Issue link: https://maltatoday.uberflip.com/i/694236
14 PERCEPTIONS can be danger- ously misleading at times. And there can be little doubt that popular perceptions surround- ing the 'morning-after pill' – and emergency contraception in gen- eral – are somewhat on the nega- tive side in Malta. This can be attested by public reactions to the fact that a wom- en's rights organisation this week filed a judicial protest to overturn an apparent 'ban'. Inevitably, the sternest resistance to this pro- posal comes from the pro-life lobby. The Gift of Life Founda- tion lost no time in branding the judicial protest as part of a con- spiracy to 'introduce abortion by stealth'; whereas another pro-life group, 'Women For Life' added that Malta would be 'promoting rape' by making emergency con- traception available to women. This is to an extent consistent with the same lobby's very vocal views on all areas touching on female reproductive rights. But on this occasion, similar doubts were expressed also by former Health Minister Godfrey Farru- gia: who likewise insisted in par- liament that the morning-after pill is 'abortifacient'. This view is hotly contested by the WRF, which argues that this is an issue about basic women's rights, and has nothing to do with abortion. Clearly, there are a good deal of conceptions and misconceptions flying about here. As chairperson of the group, Lara Dimitrijevic both signed and presented the protest on behalf of another 102 Maltese women… and therefore may be able to clarify at least one side of the argument for us. Is the morning-after pill aborti- facient, or not? And what, exact- ly, is the purpose of the judicial protest to begin with? "Let's start off with the fact that we are not talking about a 'ban' here," she begins in her legal of- fice in Valletta. "There is no ban on the morning-after pill in Mal- ta. The situation is simply that the pill has not been licensed by the health authorities. It was an administrative decision not to is- sue a licence for emergency con- traception… and as such, not the result of any prohibition at law. The point of our judicial protest was to challenge this decision, which we feel breaches women's most basic rights…" Why a judicial protest, though? Why not an outright court case to overturn the decision? And for that matter: why go directly to court, and not (as other voluntary groups often do when lobbying for change) approach the govern- ment with a view to convincing it to change policy? "Given that we are bringing to attention a breach of human rights, we considered a judicial protest to be more appropri- ate than taking to the streets, or lobbying with the govern- ment. It was an administrative decision, and we are challeng- ing it administratively. We be- lieve this decision breaches the fundamental rights of women, enshrined by a number of in- ternational treaties that Malta has itself signed and ratified. Namely, the Convention on the Elimination of All Forms of Discrimination against Wom- en (CEDAW)…." On closer scrutiny, the con- vention cited by Dimitrijevic turns out to be rather specific on the issue of emergency con- traception… and especially the obligation of all signatory governments (Malta included) to make it available in their re- spective countries. Article 10h even states that: "It is discriminatory for a State party to refuse to legally pro- vide for the performance of certain reproductive health services for women" Of arguably greater relevance to the local issue is the fact that the UN Committee oversee- ing the implementation of this convention has separately con- demned the Philippines for dis- allowing the morning-after pill. Its ruling observed that that Filipino women "bore the con- sequences of and were dispro- portionately disadvantaged by the inability to access and use the full range of reproductive health services, including mod- ern methods of contraception." "Yes, that is why this is ul- timately an issue of human rights, Dimitrijevic continues. "And we feel that, in order to protect one's rights, one has to go to the law-courts. We did this by filing a judicial protest… not a court case, as some have mistakenly described it. We are not asking for a ruling from the courts. This is simply an ad- ministrative procedure to make our request known. The protest was separately addressed to the Ministry of Health, the Minis- try for Social Dialogue, and the Attorney General… who natu- rally has to be copied in to any request concerning any legisla- tive changes. Now that the protest has been filed, what sort of response – if any – is she expecting? And has any been received to date? "So far, no. We haven't heard anything in the way of official feedback yet. Technically the government entities we ad- dressed all have the right to reply if they wish. But there is no legal obligation for them to do so. This is more a case of us standing firm on the point that we feel our rights are being breached. Through the judicial protest, we are both asserting our own position, and placing the au- thorities 'in mora' [that is to say, in a position where the onus of reply lies with them]." Fair enough, but that doesn't give any indication of what WRF's expectations are on a re- alistic level… "Ideally, we expect the change to happen. The ball is now in the government's court; it is up to the government to see what it wants to do about the situation. We will wait and see what its response is, before deciding to take the matter any further…" At the same time, the request it- self is to overturn a (seemingly ar- bitrary) decision not to license a single pharmaceutical product. Is it really as simple as that, though? Does the requested change neces- sitate any change to Malta's leg- islation? "No, the law does not come into the equation, because the morn- ing-after pill itself is not illegal. Nor is it abortifacient, which would be the only reason for any law against it in the first place…" Yet there seem to be contrast- ing views on that point. The pro- life lobby clearly disagrees, and enjoys the support of a former health minister…. "Yes, but in matters such as this decisions shouldn't be taken on the basis of individual views. This is a scientific issue, and should be based on what science says on the subject. The simple truth is that emergency contraception does not induce abortion…" How does she account for the controversy, then? "It all boils down to what you consider a pregnancy. That is the crux of the matter. The scien- tific definition is clear, but what causes the controversy is the amount of misinformation and scaremongering surrounding the issue. Some people are creating their own definitions. Naturally, everyone has a right to their own moral definitions, and base their own personal decisions on those convictions. That's perfectly fine. But we are talking about scientific definitions here. Our point is that decisions such as licensing a con- traceptive pill should be taken on the basis of fact, not moral opin- ions…" But if science is so clear on this point, why is there so much re- sistance to licensing this pill in the first place? "A lot of it has to do with mis- conceptions regarding what the morning-after pill really is, and what it does. It is partly based on outdated information going back to the 1970s, when the morning- after pill was first introduced. At the time, the oral contraceptive pill contained very high hormo- nal content, which proved harm- ful to women. The dose was re- duced, and this gave rise to what became known as the 'third way' (of a three-way action): the thin- ning of the uterus lining, which prevented fertilised eggs from be- ing implanted…" Some 40 years ago, then, there may have been some truth to the claim that MAP was 'abortifa- cient'. But the pill itself has been modified over years of clinical testing since then, she adds. "The most recent research, car- ried out by Princeton University (March 2016) shows that there is no evidence that the morning- after pill has any effect at all post- fertilisation. It does not thin the uterus lining, or prevent implan- tation from taking place. These findings have been endorsed by the World Health Organisation, the International Federation of Gynaecology and Obstetrics, and the European Health Authority. Ironically, other forms of hormo- nal contraception that are freely available in Malta have more of a chance of inducing an abortion than the morning-after pill…" Interestingly, the same 'abor- tifacient' effect can even be in- duced by entirely natural ac- tivities. "Such as breastfeeding, for instance. That can thin the uterus lining, too. So what do we do? Ban breastfeeding, because it might be 'abortifacient'…?" Dimitrijevic also hints that there may be an ideological driv- ing force behind the authorities' insistence on maintaining such an outdated view. "On the government's sexual health promotion website, until yesterday it stated that emergen- cy contraception was unlicensed in Malta, and the reason it gave was because, 'according to the Catholic Church' – or words to that effect – the morning-after pill is abortifacient. Strangely, that has been removed since yes- terday; and there is now a new version which does not refer to the Church, but which echoes the same line that it is 'abortifacient' from an 'ethical' point of view. And also that it is 'illegal'…" Both statements, she adds, are highly problematic. "When discussing people's rights, you cannot impose mo- rality. Human rights cannot be made subject to personal ethi- cal interpretations. And I think people are ready for this. We saw this, up to a point, with the divorce referendum. People are tired of having moral choices imposed on them. They want to move on. It is the second assertion, how- ever, that Dimitrijevic finds more objectionable. "I invite the health department to tell us where, exactly, it tran- spires that emergency contracep- tion is illegal in Malta. We con- test that view." Interview By Raphael Vassallo maltatoday, SUNDAY, 19 JUNE 2016 Breastfeeding can thin the uterus lining, too. So what do we do? Ban breastfeeding, because it might be 'abortifacient'…? ABORTIFACIENT Aborting misconceptions