Contraception and Abortion
A major talking point in the Church’s opposition to the contraception mandate has been that the mandate goes beyond requiring employers to cover contraception and requires them to pay for products that, in the Church’s view, amount to abortion. For example, the Notre Dame complaint (.pdf) repeatedly claims that the mandate requires Notre Dame “to provide, or facilitate the provision of, abortion-inducing drugs.” (see, e.g., para. 87, 90, 107, 109, 125, 140, 146, 147, 149, 156…and many more) The complaint asserts that, as a matter of fact, Plan B “operates by preventing a fertilized embryo from implanting in the womb.” Count IX of the Notre Dame complaint claims that the mandate is illegal precisely because it violates the APA’s commitment not to require employers to cover abortion services. When the complaint lists the services to which it objects, it routinely uses the following formulation: ”abortion-inducing drugs, sterilizations, and contraceptives.”
Why this emphasis on abortion in a complaint to block the contraception mandate? The question is made a little more urgent by today’s article in the New York Times reporting that the weight of scientific evidence is decidedly against the claim pressed by the Notre Dame complaint (and many Catholic opponents of the mandate) that Plan B “operates by preventing a fertilized embryo from implanting in the womb.” Let’s just start by pointing out that this claim is grossly misleading even in terms of the claims made by Catholic commentators who oppose Plan B. They tend to concede that the drug operates primarily by blocking ovulation but argue that it MAY occasionally work by preventing implantation. The Notre Dame complaint’s language suggests that blocking implantation is part of the design of the product and its primary mechanism for preventing pregnancy. Although the USCCB [official quoted in the article] continues to assert that the jury is out on Plan B’s effects on implantation (a concession at odds with the certainty in the Notre Dame complaint) I found this study described in the NY Times to be particularly persuasive:
Later, in 2007, 2009 and 2010, researchers in Australia and Chile gave Plan B to women after determining with hormone tests which women had ovulated and which had not.
None who took the drug before ovulation became pregnant, underscoring how Plan B delays ovulation. Women who had ovulated became pregnant at the same rate as if they had taken no drug at all. In those cases, there were no difficulties with implantation, said one of the researchers, Gabriela Noé, at the Instituto Chileno de Medicina Reproductiva in Santiago. Dr. Blithe of the N.I.H., said, “No one can say that it works to inhibit implantation based on these data.”
It seems likely to me that the desire among mandate opponents to blur the lines between abortion and contraception stems from at several sources. First, and most obviously, some Catholics take the principled, though in my opinion mistaken, view that contraception and abortion are equally part of a “Culture of Death” and self-gratification, etc. and so must be treated as equivalently incompatible with the practice of the Catholic faith. Although the hierarchy sometimes talks this way, there is no question that, in the domain of public policy, it usually treats abortion as a considerably more serious issue than contraception.
If that’s the case, then why mix the two together in the fight against the contraception mandate? I think there are two reasons that mandate opponents have taken this tack. The first is likely a concern that if a contraception mandate survives legal challenge, an abortion coverage mandate might as well. This is a legitimate concern, but it is also one that Church has itself helped to bring about. By arguing that any facilitation of the provision of contraception constitutes impermissible cooperation with evil, the Church has teed up its religious exemption claim in a way that, if it loses, the logic of the loss will extend to similar policies concerning activities that facilitate access to abortion. If the Church had made more fine grained distinctions about cooperation with evil based on the perceived gravity of the evil in question (for example, if it had argued that more proximate cooperation with contraception is permitted than with abortion because of the greater evil of the latter), it might have created the basis for distinguishing (as a legal matter) between the burden on the practice of religion imposed by a contraception mandate and an abortion mandate. Instead, it has decided, foolishly in my opinion, to go all-in on the contraception mandate as if it were just as much a challenge to religious freedom as an abortion coverage mandate, generating something of a self-fulfilling prophecy for efforts to distinguish contraception and abortion down the road.
A second likely reason mandate opponents have blurred the categories between contraception and abortion is more political. Recognizing that lay Catholics (and many non-Catholics) are more in agreement with the Church’s teaching an abortion than with its views on contraception, they likely hope that by emphasizing abortion and downplaying contraception, opponents of the mandate can build on the perceived legitimacy of concerns about being required to facilitate abortion. But to the extent that this political calculation contributes to the dynamic underlying the fear that the contraception coverage mandate might someday become an abortion coverage mandate, it seems extremely shortsighted.
Tags: abortifacients, abortion, contraception, Ella, emergency contraception, health care reform, HHS, Plan B, USCCB
I read that article in the New York Times. It is a well-researched article about medical research.
“Never let facts get in the way…..”
Ditto, read it yesterday, now added to my files. Gamesmanship in blurring distinctions will come to no good end, further eroding the credibility of bishops.
The NY Times article is a good example of when ideology is confronted with the facts of reality.
When Dignitatis Personae was released in 2008, This article pointed out that Catholic hospitals in several states were providing the morning after pill to rape victims and would be in conflict with DH (the article assumes that the pill does prevent implantation).
It would be helpful to know if the hospitals have changed their policies since then.
Without any desire to sound cynical, Jim Jenkins, I say that ideology usually prevails in that confrontation, at least in the short term. The facts of reality have to wield a mighty big cudgel to make any headway.
The Bishops and their surrogates will argue thusly: There is no conclusive proof. One cannot rely on simply one study that is, after all, contradicted by the government mandated language in the drug package insert. Even if it turns out to be scientifically correct, it still acts as a contraceptive, interfering with the natural order. Finally, in the end this is not about even contraception, per se, it is about religious liberty — being required to pay for services that offend the properly informed Catholic conscience.
Just sayin’
Eduardo overlooks a couple of things that severely undermine his position. (1) The NYT article ADMITS that IUDs are abortifacient. Guess what–IUDs are included in the HHS mandate, because that mandate includes all things the FDA labels as contraceptive methods. So now, by testimony of the New York Times, it is false to say that religious objectors to the HHS mandate should not claim any abortifacient aspect to it. The NYT now admits abortifacients are included in the mandate. So much for Eduardo’s desire to claim that talking about abortifacients is false.
(2) On Plan B, the NYT article is not based on new studies–it is just an expose of a debate that has been going on for years. Eduardo, the attorney, upon reading the summary by a pro-contraception newspaper, of merely one study about Plan B, finds it “particularly persuasive” that Plan B is not abortifacient. That’s fascinating. But it ain’t science. Pro-life scientists, including Dr. Harrison quoted in the article, have scientific reasons for disagreeing with this view. Out of some semblance of integrity the NYT had to give a hint of this view, while making sure not to explore it in detail. That is, the scientific view of why those studies DON’T show Plan B is not abortifacient, and why other studies may well suggest a risk, are NOT explored in any detail in this article. Fine, but no reputable scholar in any field can conclude as a matter of science that this issue is resolved in the NYT’s favor only based on the newspaper’s summary, when *other scientists disagree* and the disagreeing scientists’ views were only mentioned in passing. You can’t just call Notre Dame “grossly misleading” by saying, “oh yeah, some scientists who advocate contraception totally disagree with you.” REASONABLE DISAGREEMENTS ARE POSSIBLE. Unless you want to beg the question and say ND is not being reasonable, it has no scientific edvidence, because you said so, and to prove it here are scientists who disagree.
(3) The NYT article, as much as it desperately desires to, presents a weak case saying that “ella” is not abortifacient. In fact, ella may not only *prevent* implantation, it may dislodge already implanted human embryos, just like the similar drug RU-486 does. The NYT’s failure to make a strong case that ANYTHING other than Plan B is *not* abortifacient, when the author clearly desires to believe that as widely as possible, proves that a variety of other “contraception” methods do indeed have a significant abortifacient risk.
Eduardo wants to say that anyone who believes that some birth control is abortifacient is “grossly misleading” others. But the NYT just admitted that the HHS mandate includes some abortifacients, and probably many others in the general birth control category that it decided not to discuss. No reputable scholar could take Eduardo’s dismissive position based on the mere fact that some people disagree with the view he opposes.
I too thought this was a significant development and wondered if it would find its way into the debate
Even if it has been shown to be an incontrovertible fact that Plan B does not act as an abortifacient, the mandate’s problems with contraception and sterilization remain. The latter, in my opinion, hasn’t received the focus it deserves.
Anitra — I am not sure why you cannot just present your comments without resorting to personal attacks. You are skating very close to the line I draw for deleting comments that amount to little more than ad hominem. As for the substance of your views, I think if you read my post, you will see that I referred very specifically to ND’s categorical claims about Plan B as misleading. I did not reject the notion that there might be some form of contraception that works by preventing implantation. Whatever is true of IUDs or Ella, this does not appear to be the mechanism by which Plan B “operates,” and for mandate opponents to claim otherwise without a great deal of qualification is to undermine their own credibility. I think the article bears that out and nothing in your comments cuts the other way, not even your claim that there is room for debate.
This really isn’t cut and dried. A major problem is defining when pregnancy begins. This is not normally more than a verbal matter for doctors, as the physiological process is well enough known. The lay public is not interested in this. If they believe that a minute group of cells is a human being, they want to know when it becomes human.
So, does pregnancy begin when the ovum is fertilized, forming a zygote, or when a blastocyst becomes implanted, a week or more later?
Regular contraceptive methods that prevent fertilization are a problem for the Catholic Church, but only because they subvert the primary purpose of human sexuality and replace it with the pursuit of pleasure, allowed as a secondary purpose if part of marital affection and mutual duty. This is, of course, why other non-reproductive forms of sexuality are condemned in the Catechism, unread by most Catholics. But loudly attacking contraception directly would be an impolitic move as parish priests know, even if the bishops don’t always realize it.
Forms of emergency contraception, whether chemicals or the IUD, are most effective if given within 24 hours, when they may prevent fertilization, which must happen within that period of time. However, they are also prescribed within five days of sexual activity. That is the prevention of implantation.
If one defines, for religious or philosophical purposes, the beginning of human life as fertilization, then preventing implantation can readily be seen as a form of abortion, even though more than 50% of zygotes are either not implanted as blastocysts or do not survive. If one portrays the prevention of implantation as the destruction of a human being, the roar of the crowd will result, however small that crowd of loud enthusiasts may be. There may well be other reasons behind their passion, such as hatred of sex itself or contempt for the single women whom they imagine to be the only people who would not wish to carry a baby to term. This would include those whom they blame for being raped, because they shut their eyes to how dangerous a place one’s own home can be.
Why should the precise details matter? It is ensoulment. The definition of the starting point for human life is the key to ensoulment. This may be too abstract for most lay Catholics, let alone non-Catholics, but “personhood” makes an adequate stand-in.
After centuries of theological wrangling, and papal bans on the bitter debates, the Immaculate Conception defeated the Aristotelian doctrine of quickening as the moment of ensoulment. If the Virgin was conceived without sin, she must have been ensouled at the moment of conception. Once that had been declared ex cathedra, in the papal bull Ineffabilis Deus, the earlier dispute could be erased from the collective memory of the Church. Quickening might remain a key moment for Jews and Muslims, but no longer for Catholics.
As was clear in the debates that preceded Humanae Vitae, papal infallibility is at stake here, and hence the whole authority of the Church. Whenever a new doctrine is declared, care is taken to insist that it has always and everywhere been held by the Catholic Church.
The encyclicals of Leo XIII from 1878 to 1902, Casti Connubii (1930), Humanae Vitae (1968), the Pastoral Constitution on the Church in the Modern World, the Vatican Declaration on Abortion (1974), Evangelium Vitae (1995), these are among the specific items that must be defended, but it is the infallibility of the magisterium that is at stake. If the political pressure of four decades fails at last, civil disobedience and even martyrdom must be the forms of resistance.
Defying the “Culture of Death” rallies the troops, but there is much more at stake for the Curia.
David Harley: But the doctrine of papal infallibility was not declared until the First Vatican Council in the nineteenth century. How did the Roman Catholic Church manage to teach anything before the doctrine of papal infallibility was declared?
Perhaps the doctrine of papal infallibility should be rescinded and expunged from official church teaching.
Eduardo, most of your first paragraph is not Plan B specific, it makes reference to contraception-amounting-to-abortion generally. Likewise the opening sentence of your second paragraph asks about the abortion claim generally. Then after talking about Plan B you elaborate generally on “the desire among mandate opponents to blur the lines between abortion and contraception”. If you intended this entire blog post to presume a Plan-B-only caveat, I didn’t sense that at all from the text, so I can assure you I was not intending a “personal attack” by interpreting your article as applying to the general question of abortion-contraception mixing.
Since you ask the question “why mix the two together in the fight against the contraception mandate,” (the “two” being abortion and “contraception”) the plain answers to your question should be (a) that the FDA has mixed the two together, by explicit admission of this NYT article, which admits that some things the FDA calls “contraception” (copper IUD) are embryocidal; and (b) though the article does not think so, it seems to me we observers are bound to think that reasonable people disagree on this question, even for Plan B. But why did you not at least mention these answers?
Leaving aside Plan B for the moment, my recollection of having read up on the “abortifacient” character of contraceptives several months ago is that at least some of he FDA-approved contraceptives required by the HHS mandate do inhibit implantation, which means that by the church’s definition (DP), they cause an abortion.
I think the USCCB would have a stronger case if they proposed that the mandate be changed to cover only “FDA-approved contraceptives that do not cause an abortion” and that “sterilization” be deleted. They have better arguments for those two changes than for the elimination of the whole mandate or for the expansion of the exemption to every individual.
In doing that, they would have to get agreement on a definition of abortion that includes inhibiting implantation. Some medical definitions require implantation to have happened before an abortion can occur.
Regarding Plan B, my recollection is that the Connecticut bishops said that because it was unresolved at that time whether it inhibited implantation, it could be used in their Catholic hospitals – but if it was determined later that it did inhibit implantation they would review the situation then.
“Anitra” is wrong. Let me count the ways.
“Anitra” says: “On Plan B, the NYT article is not based on new studies–it is just an expose of a debate that has been going on for years.” So what? And when was the last time anyone read any of those recent studies collected in one place? “Eduardo, the attorney, upon reading the summary by a pro-contraception newspaper, of merely one study about Plan B, finds it ‘particularly persuasive’ that Plan B is not abortifacient. That’s fascinating. But it ain’t science.” “Anitra,” the one whose IP address resolves to the Australian desert, does not know how to identify a scientific study. Or “Anitra” believes the only scientifically valid studies are those than reach conclusions he or she approves of. Here’s what the Times article says: “In one study using fertilized eggs that would have been discarded from fertility clinics, Dr. Gemzell-Danielsson found that adding Plan B in a dish did not prevent them from attaching to cells that line the uterus. Later, in 2007, 2009 and 2010, researchers in Australia and Chile gave Plan B to women after determining with hormone tests which women had ovulated and which had not.” And: “Research on Ella, approved in 2010, is less extensive, but the F.D.A., Dr. Blithe, and others say evidence increasingly suggests it does not derail implantation, citing, among other things, several studies in which women became pregnant when taking Ella after ovulating.” That is not old data.
“Anitra” says: “Pro-life scientists, including Dr. Harrison quoted in the article, have scientific reasons for disagreeing with this view…. no reputable scholar in any field can conclude as a matter of science that this issue is resolved in the NYT’s favor only based on the newspaper’s summary, when *other scientists disagree* and the disagreeing scientists’ views were only mentioned in passing.”
Let’s look at Harrison’s reasoning. From the Times article: “With Ella, Dr. Harrison cited a document from the European Medicines Agency (similar to the F.D.A.) and animal studies that she said suggest the lining of the uterus could be altered. Dr. Blithe said that the European document did not demonstrate that effect, and that the animal results were not analogous to human experience, partly because the doses were higher. So far, in only one human study have researchers suggested that Ella’s active ingredient might thin the lining in doses higher than the dose in an Ella pill. But Dr. Blithe said that study, conducted by researchers at her agency, the N.I.H., produced results too unclear or insignificant to show that effect. Most human studies suggest otherwise, she said.” Why does Harrison worry that Ella could act as an abortifacient? Because in animal studies doses much higher than those prescribed to humans have been shown to affect the uterine lining, and could act on an existing pregnancy. You know what else acts against existing pregnancies in very high doses? Aspirin.
“Anitra”: “The NYT article, as much as it desperately desires to, presents a weak case saying that ‘ella’ is not abortifacient. In fact, ella may not only *prevent* implantation, it may dislodge already implanted human embryos, just like the similar drug RU-486 does…. The NYT’s failure to make a strong case that ANYTHING other than Plan B is *not* abortifacient, when the author clearly desires to believe that as widely as possible, proves that a variety of other ‘contraception’ methods do indeed have a significant abortifacient risk.” Significant? Prove it. Scientifically, if you don’t mind. RU-486 acts on established pregnancies to end them — and only in conjunction with another drug, misoprostol, which Ella lacks. Dr. Harrison and the USCCB have pointed out Ella’s “similarity” to RU-486. But similarity is not enough. RU-486 is administered in doses 20 times higher than Ella.
The weight of scientific evidence is against those who claim Plan B and Ella are “abortion drugs.” If they can’t provide contrary evidence, they should stop calling those drugs “abortifacients.”
Yes, John, you’re right. After the Connecticut bishops — including now-Archbishop Lori — railed against a state that would require hospitals to provide Plan B to rape victims, the bishops had a “revolution in thinking,” and decided that we did not have enough information to make a definitive moral judgment that Catholic hospitals could not licitly dispense Plan B. I wrote about that here: http://www.commonwealmagazine.org/blog/?p=17741
“After centuries of theological wrangling, and papal bans on the bitter debates, the Immaculate Conception defeated the Aristotelian doctrine of quickening as the moment of ensoulment. If the Virgin was conceived without sin, she must have been ensouled at the moment of conception. Once that had been declared ex cathedra, in the papal bull Ineffabilis Deus, the earlier dispute could be erased from the collective memory of the Church. Quickening might remain a key moment for Jews and Muslims, but no longer for Catholics.”
You’re being serious … right? Try that IC argument on the rest of society and when the laughing ceases, try it again.
Nice try, Grant (and what happened to the no personal attacks rule?) But as illustrated in this a link from Dr. Donna Harrison, http://www.nationalreview.com/corner/301980/itimesis-convolution-facts-abortifacients-donna-harrison# , what I mentioned above is true: (A) that the NYT article cannot serve to render the Catholic plaintiffs or other prolifers “grossly misleading” in their belief that Plan B may be abortifacient, (B) and/because the NYT article, while mentioning pro-life views, did not give them the detailed scientific attention that it gave the pro-contraception view. Thus laymen are not justified in concluding from the NYT article that the pro-life contention about Plan B’s abortifacient potential, such as in these lawsuits, is “grossly misleading” or not a reasonable position.
Your or Eduardo’s reading of this NYT summary cannot possibly show that anyone who disagrees is “grossly misleading” and unreasonable. This article gave short shrift, at best, to the contrary scientific views, including Dr. Harrison’s (which, on its flawed “summary” of her views about ella that you find so compelling, is entirely inadequate compared to her actual articles on that subject). Believe what you want about Plan B. But don’t say anyone who disagrees with you is unscientific. You haven’t established that. Much less is it established that the HHS mandate involves a “blurring” about implantation prevention that is wholly a product of pro-life plaintiffs’ “political” and “slippery slope” arguments. The NYT article admits the opposite, and I notice that you failed to concede that point.
By the way, RU-486 does not kill babies “only in conjunction with another drug.” It kills the baby. Cytotec delivers the baby. You have to redefine abortion to “ending a pregnancy” to say RU-486 is not lethal. But that is clearly not the moral definition we are talking about, and it doesn’t make the plaintiffs’ allegation’s “grossly misleading,” because they are speaking morally.
It is now generally agreed, even by serious pro-lifers like Nic Austriaco, than the chances of Plan B being an abortifacient are (at best) vanishingly small.
But the same cannot be said of Ella, at least according to the medical literature:
“Based on these data, it can be reasonably expected that the prescribed dose of 30 mg of ulipristal will have an abortive effect on early pregnancy in humans.” http://www.theannals.com/content/45/1/115.full
Both WebMD and drugs.com talk about Ella’s abortifacient properties…which is not surprising given that the company which makes the drug has the following to say:
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
When taken immediately before ovulation is to occur, ella postpones follicular rupture. The likely primary mechanism of action of ulipristal acetate for emergency contraception is therefore inhibition or delay of ovulation; however, alterations to the endometrium that may affect implantation may also contribute to efficacy.
http://pi.watson.com/data_stream.asp?product_group=1699&p=pi&language=E
Eduardo may well be correct about there being other reasons behind those pushing the lawsuit talking about abortion as well as contraception, but as far as I can tell it is perfectly reasonable to consider Ella to be an abortifacient drug.
“Anitra”: You really ought to go to bed. It’s very late in Australia. Or is it early?
Nothing you’ve offered confirms that describing Ella and Plan B as “abortion drugs” is correct.
Ella is derived from cholesterol too. Why do you think Harrison fails to mention that? Why do you think she links to her own paper but fails to link to the one from the European Medical Association, which she says defines Ella as “embryodical”? She doesn’t explain how. At very high doses? Higher then the dose a woman would receive if she had a prescription for it? At very high doses, aspirin is also embryocidal.
Charlie,
From the Times article:
It isn’t enough for those claiming that morning-after pills are abortifacients just to say we can’t prove conclusively that they’re not. It isn’t even enough for them to say, “This might be how they would prevent implantation of a fertilized egg if they did prevent implantation.” They need to provide evidence that, at the prescribed dose, these drugs do prevent implantation — and they have to reckon with evidence that they don’t. The Times article persuasively argues that the best evidence now available suggests that neither Plan B nor Ella is an abortifacient in the proper sense of that term. In the case of Ella, the evidence isn’t as conclusive, but it’s certainly enough to keep honest people from calling it an abortion-inducing drug. The bishops ought to draw a clear line between RU-486, which is indisputably an abortion-inducing drug, and every kind of contraception, including emergency contraception. They should make it clear to the Obama administration that they are more opposed to the requirement that Catholic institutions cooperate with coverage of RU-486 than they would be to a requirement that they cooperate only with coverage of contraception. As Eduardo points out, it is a mistake for them to leave anyone with the impression that they oppose birth control and abortion equally and for the same reason.
Matt, it is difficult to know for certain to what drug that part of the article is referring, but both from the context of the article and the fact that Ella is not a “morning after pill” (and actually works five days after sex), it seems that this refers to Plan B (a morning after pill) which I agree is almost surely not an abortifacient.
The medical science about Ella, as well as the claims made by the company that produces Ella, are quite different.
“Anitra Williams” says that “the NYT article, while mentioning pro-life views, did not give them, the scientific attention that it gave the pro-contraception view.”
But what does the expression “scientific attention” mean here?
The pro-life views advanced by the Catholic bishops are not based on science, but on debatable moral theory.
So what would it mean to give “scientific attention” to Catholic pro-life views based on moral theory?
Would it mean, for example, to use scientific studies to try to support the claims of Catholic moral theory?
Matt, sorry, I think I responded to an earlier version of your comment that didn’t have the text after your block quote, so let me respond to that as well.
The medical science seems to be that it be “reasonably expected” that Ella has an abortifacient effect. It is true we don’t (yet) have absolute proof, but what does that mean for purposes of this discussion? How different is act X which we know kills a prenatal child from act Y which can reasonably be expected to kill a prenatal child? Would conscience protections be different, in your view, with regard to X and Y?
I remain astonished at how obsessed the bishops are with these issues. And because they do not make equal efforts to understand WHY contraception and (to a lesser extent) abortion are settled matters of privacy and conscience on the part of many thoughtful citizens, but instead characterize such people as selfish, culture-of-death proponents, their arguments are almost always ineffective and ring hollow. The fact that they are a bunch of celibate men railing against “sins” they can’t commit doesn’t help their cause.
Charlie,
According to the Times article at least, it does not seem reasonable to expect Ella to have an abortifacient effect. I’m not demanding absolute proof; I’m asking for compelling evidence.
It is unreasonable to call it an abortifacient on the basis of nothing more than plausible speculation, especially when the plausibility seems to correlate so closely with one’s attitude toward contraception.
Just speaking as a medical/scientific layperson – a situation that probably also describes any judges and jury members who are likely to be called on to weigh evidence in the Notre Dame lawsuit – I don’t know how I would judge between the competing claims on Ella cited by Charlie and the NY Times article. From a legal-strategy perspective, would it be smarter to not get bogged down in competing expert claims, and simply focus on items (contraception and sterilization) about which the science is pretty much settled?
Here are links to two academic journal articles on Ella.
http://www.theannals.com/content/45/6/813.abstract
http://www.theannals.com/content/45/6/780.abstract
One says “it could quite possibly be used as an effective abortifacient.”. The other says “Due to the similarity of its structure to mifepristone, controversy regarding ulipristal’s mechanism of action has arisen.”
I’ve read only the abstracts – didn’t want to pay $25 each for the full papers. You may be able to get free access in a university library.
Grant says “Why do you think she links to her own paper but fails to link to the one from the European Medical Association?”
Your statement is false. “Her own paper” which you admit she linked to, in footnote 11, does fully cite the EMA source. And it is replete with many other footnotes.
One cannot conclude from the NYT article that the pro-life view on ella is unreasonable. One cannot conclude from it that the pro-life view on Plan B is unreasonable, giving it the short shrift it does. The pro-life view that the HHS mandate includes abortifacients is, if anything, proven by this NYT article, which admits that the cooper IUD is abortifacient. And the article strongly implies the same is true for other birth control methods. You don’t have to agree. But to call the pro-life and the bishops’ view “grossly misleading” is unwarranted from this article. Both sides are not sufficiently explored, nor the pro-life one fairly treated or debunked, as would be necessary to reach that scientific conclusion. The documentation on Dr. Harrison’s ella research alone destroys the NYT article’s reliability as an absolute debunking source for the pro-life view.
Anitra Williams: The pro-life view against legalized abortion in the first trimester is itself unreasonable.
All the above assertions, regardless of source, to the effect that Plan B is not an abortifacient, depend entirely upon one’s definition.
All of the relevant sources, commercial or medical, sya something like this:–
You only have a few days to help prevent pregnancy after unprotected sex or contraceptive failure. Plan B One-Step® works better the sooner you take it. It’s only one pill, so you can get what you need right away—within 72 hours (3 days) after unprotected sex or contraceptive failure.
At 24 hours after sex, the ovum will be fertilized. For five to twelve days the zygote will not yet be implanted. Thus, if one takes the drug 48 hours after sex, one is preventing a zygote from becoming an implanted blastocyst.
If one defines a zygote as a human being, possessed of a soul and a right to life, then preventing its implantation is abortion. Or murder, or whatever.
If one defines human life as beginning at any time after implantation, then Plan B or an emergency IUD is not abortion.
At what point does human life (or ensoulment) begin? Is a zygote a human being? Is an unattached blastocyst a human being? Is an embryo the size of a quarter (25c) a human being?
Until opponents lay their definitions on the table and justify them, whether in moral, religious, philosophical or scientific terms, there is no point in debating the matter.
How can there be a “pro-life” view and a “pro-choice” view of how a drug works? Plan B works the way it works, whether you are pro-life or pro-choice. These are matters of empirical fact. Granted, there may not always be sufficient evidence to prove something beyond a shadow of a doubt. But even then, both sides should be able to agree on the amount of uncertainty involved.
There’s no point in debating here the church’s definition of abortion. If you do not accept that definition, the question at hand may seem trivial. If you do accept it, and agree that abortion is a grave injustice, then the question becomes urgent: Is there good evidence that Plan B or Ella, when used as directed, prevents the implantation of a fertilized egg? Pace “Anitra,” who has been reduced to repeating her- or himself, I don’t see that there is such evidence, but I could be wrong. The Times reporter and the experts she quotes could be wrong. They might be overlooking important evidence; I might be ignorant of it. In which case I am eager to be corrected. Moreover, I’m suspicious of those on either side of the debate who seem unwilling to be corrected on a point of information, including those who dismiss the Times article out of hand as the predictable misrepresentation of a pro-contraception, pro-abortion newspaper.
One more point may be worth noting: for the bishops these drugs would be problematic even if they only sometimes prevented implantation of a fertilized egg when used as directed. They would not be reassured by the claim that the drugs normally work otherwise to achieve the same apparent effect. On the other hand, one cannot call a drug an abortifacient simply because it may induce an abortion when it is not used as directed. Lots of drugs do that.
At 24 hours after sex, the ovum will be fertilized. For five to twelve days the zygote will not yet be implanted. Thus, if one takes the drug 48 hours after sex, one is preventing a zygote from becoming an implanted blastocyst.
David Harley,
Sperm can live up to 5 days in a woman’s reproductive tract after intercourse. So if a woman has sex on day 1 and ovulates on day 4, she can still get pregnant. If this woman takes Plan B on day 3, she can still prevent a pregnancy by preventing ovulation and conception. It is because women can have sex first and later ovulate and conceive that emergency contraceptives can work even several days after sex.
Thomas Farrel:
“David Harley: But the doctrine of papal infallibility was not declared until the First Vatican Council in the nineteenth century. How did the Roman Catholic Church manage to teach anything before the doctrine of papal infallibility was declared?”
Are you asking tongue-in-cheek? Do you realize the total absurdity of the question? Do you think that Vatican One MADE the Pope infallible on matters of faith and morals and before he was not?
David Harley, the church does not have a position on the time at which ensoulment takes place but teaches that life must be protected beginning at the moment of conception.
Carlos,
As usual you miss the point by trying to be cute. But what you should consider seriously is that infallibility was unheard of until the 12th century.
Grant, you say, “The Notre Dame complaint’s language suggests that blocking implantation is part of the design of the product,” as if that is an absurd claim.
Yet the first paragraph of the NYT article explains: “Labels inside every box of morning-after pills, drugs widely used to prevent pregnancy after sex, say they may work by blocking fertilized eggs from implanting in a woman’s uterus. Respected medical authorities, including the National Institutes of Health and the Mayo Clinic, have said the same thing on their Web sites.”
Given that, how can you speak as if Notre Dame is being dishonest about this. If new evidence becomes conclusive enough that the Mayo Clinic changes their opinion, then it would no longer be reasonable to make such claims in a law suit, but now?
Note also another key line in the article that undermines your premise: “By contrast, scientists say, research suggests that the only other officially approved form of emergency contraception, the copper intrauterine device (also a daily birth control method), can work to prevent pregnancy after an egg has been fertilized.”
Grant Gallicho
What is your problem? Your constant, pathetic asinine, sarcasm and personal attacks on commenters – in this instance, Ms. Williams – is tiresome and really detracts from this blog. Knock it off.
Does anyone have citations or links for the studies the article is referring to, the ones apparently proving the lack of an abortifacient effect?
There is a significant difference between a substance that has a small risk of hindering implantation and one that reliably does so. If taking the former makes a woman a murderer, there are many more murderers about than we ever imagined. Among the substances known to hinder implantation and/or increase miscarriage risk are ibuprofen and caffeine. Bad dental hygiene also (not a substance, but a preventable condition). If I take an Advil after I’ve ovulated, or fail to visit the dentist in my fertile years, am I a murderer if I’m aware of these risks? How bad does my headache or aversion to dentistry have to be to outweigh the moral risk of killing an embryo? Is there a sliding scale.
There are some women with medical conditions known to hinder implantation, or who just have issues with thin uterine lining. If I’m one of these women, do I have a moral obligation to use barrier contraception?
I’m not being snarky. I just think that privileging the survival of the embryo over all other concerns raises issues that are far more complicated than the Church acknowledges.
Tim, the really solid pro-life scientist and ethicist Nic Austriaco devastates the argument that Plan B is an abortifacient here:
http://ncbcenter.metapress.com/app/home/contribution.asp?referrer=parent&backto=issue,5,9;journal,17,44;linkingpublicationresults,1:119988,1
Amanda, at least from the standpoint of the action theory of traditional Catholic moral theology, engaging in activity in which the object of one’s act is the death of the embryo via refusal of implantation into the uterus is quite a different thing (morally speaking) from engaging in activity (you didn’t mention exercise and breast feeding!) which may unintentionally lead to the same result. It isn’t privileging the survival of the embryo over all other concerns, it is about staying true to protecting the vulnerable via the exceptionless moral norm of refusing to aim at the death of the innocent.
Charles: I’m a lawyer, not a theologian. But under the law, knowing that one’s act may have a certain consequence is in most contexts (even some degrees of murder) no different from specifically intending that consequence.
And if an embryo really is the equivalent of a child, would my taking Ibuprofen for fleeting pain or drinking 4 cups of coffee knowing there is, say, a 5% chance of my child dying be an acceptable risk if the child’s death wasn’t the object of my action? Hardly.
If we were really going to treat an embryo as if it had the same value as a child, a lot would have to change. I’m not sure that even very conservative Catholics would advocate the extreme limitations that a fertile woman would have to impose on her daily activities if that were the case.
It is too complex to get into on a message board, but I would argue that merely choosing to risk a refusal to aid another with one’s body by drinking coffee is much different, morally-speaking, from taking Ella with the intention of aiming at death by refusing to aid a child because one is trying to avoid pregnancy (or because one is putting pressure on one’s partner to avoid child support).
I agree that much would have to change in our culture if we sought justice for our prenatal children such that they received equal protection of the laws, but I don’t think it would be as dramatic as you suggest, and we should remember that all difficult pushes for civil rights have been met with skepticism and claims of impracticality from those who were invested in not rethinking social structures which assume the exploitation of the vulnerable population in question.
Charles, putting aside ella, and IUDs, and other birth control methods, I don’t dispute that some good pro-life people disbelive the abortifacient effect of Plan B. Yet it seems to me there is still reasonable dispute about it, even among some abortion advocates. Dr. Harrison mentions this in her comments. And in another context, it is noteworthy that pill advocates have passed laws mandating the provision of Plan B for sexual assault, even after the lH surge. What exactly is the effect, and intent, of administering or taking Plan B after the lH surge? At that point, it could only possibly be abortifacient, if Plan B is supposed to act by stopping the lH surge. Yet a Catholic hospital’s desire not to administer Plan B after that moment is deemed unacceptable by pill advocates. I think the abortion side wants Plan B to be nonabortifacient when they are advocating its acceptability to the public, and abortifacient when they are advocating its effectiveness.
About “fertilized egg” ==
Last I read (can’t remember where) fertilization (in the biological sense of the term) takes place within about 3 days of intercourse. That is, the egg and sperm are joined chemically. However, in some cases the resulting unit duplicates itself (called “twinning” both in biology and in common parlance). BUT in some cases of “twinning” the two so-called “organisms” REJOIN into a single organism.
I don’t know how this should be described metaphysically (how many organisms are present in them whole process). But it does indicate that within the first 3 days or so the “fertilized egg” is quite possibly not a person at all. Persons don’t turn into two people then back into themselves.
Not to mention the fact that there is no indication until after 5 days (when the brain cells start to appear) that the organism is yet a person. (Check out the metaphysical principles that the medievals applied to such a situation; if there are not organs corresponding to rational acts, then the organism cannot be a rational animal, i.e., it cannot be a person.)
Not to mention that we don’t know yet just when the organs for rational thinking have developed. (Rational thinking is highly complex and probably needs many of the brain areas to happen. It is known that the prefrontal cortex is involved, but is that enough to make a generalization? to make a judgment? to argue from premises to conclusions? By the way, Peter Singer makes this ability to reason part of his definition of “personhood”. He think that the organism is not a person until it is three years old. (Now the arguments get really nasty.)
Jes notin’.
“To this perpetual evidence … modern genetic science brings valuable confirmation. It has demonstrated that, from the first instant, the programme is fixed as to what this living being will be: a man, this individual-man with his characteristic aspects already well determined.”
John Hayes –
Note that this says that genes determine what *will be* not what *is*. To identify “a man”, an actual one, with the presence in a cell of a particular set of genes, would be to imply that every single cell in a mature human body is *also* a man/person. The presence of pairs of genes in a cell does nothing to establish what the organisms *are* at the very beginning of the gestation period. Such talk is irrelevent to the issue: when is there a person present in the gestation process?
At least one study has suggested that a woman’s drinking more than 2 cups of coffee a day increases her miscarriage risk by 50% (to about 25%). The same percentage of increased miscarriage risk applies to any use of ibuprofen, according to an even more recent study. (Thus, I’ve dramatically understated the actual percentages above.) Can it really be the moral teaching of the Church that a substance merely suspected — not even proved — to impede implantation of an embryo should be denied to, say, a rape victim, when pregnant (or possibly pregnant) women take dramatic known risks without incurring moral condemnation? If I shoot a gun into a public square, likely resulting in similar percentages of risk, it is what we lawyers call depraved indifference/malignant heart murder, and one can be jailed for it for life. Are we really prepared to apply the same moral standards to conduct that risks the lives of embryos/early-stage fetuses? If an embryo is precisely the same as a child, why wouldn’t we?
I speak as one who basically agrees with the Church’s teaching on abortion — though, contrary to the politics embraced by many Catholics, I’m still not precisely sure how those teachings should best be translated to the realm of law, both from a moral perspective (there is an intervening moral agency at play — that of the woman) and from a practical one (restrictive laws haven’t been shown to decrease abortion rates, and anti-abortion platforms seem to give politicians fig leaves allowing them to adopt all sorts of policies that make it more difficult for women in difficult straits to support children — and, separately, converting the moral question of abortion into what has become primarily a question of legal rights has given those who advocate abortion with no moral qualms a rights-defending legitimacy in the public square they may not have had otherwise).
I also speak as a woman who has struggled with infertility for years. No one obsesses more than an infertile woman (and the often demonized doctors who try to help infertile women) about the myriad factors that risk impeding implantation or causing early miscarriage, and about the fragility of early life. We don’t, and in practical terms I don’t think we can, view risks to an eight-celled embryo in precisely the same way as we do risks to a born child, unless we’re willing to impose moral strictures on women’s conduct that are simply unprecedented.
Michael: There is nothing asinine about wanting to know whether a frequent, aggressive comment-writer here is deliberately deceiving us about her or his IP address. This is a favored — not to say constant — strategy of conservatives here: the victim pose. How tired. Is “Anitra” unable to answer for herself or himself? What do you care?
Charlie, what does this mean? “Taking Ella with the intention of aiming at death by refusing to aid a child because one is trying to avoid pregnancy.” Do you think most or even many women who take Ella are “aiming” at death?
Charles,
It seems to me one would have to judge an emergency contraceptive by what the reasonably intended mechanism of the drug is. Certainly one would not have to prove that an emergency contraceptive never resulted in implantation failure. Some of the prescription drugs marketed to consumers on television (asthma drugs, smoking-cessation drugs) occasionally result in death. Dropping dead is a very effective way to stop smoking or to never have an asthma attack again, but doctors do not intend for death to be the mechanism of action when they prescribe these drugs for smokers or asthma sufferers. Unless one objects to contraception altogether, it seems to me it would be unreasonable to rule out an emergency contraceptive for theoretically possible—or even occasional but rare—unintended side effects.
Amanda makes good points. If we are going to assign near-infinite value to the life of a fertilized egg when dealing with emergency contraception, we can’t reasonably turn around and assign no value in other circumstances. Somewhere between 60% and 80% of early human embryos fail to implant, and really, nobody cares (unless a couple is deliberately trying to conceive). There is much more research on implantation failure and ways to remedy it for pigs, horses, and cows than there is for humans. As Michael Sandel points out, if babies were dying at the rate of 60% to 80% a few days after they were born instead of a few days after they were conceived, it would be a medical emergency of unprecedented proportions. Yet in the case of human implantation failure, except in rare cases where infertile couples are trying to conceive, not only does nobody care. I am sure billions of people are happy that the chances of clinical pregnancy (i.e., implantation) after fertilization are not higher.
Several things quickly from the airport:
Ann, Singer now thinks we should legally protect infants from birth, and I don’t recall him ever saying or writing that they don’t become a person until year three. Got a cite on that one?
Grant, I think you are right to suggest that intention is complicated…and I would say that it is dangerous to try to determine intention in the abstract. While some certainly would take Ella with the abortifacient effect as part of the object of their act (the company is marketing this effect because some people want it), others would not. For those that would not, and those that understand the abortifacient effect to be a refusal to sustain rather than aiming at death, there would not be the violation of an exceptionless moral norm, and the question would then become whether there was a proportionate reason.
David N, as usual you say a lot in a smallish space! I can’t respond to it all, but let me say some things. First, we just don’t know the actual numbers of natural embryo loss–in fact, we don’t even know what the moral status is of the entities that are dying. It is possible that these are malformed embryos, more akin to tumors than members of the species Homo sapiens. Second, it is just not the case that “no one cares”…but even granting that a clear majority don’t care, what follows from it? The whole reason that some of us are advocating on behalf of the civil rights of prenatal children is because not enough people care. This is part of what it means to be a marginalized, vulnerable population…not enough people care about you. Third, Sandel’s (poor) argument can be used to show that human infants don’t have full moral status as well! Consider how few of us care that infant morality approaches the (guessed at) rate of natural embryo loss in some places in the world. Most of us can’t be bothered to lift a finger to help, and instead maintain our oil-soaked, consumerist lifestyles. Hopefully we agree that this reveals far more about us than it does about these dying infants.
Incidentally, the American Journal of Bioethics had a target article on natural embryo loss a few years ago (I had one of the several short responses) and it is well worth reading if you want to know more about these topics: http://www.bioethics.net/articles/the-scourge-moral-implications-of-natural-embryo-loss/
Charles, there are ways to study the likelihood that a given contraceptive method causes embryo loss. They have been done for IUDs, for instance, and showed that transient HCG (that is, evidence of fertilization that did not result in a pregnancy) occurs in women who use an IUD no more frequently than in women who don’t use an IUD. That is, an IUD is not correlated with loss of conceptus in excess of the rate that occurs in nature, through whatever combination of gentic and environmental factors might be at work, including other medications (aspirin, for instance). This is rather good evidence that an IUD works through means other than what you refer to as abortifacient (it blocks fertilization, primarily).
Which is a long way of saying that if we really wanted to know the “real” rate of embryo loss there are ways to study it. And one of the reasons why it isn’t more obvious is because it never creates a documented pregnancy. Once it does, we know that the rate of loss is at least somewhere around 20%. It’s high.
The logical conclusion of the Church’s position seems to be that there are only two choices: abstinence or random sexual intercourse without regard to the chance of pregnancy. How can ‘natural family planning’ be acceptable, since that is only trying to sneak that intercourse in when pregnancy is not likely. It’s like saying embezzlement is not theft because its done when no one is looking.
Several thoughts:
1) 100% of humans die. So the discussion of fertilized egg, zygote, embryo mortality rates is neither here nor there. The point is no human has the right to take the life of another human.
2) Everyone here started as a fertilized egg. That is, you had the correct number of chromosomes to self-direct your development and growth into who you are today.
3) It seems to me that drugs which are taken after sexual intercourse must by definition have at least 2 purposes: prevent fertilization or stop development of the fertilized egg. Thats because the its always possible ovulation and fertilization have occurred before the drug has had a chance to act.
4) As a regular reader of the NY Times, the paper has an aggressively secular agenda and that bias shows through in virtually every article even in its articles on ‘scientific research’.
Finally, I found this data from Dr. Harrisons article particularly interesting:
The quote from Trussell in the NYT article was particularly amusing. If you read his previous research papers, sometimes he claims over 90 percent efficacy from Plan B, and sometimes he claims around 50 percent efficacy. Why these differences? Well, as he so readily admits, you can’t get numbers of 90 percent efficacy without some sort of post-fertilization effect. So when the issue of mechanism of action is raised, suddenly the efficacy for Plan B gets “adjusted” to what would be expected from a drug with no post-fertilization effect. But, when issues of funding arise . . . well Plan B becomes much more effective.
I never cease to be amazed at how some American Catholics simply refuse to accept Church teaching on abortion and contraceptives.
The Church has said time and again, that non therapeutic (elective) use of contraceptives is seriously wrong, and that abortion is murder, plain and simple.
Two thousand years of teaching, encyclicals like Humanae Vitae (and newer ones as well), and then some Catholics, thinking themselves brilliant no doubt, say things like “I am not sure what abortion actually is”, “is that really an abortion?”, “is that really a contraceptive?”, and the most famous one “things are so complicated”.
To simplify: Don’t have sex outside of marriage and don’t cheat on your wife. If you want to limit the size of your family, develop and exercise some self-control and use NFP. If a surprise pregnancy comes along, enjoy the child and the experience as a gift from God. You are not God and you cannot and should not control everything. Stop being so selfish and demanding.
Jeez -
One other point
Intention matters. It matters in law and to the church. In the law, first degree murder and involuntary manslaughter are examples. For the church, its licit to remove the cancerous uterus of a pregnant woman even though the death of her child is an obvious and foreseen outcome, because its not the purpose of the surgery.
Bruce,
Your first thought misses Barbara’s point, which is that one can’t conclude that a contraceptive causes the loss of a fertilized egg just because the fertilized egg is lost after a woman uses the contraceptive. A certain number of fertilized eggs are lost naturally. If it can be demonstrated that the rate of this phenomenon is higher for women who use a contraceptive, then you may have evidence that the contraceptive sometimes functions as an abortifacient. But you can’t skip that step in the argument: you can’t simply speculate about how the contraceptive would function as an abortifacient on the assumption that it is.
Your third thought is an invalid inference. You might as well conclude that a condom has two purposes — to “prevent fertilization and stop development of the fertilized egg” — since it’s always possible that the condom will fail to prevent fertilization. The inference is invalid whether the contraceptive in question is used before or after sexual intercourse.
Your fourth thought is unlikely to persuade anyone here. It is not as if the rest of us have no prior experience reading the New York Times and depend on you for information about how the paper usually covers these issues. Say what you will about the Times, but I doubt their editors would let a paragraph like the one you approvingly quote get past them. Dr. Harrison’s presumption is breathtaking. Since the church’s teaching about abortion is based on natural law, not special revelation, it makes no sense to suggest that the reason the Times is wrong about abortion is that the Times is “secular.”
Barbara contends that the IUD is not abortifacient. In this she disagrees with even the New York Times article cited here, which states otherwise, and on whose authority this entire blog post about pro-lifers playing politics with science is based. Which goes to show that there are reasonable disagreements about whether many of these “contraceptive” items are abortifacient. Meaning, this NYT article cannot be used to accuse pro-life opponents of the HHS mandate of a “grossly misleading” blurring of abortion and contraception based on merely political and slippery slope arguments. Many people here disagree with the HHS mandate opponents. You and they draw different conclusions from the science. Fine. Disagreement with you doesn’t mean they are deluded or they are seeking to mislead.
Dr. Harrison’s comment isn’t based on “presumption”–Tressel “readily admits” a post-fertilization effect in the efficacy rate he sometimes uses. She’s working off the fine print from the authors of these studies, because she’s a scientist and has actually read and understood the studies, rather than just reading a partisan newspaper article about them.
“Anitra,”
The fact that people disagree about the questions addressed in the Times article does not go to show, much less to prove, that the disagreements are all reasonable. Reasonable is as reasonable does. A position based on the demand that one’s opponents prove a negative is not reasonable. A blinkered distrust of scientific data gathered — or reported — by anyone whose positions on related ethical and political issues is different from one’s own is not reasonable. I wish you were half as rigorous about the science behind this controversy as you are about the law behind the HHS controversy.
My remark about Harrison had to do with her casual attribution of a venal motive to Trussell.
Apparently the NYT is entirely secular, unreliable and untrustworthy except when it tells you exactly what you want to hear. Regarding the method or mode of action of IUDs: http://www.popcouncil.org/pdfs/Sivin.pdf
It’s easily found, Anitra, no need to lash out at me.
“The fact that people disagree about the questions addressed in the Times article does not go to show, much less to prove, that the disagreements are all reasonable”
Nor does it show that one side is unreasonable, which is what Eduardo essentially asserted: that this article’s summary shows the HHS mandate opponents “grossly mislead” and are “blurring” the distinction between abortion and contraception for political and slippery slope reasons. The article doesn’t serve that purpose. A dispute about science could, but the reasonableness of different sides of that dispute is apparent in several ways just on the surface that we have all skimmed here: (1) the NYT itself, taken as the correct view on Plan B, admits in the context of talking to those same trusted experts that IUDs are abortifacient; (2) “serious pro-lifers” as Charles calls them, such as Dr. Harrison, and such as Charles himself, differ on various aspects of this question, sometimes agreeing with each other and sometimes disagreeing with themselves and with abortion advocates, and they offer scientific reasonsing for their views (such as the scholarly article on ella that Dr. Harrison’s article links to). If we dug deeper than the surface, which the Times did not do with respect to the pro-life side of this debate, we would find even more articles by serious pro-lifers about the science behind each of these debates.
Barbara, apparently the NYT article is entirely reliable to critics of pro-lifers until it tells them something they disagree with about IUDs. The people who planted their flag on the significance of this article for undermining pro-life claims cannot turn around and say the article is hogwash on a nearly identical point. Sources-deemed-reasonable-by-critics-of-pro-lifers agree with pro-lifers on part of the point those critics are aiming to shoot down. The Times says IUDs are abortifacient, relying on experts it consulted. The Times did this despite, and in the midst of, its high motivation to prove otherwise about “contraception.” The Times’ admission was against interest.
“Anitra”: Are you deceiving Commonweal about your location? It’s 4 a.m. in Australia. You never post during the day. If you’re spoofing your IP address, why?
Anitra — I say this not so much for you (since you seem to have very little interest in reasoned dialogue) but just to put down a marker because of your repeated misrepresentations of the content of my post. (In my opinion, you have demonstrated that you are not interested in a rational discussion of the facts of this topic but rather a scorched earth argument in search of any shred of doubt, however flimsy.) I very carefully characterized only the Notre Dame complaint’s description of the mechanism (not one of the mechanisms, not a possible mechanism, but THE mechanism) of Plan B as prevention of implantation. This is grossly misleading on any reading of the data, even as you have admitted it to be– and yes, the claim about Plan B has the tendency to confuse the categories of contraception and abortion (which is surely no accident). The question then is why a litigant would make such a claim. In my experience, they tend to do so only for a reason (I never argued that any claim that there is an overlap between the two categories would be grossly misleading. But the claims about Plan B are a telling example of overreach, and when a party overreaches in a particular direction, then that tends to say something interesting and important about their motivations and strategies.) Your own histrionics in this thread provide additional examples of this phenomenon in action. Why is the need to commingle these two categories so urgent that the opponents of the mandate cannot simply accept the partial overlap for which there is actually some evidence (e.g., IUDs, as you point out)? That is the question prompted by the misleadingly categorical claims about Plan B in the Notre Dame complaint and elsewhere. And that is the question that I attempt to answer in the post. (None of this is to concede that even if some contraceptives SOMETIMES operate by destroying embryos that their use with contraceptive intent can, consistent with Catholic moral thought, be described as equivalent to abortion.)
Matthew,
I disagree with you on my first point. Here intention is the critical concern. Just because fertilized eggs are naturally lost before implantation doesnt absolve one of their actions. Once a person has intervened by taking a drug to interfere with the natural process, you own the outcome. Once you’ve take the drug, the ‘natural’ outcome is no longer possible.
Your comment about my third point is factually incorrect and unintelligible. It does not follow that a condom can prevent fertilization and stop development of a fertilized egg since of course it does neither. It prevents sperm from entering the woman. If it fails in that function, then both fertilization and development of a fertilized egg are possible.
Finally, with regard to the NY Times article. The author of the article and the editors have no particular expertise in the areas they are discussing; they, after all, are journalists. When their writing is baised, that bias needs to be considered very skeptically because it may have little or no basis in fact. One the other hand, the quote I gave is from a well educated, licensed ob-gyn who is an expert in this field. Her opinion, while it may also be biased, carries much more weight IMHO. Further, she’s not giving an opinion but quoting research papers authored by the person quoted in the NY Times article. I agree it probably wouldn’t have gotten by the NY Times editors, but that says more about the Times than Dr. Harrison.
Grant,
I think if you have a problem with ‘Anitra’ you should either take it up directly and not through the blog, or delete the comments. Publicly questioning her authenticity and thereby indirectly denigrating her opinions seems like a pretty low debating tactic.
I don’t know why you characterize reasoned disagreement with you as “histrionics” and other dismissive descriptions you throw out. Your frustration is palpable, but I find it difficult to justify based on the reasoned objections I have made.
You contend that the Notre Dame complaint asserts implantation prevention as “THE” mechanism of Plan B. If it does so assert, you certainly don’t quote any such assertion. You quote the complaint as saying Plan B “operates” by implantation prevention. But that assertion is NOT the assertion that it ONLY or even primarily operates that way. It is undoubtedly true that if Plan B partially operates in that way, it “operates” in that way, regardless of whether it only operates in that way. This is not only true as a matter of the english language, but it is the central point of Notre Dame’s religious claim, namely, that it has distinct religious reasons for opposing providing coverage of drugs that “operate” in an abortifacient way to any extent, regardless of whether it is the primary or only mechanism.
From what seems to be your incorrect interpretation of “operates” as “only operates,” you proceed to speculate as to why the complaint would misstate this fact. If that is your interpretation it makes your post somewhat more understandible., though I am learning this interpretation for the first time–your blog post relies on the notion that ND would allege implantation-prevention as a way the drug “operates”, not as an allegation that that is the only way it operates. I have never even heard of someone who thinks that is the only way Plan B operates, so I doubt I am the only one who would be surprised at an interpretation of ND’s allegation as if they are asserting this as Plan B’s only mechanism.
On the other hand, the point stands that even on the Plan B question, this NYT article is insufficient to show people who disagree with you to be unreasonable and therefore driven by nonfactual motives. But we have already gone over whether your blog post clearly explains that you are not in any way faulting the complaint for “blurring” contraception and abortion on any issue except the issue of Plan B. And at this point in the comments box, the discussion has gone well beyond that issue too, to the general question of blurring.
As far as Grant is concerned, I find the tone of his remarks distrubing and, frankly, a little creepy. I am surprised the moderators permit them here. I am interested in discussing things with people who like Eduardo have substantive responses to rational arguments, even if (sadly) they call people who they disagree with irrational in the process of responding.
Bruce,
You beg the question at every point. For the purposes of the discussion here — which is about whether it’s fair to call either Plan B or Ella an abortifacient — it really does not matter what the intention of the person taking the drug is. Intending that either drug prevent the implantation of a fertilized egg (or failing to intend that it not do so) has absolutely no bearing on the way the drug actually works. You need to show empirical evidence that one or both of these drugs prevent implantation. Evidence that the fertilized eggs of some women who have used emergency contraception fail to implant is not evidence that it was the emergency contraception that caused this failure, for just the reason Barbara mentions.
You originally wrote, “It seems to me that drugs which are taken after sexual intercourse must by definition have at least 2 purposes: prevent fertilization or stop development of the fertilized egg. Thats because the its always possible ovulation and fertilization have occurred before the drug has had a chance to act.” Your conclusion does not follow from you premise. From the fact that a drug may fail to work one way, it does not follow that it must be intended to work some other way as well — much less that it actually works that other way. If I give a baby a pacifier in order to keep him from crying, but he ends up not sucking on it, as I had intended him to, you may not conclude that I also intended for the baby to choke to death on the pacifier simply because that would also have kept him from crying. I had only one of those two possible purposes. This is not a technical point about contraception. It’s a basic point of logic.
Finally, there are experts on both sides of the debate about Ella. (You will notice that not even Harrison claims that Plan B is an abortifacient, though she would have to if your third point made any sense.) The dispute, then, is not between Harrison and the New York Times reporter; it’s between Harrison and the other experts quoted in the story. You are free to stop thinking about this question because you’ve found an expert whose opinion matches your original intuition, but that is not the way these questions are settled.
“Anitra,”
If you are going to disguise your identity, you could at least be a little more polite and a little less familiar toward the people here who write under their own names. Big-footing trolls are annoying; commentors who spoof their IP addresses (yours resolves to an uninhabitable patch of Australian desert) are annoying. Trolls who spoof their IP addresses and then put on lordly airs as they belabor our contributors are especially annoying and, frankly, a little creepy.
This comment thread is long enough, so I will not belabor the point. The ND complaint says “the FDA has approved ‘emergency contraceptives’ such as the morning-after pill (otherwise known as Plan B), which operates by preventing a fertilized embryo from implanting in the womb….” The plain meaning of this assertion is that the way Plan B works is to prevent implantation. Not the way it may work; not the way it occasionally works. Yes, you can logically read the claim in the more limited way you suggest, but that is why I merely called it “misleading.” If something works 99% of the time one way (e.g., a painkiller working by dulling the nerves) and then, although we’re not sure, we suspect 1% of the time it does something else (e.g., the same painkiller destroys the nerve cells causing the pain), it is an abuse of the English language to say that it “operates by destroying the nerve cells.” Now, in the case of Plan B, we’re not even operating in the world of 99/1 percent, since, at best on your view we don’t know the answer and at worst we have good reason to believe that it is actually 100/0. But either way, the ND complaint is a misleading description of Plan B. Misleading, but unlikely an accident, and, again, for that reason, interesting in its almost certainly intentional valence (to merge the categories of contraception and abortion). This bias towards bringing the two categories together should be explained. As for the term histrionics, I used it primarily to refer to your highly charged rhetorical aggressiveness, such as repeatedly ascribing the intention of my “grossly misleading” language to all claims made about contraception by mandate opponents. It might not have been the most appropriate word, in retrospect. I did not intended to impugn your rationality in general, just your interest in reasoned discussion on civil terms (which include charity towards your interlocutors). I actually don’t get paid for this, and I don’t generally like to get sucked into the comments, so I’m not going to spend any more work time on this thread.
Thank you for responding. I’ve made the points regarding ND’s complaint so I won’t repeat them.
Matthew,
You seem to want me to prove to you that the drug is definitively an abortifacient without your having to prove it isnt. Drugs taken after sexual intercourse cannot, by definition, have the same efficacy in preventing pregnancy as those taken before sexual intercourse because of the intervening time. Something else has to be occurring. That is what makes Dr. Harrisons quotes of Trussells different efficacy rates so telling.
Finally, if you believe this is human life we are talking about, its not clear to me we should be advocating running experiments like those necessary to answer the question you and Barbara raise. But since you already know definitively how Plan B works, presumably you are not advocating human experimentation.
Drugs taken after sexual intercourse cannot, by definition, have the same efficacy in preventing pregnancy as those taken before sexual intercourse because of the intervening time.
Bruce,
This is not true, as I believe I explained above. If you check out almost any site giving advice on how to get pregnant, you will see that the best time for intercourse is before ovulation. Sperm can live in a woman’s reproductive tract 5 days. The egg, when it becomes available, lives only 12 to 24 hours. So stopping ovulation after intercourse generally prevents pregnancy in precisely the same way that stopping ovulation before intercourse does. It prevents an egg from being released.
If the above is not clear, then let me say that pregnancy is usually the result of sperm already present when an egg is released, not an egg already present waiting for sperm to come along. So the best way to prevent pregnancy is to make sure the sperm waiting to fertilize an egg never get the egg. That is what contraceptives, including emergency contraceptives, do.
David,
I agree with your statements about improving the probability of getting pregnant. But it does not follow that just because more pregnancies result by having intercourse before ovulation, that drugs taken afterward will have the same efficacy or for that matter work the same way in all circumstances. There are two time delays – taking the pill and its subsequent action – during which either ovulation or fertilization or both could have occurred. It is also possible that ovulation occurred before sex, which may have a reduced probability of pregnancy but doesn’t eliminate it. Each of these outcomes would be much less likely – most people assume zero, but its actually positive – in the case of the traditional pill.