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Doctors Should Not Be Forced to Prescribe the Pill

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areeya_ann via Getty Images
areeya_ann via Getty Images

There's a Toronto-based business called the Red Tent Sisters, which gives sex advice to women. They are advocates for women's health, offering classes in everything from contraception to fertility and sexuality. They encourage women to leave hormonal contraception behind. "Ditch the Pill," says their website, "and reclaim your health, happiness and future fertility."

Ditch the pill? To reclaim health? Happiness? What? The founders of the Red Tent Sisters teach that fertility awareness, also known as natural family planning, provides reliable contraception and is better for women's health and the environment. There are many methods, but the commonality between them is that they eschew daily hormones and put women themselves in charge of their own sexual health without relying on Big Pharma.

In short, fertility awareness is healthy and empowering. It could also soon be forbidden to advise or explain it for Ontario's doctors.

The College of Physicians and Surgeons of Ontario is reviewing their current policy on conscience rights for doctors. They have favoured conscience rights for non-emergency procedures to date. This reasonable position is at risk of changing.

This is due, in part, to complaints about three Ottawa doctors who won't prescribe the birth control pill. They don't prescribe it partly out of religious conviction, but also because they believe it's bad medicine. Their motivations are different than those of the Red Tent Sisters, but the outcome looks similar. And regardless of motivation, these are doctors who have published numerous times in peer-reviewed journals in the last six months. They are committed professionals, concerned about their patients' health.

The complaint is that their refusal to prescribe the pill is denying fundamental rights and good healthcare.

Where to begin? Firstly, dislike of the birth control pill does not stem uniquely or even primarily from religious sentiment. It comes from the research.

In 2005, the World Health Organization added the pill to its list of known carcinogens. Recent studies show an increased risk of breast cancer between 19 and 60 per cent the result of taking the pill. (The four studies that are statistically significant, i.e., have a confidence interval greater than one all show an association between breast cancer and the pill.) There are risks of embolism and stroke -- side effects we've gotten used to hearing about, but which are severe and debilitating as well as scary and unexpected for young women. And there's a class action law suit against Bayer's Yasmin. The CBC reported in June 2013 that at least 23 Canadian women died taking this particular birth control pill. The death of young women is simply not a commensurate side effect when the goal is preventing pregnancy, especially when there are safer ways.

Secondly, anecdotal evidence abounds. Some women feel permanently nauseous on the pill, others get depressed. Still others lose the desire to have sex.

Finally, there is an environmental side. There have been reports of damage to the ecosystem, the result of flooding our water system with synthetic hormones.

Given the many negatives of the pill, it seems natural that many more women will seek these natural methods of health and family planning in due course. If doctors aren't free to practice it, then denying freedom of conscience to doctors in this case means denying this form of care.

Ultimately, the case at hand is not exclusively about conscience. It is about freedom to practice medicine as a doctor considers best, according to the best evidence available.

When a government body can tell doctors how to consider medical literature, at best, it's an extreme micro-managing of their affairs. At worst, it makes them into robots.

Defending conscience for these three Ottawa doctors is defending the life and health of patients. By extension, it is defending your own ability to live, think and work freely, according to your own conscience.

Research shows plenty of evidence against the pill. If conscience is overturned and doctors who disagree are forced to prescribe it, this will ironically mean the provision of inferior care. Using hearts and minds together is what conscience protection allows for. Does anyone actually want anything less in their doctor?

The College of Physicians and Surgeons of Ontario is accepting opinions from the public on this matter until August 5, 2014. Andrea Mrozek is the Executive Director of the Institute of Marriage and Family Canada (

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