Raises questions about the government’s letter encouraging the pill’s manufacturer to apply for permission to market the drug in Canada

In the April 1999 issue of The Interim, Sue Careless reported on a letter from Health Canada to Exelgyn, assuring the abortion pill manufacturer that any application to market RU-486 in this country will be given a “fair” hearing by the federal government. The unprecedented move, apparently made at the request of B.C.’s NDP health minister, seemed to contradict the Food and Drug Act, which forbids Health Canada from inviting drug applications, in order to avoid the appearance of bias in favour of certain drugs. What follows is taken from an interview Sue Careless conducted with Michael Izzotti, co-ordinator of Pharmacists for Life Canada.

“The decision to abort must be made quickly with RU-486 since the ‘window of opportunity’ is so brief,” says Michael Izzotti, co-ordinator of Pharmacists for Life Canada.

“Yet it is at this time (the first eight weeks of pregnancy), when a woman is first aware that she is pregnant, (and when) she is most vulnerable to abortion rhetoric. The panic from the discovery of an unwanted pregnancy brings about hasty but irreversible decisions, and thus can lead to serious future trauma.”

The “home remedy” could also happen on the street, according to Izzotti. “The actual abortion could happen on the way home if the woman’s system is sensitive and reacts quickly.”

“The long-term side-effects profile of RU-486 have never been studied,” he continued. “Because of the nature of this potent steroid-based chemical, the potential for side effects both immediate and long-term is very real. Prostaglandins are a steroidal class of chemicals that of themselves have serious side-effect profiles.”

Izzotti describes RU-486 and the prostaglandin which is used along with it as “a dangerous chemical cocktail that is offered to innocent and susceptible women in the name of privacy and choice. It is a powerful steroid specifically designed to kill a preborn child in the womb. The drug would force pharmacists to become accomplices to abortionists – a development which most pharmacists would find repugnant.”

Izzotti believes the College of Pharmacy needs to be questioned about handling a drug that, along with the “morning-after” pill, will change the face of pharmaceutical care. The CPhA describes RU-486 as a “politically offensive drug” but Izzotti insists it is a “biologically dangerous” one, too.

Currently pharmacists enjoy a positive image with the public as the most accessible and trusted of the health care providers. Izzotti fears that dealing with RU-486 and the “morning-after pill” (which is often abortifacient) will desensitize pharmacists to the use of drugs for other unethical purposes, such as euthanasia.

“The intent of RU-486 is specifically to end the life of a human being which doesn’t fit into the pharmaceutical care model promoted by the CPhA,” Izzotti told The Interim. “Whether an abortion employs a surgical or a chemical means, it still ends the life of a baby. A chemical abortion is still an abortion. Pharmacists should not be suppliers of chemicals intended to cause death.”

Some pharmacist associations are developing conscience clause guidelines that affirm a pharmacist’s right to refuse to dispense drugs on ethical or religious grands. They are also urging legislation to protect pharmacists who exercise their conscience rights from discrimination in training, hiring, and promotion.

Pharmacists for Life International holds that pharmacists who refuse in conscience to dispense RU-486 or the “morning-after pill” or drugs for assisted suicide have no obligation to refer patients elsewhere, since to do so would be to accommodate something the pharmacist believes is morally wrong.

Steps for an
RU-486/prostaglandin
abortion

According to the latest Canadian Pharmaceutical Association drug brief on RU-486, released in 1992 RU-486 is taken orally on day one. The woman will be observed for an hour and then sent home.

Bleeding may begin within 20 hours in a few women, and three per cent will actually abort without receiving the second drug.

Two days later, the woman returns again to the clinic for the second drug, prostaglandin, which is inserted into the vagina.

Within one to two hours, cramping and bleeding will begin and severe pain (enough to require opiate analgesia) may be experienced by about 10 to 17 per cent. The pain is worse in a woman who has not given birth to a live infant.

Within four hours, many will have aborted. Some will need to stay in the clinic for several hours more because of heavy bleeding or severe pain. Most abortions will be completed nine hours after the prostaglandin is given. The pains should subside by that time.

Heavy bleeding may occur for the next two days (days four and five) but should become moderate after this time for up to 10 days.

The woman returns to the clinic around day seven to day 12 for another exam to determine if the abortion was complete. If it was not, she must undergo a surgical abortion.