Patrick Craine

Plan B, rape, and abortion: Err on the side of life

Patrick Craine
Patrick Craine

February 3, 2012 (LifeSiteNews.com) – Elise Hilton took a strong stand rooted in her pro-life convictions last week when she refused the drug Plan B after her mentally disabled daughter was brutally and repeatedly raped.

After we reported her story yesterday, words of sympathy came flooding in, but many also questioned Hilton’s concern that the drug could cause an abortion. Others outright attacked her and accused her of trumpeting an “anti-choice” myth at the expense of her daughter.

The use of Plan B for rape victims has become the standard practice in health facilities throughout North America – to the point where state legislatures have even forced it on Catholic hospitals. But it’s a hot-button topic within the pro-life movement, and is more complex than it may seem.

There are essentially two key issues: First, is Plan B in fact an abortifacient? And second, if it is an abortifacient, is it possible to administer the drug without the risk of deliberately causing an abortion?

Is Plan B an abortifacient?

The drug’s purported aim is to prevent pregnancy within the first few days after intercourse.  It acts firstly by preventing the fertilization of the women’s ovum by either (1) delaying or suppressing ovulation, or (2) inhibiting the transport of the sperm or the ova.

But studies have found that if fertilization has already occurred, the drug can also act by thinning the uterine lining to prevent the newly conceived zygote from implanting, and thus cause an early abortion.

The Food and Drug Administration and even Plan B’s manufacturer, Barr Pharmaceuticals, both recognize the possibility of this “anti-implantation” or “post-fertilization” effect. One 1994 study found that this effect could account for most cases where the drug “prevents” pregnancy.

Recent studies have called this abortifacient function into question, however, leading some pro-life organizations like the Catholic Health Association to dismiss it.

But even the CHA, which supports the use of Plan B for rape victims at Catholic hospitals, still admits the possibility of the abortifacient function. Dr. Ronald P. Hamel, the CHA’s Senior Director of Ethics, wrote in 2002 that “the destruction of a conceptus cannot be absolutely ruled out.” In 2010, when CHA was attempting to justify their stance in favor of the use of Plan B, Hamel still could not rule out an abortifacient effect. He wrote that “virtually all of the evidence in the scientific literature indicates Plan B has little or no post-fertilization effect.”

Furthermore, some studies continue to find evidence suggesting an anti-implantation effect, so the more recent studies are not unanimous.

Of course the wider scientific and bioethical community reject the whole debate about the drug causing an abortion, because they long ago redefined pregnancy to begin at implantation. But obviously that won’t fly for pro-lifers who believe, as the embryologists do, that life begins at conception.

The overwhelming view among those who have not bought into this redefinition is that Plan B carries at least a minimal risk of causing a chemical abortion.  Some, including the Pontifical Academy for Life, believe the risk to be far more than minimal.

Can Plan B be taken without the risk of deliberately causing an abortion?

Acknowledging this risk, some Catholic moral theologians have argued that you can avoid the abortifacient effect by simply ensuring the woman is not pregnant when she takes it. They oppose its use in general as a contraceptive, but support the drug in cases of rape, arguing that it’s morally just for the woman to repel the attacker’s semen.

So Catholic doctors have proposed two approaches to testing the victim for pregnancy.

The first involves a simple pregnancy test. But even advocates of this approach admit that all this will do is establish a pregnancy existing prior to the rape. The test only actually shows up positive a week or so after intercourse, so it wouldn’t detect a baby conceived from the rape.

The second approach seeks to determine whether the woman has ovulated or not based on an assessment of her menstrual history, or in the case of the more rigorous Peoria Protocol, also based on a urine test and blood test. If she has not ovulated then she is clearly not pregnant, the theory goes. But even with all of these tests, advocates of this approach admit the possibility of “break-through ovulation” even if the results are negative, meaning the victim could still become pregnant.

The fact that these tests can still fail to circumvent the abortifacient function would be enough for many to rule the drug out. It goes back to the classic hunter in the woods scenario. If a hunter sees something moving behind a bush he can’t shoot until he knows for sure it’s not another person.

But some Catholic theologians argue that the improbability that the drug would cause an abortion raises enough doubt to offer “moral certainty” that an abortion will not occur. They argue that the child’s death would be an unintended consequence outweighed by the broader concern for the rape victim’s psychological state.

But this argument reduces moral certainty to a weighing of probabilities. If we acknowledge even the remote possibility that the drug will “prevent pregnancy” by destroying a human life, then we are directly responsible if it does. We cannot say that we are morally certain a child will not die as a result of Plan B when we admit there is a chance one could die, no matter how improbable we believe that chance to be.

The hunter in the woods can’t settle for probabilities. If we accept that Plan B carries a risk of abortion, there is a reasonable fear that an abortion could take place, and we cannot be morally certain that one will not.  Any risk of directly committing an abortion is unacceptable, however remote.

As bioethics expert Bishop Elio Sgreccia, then-president of the Pontifical Academy for Life, told LifeSiteNews in 2008, Plan B “is not able to prevent the rape. But it is able to eliminate the embryo.  It is thus the second negative intervention on the woman (the first being the rape itself).”

We must always err on the side of life

I know that this is a heart-wrenching and deeply personal issue, especially of course for women who have suffered rape and taken Plan B on doctors’ advice. I want to emphasize that I am no way intending to make accusations. This is a complex issue, and I am in no position (and have no desire) to judge a decision made in such horribly difficult circumstances.

I’ve made my case against Plan B from the perspective of those suggesting the abortifacient risk is minimal. But many researchers, theologians, and pro-life advocates are gravely concerned that it’s more than a remote possibility, and it’s not my intention to suggest otherwise. My point is that even if we accept the premise that it is simply a remote possibility, that’s still enough to rule it out on moral grounds.

Commenters accused Elise Hilton of jumping into a serious life-or-death decision based on faulty science. But the science is far from settled, and where there is doubt we must always err on the side of life.

I stand with her.

Patrick Craine is Canadian Bureau Chief for LifeSiteNews.com and the president of Campaign Life Coalition NS.  He lives with his wife and two children in a rural town in Nova Scotia.


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Jonathon van Maren Jonathon van Maren Follow Jonathon

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Arguments don’t have genitals

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By Jonathon van Maren

“As soon as he grows his own uterus, he can have an opinion.”

That was a comment left on The Abortion Rights Coalition of Canada’s Facebook page by a woman who presumably opposes men speaking out against misogyny, domestic abuse, rape culture, and female genital mutilation as well. Apparently, you see, male genitals disqualify people from speaking out on various human rights issues deemed by women who define themselves by their uteruses while protesting angrily against being defined by their uteruses as “women’s issues.”

Which abortion isn’t, by the way. It’s a human rights issue.

To break it down really simply for our confused “feminist” friends: Human beings have human rights. Human rights begin when the human being begins, or we are simply choosing some random and arbitrary point at which human beings get their human rights. If we do not grant human rights to all human beings, inevitably some sub-set of human beings gets denied protection by another group with conflicting interests. In this case, of course, it is the abortion crowd, who want to be able to kill pre-born children in the womb whenever they want, for any reason they want.

Science tells us when human life begins. Pro-abortion dogma is at worst a cynical manoeuvre to sacrifice the lives of pre-born human beings for self-interest, and at best an outdated view that collapsed feebly under the weight of new discoveries in science and embryology. But the abortion cabal wants to preserve their bloody status quo at all costs, and so they make ludicrous claims about needing a uterus to qualify for a discussion on science and human rights.

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In fact, feminists love it when men speak up on abortion, as long as we’re reading from their script, which is why the carnivorous feminists have such a support system among the Deadbeat Dads for Dead Babies set and the No Strings Attached Club.

Male abortion activists have even begun to complain about “forced fatherhood,” a new cultural injustice in which they are expected to bear some responsibility for fathering children with women they didn’t love enough to want to father children with, but did appreciate enough to use for sex. Casual fluid swaps, they whine, should not result in custody hearings.

This is not to mention a genuine social tragedy that has men forcing or pressuring women to have abortions or abandoning them when they discover that the woman is, indeed, pregnant.

Or the fact that abortion has assisted pimps, rapists, and misogynists in continuing the crimes of sex trafficking, sexual abuse, and sex-selection abortion.

And coming against these disgusting trends are thousands of men in the pro-life movement who believe that shared humanity means shared responsibility, and that when the weak and vulnerable are robbed of their rights, we have to stand up and speak out.

We are not at all convinced by the feminist argument that people should think with their reproductive organs or genitals. We think that the number of people currently doing that has perhaps contributed to the problems we face. And we refuse to be told that protecting the human rights of all human beings is “none of our business” and “outside of our interests.”

Arguments don’t have genitals, feminists. It’s a stupid argument trying to protect a bloody ideology.

Reprinted with permission from CCBR.


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Rachel Daly

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Gvmt strikes UK Catholic school admission policy that prefers Mass attendees

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By Rachel Daly

St. Joseph's Catholic Primary School in Epsom, England, was ordered to change its admissions policy after it was ruled discriminatory by the nation's Office of Schools Adjudicator, according to Your Local Guardian. St. Joseph's reportedly had been granting preferred acceptance to students whose families attended Mass at the affiliated church.

St. Joseph’s School is for students from age 4 to 11 and describes itself as “enjoy[ing] a high level of academic success.” The school furthermore places high priority on its Catholic identity, affirming on its homepage that “We place prayer and worship at the center of everything we do.”

The school states in its current admissions policy that it was "set up primarily to serve the Catholic community in St Joseph’s Parish" and that when the applicant pool exceeds 60 students, its criteria for prioritizing students includes "the strength of evidence of practice of the faith as demonstrated by the level of the family's Mass attendance on Sundays." 

Opponents of this policy reportedly argue that since donations are asked for at Mass, it could allow donation amounts to influence acceptance, and that forcing non-accepted local students to seek education elsewhere imposes a financial burden upon their families. 

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As Your Local Guardian reports, the adjudicators dismissed claims that donation amounts were affecting school acceptance, given that it is impossible to track donations. Nonetheless, the adjudicators maintained that "discrimination ... potentially arises from requiring attendance at the church rather than residency in the parish."

The Office of Schools Adjudicators, according to its website, is appointed by the United Kingdom’s Secretary of State of Education, to perform such functions as mediating disputes over school acceptances. The Office's ruling on St. Joseph's will require the school to release a revised admissions policy, which is expected in the next few days.

Reprinted with permission from the Cardinal Newman Society.


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Carolyn Moynihan

African women at risk of HIV, hostages to birth control

Carolyn Moynihan
By Carolyn Moynihan

Which should be the priority for a health organisation: preventing an incurable disease, or preventing a natural function that might have adverse physical consequences?

Preventing the disease, you would think. But the World Health Organisation would rather expose African women to HIV-AIDS than withdraw its support from a suspect method of birth control, arguing that childbirth is also risky in Africa. Riskier, apparently, than the said contraceptive. And at least one of WHO’s major partners agrees.

This is one of the stories you will not have read in coverage of the International AIDS Conference held in Melbourne last week, despite the fact that WHO made an announcement about it during the conference and the findings of a highly relevant study were presented there.

The story is this: there is increasing evidence that the method of contraception preferred by family planning organisations working in Africa (and elsewhere) facilitates the transmission of HIV. The method is the progesterone injection in the form of either DMPA (Depo Provera, the most common) or NET-En (Noristerat).

Millions of women in sub-Saharan Africa receive the injection every three months. The method overcomes problems of access. It can be given by nurses or health workers. A wife need not bother her husband for any special consideration; the teenage girl need not remember to take a pill.

But for 30 years evidence has been accumulating that, for all its “effectiveness” in controlling the number of births, the jab may also be very effective in increasing the number of people with HIV.

Three years ago at another AIDS conference in Rome, researchers who had analysed data from a number of previous studies delivered the disturbing news that injectables at least doubled the risk of infection with HIV for women and their male partners.

That study had its weaknesses but one of the experts present in Rome, Charles Morrison of FHI 360 (formerly Family Health International, a family planning organisation that also works in AIDS prevention), considered it a “good study” and subsequently led another meta-analysis that addressed some of the issues with previous research.

Last week at the Melbourne conference he presented the results. His team had re-analysed raw data on the contraceptive use of more than 37,000 women in 18 prospective observational studies. Of these women, 28 percent reported using DMPA, 8 percent NET-En, 19 percent a combined oral contraceptive pill, and 43 percent no form of hormonal contraception. A total of 1830 women had acquired HIV while in a study.

The analysis showed that both injectables raised the risk of infection by 50 percent:

Compared to non-users [of any hormonal contraceptive], women using DMPA had an elevated risk of infection (hazard ratio 1.56, 95% CI 1.31-1.86), as did women using NET-En (1.51, 95% CI 1.21-1.90). There was no increased risk for women using oral contraceptives.

Similarly, comparing women using injections with those using oral contraceptives, there was an elevated risk associated with DMPA (1.43, 95% CI 1.23-1.67) and NET-En (1.30, 95% CI 0.99-1.71).

Morrison also noted:

The results were consistent in several subgroup and sensitivity analyses. However, when only studies which were judged to be methodologically more reliable were included, the increased risk appeared smaller.

Morrison acknowledged that observational studies such as the FHI analysis depended on have their limitations. He is looking for funding to conduct a randomised controlled study – something that, after 30 years of suspicions and evidence, still has not been done.

So what is his advice to the birth control industry? Stop using this stuff in regions with a high prevalence of HIV until we are sure that we are not feeding an epidemic?

No.

One reason is that FHI is at least as interested in contraception as it is in HIV prevention. Though its website reflects a broad range of development activities, its core business is integrating birth control programmes with HIV prevention. The WHO – one of its partners -- describes the US based, 83 percent US government funded non-profit as “a global health and development organization working on family planning, reproductive health and HIV/AIDS.”

Another reason is that FHI 360 has a vital stake in precisely the kind of contraceptives that are under suspicion. Its annual report refers to:

Our trailblazing work in contraceptive research and development continues, as we develop and introduce high-quality and affordable long-acting contraceptives for women in low-income countries. Research is under way to develop a new biodegradable contraceptive implant that would eliminate the need for removal services. We are also working with partners to develop an injectable contraceptive that would last for up to six months. Currently available injectables require reinjections monthly or quarterly, which can be challenging where health services are limited.

That project is funded by the Bill and Melinda Gates Foundation and USAID.

So Morrison did not argue in Melbourne for restrictions on the use of injectables, and neither did the WHO, whose representative at the conference outlined the UN body’s new guidelines on contraception and HIV. Mary Lyn Gaffield said a review of studies up to – but not including Morrison’s – did not warrant a change to WHO’s policy that DMPA and NET-En should be available, without restriction, in areas of high HIV prevalence.

The most WHO will advise is that women should be informed of the risk:

“Women at high risk of HIV infection should be informed that progestogen-only injectables may or may not increase their risk of HIV acquisition. Women and couples at high risk of HIV acquisition considering progestogen-only injectables should also be informed about and have access to HIV preventive measures, including male and female condoms.”

Condoms? How do they defend such cynicism? By equating the risk of HIV with the risks of motherhood – complications of pregnancy or childbirth, maternal death and the effect on infants... And yet motherhood remains risky precisely because 90 percent of the world’s effort is going into contraception!

Seven years ago a meeting of technical experts convened by WHO to study the injectables-HIV link showed the reproductive health establishment worried about that issue, to be sure, but also concerned that funding was flowing disproportionately to HIV-AIDS programmes, setting back the cause of birth control. The integration of family planning and HIV prevention spearheaded by FHI 360 looks like they have found an answer to that problem.

Whether African women are any better off is very doubtful. They remain pawns in a game that is, above all, about controlling their fertility. They and their partners are encouraged to take risks with their health, if not their lives, while researchers scout for funds to do the definitive study.

FHI had an income of $674 million last year, most of it from the US government. Couldn’t it give Charles Morrison the money to do his research today?

Reprinted with permission from Mercatornet.com.


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