Catholic Views on Emergency Contraception and Its Role in the 2010 Massachusetts Special Election

January 16, 2010 by Daniel Stack

Coakley explained that this should not be a problem because “we have a separation of church and state.” “Let’s be clear,” the attorney general added.

Ken Pittman, pointed out that complex legal principle that “In the emergency room you still have your religious freedom.”

Coakley agrees that “The law says that people are allowed to have that.” But, making clear her view — the attorney general who wants to be the next senator from Massachusetts — she declared that “You can have religious freedom, but you probably shouldn’t work in an emergency room.

And perhaps Saint Elizabeth’s on Cambridge Street shouldn’t have an emergency room at all?

Martha Coakley is a terrible candidate.

– Kathryn Jean Lopez, “It’s a Good Thing for Martha Coakley That There Are No Catholics in Massachusetts“, National Review Online, January 14, 2010

Brown even favors letting hospitals deny emergency contraception to rape victims. (On screen: Deny rape victims care.) He lacks understanding and seriousness. In times like these, we can’t afford a Republican like Scott Brown.

– Martha Coakley Campaign Advertisement, Transcript from factcheck.org.

There’s a special election coming up next Tuesday, January 19, here in Massachusetts, for the late Ted Kennedy’s senate seat. Democrat State Attorney General is running against Republican State Senator Scott Brown. Coakley was expected to coast to an easy victory and ran her campaign like that – basically sitting stationary to avoid misstep while Scott Brown canvassed the state. That seems to be paying dividends, with the race being very tight – which in heavily liberal Massachusetts, is quite a surprise. Given Obama still polls positive in Massachusetts I suspect this is due to Coakley running a play-it-safe campaign. That said, given my strong support of health care reform, I will still be voting for Coakley – Brown has indicated he fully intends to stop health care reform by removing the Democrat’s filibuster-proof majority.

One thing which has come up is the debate on emergency contraceptives given to women who are victims of rape. This has led to some sniping between the two candidates and their supporters. Scott Brown’s positions are a bit easier to discuss. In 2005 the Massachusetts legislature was debating a bill to require all hospitals to provide emergency contraceptives to rape victims. Scott Brown proposed the addition of a conscience cause, allowing doctors to refuse to provide this. One argument in favor of this is an urban location like Boston has multiple hospitals, though this argument falls through for the rest of the state (and referring a rape victim to another hospital seems darn mean). This amendment was defeated. As FactCheck indicates, Brown did wind up voting for the unamended bill which became law. Coakley’s statement is still reasonably valid (as far as political attacks go) in that he favors giving hospitals this option.

The attack on Coakley is on similar ground. During an interview Coakley discussed the role of conscience in the emergency room. This interview has been spun by the National Review, Fox News, and others to suggest that she said Catholics shouldn’t work in the emergency room. Below is a longer excerpt of the transcript (compared with the quote at the beginning of this blog entry).

PITTMAN: Right, if you are a Catholic, and you believe what the Pope teaches, you know, that any form of birth control is a sin. And you don’t want to do that, that —

COAKLEY: No, but we have a seperation of church and state here, Ken, let’s be clear.

PITTMAN: Yeah, but in the emergency room you still have your religious freedom.

COAKLEY: The law says that people are allowed to have that. And so, then, if you — you can have religious freedom, you probably shouldn’t work in the emergency room.

PITTMAN: Wow. OK, so if you have religious conviction, stay out of the emergency room.

COAKLEY: Well, no, I’m not — look, you’re — you’re the one who brought the question up. I don’t believe that the law allows for that, and I know that we accommodate all kinds of differences all the time. I think Roe vs. Wade has made it clear that women have a right to choose, and in Massachusetts, particularly if someone has been the victim of a rape, an assault, and she goes to an emergency room to get contraception, someone else should say, “Oh, no, I don’t believe in this, so I’m going to affect your constitutional rights?”

PITTMAN: I agree that you’ve gotta have some balance there.

– Martha Coakley Interview, Transcript form MediaMatters.org: Fox Nation, Hoft falsely declared Coakley said Catholics “shouldn’t work in the emergency room”

A few thoughts on this. The first is what she is saying is if you are unable to follow state or federal laws you shouldn’t work in an emergency room. Not that no Catholics are allowed. I tend to agree with her on this — for example my job as a software engineer often requires me to be on call, even on the sabbath. Court cases have indicated that while religious views are to be respected, there are certain cases where an employer can require an employee to work on the sabbath. (Obviously there is a difference in degree. The point being though there is precedent in employers having the right in certain circumstances to override the religious beliefs of employees.)

That said, what are the actual views of the Catholic Church on this issue? In actuality, the Catholic Church does not prohibit the use of contraceptives in all cases. Rather they are forbidden in consensual sex acts to avoid procreation. To quote the United States Council of Catholic Bishops:

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.¹⁹

[Footnote 19 states – It is recommended that a sexually assaulted woman be advised of the ethical restrictions that prevent Catholic hospitals from using abortifacient procedures; cf. Pennsylvania Catholic Conference, “Guidelines for Catholic Hospitals Treating Victims of Sexual Assault,” Origins 22 (1993): 810.]

– USCCB, Ethical and Religious Directives for Catholic Health Care Services, Fourth Edition

So what this comes down to is answering the question as to whether or not the morning-after pill is a form of abortion. Despite what is generally assumed, the Catholic Church has not made a decisive ruling on this. Bishops in Connecticut and Wisconsin have given permission to use the pill in such cases. The Catholic Health Association has also come out in support of it. Why is that? It is certainly not because they believe it prevents the implanting of a fertilized egg which is an abortion, something absolutely forbidden by the Catholic Church in the strongest terms. It is that newer science has indicated that the morning-after pill works by preventing conception, not by preventing the implanting of the fertilized egg. There is some debate as to sufficient certainty:

It may seem as though we are invoking the principle of double effect here. However, we are not convinced that the principle applies in its classic form because the action of administering emergency contraception to women who have been sexually assaulted does not really have a “double” effect — one good and intended (prevention of conception) and the other bad and foreseen but unintended (inhibition of implantation). First, no evidence to date definitively supports the claim that emergency contraceptive medications in fact produce the unwanted effect, so it is not certain that a bad effect actually results from the action. Second, even if the administration of the medications results in a bad effect, this obviously cannot occur at the same time as the good effect. Either the medications will work as a contraceptive or as an abortifacient but not as both. For a further discussion of the appropriateness of the principle of double effect to this situation, see Cataldo and Moraczewski, p. 11/14.

Some might argue that the tradition requires taking the safer, even tutioristic, course in situations of doubt when a value of great importance (e.g., innocent human life) is at stake. In such situations, not even a slight risk can be taken that might lead to undermining the value. One of the examples frequently offered to make the point is the hunter in the woods. A hunter is in the forest and notices movement behind a bush. However, the hunter is unsure whether what is behind the bush is a deer or a human being, possibly another hunter. In the face of this doubt, may the hunter shoot? The tradition answers in the negative. The hunter must first resolve the doubt and, if this is not possible, refrain from shooting.

Like Cataldo and Moraczewski, we do not believe that the example is applicable in the case of sexual assault. In this classic example, the doubt is about the nature of what is behind the bush (a deer or a human). There is definitely something behind the bush; the hunter is simply not sure what it is. In the case of sexual assault, however, the doubt is about whether there is anything (i.e., a conceptus) there at all. And the probability is that there is not. Furthermore (and here we go beyond Cataldo and Moraczewski), in the example, the hunter’s intention is presumably to kill what is behind the bush and the assumption is that the shot will be lethal. Neither of these conditions applies to administering emergency contraception in cases of sexual assault. As we have already noted, the intention is certainly not to destroy a conceptus, and it is unlikely that contraceptive medications have an abortifacient effect.

One final point should be made here. The Catholic tradition does not insist on the “safest” course even when actual human life is at stake, let alone when the presence of human life is seriously doubtful, as in the case of sexual assault. For example, the tradition permits the administration of opioid analgesics for patients in severe pain even though the possibility exists this action might hasten or even cause the patient’s death. The tradition also justifies bombing military targets even when the possibility exists or it is likely that civilians will be killed in the attacks. From these examples, it is clear that the tradition is willing to allow certain actions that may result indirectly in the loss of human life for a proportionate reason. It would seem to follow that the tradition would also be willing to permit the administration of emergency contraceptive medications, which have not been proven to be destructive, when the fact of conception is so seriously in doubt. Although the destruction of a conceptus cannot be absolutely ruled out, it is highly unlikely to occur as best we can determine given the current state of medical knowledge. If it should occur, as we have previously stated, it would be an unintended and even an unforeseen tragic consequence.

– Ronald P. Hamel, Ph.D. & Michael R. Panicola, Ph.D. Emergency Contraception and Sexual Assault. Assessing the Moral Approaches in Catholic Teaching. Journal of the Catholic Health Association, September-October-2002. Retrieved 16 January 2009.

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