The “Catholic Conscience” is under attack in many areas of the media and medicine. It is as important as ever to have an informed conscience on true Catholic teaching in this regard. Catholics in the pew, along with those who have not sat in the pew in a long time, oftentimes take the easy road and let media outlets (mis)inform them on their own faith. Our clergy often fail to help matters when they choose not to preach on these topics from the pulpit. This legacy not only has left my generation misinformed, but as parents my generation is now raising a new generation of Catholics without the opportunity for an informed conscience on issues they face every day in social media. An uninformed conscience is often the basis for unsubstantiated opinion under the guise of fact.
With this in mind, it was with great interest and even surprise on my part when I recently read the article “Emergency Contraception for Women Who Have Been Raped: Must Catholics Test for Ovulation, or Is Testing for Pregnancy Morally Sufficient?” by Daniel P. Sulmasy. (Kennedy Institute of Ethics Journal, Dec. 2006) As a husband and father of three daughters, thoughts of rape are on my long list of stressors. With emergency contraception and rape, many of the traditional notions we have been brought up with in regards to contraception diminish. With all the media hype in regards to the Catholic stance on abortion, even in cases of rape, I was unaware that Catholic hospitals can provide emergency contraception (EC) to women who have been raped. This is possible for two reasons. First, given that rape is an “unnatural act of violence,” preventing conception is not immoral because it “does not interfere with a natural process.” Second, the use of ECs are acceptable when the drugs stop ovulation and do not act as an abortifacient.
Traditional Catholic objection to EC drugs was that the original studies thought these drugs worked by “denuding the lining of the uterus” and preventing the implantation of any conceptus that might be present. However, since then the scientific understanding of the mechanism has changed in regards to the drug’s affect upon ovulation. As a pharmaceutical scientist, I have no issue with a developing counter argument. Drug mechanisms are continually looked at and improved upon with clinical data. Today, many scientists feel that the data suggest that EC drugs do not work by preventing implantation.” However, to be fair, not all medicinal scientists are convinced of this yet.
My informed conscience starts with the data. The statistic cited in regard to the probability of a pregnancy due to rape is 0.0099. I never realized that a statistic used to defend abortion in all cases is relatively insignificant; though one could argue it is quite significant if you are a member of the 10 in 1000 cases where it may occur. Yet, further calculation of the data leads to the probability of a 0.04% (1 in 2500) chance that that ECs will be administered during a fertile cycle to potentially act as an abortifacient. It is true of all medication that “no drug ever does what one expects it to do all the time.” As an active pharmaceutical scientist who is also pro-life, I find these statistics comforting, and will be of much use to me moving forward.
Moral theology would review whether the use of ECs are permissible using the Rule of Double Effect (RDE). Those who object believe that because the scientific evidence precludes any reasonable chance that the drugs are acting as abortifacients, that there is no “double effect.” In addition, it may be argued that the RDE would not apply because there could be no other intention but a direct abortion if the ovulation test were “positive.” The author provides several counter arguments as to why the RDS does apply. I would be in this camp as well.
Today there are politicians and scholars who advocate eliminating freedom of conscience for physicians in order to push Catholic moral teaching out of medicine. Some authors suggest that with all the various challenges Catholic physicians face today, there are some medical fields that Catholics be required to exit. I find such notions distressing. Sulmasy’s article gives evidence of the importance of having Catholics not abandon select areas of medicine. Medical professionals such as Sulmasy are the solution to help us navigate these political minefields. His expertise helps promote Catholic alternatives; ones that perhaps would not be explored if no Catholic were an advocate or involved in the discussion. He is helping us to have an informed conscience regarding the decisions we must face in life.
More than ever before, we must stand up and inform ourselves so that we too can correctly inform others. Of course, teaching on ECs must come from our bishops. You should also know that the data and opinions of this essay belong to me in an attempt to inform my conscience. I invite you to read Sulmasy’s article and other articles on this topic to inform yours. In a dire situation, such as rape, bioethics professionals and clergy should be consulted for the particulars of each case.