He made his protest after a futile request to the authorities and the police to do something about it. Noise as a source of pollution is a difficult subject to tackle because irritating noise levels are so subjective but, make no mistake, it can produce very disturbing health patterns in human beings causing insomnia, anxiety and depression if it is repetitive and loud, especially in those who are ill and the elderly.
It is also something that we in Malta have not even started to tackle as an environmental issue. Traffic, entertainment areas, petards, discos and building sites all create noise which may be repetitive, loud and disturbing, making life for those living nearby – and even the workers involved themselves – difficult or unbearable. We even have motor cycles and cars removing their silencers to sound more powerful to the detriment of people living in the roads they pass through.
I think that Dean raised an important issue in Malta that is not being tackled at all and needs to be. My first advice to him is to keep this effort up and my other advice is for him to choose carefully the tools he uses for his mission. Battles on the environment are usually prolonged in nature.
I particularly have in mind the true story of Erin Brockovich, who had to labour for several years against the poisoning of the water supplies of the neighbourhood in which she lived. Several hours, days or years spent fighting for a particular cause means Dean will need energy and perseverance and it means that he has to preserve his health so that he can live to fight another day. So I do not suggest hunger strikes as a method of grabbing attention as they usually finish in a dead end. I do, however, suggest fortitude and seeking active solidarity as some of the tools he should use. Involve more people and make more ‘noise’ on the issue. An environmental lobby should be strong and persistent leading those responsible to political action! So good luck in your quest and persist.
The second series of disturbing noises this week were from the chairman of the Medicines Authority, Prof. Anthony Serracino Inglott who, contrary to the advice of the Medical Council, suggested that the morningafter pill should be available over the counter (OTC) without a doctor’s prescription. The Medical Council, a council elected by its doctor members and having statutory powers at law, suggested that caution had to be followed in dispensing the morning-after pill due to uncertainty, but also stated that if the authorities should go ahead with making it available, it should be available only on a prescription basis by a medical practitioner.
Prof. Anthony Serracino Inglott goes on to say that pharmacists have the necessary training as to whether or not it should be prescribed, and should only consult a doctor (regarding a patient) when the pharmacists have doubts. He goes on as reported as saying that this is not only about the morning-after pill, it is with every other medication as it is standard practice! Now I do not know where he has got this from, as everybody knows that unless one has a prescription for drugs, one cannot get them over the counter, although there are a few OTC preparations.
If anything, after the antibiotic debacle as a result of which most antibiotics are now useless because they were available OTC for a long time, the Health Department is going in the opposite direction, where it is increasing prescription items and reducing OTC items! This makes much sense because often the history of a patient is needed – as is a family history and an examination – before the correctly dosed item is prescribed for the necessary number of days!
The official SPC of one of these emergency contraceptive products is full of contra-indications, precautions and interaction warnings. How are these things to be ascertained over the counter? Who will be responsible if things do not go well with the patient, to put it mildly? What if, for example, the patient has liver problems, Crohn’s Disease, ulcerative colitis, galactose intolerance, already has an ectopic pregnancy, is on phenytoin, phenobarbitone, carbamazepine, several antibiotics, herbal preparations, warfarin or has had intestinal surgery? Who will be responsible for what happens then when things go wrong?
There is also another serious issue here and it is a public health one. In public health we teach the public the ABC of safe sex. First Abstain, if not BE Careful who to have relations with and if not, a very distant thirdly, use regular methods of Contraception to protect against illnesses and unconsidered pregnancies. Emergency contraception, on the other hand, is an occasional method. It should in no instance replace a regular contraceptive method! Emergency contraception does not prevent a pregnancy in every instance. If a woman has had unprotected intercourse earlier in the cycle, conception and even implantation may have already occurred!
What rotten medical advice is this, to have the morning-after pill available over the counter when the regular contraceptive pill is currently available only on a doctor’s prescription because of the dangerous medical issues involved like venous and arterial thromboses and smoking? Is not this telling the woman to dispense with regular contraception and only use the morning after pill which is useless after implantation has occurred apart from all the other ethical issues concerned with its use?
If it is decided to allow the use of the morning-after pill, this should be only on a doctor’s prescription, allowing the prescribing doctor and the dispensing pharmacist to look at the medical – as well as ethical – issues involved. All medical professionals have the right to object if they identify a danger to the patient’s life, just as they have the right to conscientious objection on ethical grounds if they feel it appropriate. Professionals should not be considered as puppets in the hands of the state or of ill-advised patients’ requests.
I cannot understand how this issue is being piloted by Civil Rights Minister Helena Dalli, who is not a physician, and not the Health Ministry. I cannot understand how the Medical Council and several other health professionals give advice against certain practices and one has to only consider the singular advice by the Chairman of the Medicines Authority? What about the Bioethics Committee set up by government? Are they asleep or have they been switched off by their Ministry?
I suggest that if the government goes along with Prof. Serracino Inglott’s singular advice on this issue, then civil indemnities for health damages caused should also be laid at the feet of the people involved, his feet and at the feet of the Minister taking his advice!