German Catholic bishops and the “morning-after” pill

A recent decision of the German Roman Catholic Church to administer certain Emergency Contraception, (EC), medication (i.e. “morning-after” pills) to rape victims has aroused controversy within the wider Church on an issue that has theological, scientific and canon law implications.  The situation arose after two Catholic hospitals in Cologne declined to give emergency contraceptives to a rape victim.  However, following a public outcry, a more nuanced approach was suggested by Cologne’s Cardinal Joachim Meisner, and this was supported during a four-day meeting of German bishops in town of Trier.  A report of the meeting included the statement

“The plenary meeting affirmed that at Catholic hospitals women who are victims of rape receive human, medical, psychological and pastoral help as a matter of course. This can include administration of a “morning-after pill” to the extent that it has a preventative and not an abortifacient effect. Medical-pharmacological methods that cause the death of an embryo still may not be used. The German bishops trust that in Catholic institutions practical treatment decisions will be made on the basis of these moral theological precepts.”

This confirms the view of the German bishop that it is licit to administer EC medications to rape victims if those medications act to prevent conception, but they may not be administered if they act as abortifacients.  Whilst this represents no change in the Church’s opposition to abortion and artificial birth control, in cases of rape there is a distinction between medication that prevent sperm from fertilizing an egg in the womb and that which induces an abortion.  Thus “abortion pills” based on the drug mifepristone or RU-486, and marketed as Mifegyne or Mifeprex remain banned.

The German bishops’ approach has received a mixed reception.  The Catholic News Service reports Bishop Ignacio Carrasco de Paula, President of Vatican’s Pontifical Academy for Life, as saying

“the Catholic Church has long accepted the possibility of preventing ovulation in a woman who has been raped, but withdraws that option if there is a possibility that ovulation may have already occurred . . . . To consider the possibility of using a drug whose active ingredient is a contraceptive in the case of a woman who has been raped seems acceptable to me”

Further support was given by Richard Doerflinger, Associate Director of the U.S. bishops’ Secretariat for Pro-Life Activities and a member of the pontifical academy,

 “you are not violating the teaching on contraception by seeking to stop ovulation or fertilization. . . . .[Rape] is not an act of unitive love, it is an act of violence (and) the woman has a right to defend herself against this attack. . . . . . .[However] once a new life has been conceived, now you have a second innocent victim, and you don’t attack that victim by administering drugs with abortive effects like preventing implantation, he said.

Bishop Carrasco and Doerflinger agreed that it is up to doctors and scientists, not the Church, to determine if a drug’s effect will be contraceptive or abortive, but in a note of caution, accepted that while the Church’s moral stance is clear, science is still not 100 per cent certain in determining whether ovulation has occurred.

This was emphasized more forcefully in a statement by Bishop Juan Antonio Martínez Camino, Secretary of the Spanish Episcopal Conference, who is quoted in El Mundo and elsewhere as saying

“If there is a pill that prevents that there be a conception in cases of rape, then it is licit to prevent it. . . . .[However, we] have no knowledge of a morning-after pill without abortifacient effects. If it does exist, it may be used, with the doctrine we have . . . . . If it does exist, we will be sure to know it . . . .  all morning-after pills have this possible abortive effect. Therefore, its use is illicit.  If it does exist in Germany, we are not aware of it.  It is not known to us that this technical possibility exist,” [English translation, Rorate Caeli].

Comment

An analysis of the moral issues involved is given by Christian Brugger, who addresses two questions: Aren’t contraceptive acts always wrong? and Do EC medications sometimes act as abortifacients?  With regard to the former and noting the similarity with the position of the German bishops, he points out that the U.S. Catholic Conference of Bishops addresses this as follows:

“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 (“Ethical and Religious Directives for Catholic Health Care Services [ERDs], 5th ed., 2009, No. 36)”.

Although the potential abortifacient consequences of many contraceptives was noted by Pope John Paul II in Evangelium vitae, 13, it is a large step to apply this general comment made on the basis of medical knowledge 18 years ago to the specific situation addressed by the German bishops.  However, acknowledging this uncertainty, Brugger states

“[a]lthough neither the German bishops’ statement nor the U.S. bishops’ directives explicitly states it, both imply that before EC would be licit to administer health-care workers should have moral certitude that the treatment will not act as an abortifacient”,

an issue that is effectively addressed in the United States where most Catholic hospitals that treat rape victims administer a pregnancy test and require it to be negative before giving EC medications; some administer in addition one or more ovulation tests.

From the canon law point of view, Ed Peters emphasizes that excommunication for abortion is a penalty levied for the crime of abortion (and not for the sin of abortion per se), the elements of the crime of abortion must be proven for the penalty to be applied.  He argues that a man’s providing post-coital assistance to a female sexual partner toward her taking a “morning-after” pill does not amount to cooperation in abortion sufficient for him to incur an irregularity for holy Order.  He concludes

“the administration of a “morning-after” pill, even if such a pill works abortifaciently (let alone if the mechanism of the drug remains unclear), is not punishable under Canon 1398 for abortion. The use of such a pill might well be immoral, nay, even gravely immoral. But at present, the use of a “morning-after” pill is not a crime under canon law. In prohibiting its use if conception has likely occurred, the German bishops’ have adopted, I suggest, the safer policy and built, as it were, a fence around the law of Canon 1398”.