that they were inferior to her own, she must explain why her moral views are superior to those that she seeks to suppress. Finally, in view of human rights jurisprudence that generally requires accommodation of belief rather than its suppression, she must explain why accommodation of those who disagree with her is impossible or undesirable.

Sean Murphy, Administrator
Protection of Conscience Project

Project letter to the editor, The Standard

A number of health care professionals have moral or ethical objections to dispensing the ‘morning after pill’, so a recent article in The Standard (“Morning-after pill poses moral dilemma for some Mds”, 29 June 2000) is of interest beyond the community served by your paper. I would like to make two points.

First: though the drug in question was described as a ‘contraceptive’ that ‘prevents pregnancy’, many who are familiar with the action of the drug consider it an abortifacient, not a contraceptive, and object to dispensing it for that reason. Moreover, people attempting to understand the issues involved need to be aware that the words ‘abortion’, ‘pregnancy’, ‘conception’ and ‘contraception’ are often assigned completely different meanings by parties in the dispute about Preven.

Second: the good news in the story is almost too obvious for many to see. The woman obtained the drug that she wanted, and the physician was not forced to involve himself in something that he considered to be morally abhorrent. Arrangements at the hospital accommodated both her request for the drug, and his request not to have someone else’s morality imposed upon him.

This is the kind of common-sense accommodation that ought to be more widely practised.

Sean Murphy, Administrator
Protection of Conscience Project

Letter to the editor, Globe and Mail

Reproduced with permission

Re: April 27, 2000: Don’t let drugstores become pulpits

An “inability to distinguish between emergency contraception and the abortion pill”, and “irresponsible and blatantly uninformed” actually describes Planned Parenthood, not educated pharmacists. Planned Parenthood eagerly wants women to ingest dangerous hormones, which in the case of the morning after pill, fails at least 25% of the time. Planned Parenthood, not pharmacists, makes the choice for women by withholding facts and “spreading misinformation” in the name of sexual freedom.

Let every woman exercise her right to make an informed decision: the scientific literature is clear and abundant that the morning after pill (post-coital interception) acts primarily to prevent implantation, not ovulation. Therefore, to call it a contraceptive is false and misleading. To argue that pregnancy is not already established is a minority viewpoint ignoring virtually all embryology, biology and genetics texts.

Dr. Albert Yuzpe invented the morning after pill, yet does not mention ovulation prevention in his Contemporary Obstetrics and Gynecology article in 1994. He does mention, however, structural changes in the endometrium might “represent a hostile or non-receptive site for implantation”.

Futhermore, Jennifer Kessell, spokewoman for the company making Preven, confirmed that “more often it would prevent implantation” (The Report, Dec 6, 1999).

Pharmacists are objecting to participate, not attempting to block patient access to products. Doctors cannot be forced to perform procedures that violate their consciences, why should pharmacists? By pushing their morality on health care workers, the public violates a pharmacist’s autonomy, integrity, and basic human rights in a country that protects its minorities

Maria Bizecki
Concerned Pharmacists for Conscience

 

 

Concerned Pharmacists cite lack of consultation in Alberta

News Release

Concerned Pharmacists for Conscience

In a controversial policy change, announced this week the College of Pharmacists of B.C. decided to allow pharmacists to hand out the morning after pill, Preven, over the counter without a doctor’s prescription.  In response, Greg Eberhart, registrar of the     Alberta Pharmaceutical Association (APhA) has stated that “The APhA hopes to follow  B.C.’s push…”

“There has been no dialogue between the membership of the APhA and its executive, as to how pharmacists stand on this position,” says Ms. Maria Bizecki, spokesperson for  the group Concerned Phamacists for Conscience (CPC).  Ms. Bizecki further states the  APhA executive finds itself under increased pressure from the Society of Obstetricians and  Gynecologists of  Canada (SOGC), to dispense this product over the counter.

In 1995, the issue of a “conscience clause” came before the  APhA  membership and was passed, but, after consideration, dismissed by the APhA’s self-appointed Regulatory Affairs Committee.   “Forcing pharmacists to dispense or refer patients requesting Preven, an abortion causing drug developed to primarily act during Implantation of an embryo, is an insult to the autonomy of the pharmacist, the profession of pharmacy, and a health risk to women” adds  Ms.Bizecki.

Concerned Pharmacists for Conscience (CPC) is opposed to pharmacists dispensing     medications that violate their conscience on moral, medical ethical, or religious grounds.

For further information: Ms. Maria Bizecki, spokesperson Tel: (403) 228-2190  Fax:(403) 228-2249

 

Canadian Pharmacists Association re: conscientious objection

A report from Life Site News referred to an article in the January edition of the Canadian Pharmacy Practice journal. With respect to the drug ‘Preven’ (‘morning after pill’), Jeff Poston, executive director of the Canadian Pharmacists Association (CPhA), was reported to have commented that while the CPhA “supports the use of the new drug, it also recognizes the pharmacist’s right to refuse to fill [a prescription] based on moral or religious beliefs.”