Wednesday, January 31, 2007

Free Emergency Contraception in Chile

A follow-up to my post on the avilability of the emergency contraception pill in Latin America. From Chile:

SANTIAGO, Chile - The government on Tuesday said it will resume its program to provide free "morning-after" contraceptives to girls as young as 14, but will also offer them advice by specialists.

The program started in September last year, but it was halted earlier this month when the Constitutional Court ruled it had been improperly implemented by administrative decree rather than by a presidential decree or legislation.

The government said it would correct the legal problem.

President Michelle Bachelet on Monday signed a new decree, which should be cleared by the General Comptroller's Office this week, allowing resumption of the program, according to Health Minister Soledad Barria.

She said that the government introduced a change in the program by appointing physicians and psychologists to offer free advice to girls requesting the pill.


The program triggered heated debate in a country considered politically liberal but socially conservative. Chile prohibits abortion in all cases and divorce was only legalized here in 2004.

Some conservative mayors have refused to let their city health services distribute the pills.

One of them, Pablo Zalaquet of La Florida near Santiago, called Bachelet's decree "a black day for our country, a slap to the institution of family."

The morning-after pill contains a high dose of the most common ingredient in regular birth-control pills. When taken within 72 hours of unprotected sex, the two-pill series can lower the risk of pregnancy by up to 89 percent. Officials say it will not work on a woman who is already pregnant.

Before the program was implemented, the pill was available only to women who had been raped. The pill was legalized here in 2002 after a Supreme Court battle.

Bachelet has said her program is necessary because the price — $22 per two-pill package — is beyond the reach of poorer women.

Of course, just because in this one instance a government has decided to make emergency contraception available for free in no way means it's ever a good thing for your private medical decisions to be at the mercy of presidential decrees. Politicians, even well intentioned ones, have no business substituting their judgement for yours in medical matters. [Note to the Chilean government: just because a patient requests the emergency contraception pill doesn't mean she needs a psych consult.]

And then there are politicians like Mayor Pablo Zalaquet. Do you really want the mayor of your town deciding what meds, if any, you may be permitted to access?

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