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    AmP Countdown: Time left to demand that Congress make health care reform pro-life: 2009-11-07 18:00:00 GMT-05:00

    Tuesday, October 23, 2007

    Fr. Fehlner speaks out on Plan B ... and takes it an extra step

    LifeSiteNews reports:

    In what is likely the most significant contribution to date in the debate over the use of the so-called "emergency contraception" pills at Catholic hospitals, renowned theologian Fr. Peter Damian Fehlner has written on the subject. The Doctor of Sacred Theology who has been teaching theology in Franciscan universities and seminaries in the US and Italy for forty years, has questioned the basis on which the whole issue is based - namely whether it is permitted for Catholics to administer Plan B even if it acted as a contraceptive rather than causing abortions.

    Fr. Fehlner, who was the North American Superior for the Franciscan Friars of the Immaculate in the United States from 1996 to 2002, dismissed outright the use of Plan B at Catholic hospitals where there is any doubt as to it possibility of causing an abortion. "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," he writes. "That means even if the pill in Plan B is only 'dubiously' abortive, we simply may not use it at all."

    The same point in the debate was made by the Catholic Medical Association and by pro-life groups which have been involved in the debate. However, Catholic bioethicists working for hospitals have advised bishops that it is good enough to have "moral certainty" rather than absolute certainty that the pills will not cause an abortion.

    My only response to this valid point is that currently there is no way to definitively prove that Plan B never acts abortifaciently.

    As I read the current medical findings, the "doubt" of a person proscribing Plan B in cases of rape treatment amounts to something like this:
    "I know there were reports many years ago which claim that this treatment could possibly harm a human life. However, recent medical evidence seems to deny these earlier claims."
    The prudential question is then whether or not this represents sufficient doubt to make it morally imperative that one choose against treatment. The recently-passed Connecticut Legislation deprives individuals (both doctors and patients) the freedom to make this prudential decision.

    Fr. Fehlner, however, takes his argument against Plan B one step further:

    However, beyond the question of the abortifacient effects of the pills, Fr. Fehlner - a familiar name to those who watch EWTN, points out that the Church teaches that contraception is intrinsically evil and thus is not permissible even in cases of rape."

    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, explains Fr. Fehlner. "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."

    The stance of Fr. Fehlner calls into question not only the decision of the Connecticut Bishops, but also that of the Ethical and Religious Directives for Catholic Health Care Services put out by the US Conference of Catholic Bishops.

    The document permits contraception in cases of rape. It says specifically that in cases of women who have been raped: "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."

    Nonetheless, Fr. Fehlner is standing on firm ground since several Popes have also taught that contraception is "intrinsically evil" and thus impermissible regardless of circumstances.

    This is a more serious claim. And I think if Plan B stands or falls, it won't stand or fall on this particular issue.

    Let me explain: while Fr. Fehlner is correct in saying that contraception is "intrinsically evil" and hence never to be done, what is in fact "intrinsically evil" about contraception is primarily that it destroys the connection between the unitive and procreative dimensions of marital intercourse, as is taught in Humanae Vitae #12.

    However, in cases of rape, there is no unitive dimension for contraception to separate from the procreative. Indeed, rape is a wilful and violent perversion of what should be a unitive act. Part of its horror is that it is so clearly a violation and a "taking" of something which should be freely given and sacramentally confirmed.

    Therefore, individual Church conferences and directives have taught that a victim of rape may take non-abortifacient contraceptives to prevent the further violence of the attacker's sperm upon her body (in this case, ovum). A primary example of this teaching is present in #36 of the USCCB's ERDs.

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    Tuesday, October 16, 2007

    The state of Plan B and the CT bishop’s decision

    This post will provide two services:

    • As promised, it will present recent medical findings which make a compelling argument that Plan B does not, in fact, act abortifaciently
    • Additionally, it will cite examples of a growing consensus among reasonable commentators that the recent decision of the Connecticut bishops was still not in the best interests of Catholic hospitals in the U.S.

    Before I continue I must make this very clear: I am not claiming definitive knowledge about what I discuss. I am in the process of coming to decisions about the moral issues involved here, and I present below my current position on the questions - albeit a position that I have been researching and thinking through at some length. The main purpose of this post is to keep this debate in the public eye and not rest until we are satisfied with the conclusions that have been reached. That said....

    First, the medical findings:

    I have been corresponding with a practicing family physician who has reviewed the medical literature and concluded that levo-norgestrel as dosed in Plan B is probably not abortifacient, granted that it is very hard in this case to prove a negative. However, what is required here is moral certainty, not absolute certainty. There is the possibility, as yet undiscovered, that Plan B could act against an already-conceived human being. I think one of the problems in this debate is that previous reports, now contradicted, did claim to detect an abortifacient side-effect to Plan B in some cases. If those reports were in fact false, and had never been issued, we would be in a very different frame of mind when viewing this situation now.

    First, some summarized background on the medical situation (and several facts you might not necessarily take into consideration immediately without prompting):

    • A pre-implantation embryo is invisible, which means absolute moral certainty regardings its presence and survival is difficult to obtain
    • While most oral contraceptives, when taken regularly, do in fact reduce the endometrial lining (typically from 5mm to even less than 2mm), Plan B apparently does not have enough time to begin reducing the lining of the endometrium. And since it is only administered once, nor does it have a chance to reduce the endometrial lining after implantation.
    • There is also increasing evidence that Plan B operates primarily by preventing ovulation
    • Furthermore, its secondary effect of thickening cervical mucus and altering uterine pH levels are also demonstrable
    • One of the frequently-cited sources for the claim that Plan B acts abortifaciently has since been shown to have relied on unscientific methods for determining its findings
    • Often people claim something to the effect that "clearly Plan B is an abortifacient because it says so on the label!" However, there is plausible reason to believe that this warning was placed on the label to avoid legal complications because the manufacturers did not know (and admittedly, probably did not care) whether the chemical effects the endomitrium.
    • Other research into the effects of Plan B [like this notable one] seem to ignore the fact that Plan B, while similar to the contraceptive pill, does not have the same duration of time than the contraceptive pill has to deplete the endometrium.

    Here is an extract of the physician's findings:

    Plan B, levo-norgestrel does not appear to cause abortion by damaging the endometrium. A 1974 article and extrapolation from daily oral contraceptives have contributed to this common misperception.

    Some “emergency contraception” such an IUD’s and mifepristone most likely do prevent implantation.

    There is now good evidence that Plan B does prevent ovulation in some women. Plan B, given after ovulation has occurred, may still prevent some conceptions by making the uterine environment unfriendly for spermatozoa.

    You can read the two-page summary of the medical findings (as well as a note regarding ovulation testing) in a Word Document here.

    I think this short summary reveals that a very serious study of Plan B's effects needs to be undertaken to provide the Catholic medical community with the scientific data it needs to evaluate the morality of proscribing it to rape victims.

    As a side-note, I'm also hearing reports than Plan B's effectiveness is drastically below the near-100% figures claimed by the manufacturer (as low as 60%). We can probably expect pharmaceutical companies to eventually develop a "99%" effective pill that may include endometrial thinning as one of the mechanisms for preventing sustained pregnancy. Such a pill, on principle, would have to be resisted once it is scientifically demonstrated that it in fact has the ability to act against an already-conceived human being.

    Now, a look at the the emerging consensus:

    Having analyzed the recent medical findings on Plan B, we must now take a look at the prudential nature of the CT Bishop's decision from the standpoint of legal precedent, and therefore, within a wider context. After all, this decision did not occur in a vacuum.

    As I said at the time, I believe the National Catholic Bioethics Center statement on this question is best. I will re-iterate here the conclusion that I came to in my commentary on the document:
    While the NCBC understands the judgement of the CT bishops regarding the claimed moral neutrality, as such, of allowing Plan B, the NCBC also brings up the point that because a) it is immoral to violate one's conscience and b) this law does not allow an exemption of conscience therefore .... c) this law immorally legislates that people violate their consciences.
    Simply put, a law which requires Catholic hospital employees to violate their conscience in the practice of their medical profession is unjust. Numerous commentators have agreed.

    Fr. Thomas J. Euteneuer, president of Human Life International had this to say:
    "Acts of blatant coercion of Catholic consciences are already far advanced and will only continue unless the church is willing to stand up and rebuke the arrogance of these coercive measures and carve out strict realms of conscience which are unreachable by activist courts and corrupt politicians." {Source.}
    The Catholic Media Coalition has been especially vocal about reversing the situation of compliance.

    More recent related stories:

    From the proceeding I conclude:

    • Medically speaking, it appears that prior claims regarding the abortifacient properties of Plan B, when administered once, are unable to be substantiated. Indeed, the best review of current research would seem to suggest that Plan B, when administered once, does not render the uterus inhospitable to new human life.
    • That said, legally speaking, it is unjust for the Connecticut State Legislature to enact a law that a) contravenes the consciences of Catholic employees, b) legislates restrictions upon what testing may or may not be administered to rape victims and c) withholds pertinent information from these victims at a crucial time in their decision-making process.

    As such, and in times such as these, we need to support the CT Bishops in reversing this unjust law.

    Previous AmP coverage of this story - starting the day it happened - available here.

    Constructive comments are always welcome. Emails receive greater attention and priority.

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    Thursday, October 04, 2007

    NCBC publishes statement on Connecticut Bishop's Plan B decision (with commentary)

    The National Catholic Bioethics Center has published a statement on the Connecticut Bishops' decision to allow the use of Plan B without an ovulation test in cases of rape. The NCBC is, in my opinion and many others, the foremost institution on Catholic bioethics in the United States. Their quarterly journal is widely-read and highly regarded. I have read this journal extensively for various courses and have drawn on it heavily for bioethics papers and research.

    I have always agreed with their positions and reasoning. I further take this statement to be normative for my own opinion about this matter, with the comments I include below. To fast-forward and summarize my conclusion: I believe that this document both a) is willing to admit the validity of the Bishops' prudential decision while simultaneously b) claiming that the law is essentially immoral because it requires health care workers to violate their conscience.

    That said, I would encourage anyone who has been following this story closely to read the statement in its entirety.

    I'll now excerpt the most important passages [my comments in brackets]:

    ... This is a complex moral matter and does not lend itself to brief explanation. This difficulty was rendered all the worse by inaccurate reporting and inappropriate, indeed misleading, terminology.

    These are good initial observations, which I have previously voiced.

    ... The state does allow a pregnancy test. However, this test can have nothing to do with the sexual assault. This test only identifies a conception that had taken place before the assault. It takes an embryo 5 to 7 days to make its way down the oviduct and implant in the womb.
    Correct. The pregnancy test does not provide the information needed by the health care workers or victim to make a fully-informed ethical decision.

    ... In other words, [under this new law] the physician would have to administer a drug preventing ovulation even if ovulation had already occurred. Frankly, that makes no medical sense. The state was preventing a physician from exercising his or her best medical judgment about a procedure he or she was considering.

    Yes. The new law requires that health care workers not perform a scientifically-relevant and morally-necessary simple test.

    ... A second objection centered around the fact that the medication(s) might prevent an implantation if a conception had occurred. To intend and to do such a thing is immoral. However, there was considerable debate among medical and drug experts whether or not the drugs actually had that effect. And everyone agreed there was no test even to know whether a new life had been conceived.

    In a situation of doubt, it is not prudent to forgo testing which might aid an honest decision-making process.

    Finally, attention should be drawn to the fact that the Federal Drug Administration includes the intra-uterine device as “Emergency Contraception” which is a misnomer since it is known to have an abortifacient effect.

    I had not heard this before, but I have heard that the FDA protocols often fall well-below standards acceptable to Catholics.

    Unlike the state of Colorado, for example, the state of Connecticut would not allow physicians to exercise their best medical judgment and provided no conscience protection to physicians or hospitals to refuse to administer the drug when requested.

    The crux of the matter: this law inhibits Catholic hospitals and workers to exercise good medicine and their conscience. This is a very dangerous precedent to allow in general.

    The Connecticut Catholic bishops and hospitals, under strong protest, have allowed a new protocol to be used that was developed by Catholic health care institutions. Furthermore, they made it clear that if a test were ever developed that allowed one to detect a conception after an assault, and if it became clear (as is not yet the case) that the medication(s) would work as an abortifacient, they could no longer accept the protocol. Finally, the Connecticut bishops pointed out that the Doctrine Committee of the United States Conference of Catholic Bishops had studied this matter for years and could not come to the conclusion that the protocol previously allowed by the Connecticut bishops (the ovulation test protocol) would have to be used by all Catholic institutions.

    I'm not sure here that it is necessary for the Connecticut protocol to be universally-applicable to other hospitals for it to constitute the moral course of action. The logic of the document in this paragraph is not quite clear to me. Just because the USCCB did not endorse the details of the previous CT protocol does not mean that the protocol was deficient. It simply meant that their prudential decision was well-founded enough, at the very least, to avoid challenge.

    In matters that have not yet been decided definitively by the Holy See, The National Catholic Bioethics Center has refrained from adopting one or another position on a disputed question. However, in the matter of protocols for sexual assault, there is virtual unanimity that an ovulation test should be administered before giving an anovulant medication. The protocol the NCBC has supported requires the ovulation test because it provides greater medical and moral certitude that the intervention will have its desired anovulatory effect.

    I think it is clear from this paragraph that the NCBC would have preferred the CT bishops to not abandon their previous requirement of an ovulation test (i.e., language such as "virtual unanimity"), but they do not state this explicitly here. Furthermore, their reasons for thinking the law is unjust are a bit more nuanced and the grounds for their reservations are more novel than the discussion have taken into account up to this point. But let's read on....

    The NCBC objects strongly to state mandates, such as those passed by Connecticut and Massachusetts, that do not allow health care professionals and facilities to exercise their best medical judgment and which do not protect the consciences of all parties. We also object to state mandates that do not allow the victim of sexual assault to have all the information necessary for a medical intervention so that she might make an informed judgment.

    This argument also seems to tend towards resisting the law. Indeed, what they are proposing here is that one might resist the law on principle alone, because it violated the consciences of Catholic hospital doctors and employees and furthermore acts against the interest of the victim.

    However, the NCBC understands the judgment of the Connecticut bishops that the administration of a contraceptive medication in the absence of an ovulation test is not an intrinsically evil act. However, it is immoral to violate one’s conscience, including the corporate consciences of health care agencies, and the unwillingness of the state to allow an exemption of conscience makes the law unjust and onerous.

    Back-to-back "However's" tend to set off warning bells in my mind that an author is trying to have it both ways. I think the first line here about the CT decision is acknowledging, for instance, that strictly-speaking the CT bishops have not acted against any specific moral norm. However, the second line formulates a premise upon which the law could be challenged because "it is immoral to violate one's conscience" ... and as such, the law is "unjust and onerous."

    Conclusion: While the NCBC understands the judgement of the CT bishops regarding the claimed moral neutrality, as such, of allowing Plan B the NCBC is also bringing up the point that because a) it is immoral to violate one's conscience and b) this law does not allow an exemption of conscience therefore .... c) this law immorally legislates that people violate their consciences.

    This conclusion prompts the next question, which this statement does not address: is it moral to accept a law that is immoral for the proportional good of allowing Catholic hospitals to continue treating rape victims? I think that's what the discussion must now explore.

    As I've promised before in previous posts, I still hope to publish a summary of the medical details regarding Plan B by the end of this week (waiting for more input). Previous coverage of this issue can be found here:

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    Tuesday, October 02, 2007

    Bp. Lori issues clarification on CT Plan B decision

    And he chose to use his blog as the medium for his thoughts (underlining is mine, bolding is his):

    Plan B, an issue previously discussed in this blog (“Sad State of the Constitution State”, April 24th—see “Archive”) is back in the news. Many of you posted comments about those media reports, so I’d like to offer a number of clarifications and some additional perspective.

    Last spring, the Connecticut Bishops worked hard to defeat the so-called “Plan B” legislation. It’s not that the Church opposes administering Plan B to victims of rape; these women have suffered a gravely unjust assault. Last year, nearly 75 rape victims were treated in the four Connecticut Catholic hospitals; no one was denied Plan B as the result of the Catholic hospital protocols which required both a pregnancy test and an ovulation test prior to the administration of that drug.

    What’s really at issue here is how much testing is appropriate to ensure that Plan B does not induce the chemical abortion of a fertilized ovum. There is uncertainty about how Plan B works. Its effect is to prevent fertilization of the ovum. Some believe, however, that in rare instances Plan B can render the lining of the uterus inhospitable to the fertilized ovum which must implant in it in order to survive and grow; many other experts dispute this. For their part, the Bishops of Connecticut felt it was best not only to administer the standard FDA-approved pregnancy test, but also an ovulation test. However, this course of action was only a prudential judgment, not a matter of settled Church teaching and practice. Other bishops and moral theologians hold that a pregnancy test alone suffices. Indeed, the Church does not teach that it is intrinsically evil to administer Plan B without first giving an ovulation test or that those who do so are committing an abortion.

    Unfortunately, Connecticut Legislature decided last spring to settle the question of whether both tests are necessary, instead of letting the Church do so in her own way. The Governor signed into law a measure that forbids health care professionals from using the results of an ovulation test in treating a rape victim. We bishops, as well as health care professionals, continue to believe this law is seriously flawed and should be changed. You should also know that we carefully explored with very competent experts the possibility of challenging the law. Unfortunately, such a challenge would most likely not succeed. Failure of the hospitals to comply would put them and their staffs at risk.

    In the course of this discussion, every possible option was discussed at length with medical-moral experts faithful to the Church’s teaching, with legal experts especially in the area of constitutional law, and with hospital personnel. “Reluctant compliance” emerged as the only viable option. In permitting Catholic hospitals to comply with this law, neither our teaching nor our principles have changed. We have only altered the prudential judgment we previously made; this was done for the good of our Catholic hospitals and those they serve.

    At the same time, we remain open to new developments in medical science which hopefully will bring greater clarity to this matter. Above all, we continue to pray for the healing of those who are victims of sexual assault.

    I'm very happy he published this statement, although I would have preferred that it appeared in a more official context than his personal blog. Still, it's available, and hopefully more so now.

    Bp. Lori's statement does not add anything "new" to the debate, it merely endorses some of the speculation that has occurred here and elsewhere. In it, crucially, he reminds us that "neither Church teaching nor principles have changed" on this issue. But the prudence of allowing the CT legislature to further violate the autonomy of Catholic hospital practice remains up for debate, in my opinion. In essence the CT bishops decided that they did not want to draw a line in the sand on this issue. But with each concession it becomes more difficult to draw it when the time comes. And I think it will, soon.

    "Reluctant compliance", as Bp. Lori calls it, is hardly an ideal state of affairs....

    Update: Since this story is still receiving attention I'd like to copy what was said before here:

    I am working with a couple of knowledgeable contributors to produce a summary of the recent relevant medical findings on Plan B, ovulation testing, and related issues. I hope to have that posted by the end of this week. Contributions to that project are welcome, if you want to email me. Thanks for the helpful comments so far.
    Previous posts on this topic:

    Furthermore, LifeSiteNews is trying to get to the heart of the matter regarding whether Plan B falls under the condemnation issued by the Vatican in 2000 of "morning after pills." More here.

    The relevant passages from the Pontifical Academy for Life's "STATEMENT ON THE SO-CALLED "MORNING-AFTER PILL:

    3. It is clear, therefore, that the proven "anti-implantation" action of the morning-after pill is really nothing other than a chemically induced abortion. It is neither intellectually consistent nor scientifically justifiable to say that we are not dealing with the same thing.

    Moreover, 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, which is what is being implicitly suggested.

    4. 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.


    6. 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.

    Stepping aside for a moment from the scientific questions (which are completely relevant), take a circumspect look at the moral principle the document asserts: in essence, everyone involved with the choosing, distribution and proscribing of medications that may harm a newly-conceived zygote are to treat their decision with the utmost carefulness and respect for human life.

    It's distressing that the CCC (or other competent bodies) do not seem willing to defend their claims that the proscribed medication is in fact proven to be non-abortifacient. And if they don't have solid science to back up their claim, they shouldn't be allowing the medication to be distributed without an ovulation test. That much, at least, can be deduced from an informed reading of the principles outlined in the Vatican document.

    Update 2: From what I've read and some consultation, it seems fairly certain that Plan B and the "morning after pills" are extremely similar, if not identical treatments. The emergency contraception website at Princeton, for instance, says there is "no difference." While it tries to claim later that emergency contraception pills are not "abortion pills", if you read further, the same website admits that these "abortion pills" in fact "may also prevent implantation of a fertilized egg" (= abortion).

    Of this much, at least, I am fairly confident: the CCC spokesperson doesn't have his facts straight regarding the difference between Plan B and morning after pills. If he is privy to scienctific research that is not generally available it would be best that he provide some medical citations.

    If anyone has a citation to the contrary of what I just cited feel free to email me (ideally) or for short-hand post a link in the comments box.

    Update 3: Diogenes at CWNews takes a more harsh view of Bp. Lor's statement. See why here.
    Update 4: Jeff Millerat CurtJester adds his thoughts on the latest, and Matt Bowman has a very good contribution over at Constitutionally Correct:

    The position of CHA is well known and seriously flawed. It basically presents “emergency contraception” as permissible even after a positive ovulation test. To get there it shamelessly adopts the definition of pregnancy at implantation, and broadly justifies acts that prevent “pregnancy.”


    The new policy for Catholic hospitals in Connecticut will be to dispense Plan B regardless of whether its pre-fertilization effects are negated and its post-fertilization death-dealing effect is the only remaining mechanism. Their spokesman and the sources they rely on seem to adopt the very pro-death word games that are designed to cheapen the lives of human embryos. This situation is becoming more troubling as it unfolds.

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    Monday, October 01, 2007

    Follow-up: Connecticut Plan B Bill goes into effect today

    Update: Bp. Lori has issued a clarification on his blog. That text available here.

    Over this weekend AmP served as a nexus for Catholic debate prompted by recent news that the Connecticut Bishops Conference had reversed a long-standing policy of opposing the distribution of Plan B to rape victims in some cases and had instead decided to accept the current legislation that goes into effect today. In their statement, they claimed essentially that a lack of definitive Church teaching on the question combined with an ignorance regarding the abortifacient potential of Plan B prompted their decision.

    You can find the full AmP coverage here.

    The American Life League has since issued a very strong condemnation of the decision here.

    News has also surfaced that there are plans in the works by a lay organization to challenge the law:

    Peter Wolfgang, executive director of the Family Institute of Connecticut, said his organization hopes to challenge the new law. But the institute has not yet been able to find a plaintiff who has been harmed, such as a hospital worker who was forced to distribute the medication despite their religious convictions.

    "Someone ought to rise up and do something," he said. "This is just one of the biggest pro-abortion attacks on religious liberty that we've ever seen in the state of Connecticut." [source]

    LifeSiteNews suggests that Catholics should respectfully request a clarification from the Vatican:

    To express concerns to the Vatican:

    Pontifical Academy for Life:

    To email the Congregation for the Doctrine of Faith:

    Cardinal William Levada E-mail:

    Given an average account of the situation in the media, clarification would be most welcome.

    I am also working with a couple of knowledgeable contributors to produce a summary of the recent relevant medical findings on Plan B, ovulation testing, and related issues. I hope to have that posted by the end of this week. Contributions to that project are welcome, if you want to email me. Thanks for the helpful comments so far.

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    Friday, September 28, 2007

    Statement: Connecticut Bishops On Plan B and Catholic Hospitals

    Update: Bp. Lori has issued a clarification on his blog. That text available here.

    Released on the CCC website this morning (and issued to the general press yesterday):

    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. [source.]

    Complete coverage of this story is available here.

    To summarize, this statement is problematic for the following reasons:
    • The medical facts regarding the abortifacient effects of Plan B are not up for debate. If administered to a woman who is ovulating Plan B may cause an abortion. Plan B itself admits its abortifacient potential on its warning label and website.
    • The Catholic Church teaches (c.f. DV #13) that contraceptives with abortifacient potential fall under the same moral category as abortion because, when acting abortifaciently, they cause the death of a human being. The United States Bishops have similarly ruled-out the use of abortifacient pills like Plan B when the women is ovulating (c.f. Ethical & Religious Directives for Catholic Health Care Services, # 36).
    • The document claims "To administer Plan B pills without an ovulation test is not an intrinsically evil act", but for the reasons already mentioned, since Plan B can act as an abortifacient in cases where the women has ovulated, it is at least gravely irresponsible to administer chemicals that could very well bring about the death of a human being.

    Thus this statement of the CCC appears to contradict both Church teaching and USCCB directives. [update: in response to some reasonable criticism, I should clarify that I believe this statement certainly both a) takes a step back from the previous position of U.S. hospitals regarding the morality of dispensing Plan B to rape victims who have ovulated and b) charts a different course of action than the USCCB has previously suggested, in accordance with principles ennunciated by Church documents. To this extent, and no further, I believe the document is problematic and must therefore be either a) repealed or b) further explained.]

    Moreover, this decision contradicts a long-held, widespread and fiercely-defended claim by American Catholic bishops that state laws must not force Catholic hospital staffs to administer abortifacients in situations where the woman may have in fact conceived a new human life.

    The final line of this statement (which reads: "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.") seems to demand an immediate review of the Bishops' statement. The law in question will go into effect next Monday, October 1st.

    This post will be updated. CWNews has covered the story here. Full past coverage available here.

    Update: A commenter below has made what seems to be a reasonable claim that some recent scientific studies call into question the presumed abortifacient properties of Plan B, despite the literature produced by the company itself which describes an abortifacient mechanism as one method of preventing sustained pregnancy.

    However, the statement of the CCC clearly does not take this research to definitively disprove the prior medical consensus. Indeed, the statement of the CCC operates under the principal that Plan B is to be administered in a situation of legislated ignorance as to whether there is an ovum present at all (since an ovulation test - prophibited by the new law - would provide this information). It is puzzling that Catholic hospitals would allow legislation to prevent medically-relevant knowledge from being obtained. Especially because Plan B poses the greatest threat to new human life when a woman is ovulating. One must also call into question the good faith of legislation that prohibits an ovulation test. Why prohibit it unless the lawmakers want to see Plan B proscribed in all cases? Why is the CCC still complaining if Plan B has no abortifacient potential?

    Prudence would seem to dictate in a situation where human life is at stake that recent, disputed scientific research should not overrule the findings of prior investigations as well as the position of Plan B's manufacturer. Rushing a decision because of an impending legal compliance date (next Monday) compounds the likelihood of error.

    [Note: Some statements made by the CCC's spokesman are not helping matters. Saying that the bishops had an "evolution of thinking" is poor wording. The bishops had an evolution of data if Plan B turns out to not be abortifacient. The thinking concerning the immorality of proscribing abortifacients has not undergone any evolution. It is still wrong.

    Similarly, claiming that there are "many who are affiliated with the church that believe the ovulation test isn't necessary" is completely irrelevent if Plan B is not an abortifacient. This raises the question: if the new scientific findings are so definitive, why do we need so many other added reasons to accept the CCC's policy change?]

    Update 2: LifeSiteNews has posted coverage here.

    Since there is still much confusion on this topic, it might be helpful to restate some of my reservations:

    • This statement by the CCC is a reversal of precedent. Previously, Catholic hospitals in the US have overwhelmingly followed a protocol that prohibited dispensing Plan B to rape victims who have ovulated. The CCC itself followed such a protocol, until this week.
    • Up to this point, the scientific consensus which formed the basis of these protocols for Catholic hospitals said that Plan B could act as an abortifacient, in that it prevents the human embryo from implanting in the uterine wall as one of its mechanisms for avoiding sustained pregnancy and gestation.
    • Given points one and two, new scientific claims that call into question the previous consensus do not sufficiently justify a change of course. In cases where human life is at stake, prudence dictates that one not choose a course of action that may harm newly-conceived human life.
    • Clearly this statement is causing confusion among the faithful. The fact that this decision has taken so many Catholics by surprise in turn demands a response from Church leaders, if at the very least to avoid scandal among the faithful. Certainly the secular world is taking this decision as a retreat from Catholic principle and this too must be aggresively addressed.
    • Furthermore, it is a disservice to the cause of building a Catholic culture and a culture of life when decisions are made under constrained circumstances and bear the stamp of hastiness. More explanation and clarity is required in this situation, because more than the isolated issue of rape protocols is at issue. This debate also touches upon a) the right of Catholic hospitals (and employees) to operate free from legal intrusion in moral matters. b) the relationship between scientific fact finding and subsequent Church guidelines. c) the important comprehensive witness the Church provides to the world on life issues.
    • It is also probably useful to note that there seems to be an inherent contradiction in the CCC statement. Namely, if Plan B cannot act as an abortifacient, than it should not matter if the woman has ovulated. That said, why does the CCC continue to demand that the law be changed to allow an ovulation test? Either the statement is wrong to request the ovulation test be written into the law, or they are actually not confident that Plan B is non-abortifacient, and if they are not confident that Plan B is non-abortifacient, they should not be allowing it to be given to rape victims who may have ovulated.
    • If this statement by the CCC is correct, and Plan B cannot act abortifaciently, then any Catholic hospitals in the US could proscribe Plan B to all rape victims. So, either the rest of Catholic hospitals can change their policy, or the CCC must revise its statement. Similarly, if Plan B may or may not cause abortion, the correct protocol for both the CCC and the US Bishops is to disallow its use in cases where the woman has ovulated. I am here invoking the principle that when human life is at stake, the prudent choice is to err on the side of life and not choose a course of action that may result in killing an innocent life.

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