Chile's plan to ensure wide availability of emergency contraception is running into resistance. One group of politicians has filed a lawsuit to block access and three pharmaceutical chains have balked at selling it.
Chile's Constitutional Court is reviewing a case that threatens to make all forms of emergency contraception illegal. The lawsuit also challenges the government of President Michelle Bachelet to prevail or face a reversal of years of contraceptive policy advances.
Thirty-six socially conservative legislators brought the case in March 2007. Echoing Catholic authorities - who say that emergency contraception is tantamount to abortion - the legislators argue that emergency contraception violates the right to life ensured by the Chilean constitution.
Chilean law bars abortion in all circumstances, even in cases of rape or when the woman's life is in danger.
Lawyers representing both sides have given their arguments, but officials here say it is unclear when the judges will rule. While the verdict looms, the government is also battling three private pharmacy chains that have refused to stock emergency contraception, also known as the "morning-after pill."
Pharmacies sell the pill for about $20 and are obligated by law to offer it. Prescription sales were first approved in 2001 but were not made fully available to the public until November 2005, when the Constitutional Court legalized usage in a separate case.
Since assuming office in March 2006, President Bachelet and Health Minister Maria
Soledad Barria have instructed public health authorities to work aggressively to ensure the pill's availability not just at public clinics - where it is distributed for free to women 14 and over - but at all major pharmacies, enabling its availability to women from all social strata.
The issue of pharmacists who refuse service for moral reasons continues to simmer. In Washington State, for instance, a bill to prohibit pharmacists from refusing to dispense emergency contraception was tabled by a state senator last week pending the outcome of a legal challenge.
Two pharmacists and a pharmacy owner have sued the state for the right to refuse on grounds of religious freedom.
Emergency contraception, sold in Chile under the brand name Postinor 2, is taken orally up to 72 hours after unprotected sexual intercourse to prevent fertilization or implantation.
The pills are readily available in most Western nations, but Catholic influence in Chile and other South American countries has made them a contentious issue.
"Pharmacists should not only be able to advise patients on the appropriate use of the medication, but also the ethical implications of the use of certain medications," said Pope Benedict XVI during an October congress of pharmacists held at the Vatican. "How can they alleviate their consciences knowing that they have averted the implantation of an embryo?"
Nevertheless, governments across South America are moving to make emergency contraception more widely available in the region, which is home to half of the world's Catholics.
Brazilian and Argentine lawmakers legalized the emergency contraception pill in 1999 and 2002 respectively, and it continues to be available in pharmacies and clinics.
Peru's Constitutional Court ruled last year that emergency contraception should be available to every woman.
Ecuador is an exception. Its Constitutional Court ruled in 2007 that no form of emergency contraception should be available.
Chile's efforts come amid signs of public approval. Forty-nine per cent of Chileans said that emergency contraception should be made available to any woman who wanted it, up from 40 per cent the year before, according to a November poll by La Tercera.
Nearly 60 per cent of respondents said they would want their daughters to take emergency contraception after unprotected sex.
"We want people to be able to decide for themselves. Pharmacies are private entities, but they provide a public service," Barria told reporters. "It is part of our job to make sure that the pharmacies provide the pill," said Cesar Torres, director of the southern Region IX health ministry.
"It is pharmacies' job to have available all medications mandated by the government so that their clients can buy them if they want."
Meanwhile, anti-pill politicians have attempted to redirect Chile's contraception debate, claiming the government's stance abridges economic and political freedoms.
Source: Women's eNews, 31 January 2008