The recent statement by the Connecticut bishops that they will allow Plan B to be used for rape victims in Catholic hospitals is causing a great deal of consternation in the Catholic community, and I have received numerous requests for help in figuring out what is going on.
I’ll do my best to help, but let’s begin with some background.
FIRST, HERE IS AMERICAN PAPIST SUMMARIZING WHAT HAS HAPPENED SO FAR.
AND HERE’S COVERAGE BY THE CURT JESTER.
Some of the early coverage of this was hampered by the fact that the statement of the Connecticut bishops did not seem to be on their web site, making it hard for people to know what they said without the lens of the news media.
The statement is now there, but it’s in a Word doc, so here’s the full text of it in html:
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Connecticut Bishops Statement On
Plan B and Catholic Hospitals
Issued September 27, 2007
The Catholic Bishops of Connecticut, joined by the leaders of the Catholic hospitals in the State, issue the following statement regarding the administration of Plan B in Catholic hospitals to victims of rape:
The four Catholic hospitals in the State of Connecticut remain committed to providing competent and compassionate care to victims of rape. In accordance with Catholic moral teaching, these hospitals provide emergency contraception after appropriate testing. Under the existing hospital protocols, this includes a pregnancy test and an ovulation test. Catholic moral teaching is adamantly opposed to abortion, but not to emergency contraception for victims of rape.
This past spring the Governor signed into a law “An Act Concerning Compassionate Care for Victims of Sexual Assault,” passed by the State Legislature. It does not allow medical professionals to take into account the results of the ovulation test. The Bishops and other Catholic health care leaders believe that this law is seriously flawed, but not sufficiently to bar compliance with it at the present time. We continue to believe this law should be changed.
Nonetheless, to administer Plan B pills in Catholic hospitals to victims of rape a pregnancy test to determine that the woman has not conceived is sufficient. An ovulation test will not be required. The administration of Plan B pills in this instance cannot be judged to be the commission of an abortion because of such doubt about how Plan B pills and similar drugs work and because of the current impossibility of knowing from the ovulation test whether a new life is present. To administer Plan B pills without an ovulation test is not an intrinsically evil act.
Since the teaching authority of the Church has not definitively resolved this matter and since there is serious doubt about how Plan B pills work, the Catholic Bishops of Connecticut have stated that Catholic hospitals in the State may follow protocols that do not require an ovulation test in the treatment of victims of rape. A pregnancy test approved by the United States Food and Drug Administration suffices. If it becomes clear that Plan B pills would lead to an early chemical abortion in some instances, this matter would have to be reopened.
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Commentary later.
“Catholic moral teaching is adamantly opposed to abortion, but not to emergency contraception for victims of rape.”
Not opposed to emergency contraception?
Since when? It’s always opposed to contraception.
Someone get B-16 on the phone, please.
–Ann
Additional coverage from American Papist.
Actually, from what I can tell they are acting within Catholic teaching. From the statement:
Bolding is mine.
If it can be determined that ovulation has not yet occured in that woman’s menstrual cycle, then it can be licit to give drugs designe to delay ovulation so there is less chance of conception occuring.
From what I understand, emergency contraception is only illicit IF it may kill an already-conceived child, not one that MIGHT be conceived (but hasn’t yet been conceived) IF ovulation should occur in the next few days.
Contraception IS illicit in rape cases IF conception has already occured, or if ovulation has occured and it’s too early to determine if pregnancy has occured. It sounds like the statement recognizes that.
I will try to find official documents to back that up, but that was my understanding of Church teaching on the issue.
Just to clarify, the bolded passage was hospital policy. Past tense. The new law does not permit the hospital to require an ovulation test, so it cannot be determined that ovulation has not occurred.
“since there is serious doubt about how Plan B pills work,”
What is exactly meant by this? There is information on what DOES happen.
The administration of Plan B pills in this instance cannot be judged to be the commission of an abortion because of such doubt about how Plan B pills and similar drugs work and because of the current impossibility of knowing from the ovulation test whether a new life is present. To administer Plan B pills without an ovulation test is not an intrinsically evil act.
If she isn’t pregnant, then why give it? Oh yeah…the pregnancy test isn’t always accurate so she COULD be pregnant!!!
This is alarming.
Okay, hold the phone, I misread the last paragraph.
That seems to directly contradict the paragraph I quoted above, and would definitely be contrary to Church teaching (to my knowledge).
“If it becomes clear that Plan B pills would lead to an early chemical abortion in some instances, this matter would have to be reopened.”
Since it is already known that Plan B pills do this in some cases, I have to question these bishops’ intelligence; the status of their backbones has, unfortunately, already been made clear.
Perhaps the faithful in Connecticut could speak to their bishops in language they’ll understand: Donate no money to the diocese. If enough people direct their donations elsewhere, I guarantee it will get the bishops’ attention.
Numerous moral theologians (good ones, Fr. Vincent Serpa for instance) hold that a woman who uses a contraceptive pill for LEGITIMATE therapeutic means to treat some illness is not morally obligated to abstain from marital relations even though pregnancy and early miscarriage may occur because of the medication. This would seem to be the same situation. Clearly, the woman has a right to repel an unjust aggressor and the act of taking this emergency “contraceptive” pill (this is NOT contraception which IS intrinsically evil) is not intrinsically evil. Now, if as an unintended consequence a miscarriage occurs, that would be unfortunate but would not render the act immoral. At least, this would be the reasoning that the theologians are using to allow this. It would seem that an ovulation test would be nice, but not necessarily morally obligatory.
Yes, Bill912, meeting sin with sin is always a good option.
One of the commenters at American Papist has been actively researching the question and her conclusion based on various studies that she cited over there is that Plan B didn’t have an abortifacient effect. YMMV.
Folks,
I would urge caution prior to any sort of immediate condemnation of the bishops.
Different above seems to have provided one aspect that could clue in to a possible understanding of the current issue.
Let’s not judge so hastily prior to a careful consideration of all the pertinent facts.
“Since it is already known that Plan B pills do this in some cases, I have to question these bishops’ intelligence; the status of their backbones has, unfortunately, already been made clear.”
Is it? Citation please?
M. Z. is correct, and I agree with Esau’s appropriate admonition. And that commentator’s conclusions are consistent with mine after I undertook similar research some months ago. I urge folks to read those comments and do a bit of research to form their own informed conclusions before we assume the bishops are all wet.
Different, I think that is flawed thinking.
A woman does indeed have the right to repel the attack. Since sperm is in her body, the attack continues. So in general, it would seem contraception to PREVENT FERTILIZATION would be licit. If she has not yet begun ovulation, then there is a 0% chance she is currently pregnant. Thus the contraception (Plan B) works to PREVENT OVULATION.
HOWEVER, if a woman has begun ovulation, there is a possibility that the egg and sperm have combined. This is now new life, since life begins at the very instant of conception. The new life is no longer an invader, but a new and distinct human being. That means the new baby has a right to live. However, the new baby may not have implanted yet, meaning a pregnancy test wouldn’t provide correct information.
In other words, we are talking about the “Deer Hunter Principle.” If there is even a slight chance it’s not a deer, if you’re not 100% sure it’s a deer, you don’t take the shot.
So it would seem– IF ovulating, no pill. If not ovulating, pill. All well and good, except the law MANDATES that no ovulation test be given. This is not invincible ignorance, but intentional legislated ignorance.
The bishops have said that they will go along with this. I can not see how, in any way, shape, or form, this is compatible with Church teaching.
Some new research suggests that Plan B doesn’t prevent implantation, and doesn’t causes abortions.
HOWEVER, that is directly contrary to what appears on the label of Plan B. That is directly contrary to the statements of Plan B’s manufacturer. In all charity, we must assume the goodwill and honesty of Plan B’s manufacturer. Are they trying to deceive consumers, and Plan B may not ever cause abortions? Indeed, one of Plan B’s selling points is that it may cause an abortion! The FDA signed off on that label. The manufacturer (presumably) ran tests to arrive at that conclusion. All the reasonable evidence, with the exception of a few recent scientific studies which have not been extensively reproduced, says Plan B can cause an abortion.
I really wish there were an error in the above logic, but for the life of me, I can’t find. Unfortunately it isn’t my life on the line—rather, babies’ lives in CT are on the line.
Et Tu, Bp. Lori?
The thing about ovulation tests is that they cannot pinpoint the exact moment that ovulation occurs. If you get a “positive” ovulation test, all it means is that ovulation will probably occur in the next 48 hours; however, sometimes there can be a false LH surge that doesn’t quite reach the point that stimulates ovulation. If a woman is charting her cycle, she will have a much better idea if ovulation has or hasn’t yet occured because she can correlate the LH surge (which is what ovulation tests test for) with a rise in body basal temperature (a jump of .4 or more degrees from a lower pattern usually indicates that ovulation has occurred).
Unfortunately, many women don’t chart their cycles and thus would have no idea what part of their cycle they are in, other than “My period is due in X days” or “I just had my period X days ago.”
One may be able to determine via ultrasound, by looking at the ovaries, if ovulation has already occured or is going to occur soon as well.
So even with ovulation tests it can be difficult to determine where a woman is in her menstrual cycle. As Mike said, it doesn’t justify using Plan B if you’re not 100% sure, even in a rape situation.
“All the reasonable evidence, with the exception of a few recent scientific studies which have not been extensively reproduced, says Plan B can cause an abortion.”
I don’t think that is quite right. To the best of my knowledge there is no such evidence. What does exist are articles that hypothesize how Plan B could work to prevent implantation (i.e., cause an abortion) under certain conditions assuming a failure of contraceptive efficacy. These articles were not “studies” as such and produced no “evidence.” Nonetheless, the warnings issued by the manufacturer are based on these articles, and were the product of some lobbying done by pro-life groups with the FDA as I recall.
Those studies that have been done have consistently indicated that the risk of abortion is either zero or close to zero. If the object of the use of Plan B is to prevent conception (not induce abortion) then I believe a remote risk of abortion may be morally acceptable under the principle of double effect. Now, it may be fair to say that prudence dictates that further studies should be performed in order to secure greater confidence in the assessment of the risk; perhaps. But I do think that commentators would be well-advised to research these matters before accusing the bishops of betrayal. After all, the Deer Hunter Principle does not really contribute to moral clarity under Catholic moral theology.
Respectfully(!), I don’t see how people get confused about Natural Law and Church teaching–which I respect and hold very dear–enough to say that merely delaying ovulation, in cases of rape, is intrinsically wrong and falls under the contraception teachings (which in my opinion need elaboration).
The rape wasn’t meant to happen. The insemination that results wasn’t meant to happen. Are medical personnel also doing something illicit, when they go through procedures to clean a victim of semen? That’s just as “contraceptive”, albeit not quite as effective as administering a pill. I even saw douching with the intent to contracept mentioned in a Church teaching on the Vatican website (Humanae Vitae, was it?) So would you be against administering this procedure to rape victims? The Church isn’t. Why isn’t She, then, when the Church also says “Contraception is always wrong?” Because obviously there are essential elements of what She is calling “contraception” which set it apart from the clinical definition of “contraception”–elements which are not present in this situation. When a victim is cleaned, or her ovulation is delayed after a rape, there’s no culture of death, “my fertility is a sickness to be medicated”, “I want to abuse sex” mentality at all.
It sounds like, by some people’s logic, though, one would have to say that once semen is present in that environment, that we have to just leave it there and “let nature take its course”, when semen is ONLY present as a sick violation of the proper moral and natural (in the sense of human nature) order of things! I’m trying not to be emotive here, but the idea that people use this logic scares me. It seems entirely, illogically and blindly legalistic and draconian. It’s like saying, “Now that that poisonous food is in your stomach, you have to digest it no matter what could happen to you, because that’s what your digestive system is supposed to do with food, and you’re meant to respect its nature,” even though poisoning, like rape, is a very disordered situation to be in.
The Church teaching very clearly tells us that the only proper situation in which to conceive and bear children is via a pure, consensual act within marriage. It’s not for boyfriends and girlfriends, or for doctors and petri dishes, or for rapists and victims. It seems incongruous with other established teaching, to declare that we’re under an obligation to facilitate the consequences of a clearly disordered, unnatural act like rape, by doing nothing, in light of what the Church teaches us as ideal. The whole situation during and immediately after a rape is an aberration itself. The natural, reproductive faculties are withstanding actual abuse, and it has nothing at all to do with Natural Law or the general order of things. How is it in compliance with Natural Law or the natural, intended order of conceiving children, as taught by the Church, to enable the abuse of this reproductive faculty, to continue to the point of conception? Conception can’t be considered a bad thing in itself, but surely its facilitation need not be mandated in every instance where it is made a possibility, just because circumstances might be conducive to it. Meals are a good thing, but just because my refrigerator is full does not mean that I should go down there and eat everything I possibly can, as often as I can!
Joanna, if I said that I misspoke. I don’t think 100% certainty is necessarily the test. If the purpose of utilization of Plan B is licit (i.e., use as a contraceptive rather than an abortifacient) and it is not the nature of Plan B to act as an abortifacient, but it can be a rare or remote side effect, then it is quite possible that use of Plan B is morally justifiable. The key to this question is whether, how, and even how often Plan B might act as an abortifacient. It is reasonably plain that the treatment is designed to act as a contraceptive, and we might stipulate that one’s use is limited to that intent, but if the nature of the treatment is also to cause abortions then it cannot be morally licit. The only actual “studies” on the matter indicate that abortion, while theoretically possible, would seem to be rare and not a typical effect. Whether these studies are sufficient to induce enough prudential confidence is a fair question, but I suspect that the bishops in question have made an honest effort at addressing that question.
IF ovulation has occurred and conception has a occurred, a miscarriage could result from the Plan B. But that remains an unintended and unfortunate side effect. The intention is to stop the rapists sperm. The object is the administration of a medication to stop the sperm. The unintended consequence is the possible miscarriage.
It’s similar to the case I noted above or, maybe better, to a woman with cancer… A woman has cancer and the doctor wants to use aggressive chemo to treat it. The woman “might” be pregnant, she may have just ovulated and recently had relations with her husband. Can she take the chemo even though it will certainly cause a miscarriage IF she is pregnant? Of course, she can. So it is with the Plan B.
At least, that’s the way I see the double effect here. Miscarriages happen for many reasons, if a medication happens to cause one in the course of being administered for a legitimate reason that is unfortunate but certainly moral.
What Karen said.
Amen to that!
Yes, indeed — what Karen said!
Amen indeed to what Karen said. The cadre of Catholic minipopes who, ignoring orthodox Catholic moral theologians and the USCCB guidelines, are simply horrified that a rape victim doesn’t just let the rapist succeed in impregnating her are beginning to drive me nuts. The worst part is that they’re probably driving people away from Catholicism and orthodoxy re: contraception.
Thank you, Karen.
I have never posted here before, though I am a regular reader. I think some perspective on this will help.
First, the Ethical and Religious Directives on this are clear:
“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.”
Second, the determination of as to how determine whether conception has occurred is a medical matter, although a bishop can weigh in as to whether a particular method provides enough “moral certainty” to proceed. (100% certainty is not required.) Different facilities, dioceses use different methods, usually the pregnancy test or the ovulation test. Both methods have their flaws. I believe that the USCCB Committee on Doctrine, in consultation with the Vatican has looked into this – maybe more than once — and concluded that both types of tests are licit.
The Connecticut legislature should not have directed how a facility should practice medicine or infringe upon how a religious body clinically applies its ethical policies. This is why the Connecticut bishops opposed the legislation.
Given that the legislature did mandate a particular procedure, and that that procedure is not currently understood as contrary to Catholic teaching — and is, in fact, commonly practiced in Catholic hospitals, the bishops are not doing anything wrong by merely saying that the hospitals can comply with the law. They are not saying it is a good law or that they prefer the pregnancy test over the ovulation test. They are only saying that, given the circumstances, they can “live with” the mandate.
Just one other thought (albeit, unrefined) —
It is right that we treat the embryo as a baby for obvious reasons; but to make such an assumption as early as during the processing of the raw materials themselves would seem to assume some sort of Godly divine knowledge — to the very extent of saying that when the act has already begun, there, a soul has already been born.
Being humans, I believe folks who are thinking in this manner are overstating their knowledge and assuming that their knowledge is that of God, which certainly is not the case.
One cannot be so arrogant as to make the declaration, either implicitly or explicitly, that a soul has already been born as soon as the sexual act had commenced.
Just wanted to also point out what might not have been clear: The mentality in delaying an ovulation is not the same as the culture of death “fertility is bad” mentality. There’s a whole other focus that conveys a completely different intent, and makes it a whole other animal. The focus isn’t on “fixing” anything perfectly natural in the way of the victim’s fertility–a component in “contraceptive mentality” part of “contraception” teaching which seems distinct from the purely clinical definition of “contraception”. Rather, it’s focus is thwarting a further potential consequence of a very disordered situation–a conception that could happen under the wrong circumstances. It’s okay to delay ovulation, just as we delay meals when we fast, when nature clearly compels us to eat more than we do when we fast.
Certainly not — otherwise, a woman who breaks free from her attacker during the rape is committing contraception by coitus interruptus!
Reminds me of the 60’s when contraceptive pills were approved for nuns in the Congo at risk for rape. Also reminds me of Vatican opposition to morning-after pills in ’99 for rape victims in the Kosovo refugee.
Thanks, SDG, for that comedy relief!
It’s just I shudder to think that folks actually take raw materials (prior to the actual existence of the embryo) as actually having equivalent status to that of a baby.
That’s almost like claiming that a mere part of a vehicle is actually a Ferrari or Lambo (or any other desired car).
Here’s my commentary on the subject, as I eagerly await Jimmy’s!
http://www.constitutionallycorrect.com/archive/2007/09/28/552.aspx
Hair-splitting aside, isn’t this just the camel’s nose in the tent?
The question is, how many other yahoos are going to jump on this bandwagon and drive it over the cliff?
And how many more metaphors can I mix in here?
Karen,
Your post was well written and emotionally charged. I applaud you for maintaining clear thinking while still writing with such emotion.
I certainly hope your post was not aimed at what I had previously written, because I am in full agreement with, “”When a victim is cleaned, or her ovulation is delayed after a rape, there’s no culture of death, “my fertility is a sickness to be medicated”, “I want to abuse sex” mentality at all.”
That being said…
Different,
I think you are misapplying double effect here. You wrote, “IF ovulation has occurred and conception has a occurred, a miscarriage could result from the Plan B. But that remains an unintended and unfortunate side effect. The intention is to stop the rapists sperm. The object is the administration of a medication to stop the sperm. The unintended consequence is the possible miscarriage.”
I disagree. The reason for prescribing Plan B is (OR, ought to be), “To prevent ovulation, so the woman can not become pregnant.” Stopping the sperm is the means, preventing pregnancy by preventing ovulation is the end.
If a test is capable of determining (to a high probability) that ovulation has already taken place, it should be used. If ovulation has already taken place, there is no reason for prescribing Plan B.
In other words, it can easily be determined if there is a legitimate reason to use the suggested means. This law prevents the determining of legitimate reasons.
In this case, The ONLY reason for using Plan B for a purpose other then preventing ovulation is…drumroll please… terminating a pregnancy. Reqouting you, “a miscarriage could result from the Plan B. But that remains an unintended and unfortunate side effect” Once ovulation has begun, ovulation can no longer be prevented. SO I must ask:
How does the good effect outweigh the bad effect when, in this case, the good effect and the bad effect are both terminating a pregnancy? It doesn’t, ergo, no double effect.
All this law does is prevent information from being obtained…because the goal is the bad effect. No dice on that, since this is willfull (legislated) ignorance. I can’t drive through a red light with my eyes closed, and claim no responsibility for the consequences since my eyes were closed.
To clarify the above post, since others might be confused:
The debate is not about Plan B in general for a rape victim outside ovulation with the purpose of preventing ovulation, there isn’t a whole lot of disagreement on that.
The debate is about using Plan B without checking for ovulation, or using Plan B despite ovulation– knowing that there is at least a possibility of killing a baby. In those murky situations is where this question lies.
If others think I’m incorrect, please correct me, since I may not be understanding the actual issue.
This is contraception. This is absolutely wrong. Everyone should condemn it, but everyone won’t because even most Catholics think contraception is okay. It isn’t okay. It’s gravely sinful 100 % of the time. This is true even in instances of rape or incest. God help us.
“This is contraception. This is absolutely wrong. Everyone should condemn it, but everyone won’t because even most Catholics think contraception is okay. It isn’t okay. It’s gravely sinful 100 % of the time. This is true even in instances of rape or incest.”
OK, are you saying that a rape victim cannot attempt coitus interruptus during rape or a vaginal douche afterward? I am not aware of any Catholic teaching that says that, and that includes HV; yet prominent Catholic moral theologians have expressed opinions that would allow such contraceptive practices.
I suggest that you take off your mitre and learn before engaging in feckless self-righteousness.
And ciaw:
Consider Directive 36 from the USCCB Document on Ethical and Religious Directives for Catholic Health Care services, “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.”
Thank-you, Mr. Mike Petrik, for your comments here as well as on the other thread.
There have been far too many Luther-leaning authorities on this matter who would rather impose their own personal interpretations rather than the actual one from the Church.
Thanks, Esau, agreed and back atcha.
Ironically, these “Luther-leaning authorities” would accuse us of the same. They have a simplistic black-letter understanding of Catholic teaching, and for whatever reason seem to have little appetite to try to learn more. In all fairness, I don’t expect most Catholics to get take up Catholic moral teaching and theology as a serious interest, but you’d think people would actually research and investigate before posting emotional commentary.
I believe that EWTN’s The World Over covered this issue quit well last night and there is little doubt the bishops in my state erred. Pity the poor healthcare workers with well-formed consciences who have to either give up their jobs of commit serious sin. The lion’s in the coloseum equivelent would have been to let the state close all four of Connecticuts hospitals -if they dared.