Plan B For Rape Victims?

[Birgitta Noel]

[quote name='toledo_jesus' post='1114463' date='Nov 7 2006, 08:28 PM']
seems like practical applications for this are...practically...nil, as most doctors will not be interested in a theology lesson and won't bother to make sure there is no abortifacient effect. practically.
[/quote]

A few points of clarification. (I am quite exhausted so please don't take my directness and brevity as being terse, only as economy of scale!)

1. "Plan B" is only one of a number of contaceptives which may be administered in cases of rape, there are others which have different mechanisms of action. The proper term to be used would be "emergency contraception" as that covers the purpose of the drug rather than specifying a particular drug formulation. Not all emergency contraceptives are abortifacient and some may be so only some of the time.

2. I assure you that there are many physicians (and women) who are concerned about the abortifacient effects of emergency contraceptions, as well as Catholic health care systems. This is not just a theological or theoretical issue, it is a very real issue.

3. There are protocols which have been developed for use in Catholic hospitals which discern based on menstrual cycle data, hormone levels, and other signs whether a woman is pregnant at the time of the rape and in some cases whether or not she has recently ovulated and thus whether or not it would be appropriate to give emergency contraception. The two most common protocols are "the pregnancy approach" and "the ovulation approach". There are pros and cons to each and each is morally acceptable IMHO though there may be reasons to prefer one over the other.

4. I don't remember what my last point was so I'm going to bed.

Edited November 8, 2006 by The Little Way

[beatty07]

Thanks for the clarification and reasoning...that helps a lot!

hope you slept well.

[thessalonian]

Thx for the discussion. It is helping. I am interested in any statements by the vatican on this if there are any or will be in the future.

I think I am understanding this and am okay with it. Contraception is wrong in marriage because it is a denial of the vows, giving eachother to eachother totally, faithfully, and fruitfully. It places a barrier in the one flesh union of the man and woman. Outside of marriage however, specifically in the case of rape there is no total, faithful, and fruitful committement and so it would not be immoral to prevent a conception in that case. The gift of self is not given to the man, who is taking and using. The conception can be morally prevented but not morally terminated because at the point that it occurs there is a life of another human being, a third party involved in the moral decision making process.

I do need to give some more thought to the unmarried fornication aspects of this discussion. Most certainly the grave sin of the fornication puts one's soul at risk. Could one go to a priest, confess the sin, find out if they were pregnant, and if not use plan B morally? I think that the fact that she willfully chose to unite herself with the other adulterous partner would have a play in this senario. But once again it seems to me the lines have been greyed.

Edited November 8, 2006 by thessalonian

[beatty07]

[quote name='thessalonian' post='1115149' date='Nov 8 2006, 01:10 PM']
I do need to give some more thought to the unmarried fornication aspects of this discussion. Most certainly the grave sin of the fornication puts one's soul at risk. Could one go to a priest, confess the sin, find out if they were pregnant, and if not use plan B morally? I think that the fact that she willfully chose to unite herself with the other adulterous partner would have a play in this senario. But once again it seems to me the lines have been greyed.
[/quote]

Yeah, that's the circumstance I had in mind too. As a medical possibility, it's fraught with problems, but it still makes an interesting moral question.

For instance, let's say she comes to her senses in the moments following the actual sin. Filled with repentance and, of course, panic, she could take measures related to her bodily posture that would affect the likelihood of conception. Isn't that a contraceptive measure, albeit an extremely inefficient one? It seems allowable in her case. Whereas, it doesn't seem that this would be a moral attitude for a married person to take.

I'm worried about the sensitivity of this topic... are we crossing the "appropriate for children" line in this thread? advice from mods would be appreciated.

[toledo_jesus]

[quote name='beatty07' post='1115175' date='Nov 8 2006, 04:41 PM']
I'm worried about the sensitivity of this topic... are we crossing the "appropriate for children" line in this thread? advice from mods would be appreciated.
[/quote]
I think we're maintaining a proper level of decency.


I still don't think that a doctor will go out of his way to prescribe contraceptives that aren't abortifacient. Nor would they explain to a distraught woman the mechanism of whatever drug they use. Maybe I'm too cynical.

[Socrates]

As long as a contraceptive is not abortifacient, there is absolutely no problem with using it in a case of rape. Rape is not unitive, but is an act of violence to a woman's person.

The abortifacient issue remains, but in such a case, it is the taking of human life that is wrong, not the contraception.

[XIX]

Yeah. I agree with you Socrates.

Good luck finding any pill that isn't abortifacient.

Edited November 10, 2006 by XIX

[Azriel]

In regards to the sensitivity issue of this thread, so far there are no lines that have been crossed. This is a very real and important issue, and so far has been dealt with delicately, and with tact.

Ye old mod has spoken, let the discussion commence.

[Theoketos]

Contraception is not intrinsically evil. Destroying the unitive bond between two consenting people is evil. Contraception does not destroy any unitive bond in the case of rape, because there is no unitive bond.

[toledo_jesus]

[quote name='Theoketos' post='1116712' date='Nov 10 2006, 11:29 AM']
Contraception is not intrinsically evil. Destroying the unitive bond between two consenting people is evil. Contraception does not destroy any unitive bond in the case of rape, because there is no unitive bond.
[/quote]
there's no unitive bond in fornication, just the fornicating. So, is contraception licit in that circumstance?

[beatty07]

[quote name='toledo_jesus' post='1117249' date='Nov 10 2006, 10:48 PM']
there's no unitive bond in fornication, just the fornicating. So, is contraception licit in that circumstance?
[/quote]

it seems like that wording crosses a line... nothing about fornication is licit. However, I think a strong case could be made that contraception is not [i]additionally [/i]sinful.

A man works for months on a portrait of his wife, pouring much of himself and his love for her into the work. One day, he presents it to her with great joy. He hangs it on the wall over the fireplace, so happy that he was able to give her such a beautiful gift! Wouldn't he be astonished and offended if she chose to cover it with a bedsheet? It would be a terrible diminishment of his gift.

BUT, let's say she's even more ungrateful than that. She intends to use his painting as a doormat, ripping it from it's intended context and cheapening it beyond recognition. If, before doing so, she then covered it with a bedsheet, in order to minimize the damage, he would not be further offended. The bedsheet, in this case, is no [i]further[/i] outrage. In fact, he would consider it preferable.

Now obviously that analogy can only go so far (and it isn't very far at all!), but I do think it might shed some light. I'm not taking a big old stand on this, just advancing an argument for consideration.

[toledo_jesus]

[quote name='beatty07' post='1117334' date='Nov 11 2006, 02:46 AM']
it seems like that wording crosses a line... nothing about fornication is licit. However, I think a strong case could be made that contraception is not [i]additionally [/i]sinful.

A man works for months on a portrait of his wife, pouring much of himself and his love for her into the work. One day, he presents it to her with great joy. He hangs it on the wall over the fireplace, so happy that he was able to give her such a beautiful gift! Wouldn't he be astonished and offended if she chose to cover it with a bedsheet? It would be a terrible diminishment of his gift.

BUT, let's say she's even more ungrateful than that. She intends to use his painting as a doormat, ripping it from it's intended context and cheapening it beyond recognition. If, before doing so, she then covered it with a bedsheet, in order to minimize the damage, he would not be further offended. The bedsheet, in this case, is no [i]further[/i] outrage. In fact, he would consider it preferable.

Now obviously that analogy can only go so far (and it isn't very far at all!), but I do think it might shed some light. I'm not taking a big old stand on this, just advancing an argument for consideration.
[/quote]
interesting point.

But if one were to sin by fornication, and also use contraceptives, would they be required to confess both or only the fornication? I lean towards both, as the use of the contraceptive violates the other essential component, procreation. You can't have unitive without procreative (or at least the possibility, for the NFP crowd) and vice versa.

[beatty07]

[quote name='toledo_jesus' post='1117741' date='Nov 11 2006, 05:24 PM']
interesting point.

But if one were to sin by fornication, and also use contraceptives, would they be required to confess both or only the fornication? I lean towards both, as the use of the contraceptive violates the other essential component, procreation. You can't have unitive without procreative (or at least the possibility, for the NFP crowd) and vice versa.
[/quote]

Well since there's ambiguity enough for us to discuss it, it's certainly better to bring it up in the confessional, I think. 'better safe then sorry', to put it somewhat crudely.

Regarding the reasoning, though, I guess it depends on what you mean by "can't have." If you mean "shouldn't have," then I agree. But if you mean "it's not possible to have" then I would disagree. It's easy enough to imagine a circumstance wherein the procreative end is pursued exlusively, void of any unitive intention or feeling. That would be the flipside abomination from contraception. Can you have the unitive without the procreative? I would say you could have a cracked, limping unitive meaning even with contraception. It's a little overboard to say that married couples who contracept experience NO unitive meaning in the marital act.

Remember how we started on this topic, with a discussion of contraceptives and rape. Going back to that, suppose a man confessed to rape, and then confessed additionally that he wore a prophylactic. I don't think that worsens his crime (nor does it lessen it). If, God forbid, he were to do it again, I for one hope he would do the same.

Fornication is in a different world, but some of the principles MIGHT overlap, is all I'm suggesting. Contraception is evil because it's a sin against the intended unitive meaning of the act. But in fornication, the unitive meaning is already destroyed. It isn't there to be sinned against. So the contraception becomes simply a matter of limiting consequences to the sin. Doesn't lessen the sin, but it does express some degree of prudence.

Does that sound plausible? I guess it's really the same point from my silly little analogy up there.

[toledo_jesus]

My thinking was that one can pursue either unitive or procreative ends, but not at the exclusion of the other. So, a person bent on children and nothing else would be in the wrong, as would a person who wanted to have a connection like that found in the marital union.
While contracepting married couples might think they are enjoying the unitive aspect of their marriage, my personal thinking is that they aren't really being 'unitive' at all. Without procreation there is no actual unitive aspect. Outside of marriage there is no real unitive aspect as the two people are acting out of selfish desire for one another's bodies. They are both severing their connection from God, and so despite any warm and cozy feelings they might share they are in point of fact not united at all.
If the Church has spoken about contraceptives in case of rape, then so be it. If contraception is not intrinsically evil, then I can understand how the use of it would not add to sin.
But what sort of contraception would be effective for treating rape victims? Meaning, what would have no chance of abortifacient effect while still preventing the fertilization of the egg? I don't trust doctors to be so thorough.

[Birgitta Noel]

[quote]If the Church has spoken about contraceptives in case of rape, then so be it. If contraception is not intrinsically evil, then I can understand how the use of it would not add to sin. But what sort of contraception would be effective for treating rape victims? Meaning, what would have no chance of abortifacient effect while still preventing the fertilization of the egg? I don't trust doctors to be so thorough.[/quote]


A few points. In cases of rape there is not an exception being made re contraception. William May (an orthodox Catholic) notes that: "Contraception, as a human, moral act is specified by the object freely chosen, and this object is precisely to impede the beginning of new human life that one reasonably foresees may come into existence through freely chosen genital acts.”

Next, if the fertilization of the egg is prevented then the contraceptive cannot be additionally abortifacient.

There are two ways to determine whether the administration of EC is acceptable which are condoned by Catholic Health Care: the pregnancy approach and the ovulation approach. Both approaches require determining whether the woman is pregnant, if she is not the ovulation approach additional discerns whether the woman is ovulating currently.

If the woman has already ovulated prior to the rape or is in the period of her cycle which is not near ovulation then the contraceptive given will not be abortifacient as there is little to no likelyhood of conception. The American College of Obstetricians and Gynecologists (ACOG) notes that emergency contraceptives have four possible mechanisms of action: 1) preventing or delaying ovulation, 2) preventing sperm capacitation or 3) preventing fertilization, 4) preventing the transfer of an embryo from the fallopian tube to the uterus or preventing implantation of a fertilized egg. It is the last way that is of course objectionable, but by determining that the woman is not pregnant and additionally where she is in her ovulatory cycle, that fourth effect may be avoided.

The Ethical and Religious Directives for Catholic Health Care Services, Directive #36, address this situation directly: "Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. 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."

Both those who favor the pregnancy approach and the ovulation approach recognize that there may be instances of unintended abortion when emergency contraception is utilized, but accept that small risk in favor of protecting the woman from pregnancy.

There is a huge debate about which approach is to be favored, as both sides argue that their method provides sufficient moral certainty on which to act.

As for trusting physicians, women need to be informed about EC and understand that when most physicians say that EC is not abortifacient that they understand "pregnancy" to refer to implantation rather than fertilization. Thus, women should request a pregnancy test before receiving EC after rape.

One must not forget the woman who has been raped. She has a right to defend herself against her aggressor, who remains embodied in her in millions of sperm. While we must protect innocent life, we also have an obligation to respect the woman.