An unforeseen, positive effect of the HHS mandate’s dramatic affront to religious liberty is to have brought renewed attention to the abortive effects of contraception. But there still needs to be far more discussion of their full moral import—for social policy, institutional behavior, conscience rights, voting behavior—and, ultimately, pro-life rhetoric.
This essay makes two points. First, the Catholic tradition holds that even when there is medical dispute about whether contraceptives act as abortifacients, morality requires that one should treat them as having these effects. Second, the pro-life community, on balance, has hardly yet addressed the serious implications of this principle.
What does medical science say about the abortive effects of contraceptives?
There are many persons with serious concerns. The Charlotte Lozier Institute published a review titled “New Studies Show All Emergency Contraceptives Can Cause Early Abortion.” Another recent review published by the National Catholic Bioethics Center challenges claims that so-called “Plan B One-Step” does not have these effects. There has been ongoing concern about the effects of the “everyday,” non-emergency “pill.” Quick caveat: anyone who wants to wade into the medical literature, or reads popular press opinions about the abortive effects of contraception, should beware of unscientific, Lysenko-like ideological ploys to redefine when pregnancy starts.
Shifting to morality, the Catholic tradition regards use of contraceptives as gravely wrong. Still, we must consider whether uncertainty about their abortive effects reduces whatever additional gravity abortifacient contraceptives involves—and whether their use is tantamount to surgical abortion.
What do Catholic writers say?
Germain Grisez says “in general, a person who is willing to do what is wrong and is uncertain because of a doubt of fact how grave that wrong will be, is willing to do the more serious wrong” and applies this point to the abortive effects of contraceptives. Compare the Catholic Encyclopedia’s point that “the virtue of justice demands equality, and as such excludes the use of probability when the established rights of another [compare here the fertilized embryo] are concerned.” Also, the moral theologian Henry Davis, S.J. claims:
[O]thers may have certain natural rights which it is wholly unlawful for us to invade; even a probable invasion of such rights will be entirely wrong, where there is no countervailing probable right on our side. Thus, for example, an innocent man has a right to his life. Consequently, I may not shoot at an object which is very probably not a man at all, though probably it is. My very probable conviction that it is a wild beast will not, as a fact, safeguard the man, if a man happens to be there, and every man has a right that I should not take the risk or injuring or killing him (Moral and Pastoral Theology, volume I, p. 99).
While the Catholic tradition does not necessarily condemn the shooting of a “wild beast,” it condemns use of contraceptives. Nonetheless, the cases are relevantly similar; in each case one should always respect innocent human life.
Mathew Lu in effect agrees with these authors, though does not address disputes about double effect (an important aspect of Catholic moral analysis) in relation to use of contraceptive agents in rape cases. Without going astray into a big topic that deserves a separate essay, suffice it to say these authors’ point extends to non-rape cases and (in my view) disposes us to the utmost life-respecting position in analyzing rape cases.
Does the tradition agree with all these authors? The 1974 Declaration on Procured Abortion states (section 13): “From a moral point of view this is certain: even if a doubt existed concerning whether the fruit of conception is already a human person, it is objectively a grave sin to dare to risk murder.” While the focus here is on the issue of personhood of the embryo, this statement agrees with the above writers’ moral premises. Also, Dignitas Personae (2008) states in section 23:
It is true that there is not always complete knowledge of the way that different pharmaceuticals operate, but scientific studies indicate that the effect of inhibiting implantation is certainly present, even if this does not mean that such interceptives cause an abortion every time they are used, also because conception does not occur after every act of sexual intercourse. It must be noted, however, that 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.
The use of the word “possibly” indicates that one who intends to prevent implantation is guilty of abortion even when there is uncertainty. The views expressed by the writers above strongly criticizes the stance of persons who claim they only intend contraception and do not seek to prevent implantation, if they know that the latter is a possible effect.
So these writers and the tradition affirm that, in situations of doubt whether contraceptives have abortive effects, one should act as if innocent life is in danger. This principle has radical implications for individuals, institutions, and social policy.
The Principle Applied to Concrete Situations
First, the principle—that doubt about the abortive effects of contraception in no way justifies its use—challenges pro-lifers who defend contraception. Writing in the Atlantic online, Karen Swallow Prior remarks “I have never understood pro-lifers’ squeamishness at the morning after pill absent the same concern with the daily pill—except perhaps the latter hits a bit closer to home for so many.”
Also, this moral point (again, doubt about the abortive effects of contraception in no way justifies its use) also challenges self-described Catholic institutions, e.g. colleges or universities, that comply with the HHS mandate. These institutions cooperate not just with contraception, but with a potentially significant number of abortions. Their administrators and trustees might argue that they only materially and remotely cooperate with the mandate. But would they be willing to cooperate with the government in this way if the mandate concerned surgical abortion? If not, why not? Had the pro-life movement recognized the full import of the moral principle above, far greater pressure would now be placed on these institutions—including by the bishops.
The moral principle also challenges Catholic politicians who regard themselves as “pro-life” and yet actively promote use of contraceptives. The office of Senator Bob Casey (D-PA), for example, sent me a letter that affirms pro-life views but also contraceptive use: “with more than half of unintended pregnancies ending in abortion, I believe that responsible family planning is essential to reducing the number of abortions.” The letter of course does not distinguish contraceptive types, suggesting that the Senator not only trivializes his Church’s ban on contraception, but that he is not concerned about the abortive effects of contraception. (Concerning the letter’s claim, unaccompanied by reference to any study, that contraception reduces abortion, see Evangelium Vitae, section 13.) Also, a letter by Barbara Comstock, a Republican running for Congress in Virginia, openly promotes contraceptive use and makes no mention of abortive contraceptives.
The moral principle is also very relevant globally. Funding of so-called “reproductive health” initiatives is central in many economic development schemes. Pro-lifers need to ensure that abortive contraceptives are encompassed under any legislation that precludes funding of abortion in foreign aid.
Also, given this principle, there is even greater urgency to enact conscience protections for doctors and pharmacists unwilling to prescribe abortifacient contraceptives. A court evaluating their cases cannot dismiss their concerns by saying abortive effects of contraceptives are relatively improbable. Even in that scenario, the conscience claims are still serious.
Finally, consider two political candidates. I will not address here whether or not this is a primary election, which may figure in the calculus of voting decisions. One is pro-life and publicly opposes use of abortive contraceptives or contraception generally. The second also claims to be pro-life but promotes contraception without distinguishing types thereof. For whom should we vote, assuming all other things are equal? The first candidate, if we take seriously the value of innocent human life.
Of course, all other things are not always equal. For example, would the candidate’s views on other issues be relevant? Likely not. There are many grave social evils, but none so serious as the threat to innocent human life.
Or what if candidate two’s prospects of winning are greater than those of candidate one, e.g., precisely because of candidate one’s controversial views on abortive contraception or contraception generally? For the sake of the pro-life cause and on prudential grounds, would it be better to vote for candidate two, especially if she or he faces a pro-abortion candidate in the contending party?
Grisez has relevant things to say here for persons who want to explore this issue. However they decide to vote, Catholics who have visible, influential leadership roles, and who shape public opinion, should never endorse any pro-contraceptive candidate without also publicly criticizing that candidate’s endorsement of contraception. They should also make it clear that it is merely prudential considerations about the “lesser evil” that leads them to endorse a problematic candidate.
Some pro-lifers will likely argue against making the abortive effects of certain contraceptives an issue in the public square, as this will undermine the unity or political viability of the pro-life movement. Such effects, however, are very hard to measure, and this assessment is merely speculative. Also, the assessment commits one to holding innocent human lives hostage to questionable prudential judgments.
An alternative approach recognizes that pro-lifers need to face, far more squarely, the moral challenges posed by abortive contraceptives. Few pro-lifers want to think about the stark implications of the principle that we must respect innocent life even when there is doubt about the effects of contraceptive use. But the pro-life movement must do far more to address these implications, and sooner rather than later, lest the status quo persist indefinitely—and continue to worsen.
A linguistic point: The medical textbook quality of the term “abortifacient” distracts. We should work to purge the language of the clunky terms ”abortifacient contraception” and “abortifacients” and replace them with the more direct and informative terms “abortive contraception,” or better yet, “abortives.”
Far more public discussion of abortive contraceptives—abortives—can provide a vehicle for addressing the ravages of contraception more generally. These ravages include not just the harmful effect of chemically polluting the bodies of women, or contraception’s effects on marriage, or questions about environmental damage, but also on how intertwined contraception—regardless the type—is with abortion.
The heightened attention the HHS mandate has brought to the abortive effects of contraception creates an opportunity to reshape pro-life rhetoric. It is an opportunity worth seizing.