A Hard Pill to Swallow
"Emergency Contraceptive" Fuels Legal Fights
NEW YORK, JULY 24, 2005 (Zenit) - A federal agency might soon decide whether the so-called morning-after pill can be sold without a prescription in the United States. The Food and Drug Administration could decide on the issue by Sept. 1, the New York Times reported July 16.
Last year the FDA rejected an application by Barr Pharmaceuticals to make its morning-after pill, Plan B, available over the counter. Regulators cited concerns about whether young girls would be able to use it safely. Since then advocates of the pill have waged a campaign to overturn the decision.
The battle has also continued at the state level. In Massachusetts, legislators in the House have passed a measure allowing pharmacists to dispense the morning-after pill without a prescription, the Boston Globe reported July 7. The state Senate already approved a similar bill. Once the differences between the two bills are settled, it will be presented, with a vetoproof majority, to Governor Mitt Romney for his signature.
The bill also obliges hospitals to offer the pill, also referred to as "emergency contraceptives," to rape victims. At this stage it is unclear if Catholic hospitals will be exempt from this requirement. Commenting on the issue to the Globe, Maria Parker of the Massachusetts Catholic Conference, explained: "The moral problem for us comes when she is pregnant, and giving her emergency contraception would cause a chemical abortion."
Last month the New York state Senate passed a bill that would allow pharmacists and nurses to dispense the morning-after pill without a prescription, the New York Times reported June 23. The state Assembly has until the end of the first week in August to send the bill to Governor George Pataki, the Kaiser Daily Reproductive Health Report said Monday.
A Republican, Pataki is planning to decide soon whether to seek a fourth term or explore a run for president, the Times said. He was reportedly noncommittal on whether he would sign the bill.
On July 6, eight Catholic bishops of New York state sent a letter to Pataki urging him to veto the bill. The morning-after pill, they explained, can either prevent pregnancy or terminate a pregnancy already begun. "Medical experts, including those at the U.S. Food and Drug Administration (FDA), agree that the morning-after pill can alter the lining of the uterus so that a new human embryo would be unable to implant. If the pills act in this manner, a chemical abortion has occurred, destroying the life of this new human being," the bishops stated.
Hence the bishops argued that the promotion of such pills as being a simple contraceptive, albeit taken the next day, "is false advertising and denies women and girls fully informed consent regarding the drugs they may be ingesting."
The bishops also observed that another ground for concern is that the bill has no age limit, thus allowing young children "to access these drugs repeatedly without parental consent and without a physician's oversight."
The spreading use of the morning-after pill has also brought with it controversy over whether pharmacists who are opposed to abortion can opt out of selling the pill. The issue came to a head in Illinois when Governor Rod Blagojevich issued an emergency ruling requiring pharmacies to fill prescriptions without delay, the Associated Press reported April 1.
The governor made the ruling following the refusal of a Chicago pharmacist to refuse to fill a prescription due his moral objections. The new rule stipulates that if a pharmacist does not fill the prescription because of a moral objection, another pharmacist must be available to fill it without delay.
Many states are in the midst of conflicts over the conscience objections by pharmacists, the Christian Science Monitor reported April 8. The article noted that 13 states are considering giving pharmacists a type of conscience-clause opt-out that would allow them to refuse to fill some prescriptions that go against their personal beliefs. At the time of writing four states already had such laws on the books, the Monitor added.
In April, Colorado was involved in the issue, when Governor Bill Owens vetoed a bill that would have required all hospitals in the state to inform rape victims about emergency contraception pills, the Denver Post reported April 6.
Owens cited freedom of religion when he vetoed the bill. "It is one of the central tenets of a free society that individuals and institutions should not be coerced by government to engage in activities that violate their moral or religious beliefs," the governor wrote in his veto message.
He noted: "While this bill did offer health-care professionals the right to decline to offer emergency contraception due to religious or moral beliefs, it did not offer those same protections to health-care institutions. This is wrong. And it is unconstitutional."
But a few days later, Arizona Governor Janet Napolitano vetoed a bill that would have allowed pharmacists to refuse to provide abortion-related medications on the grounds of moral or religious beliefs, the Associated Press reported April 14.
Supporters of the proposal were disappointed with the veto of what three Catholic bishops called civil rights legislation for health care professionals and institutions, the AP reported.
Doubts and dangers
Meanwhile, researchers are raising doubts about the morning-after pill. The Washington Times reported Jan. 5 on a study published in the Journal of the American Medical Association. That study compared young sexually active women who were handed packages of morning-after pills, to women who had to go to drugstores or clinics to obtain them.
Six months later the two groups had virtually identical pregnancy rates. "That was definitely a disappointing finding," said Tina Raine, lead researcher of the study of 2,117 women. A core hypothesis, she said, was that groups of women with easy access to the pills would have half as many pregnancies as women who had to see a health provider to get the pills. Instead, the groups had the same pregnancy rates of around 8%.
On June 9 a Spanish Internet news site, Periodista Digital, published a report that warned the morning-after pill was becoming something used habitually on weekends, leading to health risks.
The warning came during the 28th congress of the Spanish Gynecological Society. José María Lailla, vice president of the group, affirmed that the pill is only meant for emergency use and should not be given without a medical prescription. Yet the emergency clinics of many hospitals are being converted into free-for-all distribution centers for the morning-after pill, many of them given out to adolescents.
Other specialists at the meeting explained that the morning-after pill brings with it certain risks and that its use should be "exceptional." Rosa María Sabatel, a doctor at the University of Granada, added that the use of the morning-after pill had not cut the number of unplanned pregnancies.
The pill is also causing controversy in other countries. In England, parents have attacked authorities for distributing it at school without parental consent, reported the Telegraph newspaper on April 24. At least one school in each of 68 local education authorities in Britain offers emergency contraception, according to the article.
And in Mexico last Sunday Cardinal Norberto Rivera Carrera, archbishop of Mexico City, said that distributing the morning-after pill is equivalent to allowing the recipients to kill, given that it is abortive, reported the newspaper El Universal. Controversy over the use of this pill is clearly set to continue.
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