Ethical Issues Regarding Post-Fertilization Effects of Oral Contraceptives

December 1, 2015

A Physician’s Commentary

I have prescribed “the Pill” since 1978. My wife and I used the Pill for years, having no moral concerns about it. Then, in 1995 my friend and practice partner John Hartman, MD, showed me a patient information brochure–given to him by a friend–that claimed the Pill had a postfertilization effect causing “…the unrecognized loss of preborn children.” John asked me if I had ever heard of such a thing. I had not. I did read the brochure and its claims seemed to be outlandish, excessive, and inaccurate. So, I decided to begin a literature search to disprove these claims to my partner, myself, and any patients who might ask about it.

The more research I did, the more concerned I became about my findings. I called researchers around the country and interviewed them. During this process I met Joe Stanford, MD. Joe volunteered to assist in the research that ultimately became this systematic review. We were concerned enough about our findings and about the fact that so many of our colleagues and patients seemed to share our ignorance about this potential effect that we presented the preliminary results of our research at a number of research forums, just to see if we were off base. Most of the reviewers suggested that, although this evidence was new to them (as it was to us), it seemed accurate and not off target. Furthermore, several said that they thought it would change the way family physicians informed their patients about the Pill and its potential effects.

The most difficult part of this research was deciding how to apply it to my practice. I discussed it with my partners, my patients, ethicists I know and respect, and pastors in my community. I studied the ethical principle of double effect and discussed the issue with religious physicians of several faiths. Finally, after many months of debate and prayer, I decided in 1998 to no longer prescribe the Pill. As a family physician, my career has been committed to family care from conception to death. Since the evidence indicated to me that the Pill could have a postfertilization effect, I felt I could no longer, in good conscience, prescribe it–especially since viable alternatives are available. The support and encouragement that my partners, staff, and patients have given me has been unexpectedly affirming. It seems that my patients have appreciated the information I have given them. Many have been surprised or even shocked (as I was) to learn about this potential effect. Many of my patients have chosen to continue taking the Pill, and we have physicians in our practice and community who will prescribe it for them. Patients who take the Pill tell me that they are much more careful with their compliance. Others have chosen other birth control options–especially one of the modern methods of natural family planning. So, this is research that has changed my soul and my practice. It has been an extraordinarily difficult issue with which I have had to wrestle. I suspect it will be so for many who thoughtfully read and consider the evidence contained in this review.

Source: Author’s Comment, WL Larimore, JB Stanford, Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent, Archives of Family Medicine, 2000;9:126-133.

http://www.epigee.org/guide/news/postfert0200.html

Walt Larimore, MD

Walt Larimore, MD

Colorado, UNITED STATES OF AMERICA Award-winning Family Physician and Best-Selling Author Walt Larimore, MD Nationally-Recognized Family Physician and Educator Dr. Larimore has been a practicing family physician for over 30 years (delivering over 1,500 babies). Besides seeing patients, part time, and volunteering for Mission Medical Clinic, a free, faith-based health clinic for the poor sponsored by over 100 churches and religious organizations in Colorado Springs, Dr. Larimore teaches family medicine part-time, holding adjunct clinical academic appointments at the In His Image Family Medicine Residency Program in Tulsa, OK and the University of Colorado Family Medicine Residency Program in Denver, CO. Dr. Larimore has been listed in Distinguished Physicians of America, The Best Doctors in America, Who's Who in America, Who's Who in Medicine and Healthcare, Who's Who in Science and Engineering, International Health Professionals of the Year, and International Health Scientists of the Year. In addition, Dr. Larimore has been listed in the Guide to America's Top Family Doctors, America's Registry of Outstanding Professionals, and The 2000 Intellectuals of the 21st Century. In 1996, Dr. Larimore was named America's Outstanding Family Physician Educator (Thomas W. Johnson Award) by the American Academy of Family Physicians and in 1999, he and his wife, Barb, were named National Educators of the Year by the Christian Medical Association. Dr. Larimore was listed as an inaugural member of the Leading Educators of the World (in the field of family medicine), by the International Biographical Centre of Cambridge, England. Dr. Larimore served as Medical Director of Mission Medical Clinic from 2008-2012 and as Vice President and Family Physician in Residence at Focus on the Family from 2001 through 2004. Prior to moving to Colorado in 2001, Dr. Larimore practiced family medicine in Kissimmee, Florida for 16 years. During this time he served over a decade as a volunteer physician for the U.S. Olympic Committee and was named to the Great Florida Shootout Basketball Tournament Hall of Fame. From 1981 to 1985, Dr. Larimore practiced in the small town of Bryson City in the rural Smoky Mountains of North Carolina. Dr. Larimore completed his Residency in Family Medicine at Duke University Medical Center in 1981 and completed a General Practice Teaching Fellowship at Queen's Hospital in Nottingham, England in 1978. His M.D. degree, with AOA honors, was from Louisiana State University School of Medicine in 1977; and his B.S. degree was from Louisiana State University in 1974. Dr. Larimore is Board Certified and re-certified (four times) by the American Board of Family Medicine and has been awarded the Certificate of Added Qualification in Sports Medicine by the ABFM. Dr. Larimore and his childhood sweetheart, Barb, live in Colorado and have been married over 38 years, have two adult children, two beautiful granddaughters, and a cat named Jack. Best-Selling, Award-Winning Author Dr. Larimore is a prolific author and has written, co-written, or edited thirty books, thirty medical textbook chapters, and nearly 700 articles in a variety of medical journals and lay magazines. His best-selling books include Bryson City Tales, Bryson City Seasons, and Alternative Medicine: The Christian Handbook. His books have garnered a number of national awards, including three Gold Medallion Award nominations, three Christy Award nominations, a Retailer’s Choice Award, and a Book of the Year Award from ECPA. Dr. Larimore currently posts a twice-a-day topical devotional (www.Devotional.DrWalt.com) and since 2007 has written a health column, Ask Dr. Walt, for Significant Living magazine. From 2007-2012, Dr. Larimore posted a medical and health news blog (www.DrWalt.com/blog), for which he posted nearly 3500 articles. Dr. Larimore co-wrote, with Barb, his childhood sweetheart and wife of over 38 years, His Brain, Her Brain: How divinely designed differences can strengthen your marriage. He also wrote the health chapter for Coach Joe Gibb’s best-selling book Game Plan for Life. Dr. Larimore’s most recent health book is 10 Essentials of Happy, Healthy People. He’s also recently written two books for kids going through puberty (and their parents). The Ultimate Guys' Body Book: Not-so-stupid questions about your body was published in 2012 and The Ultimate Girls' Body Book: Not-so-stupid questions about your body will be published in 2014. Since 2010, Dr. Larimore has published four novels. The first two, The Gabon Virus and The Influenza Bomb, were written with his dear friend Paul McCusker. His first two solo novels, Hazel Creek, and its sequel, Sugar Fork were released in 2012. His best-selling books, about his first years in practice as a family physician in the Great Smoky Mountains of North Carolina, includesBryson City Tales, Bryson City Seasons, and Bryson City Secrets. In 2012, Dr. Larimore wrote the introductions to two books: a devotional, Walking with Jesus in Healthcare and a book on nutrition, Alive! A Physician's Biblical and Scientific Guide to Nutrition. He was also featured in Miracles & Moments of Grace: Inspiring Stories from Doctors. Dr. Larimore was the General Editor for Updates in Maternity Care (2000) and served as a contributing author for the Mayo Clinic's Complete Book of Pregnancy and Baby's First Year, Focus on the Family's Complete Book of Baby and Child Care, and Focus on the Family's Caring for Your Aging Loved Ones. His thirty medical textbook chapters have been on topics ranging from maternity care, prenatal care, sports injuries, endoscopy, rural health economics, and ethics. Award-Winning Medical Journalist Dr. Larimore was a medical journalist from 1995 to 2012. From 1995-200, he hosted over 850 live daily episodes of the National Cable TV Show Ask the Family Doctor on America's Health Network and later on Fox's Health Network. While with Fox, Dr. Larimore was awarded the prestigious "Gracie" Award in 2000 by the American Women in Radio and Television for his work on a program about breast cancer and reconstructive surgery for Fox News' Health Network. Besides hosting the show in-studio, he also performed investigative and fieldwork. At its peak, his show was available in over 28 million American homes. Joe Maddox, the past President and COO of America's Health Network, said that Dr. Larimore had more "... actual on-air TV experience than any physician in the history of television." Dr. Larimore also hosted a medical news minute on The Health Network and the Apple a Day segment on The Health Network and later on Discovery Health TV Network. On Ask the Family Doctor, Dr. Larimore hosted several of the nation's first live televised medical procedures. He conceived and hosted the first worldwide live Internet and TV birth in June 1998 – a then innovative approach to reality TV that was covered by most large media outlets. Of his hosting, the international edition of Time Magazine said, "Dr. Walt Larimore, a distinguished private physician conducted the exercise like a veteran 60 Minutes reporter." Dr. Larimore appeared in interviews on NBC's "The Today Show;" "CBS Good Morning;" "CNN Headline News;" CNN's "Anderson Cooper 360," CNBC's "The Abrams Report;" PBS' "Family Works;" and several Fox News shows. He has also been interviewed on Bill O'Reilly and Sean Hannity's shows. Dr. Larimore served as an on-air Medical Consultant for many radio stations, including WDBO in Orlando; WMBI, Chicago; WISG, Indianapolis; KNKT, Albuquerque; WBCL, Ft. Wayne and the Indiana State Network; WOCL, Baltimore; Kim Jeffries’ Along the Way, Northwest Radio Network; KFSH, Los Angeles; WKES, Tampa, Lakeland, Orlando, FL; WSOR, Naples, Ft. Myers, Cape Coral, FL; WHGN, Crystal River, Inverness, Ocala, FL; WKZM, Sarasota, Bradenton, FL; Life Perspectives, American Family Radio; KTIS, Minneapolis; WRMB Boynton Beach, Okeechobee, Stuart, and Ft. Pierce, FL. Dr. Larimore has also served as a medical consultant for the Total Living Television Network, CCN (Christian Communications Network), HealthTeacher.com, and DiscoveryHealth.com. Dr. Larimore hosted the nationally syndicated Focus on Your Family's Health from 2001 to 2004. These 90-second daily news features were in as many as 75 radio and 37 TV markets across the U.S. Dr. Larimore also provided live on-air interviews to local TV affiliates and national cable TV outlets about breaking medical news. As a family health and medical expert, Dr. Larimore has been sought for print interviews with dozens of newspapers: including the Wall Street Journal, New York Times, LA Times, Boston Globe, Boston Herald, Chicago Tribune, Washington Times, Orlando Sentinel, National Catholic Register, Malaysia Strait Times, South China Post, and the UPI. Dr. Larimore has been interviewed by a number of national magazines including Redbook, In Touch Weekly, Life & Style, Significant Living, Today’s Christian, Home Life, Family Life, Stand Firm, First for Women, Today’s Christian Physician, My Family Doctor, AMA News, Family Practice News, and Pediatric News. Contact Dr. Larimore by email.