REVIEW   

Panminerva Medica 2021 March;63(1):75-85

DOI: 10.23736/S0031-0808.20.03921-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Emergency contraception: unresolved clinical, ethical and legal quandaries still linger

Simona ZAAMI ¹ ✉, Fabrizio SIGNORE ², Alberto BAFFA ², Raffaella VOTINO ², Enrico MARINELLI ¹, Alessandro DEL RIO ¹

¹ Section of Legal Medicine, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University, Rome, Italy; ² Department of Obstetrics and Gynecology, Misericordia Hospital, Grosseto, Italy

Emergency contraception (EC) has been prescribed for decades, in order to lessen the risk of unplanned and unwanted pregnancy following unprotected intercourse, ordinary contraceptive failure, or rape. EC and the linked aspect of unintended pregnancy undoubtedly constitute highly relevant public health issues, in that they involve women’s self-determination, reproductive freedom and family planning. Most European countries regulate EC access quite effectively, with solid information campaigns and supply mechanisms, based on various recommendations from international institutions herein examined. However, there is still disagreement on whether EC drugs should be available without a physician’s prescription and on the reimbursement policies that should be implemented. In addition, the rights of health care professionals who object to EC on conscience grounds have been subject to considerable legal and ethical scrutiny, in light of their potential to damage patients who need EC drugs in a timely fashion. Ultimately, reproductive health, freedom and conscience-based refusal on the part of operators are elements that have proven extremely hard to reconcile; hence, it is essential to strike a reasonable balance for the sake of everyone’s rights and well-being.

KEY WORDS: Contraception, postcoital; Guideline; Ethics; Legislation and jurisprudence