Even though I am not adverse to controversy (I like spicy arguments now and again…”), I really wanted to avoid abortion and emergency contraception for awhile. But, I just can’t…

Last weekend I was involved in a case that was an opportunity for further reflection. I performed a cesarean section on a newly-turned fourteen-year-old. Unfortunately, her pregnancy was the result of a rape by a “family friend” when she was 13 years old.

In this particular case, the rape was not revealed until well after the time that emergency contraception was an option. And, abortion was never an option.

But, as I sat with this patient and her family over the weekend and helped them deal with the unarguably far-reaching consequences of life’s events, which included major surgery, adoption vs. parenting, etc., etc., I couldn’t help but reflect on the following:

What if I were in the emergency room responding to a similar case of the rape of a thirteen year-old? The gathering of evidence and the recommendations around STD prevention are fairly straightforward.

But what about the potential of pregnancy and the choice to offer her emergency contraception? I find myself wondering whether any physician, no matter his or her beliefs about abortion or the mode of action of “emergency contraception” or practice setting, would or could ethically withhold the choice to take the “morning after pill” under such circumstances. I would like to believe that no physician would put his or her “morals” in the path of such a patient choice. It seems clear to me that at least offering the prescription is the right thing to do, and I believe that most, if not all of the physicians with whom I have worked would offer that choice.

I am left feeling kind of numb with the whole conversation about the legalities of abortion and emergency conversation. I feel that legislating what patients may or may not do, or what doctors or clinics or hospitals must or must not do is polarizing, and only gets in the way of doing the right things for patients. I’m tired of arguing.

RW, MD

Related Topics: Syphillis Rising in the US, Protecting Your Child from Sex Abuse

Technorati Tags: birth control, morning after pill, sexual abuse, medical ethics