Msgr. William Smith on Catholic teaching about "emergency contraception"

Editor's note: The following is from Monsignor William Smith's Modern Moral Problems: Trustworthy Answers to Your Tough Questions (Ignatius Press, 2015). Monsignor Smith, who died in 2009, for many years wrote a regular column for Homiletic & Pastoral Review. This particular question-and-answer appeared in the March 2004 edition of HPR; it appears on pages 147-151 of Modern Moral Problems.

Emergency Contraception

Question: Various bills and regulations propose to mandate “emergency contraception”. Not all Catholic responses to this movement seem to say the same thing. How does this stand?

Answer: I agree with your uncertainty: not all Catholic responses are the same response to this challenge. What I take to be the clearest and best response is that of Dr. Eugene F. Diamond: “The Ovulation or Pregnancy Approach in Cases of Rape?” [18] Indeed, Dr. Diamond writes in response to and presents a critique of Drs. Ronald Hamel and Michael Panicola’s “Emergency Contraception and Sexual Assault”. [19]

A first problem is terminology, i.e., the very expression “emergency contraception” seems to beg the question that needs to be answered. Is this simply a question of contraception or does it risk abortion and is called “emergency contraception” to distract attention away from the abortion problem? Once this is called “contraception”, the public relations effort is probably lost.

Some of the general public will give some space for Catholic institutions and Catholic individuals to distance themselves from any participation in abortion procedures and abortifacients. However, the same general public is not so willing to allow or acknowledge Catholic reluctance about contraception. Thus, by calling this “emergency contraception”, the impression is given and taken that the only point at issue is “contraception” when, of course, the crucial point at issue is the risk of abortion and abortion consequences.

In the conventional terms of the 1950s, when the term contraception meant diaphragms, the case for self-defense against rape was and remained a defensible opinion. This was the reported advice of the German bishops to German women in post-war Berlin, then occupied by the Red Army, an army not known for good manners. However, during the “Nuns in the Congo” case in the early ’60s and the rapes in Bosnia in the early ’90s, the contraceptive in question was no longer a simple barrier method to prevent conception, but rather the birth control pill—at first called an anti-ovulant or anovulant.

This is and remains the problem. The pill is not simply or only a chemical method of preventing ovulation. All commercially available birth control pills marketed in the United States have some abortifacient properties. This element raises some moral questions that simply did not exist in the post-war Berlin context.

To approach this dilemma today, some Catholic authors speak of a “Pregnancy Approach” while others speak of an “Ovulation Approach” in the aftercare of rape victims. An example of the former is the Hamel and Panicola article in Health Progress cited above; an example of the latter is Peter Cataldo in Catholic Health Care Ethics. [20]

In the pregnancy approach, only a pregnancy test is given. If a woman has been raped while pregnant, the need for post-rape hormone therapy is moot, indeed counterproductive. If she is not pregnant, this approach presumes the emergency contraceptives will only prevent ovulation, sperm migration, or sperm conception—these are seen as selfdefensive contraceptives in this context. However, multiple-dose oral contraceptives can also have the effect of disturbing the receptivity of the endometrium, which does not prevent conception but prevents implantation and is thus in effect abortifacient.

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