Guidelines on MAP by Arthur Galea Salomone

The debate in respect of the licensing of the morning-after pill has many facets and should be guided by scientific findings, ethical considerations and full respect for human rights.

The issue has sometimes been presented as a tussle between science and ethics, a clash between women’s civil rights on the one hand and the rights of the unborn on the other hand. In an attempt to reconcile apparently conflicting considerations, it is sometimes necessary to outline basic principles.

It is not uncommon for competing rights to conflict with one another. It is for this reason that in developed legal systems there exists a hierarchy of rights.

Within this hierarchy, the first guiding principle is that fundamental human rights trump civil rights and not vice versa. Besides, the right to life tops the hierarchy of rights which exists in our legal system.

Accordingly, any debate in respect of women’s civil and reproductive rights, including a debate in respect of the morning-after pill, cannot be carried out in isolation. It should be placed in the context of an established hierarchy of rights and the right to life tops that hierarchy.

The second principle to bear in mind is that life starts from the moment of conception and accordingly should be protected and treated with dignity from that moment.

Maltese law is replete with provisions which recognise the principle that life starts at conception and that accordingly legal protection is provided to the conceived though as yet unborn.

A technical committee to report on the scientific findings of the effects of morning-after pills is understandable and advisable

Thus for example, the Embryo Protection Act defines an embryo as a “human organism” that results from fertilisation. Politicians should therefore be unequivocal about the start of life and the deliberations in respect of the morning-after pill should be placed in this context.

The corollary to the above principle is that a morning-after pill which prevents ovulation and/or fertilisation is a contraceptive and not an abortifacient. On the other hand, a morning-after pill which interrupts life after conception by preventing implantation is an abortifacient and not a contraceptive, regardless of how it is labelled.

Contraceptive and abortifacient effects are not invariably mutually exclusive, as there may be instances where an intended contraceptive is also potentially abortifacient. In this case responsible decision makers or prescribing doctors are called upon to decide whether to err on the side of life or on the side of death.

The precautionary principle and the dictates of prudence would suggest that when in doubt life should be safeguarded and not endangered.

An unbiased understanding of the effects of the morning-after pill is therefore critical for legislators and authorities to take an informed decision. The pharmacological effects of morning-after pills differ from one pill to another.

From a legal perspective, it is therefore not possible to generalise and categorise all forms of pills uniformly as either contraceptive or abortifacient. Besides, academic research is not entirely consistent in its findings.

In this context the suggestion coming from various quarters, including the Medical

Association of Malta, for a technical committee to report on the scientific findings of the effects of morning-after pills is understandable and advisable.

To ignore this suggestion would be rash and indicative of a parliamentary committee which is prejudiced, in the sense that it has prejudged the matter without giving due consideration to conflicting views and legitimate concerns.

The constitution of a technical committee should not however be the pretext for our politicians to pass on the buck of their responsibility.

The competence and responsibility of technical specialists should be to highlight prevalent scientific findings and to convince decision makers that various forms of morning-after pills are not abortifacient in the sense that they do not interrupt life by preventing implantation.

The onus and responsibility of politicians and local authorities is then to take their onerous decision in respect of the legalisation and licensing of the morning-after pill in the light of scientific findings, bearing in mind the hierarchy of rights, the value of life, as well as the existing position at law, in terms of which, life starts at conception and should therefore be safeguarded from the moment of conception.

 Arthur Galea Salomone is president of the Cana Movement.


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