Matthew Lu

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Abortifacients, emergency contraception, and terminating pregnancy

Matthew Lu
By Matthew Lu

April 14, 2014 (Public Discourse) - One of the more controversial issues in the Supreme Court case concerning Hobby Lobby is the company's claim that some of the “emergency contraceptives” demanded by Obamacare and the HHS mandate are actually “abortifacients.” The mainstream denial of this claim, supposedly backed by science, has largely revolved around a tendentious use of terms and a confusion about the real moral issues involved.

The defenders of emergency contraception, such as Guttmacher’s Sneha Barot, like to claim that

major medical organizations . . . as well as U.S. government policy, consider a pregnancy to have begun only when the entire process of conception is complete, which is to say after the fertilized egg has implanted in the lining of the uterus.

So, according to this putatively scientific definition, conception is distinct from fertilization and pregnancy occurs only with the actual implanting of the embryo in the uterine lining. According to this definition of conception, anything that interferes with any part of this process, whether a physical barrier, hormonal regulation of ovulation (or sperm production), the destruction of the embryo prior to implantation, or prevention of successful implantation, can intelligibly be called contraceptive.

Similarly, if pregnancy only occurs once conception is complete with implantation, then it is intelligible to claim that abortion is best understood as the termination of a pregnancy—not the destruction of an embryo. This also explains the medical practice of calling early miscarriage “spontaneous abortion.” Along these same lines, a method could only properly be called abortifacient insofar as it can cause (from the Latin facio) an abortion, which, in turn, is only possible after implantation.

These definitions allow emergency contraception advocates such as the Office of Population Research at Princeton University to make blanket assertions such as: “There is no point in a woman's cycle when the emergency contraceptive pills available in the United States would end a pregnancy once it has started” (emphasis added). Using the definitions of contraception and pregnancy given above, that statement could very well be true, even if the “contraceptive pills” in question directly kill a living embryo or prevent its implantation.

The rhetoric sounds good. Emergency contraception does not prevent “pregnancy,” therefore no “abortion” is involved, and no “abortifacient” methods are used.

However, this tendentious exercise in lexicography leads these advocates to confuse the real issue. Consider Sneha Barot’s claim that

if pregnancy were synonymous with the act of fertilization, all of the most effective reversible contraceptive methods—including oral contraceptive pills, injectables and IUDs—could be considered, at least theoretically, to be possible abortifacients.

Barot apparently takes it as obvious that these methods are not abortifacients, and therefore that pregnancy is not synonymous with fertilization. But, of course, whether some of these methods are abortifacients is exactly what’s in question. It doesn’t matter whether pregnancy is defined as synonymous with fertilization, but whether the methods in question directly kill an embryo or prevent its implantation.

The Principle of Double Effect

Ultimately, the moral question of abortion has little to do with the proper understanding of pregnancy at all. We can see this by reflecting on the fact that terminating a pregnancy is not evil per se. Any time a child is delivered by caesarian section, the pregnancy is terminated, but obviously there is no direct moral evil in that procedure. In fact, some pro-life moralists have even argued that some terminations of pregnancy are morally legitimate even if they result in the death of the child.

This line of argument makes use of the Principle of Double Effect (PDE), which broadly holds that an act is morally permissible insofar as it meets four conditions (this formulation is derived from David Oderberg): (1) the intended effect of the act must not be intrinsically evil (e.g., aiming at the death of an innocent); (2) any evil side effects of the act must be unintended (though they may be foreseen); (3) the good intended effect must be at least as causally direct as any unintended side effect (i.e., one cannot do evil so that good may come of it); finally, (4) the intended good must be proportionate to any unintended evils (i.e., the good must “outweigh” the evil).

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This method of moral reasoning has allowed some of these pro-life moralists to argue that in certain extreme circumstances it is morally permissible to terminate a pregnancy in a way that results in the death of the innocent child, so long as that death is not directly intended. Rarely, an embryo will implant within its mother’s body outside the uterus (an ectopic pregnancy). While there have recently been extremely rare cases of ectopic pregnancy that were safely brought to birth (through caesarian section), it had traditionally been considered a death sentence for both the mother and child. For these reasons, some adherents of PDE have argued that it is permissible to remove the child surgically from the mother (intact) even though this foreseeably results in the death of the child. Simultaneously, these same moralists argue that the use of a chemical abortifacient to destroy the embryo is impermissible.

They reason that the surgical removal of the intact child is a medical treatment directly intended to save the mother’s life. Killing the child is no part of that treatment (even as a means); were the technology available to save the child’s life that would certainly be done. So the child’s death is a foreseeable but unintended side effect of the surgery to treat the mother, and that foreseeable death is proportionate when weighed against the life of the mother. On the other hand, a chemical abortifacient would violate the PDE because, in treating the mother, the death of the child would be directly pursued. In other words, in the abortifacient case, the mother is being treated by means of killing the child. The child’s death is not merely foreseen, it is actively pursued. That is also why the surgeon must remove the child intact; otherwise, the child’s death would be directly pursued as a means.

Whether or not this particular analysis of ectopic pregnancy is ultimately correct, and we must be careful not to misuse the PDE as has sometimes been done, these examples clearly show that the moral defect of abortion lies not with the termination of the pregnancy, but with the direct killing of the child. In fact, one leading pro-life philosopher has argued that the ultimate solution to the abortion problem might lie in the technological development of artificial wombs. This would, at least in theory, allow the intact removal of “unwanted” embryos without necessarily resulting in their deaths.

If we return to the emergency contraception case, then it is apparent that the real issue is the mechanism by which they work, not what counts as pregnancy. While there are good reasons to think that contraception (understood merely as the prevention of fertilization) is itself morally defective, it is clearly a lesser evil than the destruction of an innocent human being. So I will mostly set the contraception question aside and focus on the destruction question.

The Unintended Evil: Killing an Innocent Human Being

On the one hand, the advocates of emergency contraception are quick to claim that “emergency contraceptive pills prevent pregnancy primarily, or perhaps exclusively, by delaying or inhibiting ovulation.” Obviously, if no ovum is released, then fertilization is impossible. In that case, the moral concern is solely with contraception, not homicide. However, as Donna Harrison previously argued at Public Discourse, there are good empirical reasons to believe that some of the methods in question in the Hobby Lobby case “can and do cause embryos to die after fertilization.”

It seems fair to say that the emergency contraception advocates’ hedge that emergency contraception works “primarily, or perhaps exclusively, by delaying or inhibiting ovulation” (emphasis added) reflects lingering doubt about exactly how the methods work, even among those committed to promoting their use. This is a telling hesitation, a kind of residual honesty in admitting the possibility that, in at least some of the cases, these methods directly result in the death of embryos. (Hedging phraseology of this sort occurs on numerous online discussions, including both of those previously linked and the Mayo Clinic. The New York Times approvingly notes a recent movement to remove these hedges.) I suspect this hedging represents a kind of bad faith, and this in turn explains their repeated appeals to authority and attempts to take refuge in medical definitions of pregnancy and abortion that are morally irrelevant.

In the end, of course, none of the linguistic hairsplitting matters. What really matters in the morality of abortion is not whether a pregnancy has been terminated, but whether an innocent human being has been murdered. Understanding the mechanism of how these methods work is an empirical, scientific question about which there seems to be controversy within the medical community itself. However, I think it is significant that even the advocates of emergency contraception admit uncertainty about how the methods work and whether they kill embryos or prevent implantation.

From a moral perspective, if there is any plausible reason to believe that one of the consequences of the drugs is—even occasionally—the death of embryo, then they are morally equivalent to abortifacients that work after implantation. The fact that the intended purpose of the drugs is to prevent ovulation is ultimately immaterial if their actual consequence is to kill living embryos or prevent implantation.

Ultimately, even if one thinks that the prevention of fertilization is morally indifferent, surely it is not worth pursuing at the cost of innocent human life. That is, it would not meet the proportionality requirement (4) of PDE. Furthermore, if contraception is itself an evil, then there is absolutely no good to set against even the possibility of killing an innocent human being, so proportionality would not even enter into it.

Reprinted with permission from Public Discourse

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Vatican’s doctrine chief: ‘Absolutely anti-Catholic’ to let bishops conferences decide doctrine or discipline

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By John-Henry Westen

VATICAN, March 26, 2015 (LifeSiteNews.com) - Cardinal Gerhard Ludwig Müller, prefect of the Congregation for the Doctrine of the Faith, has rejected outright the idea floated by Germany’s Cardinal Reinhard Marx that various bishops’ conferences around the world would decide for themselves on points of discipline or doctrine. 

“This is an absolutely anti-Catholic idea that does not respect the catholicity of the Church,” Cardinal Müller told France’s Famille Chrétienne in an interview published today

The question was raised because Cardinal Marx, the head of the German Catholic bishops’ conference and a member of Pope Francis’ advisory Council of Nine, told reporters that the German bishops would chart their own course on the question of allowing Communion for those in “irregular” sexual unions.

“We are not a subsidiary of Rome,” he said in February. “The Synod cannot prescribe in detail what we should do in Germany.”

Vatican Cardinal Müller remarked that while episcopal conferences may have authority over certain issues they are not a parallel magisterium apart from the pope or outside communion with the bishops united to him.

Asked specifically about Cardinal Marx saying that the Church in Germany is “not a subsidiary of Rome,” the head of the Congregation for the Doctrine of the Faith said pointedly “the president of an Episcopal Conference is nothing more than a technical moderator, and as such has no special teaching authority.”  He added moreover, that the dioceses in a particular country “are not subsidiaries of the secretariat of an Episcopal conference or diocese whose Bishop presides over the Episcopal Conference.”

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The CDF head warned that “this attitude makes the risk of waking some polarization between the local churches and the universal Church.” He did not however believe that there was the will for Episcopal conferences to separate from Rome.

The important interview also saw Cardinal Müller contest the notion that the pastoral practice or discipline could change while retaining the same doctrine. “We can not affirm the doctrine and initiate a practice that is contrary to the doctrine,” he said.

He added that not even the papal Magisterium is free to change doctrine. “Every word of God is entrusted to the Church, but it is not superior to the Word,” he said. “The Magisterium is not superior to the word of God. The reverse is true.”

Cardinal Müller rejected the notion that we would have to modify Christ’s unflinching words totally forbidding divorce and remarriage.  We cannot “say that our ministry should be more cautious than Jesus Christ Himself!”  Nor could we, he added, say that Christ’s teaching is out of date or that “we need to correct or refine Jesus Christ because He lived in an idealistic world.” 

Rather, the cardinal said, bishops must be ready for martyrdom.  Quoting Jesus he said, “Blessed are you when people insult you and persecute you, and if we speak all kinds of evil against you because of me.”

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‘Groundbreaking’: Kansas may become first state to ban dismemberment abortions

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By Ben Johnson

TOPEKA, KS, March 26, 2015 (LifeSiteNews.com) – Kansas will become the first state in the country to ban a procedure in which unborn children are dismembered in the womb, if Gov. Sam Brownback signs a bill that recently passed the state legislature.

The state House passed a ban on dilation and evacuation (D&E) abortions, called dismemberment abortions in common parlance, by 98-26 on Wednesday.

The Unborn Child Protection from Dismemberment Abortion Act, which had already passed the state Senate in February 31-9, now heads to Gov. Brownback's desk.

Brownback, a staunch defender of life, is expected to sign the act into law.

"Because of the Kansas legislature's strong pro-life convictions, unborn children in the state will be protected from brutal dismemberment abortions," said Carol Tobias, president of the National Right to Life Committee, which has made banning dismemberment abortions a national legislative focus.

The procedure, in which an abortionist separates the unborn child's limbs from his body one at a time, accounts for 600 abortions statewide every year.

Nationally, it is “the most prevalent method of second-trimester pregnancy termination in the USA, accounting for 96 percent of all second trimester abortions,” according to the National Abortion Federation Abortion Training Textbook.

“It’s just unconscionable that something happens to children that we wouldn’t tolerate being done to pets,” Katie Ostrowski, the legislative director of Kansans for Life, told The Wichita Eagle.

Leading pro-life advocacy groups have made shifting the debate to dismemberment a national priority, with similar legislation being considered in Missouri and Oklahoma. Mary Spaulding Balch, J.D., who is NRLC's director of state legislation, called the bill's passage in Topeka “groundbreaking.”

"When the national debate focuses only on the mother, it is forgetting someone," she said.

The abortion lobby has made clear that it is uncomfortable engaging in a public relations tussle on this ground.

Elizabeth Nash, the senior state issues associate of the Guttmacher Institute, said that dismemberment is “not medical language, so it’s a little bit difficult to figure out what the language would do.”

On the state Senate floor, Democrats tried to alter the bill's language on the floor by replacing the term “unborn child” with fetus. “I know some of you don’t believe in science. But it’s not an unborn child, it’s called a fetus,” said state Senator David Haley, D-Kansas City.

If the bill becomes law, the abortion industry has vowed to fight on.

Julie Burkhart, a former associate of late-term abortionist George Tiller, said the motion's only intention is “to intimidate, threaten and criminalize doctors.”

“Policymakers should be ashamed,” she said, adding, “if passed, we will challenge it in court.”

Gov. Brownback has previously signed conscience rights protections and sweeping pro-life protections into law.

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Anne Hendershott

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How NOT to move beyond the abortion wars

Anne Hendershott
By Anne Hendershott

March 26, 2015 (CrisisMagazine.com) -- A few years ago, when an undergraduate student research assistant of mine—a recent convert to Catholicism—told me that he was planning to meet with a well-known dissenting Catholic theology professor who was then ensconced in an endowed chair at a major metropolitan Catholic university, I told him: “Be careful, you might end up liking him too much.” I jokingly told my student not to make eye contact with the theologian because he might begin to find himself agreeing with him that Catholic teachings “really allow” for women’s ordination and full reproductive rights—including access to abortion.

I was reminded of that conversation this week when I began reading a new book by yet another engaging Catholic theology professor at a major metropolitan university who also claims (pg 6) that the argument he puts forward in his book, Beyond the Abortion Wars, is “consistent with defined Catholic doctrine.” Written by Charles Camosy, associate professor of theology at Fordham University, the new book purports to be in line with Catholic teachings and promises “a way forward for a new generation.” But, Camosy delivers yet another argument for a woman’s right to choose abortion when confronted with an unborn child that he has described—in the past—as an “innocent aggressor.”

Indeed, Camosy has spent much of his career trying to convince us that he knows Catholic teachings better than the bishops. Criticizing Bishop Olmsted for his intervention and excommunication of a hospital administrator for her role in the direct abortion at a Phoenix Catholic hospital, Camosy suggested in 2013 that “the infamous Phoenix abortion case set us back in this regard.” Implying that Bishop Olmsted was not smart enough to understand the moral theology involved in the case, Camosy claimed that “The moral theology in the case was complex—which makes the decision to declare publicly that Sr. McBride had excommunicated herself even more inexplicable. The Church can do better.” For Camosy, “Catholics must be ready to help shape our new discussion on abortion. And we must do so in a way that draws people into the conversation—not only with respectful listening, but speaking in a way that is both coherent and sensitive.”

This new book is likely Camosy’s attempt to “draw people into the conversation.” But, there is little in his book that is either coherent or sensitive. Claiming to want to move “beyond” the abortion wars, Camosy creates an argument that seems designed to offend the pro-life side, while giving great respect to those who want to make sure abortion remains legal.

Especially offensive for pro-life readers will be Camosy’s description of the abortifacient, RU-486 as a form of “indirect abortion.” The reality is that RU-486, commonly known as the “abortion pill,” effectively ends an early pregnancy (up to 8 weeks) by turning off the pregnancy hormone (progesterone). Progesterone is necessary to maintain the pregnancy and when it is made inoperative, the fetus is aborted. For Camosy, who claims that his book is “consistent with settled Catholic doctrine,” this is not a “direct” abortion. To illustrate this, Camosy enlists philosopher Judith Jarvis Thompson’s 1971 “Defense of Abortion”—the hypothetical story of the young woman who is kidnapped and wakes up in a hospital bed to find that her healthy circulatory system has been hooked up to a famous unconscious violinist who has a fatal kidney ailment. The woman’s body is being used to keep the violinist alive until a “cure” for the violinist can be found. Camosy makes the case—as hundreds of thousands of pro-choice proponents have made in the past four decades—that one cannot be guilty of directly killing the violinist if one simply disconnects oneself from him. Likewise, for Camosy, simply taking the drug RU 486 is not “directly” killing the fetus. He writes:

The drugs present in RU 486 do not by their very nature appear to attack the fetus. Instead, the drug cuts off the pregnancy hormone and the fetus is detached from the woman’s body…. Using RU 486 is like removing yourself from [Judith Jarvis Thompson’s] violinist once you are attached. You don’t aim at his death, but instead remove yourself because you don’t think you have the duty to support his life with your body…. Some abortions are indirect and better understood as refusals to aid (pp 82-83).

Perhaps there are some readers who will find Camosy’s argument convincing, but I am not sure that many faithful Catholic readers will agree that it is consistent with settled Catholic doctrine.

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As one who is hardly a bystander in the abortion wars, I wanted to like this book. As an incrementalist who celebrates every small step in creating policy to protect the unborn, I had high hopes that this book would at last begin to bridge the divide. A decade ago, in my own book, The Politics of Abortion, I joined the argument begun by writers like Marvin Olasky in his Abortion Rites: A Social History of Abortion in America, that it is more effective to attempt to change the hearts and minds of people than to create divisive public policy at the federal level. I share Charles Camosy’s desire to end the abortion wars—but this war cannot end until the real war on the unborn ends. This does not mean that the two sides cannot work together—battling it out at the state level—where there is the opportunity for the greatest success. But, complex philosophical arguments on whether RU 486 is a direct or indirect form of abortion are not helpful to these conversations.

Camosy must know that we can never really “end” the abortion wars as long as unborn children are still viewed as “aggressors” or “invaders” and can still be legally aborted. Faithful Catholics know that there is no middle ground on this—the pro-life side has to prevail in any war on the unborn. It can be done incrementally but ground has to be gained—not ceded—for the pro-life side. Besides, Camosy seems a bit late to the battlefield to begin with. In many ways, he seems to have missed the fact that the pro-life side is already winning many of the battles through waiting periods, ultrasound and parental notification requirements, and restrictions on late term abortion at the state level. More than 300 policies to protect the unborn have been passed at the state level just in the past few years. The number of abortions each year has fallen to pre-Roe era levels—the lowest in more than four decade.   Much of these gains are due to the selfless efforts of the pro-life community and their religious leaders. Yet, just as victory appears possible in many more states, Camosy seems to want to surrender by resurrecting the tired rhetoric—and the unconscious violinists—of forty years ago.

While it is disappointing, it is not unexpected considering Camosy’s last book lauded the contributions of Princeton’s most notorious professor, Peter Singer—the proponent of abortion, euthanasia and infanticide. Claiming that Singer is “motivated by an admirable desire to respond to the suffering of human and non-human animals,” Camosy’s 2012 book, Peter Singer and Christian Ethics: Beyond Polarization, argues that, “Though Singer is pro-choice for infanticide, on all the numerous and complicated issues related to abortion but one, Singer sounds an awful lot like Pope John Paul II.”  In a post at New Evangelical Partnership for the Common Good, a progressive organization led by Rev. Richard Cizik (a former lobbyist for the National Association of Evangelicals who was removed from his position because of his public support for same sex unions, and his softening stance on abortion) Camosy wrote that he found Singer to be “friendly and compassionate.”  Camosy currently serves on the Advisory Board of Cizik’s New Evangelical Partnership—where he has posted Peter Singer-like articles including: “Why Christians Should Support Rationing Health Care.”

One cannot know the motivations of another—we can never know what is in another’s heart so it is difficult to know why Charles Camosy wrote this book. It must be difficult to be a pro-life professor at Fordham University—a school known for dissenting theologians like Elizabeth Johnson. But, if one truly wants to advance a culture of life in which all children are welcomed into the world, it would seem that inviting Peter Singer to be an honored speaker to students at Fordham in 2012 is not the way to do it, nor would claiming that RU-486 “may not aim at death by intention.” Perhaps it is unwise to continue to critically review Camosy’s work from a Catholic perspective because it gives such statements credibility—and notoriety. But, as long as Camosy continues to claim that his writings and policy suggestions—including his newly proposed “Mother and Prenatal Child Protection Act”—are “consistent with defined Catholic doctrine,” faithful Catholics will have to continue to denounce them.

Reprinted with permission from Crisis Magazine. 

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