Friday, November 18, 2005

The other day David brought to my attention an article that can be found at http://www.realclearpolitics.com/Commentary/com-11_17_05_SC.html. According to the author, the "morning-after" pill is not what we've all been told it is. The article sparked some interesting (and potentially important) questions about both the "official" Catholic and Protestant positions on contraceptives. What is more important: the motive for using them, or the particular method used? Or are both important? I heard good arguments on all sides. I'm still thinking.

Along similar (but distinguishable) lines, I found a post on Mirror of Justice from last Wednesday particularly on-point about perspectives on abortion. It can be found at http://www.mirrorofjustice.com/
mirrorofjustice/2005/11/avoiding_pain.html
.

9 comments:

Monkey Lung said...

It seems this blog takes a turn toward healthcare once again. Let me state what I know about the morning after pill, which is a very small amount, and then let you debate what you will.
The morning after pill has been around for quite sometime and is no different from traditional oral contraceptives (in fact, the chemicals are indentical) except for the dosage and timing of use. Some of the article you refer to is correct. The newer Plan B method uses a progesterone only formula (largely because the side effect profile is better) which does work primarily by inhibiting pre-fertilization events such as ovulation and sperm motility. Previous formulations which are still on the market inlcude mixtures of estrogen and progesterone and estrogen only formulas. Estrogen acts primarily by inhibiting implantation. Estrogen/progesterone mixtures have been shown to be most effective (not nearly as effective as traditional oral contraceptives, mind you) but progesterone formulas have come into popularity becasue of less nausea/vomiting associated with them. Interestingly, studies correlating the time of administration during the menstrual cycle with emergency contraceptive use show the progesterone formulas are far less effective at preventing post-ovulation pregnancy (17%) vs pre-ovualtion pregnancy (85%). This would lend support to the point the article is making. However, no one can be absolutely certain what is going on in a woman's uterus at any given moment and who are we to say any number of benign activities a sexually active woman enganges in everyday do not inadvertently terminate numerous potential pregnancies? Epidemiologic data about miscarriage show 1/3 of women will miscarry at least one pregnancy; that they know of. Most believe these numbers to be far higher. So where does that leave us? Mucking around in molecular probabilities to justify or prohibit a potentially morally unexceptable healthcare practice? There are interminable lines to be drawn within the molecular process of fertilization itself if one really wants to draw the line there. I too am torn on this issue. The best position I can come up with is that abortion is a nasty thing no matter how you look at it and everything within our power should be done to prevent and lessen the number of abortions that happen every year. As for contraceptives, you can make your own decisions there. Traditional oral contraceptives do work by preventing fertilization, mainly by making it difficult for sperm to reach the fallopian tubes, so no more controversy than using a condom there. The type of morning after pill used would seem to make a difference if fertilization is your moral alamo, but the whole mess seems to involve far too much imagination about what's happening inside a woman's uterus at any given moment. Better to work on education aimed at avoiding the need to use the pill (it's not the safest thing in the world) than at expanding access to it or celebrating it as a way to prevent abortion.

Becca said...

One point raised in coversation: is there a moral difference in abstaining from an act that naturally leads to pregnancy, and in engaging in the act and trying to prevent its natural consequence? I had not thought of it before in that light. My Catholic friends make a point; I just haven't decided how significant I think it is. If the only reason you think contraception is wrong is because it is some form of "playing God" by deciding when you will have have kids, your moral questions only involve probabilities. But it is a different issue altogether to raise the question of whether you are trying to escape the natural consequence of an action. I think you are right to point out that this is an issue best left to each individual's conscience. It is still important for each to be persuaded in his or her own mind, though. Good questions to ask...

Good thing it doesn't matter yet.

Monica said...

The "natural consequences" argument makes me a little leery. It's not necessarily a bad thing to try to escape natural consequences. Were God to send you as a missionary to an area rife with malaria, would you not take the preventative medicine before you went and while you were there? It would seem that knowingly going to an area that is dangerous to your health and taking drugs to maintain your health would count as trying to prevent natural consequences.

To address the morning after pill itself, perhaps the reason there has been so much outcry is because people get Plan B messed up with RU-486, which is a rather dreadful drug. RU-486 was actually designed to be taken as soon as you thought you were pregnant, and it caused an abortion and expulsion of the devoloping fetus. So if your line is implantations, this did create a moral problem. But morality aside, it was horribly dangerous. Many girls died from hemorrhages or infections from parts of the uterine lining that didn't get all the way out. The FDA was perfectly right to refuse to license that drug for sale here in the States.

It seems to me though, that if you don't have a problem with oral contraceptives, then you shouldn't have a problem with Plan B.

Monica said...

Correction to my last post: the FDA did license RU-486 for sale in the US.

The Bard said...

Monica's "natural consequence" point is a good one, and I want to use it to make one of my own.

I had numerous discussion on this subject over the summer b/c my religous liberty intern program included a larger percentage of Catholics, and it seemed to be one of their favorite subjects. Having thought the issue out, I think the bigger picture is how we define "action" when determining sin. This includes the distinction between "action" and "inaction," and also deciding where, in a chain of events, "the action" lies. Further, is the sin in an act, a motive, or both?

This question is essential because it is what we lawyer outcome-determinative (how you answer it decides how the issue comes out), and because it applies in many other areas, some much more relevant to my immediate future than contraception. I reject the Catholic view of contraception because I cannot accept their views of where the "action" is. Likewise, I think their support of NFP is inconsistent for the same reason Any Catholic friends on the Blog--that means you, Chad--are welcome to argue differently and I shall respond.

The Bard said...

PS-however, I am even more interested in the action/inaction dichotomy, in case anyone else is.

Monica said...

I'm willing to move the action/inaction question over to my blog, if that's agreeable to all. I'll put a post up later today, once I've finished reading David's law review article.

Becca said...

I get it, Monica... You're just trying to attract more visitors to your blog by stealing interesting topic strands from mine! Ha! I'm on to you, kid! :-) (Rock on, I don't really mind.)

Monica said...

You know, Becca. That's exactly what I'm trying to do. (insert evil, diabolical laugh)