Scientific American biased

The October, 2005 edition of Scientific American includes a biased, political editorial, "Fill This Prescription." (subscription only)

The summary:

SA Perspectives: Fill This Prescription; October 2005; by Staff Editor; 1 page(s)

No one's health should be hostage to a caregiver's opinion of his or her morality. In prisons, even hardened murderers are entitled to decent, prompt medical attention. A woman walking into a pharmacy with a prescription deserves no less.

Yet in at least a dozen states, pharmacists have refused to fill clients' orders for birth control on personal moral grounds. Often the prescriptions have been for emergency contraception--the "morning-after" pills marketed as Plan B and Preven that prevent a fertilized egg from implanting in the uterus if taken within 72 hours of unprotected sex. By medical definition, the pills block rather than terminate pregnancy. To the objecting pharmacists, however, it is abortion, and they want no part of it.

The editorial concerning pharmacists who act on their consciences contains factual errors and false assumptions. Every time a woman has a prescription filled by a pharmacist, her "health is at the mercy of their pharmacist’s conscience." As a physician and a patient, I don't want pharmacists to practice suppressing their consciences.

First, pharmacists are members of a profession which is charged with protecting the patient and aiding the physician in treatment. We all depend not only on the ability of pharmacists to count pills and read labels correctly but to judge to the best of their ability about interactions with the patient's other medicines and medical conditions. They often act on knowledge that the physician or the patient may not have about the risks (such as allergies, interactions and prescriptions form other physicians) to the patient from a given medication. It is also a legal, common and helpful practice for pharmacists to judge the legitimacy of a prescription and to refuse to fill it if it is forged or if the patient is abusing medications by obtaining multiple prescriptions from different doctors for addictive and otherwise harmful medications.

Second, the latest medical information indicates that the morning after pills block ovulation when they work. There is no evidence that the pills stop the implantation of an embryo. The editors should review the information published in May 2005 concerning the work of Croxatto, et. al.,
at http://www.popcouncil.org/pdfs/popbriefs/pbmay05.pdf or the original articles which are even older. It would be helpful if they used their platform to educate rather than to politicize medicine.

Third, in nature, the pregnancy of a human woman begins in the fallopian tube, at the time of fertilization. In those pregnancies begun by artificial reproductive methods, the pregnancy of the woman and the fertilization of the child may be artificially separated by time and location. Regardless, the human child's life begins at fertilization, as did the life of each of us.

Fourth, birth control (as the information above indicates) is not synonymous with abortifacient.

Fifth, the difference between dispensing abortifacients and dispensing antivirals is that one of these is intended to end the life of a human being and the other is intended to save life. (By the way, pregnancy is not a disease state.)