Conclusions About the Science
In this space I will not re-present the science from previous articles. But, conclusions must be articulated:
Father Austriaco, a faithful priest and scientist who defends the German bishops’ decision, argues that we can have scientific and moral certitude that an abortion will never occur if Plan B is administered any time during a woman’s fertility cycle. And although the studies by Noe et. al make this conclusion increasingly difficult to defend, two studies by the same team do not a scientific consensus make. I believe a potential abortifacient effect of Plan B has neither been disproven nor proven. I believe that the current status of the science indicates that if there is an abortion inducing effect it may be (or is likely to be) present when Plan B is administered during the fertility window prior to the LH surge that initiatives ovulation.
A non-invasive test for luteinizing hormone (LH) may determine if a woman is within her fertility window. Results of this test have been used to determine whether or not administration of Plan B might cause an early abortion. To my knowledge, the majority of faithful Catholic ethicists have supported such a test. A negative test (often confirmed by a serum progesterone test) followed by administration of Plan B is the accepted practice in many Catholic hospitals and dioceses. It seems that the Noe et. al. study, explained by both Drs. Yeung and Peck and their co-authors necessitates a reconsideration of this protocol.
Secondary research (that is, analysis of primary scientific research) and ethical analysis likely will be ongoing in Catholic dioceses and hospitals. This will take time. We should neither rush to conclusions nor ignore inconvenient evidence. Catholics may not in good conscience do the original scientific research necessary to answer the scientific questions because we cannot cooperate in immoral research. So, we have to wait patiently as a scientific consensus (hopefully) emerges.
Prudential Certitude not Scientific Certitude
Allison LeDoux has argued that we should “not proceed in doubt” and “when in doubt, choose life.” Her expression of this important principle requires, I believe, an important qualification. A compelling and reasonable doubt is required to force an individual to refrain from acting. The practitioner is moved by her duty to protect the woman from the completion of the grievous act of rape. In light of this obligation, only a reasonable doubt should prevent a practitioner from administering Plan B as she secures the care the victim deserves.
Prudence requires us to pursue the safer course of action when a reasonable fear of being in error or of causing harm moves us to refrain from an action. We rarely if ever have absolute certainty that a specific action cannot lead to loss of life. To require absolute certainty in this case is to apply an unreasonable standard that can never be met for any proposed human act.
Prudential certitude, not absolute certitude, is the kind of certitude we must have to proceed. As Dr. John Haas has written:
Prudential certitude cannot remove every concern about a proposed course of action. But it does remove any concern which would prevent one from acting. And it certainly is not a ‘lower standard’… It is rather the appropriate standard applied to moral action even in the midst of ambiguity. Again, if one waited for absolute certitude, one would never act, one would be incapacitated” (Ethics and Medics July 2008).
The essential question is does the data presented in this series (and elsewhere), especially by Drs. Peck and Yeung, present a concern which would prevent a hospital or practitioner from dispensing Plan B?
The current state of the science compels me to say that Plan B should not be administered in Catholic hospitals. I am unconvinced that the LH test can prevent early abortions because an LH test reads negative during the first few days of the fertile window which is precisely when Noe et al. indicate abortions are likely to occur. Unless there is a sea-change in the science, or research that I am unaware of, I do not think administration of Plan B can be pursued in good conscience.
Attacking Bishops
We need to respond with dignity and respect if we disagree with the conclusions of bishops. We have no reason to believe that the German bishops did anything other than responsibly fulfill their role as teachers of faith and morals as they relied on the science presented to them in applying the Church’s teaching to a specific question. Further research and time will tell whether their conclusions were correct.
We all hold the same principles that are at stake. If we disagree with one another’s conclusions it may be because we lack formation. It may be because the science studied is deficient in some way. We should, therefore, engage the bishops as human beings, recognizing that they too are capable of having ill-informed advisors, of making wrong prudential judgments, but trusting that they are willing to discuss such matters. In other words, make the argument that may actually have a positive impact, to the people who may need to be impacted.
Conclusion
The bishops of the United States and Germany are fully aware of the Church’s teaching as expressed in Dignitas personae: “Anyone who seeks to prevent the implantation of an embryo which may possibly have been conceived, and who therefore either requests or prescribes such a pharmaceutical, generally intends abortion (no. 23).” They also are aware that women have a right to protect themselves from the aggressor and we have a responsibility to support them in doing so.
The fundamental teaching of the German bishops and U.S. bishops reveals no contradiction: If and when a contraceptive will not cause an abortion it may be administered in cases of rape. If and when a contraceptive is likely to cause an abortion it may not be administered. Researchers, medical practitioners, ethicists, and bishops are working together to ensure that the care given to victims of rape is secured and to ensure that such care never lead to another innocent victim of abortion.
Read part 1, part 2, part 3, part 4, and part 5 of this series.
*This article has been updated from its original version.
Arland K. Nichols served as HLI’s director of education and evangelization and executive editor of the Truth and Charity Forum until February 2014. He is currently president of the John Paul II Foundation in Texas, where he resides with his family.
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