Category: Drugs

NHS to give sex change drugs to nine-year-olds: Clinic accused of ‘playing God’ with treatment that stops puberty

Mail on Sunday

Sanchez Manning, Stephen Adams

Children as young as nine will be given controversial drugs on the NHS to prepare them for sex-swap surgery, The Mail on Sunday can reveal.

The treatment, which halts the onset of adulthood, is aimed at youngsters who believe they are trapped in the wrong body. But critics accused the clinic offering the puberty- postponing injections of ‘playing God’.

‘I think many people will be horrified at the thought of a nine-year-old being provided with a drug that effectively stops them developing and maturing naturally,’ said Conservative MP Andrew Percy.

Others insisted that undisputed research shows that the vast majority of under-16s who are troubled about their gender do not go on to take the drastic step of surgery. Many turn out to be gay, but no longer feel confused about whether they are male or female.

Although the gender treatment is reversible, there are concerns about the long-term effects on brain development, bone growth and fertility.

The drugs, known as hypothalamic blockers, stunt the development of sexual organs so less surgery is required if a child chooses to change sex after reaching adolescence. . . [Full text]

Canadian Pharmacists Association queried by Catholic bishops

The Canadian Pharmacists Association has been asked by the Canadian Organization for Life and Family to ensure that pharmacists disclose to patients the fact that the morning-after pill can cause the death of the early embryo by preventing implantation. COLF, which addresses life issues for the Canadian Conference of Catholic Bishops, also asked the Association about its policy on freedom of conscience for pharmacists who do not wish to dispense the morning-after pill. [COLF letter]

Some corrections and clarifications

Project letter to the Calgary Herald

Sean Murphy*

While I am pleased to see that Laura Wershler is willing to accommodate freedom of conscience among health care workers, I must correct some misleading statements included in her article (“The morning after: Pro-life agenda misrepresents the emergency contraceptive pill, or ECP”,Calgary Herald, 13 February, 2004).

In the first place, http://www.consciencelaws.org is the URL of the Protection of Conscience Project, not “Repression of Conscience”. Contrary to Ms. Wershler’s assertion, this is a non-denominational human rights project, not a not a pro-life initiative. Pro-lifers are interested in the Project and sometimes link to our website, but the Project does not take a position on the morality of controversial procedures. It is enough to recognize the controversy, and advocate the accommodation of conscientious objectors. At least one pro-life pharmacist does not use the Project pamphlet about the morning-after pill precisely because the pamphlet does not argue against its use.

Second, Ms. Wershler’s article incorrectly attributes to the Project the use of the terms “abortion drug” and “emergency contraceptive (ECP)”. The Project does not use either term, except when quoting other sources. They are confusing, and complicate articulation of freedom of conscience issues.

“Abortion drug” is an appropriate description of mifepristone (RU486), which is designed specifically to cause the abortion of an embryo that has implanted in the uterus. The morning-after pill has not been designed for that purpose, and does not act in that way.

“Emergency contraception” is a fabulously successful marketing term. However, 94% of the women who take the morning-after pill do not require it to prevent childbirth. This statistic, provided by the drug’s advocates,[1] belies the notion of ’emergency’ that is often used to browbeat conscientious objectors. As to “contraceptive”, Ms.Wershler herself acknowledges that these drugs have three mechanisms of action, one of which may prevent implantation of the early embryo, thus causing its death. This is considered by many conscientious objectors to be the moral equivalent of abortion, a term acknowledged as appropriate by some authorities,[2] though the usage is not uncontested. The Project refers to these drugs generically as the ‘morning-after pill’ because this term is widely understood. We describe the morning-after pill as “potentially abortifacient”, in the sense that it may cause the death of the early embryo, but does not necessarily do so.

A final note to prevent further confusion: the meaning of “abortifacient” in a medical or scientific context is not the same as its meaning in a moral context. In a medical context, a drug that prevents fertilization (acts contraceptively) 95 to 99 times out of a hundred would be called a contraceptive rather than a abortifacient. But in a moral context, when the outcome may be death, a drug may be treated as an abortifacient if there is even a 1% chance of it killing the embryo by preventing implantation. A number of disputes that arise about the morning-after pill are a regrettable consequence of failing to recognize these distinctions.

Notes

1. Apply a calculator to the following statement: “In 16 months of ECP services, pharmacists provided almost 12,000 ECP prescriptions, which is estimated to have prevented about 700 unintended pregnancies.” Cooper, Janet, Brenda Osmond and Melanie Rantucci, “Emergency Contraceptive Pills- Questions and Answers”. Canadian Pharmaceutical Journal, June 2000, Vol. 133, No. 5, at p. 28.

2. Keith L. Moore and T.V.N. Persaud, The Developing Human: Clinically Oriented Embryology (6th ed.) (Philadelphia: W.B. Saunders Company, 1998), p. 532. Quoted in Irving, Diane N., A “One-Act Drama:The Early Human Embryo:’Scientific’ Myths and Scientific Facts:Implications for Ethics and Public Policy, Medicine and Human Dignity.” International Bioethics Conference, ‘Conceiving the Embryo’, Centre Culturel, Woluwe-St. Pierre, Brussels, Belgium: October 20, 2002 (9:30 A.M.)(Revised 23 October, 2002) Note 23.

When rights collide

© Copyright 2004 Calgary Herald
Reproduced with permission

Nigel Hannaford

A few years ago, a customer asked Co-op pharmacist Maria Bizecki to fill a prescription for an abortion drug. For Bizecki, a Roman Catholic and active pro-lifer, this was akin to being invited to become an accessory to murder. She declined.

It was a risky stand against the prevailing view of pharmaceutical professional associations, and employers retailing drugs. Yet, ultimately it led to a small step forward for Albertans’ religious freedom.

The Alberta College of Pharmacists (ACP), for instance, her profession’s ethics watchdog, emphasizes a client’s right to have pharmaceutical needs met. It grants conscience leeway to its members, though this did not save Bizecki from facing complaints about her stand.

More particularly, the conscience clause is little help to pharmacists dealing with unsympathetic employers.

The letter one Pro-Life Ontario pharmacist got from his boss (quoted in the Pro-Life paper, Interim) eloquently expresses the all-business perspective: “You are not employed by the company to make moral or philosophical decisions about whether birth control is appropriate for the customer . . . we are engaged in a retail activity.”

The letter concluded with a threat of termination, noting that if the pharmacist couldn’t separate his beliefs from his job, he should “think long and hard about whether you could continue in your capacity.”

Co-op was comparatively gentle. Bizecki had been straightforward with them about her views, and was known in the community as a pro-life activist. She was suspended with pay.

She doesn’t talk about the complaints which led to her being investigated by the ACP; the details are subject to her duty of confidentiality. Still, when in 2000, a pro-choice website challenged the conscience rights of pharmacists, the prompt arrival of the first complaint was no surprise.

The situation was a pickle of contending rights and obligations.

Obviously, if a prescribed drug is legal, a client has a right to buy it, and a druggist to sell it. But, only the wilfully blind wouldn’t admit honest people can sincerely disagree over abortion. As employees are not mere instruments of an employer’s will, but have a right of conscience, even an obligation, how does one loosen the tangle?

One way is to choose. When human rights commissions do so, religious freedoms sometimes lose. The case of a Catholic school board
compelled to allow a gay student to bring his boyfriend to a prom, is illustrative.

The other way is negotiation. It took nearly three years for Bizecki’s lawyer, Gerry Chipeur, the college and Co-op to work it out, but there was a happy ending. That is, something which worked for everybody, and it serves as a useful template.

The reasonable accommodation of Bizecki’s principles was a written agreement in which she recognized the public’s right to have a prescription filled by a pharmacist, and that she could not and should not obstruct it. But, employers have a duty to reasonably accommodate employee scruples, and Co-op agreed not to demand she fill prescriptions for drugs which effect abortions. Thus, with the college’s blessing, she would always be part of a two-person dispensary.

Chipeur adds this might not be a reasonable accommodation for a one- person pharmacy: “However, in Canada employers have always had a duty to be reasonable, so long as there’s no undue burden. This is the first time that I’m aware, that there has been such an accommodation. If there’s a similar breakdown in Alberta in the future, it would be unwise for any health employer to not accommodate a pro-life position. I’d just say this to pro-lifers: Don’t take a job in an abortion clinic and then say you don’t want to do abortions.”

What distinguishes this case from some of the head-on rights collisions we’ve seen in Canada, is that the parties would accept a solution, not hold out for a victory. Canada aspires to be a tolerant country.

This is what tolerance looks like.

Related Links:

Louisiana Health Dept. Reverses Itself In “Morning-After” Pill Case

State Agrees To Provide Religious Accommodation For Nurse After Discrimination Complaint Filed With EEOC

News Release

American Center for Law and Justice

(New Orleans, LA) – The American Center for Law and Justice, an international public interest law firm committed to protecting life, announced today that the Louisiana Department of Health and Hospitals has reversed itself and has now agreed to stop discriminating against a public health nurse from New Orleans who was threatened with termination for refusing to dispense pregnancy-ending medication – a job requirement that violates her deeply held religious beliefs.

The move comes less than one week after the ACLJ filed formal complaints with the Equal Employment Opportunity Commission (EEOC) and the Louisiana Commission on Human Rights contending that Louisiana Dept. of Health and Hospitals is discriminating against the nurse because of her religious beliefs.

“We’re delighted that the religious beliefs of our client will now be accommodated in the workplace,” said Stuart J. Roth, Senior Counsel of the ACLJ, which is representing the nurse. “From the beginning, our client just wanted to do her job without violating her conscience and her religious beliefs. Unfortunately, it took formal action on our behalf and publicity about the case before the state agreed to do what it should have done all along – stop threatening and criticizing our client and permit her to work without violating her religious beliefs.

Last week, the ACLJ filed complaints with the EEOC and the Louisiana Commission on Human Rights on behalf of Cynthia Day of Marrero, Louisiana who is employed as a Public Health Nurse III with the Louisiana Department of Health and Hospitals, Office of Public Health at a clinic in New Orleans. The complaints contend that Day repeatedly told her supervisors that she could not dispense what is known as an emergency contraception pill, also known as a “morning-after” pill – medication designed to end pregnancies. Day says she holds a sincere religious belief that human life, beginning at fertilization, is sacred and cannot be harmed in any way.

But instead of accommodating her beliefs, the complaints contend that Day was criticized for her beliefs and threatened with being fired. In fact, as the complaints were being filed last week, Day received a disciplinary letter from her employer – a letter proposing a five-day suspension without pay for insubordination.

Then, within days of filing the complaints and following publicity about the case, Day received a letter from Madeline W. McAndrew, Assistant Secretary of the Dept. of Health and Hospitals. In the letter dated October 25th, McAndrew said the Health Department “is rescinding the proposed action and will accommodate your request based on religious and moral grounds.” McAndrew told Day that she instructed officials to “immediately remove you from any duties that require you to discuss or provide the emergency contraception pill.” At the same time, McAndrew stated that a listing of “reassignment opportunities” will be made available to Day “for future permanent duty assignments to accommodate your request …”

“We plan to withdraw the complaints filed with the EEOC and with the Louisiana Commission on Human Rights when our client receives the accommodation,” said Roth. “We will continue to work with our client to ensure that her religious beliefs are accommodated and monitor the ongoing employment status very closely to make sure she is not discriminated against in the workplace.”

“This is a very important victory in one of the fastest growing areas of pro-life litigation – protecting the conscience rights of health care workers,” said Roth.

The resolution of the Louisiana case comes on the heels of a major federal court decision in California. In May 2002, the ACLJ successfully convinced a jury that Riverside County violated the constitutional rights of a former nurse who was fired from her job for refusing to dispense “morning-after” medication. A federal court jury found that the county violated her First Amendment rights of free speech, freedom of religion, and failed to reasonably accommodate her religious beliefs. Damages in that case – including a jury award and attorney’s fees – totaled $100,000.

The American Center for Law and Justice is an international public interest law firm specializing in constitutional law and protecting human life. The ACLJ is headquartered in Virginia Beach, Virginia, USA.