Friday, October 28, 2005

Emergency Contraception and Rape: A Catholic Perspective

Emergency Contraception and Rape: A Catholic Perspective

from "Notes from the Hill", occasional reflections on legislative developments in Massachusetts, March 9, 2003

Massachusetts Catholic Conference,

The Boston Globe reported recently on a bill filed in the Massachusetts legislature that would add to the state "patients rights act" a new mandate requiring sexually assaulted women to receive information about and access to "emergency contraception". The February 28 article by Liz Kowalczyk, headlined "Wider Use Promoted for ‘Morning After’ Pill," raises a topic about which some Catholics might be confused.

Senate bill 546 (the House has not assigned a bill number yet) is entitled "An Act to Provide Timely Access to Emergency Contraception". It would require all medical facilities "to promptly offer emergency contraception at the facility to each female rape victim of childbearing age, and to initiate emergency contraception upon her request." For reasons described below, the Massachusetts Catholic Conference opposes the bill as currently drafted.

The Globe article reported, accurately, that Catholic hospitals provide contraceptives to some but not all rape victims. After the article was published, a few upset readers called the Massachusetts Catholic Conference and other church agencies. Some were concerned that contraceptives were being distributed by Catholic institutions. Other callers were angry that contraceptives were not given to all rape victims.

The Catholic Church affirms that "marriage and married love are by their character ordained to the procreation and the bringing up of children" (Humanae Vitae, no. 9). However, "to force the use of marriage on one’s partner without regard to his or her condition or personal and reasonable wishes in that matter, is no true act of love, and therefore offends the moral order" (Humanae Vitae, no. 13).

Likewise, as the Catholic Catechism recognizes when discussing offenses against the 6th commandment, rape "is the forcible violation of the sexual intimacy of another person" and "an intrinsically evil act" (no. 2356). By implication, sexual assault cannot be considered ordered to the unitive and procreative functions.

Thus, according to the U.S. Catholic Bishops in their Ethical and Religious Directives for Catholic Health Care Services, a woman "who has been raped should be able to defend herself against a potential conception from the sexual assault" (Directive 36). She is not obliged when raped, as would be the case in consensual relations, to accommodate the natural potential for conception. The forced introduction of sperm is an act of aggression she may resist even through means that prevent the creation of new life. That explains why Catholic hospitals may distribute contraceptives in some rape cases, particularly within 24 hours after the assault. Immediate care is essential as well to address issues related to the transmission of venereal disease and for appropriate and compassionate trauma counseling.

However, if it is determined that a particular rape treatment would "have as [its] purpose or direct effect the removal, destruction, or interference with the implantation" of an embryo (Directive 36), a Catholic facility cannot offer it. A human life conceived by rape is not an act of aggression but a new person innocent of any wrongdoing. Some contraceptives may act as abortifacients by preventing implantation. Forcing Catholic hospitals to offer contraceptives in rape cases when an early abortion may result conflicts with the religious and ethical duty to do no harm. That explains why Catholic hospitals cannot offer or distribute contraceptives in every rape case and why S. 546 is objectionable.

Rev. William Saunders concurs with the Massachusetts Catholic Conference. In an article published at:, he writes:

Rape is a detestable, evil action. The Catechism offers a clear moral teaching: "Rape is the forcible violation of the sexual intimacy of another person. It does injury to justice and charity. Rape deeply wounds the respect, freedom, and physical and moral integrity to which every person has a right. It causes grave damage that can mark the victim for life. It is always an intrinsically evil act. Graver still is the rape of children committed by parents (incest) or those responsible for the education of the children entrusted to them." (no. 2356) Note that rape is "an intrinsically evil act," meaning that it is evil at its very root, nothing justifies it, and it is objectively a mortal sin.

If a woman is raped, even though she may fear exposing herself to shame and notoriety, she should seek proper medical care as soon as possible. Such care must be extremely sensitive and compassionate.

In accord with the Ethical and Religious Directives for Catholic Health Care Services (no. 36), the care for the rape victim has four aspects: First, she must receive spiritual and psychological support and counseling to help her deal with the trauma of the attack. Such support and counseling will probably continue for some time after the immediate period.

Second, health care providers need to cooperate with law enforcement officials, gathering evidence that can be used in the prosecution of the rapist.

Third, the victim needs treatment for bruises, cuts, or other injuries.

Finally, health care providers must provide treatment to prevent the possible contraction of venereal disease and pregnancy. The Directives state, "A woman who has been raped may defend herself against a conception resulting from sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medication 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."(no. 36)

The woman who is a victim of rape has the moral right to prevent the pregnancy for the following reasons: First, the rapist (including his sperm) is an unjust aggressor who has violated the woman's dignity. Second, rape is an act of force and violence, unlike the conjugal love in marriage whereby both spouses give freely of themselves in an act of unitive and procreative love. Third, the woman is not responsible for the action, and thereby has the right to prevent the pregnancy. (Please note that for these three reasons, this guidance does not violate the Church' s teaching regarding contraception as expressed in Humanae Vitae, which, because of the free-giving between spouses, stated, "Each and every marriage act must remain open to the transmission of life (no. 11).)

In preventing pregnancy, most rape treatment protocols recommend anti-fertility drugs to be administered within 72 hours and over a period of several days. These drugs, such as Ovral, inhibit ovulation. However, some contraceptives may also affect the endometrium of the uterus, causing the expulsion of a conceived ovum. This latter effect is problematical.

The real difficulty in rape treatment protocols is having moral certainty (not absolute but the best possible, good faith, certainty one can have) that conception has not occurred, for once conception has occurred, the new life has a right to life and must be protected. The Second Vatican Council asserted, "Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes."(Gaudium et Spes, no. 51) Subsequently, the Declaration on Procured Abortion (1974) affirmed that life is sacred from conception and that directly intended abortion is an intrinsically evil act: "From the time the ovum is fertilized, a life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with his own growth. It would never be made human if it were not human already"(no. 12). Not only does this new life have physical integrity, it also has a soul, created and infused by Almighty God. This unique human being, with both body and soul, has a right to life no matter who he is or how he was conceived.

For this reason, The Ethical and Religious Directives for Catholic Health Facilities state, "Abortion, that is the directly intended termination of pregnancy before viability, is never permitted nor is the directly intended destruction of a viable fetus. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo" (no. 12). Therefore, abortifacients — those drugs which would cause the expulsion of a conceived ovum — are morally wrong.

Therefore, before administering contraceptives to a rape victim, health care providers must ascertain first her medical history (including menstrual history, recent sexual activity, and contraceptive usage). A pregnancy test should be performed. If she is not pregnant but her medical history suggests the possibility that ovulation may have occurred, then health care providers ought to administer a Luteinizing Hormone urine dip test or a progesterone blood level test. These tests would indicate if ovulation has indeed occurred and thereby a child was possibly conceived. If these tests are not available in a timely way or at all, treatment should proceed as long as there is a reasonable doubt that ovulation has occurred.

Here again is a key point. If there is a reasonable doubt that ovulation has taken place, the right of the woman to prevent the pregnancy should be favored, even if this unknowingly and unintentionally expels a conceived ovum. However, if there is certainty that ovulation has occurred and conception may have taken place, then the child has the right to life and the mother must not risk an abortion from the antifertility drugs.

On this latter point, some may have difficulty with the situation of a woman carrying to birth a child conceived through rape. Even though studies indicate a 0-2.2 percent occurrence of pregnancy due to rape (Abortion: The Hard Cases), the fact remains pregnancies do occur. We must never forget that the child is an innocent human being, made in the image and likeness of God, who did not ask to be conceived.

Also, as Christians, we bear the cross and suffer for the love of God. Consequently, a mother in such a case must love as Christ would truly love, and give life to the innocent child. For a mother who is the victim of the violence of an unjust aggressor to take the life of an innocent unborn child would make her now the unjust aggressor. As our Holy Father Pope John Paul II taught, whatever the reason for abortion, "however serious or tragic, can never justify the deliberate killing of an innocent human being."(Evangelium Vitae, no. 58) Instead, the faithful must support the woman who is the tragic victim and, if she has conceived, her child.

Father William Saunders is dean of the Notre Dame Graduate School of Christendom College and pastor of Queen of Apostles Parish, both in Alexandria, Virginia. The above article is a "Straight Answers" column he wrote for the Arlington Catholic Herald. Father Saunders is also the author of Straight Answers, a book based on 100 of his columns and published by Cathedral Press in Baltimore.

This is also the teaching of Dr. Germain Grisez, the Rev. Harry J. Flynn Professor of Christian Ethics at Mount Saint Mary's College in Emmitsburg, Maryland. Dr. Grisez writes that, "Preventing conception due to rape need not be contraception. In choosing to prevent a conception that might result from rape, someone could be choosing to contracept. This plainly is so when an administrator of an institution housing men and women incapable of giving consent to sexual intercourse makes little or no effort to prevent their copulation but takes measures to prevent pregnancies.

However, other sorts of cases must be considered. Rape is the imposition of intimate, bodily union upon someone without her or his consent, and anyone who is raped rightly resists so far as possible. Moreover, the victim (or potential victim) is right to resist not only insofar as he or she is subjected to unjust force, but insofar as that force imposes the special wrong of uniquely intimate bodily contact. It can scarcely be doubted that someone who cannot prevent the initiation of this intimacy is morally justified in resisting its continuation; for example, a woman who awakes and finds herself being penetrated by a rapist need not permit her attacker to ejaculate in her vagina if she can make him withdraw. On the same basis, if they cannot prevent the wrongful intimacy itself, women who are victims (or potential victims) of rape and those trying to help them are morally justified in trying to prevent conception insofar as it is the fullness of sexual union."

I wrote a Catholic laywoman back in July and quoted from both Dr. Grisez and Rev. Saunders to make my case that in cases of rape, a woman is justified (as are those who are assisting her) to try and prevent conception. But that once conception has taken place, it is never morally licit to procure an abortion or to employ abortifacients in an attempt at expulsion of the conceived ovum. This fine and intelligent woman wrote a post for her website in which she basically agreed. But then she wrote something strange. She wrote, "..I know Paul posted an article that sounded very convincing....and...bottoms up to anyone who wants to - but I'm not drinking the Koolaid."

The U.S. Bishops have said the same thing in No. 36 of their Ethical and Religious Directives for Catholic Health Care Services.

This is authentic Catholic teaching. It is not "Koolaid" laced with cyanide intended for the destruction of Catholic souls. It is not back-peddaling or "watering-down" Catholic teaching on the sinfulness of contraception. In cases such as those described, the measures taken are a defense of the woman's ovum (insofar as it is a part of her person) against the rapist's sperms (insofar as they are parts of his person). This is different from the case where an intimate, bodily union of intercourse is not imposed on the woman but sought or willingly permitted. In such a case, neither the woman nor anyone who permits the union can intend at the same time that it not occur. And so, Dr. Grisez says that, "..rape apart, contraceptive measures are chosen to prevent conception not insofar as it is the ultimate completion of intimate bodily union but insofar as it is the beginning of a new and unwanted person."

This is a fine point easily missed by some. But nevertheless true.

God love you all,
Paul Anthony Melanson

1 comment:

Morning After Pill said...

Levonelle is a morning after pill that is easily available with most pharmacists. You will need to take an emergency contraceptive measure when you have had unprotected sex or you fear that something went wrong with the protection during the intercourse.

Site Meter