The morality of using emergency contraception in the case of rape

Recently there has been a great deal of controversy around the morning after pill otherwise known as “emergency contraception”.  Several studies have seemed to show that the pharmaceutical works only in a contraceptive manner (meaning conception is prevented) rather than in an abortifacient manner (meaning nascent human life is prevented from implanting in the woman’s womb).

Understanding the morality of using the drug when a woman has been violated by rape has also been blurred by the studies.  So much so that the Bishops of Germany have said, on the grounds that emergency contraception only blocks fertilization, it would be licit for Catholic hospitals to treat rape victims with the drug.  However, they noted that “medical-pharmacological methods that cause the death of an embryo still may not be used.”

The decision of the German Bishops was called “exemplary” by Bishop Ignacio Carrasco de Paula, President of the Pontifical Academy of Life.  He also said:

The Church needs to shape people’s consciences. What Church teaching says in this case is: in cases of rape all possible action must be taken to prevent a pregnancy but not to interrupt it. Whether a given medicine is classed as a contraceptive or abortion-inducing medication, is up to doctors and scientists, not the Church.

The statement made by Bishop Ignacio Carrasco de Paula is a complete turn-around from the statement the Pontifical Academy of Life made in 2000, where it was stated

In the end, since these procedures are becoming more widespread, we strongly urge everyone who works in this sector to make a firm objection of moral conscience, which will bear courageous and practical witness to the inalienable value of human life, especially in view of the new hidden forms of aggression against the weakest and most defenceless individuals, as is the case with a human embryo.

It is important to note that the Jury is still not out on whether emergency contraception is in fact abortifacient or merely contraceptive.  In fact, in February of this year (at the same time the German Catholic Bishops made the decision to allow emergency contraception in the case of rape), Dr. James Trussell, a leading authority on the drug, and pro-abortion advocate, stated that it “may at times inhibit implantation of a fertilized egg in the endometrium.”

It could be, and is most likely the case, that the Bishops of Germany and the Pontifical Academy for Life have been given biased studies which act in the best interests of the pharmeceutical companies and those that wish to further their own agendas.

In light of the decisions of the German Bishops, NZ Catholic, asked John Kleinsman from the The Nathaniel Centre (the NZ Catholic Bioethics Centre) to write about the ethics of giving emergency contraception to victims of rape.  In the article Kleinsman states that

The ECP progestogen pills that are available in New Zealand are Levonelle-1 and Postinor-1, and both work by preventing fertilisation.

A quick look at Medsafe’s consumer data sheets for Levonelle and Postinor-2 (both updated 28 June 2007) reveals that the possible modes of action are:

  • Stopping your ovaries from releasing an egg;
  • Preventing sperm from fertilising any egg you may have already released; or
  • Stopping a fertilised egg from attaching itself to your womb lining.

It may be that Medsafe have not yet updated their information in light of the latest studies.  However, it is more likely that they can’t in all conscience remove reference to the abortifacient action of the drug.  They can’t because there is just not enough conclusive evidence out there to say that emergency contraception does not have an abortifacient effect.

The NZ Catholic asked John Kleinsman to respond to a letter from Ken Orr of Right to Life, which addressed the abortifacient nature of emergency contraception.  Kleinsman cited a recent statement by the International Federation of Gynecology and Obstetrics (FIGO) which found that there was no abortifacient effect of levonorgestrel (the active ingredient).  FIGO is a known abortion advocacy group and are tied to organisations such as The Bill and Melinda Gates Foundation, International Planned Parenthood Federation and the United Nations Population Fund.

To base a decision on one particular statement would be unwise, especially when the author of the study has a vested interest in the outcome.

In a series of articles, Human Life International has addressed the disparities amongst the understanding of how levonorgestrel actually works, and have come up with a final position statement that it cannot be morally permissible to administer the morning after pill, Plan B (which is the brand name used in the US), to victims of rape citing the following reasons:

1.    Recent large and robust studies indicate that Levonorgestrel-only contraceptives such as Plan B rarely block ovulation, and most likely do result in the death of the embryo if administered during the first 4-5 days of the fertile window.

2.    A Luteinizing Hormone (LH) protocol – a test whose outcome has been understood to determine whether a drug can be administered based on where the victim is in her cycle – cannot in fact detect that a woman is in these first days of her fertile window. Therefore a negative LH  test may well encourage administration of Plan B precisely when it is most likely to cause an early direct abortion.

3.    Because  recent  scientific studies have provided very strong data that indicates  Plan B rarely has any contraceptive effects and is likely to have  embryocidal effects, a medical practitioner cannot attain moral certainty that administration will not lead to early abortion.

4.     Since one  cannot attain moral certainty that abortion will be avoided, protocols and policies that currently permit Catholic health care providers to administer Plan B need to be reconsidered by the  appropriate diocesan authorities and hospital administrators.  Nations in which abortion is illegal should be aware of this potential abortion-inducing effect and should prohibit the administration of these drugs.

These are our conclusions pending any developments in scientific research. Further, it appears that no contraceptive exists that is known to meet the reasonable criteria expressed by the Church above.

Family Life International NZ takes the same position as HLI.

Unfortunately, the “emergency contraception” agreed to be used by the German Bishops by victims of rape seems not to exist.  John Kleinsman supported the German Bishops decision and erroneously ‘approved’ of the use of both Levonelle and Postinor in cases of rape in New Zealand.  A disppointing conclusion, considering it has been shown that it cannot be ruled out that in some instances early abortions (prior to implantation) do take place in the use of the emergency contraception.

The crime of rape is to be condemned in every instance.  Women who have been brutally violated in this way need compassion, support and Christian love.  Emergency contraception is not going to give this to her.

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