BY: BR. DANIEL P. SULMASY, OFM, MD, PhD
St. Vincent's Manhattan and New York Medical College
I find much with which to agree in Hamel and Panicola's thoughtful article.
However, I think they have overstated the case against the abortifacient effects
of high-dose estrogen-progestin pills. Unfortunately, there is "advocate science"
on both sides of this issue, and the sources they cite may well provide an example.
I have also grown uncomfortable using the term "contraception" in this context.
"Contraception" refers to interference in the natural process of intercourse
and conception. Rape, however, is an act of violence, contrary to nature, and
it is thus that the church can teach that contraception is morally wrong and
yet allow a woman who has been raped to "defend herself against a possible conception."
Nonetheless, I find their moral arguments persuasive. Catholic ethics has
always been a "real world" ethics. This tradition has never required that one
do everything imaginable to avoid harm to actually existing persons, let alone
possibly existing future persons. The automobiles we drive cause far more premature
deaths than the use of a "pregnancy approach" to implementing Directive 36.
Pollutants cause mutations and chemical abnormalities that can kill human persons
from fertilization to adulthood. Even responsible drivers cause accidents. But
we still drive. And we know that hundreds of thousands of people will die prematurely
because we do.
The church does not claim the authority to analyze scientific data scientifically
but provides moral principles to guide the conduct of science and its human
applications. The accuracy of the "ovulation method" is a matter of scientific
dispute. But more importantly, this testing is not reasonably available in most
hospitals, especially in the middle of the night. Most hospitals send these
tests to an outside laboratory — hardly a timely response to a rape victim. And
it is unreasonable to insist that the expensive staff, training, and apparatus
be available for use once or twice per year.
The "pregnancy approach" is by no means perfect either. But it is a reasonable,
realistic, and ethical protocol. Pregnancy testing is widely available, rapid,
and easily interpretable. Above all, this approach maintains absolutely strict
adherence to our deeply held conviction that it is never morally permissible
to destroy directly any innocent human life from the moment of conception to
natural death.
At present, there is significant legislative pressure in some states to require
all hospitals to offer "emergency contraception" to every victim of sexual assault
without respect for conscientious objection by the institution. In light of
this, it is noteworthy that the New York State Catholic Conference, in consultation
with theologians, has negotiated guidelines with the State Department of Health
that would allow Catholic health care facilities, working with their local bishops,
to implement the "pregnancy protocol" in responding to victims of sexual assault.
I do not believe a hospital can reasonably be accused of being unfaithful to
the Gospel of Life by using a pregnancy approach to Directive 36.