In cases of rape, a woman or her healthcare provider may use contraception to prevent the conception of a child as a result of the rape. This use of contraception is indirect, and therefore not intrinsically evil. Contraception is immoral because sexual intercourse naturally proceeds toward conception. For the same reason, use of contraception in cases of rape is, morally, an interruption of the rape. The object is to interrupt the rape, as it continues toward conception. Since the object of the act is good, all that is needed is only good in the intention and that the reasonably anticipated good consequences morally outweigh the bad. Thus, mere contraception is moral in cases of rape.
However, most hospitals will not only use mere contraception, such as lavage or spermicides, but also emergency contraception (EC). The latter is a chemical contraceptive which may have both pre- and post-fertilization mechanisms of action. Studies show conflicting information on which forms of EC are abortifacient and which are perhaps not. Given that a type of EC has both contraceptive and abortifacient properties, can abortifacient contraception be used in cases of rape?
In theory, if the physician or woman has moral certitude that the abortifacient contraception will only work as a contraceptive in that particular case, then the chemical contraceptive would be moral to use. It would function, then, only as a contraceptive, and contraception in cases of rape is moral.
However, there are a number of factors that need to be considered to arrive at that moral certitude. What is the elapsed length of time between the rape and the use of EC? The shorter the time, the greater the likelihood of contraceptive, rather than abortifacient mechanisms of action. Where is the woman in her cycle? If ovulation has not yet occurred, then the EC is more likely to work as a contraceptive. Has the woman already conceived, prior to the rape, by consensual sexual relations? Would the abortifacient contraception terminate the life of that earlier conception? In theory, the physician or the woman could determine, by answering the above questions, whether or not the EC would work as an abortifacient.
In practice, most physicians working in a Catholic hospital or specifically in the emergency department of a Catholic hospital are unwilling to make such a determination. In the face of permission to use abortifacient contraception after determining the above facts, they would fill out the requisite form with the answers needed to obtain permission, and then use the abortifacient. Physicians and nurses are quite willing to lie, if they think that a particular medical intervention is needed for the care of their patient. And hospital administrators do not have the influence to obtain compliance with rules concerning the use of abortifacient contraception in cases of rape.
Therefore, permission to use EC which is both a contraceptive and an abortifacient would result in the indiscriminate use of that intervention. Over time, a percentage of cases of rape would result in a number of abortifacient events.
In theory, abortifacient contraception can be used in cases of rape, if it will not work as an abortifacient for that particular medical case. But it is highly unlikely, in the current social and religious climate, that emergency department staff will discern one case from another. In addition, attaining moral certitude is difficult, as some women have irregular periods, some women will have been sexually active prior to the rape, and time between rape and treatment may be lengthy. Therefore, Catholic hospitals should not use abortifacient types of contraception, even in cases of rape. They should use only interventions that are purely contraceptive in nature.
Abortifacient contraception would be moral in cases of rape, if the physician or woman could be morally certain that it would act only as a contraceptive, in any particular case. Unfortunately, all of the currently available forms of Emergency Contraception (EC) are highly abortifacient. They obtain more than 50% of their effectiveness from abortifacient mechanisms of action.
Ronald L. Conte Jr.
Roman Catholic theologian