Monday, October 29, 2007

Objection Overruled

Or "Every sperm is sacred"

Alice pointed me to an article about the Pope pushing "conscientious objection" as what "true" Catholic pharmacists should use to prevent people from getting pharmaceuticals their doctors believe they should have. Numerous religious leaders have been pushing this as a religious freedom issue, but I believe this is another area where one person's rights can do serious harm to another person.

The drug most commonly brought up in this discussion is the morning after pill. This is often claimed by objecting pharmacists to be an abortion pill, but that is patently false. Here is a quick bio refresher. After sex, sperm survive at most seven days, in that time they have to find their way to the egg and fertilize it. This does not create a human being yet. There are several more things that must happen, and only rarely do, before this embryo can have a chance to become a child. After becoming fertilized, the egg needs to embed itself in the uterine lining. This happens in, on average, less than 25% of fertilized eggs.

The standard birth control pill does the following (from Go Ask Alice):

The synthetic estrogen in the combination pill works to prevent the ovaries from releasing an egg. If no egg is released, there is nothing to be fertilized by sperm and the woman cannot get pregnant. In addition, the synthetic estrogen works by suppressing the body's normal hormonal pattern (which involves one egg being developed per menstrual cycle and released for possible fertilization). The synthetic progestin (present in both types of pills) works to:
  1. thicken the cervical mucus which hinders the movement of sperm,
  2. inhibit the egg's ability to travel through the fallopian tubes,
  3. partially suppress the sperm's ability to unite with (and thereby fertilize) the egg, and
  4. alter the uterine lining so (in the event that an egg is released and fertilized) the egg will likely not be able to implant into the uterine wall. (A fertilized egg would then be discharged with the rest of the menstrual blood.)

The morning after pill is a much stronger dose of the synthetic progestin in order to rush the last effect. This causes the egg, like 75% of fertilized eggs, to fail to attach, thus preventing (not ending) a pregnancy.

As far as reasons for use of this, and the other drugs the Pope and others would like to see effectively banned from sale, they are legion. Many women aren't healthy enough for a pregnancy. Others have been raped or are in an abusive relationship. The pharmacists have no knowledge of this, and don't have a right to such knowledge. The prescribing doctor should have made all of the objections already. The doctor knows about the patient's living status, everything leading up to the prescription, and should have already discussed this with the patient. If the pharmacist has questions, feel free to call the doctor, but the doctor should be the arbiter of care, not the pharmacist.

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