I refer to Martin Scicluna’s article on the morning after pill (July 13). The title ‘Ovarian Obsessions’ is disparaging, the right-to-life lobby are “a rag-bag”, and the priests who have contributed to the discussion are “sundry clerics”. Scicluna is a master of vocabulary, but I do not find that insulting people helps one’s argument. Such prejudice affects objectivity, and so his credibility suffers.
In his article, Scicluna states: “Women’s human rights are enshrinedin international treaty, the Convention on the Elimination of All Forms of Discrimination against Women, which Malta signed and ratified decades ago. This specifically states that signatory countries are obliged to make emergency contraception (the morning-after pill) available: It is discriminatory for a State to refuse to legally provide for the performance of certain reproductive health services for women.”
I read through this treaty and found it does not state those words, it does not mention emergency contraception, and it does not mention the morning-after pill.
Scicluna might also have added, once he mentioned ratification by Malta, that Malta at that time (1991) made an express reservation to the part of the treaty, article 16(1)(e), that says that the countries that are parties to the treaty “shall take all appropriate measures to eliminate discrimination against women in all matters relating to marriage and family relations and in particular shall ensure, on a basis of equality of men and women… the same rights to decide freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise these rights”.
The central issue in this debate is whether the morning-after pill is just a contraceptive, or whether it could also have an abortive effect
The government of Malta made the reservation that it does not consider itself bound by this sub-paragraph (e) of paragraph (1) of article 16 in so far as the same may be interpreted as imposing an obligation on Malta to legalise abortion.
The central issue in this debate is whether the morning after pill is just a contraceptive or whether it could also have an abortive effect.
On this, Scicluna says that the overwhelming scientific evidence is clear that the morning after pill is not an abortifacient and cannot interfere with an embryo once fertilisation has taken place.
One notes his careful insertion of the word “overwhelming”, which I take to mean that he accepts that what he says so emphatically does actually fall somewhere short of absolute.
However, he does not elaborate.
Is Scicluna correct in saying that it is so clear that the morning after pill is not an abortifacient and cannot interfere with an embryo once fertilisation has taken place? I have tried to find out. He might have been referring to ‘Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy, an article by James Trussell et al, June 2016, referred to recently by the Malta Chamber of Pharmacists. It states: “ECPs (emergency contraceptive pills) do not interrupt an established pregnancy, defined by medical authorities such as the United States Food and Drug Administration/National Institutes of Health and the American College of Obstetricians and Gynaecologists as beginning with implantation. Therefore, ECPs are not abortifacient.”
Of course, if one does not agree with that definition and believes, as so many people do, that life begins earlier, with fertilisation, the above statement no longer holds true. Trussel goes on to say:
“To make an informed choice, women must know that ECPs – like all regular hormonal contraceptives such as the birth control pill, the implant Implanon, the vaginal ring NuvaRing, the Evra patch, and the injectable Depo-Provera, and even breastfeeding – prevent pregnancy primarily by delaying or inhibiting ovulation and inhibiting fertilisation, but it is not scientifically possible to definitively rule out that a method may inhibit implantation of a fertilised egg in the endometrium.
“At the same time, however, all women should be informed that the best available evidence is that the ability of levonorgestrel and ulipristal acetate ECPs to prevent pregnancy can be fully accounted for by mechanisms that do not involve interference with post-fertilisation events.”
I am not able to say whether the above, in a nutshell, accurately states the current scientific position. However,I am comforted by the fact that the Malta Chamber of Pharmacists has referred to it.
The conclusion one can fairly reach is that the scientific investigation is ongoing, that in most cases the morning-after bill will not act as an abortifacient, but there is the possibility that the morning after pill can be abortifacient.
David Grech is a practising lawyer.