Conscientious Objection to Emergency Contraception

Photo by Reproductive Health Supplies Coalition on Unsplash INTRODUCTION Emergency contraception is formally recognized as the only effective way to prevent pregnancy after sexual intercourse World Organization.[1] The word emergency used due brief time during which it efficacious. It useful when administered within 72 hours of a encounter.[2] When pharmacists withhold contraception, they permanently eliminate window opportunity in can take effect. If patients do not find another source may become pregnant. Yet, both abortion and present more risks patient health than contraception.[3] Conscientious objection deserves heightened scrutiny. In light Dobbs v. Jackson Women’s Organization[4](allowing states limit access abortion) COVID-19 pandemic, an important tool that people must be able pregnancy. ANALYSIS So why are providers allowed bar such invaluable care? refusal perform task because personal value or belief. dispensing legal several including Idaho, Arkansas, Georgia, Missouri, Arizona, South Dakota.[5] There no exceptions made for assault. Texas, also permits refuse distribute there were 13,509 forcible rape cases 2020, highest number all fifty states.[6] With many imposing strict limits accessing care, ever. who oppose themselves, but whose would endangered considering could even punitive women need wish avoid Once pregnant, some have few options. avoids moral conundrum creates pregnant women. Avoiding generally far safer, simpler, less morally charged care. Advocates supporting conscientious frequently mistake abortifacient. However, does terminate Instead, prevents fertilization implantation from occurring. Some argue distinction should negate religious rationales.[7] religion common rationale providing contraception. initial months government-mandated lockdown, rates assault escalated.[8] Rape crisis centers surveyed across country reported 40 percent increase demand their services.[9] Societal repercussions include economic insecurity, social isolation, quarantine, job loss, been associated with increased risk assault.[10] context strained hospital resources limited in-person medical mental resources, became increasingly victims pandemic. Several arguments set forth justify placing limitations objection.[11] First, choose enter profession bound fiduciary duties. These duties respect autonomy dignity individual patients.[12] A pharmacist withholds infringing patient’s autonomy. Secondly, expected prioritize needs over own. principle beneficence obligates clinicians act interests patients.9 requesting express intentions interests. pharmacist’s denial violates directly counters States allowing care contributing increasing unwanted pregnancies. They fail recognize wrongdoing prioritizing rights withholding seeking Denying neglects nonmaleficence, this significantly compromises health. Patients denied face physical risks. exacerbated psychological harms isolation impacted anxiety depression.[13] further exposed political unrest, racial other forms discrimination, widening disparities.[14] Sexual reproductive services scaled back essential support hotlines, centers, protection, counseling disrupted.[15] disproportionately burdened lack alternative healthcare channels.[16] For example, rural settings channels available metropolitan suburban settings. Counterarguments deserve Forcing them provide infringes ability make autonomous decision. different types birth control pills rushed timeframe. pharmacists’ dispense imposes values immediate own above professional duties, fulfil obligations. One solution, middle ground, objector recommend nearby pharmacy long one open convenient. Many stance despite its inconveniencing patient. Other alternatives entail switching shifts times least working groups personally absent these simple alternatives, causes person otherwise ethically impermissible. CONCLUSION conclusion, eliminated, especially hardships posed under circumstances unethical bioethical principles autonomy, beneficence, justice. - [1] Organization. 2014. “Emergency contraception.” Organization, November 28, https://www.who.int/reproductivehealth/topics/family_planning/ec/en/ [2] Cu-IUDs highly (283) continued regular UPA levonorgestrel ECPs similar effectiveness taken 3 days unprotected intercourse; however, has shown formulation 3–5 Glasier AF, Cameron ST, Fine PM, et al. Ulipristal acetate versus contraception: randomised non-inferiority trial meta-analysis. Lancet 2010;375:555–62. http://dx. doi. org/10. 1016/S0140-6736(10)60101-8external iconPubMedexternal icon. Raymond E, Taylor D, Trussell J, Steiner MJ. Minimum regimen Contraception 2004;69:79–81. 1016/j. 2003. 09. 013external icon [3] American College Obstetricians Gynecologists. 2019. “Access ACOG, December https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/07/access-to-emergency-contraception [4] 597 US _ (2022) [5] National Conference State Legislators. 2018. “Pharmacist conscience clauses: Laws information.” Legislators, September, https://www.ncsl.org/research/health/pharmacist-conscience-clauses-laws-and-information.aspx [6] Statistica. 2021. “Total United state.” Statista, June 30, https://www.statista.com/statistics/232524/forcible-rape-cases-in-the-us-by-state/ [7] Planned Parenthood. 2016. “Difference between morning-after pill abortion.” Parenthood, https://www.plannedparenthood.org/files/3914/6012/8466/Difference_Between_the_Morning-After_Pill_and_the_Abortion_Pill.pdf [8] Katherine A. Muldoon “COVID-19 pandemic violence.” [9] Walker. 2020. “A second, silent pandemic: violence covid-19.” Primary Care Review, May 1, http://info.primarycare.hms.harvard.edu/review/sexual-violence-and-covid [10]Katherine BMC Med, February 5, https://doi.org/10.1186/s12916-020-01897-z [11] Beauchamp TL, Childress JF. Principles biomedical ethics, 5th ed. New York City, NY: Oxford University Press; 2001. [12] Ken Baum Julie Cantor. 2004. “The Limits Objection – Pharmacists Refuse Fill Prescriptions Contraception.” England Journal Medicine, 4, https://www.nejm.org/doi/full/10.1056/nejmsb042263 [13] Min Luo impact coronavirus disease 2019 (COVID-19) staff general public systematic review meta-analysis.” Psychiatry Research, Sep. https://doi.org/10.1016/j.psychres.2020.113190 [14] Tai, D., Shah, A., Doubeni, C. Sia, I. G., & Wieland, M. L. (2021). Disproportionate Impact Racial Ethnic Minorities States. 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