German Bishops’ Approval of ‘Plan B’ for Rape Victims Fuels U.S. Debate Over Drug

Church policy for prescribing the ‘morning-after pill' after rape requires a test to confirm ovulation has not begun.

Emergency contraception pills
Emergency contraception pills (photo: Anka Grzywacz/ Wikipedia)

PHILADELPHIA — On Feb. 21, the German Bishops' Conference announced that Catholic hospitals under their jurisdiction could prescribe the “morning-after pill” to rape victims, a policy shift that reflects the position of the U.S. bishops.

The German bishops stated that Church health-care facilities could provide the medication as long as it would have “a preventive and not an abortive effect. Medical and pharmaceutical methods which result in the death of an embryo still may not be used.”

The announcement came in the wake of a public outcry in Germany, after a rape victim was denied treatment at two Catholic hospitals in Cologne because emergency contraception could not be prescribed.  

Hours after the news from Germany, some U.S. media cited the policy change as evidence that the Catholic Church no longer believed that Plan B acted as an abortifacient. Further, commentators suggested that the news raised questions about the Health and Human Services' mandate legal challenges filed by Christian business owners, who said they could not provide abortion-inducing drugs, like Plan B and “ella,” in their employee health plans.

However, Marie Hilliard, a bioethicist at the Philadelphia-based National Catholic Bioethics Center, which advises the U.S. bishops on health-care issues, rejected the suggestion that the Church no longer viewed the morning-after pill as an abortifacient.

She explained that the Church only permitted the administration of the drug for rape victims after first testing to confirm that the patient had not begun to ovulate. If ovulation had commenced, the drug was not prescribed because it could act as an abortifacient by preventing implantation of an embryo.

A Feb. 21 NPR news story suggested that the drugs were not abortifacient and thus HHS mandate plaintiffs like Hobby Lobby may have little justification for opposing the mandate. Unlike Catholic plaintiffs who have filed lawsuits against the mandate and object to providing both contraceptive and abortifacient drugs because both violate Church teachings, Hobby Lobby’s evangelical Christian owners oppose the provision of abortifacient drugs through the company’s medical plan.

“It turns out, at least when it comes to Plan B, there is now fairly definitive research that shows the only way it works is by preventing ovulation and, therefore, fertilization,” stated the NPR story.

As further evidence of the growing acceptance of morning-after pills, the NPR story reported that “ella is now available in heavily Roman Catholic Italy, for example. And on Thursday, Germany's conference of bishops said both drugs are acceptable to give to rape victims in Catholic hospitals.”

NPR also noted opposing views by Christian health-care experts, but the thrust of the story was that new research had essentially resolved moral concerns about the use of Plan B and that the German bishops’ policy reflected that fact. 

The Daily Kos was among several other news websites with a similar message: “Bad News for Religious Zealots: Plan B Isn’t an Aabortion” was the Daily Kos’ headline.


Abortifacient Effect Acknowledged

Hilliard challenged the conclusions of the experts cited by NPR and several other news organizations. She said the drug’s manufacturers have acknowledged that Plan B could function in several ways, including preventing the implantation of an embryo, effectively ending the pregnancy.

Hilliard confirmed that the German bishops’ position, as initially outlined in a Jan. 31 statement by Cardinal Joachim Meisner, “is consistent with the U.S. Conference of Catholic Bishops’ 'Ethical and Religious Directives for Catholic Health Care Services.'” 

According to the "Ethical and Religious Directives for Catholic Health Care Services" developed by the USCCB Committee on Doctrine, “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” (No. 36).

In an interview with the Register, Hilliard explained that Catholic hospitals only prescribe the morning-after pill to prevent ovulation — after first administering “a simple urine test to determine if the emergency contraception can be given at a time that offers the possibility of preventing ovulation.”

“Research clearly indicates that if this test is positive, emergency contraception cannot stop ovulation [and the morning-after pill ethically cannot be administered],” said Hilliard. “Thus, Catholic hospitals use this test as part of a sexual-assault protocol to determine if pregnancy can be prevented.” 

The patient is “provided with all the information she needs for informed consent,” she added. “This is just good medicine.” 

However, Hilliard emphasized that the Church’s effort to respond to the comprehensive medical, emotional and spiritual needs of rape victims did not mean that the U.S. or German bishops no longer viewed the morning-after pill as an abortifacient.

In her view, the effort to dismiss moral objections to Plan B reflected, at least in part, a broader campaign to “redefine” contraception to include drugs that act as abortifacients.

Indeed, since the federal contraception mandate was approved in January 2012, the public debate over the drug’s impact on pregnancy has intensified. Plan B and ella are now both accessible without cost to most female employees and their female children who receive health insurance from private companies.

The Obama administration, in public statements and in briefs filed with courts, has acknowledged that the morning-after pill can prevent the implantation of an embryo.

“These covered prescription drugs are specifically those that are designed to prevent implantation,” Kathleen Sebelius, secretary of the Department of Health and Human Services, said in August 2011, though she disputed the suggestion that any drugs covered under the mandate were abortifacient. 

Meanwhile, the Feb. 21 NPR report featured experts who said Plan B did not prevent implantation or, if it did, that did make it abortifacient. The news story concluded that the drug merely prevented “ovulation and, therefore, fertilization.”

Further, a Feb. 13 New York Times story referenced studies providing “strong evidence that the most commonly used pills do not hinder implantation, but work by delaying or preventing ovulation so that an egg is never fertilized.”

The NCBC’s Hilliard has consistently raised questions about such studies, noting that they do not effectively address discrepancies in the data collected.

Said Hilliard, “Despite secular trends to redefine conception to mean implantation of the conceived human being, it is a biological fact contained in any biology textbook that the new human being has been conceived at fertilization, which occurs five to 12 days before implantation.”  

“The newly conceived embryo needs his or her mother’s womb to be nourished and to grow. Thus, drugs which have the potential to prevent implantation of the conceived human being are abortifacient, regardless of the deceptive language used to describe their function.”

 Joan Frawley Desmond is the Register’s senior editor.

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