October 6, 2008

Religious and Moral Conflict for Some

The moral debate over the supply of emergency contraception continues to rage on in the pages of pharmaceutical journals nationwide, and Ruth Johnson's case is by no means unique. According to the Royal Pharmaceutical Society of Great Britain, pharmacists are within their rights to refuse any professional service - including the supply of emergency hormonal contraception - on the basis of moral or religious grounds. The Telegraph's health reporter SHARON BAKER spoke to members of local religious communities to discover where the conflicts between religion, morality and professionalism lie.

The "morning-after pill" could not have a more appropriate name.

Not only does its name act as a handy reminder of when to take it, but it also evokes that feeling of the morning after the night before - which millions of women the world over are familiar with.

Recent legislation has made the morning-after pill infinitely more accessible than in days gone by.

The rising rates of teenage and unwanted pregnancy have meant the Levonelle - or levonorgestrel - pill is now available in schools and to buy over the counter without a prescription.

However, despite being about since the 1970s, its usage remains a controversial issue for many.

It is believed the pill works by first preventing the ovaries from releasing an egg, but by also altering the lining of the womb - meaning that if an egg has already been fertilised (within the 72- hour window in which to take the pill) it cannot embed itself there.

Unlike abortion-inducing drugs like mifepristone, the morning- after pill will not terminate a pregnancy once the fertilised egg (embryo) has been implanted.

However, there is no way of knowing how the pill is going to act, and it is for this reason the religious and moral interpretation of the moment of conception comes into play.

For Catholics, the rules are clear: All sexual acts must be open to procreation, and contraception of any kind is seen as tampering with God's will.

The morning-after pill is seen as particularly abhorrent because it is believed that life begins at the moment of fertilisation.

In addition, the promotion of the morning-after pill is seen as an invitation to promiscuity and the disintegration of family values.

Brian Oldham, a devout member of Grimsby's Catholic community, said the church has always taken this stance.

He said: "The church has changed, but it stands by the truth that it believes in.

"However, the church can teach with great authority, but you are still responsible for what your own conscience dictates. The church doesn't take that away from you.

"I think the church teachings recognise more than we give it credit for."

In contrast, the views of Protestant churches - and the individuals within their congregations - are far less uniform, and can vary drastically.

For example, while the Archbishop of Canterbury Dr Rowan Williams has opposed the morning-after pill as a form of abortion, the Methodist Church openly supports its distribution in schools, seeing it as the lesser of two evils in an age of rising unwanted pregnancies.

In 2001, the Rev David Deeks, the Methodist Church's spokesman on church and society affairs, said: "We want to encourage young people to continue exploring our vision for human relationships even if they choose to behave in ways which contradict it."

Similarly, Canon Peter Mullins, the Rural Dean of Grimsby and Cleethorpes for the Anglican Church, said emergency contraception is sometimes the "most responsible" choice.

He added: "Christian people are sad whenever sex is casual or irresponsible, but we are far from perfect ourselves and can look very hypocritical when telling others how they should live their sex lives."

For Muslims, the issue of contraception is not one of biology, but of context.

Sex outside of marriage is strictly forbidden, but within a marriage it is recognised that sex is an essential part of a loving relationship.

By that token, any form of contraception - as long as it is mutually agreed between husband and wife - is acceptable.

This includes the morning-after pill as Islamic teaching states the human soul does not enter the body until 40 days following conception.

Dr Abdallah Mangoud, trustee of the Islamic Association of South Humberside, said: "It's important that if a couple are going to have a child that it is loved by both parents.

"So if they decide not to have a child for the time being, then any form of contraception is allowed, and the morning-after pill is one of them."

However, of those who do refuse to dispense emergency contraception, some Muslim pharmacists are among them.

Dr Mangoud said they may be morally opposed to dispensing contraception to unmarried women.

"But we do live in a free society," he added.

"You have to respect other people's beliefs."

The Royal Pharmaceutical Society of Great Britain (RPSGB) recognises this, and says its stance is standard throughout healthcare bodies.

A spokesperson explained: "While the Code of Ethics and Standards does not require a pharmacist to provide a service that is contrary to their religious or moral beliefs, any attempt by a pharmacist to impose their beliefs on a member of the public seeking their professional guidance, or a failure to have systems in place to advise of alternative sources for the service required, would be of great concern to the RPSGB and could form the basis of a complaint of professional misconduct."

One pharmacist in Grimsby, who did not wish to be named, said his colleagues often offer services to which they are morally opposed.

He said: "Put simply, as a Christian pharmacist, I feel obliged to help any patient in need of my services, especially if they need emergency hormonal contraception.

"Providing emergency contraception, especially to young people, is perhaps the most challenging aspect of my daily practice.

"But through my displaying genuine Christian care, compassion, tolerance and understanding, many extremely anxious young people leave reassured that a life-damaging crisis has probably been avoided."

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