Pharmacists should not be able to conscientiously object to supplying and dispensing the morning after pill, according to pro-choice doctor and gynaecologist Isabel Stabile.
“Since the effectiveness of emergency contraception depends on taking it as soon as possible, there should be absolutely no barriers to accessing it at any time,” she told Lovin Malta.
Currently, pharmacists have the right to refuse to stock and sell the MAP if they find it goes against their morals. Some believe the pill could have abortive effects, and therefore it would go against their ethics to dispense or refer a patient to another pharmacy to obtain it.
“Since this medicine is legally available without a prescription in Malta, this is unacceptable,” the doctor said.
“Had there been any evidence that emergency contraception did cause abortion, it would never have been legalised in Malta,” Stabile stressed, saying that Medicines Authority in Malta drew upon analysis of research of thousands of experts in the EU, which found no link between abortion and the MAP.
“This is why conscientious objection in the context of pharmacists dispensing emergency contraception makes no sense.”
Scientific evidence shows that if ovulation has already occurred, the gynaecologist continued, then emergency contraception is no longer effective, so it does not prevent fertilisation.
“Moreover, the best available evidence published in peer-reviewed mainstream scientific journals is that emergency contraception does not prevent implantation.”
The reason for this, she says, is that takes about five days for a fertilised egg to travel down to the uterus and implant there. This means that there is not enough time for emergency contraception to make the lining of the uterus so thin as to prevent implantation.
She said pharmacists who conscientiously object should be required to refer such patients to nearby pharmacies that can dispense it. When pharmacies are closed, emergency contraception should be available to anyone who needs it from Mater Dei and Gozo Hospital pharmacy.
In Malta, accessing emergency contraception can be an arduous task.
A recent study found that an average of 64% of pharmacies open on Sunday or public holidays stock the morning-after pill. Meanwhile, women in Gozo that need the pill need to travel down to Malta.
Some pharmacies, including the one in Malta’s national hospital Mater Dei, refuse to stock it.
The Chamber of Pharmacists say they’ll continue to support those who consciously object to stocking and dispensing emergency contraception, in that they are exercising their right to freedom and thought.
However, it does encourage its members to not impose their moral values on others and to refer their clients so that they can access the service, although they are not obliged to.
It said that the state should be held responsible to ensure it provides access to the MAP.
“The Chamber reiterates that since pharmacists who conscientiously object may also object to refer patients, the State should provide access to such a service as making this a legal obligation is a breach of pharmacists’ fundamental human right to freedom of thought and conscience,” the Executive Council told Lovin Malta.
“There is nothing to stop the government’s hospital pharmacies from stocking the emergency contraceptive pill and provide it after pharmacies’ closing hours,” it continued.
In order to address these barriers to access, a map displaying where patients can purchase the morning-after pill has been launched by a new political party Volt Malta. Its filters let users view which pharmacies stock it and which are open on Sundays and public holidays.
Sexual health is a sore point in Malta. Besides the less than ideal access to emergency contraception, the topic is still shrouded in shame. In a country where abortion is completely illegal, it is particularly concerning.
Less than 2% of people got tested at the GU Clinic last year. Meanwhile, sexually transmitted diseases like HIV are on the rise, there are constant shortages of contraceptives and sexual education is not standardised across the board.
It is no surprise to learn Malta’s first and only sexual health policy hasn’t been updated in a decade.
Do you think the state should be obliged to stock the pill?