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Notes

1. To understand what is at issue in the debate, one must become familiar with five key terms that are given completely different meanings by those speaking for or against the 'morning-after-pill'. The terms are abortion, conception, contraception, fertilization, and pregnancy.

Generally speaking, MAP advocates define 'conception' to mean implantation of the developing embryo (often incorrectly termed a 'fertilized egg') in the uterus, and define contraception as any mechanism that prevents implantation. Similarly, they assert that pregnancy (often called 'established pregnancy') does not begin until implantation, and abortion as something that only occurs after that point. Conscientious objectors usually define conception as fertilization (union of sperm and egg) and assert that pregnancy begins at that point. They restrict the meaning of contraception to an intervention that prevents fertilization, and define abortion to include an intervention after fertilization that prevents implantation or otherwise destroys the developing embryo or fetus.

Ironically, objectors are often accused of being 'unscientific' or ignorant, even though standard embryological texts indicate that their terminology is correct.

2. "In 16 months of ECP services, pharmacists provided almost 12,000 ECP prescriptions, which is estimated to have prevented about 700 unintended pregnancies." Cooper, Janet, Brenda Osmond and Melanie Rantucci, "Emergency Contraceptive Pills- Questions and Answers". Canadian Pharmaceutical Journal, June 2000, Vol. 133, No. 5, at p. 28. Cooper was quoted by Globe and Mail Columnist Michael Valpy to the effect that 4,600 prescriptions for the 'morning-after-pill' in BC were believed to have prevented 300 pregnancies. Valpy, Michael, "The Long Morning After", Globe and Mail, 15 December, 2001.

3. In November, 1999, the NAPRA Council approved what has been called a 'conscience clause', part of which requires a pharmacist with moral objections to a drug to "pre-arrange access to an alternate source" of the drug for a patient. (NAPRA Model Statement Regarding Pharmacists' Refusal to Provide Products or Services for Moral or Religious Reasons) A number of objecting pharmacists reject the demand that they take positive steps to facilitate what they consider to be a morally objectionable act.

The attitude of the College of Pharmacists of B.C. toward conscientious objectors was conveyed in a newspaper headline: "Pharmacists' college warns renegades about not dispensing morning-after pill" (The Province, 23 November, 2000). Its Ethics Advisory Committee published a bulletin that made a number of unsubstantiated and prejudicial statements (see Appendix "B").

4. E-mail from Maria Bizecki (Concerned Pharmacists for Conscience) to the Administrator, 3 July, 2000

5. Archer, Frank, "Emergency Contraceptives and Professional Ethics", Canadian Pharmaceutical Journal, May 2000, Vol. 133, No. 4, p. 22-26; "Whose Rights Are They, Anyway?" Pharmacy Practice, 8 January, 2001; Have your say- Openers: "Ethics and Patient Care", Pharmacy Practice, June, 2001)

6. Editorial, Pharmacy Practice, July 2000

7. Safeway Pharmacy Policies and Procedures, Section IV: Pharmacy Operations 4.6.1, Conscientious Objectors and Accommodation. 1 January, 2000.

8. Letter to the Administrator from Linda Toby Oswald, Vice-President Public Relations and Government Affairs, Canada Safeway, 8 August, 2000. It is interesting to note that the withdrawn policy was actually consistent with what was being demanded by the Ethics Advisory Committee of the College of Pharmacists of BC.

9. Letter to the Administrator from Terry Creighton, Senior Vice-President, Public Affairs, Shoppers Drug Mart, 22 August, 2000. It appears that the company was not aware of the legal status of NAPRA and its policies.

10. Letter to the Registrar from Barry Creighton, Concerned Pharmacists for Conscience, 17 February, 2000

11. Quoted in Loukidelis, David, Is the Door Opening or Closing? Assessing the State of Access to Information in Canada. Keynote Presentation, FOIP 2000 Conference, Edmonton, Alberta May 29, 2000. (accessed 30 December, 2001)

12.Dagg v. Canada (Minister of Finance) [1997] 2 S.C.R. 403. The quotations are from the dissenting judgement of La Forest, L'Heureux-Dubé, Gonthier and Major JJ., but the majority (Lamer C.J. and Sopinka, Cory, McLachlin and Iacobucci JJ.) agreed with the minority's approach to interpreting the Access to Information Act.

13.Final Report of the select Special Freedom of Information and Protection of Privacy Act Review Committee (March, 1999) (accessed 31 December, 2001)

14. Loukidelis, supra

15. http://www.oipc.ab.ca/about/welcome.htm (Accessed 9 April, 2002)

16. Letter from Registrar to Legislative Assembly re: FOIPP Act, 29 October, 1998 (Submission 144)

17. Letter to the Administrator from David Loukidelis, Information and Privacy Commissioner for British Columbia, 25 February, 2002

18. Rubin, Ken, "Access-to-information laws: they're there, if MDs want to use them." CMAJ 2002;166(1):77-8

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