Catholic hospitals and emergency contraception

Commentary by Judie Brown

Recent reports from Connecticut and Wisconsin leave us wondering what in the world is going on in the world of "Catholic" health care. It would seem that the appropriate treatment for a victim of criminal rape has become a question of whether Catholic hospitals can be put in the position of doing the unthinkable. Reports from Connecticut were the first to come to our attention. The Connecticut state senate approved a bill that would require all hospitals-including the four Catholic hospitals in the state-to provide Plan B emergency contraceptive pills to rape victims.

What is most startling about this turn of events in Connecticut is that the state's Catholic bishops asserted their opposition to this law by advising the lawmakers that "Catholic hospitals provide emergency contraception to rape victims in the vast majority of cases. In fact, it is an extreme rarity when this medication would not be provided."

This statement is astounding. The Vatican's Pontifical Academy for Life condemns the morning-after pill and makes no exceptions for cases of rape treatment, whether or not conception/fertilization has occurred. The academy goes so far as to say that this pill represents a good example of the absolute unlawfulness of any drug that has the potential to be an abortive agent. The academy makes it perfectly clear that anyone who is an agent in the provision of this drug is morally responsible for the outcome. Apparently this warning has not been taken seriously by either the Connecticut or Wisconsin Catholic hierarchy.

As if this dilemma were not already confusing to most Catholics, in the aforementioned statement to lawmakers the Connecticut bishops also wrote, "This bill is a violation of the separation of Church and state. The Catholic bishops of Connecticut are responsible for establishing and determining what moral guidelines Catholic institutions should follow; not the Connecticut General Assembly." But subsequent to this statement, these bishops dropped their opposition to the bill.

A similar scenario is playing out in Wisconsin, but with an added twist. It seems that there were lawmakers in the state who strongly opposed the measure requiring every hospital in the state-including Catholic hospitals-to provide the morning-after pill to rape victims. But when the Wisconsin Catholic bishops dropped their opposition to the bill, the lawmakers followed suit.

The outcome is at this moment uncertain, but the entire question of providing rape victims with abortive pills is seriously problematic from the Catholic perspective. There is a serious challenge facing these bishops and Directive 36 of the "Ethical and Religious Directives for Catholic Health Care Services" published by the United States Conference of Catholic Bishops is not helping. While the directives are designed to provide moral guidance in situations like this, Directive 36 (to which bishops in both states have referenced) is vague.

Directive 36 states:


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.


The two words in this directive that are playing havoc with the lives of preborn babies are "appropriate testing." Try as we might, and as many Catholic physicians have, we cannot identify a single test that provides one hundred percent assurance that a preborn child has not been conceived. One Catholic doctor, Chris Kahlenborn, pointed out in his analysis of the problem, "EC [emergency contraception] has the potential to abort a newly conceived child in the preovulatory, ovulatory and postovulatory phases. Because the potential for abortion exists, it cannot be ethically given to rape victims in any stage of the menstrual cycle" [emphasis added].

In other words, even though the directive suggests that there are tests in existence that provide the treating doctor with the evidence he needs to assure that the morning-after pill is not going to abort a human embryonic child, there is no test that can assure beyond doubt that a human embryo in fact is not already there. As I told members of Congress several years ago, Catholic hospitals have a serious problem in determining how to respond to sexual assault. It seems that any number of experts in the medical and ethical field are not clear about the means for determining whether or not fertilization might have occurred. And furthermore, they seem to be waffling about the clear evidence that indicates how the so-called "emergency contraceptive" interferes with the normal development of the new life. Thus, even though Directive 36 provides a caveat for potential use of Plan B, the actual facts of the matter would prevent its use.

The larger question in this current debate is why any Catholic facility would ever have a single type of contraceptive on hand in the first place. While it is clear that laws are being passed that require the use of this deadly drug, it is not at all clear why not a single Catholic hospital is willing to stand its ground, refuse to use what the Church teaches are unethical drugs and go to court if necessary to protect its right as a Catholic facility to be Catholic in every aspect of its health care. Separation of church and state is a bogus argument. The idea that a state can require any Catholic facility to do evil simply because the state says it must is outrageous. But if bishops are going to comply with whatever the state requires, then no distinct difference is going to exist between morally ethical Catholic health care and its secular counterpart.

A Catholic moral theologian, Msgr. William Smith, put this entire situation in the proper perspective when he wrote, "It's wrong to say you can use anything that has abortifacient properties. Emergency contraception is double talk … Catholic hospitals are not free to prescribe or provide anything with abortifacient properties without contradicting their witness." Amen!

Release issued: 3 May 07