Issue link: https://maltatoday.uberflip.com/i/736806
27 maltatoday, SUNDAY, 9 OCTOBER 2016 Editorial MaltaToday, MediaToday Co. Ltd, Vjal ir-Rihan, San Gwann SGN 9016 MANAGING EDITOR: SAVIOUR BALZAN EXECUTIVE EDITOR: MATTHEW VELLA Tel: (356) 21 382741-3, 21 382745-6 • Fax: (356) 21 385075 www.maltatoday.com.mt E-mail: maltatoday@mediatoday.com.mt Quote of the week An affront to women's rights "This particular topic has needlessly vexed individuals and groups into dogmatic postures that are entirely without basis in fact – they are fighting a lost battle" Prof. Victor Grech writes about the morning-after pill in the editorial for the Malta Medical Journal The outcome of the parliamentary debate on emergency contraception – up to this point unavailable in Malta – was unsatis- factory on many levels. After months of discussion with various experts and stakeholders, who gave con- flicting advice and opinions on the effects of the morning-after pill (MAP), MPs sit- ting on the social affairs, health and family committees decided to recommend that the emergency contraceptive pill can only be dispensed against a doctor's prescription. They said the Medicines Authority must assess and process each individual applica- tion in respect of the Criminal Code and the Embryo Protection Act. "Any decision taken by the Medicines Authority must be based on the present laws, without hinder- ing the fundamental human rights as listed in Malta's constitution," their recommenda- tions read. Considering the arguments brought for- ward during the debate itself, this appears to be an entirely pointless compromise. Time and again during the discussion, all the relevant experts in the field – including the Medicines Authority – all concurred that the morning-after pill is not aborti- facient. All clinical studies cited clearly indicate that the pill does not prevent implantation of a fertilised ovum (and hence interrupt a real pregnancy). As such, its effects as a contraceptive are no different from those of the inter-uterine diaphragm, or for that matter the condom: which can be purchased over the counter in any phar- macy, and even from dispensers in public toilets. In the words of Professor Mark Brincat, an eminent local scientific obstetrician and gynaecologist, "there is not a single peer- reviewed publication that demonstrates that emergency contraception leads to a fertilized egg (oocyte) failing to implant, let alone cause an abortion. Expressing doubt is not enough, one has to demonstrate sci- entifically and actively that such a mode of action takes place. [...] one has to demon- strate that an action has happened in order to allege a crime." The only difference is that emergency contraception is designed for use at a point when it would be manifestly too late to resort to other methods. But this, in itself, is absolutely no reason to demand that the pill be subject to prescription. One can only conclude that in taking this illogical decision, the parliamentary com- mittee was only concerned with placating a small but very vociferous lobby, in a way that appears reasonable on the surface. It is not, however, reasonable to place ad- ditional hurdles and obstacles in the path of women who would already be in a state of anxiety and stress. Nor is it reasonable to make a necessary medicinal product harder to obtain, just to placate a section of the public. It is also a counter-productive resolu- tion to the issue. Members of the same parliamentary committee had (unwisely) pronounced themselves against the morning-after pill before the debate even started. Apart from raising questions about the possibility of a biased committee, these MPs – including former minister of health Godfrey Farrugia – later withdrew their objections after Malta's medical authorities finally set the record straight regarding the non-existent connection to abortion. Under those circumstances, the only ob- jection had been quashed. Why, therefore, did the committee feel the need to impose an extra bureaucratic layer, on what is es- sentially a fundamental women's right? In order to exercise this right, Maltese women – alone in Europe – have to ask for 'permis- sion' to access a very basic emergency medi- cal service. It bears mentioning also that the direction taken by Malta's parliament is at loggerheads with the European Commis- sion on this issue. In January 2015, the EC upheld a Euro- pean Medicines Agency's (EMA) proposal to recommend classifying emergency con- traception as an over-the-counter product. Even if the recommendation is non-binding (Malta appears to be the only member state to have ignored it) one would expect valid argumentation to justify our rejection of this recommendation. There doesn't seem to be any form of scientific or medical justification. Political justifications are not good enough. Politically, this compromise may be convenient for a political class that doesn't seem interested in the plight of the people affected by their decisions. But for women, it is yet another attempt to wrest control of their bodies away from them, and place it in the hands of institutions. It is also a system that invites a clear abuse of such rules: willing doctors might allow women to use the same prescription for numerous purchases; pharmacists who know their clients might even be willing to sell the MAP without needing to see a prescription. Far more probably, however, it will result in fewer women attempting to avail of the service. It is common knowledge that on sensitive, private issues such as this, unnec- essary medical intervention is a serious de- terrent. Ironically, this could even increase the backroom (or overseas) abortion rate. Ultimately, it boils down to the question of whether this country really has women's rights at heart. A heroin addict is (rightly) given dozens of syringes, no questions asked, from a clinic because it is a health concern in the battle against HIV and other blood-transmitted diseases. On the same principle: why should a wom- an require permission to use the morning- after pill? This was the question parliament was meant to answer. It failed to do so.