Congratulations and thanks to Prof. Dr. Mélanie Levy of the Université de Neuchâtel in Switzerland’s Institut du droit de la santé whose new article focuses on the roles of pharmacists as gatekeepers of emergency contraception in Switzerland. We are pleased to circulate her abstract:

Melanie Levy, “The Walk of Shame”: Normative Misalignments Hindering Access to Emergency Contraception (2024) 45 Women’s Rights Law Reporter 151-193 (Article online).

Abstract: Women’s health-related human rights are contested. Beyond the recent pushbacks on abortion
rights, more subtle developments are discernible. This paper dissects one case study illustrating how professional self-regulation in pharmaceutical law can undermine equal access to emergency contraception (EC). In Switzerland, around 100,000 “morning after” pills are sold through pharmacies per year. Empirical evidence demonstrates how traumatic or shameful the experience can be for women. Because if regulation was liberalized in 2002 and EC has since been available without a doctor’s prescription, access remains subject to strict professional gatekeeping. Women must undergo a compulsory interview with a pharmacist in a pharmacy backroom. They must indicate their contact details, answer an intrusive questionnaire archived for twenty years, receive information about sexually transmitted diseases, and bear the costs. Prices for EC vary and peak in the evening and on weekends.

The exceptionalism of access to EC, despite formal legal liberalization, highlights gender bias and perpetuates shame and stigma surrounding women’s sexually active behavior. Switzerland’s normative position on access to contraception is based on individual responsibility and formal equality. Every woman is responsible for avoiding unwanted pregnancy, and access to EC is guaranteed since it is available in all pharmacies. In reality, access obstacles created by EC dispensing mechanisms result in intersectional inequalities, depending on women’s age, socio-economic background, and migration status. This paper critically deconstructs the intricate intertwining of a liberal focus on individual responsibility and the disciplining power mechanisms of professional gatekeepers affecting female bodies and choices. Going beyond the personal and the political, it demonstrates how backsliding on sexual and reproductive rights can happen through the backdoor of professional self-regulation. Finally, this paper focuses on a substantive concept of equality for realizing women’s health-related human rights.

Key Words: Emergency contraception; pharmacy; equality; control; discipline; gatekeeping; women’s bodies; power; gender; right to health; sexual and reproductive rights; responsibility; choice; autonomy; self-determination; agency; intersectionality; shame; insurance; conscientious objection; politics of sexuality; pharma law; pharmaceutical regulation; exceptionalism.

The entire article is available through this link.

RELATED RESOURCES:

Adriana Lamačková, Conscientious Objection in Reproductive Health Care: Analysis of Pichon and Sajous v. France, European Journal of Health Law 15.1 (2008), pp. 7-44. Institutional access. Abstract online.

Pichon and Sajous v. France, Case No. 49853/99, Eur. Ct. H.R. (2001).  Decision in English.    Decision in French.   Summary of decision.  [pharmacist complaint inadmissible; pharmacists cannot, based on their religious beliefs, refuse to sell contraceptives that have been prescribed by doctor]

Bernard M. Dickens, “The Right to Conscience,” in: Abortion Law in Transnational Perspective: Cases and Controversies, ed. Rebecca J. Cook, Joanna N. Erdman, and Bernard M. Dickens (University of Pennsylvania Press, 2014) pp. 210-238, 425-429n. Chapter abstract. Abstracts of all book chapters.

“The Right to Conscience, an annotated bibliography,” updated Feb. 15, 2021, is online here.
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Contributed by: The International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of this blog, then check your email box to confirm.

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