KSLP’s position on the purchase of the morning-after pill from the age of 15 as part of pharmaceutical advice.

The Catholic Association of Polish Physicians is against making the morning-after pill available to teenagers over the age of 15 as part of pharmaceutical advice. Such actions will disturb the reproductive health of children and young women, their psychophysical and social development, and will deprive parents of the right to raise their children.

CATHOLIC ASSOCIATION OF POLISH PHYSICIANS

on the draft regulation of the Ministry of Health allowing the availability of the morning-after pill from the age of 15 in pharmacies as part of pharmaceutical advice.

Warsaw, 10 April 2024

The Catholic Association of Polish Physicians is against making the morning-after pill available to teenagers over the age of 15 as part of pharmaceutical advice. Such actions will disturb the reproductive health of children and young women, their psychophysical and social development, and will deprive parents of the right to raise their children.1

1. The draft regulation published on 3 April 2024, which is to come into force on 1 May 2024 as a “pilot programme for pharmacist care of patients in the field of reproductive health”, trivializes the scope of the pharmacist’s responsibility for the reproductive health of adolescents by reducing them to a short interview in the back of a pharmacy and issuing a prescription for a hormonal agent, without the possibility of diagnosing the health condition of a teenage child. diagnosis of the presence of concomitant diseases or pregnancy, and lack of access to medical records. A pharmacist will receive PLN 50 for such advice, while a midwife’s advice on the prevention of maternal health disorders in the perinatal period is priced at just over PLN 30. The Ministry of Health allocates more funds to the promotion of “safe”, disorderly sexual intercourse among children than to the health of future generations of Poles.
2. From the Summary of Product Characteristics of Ulipristal Acetate 30 mg contained in EllaOne (the morning-after tablet), we know that it is “not to be used in prepubescent children in case of emergency contraception”.[1] The use of hormonal preparations that have a strong effect on the body is not indifferent to the health of women, especially adolescents, during the maturation of the reproductive and endocrine systems, which lasts at least until the age of 18. Fertility care cannot be reduced only to contraception.
3. The Minister of Health’s insistence that “a pharmaceutical service is not a health service” means that people over the age of 15 can receive a prescription for the hormonal pill “the day after” without the knowledge of their legal guardian, which leads adults and adolescents into the mistaken thinking that a teenager can take any hormonal agents without parental and medical supervision.
4. We would like to remind you that at the request of the President of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products, the preparation of ulipristal in the dose of 5 mg, by the decision of the Chief Pharmaceutical Inspector of 13.03.2020, was suspended from trading in Poland following the recommendation of the Committee for Risk Assessment under Pharmacovigilance due to the occurrence of a case of severe liver damage, as a result of which a liver transplant was necessary. [2]
5. The Minister of Health’s repeated assurance that “the available emergency contraception, the so-called ‘morning-after’ pill, is safe” to be taken once a month, does not change the fact that a hormonal preparation administered in a high, sometimes repeated dose disturbs the proper functioning of the body of a child and a young woman. The Ministry of Health has released a list of dozens of adverse reactions to the use of EllaOne, reported to the European Database of Adverse Reaction Reports in the period from 1 January 2015 to 30 April 2020[3]. Vaginal haemorrhage, abdominal pain and headache, nausea, vomiting, dizziness and fatigue, as well as chills, fever, irritability, insomnia, visual disturbances, menstrual cycle disorders have been commonly reported. drowsiness and impaired concentration. [4]
6. Easier access to morning-after drugs has been shown to increase the frequency of sexual intercourse, potentially increasing the incidence of unplanned pregnancies. [5]‘[6] Although the morning-after pill can prevent an unintended pregnancy in a particular woman or destroy the embryo, the use of this pill has no effect on abortion rates at the population level. [7] The proliferation of the pill is therefore not the right way to reduce the incidence of abortion.
7. Easy access to the morning-after pill will undoubtedly contribute to lowering the age of sexual initiation, increasing the incidence of disordered sexual relations, sexually transmitted infections, which in the future may increase the incidence of fertility disorders, premature births, genital cancers and chronic abdominal pain.
8. The Minister of Health, persistently striving, contrary to the position of the President of the Republic of Poland, to provide teenagers with the “morning after” pills, ignores the mechanisms of action of EllaOne, which consist in inhibiting or delaying ovulation, affecting the thickness of the endometrium, disturbing its maturation and structure, which may prevent the implantation of the embryo in the endometrium, leading to its death. [8] EllaOne does not prevent ovulation if taken during the most fertile days of the cycle. [9] Ulipristal slows down peristaltic contractions of the fallopian tube musculature, thereby increasing the incidence of ectopic pregnancies, which are life-threatening for women.

The Catholic Association of Polish Physicians believes that:

1. Providing teenagers with the purchase of the morning-after pill is unethical, puts their future reproductive health at risk, and deprives parents of responsibility for the health and lives of their minor children.
2. The proposed pharmaceutical service burdens the conscience of pharmacists with the decision to issue a prescription for the morning-after pill, exposes them to conflicts with parents, destroys family relationships, teaches the young generation an objective approach to conceived life.
3. Mass sharing of the morning after pill with teenagers will foster egoistic attitudes, especially among boys, moral depravity of children and adolescents, and will teach them the lack of responsibility for themselves and others and for the conceived human life.

We strongly demand the immediate withdrawal of the Ministry of Health from the proposed project, which we consider on the basis of current medical knowledge to be destructive to the physical and mental maturation of young people and very harmful to the present and future generations.

Prof. Bogdan Chazan, MD, PhD, specialist in gynaecology and obstetrics, Vice-President of the Catholic Association of Polish Physicians (www.kslp.pl)

Dr Grażyna Rybak, paediatric specialist, President of the Mazovian Branch of the Catholic Association of Polish Doctors. (www.kslpmazowsze.pl)

Dr Andrzej Niemirski, internal medicine physician, specialist in family medicine, President of the Radom Branch of the Catholic Association of Polish Physicians

They are informed of:

Minister of Health Izabela Leszczyna, President of the Republic of Poland Andrzej Duda,

President of the Supreme Medical Council Łukasz Jankowski, Marshal of the Sejm of the Republic of Poland Szymon Hołownia, media

[1] chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://ec.europa.eu/health/documents/community-register/2016/20160502134849/anx_134849_pl.pdf

[2] Practical Medicine Drug Index – https://indeks.mp.pl/leki/desc.php?id=7936

[3] https://mgr.farm/aktualnosci/krwotok-z-pochwy-wsrod-najczestszych-dzialan-niepozadanych-pigulki-dzien-po/

[4]chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://ec.europa.eu/health/documents/community-register/2016/20160502134849/anx_134849_pl.pdf

[5] Atkins D. Association between increased availability of emergency contraceptive pills and the sexual and contraceptive behaviors of women. Journal of Public Health Policy. 2014, Aug 35 (3), 292 – 310 doi: 10,1057/jphp.2014.3

[6] Polis CB, Grimes DA, Schaffer K, Blanchard K, Glasier A, Harper CC,. Advance provision of emergency contraception for pregnancy prevention (full review). Cochrane Database Syst Rev. 2010, Issue 3.  

[7] Michie L, Cameron ST. Emergency contraception and impact on abortion rates. Best Pract Res Clin Obstet Gynaecol. 2020 Feb;63:111-119. doi: 10.1016/j.bpobgyn.2019.06.008. Epub 2019 Jul 3rd PMID: 31362908.

[8] Miech RP. Immunopharmacology of ulipristal as an emergency contraceptive. Int J Womens Health. 2011;3:391-7. doi: 10.2147/IJWH. S25887. Epub 2011 Nov 22. PMID: 22140327; PMCID: PMC3225469.

[9] Mozzanega B, Nardelli GB. UPA and LNG in emergency contraception: the information by EMA and the scientific evidences indicate a prevalent anti-implantation effect. Eur J Contracept Reprod Health Care. 2019 Feb; 24(1):4-10. doi: 10.1080/13625187.2018.1555662. Epub 2019 Jan 18. PMID: 30656992.

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KSLP opposes making Ella One pills available to teenagers because they can lead to the death of the conceived life

Warsaw 10.04.2024

POSITION OF THE CATHOLIC ASSOCIATION OF POLISH PHYSICIANS on the draft regulation of the Ministry of Health, allowing access to the morning-after pill from the age of 15 in pharmacies as part of the pharmaceutical service.

The Catholic Association of Polish Physicians is strongly opposed to making the hormonal pill Ella One, enigmatically known as the morning-after pill, available to teenagers over the age of 15 as part of additional pharmaceutical services planned by the Ministry of Health as a “plan B”.

If these drugs are taken after ovulation and fertilization, their mechanism of action is to prevent the implantation of a human embryo in the mother’s uterus, leading to the death of an innocent human being in its early stages.

The truth that human life begins at conception, with the union of the genetic material of the father and mother, is not a myth or a dogma of faith, but a scientifically proven fact that is indisputable and indisputable.

The right to the protection of life is one of the most important constitutional guarantees (Article 38), which naturally determines the existence of all further freedoms and rights. Since human life is the highest constitutional value, the state is called directly to protect it. The Constitution requires the state not only to refrain from introducing regulations permitting the deprivation of human life, but also obliges it to take certain steps to protect this life.

In addition, the Republic of Poland ensures the protection of children’s rights. Everyone has the right to demand from public authorities the protection of children against violence, cruelty, exploitation and demoralisation (Article 72 of the Constitution).

Article 72 establishes the principle of the primacy of the role of parents in the care of the child and the auxiliary role of the authorities in this respect (section 2).

Juvenile demoralization is the process of children or adolescents deviating from the prevailing moral rules and values, often by instilling in young people bad and harmful patterns of behavior by adults.

This process is a serious social problem that requires, first of all, preventive action on the part of parents (or legal guardian) and a comprehensive approach on many levels of the entire society (mainly governments, educators and teachers).

The draft regulation planned by the Ministry of Health is completely inconsistent with the Constitution of the Republic of Poland, violates the right to human life, threatens the protection of children and young people against demoralization, and even facilitates their path to immoral behavior.

In the situation of deepening demographic decline in our country, the aging of the society, the lack of replacement of generations, special care should be given to the health and morale of the society, especially children and young people.

If the law is in contempt of the natural law, if it is established that it is permissible to kill unborn children, it means that we are dealing with totalitarianism in camouflage.

The words of midwife Stanisława Leszczyńska spoken in the German concentration camp Auschwitz: “No, never. Children must not be killed!” resonate very strongly today.

It is unacceptable to introduce regulations that allow the deprivation of human life.

This is a step that sets Poland back in the development of civilization.

Doctors, who are called to save lives, will never agree to such a dictate of the state!

MD, PhD Elżbieta Kortyczko paediatrician, neonatologist specialist, President of the Catholic Association of Polish Physicians (www.kslp.pl)

Prof. Bogdan Chazan, MD, PhD, specialist in gynaecology and obstetrics, Vice-President of the Catholic Association of Polish Physicians (www.kslp.pl)

Andrzej Niemirski, PhD, internal medicine physician, family medicine specialist, President of the Radom Branch of the Catholic Association of Polish Physicians