22 February 2013

Catholics and the Morning After Pill in Cases of Rape

I really try to avoid getting into anything political here, but having read so much stupid reactionary flame throwing from Catholics about this, I felt a little obligated to throw in my two cents.

First off, is this really news? Yes, the fact that the archbishops made a public teaching on the subject is newsworthy, but they didn't pull that teaching out of thin air; we thoroughly discussed this in my Christian Moral Principles course five years ago. It is based on established bioethical principles and decades of scientific understanding of the female reproductive system. The USCCB approved similar guidelines several years ago. All of the combox flamethrowers yelling "Humanae Vitae Evil Liberals Hell!" are only making themselves look stupid and the Church look bad.

Here's the basic rundown, in case you've managed to avoid it. The German archbishops released a statement yesterday explaining that Catholic hospitals in their jurisdiction would henceforth be making emergency contraception available to rape victims in cases where the pill would act to prevent conception. They carefully clarified that in cases where the pill would act as an abortifacient, it could not be given.

"[Care for rape victims] can include prescription of the `morning-after pill,' insofar as it has a preventive and not an abortive effect. Medical and pharmaceutical methods which result in the death of an embryo still may not be used."

Media outlets saw the story and thought "Catholics + contraception = controversy!" and made a big kerfuffle about it. Reactionary Catholics read headlines, didn't bother researching the subject thoroughly, and started yelling about Humanae Vitae and hell.

If a woman is threatened with rape, no sane person questions her right to defend herself. If she is raped, the principle of self-defense gives her the right to protect her body and her eggs from her assailant's sperm, for as long as fertilization has not yet occurred. If fertilization occurs, the right of self-defense does not allow her to take an abortifacient, because that would be an act of aggression against the life of the innocent child, not an act protecting against the action of her attacker.

Emergency contraception does different things, depending on where the woman is in her cycle. If she has not yet ovulated, EC works to prevent ovulation from occurring. If she has ovulated but the egg has not been fertilized, some forms of EC prevent fertilization/conception. If she has ovulated and the egg has been fertilized, then the drug may act as an abortifacient.

Many of the commentators I've seen so far have been claiming the point moot "because sperm live such a short time" or because "there's no way of knowing when a woman will ovulate." Sperm can live for up to a week within a woman's body. The ovaries create luteinizing hormone (LH) in preparation for ovulation, and a urine or blood test can indicate whether a woman is ovulating or preparing to ovulate within the next 48 hours. Fertilization/conception occurs within 24 hours of ovulation. If a woman does not test positive for LH, she is not immanently ovulating. If a woman is not immanently ovulating, conception is not yet possible and emergency contraception to prevent ovulation from occurring, thus protecting her from becoming pregnant from her attacker's sperm, would not be immoral.

Others who disagree target the drug manufacturers' claims of preventing fertilization once ovulation has occurred. This would clearly be morally permissible, on the principle of self-defense, because there is no new life yet. However, because we do not currently have the ability to ascertain with certainty that ovulation but not fertilization has occurred, critics are correct in stating that emergency contraception cannot be morally given once ovulation is immanently occurring, as indicated by the presence of LH.

To clarify, a standard pregnancy test looks for human chorionic gonadotropin (hCG), not LH. A woman's body begins producing hCG once implantation occurs, not when conception occurs. It can take a human embryo a week to travel from the site of fertilization in the Fallopian tubes to the uterus, where it implants and triggers production of hCG. For this reason, a standard hCG-detecting pregnancy test cannot provide confirmation that conception has not occurred, and is thus inadequate for determining whether it would be morally acceptable for the rape victim to take the Morning After pill.

All of that said, it is incredibly important for doctors and other hospital personnel to be thoroughly informed of Church teaching in regard to the beginning of life: if there is any question as to whether conception has occurred, emergency contraception would be immoral because of the possibility of abortion. When there is certainty that ovulation has not yet occurred, however, emergency contraception may morally be given to a victim of rape.

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  1. Ooh! Thanks for the speedy rundown!

    One more category--I mean, what I think would be the biggest news was "Catholic bishops approve contraception". My suspicion is that the standard moral proscriptions against contraception do not apply, as there was no act of love in the first place. More or less on the mark?

    1. Right; morally speaking, rape is a completely different act than consensual sex. It is an unjust attack on another person, which the attackee is certainly under no obligation to "be open to."

    2. In a weird sense, it strikes me as analogous to the concept of annulment? There was never an openness to life or to sexual gift (for good reason), and therefore nothing to interfere with?