'Morning after' pill: the London 'Tablet' debate

'Morning after' pill: the London 'Tablet' debate

AD2000 Report

Rev Dr Norman Ford, head of the Caroline Chisholm Bioethics Centre in Melbourne, during a recent debate in the London Tablet, seemingly supported the use of the "morning after" pill.

The issue arose following calls to provide the "morning after" pill to Kosovo refugees raped by Serbians.

The principles raised have particular relevance in Western countries such as Britain, Australia and the US, where there is a major push for the use of these contraceptives which have a potential abortive aim.

In a letter to The Tablet, Dr Ford said, "The risk of loss of an embryo would be a side-effect justified by the need to prevent the injustice of conception and a traumatic pregnancy caused by rape."

The "loss of an embryo" here clearly refers to abortion.

The conception that follows rape is not an injustice; it is the rape that was an injustice.

Church's teachings

While professing to support the Church's teachings about the use of abortifacients in the case of rape, Dr Ford has in fact muddied the Church's position, as outlined in The Tablet last May by Bishop Elio Sgreccia, Vice President of the Pontifical Academy for Life, who said that the "morning after" pill is "really a method of abortion".

By contradicting Bishop Sgreccia, Dr Ford has left the impression that use of the "morning after" pill, in some circumstances, is a matter on which Catholics may differ.

Dr Ford's comments will be music to the ears of medical researchers and pharmaceutical companies that wish to have such drugs approved for use in Australia, and will cause dismay among those who know that the "morning after" pill is potentially abortifacient, and produces other major physiological effects in the heavy, harmful doses required by the intervention.

There is an additional point. Dr Ford justifies the use of the "morning after" pill as a "legitimate application of the principle of double effect".

This principle permits an action, good in itself, which has an intended good effect and an unintended evil effect, provided the evil is not the means of producing the good effect, and the intended good outweighs the permitted evil.

Applied say in the case of a ruptured ectopic pregnancy, as the now pathological fallopian tube threatens the life of a woman, the principle holds that a doctor is entitled to remove a fallopian tube in which an embryo has implanted itself, because it will ultimately lead to her death, even though removal of the embryo will lead to its death.

The use of the "morning after" pill does not involve this principle at all. Rather, it involves the utilitarian principle that the end justifies the means - a principle that the Church has always rejected.

In the case of abortion, acceptance of rare and exceptional circumstances in practice has opened the floodgates to abortion on demand - whatever restrictive legislation might be theoretically in place.

The Vatican's Bishop Sgreccia, as noted above, appreciated this, in declaring the Church's opposition to "emergency contraception" via the "morning after" pill, as a solution to the problem of rape.

The statement of this moral theological position prompted a letter to the London Tablet (12 June 1999) from Professor Malcolm Potts of the University of California in Berkeley, who noted that biologists are uncertain how emergency contraception operates, other than that its use within 72 hours after intercourse is effective in preventing pregnancy. It may or may not act as an abortifacient. He called on Bishop Sgreccia to "reconsider his hasty statement" and to "conclude - as do the vast majority of ethical people - that a reasonable case can be made for permitting a woman who has suffered the horror and pain of rape to make an informed choice about using emergency contraception."

In a response to Professor Potts (19 June), Father Ford agreed that it is not known precisely how a "morning after" pill prevents pregnancy and indicated his opposition to this, where it was evidently working as an abortifacient.

However, he added: "Recent scientific literature shows that conception usually occurs when sexual intercourse takes place during the seven-day fertile period that ends on the day after ovulation. If intercourse occurs randomly only once during these fertile days, the probability of conception is about 15 per cent, whereas the probability of preventing ovulation is about 25 per cent if ECPs ["morning after" pills] are taken.

Double effect

"If this information is correct, then in accord with the legitimate application of the principle of double effect, it would be ethically permissible to use ECPs after rape unless there were reasonable grounds to believe that the woman had conceived prior to the rape or that ovulation had already occurred, or would occur on the day of treatment. The risk of loss of an embryo would be a side-effect justified by the need to prevent the injustice of conception and a traumatic pregnancy caused by rape."

Dr Ford has a deficient knowledge of human fertility, particularly under stress. In addition, he appears not to understand the principle of double effect.

The moral problem here is that we have a "blunt instrument" that is not selective, but will meet the possible range of physiological states of the women who are raped. The possible death of unborn human life is as much willed as is the prevention of fertilisation.

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