What is up with medical ethicists?

Stevens Point Journal - Catholic ethicists disagree on definition of procedure

Posted August 27, 2007

Catholic ethicists disagree on definition of procedure By Shenandoah Sowash Journal staff Members of the Catholic community vary in their definitions of emergency contraception, some believing it causes abortions.

"The science tells us that it is an abortive agent as life begins at conception. One of the effects of emergency contraception is to change the environment inside a woman's body, thus making the contraceptive an abortive agent," said Marie Hilliard, director of bioethics and public policy for the National Catholic Bioethics Center, a Catholic think tank based in Philadelphia.

[. . .]

Susan McCarthy, director of clinical ethics for Ministry Health Care, disagrees with Hilliard's definition of emergency contraception. "Accepted medical practice is that EC is not an abortive agent. It's noncontroversial and well accepted among Catholic theologians that it is not an abortive agent. I have not read anything that indicates otherwise," she said.

Hilliard also discussed post-abortive stress syndrome, a controversial "illness" comparable to post-traumatic stress disorder, often a resulting diagnosis after a sexual assault. "It normally comes 10 years after an abortion and can be very painful," Hilliard said. Data is currently unavailable as to the possibility of a woman taking emergency contraception and developing post-abortive stress syndrome. However, a majority of literature addressing the syndrome comes from pro-life sources, including crisis pregnancy clinics.

An article from the Journal of the American Medical Association discredits the concept of a post-abortive illness, calling it a myth. McCarthy was unfamiliar with the syndrome, saying a woman who had taken emergency contraception would not experience the illness. "We're talking about pre-fertilization here. A lot of things are theoretically possible, but abortion just doesn't even come into the equation here," she said.

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Dear editor,

Comments made by Susan McCarthy as quoted in the August 27th article "Catholic Ethicists Disagree on Definition of Procedure" by Shenandoah Sowash misrepresent the Catholic position on emergency contraception and require correction. Ms. McCarthy stated that emergency contraception is, "noncontroversial and well accepted among Catholic theologians that it is not an abortive agent. I have not read anything that indicates otherwise." Sadly, it seems that Ms. McCarthy is a little behind on her professional reading. It is nearly universally accepted among moral theologians that the contraceptive act is not a concern in the case of rape, since rape already steals the sexual act of the meaning and purpose that Catholic moral teachings on sexuality seek to preserve. However, there is still a lot of discussion among Catholic theologians about the moral acceptability of emergency contraception, precisely because of its abortifiacient potential.

Ms. McCarthy seems to be unaware that the "accepted medical practice" defines pregnancy differently than do Catholic moral theologians. Accepted medical practice has redefined pregnancy to mean the point at which the embryo is embedded in the uterus. Rejecting the marginalization of any human being or group of human beings that robs them of human dignity, moral theologians pinpoint of the moment of fertilization as the beginning of pregnancy, since science shows us that an embryo has human DNA from the moment of conception. So, when "accepted medical practice is that EC is not an abortive agent," or that EC has no effect on an established pregnancy, "accepted medical practice" does not consider an action of preventing implantation an abortion because it does not consider pre-implantation fertilization a true pregnancy. However, as a Catholic ethicist, Ms. McCarthy should realize that chemical interference with implantation is considered an abortion by the Catholic Church. The controversy among moral theologians revolves around the possibility of identifying whether a rape victim is pre-ovulatory or post-ovulatory. If the point of her cycle can be pinpointed, EC could be administered to pre-ovulatory women to suppress ovulation, but could not be administered to post-ovulatory women because the only action it could have at that point would be abortive. Since current practice and protocols make it difficult to ascertain whether or not a woman has ovulated, some theologians say that EC should never be used. Other theologians say that it is enough to take reasonable measures to determine the point in the woman's cycle.

I do not mean to make an ad hominem attack here, but I have to scratch my head at a medical ethicist for a Catholic hospital system that fails even to get the question right.

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Only one solution?

Ellen Goodman begins her diatribe against the ban on partial-birth abortion by referring to a historical Supreme Court case (under Justice Joseph P. Bradley) that ruled that women are unfit for public life because working outside of the home is contrary to their nature as wives and mothers. She goes on to compare this ruling to the recent Supreme Court decision to uphold the ban on partial-birth abortion, claiming that the Supreme Court is once again trying to legislate what is good for women.

Regulating women (Ellen Goodman ~ Boston... - Care2 News Network

Abortion is inherently harmful to women, their argument goes, because it violates a woman's true "nature," her role as a mother. This would be familiar stuff to Justice Bradley, but Justice Kennedy also wrote about "the bond of love the mother has for her child," suggesting that any true woman would suffer.

I don't deny that some women feel regret as well as relief after an abortion. More than 30 million American women have had abortions since Roe v. Wade. Each unwanted pregnancy comes with its own story of a failed contraceptive or failed relationship, of an economic or a health crisis.

Some women do indeed feel coerced by men or by parents. Surely thousands have suffered from the crisis they faced and the decision they had to make.

But to this range of individual dilemmas, the pro life argument offers only one solution: Criminalize abortion. To this range of life stories, it offers only one kind of "help": Take the decision out of her hands. Now their argument has been folded into a Supreme Court decision. As Yale Law School's Reva Siegel said, "The opinion imagines that the state knows better than women what they really want and need in matters of motherhood."

I want to first focus on the last argument here. Ms. Goodman's argument reminds me of a debate I had with my aunt about the Church's teaching on contraception. She was arguing that contraception must be made legitimate because a woman has the right to protect herself against an abusive husband or boyfriend who pushes sex on her. She argued that in such cases there is no way that Natural Family Planning could work.

My aunt made a very similar argument to Ms. Goodman's, "the only solution the Church offers a woman in such a condition is to get pregnant." The same is true of Ms. Goodman's claim. Is criminalizing abortion really the only solution offered by pro-life groups? Most pro-life groups that I am aware of support a total respect of reproduction, including the promotion of abstinence education (another thing that Ms. Goodman ridicules). Efforts include pregnancy crisis centers, houses for single pregnant mothers, and promotion of adoption. These and other solutions preserve the dignity of motherhood. Far from taking the choice out of women's hands, pro-life groups attempt to empower women to make the best choices, before they choose to have sex and after the natural consequence and purpose of sex occurs in their bodies. It is Ellen Goodman who is removing choice - by narrowing the decision to two options: kill your baby or suffer with an "unwanted baby."

This is exactly the point where Ms. Goodman's modernist philosophy comes to bear. I think I would find my self disagreeing with Justice Bradley's ruling that women should not work outside the home. However, my reason for disagreeing would be very different from Ms. Goodman's. For me, Justice Bradley's argument is a misapplication of a true principle. Women and men are different, and therefore play different roles in society. It does not necessarily follow that they should not be part of the workforce, or that they should not follow careers. In fact, women should be in the workforce precisely because they are different from men. While men approach their careers from the male perspective and in the role of fathers, women approach their careers from a female perspective and in their role as mothers. Motherhood and fatherhood are roles not limited to the upraising of children.

Modernists see Justice Bradley's ruling in a completely different light. Modernists don't believe that there is such a thing as motherhood, or womanhood, or fatherhood, or manhood. For a modernist, his ruling is an imposition of a subjective label (motherhood, fatherhood, male, female) on a culture. Modernists also see his ruling as a power struggle between men and women, in which men try to impose a subservient role onto women in order to keep them under their thumb. They see attempts to interfere with "abortion rights" in the same way.

This viewpoint also feeds into the liberal view of government. For modernists, the purpose of government is to ensure individual liberty, defined as the right to do whatever you want - ultimately, to make up whatever reality you choose to live. If modernists believed in such things, they would have a tough time coming up with any proof that America was founded on this view of government. Contrarily, our country was formed on a much more Catholic view of government. The purpose of government is primarily to protect the common good. The common good includes some fundamental freedoms and rights, but throughout history a society that allowed its citizens to do whatever they wanted whenever they wanted was doomed to failure.

Are gender roles important to the common good? If we examine our culture it doesn't take too much thought to see that our culture is suffering due to the failure of families, higher divorce rates, and lower marriage rates. This is what Justice Bradley was trying to prevent. Keeping women out of the workforce was probably not the way to do it, but a way must be found to bring back parenthood as a value in society and to truly respect gender differences. Government has a stake in this question because how we treat family and gender roles affects all of society.

So what about partial birth abortion? Does government have a stake in the question about whether or not abortion is good for women? Does government have a stake in the question about whether or not a medical procedure should be legal? Clearly, if you consider the purpose of government the protection of the common good, the answer to both of these questions has to be yes. Finally, can somebody please tell me how killing an unborn baby is good for women's health? Let's face it - no matter what your view of gender roles and government, killing babies in order to preserve personal freedom is depraved.

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P.S. Ellen Goodman also makes the following claims:

The abortion-hurts-women argument had its first incarnation in repeatedly debunked attempts to link abortion to breast cancer. Now anti abortionists have fabricated an entire mental illness they name post-abortion syndrome, which has been debunked by study after study.

It is my understanding that Ellen Goodman is simply wrong in calling these findings debunked. Notice that she didn't provide any reference for the studies, which isn't absolutely necessary, but it would be nice if she did. A 1995 study by pro-choice researcher Janet Daling identified specific high-risk groups: women under 18 or over 29 had a twofold increase in risk; women with a family history of breast cancer, an 80% increased risk; and teenagers with a family history who had abortions before they were 18 had an "incalculably higher risk." All 12 of the women in this last category of the study contracted breast cancer by age 45. See also the ABC Link home page

I am less familiar with studies on post-abortion syndrome. It seems to me that PAS is simply an application of Post Traumatic Stress Disorder, identified more in clinical settings than by studies. Certainly the outcomes of such projects as Project Rachel give credence to claims of PAS. However, it is also possible that pro-lifers are overstating their case by giving feelings of guilt and remorse a label as if it were a legitimate psychological disorder. I think pro-life groups do themselves a disservice if this is the case. We don't need to use deception or exaggeration to win our case, and to do so actually hurts our credibility. If anyone is aware of objective studies that show whether or not PAS is real, please leave a comment with the info!

The Myth of Reproductive Freedom

Advocates of abortion do not believe that they advocate killing babies. Most of them actually believe that they are striving for "reproductive freedom" for women. In the last pre-election cycle, a brief editorial advocated the vote for a specific candidate because that candidate was the "only one who will protect reproductive freedom."

What is freedom, as understood morally and by the US Constitution? Many modern Americans mistakenly believe that freedom means the ability to do whatever we want. However, such a definition will not stand up to scrutiny. Certainly our founding fathers did not envision a land without law or restriction. Indeed, much of the political energy expended after the Revolutionary War was in attempt to balance freedom with social order. Nobody would argue that rapists are deprived of their freedom by laws of sexual consent. Few people would argue that suicide should become an accepted practice among American teenagers (there are those who would put harm to others as the only limitation on freedom). The founding fathers understood freedom as the abiliy to maximize one's human potential. This understanding of freedom comes from enlightenment philosophy, but the Enlightenment got it from Catholic moral philosophy. Catholics would add another level, the ability to attain the greatest good, union with God.

Does abortion allow for the attainment of the greatest good, even on a human level? I recognize that a pregnancy before a young woman is ready to raise a family can seem to impede the fulfillment of her human potential. However, avoiding pregnancy and abortion are not necessarily the same option. Sexual restraint actually maximizes a person's human potential. It requires the use of the human faculties. It offers a chance to forge truly loving, life-giving relationships.

Does abortion empower women? Ellen Goodman definitely belives it does. I have to give Ms. Goodman credit where credit is due. In her article, "Taking 'choice' out of Pro-Choice ," she offers a good attempt at a logical, consistent ethic regarding her pro-choice position. She berates the idea of forcing someone to have an abortion - reminding her readers that pro-choice means just that, ensuring that woman have the choice whether or not to have an abortion. That may sometimes mean that they choose not abort. Ms. Goodman's error is to choose to comment on an extreme case (unfortuantely the same mistake made by pro-life advocates such as Cheryl Sullenger from Operation Rescue). She then uses this exreme case to argue against parental notification laws. What if the parents want the abortion, she asks? Would anti-abortion advocates still want parents to have say over their children? Her very question reveals the error of the "reproductive freedom" argument. I don't have to argue from extremes to prove it, either.

Let me offer you an anecdote. A good friend of mine - a former girlfriend, actually - had a one-night stand and got pregnant. She informed the child's father and asked him only for a little help. He told her, "I'll give you money for an abortion. If you don't want an abortion, you're on your own." I ask you - who did abortion empower in this case?

When pro-life advocates talk about women being forced into abortion, we don't have to focus on the extreme cases of "sobbing women dragged into abortion clinics by the neck and hair." Women are forced to have abortions in many more subtle ways. Women are forced to have abortions because their boyfriends offer no other options. Women are forced to get abortions because their parents have sent the message that sexual misconduct would result in being disowned. Women are forced into abortion by a culture that assumes that not having an abortion is foolhardy. No, women don't have the "choice" that Ms. Goodman advocates for them.

That's exactly why the pro-life position is actually more pro-choice than the pro-abortion position. Law is designed to establish a minimal level of morality. Oops - does that word offend you, Ms. Goodman? Let me rephrase. The purpose of law is to establish a level of protection within a society against those who would exploit us or who would have disregard for our safety and our rights in their quest for pleasure.

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Unwanted babies?

An advertisement for Planned Parenthood in Minnesota claims that babies are noisy, smelly, and burdensome unless you want them. Planned Parenthood exists to make sure that every baby is planned and wanted. I teach teenagers and there are days when the same could be said of them. They are noisy, smelly and burdensome unless you want them. There are days when I definitely don't want them. Please, Planned Parenthood, can I kill them too?

Have we really fallen so far as a culture, or is this just a loud voice from a decrepit minority? Have we forgotten what family is all about? Are children and family really about the pleasures outweighing the burdens? Since when have children and family been about me?

Planned Parenthood has forgotten, and perhaps wants us to forget, that children are noisy, smelly, and burdensome whether you want them or not. That’s not the point at all. The point is that they are human persons. Precious human persons are worthy of our self-sacrifice to love. As a father, I put up with the noisiness, smelliness, and burdensomeness of my daughter, not because the pleasures outweigh the burdens, but because she is worthy of love and care. She is worthy of love and care simply because she is a human person.

What about the desire for every child to be a wanted child? This is a beautiful sentiment, if it meant that our hearts would expand in love to accept and care for every child. However, when it means that we demand the right to kill any child that isn’t “wanted,” this statement becomes ugly and evil. What does it mean for a child to be wanted? Planned Parenthood’s main concern is ostensibly that no child be born outside of a loving family environment. Again, this sentiment has the potential to be beautiful, if it meant that we would set aside our desire for sexual pleasure until it could be enjoyed in the context of marriage for the creation of family. Unfortunately, self-sacrifice does not seem to be in Planned Parenthood’s plan. When we as a culture decide to put the enjoyment of sexual pleasure above human dignity and human life, we become shallow, ugly, and selfish. The sentiment that no child should be born outside of a loving family environment paired with the sentiment that sexual pleasure should be pursued on a hedonistic, narcissistic level creates a dark, evil sentiment indeed. Let the children die that I may have my orgasm.

I pray that the billboard posted by Planned Parenthood is a minority voice. I would like to think that people passing by this billboard were as disgusted by it as I was just hearing about it. However, I fear that we may have been lulled into acceptance of such nonsense. We have been inundated with propaganda about “reproductive rights” and “sexual freedom.” Now that we are struck with the idea that a child is useless unless it is “wanted,” do we even bat an eye? We are being drawn along slowly, imperceptibly toward a public acceptance of narcissism, hedonism, and death. Do we really want to go there?

In the love of Christ,

Jeff