The Malta Independent 29 February 2020, Saturday

Dismantling barriers to access the Morning-After Pill

Sunday, 5 January 2020, 14:55 Last update: about 3 months ago

Ryan Vella

Some took to social media to express their dissatisfaction about breach of privacy when they were asked personal questions by pharmacists before being sold the pill.

Medical professionals such as gynaecologists, pharmacists and paediatricians favour making emergency contraceptives available over the counter because the drugs, to be effective, are supposed to be taken within five days following unprotected sex.

But should the barriers to access the pill be dismantled?

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A young woman who wanted to remain anonymous said: "I have no problem in buying certain pills over the counter; when I had to buy this pill, however, I was met by a male pharmacist. I did not feel at ease with certain questions that he asked." She said that being a sensitive individual, she felt uncomfortable buying a pregnancy test, let alone the morning after pill.

Philip Sciortino, a medical practitioner was asked for his take on this dilemma. Was it necessary to question the client prior to handing over the pill? "Yes," he quickly answered. Before administering the pill, medical practitioners have to check things out.

"This pill has its risks. We're not handing out Smarties." One of the most dangerous side effects of this medication is thrombosis. Pharmacists need to understand the patient's mental state before administering such medication. Consumers need to understand what they are getting hold of and its possible side effects.  

Can a man ask to buy the morning after pill? Dr Sciortino said this could be done but added that "questions also need to be asked to a male requesting to buy the pill". Was there such a need for what seems like a regimental procedure? I asked.  

"Yes, there is, because there are huge risks. There could be instances when a man would ask for the pill after having had intercourse with an underage woman. Another risk is that there could be abuses, for example, with males having non-consensual sex with vulnerable persons. Allowing males to buy the pill might provide the perfect cover for wrong practices."

Countering these arguments, a young man said: "My wife doesn't feel comfortable buying these pills over the counter. She feels ashamed." Asked about the possible risks that the GP underscored, the man pointed out that "if someone has done something wrong, I'll doubt he'll go to a doctor or pharmacist he is acquainted with". At the end of the day, the decision whether a woman should take the pill or not should also be discussed with the male, especially if they are in a relationship.

Is the fact that pharmacists are providing the pill over the counter the correct practice? I asked Dr Sciortino. "Pharmacists are medically knowledgeable and professionally capable. There's no denying that fact. The doctor-patient relationship is, however, far better than a simple over the counter interrogation." A doctor is better equipped to earmark diverse medical risks and provide "care continuity to the patient", he added.

Dr Sciortino believes that in these situations "trust is an important factor. Most GPs have details of their patients' medical history; it's easier to trust the patient in certain situations".

Privacy of medical data seems to top the arguments against over-the-counter transactions. What about pharmacists and privacy rights? "I hope that pharmacies are well equipped and can protect privacy. It depends on the context. If they can provide consultation in a secure environment, they might as well administer the pill."

When the woman mentioned earlier was asked whether it's better to go to a doctor and buy the pill on prescription, without any grilling, she said: "Yes. I think that's a better approach because then no questions are asked in front of other customers. A sense of privacy is extremely important in these situations. Pharmacists can be extremely understanding and provide sound advice. Having said that, it would help if pharmacies have a designated area where they can discuss such topics in private."


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