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Morality/Medical topics/Catholicism/Emergency Contraception

Will Roman Catholic hospitals make EC (the
morning after pill) available to rape victims?

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About Emergency Contraception (EC), 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. One brand is sold as "Plan B."

EC medication is a contraceptive that can work in one of two 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.

Originally, researchers suspected that it might also work in a third way:

  • If conception has occurred, but the pre-embryo has not reached the uterus, EC might prevent conception by changing the uterine wall so that the pre-embryo could not attach itself there.

Subsequent research found that this third method is extremely unlikely or impossible. The Catholic church and most pro-life groups reject these findings. As of 2010, they still teach that EC can prevent implantation of the pre-embryo. Both of these groups believe that pregnancy and human personhood begins with fertilization. If it were possible for EC to prevent implantation, then by their reasoning it would be an abortifacient: it would cause an abortion with moral and ethical implications much like result from RU-486 or a surgical abortion.

In the year 2000, the Pontifical Academy for Life 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, and
  • if the Church's beliefs about implantation were accurate,

then she could not know by what mechanism it would prevent her pregnancy. It may be a contraceptive or may be an abortifacient. Women are in a lose-lose situation. They are forbidden by the Church to be involved in either contraception or abortion. However, the use of an abortifacient is a much more serious sin, akin to undergoing surgical abortion that kills the embryo.

On the other hand it is considered a contraceptive by essentially all physicians because it only works by suppressing ovulation or preventing conception. Even if EC were capable of preventing attachment of the pre-embryo, doctors would not regarded it as an abortifacient, because pregnancy had not begun at that stage according to the medical definition of "pregnancy."

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Review of definitions:

We use the definition of "pregnancy" that is used within the medical community. It states that pregnancy begins when the pre-embryo has attached itself to the wall of the uterus. Many religious and social conservatives define pregnancy as beginning at conception.

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 from conception to birth and beyond.

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Position of the Catholic church on EC:

The Church teaches beliefs what it refers 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. From this concept, the Church teaches that legal executions are moral only under rare circumstances. Suicide and physician assisted suicide are both considered profoundly immoral, although they are not necessarily considered as mortal sins if there are major extenuating circumstances that give a person no other real options.

On 2008-DEC-12, 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 "Dignitas Personae" and was published 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. Examples are: when blood starts to flow in the embryo, when the embryo's heart starts beating, when the first brain wave activity starts, when the fetus begins to look human, at some arbitrary stage of pregnancy, when fetal movement can be felt, when the fetus becomes sentient and is first aware of its environment, when it is viable, is half emerged from its mother, or when it is separated from its mother. Each of these stages can be supported by logical arguments; some have further support from biblical passages.

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.

It can be argued that this was not an accurate statement when it was written. If women were asked what they were seeking, most would probably respond that they are trying to avoid a pregnancy. Later in that decade, it became an invalid assumption because it was determined that EC is a purely contraceptive medication and has no effect after fertilization -- the point at which the Church considers a pregnancy and a human person to have begun.

The statement continues:

"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

In the year 2008, Dignitas Personae reinforced this statement. It describes EC as an interception medication: i.e. a pill that has the potential of interfering with the pre-embryo in order to prevent pregnancy. Such medication is considered "within the sin of abortion" and "gravely immoral." 1

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

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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 of refusing to refer women to an agency where they can obtain EC.

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

Opinions differ:

bullet 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


bullet United States Conference of Catholic Bishops (USCCB): They seem to have followed Vatican teaching that EC can act as an abortifacient. 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

Unfortunatley, the only test to determine whether conception has ocurred is to wait for a week or two and see if the woman is pregnant. If she has become pregnant from the rape, then EC would have no effect on the pregnancy; if see is not pregnant, then there would be no need for any medication. It is a bit of a Catch 22 situation.


bullet 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

As noted above, there is no method of determining whether conception has ocurred. The hospital can only test whether ovulation has happened. If an ovary has not released an ovum, then it can be assumed that no conception has happened, and EC could be administered ethically under the Church's rules to inhibit ovulation and/or conception.


bullet 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

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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. "Dignitas 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/

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Copyright © 2008 to 2010, by Ontario Consultants on Religious Tolerance
Originally published on 2008-DEC-24
Latest update: 2010-JUN-20
Author: B.A. Robinson
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