CATHOLIC HOSPITALS: Emergency Contraception for Rape Victims

     A "complicated and highly nuanced ethical debate within the Catholic Church" centering on hospitals' administration of emergency contraceptives to rape victims has created a rift between Catholic hospitals that offer the treatment and those who don't, according to a profile in the Chicago Tribune. Arguing that the use of such contraceptives is "tantamount to abortion," the Vatican opposes their use, but in the U.S., the decision to provide EC to rape victims is made at individual hospitals under the guidance of local bishops. While most Catholic hospitals do provide patients with the option, some -- including those affiliated with the Archdiocese of Chicago -- do not. The process by which some of the country's 569 Catholic hospitals decide to offer emergency contraceptives "involves fine distinctions about when life begins, the effects produced by drugs, and, to an extent, a question of odds." Summarizing the debate, Frances Kissling, president of Catholics for a Free Choice, said, "Emergency contraception seems to be a fuzzy area even with the bishops themselves. The area of latitude is the question of can you determine if the woman is not pregnant. When does pregnancy begin?" Some "liberal" Catholic hospitals resolve the dilemma by providing patients with EC after they have determined that patients are not pregnant.

Timing is Everything
      Administering EC poses challenges, as it is effective only when delivered within 72 hours after unprotected sex, but pregnancy tests will not detect conception until 10 days after fertilization. As a result, positive pregnancy tests administered to patients within three days of a rape indicate that conception occurred prior to the rape. If a rape victim's pregnancy test is negative, staff at Catholic-owned hospitals opposed to EC must determine whether ovulation has occurred and whether there is any chance that conception has already occurred. Catholic-owned hospitals in Chicago, for example, observe a policy mandating that "nothing can be done to interfere with a possible pregnancy." Although Catholic hospitals that don't offer emergency contraception services accept sexual assault victims "to the extent that they have the capability to provide treatment," they are advised to familiarize patients with EC services and the Catholic Church's ethical restrictions. Patients interested in receiving EC may be referred to hospitals that offer emergency contraception services. Mercy Medical Center in Baltimore, which treats all of the city's rape victims, is an example of a Catholic hospital that interprets doctrine differently: The hospital offers EC to "each and every [rape] patient, if they are capable of becoming pregnant." In California's Catholic hospitals, EC use is "widespread." Bill Cox, president and CEO of the Alliance of Catholic Health Care, an organization comprised of the state's Catholic health care providers, said the "ethical directives clearly permit the treatment of rape victims in an emergency room with medications that would prevent pregnancy." Rev. Michael Place, president and CEO of the Catholic Health Association of the United States, believes debate over interpretation of church doctrine will continue. "The teaching is clear," he said, "In the case of rape, you may intervene to prevent conception, but in doing that you can't do something that is an abortifacient. The ultimate question is about conception" (Schodolski, 8/29).