For Immediate Release
April 12, 2005

Health Canada's evasive response about 'morning after pill' concerns physicians

"Is Health Canada using the media to push a political agenda?" asked Dr. Will Johnston, president of Canadian Physicians for Life, after the media seized on apparent Health Canada reports that the agency had decided to allow pharmacists in Canada to dispense the 'morning after pill' (euphemized as "emergency contraception") without a doctor’s prescription, effective this month.

The Canadian Medical Association Journal interviewed Health Canada’s Brigitte Zirger, Director of the Policy Bureau in the Therapeutic Products Directorate, for its March 29 story in which it reported that "emergency contraception" would be available in Canada without a doctor’s prescription in early April. Since then, numerous media outlets across the country have repeated the story.

But Health Canada would not confirm this information when questioned by Canadian Physicians for Life.

Before the 'morning after pill' (MAP) can be made available without a doctor’s prescription, an amendment must be made to the Food and Drug Regulations, removing the drug, Levonorgestrel (0.75 mg) from Schedule F. The proposed amendment was published in May 2004 in the Canada Gazette Part I, at which time Health Canada initiated a consultation phase, allowing Canadians to give input on the proposal. Canadian Physicians for Life made a submission to Health Canada, objecting to the proposed amendment on the grounds that the health risks to women had not been adequately assessed and that important counselling which should accompany prescription of MAP would likely not take place. Since then, there had been no word of Health Canada’s plans until the CMAJ report.

When asked to confirm that Health Canada had made its decision and that the availability of MAP without a doctor’s prescription was imminent, a spokesperson for Ms. Zirger told Canadian Physicians for Life only that the amendment is currently in the final stages of the regulatory process and that it has not yet received Treasury Board Cabinet Committee approval, which is apparently required for all regulatory changes. No date could be confirmed because "the timing and agenda of Treasury Board Cabinet Committee meetings are subject to Cabinet confidentiality."

"Why did Health Canada give a specific time-frame to CMAJ if the decision is still up in the air?" asked Dr. Johnston. "Is this a medical de-listing or a political de-listing of the controlled substance?"

One of the controversies surrounding MAP is its potential to prevent a human embryo from implanting in the uterus, thus terminating the pregnancy. "The common description of the MAP as emergency contraception fails to accurately describe its possible abortifacient action and is misleading the public," Dr. Johnston said. "The confusion is aggravated by the current attempt to re-define pregnancy as occurring after implantation. It is a basic fact of human embryology that life begins at fertilization. A woman requesting MAP must be told that this drug may destroy a newly conceived human being--a human embryo--so that she can make an informed decision. How easy is it for a pharmacist to give her this critical information with shoppers milling about?"

Supporters of MAP speculate that easier access to the drug will reduce the number of abortions. But statistics from British Columbia seem to suggest otherwise. MAP has been available without a doctor’s prescription in BC since December 2000. According to a study published in the March 29 issue of CMAJ, the number of MAPs women received in BC more than doubled in 2002 relative to that prior to the policy change. Yet according to Statistics Canada, the number of abortions in BC has been increasing: 14,070 in 2000, 15,820 in 2001, and 16,076 in 2002.

A study of Scottish women found that advanced provision of "emergency contraception" did not reduce the abortion rate and "may not be an effective way to reduce the incidence of unintended pregnancy in the UK." ("Advanced provision of emergency contraception does not reduce abortion rates," Contraception, Vol. 69, Issue 5, Pages 361-366, May 2004).

A Swedish study found that young women requesting "emergency contraception" are at higher risk for future unintended pregnancies. Nine out of 10 of these unintended pregnancies ended in abortion. ("Young women requesting emergency contraception are, despite contraceptive counseling, a high risk group for new unintended pregnancies," Contraception, Vol. 64, Issue 1, Pages 23-27, July 2001).

Dr. Johnston concluded by asking, "If a request for MAP is a warning signal that a future abortion is more likely to occur, do we not have a duty to heed that warning in an effort to avert that outcome? What are Health Canada’s plans for addressing this problem if the physician is taken out of the equation?"

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For further information contact:

Will Johnston, MD
President, Canadian Physicians for Life
Ph/fax: 613-728-5433
email: info@physiciansforlife.ca

Canadian Physicians for Life is an educational organization representing physicians who hold that reverence for every human life lies at the root of all medical tradition. Through the ages, this tradition has been expressed in the Oath of Hippocrates. It was rephrased in modern times in the Declaration of Geneva (1948), which says in part, “I will maintain the utmost respect for human life, from the time of conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity.”