The ‘Morning-After Pill’, Rape Victims and Ethical and Religious Directives for Catholic Health Care Services Anthony McCarthy
“ 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 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 destruction, or interference with the implantation of a fertilized ovum”.1
constitutes “appropriate testing” or
1 The statement follows the Directives of 1994
and the statement by the Pennsylvania Catholic
simple urine dipstick test together with
Conference “Guidelines for Catholic Hospitals
Treating Victims of Sexual Assault” (April 1,
1993), Origins 22: 81D (May 6, 1993). The Pennsylvania statement (which refers to ovulation testing (see below)) is cited in a footnote to Directive 36 as an example of a
policy that tries to respect ethical concerns
2 A simple urine dipstick test can be done for
about early human life. In the UK and Ireland
statements were made by the Joint Committee
triggers ovulation. This test if it gives a
on Bioethical Issues of Bishops’ Conferences
negative result does not necessarily tell you
of Scotland, Ireland, England and Wales:
whether the woman is before the cycle’s LH
“‘Use of the ‘Morning-After Pill’ in Cases of
surge (where drugs can be given to prevent
Rape”, Origins (Jan. 31, 1986), 15: 633, 635-
ovulation) or just after (in which case sperm
638 (March 13, 1986); Joint Committee on
and ovum may have already have joined and
Bioethical Issues of the Bishops’ Conference
the drug is likely to work as an abortifiacient).
of Great Britain and Ireland, “A Reply: Use of
the ‘Morning-After Pill’ in Cases of Rape”
(1986), Origins 16: 237-238 (Sept. 11, 1986).
answer the question of whether conception has
This Joint Committee is in the process of
taken place. Results from this test, however,
investigating further evidence on these issues.
The Linacre Centre for Healthcare Ethics The ‘Morning-After Pill’ and Rape Victims
Following this article, and consultation
be at all necessary in a given case. This
debate, a letter was privately circulated
take seriously the possibility that drugs
based on “the present state of scientific
Pregnancy-only testing
Directive 36.4 However, in spite of this
Health Association, Health Progress,
the “pregnancy-only-testing” strategy.3
The leaked letter has led to a situation
that is troubling, not least because the
Health Progress article defending
stance on life issues have seized on the
Flaws in the Hamel and Panicola
Some have also recommended an ovarian scan
as a way of determining the stage of the
Theological/Ethical Issues”, Health Progress
3 Ronald P. Hamel, Ph.D., and Michael R.
Panicola, Ph.D., “Emergency Contraception
http://www.mergerwatch.org/edfund_docs/ec_t
The Linacre Centre for Healthcare Ethics The ‘Morning-After Pill’ and Rape Victims
include Levonorgestrel (Levonelle 2),
“emergency contraceptive” are purely
abortifacient.8 The present evidence for
define fertilization as a process ending
questionable, not to say worrying, as it
b) It is not true that no evidence exists
fertilization process (with the lining-up
of “pregnancy-only testing” is known
“direct effect” in the vast majority of
after pill” following rape would be an
and rendering it fatally inhospitable to any
Evidence suggests that Schering PC4,
8 See Swahn M L et al., “Effect of post-coital
contraceptive methods on the endometrium
and the menstrual cycle”, Acta Obstetrica et Gynecologica Scandanavica 75: 738-744
produce an abortifiacient effect.7 Other
(1996) and also Eugene F. Diamond, M.D., “The Ovulation or Pregnancy Approach in
Cases of Rape?” (and citations therein), National Catholic Bioethics Quarterly 3: 689-
6 See the study by R.B. Everett and R.F.
Mifepristone (RU486), although not licensed
Jimerson, “The Rape Victim: A Review of 117
as “emergency contraception”, can prevent
Consecutive Cases”, Obstetrics and
conception, but also has an abortifacient effect.
9 See Tonti-Filippini N., “Further Comments
7 Ling W Y et al, “Mode of action of DL-
on the Beginning of Life”, Linacre Quarterly
norgestrel and ethinyloestraidol combination in
59: 76-81 (1992) and Diamond op.cit.
postcoital contraception”, Fertility and Sterility
10 It is a matter of dispute whether the drug’s
effects on the endometrium are, in the majority
The Linacre Centre for Healthcare Ethics The ‘Morning-After Pill’ and Rape Victims
ovulatory cycle of the rape victim, it is
“emergency contraception”13 is offered
difficult to say what the “direct effect”
after pill” cannot be classified blithely
as an “unforeseen” effect of its use.
While it is true that a woman, in taking
recent rape, need not intend to cause an
take into account the risk at which they
Ovulation testing The Linacre Centre for Healthcare Ethics,
therefore results in the administering of
38 Circus Road, London NW8 9SE Tel. +44 (0)20 7266 7410 Fax +44 (0)20 7266 5424 [email protected] Registered Charity No. 274327
In contrast to this, the ovulation-testing
12 Details of a widely adopted protocol on
ovulation testing are outlined in St Francis
Medical Centre, “Interim Protocol, Sexual
Assault: Contraceptive Treatment Component”, Peoria, IL, (October 1995).
13 It has been suggested that a single, moderate
of cases, sufficient for a further abortificacient
dose of estrogen may be sufficient to delay
ovulation while at the same time being very
11 A further possible abortifacient effect of
some drugs is that their use may slow the
pregnancy if ovulation had already occurred,
transport of the embryo down the fallopian
though this requires further investigation. If
tube so that it arrives in the womb too late to
such were the case, estrogen treatment would
be the ethically preferable option. See Tonti-
slowing down the embryo’s journey is a risky
Filippini N. & Walsh M., “Postcoital
procedure, as it increases the likelihood of an
Intervention”, National Catholic Bioethics The Linacre Centre for Healthcare Ethics
COMMISSION ON POWDER DIFFRACTION INTERNATIONAL UNION OF CRYSTALLOGRAPHY http://www.iucr.org/iucr-top/comm/cpd/ NEWSLETTER No. 25, July 2001 http://www.iucr.org/iucr-top/comm/cpd/Newsletters/ . IN THIS ISSUE Structure Determination from Powder Diffraction Data (Bill David, Editor) CPD chairman’s message, Paolo Scardi Ab-initio structure determination of oligopeptid
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