It’s not a ban, and it’s not abortion, either

By now you will surely have read something, somewhere, about how a women’s rights organisation has filed a judicial protest to overturn a ‘ban’ on the morning after pill. 

If not, you will at least have heard the howls of protestation that piped up as a result, and felt the tremors of the moral earthquake that is still ongoing as I write… in fact, I reckon they were felt as far afield as New Zealand and Panama.

Ah, well. Just wouldn’t be the same old Malta, would it, if people didn’t instantly work themselves up into a tizzy at the mere mention of the word ‘abor’…

WHOAH! I nearly said it there myself. What was I thinking? Do I really want to start all that racket again? Do I really want to invite the unbridled wrath of a handful of morally outraged pro-lifers out there (who, amusingly, still seem to think they speak on behalf of the entire country)?

Erm… well, I’ve had a lot worse in my time, come to think of it. So what the heck? ‘Abortion’. There, I said it. Now let’s get back to the issue that caused all this fuss to begin with.

As I was saying, a judicial protest has now been filed to challenge… well, not quite a ‘ban’, it would seem. Technically, the pharmaceutical product known as the ‘morning after pill’ is not ‘banned’ in Malta… it is merely unlicensed, which is not the same thing at all.  

It may seem like a small detail, yet it is a crucial component of the entire debate. A ‘ban’ implies a conscious decision to outlaw something… and that in turn requires legislation, which in our country can only be enacted by Parliament. The decision to license a medical product or otherwise, on the other hand, is generally taken by the health authorities, at a much lower administrative level than the House of Representatives. And it is a routine decision that is taken constantly, too… every time a new product comes onto the market, in fact.

So if the morning after pill is unavailable in Maltese pharmacies, it is not because of any law that prevents pharmacies from actually stocking it… but only because the local health authorities have unilaterally taken it upon themselves to withhold the necessary authorisation. 

Why, do you ask? Well, it’s difficult to say… seeing as their reasons seem to keep changing from one moment to the next. 

Up until last Thursday, the official explanation, as supplied by the Sexual Health Promotion unit’s website, was that: “The Catholic Church regards any mechanism that blocks or inhibits the implantation of a fertilised ovum an abortion, therefore the morning-after pill is considered as an abortifacient.”

Suddenly, however, the wording changed (at some time between 2 and 4pm on Thursday afternoon, to be precise). It now reads: “Any mechanism that blocks or inhibits the implantation of a fertilised ovum an abortion, therefore forms of the morning-after pill is considered as an abortifacient.” [sic]

OK, I’ll admit I’m a bit of a stickler for grammar, so I immediately noticed that – in their haste to cover up the real reason – the operative verb of the main clause ended up as missing as the reference to the Catholic Church. 

The sentence should, of course, read: “Any mechanism that blocks or inhibits the implantation of a fertilised ovum IS (or CONSTITUTES) an abortion.” But that’s precisely the sort of detail you might accidentally miss, if you just select the handful of words you want deleted and cut them… without actually re-reading what’s left of the mutilated sentence afterwards.

Is this significant? As far as I am concerned: yes, very. If nothing else, it is hugely indicative of the level of seriousness employed by the Sexual Health Promotion Unit when taking sensitive decisions that have a direct impact on other people’s lives.

In any serious country, health authorities are expected to provide scientific, medical reasons when licensing or refusing to license any given pharmaceutical product. They are certainly not expected to base such decisions on their own personal views on religion and morality. 

I suspect that, in the light of the judicial protest, even the Sexual Health Promotion Unit itself must have suddenly realised how very bizarre its previous explanation must have looked… at least, to anyone living in the 21st century. 

In fact, it was not an explanation at all: it merely pointed out that one institution among many in this country happened to be of a certain opinion regarding the medical effects of this particular drug. Exactly why this opinion should have been in any way reflected in a national sexual health policy, to the exclusion of all others, was a question no one in that department had evidently bothered asking until this week.

It is worth repeating the question now. Why did the Sexual Health Promotion Unit include a reference to Catholic catechism on the subject of family planning? Why was this an important consideration, in establishing a national health policy that must cater for all people in this country, regardless of their religious beliefs (or lack thereof)?

To understand how utterly incongruous that reference really was, all you have to do is replace ‘morning after pill’ with another medical issue of your choice… and with it, the institution whose opinion was given such weight.

Let’s see now: “The Alien Abduction Conspiracy Theory Society (Malta Branch) regards all vaccinations to be the true cause of autism… therefore, Malta will no longer carry out vaccination programmes for tuberculosis, rubella, diphtheria, etc.”

That would go down a treat with the medical community, wouldn’t it? And incidentally… though the ‘society’ mentioned above is obviously fictitious… the belief that ‘vaccinations cause autism’ is very real, and shared by a great many people (in Malta and elsewhere). So if such people ever get to collectively wield as much clout as the Catholic Church… can we expect their views to also get reflected in governmental health policy affecting our health?

Hate to point out the obvious, but this is just not a serious way of doing things. The Sexual Health Promotion unit is there to promote sexual health, not to make public declarations of how very jolly Catholic its members all are.

In any case: I can picture a scene at its offices when someone belatedly realised that questions will have to be asked in the wake of the judicial protest. How would they respond to media queries regarding the unavailability of emergency contraception in Malta? Let’s look at what it says on the website, and…

Ooh, that’s not going to help, is it? We’d better delete the bit about the Church, and add a slightly more secular-sounding reason instead…

This brings us to the amended explanation… which is in many ways infinitely worse. “In view of its potential abortifacient mode of action, and in view of the fact that, in Malta, abortion is a criminal offence, the morning-after pill is not licensed locally and is illegal.”

Yikes! It would have been a good deal better – certainly a lot more honest – to stick to the original, loony explanation. This one is not only every bit as fundamentally bizarre as the one it replaced… it is also completely incorrect.

Again, let us apply the same logic to another scenario. According to the Maltese highway code, it is illegal to drive a vehicle on the right-hand side of the road (or under the influence of alcohol, or without valid motor insurance, etc). This means that anyone driving a car in Malta may, at any point, break any of the myriad rules and regulations that govern traffic in any number of ways.

In other words, a crime may always ‘potentially’ be committed. 

Now: if the mere ‘potentiality’ of a crime is enough to prevent the authorisation of a contraception method… shouldn’t the same preventive reasoning also apply to driving? 

Yes, I can really see it all happening. This, for instance, might be a section in tomorrow’s Malta Transport authority website: “In view of the potentially illegal consequences of driving a motor vehicle, drivers’ licences will no longer be issued in Malta, as they are now illegal.”

Hmm. Actually, viewed from that angle, I’m beginning to kind of like the idea. It would certainly do wonders for traffic congestion…

But seriously, people. The reasoning applied above is entirely consistent with the logic pursued when talking about contraception in this country. And it is equally flawed in both scenarios.

First of all, there is no evidence of any kind whatsoever that the morning after pill is abortifacient. The World Health Organisation doesn’t seem to think so, nor does the United Nations. It is debatable whether even the Catholic Church still argues the way the Sexual Health Promotion Unit did until Thursday (though again, I scarcely see why it should be relevant).

Indeed, the evidence points in the opposite direction. This is from a New York Times article (2012). “Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized ….”

This is also the view broadly taken by all other EU countries’ own health authorities: including those of Ireland and Poland, the only other member states where abortion is illegal. Malta is in fact alone among European member states in refusing to license the morning after pill on unabashedly discriminatory grounds.

Malta’s Sexual Health Promotion Unit (not to mention one or two MPs) may therefore owe us an explanation. Why do their scientific views on contraception differ so strikingly from accepted scientific opinion the world over?