In recent weeks, much has been made of a comment by Dr. James Trussell, a professor of economics who is considered an expert on the use of emergency contraception. In a paper published last month, Dr. Trussell and his colleague, Dr. Elizabeth G. Raymond wrote: “To make an informed choice, women must know that [emergency contraceptive pills]…prevent pregnancy primarily by delaying or inhibiting ovulation and inhibiting fertilization, but may at times inhibit implantation of a fertilized egg in the endometrium.”[viii] Some have taken this statement as an admission that all morning-after pills are inherently contraceptive.
These same individuals, however, neglect to point out that Trussell and Raymond, in the very same paper published last month, after summarizing the scientific evidence that I described above regarding the non-abortifacient mechanism of action of levonorgestrel, conclude their analysis with the following lament about those who just cannot accept weight of the scientific evidence: “While some find the existing human and animal studies adequate to conclude that levonorgestrel-only ECPs [emergency contraceptive pills] have no post-fertilization effect, others may always feel that this question has not been unequivocally answered.”[ix] The data cited by Trussell and Raymond should speak for itself: Women should be told that most — but not all –morning after pills can be abortifacient in nature.
In light of Trussell and Raymond’s observation about those who cannot accept the scientific evidence, I need to address the link between scientific certitude and moral certitude. In view of the numerous scientific studies I have summarized here, I claim that we can be scientifically certain that Plan B is neither an interceptive nor an abortifacient when it is taken as an emergency contraceptive.
In other words, I claim that the cumulative scientific data from numerous labs using a diverse range of scientific approaches and protocols – especially the relatively recent finding that Plan B does not alter the post-ovulatory hormonal profile of a woman who takes the drug prior to her LH surge – together makes a strong case for the proposal that it is very unlikely that Plan B has a post-fertilization mechanism of action.[x]
But is this scientific certitude enough for moral certitude? From my reading of the Catholic moral tradition, moral certitude includes that certitude that allows the acting person to act even when he may think that it is possible but unlikely that he is mistaken. This certitude is what moralists have called imperfect moral certitude.[xi]
According to the consensus of the Catholic moral tradition, it is sufficient to act if one only has imperfect moral certitude.[xii] As St. Thomas Aquinas explained: “For in human acts, on which judgments are passed and evidence required, it is impossible to have demonstrative certitude, because they are about things contingent and variable. Hence the certitude of probability suffices, such as may reach the truth in the greater number of cases, although it fail in the minority” (Summa Theologiae II-II, q. 70, a. 2).
Significantly, imperfect moral certitude is the type of certitude that would allow an individual to act on the basis of scientific research, even though he may worry that an unlikely but future still unpublished scientific finding could undermine his current settled certainty regarding the morality of his actions. It is a certitude grounded on the judgment that the weight of the scientific evidence is such that it is unlikely that the results of a future scientific study would invalidate the scientific conclusions drawn from the available already-published data. In other words, it is a moral certitude that emerges from scientific certitude.
Consequently, I think that one of my primary responsibilities as a Catholic priest, who in the providence of God is also a biologist and a moral theologian, is to provide the Catholic physician and other health professionals of good conscience with the scientific information that they will need to make the prudent moral judgments required for them to virtuously minister to victims of rape.
However, using both prayer and reason, each physician then has to evaluate the scientific evidence I have summarized above and the argument that I have made for Plan B’s non-abortifacient mechanism of action in order to determine if he or she could prudentially administer the emergency contraceptive to a victim of sexual assault who requests it in a moment of crisis.
For some – and from my own conversations with Catholic physicians, for most – the scientific findings described above and the argument I have made will be enough for them to administer Plan B to a survivor of rape without the fear that they are contributing in any way to an abortion. For others, the science will not yet be enough.
Read part 1, part 2, and part 3 of this series. The next article in this series presents the scientific evidence that indicates that early abortions may occur if Plan B is administered during the “fertile window.”
[i] Thomas J. Davis, Jr., “Plan B Debate Not Resolved,” NCBQ 10 (2010): 641-644.
[ii] Task Force on Postovulatory Methods of Fertility Regulation, “Randomized Controlled Trial of Levonorgestrel Versus the Yuzpe Regimen of Combined Oral Contraceptives for Emergency Contraception,” Lancet 352 (1998): 428–433; Von Hertzen et al., “Low Dose Mifepristone and Two Regimens of Levonorgestrel for Emergency Contraception: A WHO Multicentre Randomised Trial,” Lancet 360 (2002): 1803–1810; Arowojolu et al., “Comparative Evaluation of the Effectiveness and Safety of Two Regimens of Levonorgestrel for Emergency Contraception in Nigerians,” Contraception 266 (2002): 269–273; Noe et al., “Contraceptive Efficacy of Emergency Contraception with Levonorgestrel Given Before or After Ovulation,” Contraception 81 (2010): 414-420; Noe et al., “Contraceptive Efficacy of Emergency Contraception with Levonorgestrel Given Before or After Ovulation,” Contraception (2011) in press.
[iii] Durand et al., “Hormonal Evaluation and Midcycle Detection of Intrauterine Glycodelin in Women Treated with Levonorgestrel as in Emergency Contraception,” Contraception 82 (2010): 526-533.
[iv] Ibid.
[v] Ibid., pp. 531-532.
[vi] Noe et al., “Contraceptive Efficacy of Emergency Contraception,” Contraception 81 (2010): 414-420; Noe et al., “Contraceptive Efficacy of Emergency Contraception,” Contraception (2011) in press.
[vii] Verpoest et al., “Relationship between Midcycle Luteinizing Hormone Surge Quality and Oocyte Fertilization,” Fertility and Sterility 73 (2000): 75–77.
[viii] James Trussell and Elizabeth G. Raymond, “Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy.” Available at http://ec.princeton.edu/questions/ec-review.pdf. Cited by John Jalsevac, “Swiss bishops approve morning-after pill in cases of rape.” LifeSiteNews.com: http://www.lifesitenews.com/news/swiss-bishops-approve-morning-after-pill-in-cases-of-rape
[ix] Ibid.
[x] Often moral theologians and other non-scientists who have read my work or who have listened to me speak about the mechanism of action of Plan have told me that, in their opinion, the weight of the scientific evidence “demonstrates” or “strongly indicates” that Plan B is not and cannot be an abortifacient. As I explained earlier, however, as a biologist, I hesitate to make such a strong affirmative statement about the mechanism of action of Plan B because I can never rule out the possible rare case of a woman whose biological response to LNG differs so significantly from the vast majority of women who take the drug that she would experience the detrimental endometrial effects that heighten the risk of an abortion.
[xi] Thomas Slater, S.J., A Manual of Moral Theology, Volume 1, 5th ed. (London: Burns Oates & Washbourne, 1925), pp. 31-32.
[xii] Ibid.
Fr. Nicanor Pier Giorgio Austriaco, O.P., currently serves as associate professor of biology and instructor of theology at Providence College in Rhode Island. He earned his Ph.D. in Biology from M.I.T. and his S.T.L. in Moral Theology from the Dominican House of Studies in Washington, D.C.
Pages: 1 2