Re: Emergency contraception

I would like to commend Dr Malleson for her informative and practical article[1] addressing the lack of awareness and implementation of emergency contraception among patients and physicians. Perhaps the only questionable move, however, is the choice of cover artwork by Jerry Wong, which depicts an aggressive, grimacing male Viking wielding an intrauterine device (IUD) as a sword. Today, women remain primarily responsible for postcoital birth control, and certainly, courses of action should be taken to minimize, rather than reinforce, the negative conceptions regarding safety and invasiveness of IUDs.[2] Furthermore, if the Viking is to represent a physician, a female character may have been more tasteful as more than 55% of the entering classes for medicine in the last 2 years at UBC have been women. It seems contradictory to promote education about emergency contraception yet advertise it in such an invasive manner.

—Yolanda Butt, BSc, MA
UBC Medical Class of 2005

 Dr Roey Malleson ends her review of controversial postcoital contraception methods [BCMJ 2002;44(1):30-35] without explaining why they remain controversial. Instead, her article ends with the threatening suggestion that those of her colleagues who disagree with her utilitarian view of early human life may be negligent. This tone of moral superiority would be easier to endure if it were accompanied by a coherent explanation of her implicit definition of pregnancy as starting only after the embryo’s secure implantation. To fastidiously avoid mention of the abortifacient nature of the disruption of implantation is to remove oneself from the real debate about the status of the human embryo. This status awaits clarification and is at the centre of the evolving societal discussion around cloning and human experimentation. Dr Malleson’s disregard for the conscientious views of many physicians and pharmacists falls short of the necessary standards of civility in this issue. Meaning to do well is not always enough.

—Will Johnston, MD
President, Canadian Physicians for Life

References

1. Malleson R. Emergency contraception: A simple, safe, and effective approach to preventing pregnancy after unprotected intercourse or contraceptive failure. BC Med J 2002;44:30-35.Full Text 
2. Cheng D. The intrauterine device: Still misunderstood after all these years. South Med J 2000;93:859-864.PubMed Abstract Full Text