Morality/Medical topics/Catholicism

Will Roman Catholic hospitals make the
Morning After Pill available to rape victims?

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About the Morning After Pill:

"Morning After Pill" or "MAP" is the popular term for emergency contraception or "EC." It consists of a heavier than normal dose of oral contraceptive medication that is intended to prevent pregnancy in situations where regular contraception may have failed or not used, and the woman does not wish to become pregnant. It is sold as "Plan B."

EC medication can work in one of three ways:

	In the event that ovulation has not occurred, it generally prevents ovulation.
	If ovulation has occurred, but conception has not happened, it generally prevents conception.
	If conception has occurred, but pregnancy has not begun, it generally prevents conception by changing the uterine wall so that the pre-embryo cannot attach itself there.

As the Pontifical Academy for Life has stated, it is:

"... unrealistic to think that a woman, finding herself in the situation of wanting to use an emergency contraceptive, would be able to know exactly and opportunely her current state of fertility." ₁

Thus, if she were to take EC within the effective time interval of about 72 hours after intercourse, she could not know by what mechanism it would prevent her pregnancy. It may be a contraceptive or may be an abortifacient, according to the Church's definition of those terms. On the other hand it is considered a contraceptive by most physicians because it prevents pregnancy -- again according to the medical definition of "pregnancy."

Definitions:

We use the definition of "pregnancy" that is used within the medical communit. It states that pregnancy begins when the pre-embryo attaches itself to the wall of the uterus. Many religious and social conservatives define pregnancy as beginning at conception. The difference is enormous when EC is being considered.

We use the term "pre-embryo" to refer to a human zygote, morula, and blastocyst. These are the stages of development after the ovum is fertilized and before implantation of the blastocyst in the lining of the womb.  Many religious and social conservatives refer to pre-embryos, embryos fetuses, newborns, infants, etc. as "babies" or "children," thus emphasizing their belief that all are human persons deserving of protection and the right to live.

Position of the Catholic church on EC:

The Church teaches beliefs that are collectively often referred to as the "Gospel of Life." Key to this gospel is the belief that the life of a human person begins at conception when a unique DNA is formed within the pre-embryo. Her or his right to life begins at that time and must be allowed to continue until natural death happens. Thus, the Church teaches that legal executions are moral only under rare circumstances. Suicide and physician assisted suicide are both considered profoundly immoral.

The Roman Catholic Congregation for the Doctrine of the Faith at the Vatican released an Instruction from the Church that reinforces this gospel. It is titled "Dignitatis Personae" and was published on 2008-DEC-12 with the approval of Pope Benedict XVI. _2,3 The instruction states:

"The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life." ₂

Other religions and secular systems of ethics use other criteria to promote alternate beliefs concerning when personhood begins.

In the year 2000, the Pontifical Academy for Life at the Vatican issued a statement on EC. They said:

"... it seems sufficiently clear that those who ask for or offer this pill are seeking the direct termination of a possible pregnancy already in progress, just as in the case of abortion. Pregnancy, in fact, begins with fertilization and not with the implantation of the blastocyst in the uterine wall..."

"... Consequently, from the ethical standpoint the same absolute unlawfulness of abortifacient procedures also applies to distributing, prescribing and taking the morning-after pill. All who, whether sharing the intention or not, directly co-operate with this procedure are also morally responsible for it. ₃

Many in the church regard the use of EC as morally equivalent to a surgical abortion and thus the same as  the murder of a human being. There is nothing in the Instruction that would allow an exception in the case of a rape. If a woman conceives as a result of a rape, the church teaches that her only moral decision would be to give birth -- even in those rare cases where the pregnancy is certain to kill her, or presents a severe threat to her life.

Role of the Church in bioethics:

The 2008 Instruction states that the Church does not directly enforce its beliefs concerning bioethics:

"The Church, by expressing an ethical judgment on some developments of recent medical research concerning man and his beginnings, does not intervene in the area proper to medical science itself, but rather calls everyone to ethical and social responsibility for their actions." ₁

However, this statement does not appear to necessarily extend beyond the church to agencies controlled by the Church. Many Catholic hospitals have a policy of refusing to dispense emergency contraception and refusing to refer women to an agency where they can obtain EC.

Interpretations by American Catholics on EC in the case of rape:

Opinions differ:

	Doctor of Sacred Theology, Fr. Peter Damian Fehlner: Speaking in 2007, he totally rejected the use of EC in Catholic hospitals. He said: "The fact is, if we have any doubt about whether a given action would directly risk someone's life, entail a violation of justice or threaten the salvation of a soul, we may not act on the basis of a scientific probability. That means even if the pill in Plan B is only 'dubiously' abortive, we simply may not use it at all." He notes that the Church condemns contraception as intrinsically evil and this is not permitted even in the case of a rape. He continued: "Prevention of procreation is intrinsically evil prior to and independently of any good end which might be achieved thereby, such as avoiding further violence at the hands of a rapist. The woman may certainly resist and should resist to the limit permitted by divine law any sexual assault. But she may not do this by using a means which is intrinsically evil, in this case considering the conception of a child an act of violence justifying the use of contraception." 4
	United States Conference of Catholic Bishops (USCCB): They determined that Catholic hospitals can dispense EC to rape victims as long as there is an indication that conception has not yet occurred: "Victims of sexual assault should be treated with compassion and understanding. Health care providers who treat sexual assault victims should provide medically accurate information and offer spiritual and psychological support." "A woman who has been raped should be able to defend herself from a potential conception and receive treatments to suppress ovulation and incapacitate sperm. If conception has occurred, however, a Catholic hospital will not dispense drugs to interfere with implantation of a newly conceived human embryo." "Hospitals should develop appropriate protocols to determine whether administering emergency contraception would have an abortifacient effect. Tests are available to determine whether ovulation has occurred." 5
	Catholic Health Association: They posted on their website "Directive 36 of the Ethical and Religious Directives for Catholic Health Care Services:" "Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum." 6
	LifeSiteNews reported during 2007-OCT: "The Bishops of Connecticut, Wisconsin, Massachusetts, Colorado, New York, California and Washington permit their hospitals to administer the morning after pill to rape victims. While some of the hospitals require an ovulation test prior to the drug's administration, most only require a simple pregnancy test. Since a simple pregnancy test cannot detect pregnancy until usually a week after fertilization, the test is practically useless in determining a pregnancy resulting from a sexual encounter within 72 hours previous to its administration. Thus, Catholic hospitals in dioceses like those in Connecticut where the morning after pill (Plan B) is administered to rape victims with only a simple pregnancy test will find themselves out of step with the Vatican ..." 7

References:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. "Statement on the so-called 'Morning-after Pill'," Pontifical Academy for Life, the Vatican, 2000-OCT-31, at: http://www.vatican.va/
2. "Dignitatis Personae" The Vatican, 2008-DEC-08, at: http://www.vatican.va/
3. "Regarding the instruction 'Dignitas Personae'," 2008-DEC-12, at: http://www.vatican.va/
4. "World Renowned Theologian Renders Possibly Decisive Blow in Debate on Plan B in Catholic Hospitals. Says that "even if the pill in Plan B is only 'dubiously' abortive, we simply may not use it at all." LifeSiteNews, 2007-OCT-23, at: http://www.lifesitenews.com/
5. "Pro-Life Activities: Fact Sheet: Emergency Contraception and Treatment of Victims of Sexual Assault," U.S. Conference of Catholic Bishops, at: http://www.usccb.org
6. "Ethical and Religious Directives for Catholic Health Care Services," The Catholic Health Association, undated, at: http://www.chausa.org/
7. John-Henry Westen, "Vatican: Use of Morning After Pills "Fall Within the Sin of Abortion" - Will Catholic Hospitals Now Stop Using them for Rape Victims?," LifeSiteNews.com, 2008-DEC-18, at: http://www.lifesitenews.com/

Copyright © 2008, by Ontario Consultants on Religious Tolerance
Originally published on 2008-DEC-24
Latest update: 2008-DEC-24
Author: B.A. Robinson

Web ReligiousTolerance.org