A reader disagrees with a recent American College of Physicians guideline regarding contraception and abortion.
Both the ACP [American College of Physicians] and your journal are misleading practitioners into believing that contraception and abortion are medical care. (“ACP: Supreme Court contraception ruling hurts women’s health,” Medical Economics eConsult, July 2, 2014.)
The facts are that when human fertilization occurs a new living human being is conceived and from zygote on, if not intentionally killed by medical or surgical procedures, will live to be born.
Some methods of contraception act after the egg has been fertilized but before a pregnancy has become established.
Some people regard this as a very early abortion, and describe such techniques as “abortifacient.” People who object to all forms of abortion regard such contraceptive techniques as morally wrong.
There are particular problems with the “morning-after pill,” a form of emergency contraception that many people consider a potential form of abortion.
Morning-after pills are high-dose birth control pills. They work in various ways-by stopping eggs being released, inhibiting sperm, or preventing the implantation of a fertilized egg.The last of these methods of operation is regarded as an abortion by some people.
When a woman uses an emergency contraceptive, neither she nor the doctor can know whether the technique works as a contraceptive to prevent fertilization, or terminates the development of the fertilized egg. The risk of abortion leads opponents of abortion to object to these techniques.
Some IUDs [intrauterine devices] can also work by preventing the implantation of a fertilized egg, these have also been criticized as possibly abortifacient.
The ethical debate on this issue centers on whether a pregnancy begins at fertilization or at a later stage of the reproductive timetable.
This problem does not occur in cultures where abortion is viewed as a form of contraception to be used if other methods fail.
Joseph DiPoala Sr., MD, FACP
Rochester, New York