More contraception? At what cost?

New protocol allows Colorado pharmacists to prescribe the pill without patients' physician

Therese Bussen

Access to birth control is about to get a whole lot easier for Colorado at the peril of women’s health, according to Catholic healthcare specialists.

After a bipartisan bill passed last year allowing the boards of medicine, nursing and pharmacy, in conjunction with the state health department, to create protocols that address public health needs, the first initiative to roll out will allow pharmacists to prescribe birth control to patients without their physician.

Simply by filling out a questionnaire, doing a blood pressure test and having a 10-15 minute consultation to ensure the patient is not already pregnant or suffering from other health conditions that would make taking the pill unsafe, oral contraceptives can be prescribed.

The protocol will go into effect sometime this spring once pharmacists are trained, according to the Denver Post. Colorado is the third state, after California and Oregon, to pass this initiative.

Dede Chism, executive director of Bella Natural Women’s Care, a healthcare clinic specializing in women’s health and fertility, stated that this protocol goes against “best practice.”

“Bella Natural Women’s Care takes a more natural and healthy approach…we do not prescribe or refer patients for artificial contraception,” Chism said. “One important reason for this is the many physical and emotional side effects that accompany the use of artificial contraception.”

“Contraceptive medications, whether they be oral or any other form, carry with them side effects that can vary from mild to fatal. Our pharmacist colleagues are truly experts in their field, and provide awesome patient education, but their expertise is not in the day-to-day care of a patient and management of their health circumstances,” Chism added.

Catholic pharmacist Valerie Haas agreed that easier access to the pill could prove to be more harmful to women beyond the moral scope.

“I think it’s horrible, moral issues aside,” said pharmacist Valerie Haas. “I’d never want my daughters to get [birth control] from pharmacists. It needs so much screening and monitoring to prevent serious side effects.”

While the protocol requires pharmacists to be trained, Haas is concerned about what that will look like and if the screening process will be enough to prevent complications from the serious side effects that could be potentially avoided with a physician’s monitoring.

“There are so many conditions to identify ahead of time and that need monitoring during use, and patients won’t know what signs to look out for,” Haas said. “Physicians have always been the gateway to assess side effects to make sure they’re using it safely.

“Honestly, I don’t know how pharmacists will have time…to [screen properly],” Haas added. “It could take 30 to 45 minutes to do it properly, and most pharmacists I know barely have time to go to the bathroom.”

Studies have shown that the pill can have serious side effects, and can increase the risk of breast cancer and blood clotting. Haas said that several serious underlying health issues would need serious screening, as contraceptives can complicate or worsen them if undiagnosed or untreated. Some conditions that would need thorough testing and treatment are depression, diabetes, hypertension, bone mineral density, kidney or liver impairment, lupus and endometriosis.

“Endometriosis is another important thing to know, but if it’s not diagnosed, it could be pre-cancerous, and putting more hormones [in your body] could make it worse and lead to potential cancer,” Haas said.

“I would want to be followed fully by a physician who can evaluate all those things in the office…if I had underlying issues that put me at risk. And I don’t know how a pharmacist will be able to comprehensively handle all of that,” Haas continued.

Lynn Grandon, director of the Respect Life office at the Catholic Charities in the Archdiocese of Denver, agreed that easier access to the pill can have damaging effects on women’s health.

“The more people can easily get it, the more women will see the physical effects of the pill, which are documented,” Grandon said. “I’m interested to see what this training will be for pharmacists.”

Grandon also noted the moral danger of contraception that will continue to damage culture as a result of easier access to the pill.

“It’s not just bad because contraception is bad, but if we look back on what’s happened in our society in the past 50 years, we’ve had serious damage in our own society. All the predictions of Pope Paul VI [in Humanae Vitae, “on human life”] came true, if contraception was introduced,” Grandon said.

According to the Denver Post, pharmacists are not required to participate, including those who have conscience objections, which is great news for Catholic pharmacists. In addition to training, pharmacists will also be required to have liability insurance and inform the patient’s doctor when prescribing birth control. Girls under 18 will not be eligible.

COMING UP: Navigating major cultural challenges

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We’re navigating through a true rock and a hard place right now: moral relativism and the oversaturation of technology. In fact, they are related. Moral relativism leaves us without a compass to discern the proper use of technology. And technological oversaturation leads to a decreased ability to think clearly about what matters most and how to achieve it.

Fortunately, we have some Odysseus-like heroes to guide our navigation. Edward Sri’s book Who Am I to Judge?: Responding to Relativism with Logic and Love (Augustine Institute, 2017) provides a practical guide for thinking through the moral life and how to communicate to others the truth in love. Christopher Blum and Joshua Hochschild take on the second challenge with their book A Mind at Peace: Reclaiming an Ordered Soul in the Age of Distraction (Sophia, 2017).

Sri’s book describes conversations that have become quite common. When discussing moral issues, we hear too often, “this is true for me,” “I feel this is right,” or “who am I to judge?” We are losing our ability both to think about and discuss moral problems in a coherent fashion. Morality has become an expression of individual and subjective feeling, rather than clear reasoning based on the truth. In fact, many, or even most, young people would say there is no clear truth when it comes to morality—the very definition of relativism.

Beyond this inability to reason clearly, Christians also face pressure to remain silent in the face of immoral action, shamed into a corner with the label of bigotry. In response to our moral crisis, Sri encourages us to learn more about our own great tradition of morality focused on virtue and happiness. He also provides excellent guidance on how to engage others in a loving conversation to help them consider that our actions relate not only to our own fulfillment, but to our relationships with others.

Sri points out that it’s hard to “win” an argument with relativists, because “relativistic tendencies are rooted in various assumptions they have absorbed from the culture an in habits of thinking and living they have formed over a lifetime” (13). Rather than “winning,” Sri advises us to accompany others through moral and spiritual growth with seven keys, described in the second half of the book. These keys help us to see others through the heart of Christ, with mercy, and to reframe discussions about morality, turning more toward love and addressing underlying wounds. Ultimately, he asks us, “will you be Jesus?” to those struggling with relativism. (155).

Blum and Hochschild’s book complements Sri’s by focusing on the virtues we need to address our cultural challenges. They point to another common concern we all face: a “crisis of attention” as our minds wander, preoccupied with social media (2). More positively, they encourage us to “be consoled” as “there are remedies” to help us “regain an ordered and peaceful mind, which thinks more clearly and attends more steadily” (ibid.). The path they point out can be found in a virtuous and ordered life guided by wisdom.

To achieve peace, we need virtues and other good habits, which create order within us. “With order, our attention is focused, directed, clear, trustworthy, and fruitful” (10). The book encourages us to rediscover fundamental realities of life, such as being attune to our senses and to aspire to higher and noble things. The authors, with the help of the saints, provide a guidebook to forming important dispositions to overcome the addiction and distraction that come with the omnipresence of media and technology.

The book’s chapters address topics such as self-awareness, steadfastness, resilience, watchfulness, creativity, purposefulness, and decisiveness.  These dispositions will create order in how we use our tools and within our inner faculties. They will help us to be more intentional in our action so that we do not succumb to passivity and distraction.  Overall, the book leads us to consider how we can rediscover simple and profound realities, such as a good conversation, periods of silence, and a rightly ordered imagination.

Both books help us to navigate our culture, equipping us to respond more intentionally to the interior and exterior challenges we face.