Medical Council opposes sale of emergency contraceptive over the counter

The Medical Council Malta argues that the morning after pill should only be prescribed by a medical doctor • 'Provision of professional conscientious objector' must be in place

Photo: Chris Mangion
Photo: Chris Mangion

The Medical Council Malta has declared its position against the sale of the emergency contraceptive without a doctor’s prescription, arguing that the pill has different side-effects that women needed to be well aware of.

Refusing to enter into the merits of whether the morning-after pill (MAP) was an abortifacient or not, MCM spokesperson Doreen Cassar insisted that the provision of ‘professional conscientious objector’ must be in place in any law allowing the retail of the MAP.

The council was delivering its position to a joint parliamentary committee, following an internal discussion. “There are various scientific studies and papers which give conflicting and diverse views. I don’t think it is up to the medical council to enter into subjects that should be determined by the bioethics committee,” MCM president Ilona Debono said.

“In view of the different studies, it is up to the doctor to decide whether he wants to prescribe the morning after pill or not. A system of conscientious objector must be in place.”

Prompted by Health Minister Chris Fearne, Cassar said that the sale of the emergency contraceptive pill without a doctor’s prescription would undermine the principles of autonomy and competence.

“An over-the-counter purchase can be made by anyone, irrespective of the gender. If a man can purchase the morning after pill, whose autonomy are we protecting? How can a doctor advise a woman whose severely asthmatic or suffering from epilepsy, that taking the emergency contraception could be harmful? Who is going to tell an overweight woman that the morning after pill probably won’t work?”

The Medical Council Malta insists that a patient must seek doctor's assistance before taking the morning after pill
The Medical Council Malta insists that a patient must seek doctor's assistance before taking the morning after pill

The medical council said that patients had a right to know of the side-effects and risks that existed and of efficacy failure if a woman weighs over 77kg.

A debate on whether the morning-after pill – such as ellaOne and Levonelle – should be allowed in Malta has been raging on ever since the Women’s Rights Foundations filed a judicial protest demanding its legislation.

The lack of consensus, including among MPs, led Prime Minister Joseph Muscat to request a report by three parliamentary committees, before the Medicines Authority can actually give its go ahead for the importation of the morning after pill.

The report is currently being drafted and will be presented to parliament when the House of Representatives reconvenes in October.

While the morning after pill is not available in Malta, doctors in Malta still prescribe a ‘substitute’. Esmya (ulipristal acetate 5mg) is used for uterine fibroids – non-cancerous growths of the uterus that often appear during childbearing years – but taking six pills will achieve the same results of an emergency contraceptive, a medical source had told MaltaToday.

Despite the widespread practice, the medical council this afternoon told MPs that it had never received such reports.

In reply to a question by Labour MP Etienne Grech, Cassar said that a doctor caught prescribing a substitute “would be in huge trouble” if facing the council.

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