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Hobby Lobby and Science

The Hobby Lobby decision exempted the corporation from providing insurance coverage for contraceptives it believed to be abortifacients. But is that belief true? And should it matter, especially as Catholic institutions decide whether to raise similar objections?

First, a clarification: two different definitions of what counts as an abortion are in play. In medical terminology, a woman is not considered pregnant until the developing embryo implants in the uterine wall, approximately a week after fertilization, (so on average about 7-10 days after ovulation.) Since one can’t have an abortion until one is pregnant, by medical standards contraceptives that block implantation by changing the uterine lining are not abortifacient. Roman Catholic magisterial teaching, on the other hand, holds that the developing embryo should be treated as a person from conception. Anything that blocks implantation would be considered abortifacient by those who believe that personhood starts with conception. In short, in medicine, “pregnancy” is a term that refers to the woman, while for many pro-life people and groups, it refers to the presence of an embryo.

The Hobby Lobby case focused on 4 means of contraception: Plan B and Ella, both forms of emergency contraception (EC) for use after unprotected sex, and two forms of the IUD, the copper-coated IUD and a hormone-releasing IUD called Mirena.The literature is complex and developing, and I hasten to state at the outset that I'm not a pharmacologist or an MD. But here goes:

How does Plan B (levonorgestrel) work? Clearly its principal mode of action is to inhibit ovulation. Studies here and here indicate no effect on implantation or endometrial thickness (which might affect implantation.) This was controversial early on, but the most recent studies indicate no effect on implantation. Similar pregnancy rates from use of Plan B after ovulation vs. placebo also support the conclusion that Plan B does not affect implantation. Indeed, a number of studies of implantation in vitro, in animal models, and reflecting clinical efficacy state confidently that there is no effect on implantation. (The German bishops also have given their thumbs-up to EC that doesn't block implantation. The USCCB links to statements on EC are broken.)

The principal mechanism of action of Ella (Ulipristal acetate) is also inhibition of ovulation. This drug has a longer window of efficacy than Plan B, and is approved for use up to 5 days after unprotected sex. (This is because it can block ovulation closer to follicular rupture than Plan B does.) In higher doses, Ella could affect uterine lining, but at the doses used for EC appears to have no such effect. Other studies note the pharmacological similarity of ulipristal to mifepristone, (which does terminate pregnancy.) If administered after ovulation, Ella might inhibit implantation. However, there are also indications that people who take Ella after they ovulate become pregnant at a similar rate to those who take placebo, implying that any effect on the endometrium is not enough to significantly impair implantation. In sum--the scientific jury still seems to be out on Ella and implantation, as far as I can tell.

The hormone-coated IUD releases levonorgestrel (the active ingredient of Plan B), so can act to inhibit ovulation, and to thicken cervical mucus to impede sperm movement. The copper-coated IUD impairs sperm motility. Both forms of the IUD impair implantation according to most--but not all--of the sources I checked. 

It seems that Hobby Lobby cast its net too broadly, and ruled out a form of emergency contraception that is effective ONLY pre-fertilization, Plan B. It is not abortifacient by any definition. The mechanism of action of Ella on this point seems unclear so far, while most sources agree that the IUD affects implantation. 

Why does this matter? In making religious liberty-based claims, it seems to me, truth counts. It is one thing to say that the law should respect freedom of people to believe or not believe what cannot be empirically proven. (The existence of God, e.g., pace Thomas Aquinas.) It is quite another matter for laws that put significant burdens on individuals (here, women whose contraceptive choices are limited,) in the face of data that shows that the religiously-based claims are demonstrably wrong. Obviously, reliigious liberty means that people are free to believe things that are just wrong--anti-evolutionists, young-earthers and their ilk--but surely there must be a limit to how much a person's fallacious belief can be invoked to justify limiting others' freedoms. 

Beyond the law, there is a question of scandal. The image of religious institutions is affected in matters like this, and here is where Catholic institutions should tread carefully. If Catholic institutions jump on the Hobby Lobby bandwagon, they should do so only in ways that reflect the current state of biological understanding on these questions, and they should be prepared to revise as necessary. Otherwise, the banner of religious liberty will come to seem like a right to persistent and harmful ignorance. This is truly scandalous--it would imply, contrary to the best of Catholic tradition, that faith requires rejection of reason. 

Comments

Commenting Guidelines

Gerelyn - no conspiracy theories - just a perdiction.  Don't lose sleep over it.

The NYT article completely misses the fact that the DOJ is moving to declare many of these state voting bills to be in violation of voters rights.

In other states, we begin to see a groundswell that will force both local and state officials to back down e.g. North Carolina.

Congress will do nothing because that is the only chance for Republicans to squeak out any voting victories and continue its policies via re-aligning districts.
 

Lisa, could you cite your source for the following statement?
"In medical terminology, a woman is not considered pregnant until the developing embryo implants in the uterine wall, approximately a week after fertilization, (so on average about 7-10 days after ovulation.)"

Your arguments here imply the idea of a clear, definitive, unassailable consensus by "the scientific community" but I'm interested in hearing which scientific bodies *in particular* command your respect on this important definition. A medical ethics board? Several textbook publishers?

TF, exactly when a doctor will declare a woman pregnant is a dicey business, because implantation can't be picked up on sonography (as far as I know), and the doctor has to rely on hCG levels. 

While a drugstore pregnancy test works by measuring hCG levels in urine, which indicates implantation, women with a history of early miscarriage may be told not to get their hopes up until the doctor has monitored their hCG in blood tests over a few weeks to ensure that levels are increasing normally. hCG levels that are low or don't increase along expected lines could be a sign of something that has gone wrong with the pregnancy or of a whole other disease.

There is more about how doctors use and interpret hCG data at the NIH library site: http://www.nlm.nih.gov/medlineplus/ency/article/003619.htm

Definition of pregnancy as from implantation is from the ACOG, viz:

When Is a Woman Pregnant?
To be sure, not every act of intercourse results in a pregnancy. First, ovulation (i.e., the monthly release of a woman's egg) must occur. Then, the egg must be fertilized. Fertilization describes the process by which a single sperm gradually penetrates the layers of an egg to form a new cell ("zygote"). This usually occurs in the fallopian tubes and can take up to 24 hours. There is only a short window during which an egg can be fertilized. If fertilization does not occur during that time, the egg dissolves and then hormonal changes trigger menstruation; however, if fertilization does occur, the zygote divides and differentiates into a "preembryo" while being carried down the fallopian tube toward the uterus. Implantation of the preembryo in the uterine lining begins about five days after fertilization. Implantation can be completed as early as eight days or as late as 18 days after fertilization, but usually takes about 14 days. Between one-third and one-half of all fertilized eggs never fully implant. A pregnancy is considered to be established only after implantation is complete.
Source: American College of Obstetricans and Gynecologists.

The different definitions of pregnancy can be obfuscatory in educational literature on EC and birth control. Sometimes confident statements that this or that is "NOT abortifacient" are based on this definition, not on a life-at conception stance. 

This is clipped from an excellent summary of the language question by the folks at the Guttmacher Institute: http://www.guttmacher.org/pubs/tgr/08/2/gr080207.html.

Jean and Jim Pauwels,

It is reasonable error on the side of caution when we are uncertain about a medication's effects. However, it is not reasonable to hold a particular set of medications to a higher standard. We can't be 100% certain that anything we do won't slightly increase or decrease the likelihood of a fertilized egg implanting. There comes a point where we need to just say that any effect is too small to worry about. Skepticism is fine, but selective skepticism is not skepticism at all but an attempt to enforce one's preference under the guise of prudence.

"One thing I can predict - we will never see this number of *catholic* supreme court judges again."

Nor should we.  Their political leanings and religious biases do NOT reflect the overall tenor of the citizens of the U.S.  We need a selection of atheists/humanists/nones as well as a Muslim, a Jew (Ginsburg will not be on forerver), an Evangelical Protestant --- a wider representation of the public square.

Catholics need hang their head in shame at how they have been protrayed by Scalia, Thomas, Alito and Roberts.

Correction:  I forgot that Breyer and Kagan are Jewish.  But the rest of my comments still apply.  The SCOTUS is heavily weighted to a very narrow political perspective.

Ryan, I don't know what you think I am preferring. I do not now and never have accepted the Church's teaching that no abortions are ever justified nor that all artificial contraception or sexual acts that do not culminate "opennes to life" should be mortal/grave sins. I merely try to appreciate that these teachings have inspired others to live lives that would be pleasing to God.

I can offer many complaints about how the FDA tests drugs generally and particularly for women (usually drugs are tested on men). But that's not really a theological issue.

The use of different definitions in different contexts is perfectly fine as long as it is clear what definition is being used when.  This is especially true of when our growing knowledge makes it possible to make new distinctions.

Consider the case of the word planet. Originally, it was anything that appeared to move across the fixed background of stars. As our astronomical understanding increased, we realized that grouping these diverse objects together didn't make sense, so we divided the Solar System into the sun (which was at the center), the planets (which orbited the sun), and moons (which orbited planets). Later, astronomers discovered a large number of planets between Mars and Jupiter. Again, they decided that it was better to classify them as a separate category of asteroiids. More recently, the discovery of other objects like Pluto has created yet another category.

Similarly, pregnancy started relatively straightforwardedly: by the time anyone could detect a pregnancy, there was no doubt about whether it had started yet. Likewise, abortion was anything that ended the pregnancy before birth. As our understanding of pregnancy inceased, we discovered that there was a period between when an egg is fertilized and when it attaches to the womb. They decided that the attachement was the essence of pregnancy, so they defined pregnancy to begin at implantation. Likewise, since abortion is ending a pregnancy, they restricted abortion to mean things that occur after implantation. Before implantation presumably had its own new word. Meanwhile, the Catholic Church felt that the essence of abortion was causing death before birth. It chose to call the destruction of an embryo before implantation abortion.

Both groups have sensible reasons for making their choices. The Catholic Church is not opposing science by choosing its own definition, and scientists are not playing word games by chosing a different definition that works better for the way they need to use it.

@Ryan,

Well-put. As I mentioned in the original post, also, the scientific definition uses the woman as the referent, while the magisterial referent is the embryo. I agree that the magisterium is not opposing science in this respect, but the choice of where to focus one's first attention is not insignificant. 

If nothing else, this shows again how important the moral imagination is in moral reasoning. When you say "abortion," do you think first of a pregnant woman or an embryo? Indeed, as you demonstrate nicely, the history of a question is significant in formation of the moral imagination. 

Lisa,

That's an interesting point. I can't think of any point in the official moral analysis where the woman is considered beyond how the fetus needs her uterus to survive.

And making a saint of a woman who decided to die rather than have an abortion exemplifies a certain perspective.

Thanks for the response, Lisa. Having read the Guttmacher piece I'm struck that the ACOG guidelines are even more agnostic about when pregnancy begins than your summary suggested to me: it speaks of implantation as the crucial stage in a pregnancy being *established*, while I doubt ACOG or anyone else could coherently argue that pregnancy actually begins at implantation. Just that "we'll consider it begun" at implantation *relative to the goals and priorities of the practice of medicine*. This guideline then would have no real bearing on the moral questions that concern the bishops. It's the federal guidelines (which clearly include scientific judgements with the addition of moral judgements) that draw a more definitive line in the sand, (i.e. when does a pregnancy become a pregnancy to the state) and as you say that political entity has operated with a 40 year consensus on that question. Considered this way, the public debate around hobby lobby becomes not religion vs. science but science meets the moral judgment of religious leaders vs. science as previously established by democratic consensus.

Well-put. As I mentioned in the original post, also, the scientific definition uses the woman as the referent, while the magisterial referent is the embryo. I agree that the magisterium is not opposing science in this respect, but the choice of where to focus one's first attention is not insignificant. 

Yes, I agree, and many thanks to you, Ryan and others for this conversation as it has helped to clarify these different points of view.

 

 

That's an interesting point. I can't think of any point in the official moral analysis where the woman is considered beyond how the fetus needs her uterus to survive.

Ryan, are you familiar with the official moral analysis of an ectopic pregnancy?  I disagree that, in the eyes of the church, women are reduced to the status of baby incubators.  Naturally, in any Catholic moral analysis of reproduction and pregnancy, both the woman and the child both are going to be given moral weight, and this is precisely  how church teaching differs from the moral theories that underlie the regime of legalized abortion on demand.

And of course, the church in its official teaching capacity has said many other things about women apart from reproduction.  That is not to say that more needn't be said nor that this isn't an area of theological development.  

Crystal, I assume your saint reference is to St. Gianna Beretta Molla.  You may know that she was a physician who, understanding the medical risks of a difficult pregnancy and what was at stake, freely sacrificed her life so that her child could live. Many women in many cultures have given their lives for their children, in all sorts of circumstances: sometimes it is by pulling their child from a burning vehicle, or jumping into deep water to save one from drowning, or intervening in a pit bull attack.  These happened to be circumstances of a risky pregnancy.   Saving the lives of one's children generally is considered to be an admirable, even a heroic thing to do.  It is not just the church that remembers parents who gave their lives for the sake of their children.  I admire such parents whether or not the church canonizes them.

 

Bill,

Even if people agree "that God allows responsible adults to decide how best to form, raise, and support families rather than allow folks to arbitrarily decide when a person is or when a zygote is a person, etc." that simply begs the question of whether those actions are moral and just.  

Its perfectly clear that God allows his creatures to make all kinds of decisions - rape, murder, stealing, etc - which are neither moral nor just.   So the real question is whether consciously deciding to take these drugs to "prevent a potential live birth from occuring" is licit.  Its the conscious decision that matters, not the outcome.

Hey, Bruce - you reflect a simplistic theodicy argument - life begins at conception.  Realtiy - reproduction and our understanding of this process expands daily and it is a complex arena.  Some folks are trying to do the *difficult and hard work* of parsing and merging science and ethical/moral understanding.

The problem with simplistic statements such as *life begins at conception* is that it flys in the face of actual science;  it relies upon biologism; it makes the whole process into some type of pre-ordained process, and its undergirding rationale is *natural law* (as defined a century or more ago).

You give an example of a simplistic approach - to quote:  *whether consciously decidding to take these drugs to prevent a potential live birth from occuring*.......this type of analysis completely ignores the role of the couple, the role of a wife, the role of a husband....it boils decisions down to a focus on artificial vs. natural (e.g. NFP is encouraged but not contraceptives - what exactly is the different beyond a mindless reliance upon an outdated natural law concept.  And this is linked again to the unwise HV decision that went against the Papal Birth Control Commission and history now teaches us that the decision had nothing to do with the actual issue but rather was made out of fear about papal power, precedents, etc.)

Yep, the conscious decision is what matters - and that conscious decision has many factors, faces, and sides.  Your approach is to narrowly limit it to use of artifical contraception.....even HV has pages of discussion around the complex role of family decision making - what is responsible and what is not; what is a loving supportive couple to do given that marriage has dual purposes; etc. 

Here is some well reasoned arguments (and know you weren't at this presentation - I was):

http://ncronline.org/news/politics/curran-how-bishops-challenge-abortion-laws-flawed

Key points that link to this post:

Bishops’ thesis is wrong for four reasons:

  • “The speculative doubt about when human life begins;
  • “the fact that possibility and feasibility are necessary aspects involved in discussions about abortion law;
  • the understanding and role of civil law;
  • “and the weakness of the intrinsic evil argument.”

 

Doubt about exactly when infusion of “the spiritual soul” occurs is acknowledged, he said, in several modern Vatican and papal documents, including the 1974 Declaration on Procured Abortion from the Congregation for the Doctrine of the Faith. That document notes “There is not a unanimous tradition on this point and authors are as yet in disagreement.” Still, said Curran, while recognizing the philosophical problem, the document calls for erring on the side of caution. It states that it is sufficient “that the presence of the soul is probable because one cannot take the risk of killing a human person.”

So the contention by bishops today that “from the moment of conception, each member of the human species must be given the full respect due to a human person,” said Curran, “is accurate but not totally forthcoming.

“The most accurate way to state the Catholic moral teaching is that direct abortion even of a fertilized ovum is always wrong, but you cannot say it is murder. There is doubt about the reality of the early embryo,” said Curran.

Curran said in the abortion issue, he prefers the religious freedom approach and its three criteria for “determining the proper intervention of coercive law” -- justice, public peace and public morality.

“For our present purposes, the fact that the religious freedom approach could justify either position regarding abortion law means that in light of the Catholic understanding, neither the bishops nor anyone else can claim certitude as to how Catholics should decide about abortion legislation,” he said.

 In the case of abortion, said Curran, “one is not supporting a false religion, but rather the freedom of the person to choose.”

The weakness of the argument based on intrinsic evil, said Curran, “once again undermines the position of the bishops wanting to see the public policy position on abortion as differing from public policies on most other issues.

Jim,

And what message does that woman's sainthood send to other women whose doctors advise them to terminte their pregnancies because their lives are in danger?  In comments above it was discussed how different the viewpoints can be on this whiole issue  - from the pov of the fetus or the woman.  The church seems to have chosen its side.

And what message does that woman's sainthood send to other women whose doctors advise them to terminte their pregnancies because their lives are in danger?

Right - I am somewhat leery of the notion that the lives of saints are fables that deliver succinct morals to the story.  Ultimately, I believe that Gianna is in heaven because she led a holy life, not because she died of a septic infection.  

But here is what I take away from the story of her final pregnancy and its complications: children have moral worth, and so women and their medical advisers have a responsibility to think through their decisions, in freedom, while taking into account these important moral considerations.  St. Gianna's courageous decision exemplifies freedom and responsibility.

Here are some details on St. Gianna's specific medical circumstances and her choices.  She had other options, and perhaps other women in similar circumstances may have made a different choice.  And of course there are many, many other sets of circumstances that can arise during a pregnancy.  I wouldn't want to draw too straight a line between St. Gianna and all difficult pregnancies.  

Having witnessed more or less what other married fathers witness in their wives' pregnancies, I would just add that the bond between a woman and the infant in her womb is hard for a man like me to appreciate, as is the suffering and distress that accompany even a relatively problem-free pregnancy and childbirth.  I do see something holy in what St. Gianna did.

 

In comments above it was discussed how different the viewpoints can be on this whiole issue  - from the pov of the fetus or the woman.  The church seems to have chosen its side.

The two points of view that were highighted in comments above by Ryan, Lisa and T F don't exactly reduce to "fetus vs. woman", nor (to my reading) were they intended to pit one against the other in some zero-sum contest to the death.  

I believe that they were noting that the definition of pregnancy adopted by obstetricians and gynecologists is from the point of view of treating a woman who is pregnant.  A pregnancy, whatever else it is, is a medical condition that calls for medical treatment.  It seems that, prior to implantation, there isn't much medical treatment on offer to women who have a fertilized egg inside them.  Thus, *from the point of view of offering medical treatment to pregnant women*, the pregnancy is assumed, for practical reasons, to begin at implantation.

When the question, "When does human life begin?" engages moral theologians and religious authorities, they are seeking to answer a very different question than, "When do I start offering medical care to a pregnant woman?"  Thus, the two questions may yield different answers, without being in conflict with one another.  There are both medical dimensions and moral dimensions to pregnancies, and we should think about both of them.

The church doesn't "choose sides" in a pregnancy.  The church wants pregnancies to be carried to term when that is medically feasible.  In the instance of an ectopic pregnancy (and in some other types of pregnancy complications), the church approves of recommended treatments that would seem to "choose" the life of the mom over the life of the child.  

 

 

It is reasonable error on the side of caution when we are uncertain about a medication's effects. However, it is not reasonable to hold a particular set of medications to a higher standard. We can't be 100% certain that anything we do won't slightly increase or decrease the likelihood of a fertilized egg implanting. There comes a point where we need to just say that any effect is too small to worry about. Skepticism is fine, but selective skepticism is not skepticism at all but an attempt to enforce one's preference under the guise of prudence.

Ryan, I agree - I don't think we should be selectively skeptical.  But it's not straightforward to determine when a risk is insignificant enough that it is rendered morally moot.  This article by Kevin Clarke in America Magazine covers some of the same ground that Lisa has covered in her post and comments, and provides some additional details on how Catholic hospitals assess the moral issues in their treatment of rape victims in emergency rooms.

 

 

 

 In the case of abortion, said Curran, “one is not supporting a false religion, but rather the freedom of the person to choose.”

Bill,  This just begs the question.  Choose what?  Its not a false religion but rather the basic biology that a new organism is formed when the sperm and egg fuse.  You may consider this simplistic but this is what science tells us.  While there may be alot of other considerations, and God gave people freedom to choose, he did not say those choices are without consequences.  Christ's church is there to guide people in those decisions but they remain totally free to accept or reject the guidance.

FWIW, I think about the soul like this:  Something that obviously existed while the person was alive is missing when they are dead.  Call it soul, or life or whatever.  That same essence is present in the zygote because we can tell that it is alive.  It is performing self-directed actions that follow along a predictable development schedule.  

And we know its human too; it wont develop into a cow, or an ape or a tree, but only a human.  You may call that biologism, but that is in fact what the science of biology can and does tell us. The biology is not in dispute, but rather how people interpret the basic biological facts.  Those who want to justify abortion make the unsubstantiated claim that a human life hasnt begun, because something we cannot identify may not be present.  The bishops say we cannot tell, but we know we will eventually be able to identify it as human, so in an abundance of caution concerning the sixth commandment, we should assume its human from conception. 

What real difference does it make if that life can be split into two at a very early stage, or even split and then recombined into one.  The life doesnt end, its just changed.  Those are just obfuscations we humans find very easily confusing.

OK Jim, I see what you're saying, I think,  An example, though, of what I mean by the church choosing sides ... the 9 year old Brazilian girl who was pregnant with twins by her stepfather and whose doctors told her she would die unless she had an abortion.  The church excomminicated her mother and doctors when she had the abortion, and the residentarch bishop said, "Abortion is much more serious than killing an adult. An adult may or may not be an innocent, but an unborn child is most definitely innocent. Taking that life cannot be ignored."

http://content.time.com/time/world/article/0,8599,1883598,00.html

sorry, that should have been 'resident archbishop'

Crystal - I agree that's a horribly hard case.

Abortion is much more serious than killing an adult. An adult may or may not be an innocent, but an unborn child is most definitely innocent.

Ah, bless the kindly Archbishop of Recife for his enlightened views, over against the severity of Augustine and so many other apostolic successors and learned men, who taught for centuries, to the consternation of heaven only knows how many parents, that unbaptized infants were rotten with the sin of Adam and unworthy to behold the face of God. But let someone ask him tomorrow about the the need for baptism to wash away the effects of original sin, and he will affirm that as well. Sufficient unto the day is the argument thereof.

Meanwhile, the Archbishop's relatively untroubled attitude toward the killing of adults is worth noting.

That infants-are-more-innocent-than-adults argument would be deployed against the claim that pro-life advocates who support the death penalty are being inconsistent in their pro-life principles.  Needless to say, as a category, "killing an adult"  is a good deal broader than "administering the death penalty."  Either something was lost in translation, or the good archbishop didn't get the formula quite right.

Additional Information...

 

A reporter loses sight of data on Plan B

http://www.ncbcenter.org/document.doc?id=444&erid=0

Emergency Contraception can cause Abortion

http://www.thepublicdiscourse.com/2013/12/11685/

Hey, Bruce - it is so easy to deal with your junk - public discourse is not objective - it is an opinion piece that is biased.

From Fact Checkers:

http://rhrealitycheck.org/article/2014/06/19/hobby-lobbys-owners-may-sincerely-believe-emergency-contraceptives-cause-abortion-wrong/

Key point:

Undermining these basic scientific facts has been crucial to the strategy that Hobby Lobby and other corporations have employed during their holy crusade against the birth control benefit. And partisan organizations like the Charlotte Lozier Institute, the research arm of the virulently anti-choice Susan B. Anthony List, are eager to assist. They conduct “research” and propagate agenda-driven nonsense from non-credible scientists, all the while ignoring and dismissing actual scientists: The American Congress of Obstetricians and Gynecologists (ACOG), which is world renowned for being comprised of premier experts in women’s health, and whose definition of pregnancy has been the standard since 1970, for example, is dismissed as “rabidly pro-abortion.”

Birth control benefit opponents obfuscate basic concepts about reproduction and women’s health. They attempt to turn a discussion about when pregnancy begins—and therefore when and how a pregnancy can be terminated—into a discussion about when life begins. But as RH Reality Check’s own Jodi Jacobson wrote in an article entitled “Life Begins At Conception. That’s Not the Point”:

Human life has to begin with conception, but conception is not the same thing as pregnancy, the latter of which reason, science, and medical evidence agree begins when a fertilized egg successfully implants in the uterus and develops into a healthy embryo.

Reason, science, and medical evidence are dangerous to the anti-contraception agenda. Simple biological truisms—that pregnancy begins at implantation, for instance—become, according to the Charlotte Lozier Institute, “Orwellian new-speak” designed to obscure the “reality” that all hormonal contraceptives potentially are abortion pills. The fact that this “reality” is actually a fantasy doesn’t matter.

In pursuit of their fantasy, birth control benefit detractors dismiss any person or organization that doesn’t march in lockstep with their junk science agenda. They happily ignore that the Food and Drug Administration, the National Institutes of Health, the American Medical Association, and the medical community writ large agree that emergency contraceptives are not “abortion-inducing drugs.” They ignore the legal opinions of judges like Edward Korman, who, in Tummino v. Hamburg—which ultimately required that Plan B be made available over-the-counter—called the idea that Plan B could affect implantation “scientifically unsupported speculation.” 

Birth control benefit opponents even ignore people in their own camp: The official journal of the Catholic Health Association, for example, published an article stating that Plan B works only as a contraceptive and is not “abortion-inducing.”

An article quoting a number of authoratative science sources

 

http://www.crisismagazine.com/2014/media-repeatedly-deceives-public-hobb...

Hi Bruce, Indeed, they got it mostly right. They're wrong on Plan B, (which does not impede implantation,) and as far as I know, there's still reasonable doubt about Ella, (could go either way.) Clinically-focused data seems to be showing little or no affect of Ella on implantation, while earlier studies saying it did were based on things like the molecular structure of the drug, not its actual mode of action. Check out the ref's in the original post and the CHA opinion Bill dH references immediately above.

The IUD does seem to have an effect on implantation, I found a 1998 (?) paper that offered significant data to the effect that the IUD does not affect implantation, the vast majority of scientific reports indicates that it does: http://www.ajog.org/article/S0002-9378(02)00493-3/abstract. The copper and hormone-treated IUD might shift the primary mechanism of action more to pre-implantation than of prevention of implantation, but as far as I can find, both mechanisms are thought to be operative. 

What's unfair in the linked article, though, is to assess a study's scientific validity by the political leanings of the scientists involved. If they mean to accuse the scientists of fraud, they should come out and say so, then (I hope) find themselves in court needing to prove their allegations. If there are methodological flaws involved, they should point them out, which will doubtless inspire others to design better studies--that's one way science works. (It is, e.g., why Regnerus' widely debunked study on same-sex couples parenting kids was widely debunked.) If subtle or inintentional bias exists, well, that's true of all science. That's why most of the time confirmatory studies are looked for whenever an important advance is made. But political attacks are the scientific equivalent of an ad hominem, and does little to bring down the temperature of the debate. 

Still, once fertilization takes place and the individual blastocyte is formed, the human life cycle has begun.

Lisa,

You define "pregnancy" to further your argument but unfortunately most medical authorities do not agree with your definition unless you rely solely on the American Association of OB-Gyns. But they are fairly well known for their political leanings. Perhaps you should look farther.

I am a licensed technical professional, although like you, not in the medical field and I always insist that facts and opinions be separated. To say that "pregnancy" requires "implantation" is an opinion.

Control the terminology and you can win a debate.

But isn't it a risk if we kill because of a mere opinion?

@Almerin, You assign to me a position in an argument that I didn't take: my argument here is about the importance of scientific truth in matters of very significant public policy, not about one or another of the definitions of pregnancy/beginning of life. However, the divergence in definitions is, istm, an important source of confusion in the the public debate around contraception. As I showed above, Plan B is NOT ABORTIFACIENT BY ANYONE'S DEFINITION, not the magisterium's nor the ACOG's. This is a simple fact that should, I believe, shape Catholic input into the matter. Catholics should care about scientific truth--if we fail to, we violate our own tradition, in which we believe that the work of the mind does not separate us from God. To the contrary.

You said: "To say that "pregnancy" requires "implantation" is an opinion." Nope. It's a stance that focuses first on the woman, a stance that makes sense for medical professionals whose business is concerned with women's reproductive lives. As I said above, this stance makes sense for the ACOG: before an embryo implants, it is floating free in the woman's body, but hasn't yet joined itself to her. If a man holds a vial containing an embryo in his hand, or puts it in his pocket, is he "pregnant"? That would be absurd. Yet a pre-implantation embryo has no closer PHYSICAL attachment to a woman than he does. By the ACOG's definition, then, drugs and devices that impede implantation are not abortifacient because the woman is not yet pregnant.

OTOH, the magisterial concern for life from conception, (which is not conflated with personhood necessarily according to the "Document on Procured Abortion,") focuses first and foremost on the embryo, not on whether or not the woman is "pregnant." The magisterial concern that imputes personhood to the early embryo recognizes that some drugs and devices--IUD's, and MAYBE Ella, though that's still up in the air--can prevent the implantation of an otherwise viable embryo, which is what is important to the magisterium. This is the difference in point of view or stance that I spoke of. It matters in contraception, and is relevant also to IVF, pre-implantation genetic diagnosis and stem cell research, all also forbidden because of this same stance.

You ask: "But isn't it a risk if we kill because of a mere opinion?" Respect for that concern SHOULD make people careful about different definitions of terms like what counts as abortifacient. It is deceptive when people using the ACOG defintion do not inform their patients that some drugs and devices act by impeding implantation. That's part of what motivated this post--to try to clarify the roots of the confusion.

Indeed, the ACOG, regarding conscientious objection, holds the position that: "In the provision of services, the guideline emphasizes, the patient’s well-being must be paramount." Surely then, in the provision of services, adequate accurate information should be offered to women so they can understand mechanisms of action of drugs and devices whose use might violate the patient's conscience. LIKEWISE, OB-GYN's who will not discuss or prescribe drugs or devices that impede implantation on grounds that they consider them abortifacient owe it to their patients to be clear that their consciences are stopping them from providing other legal options, which might be morally acceptable to their patient. IOW, shouldn't EVERYBODY respect patients' consciences??

Finally, the ACOG has something like 57,000 members, representing about 90% of OB-GYN's. They are hardly a fringe or radical group. Note that one of their legislative priorities is reducing the need for abortion.

Let me repeat the take-home message: PLAN B IS NOT ABORTIFACIENT BY ANY DEFINITION. THIS FACT SHOULD MATTER, ESPECIALLY TO CATHOLICS.

When you state that the fertilized egg as a distinct genetic entity with a soul is a wish or an opinion, is this your opinion?  How is the fertilized human egg not, at least, a potential human being?  If you claim that this is a cultic notion that admits neither science -- human biology -- or rational thought -- a fertilized human egg never has the potential for anything other than humanness, how might you evidence this? Your question: was God the abortionist seems a bit less than unnuanced but perhaps you can explain how God could rationally commit evil -- abortion -- as opposed to the natural course of things, i.e. 2/3 of fertilized eggs don't implant. I look forward to your reply.  

I'm still attempting to understand -- irrespective of the religious overtones -- why any company should be forced to pay for anything that is of a voluntary nature, e.g. sexual activity. Do we no longer have, in our society, the notion of self-responsibility?

@Robert Curtis,

To your first point: I can only assume that you are deliberately misreading what I wrote, for reasons that aren't clear to me. I enjoy fruitful discussion, but deliberate misrepresentation is unfair. Or perhaps you were ascribing the comments of another responder to me. 

Your second post is a better question: do we no longer have the notion of responsibility for our own actions? Actually this is tricky territory in questions of medical ethics: aren't many/most cases of cardiac by-pass necessary as a result of an voluntary choice to smoke and eat unhealthy foods? What about bladder cancer, also common in smokers? Yet some fit non-smokers get bladder cancer and need by-pass. We know statistically what leads to a higher rate of certain common and expensive-to-treat diseases, but it's impossible to say for certain that a given case is due to an "irresponsible" choice. (Quotes here to indicate conflicting understandings of moral responsibility when addiction is in play, as is the case with tobacco.) Should we all become slim non-smoking vegans who eat only organic in order to qualify for medical coverage? So...how do we draw a line between what we're responsible for in medical coverage? 

With contraception specifically, there are medical conditions treated by the pill--it has medical uses beyond contraception. (NB--the Hobby Lobby case was NOT about the contraceptive pill--though arguably it should have been, since my understanding is that the pill may also work some small portion of the time by preventing implantation. Why weren't they thorough in researching what they would object to?) Should an employer get a note saying, e.g., "Sally in accounting needs the pill for medical reasons, not for irresponsible sexual frolics"? Should one's employer be involved to that degree in the personal medical conditions of employees?

Secondly, contraception itself is a matter of medical concern for many folks, e.g. for women with pre-existing conditions that make pregnancy hazardous. (That "pre-existing condition" might include being over, say 40, still fertile but of an age when pregnancy is riskier than before.) Should one's employer get a note saying, e.g., "Beth your v.p. of financial operations should not get pregnant because of a medical condition, yet she and her husband still want to have sex because they love each other and express that love sexually. Do you approve of her receiving the pill, or should they wait 15 years until she's reliably post-menopausal?" Again, is one's employer the best person to decide? Finally, how many children "should" a woman have before her employer agrees to cover her contraceptive costs as health insurance? Why does the employer get to decide? 

And I note that no one is arguing that health insurance should not cover pills for male erectile dysfunction, also a matter of voluntary activity, i.e., sexual activity. Sauce for the goose...

Hobby Lobby's argument was that the forms of contraception to which they objected were abortifacient. I tried, in this post, to examine their claims as to scientific truth, being careful about how different groups and individuals define relevant words, and I found that their research was faulty. Bad science should bother Catholics. 

If there is a matter of doubt where another's life may possibly be at stake, one does not endanger another's life.

So according to this unscientific definition of "pregnancy," a zygote or embryo does not a pregnancy make until it crosses the magic goal line of implantation.  So, if mother loses her unborn baby, she was not pregnant?  Wow, Orwell couldn't have dreamed up such double-speak.

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