For more information about The Campaign try these links.

http://www.thenationalcampaign.org/

http://www.stayteen.org/

http://bedsider.org/

It started around February, when Republicans were still eager to talk about contraception. The Obama administration, or so Mitt Romney charged in Colorado, was forcing religious institutions to provide “morning-after pills –in other words abortive pills — and the like, at no cost.”

It was, of course, a lie. Romney was conflating two different pills: emergency contraception, known as the morning-after pill, which prevents a pregnancy; and chemical abortion, or mifepristone, which ends a pregnancy of up to seven weeks’ gestation and isn’t covered under the new guidelines. Since both pills were marketed in the U.S. around the same time, even some pro-choicers have gotten confused. But Colorado happens to be the epicenter of people confusing them on purpose. It’s the birthplace of the Personhood movement and home to Focus on the Family, both of which have strategically called emergency contraception “abortion” on the scientifically unproven basis that they could block a fertilized egg from implanting.

There are a host of ironies here. Obama has earned the renewed support of reproductive-rights advocates by requiring health insurers to cover contraception, but the Center for Reproductive Rights is still taking him to court – with oral hearings being held this week before a New York federal court -– for overruling the FDA’s recommendation to lift the prescription requirement on emergency contraception for women under 17. That litigation has been winding its way through the system for over a decade, throughout the Bush-era politicization of the FDA, eventually resulting in a federal judge concluding that “the FDA repeatedly and unreasonably delayed issuing a decision on [the emergency contraception pill] Plan B for suspect reasons.” The FDA was ordered to explain why Plan B shouldn’t be available over the counter for girls 13 and up. When the Obama administration overruled the FDA’s recommendation to make it over the counter, U.S. District Judge Edward Korman suggested the Center for Reproductive Rights reopen its case.

“It seems to me that what we’re going through is a rerun of what happened before,” Korman remarked, referring to politics trumping the recommendations of medical professionals.

The Obama administration’s unspoken but unmistakable fear was of an election-cycle attack line that Michele Bachmann would use anyway: That teenage girls would be able to get Plan B from “the grocery store aisles next to bubble gum and next to M&Ms.” That was, in fact, an echo of the language President Obama himself used to invoke a highly unsupported bogeyman: that “a 10-year-old or 11-year-old going to a drugstore would be able to, alongside bubble gum or batteries, … buy a medication that potentially if not used properly can have an adverse effect.”

But there is another twist, so far mostly overlooked: Emergency contraception won’t be covered by insurance for everyone, since it’s available over-the-counter for those who can show I.D. proving that they’re 17 or older. They’ll still have to fork over around $50 a pop. But as long as girls 16 and younger need a prescription for the morning-after pill and they have insurance, it will be fully covered — effectively free. The same goes for women older than 17 who decide to jump through the hoops of getting a prescription, either for over-the-counter Plan B or the prescription-only generic and Ella versions.

As much as pro-choice advocates want to lift the barriers that make emergency contraception hard to get — because it’s more effective the faster you use it — one of those barriers, the prescription requirement, also mitigates another, the high cost. Said Adam Sonfield, a senior public policy associate at the Guttmacher Institute, of this catch-22, “It presents a tradeoff between cost and access.”

– – — – — – — – — – — – — – — – — – — – — – — – –

Part of the reason people get confused about emergency contraception and abortion is because lots of people are confused about the basic biology of pregnancy: specifically, that it doesn’t necessarily happen instantaneously and that sperm can live in the body for several days, during which time a woman can ovulate and an egg can potentially be fertilized and implant. Regular use of hormonal contraception prevents ovulation and the chance for fertilization; emergency contraception essentially works the same way except that it’s taken after sex, by which point ovulation may have already happened. But according to recent studies, there is no evidence that taking emergency contraception after ovulation and fertilization will stop the egg from implanting.

But the misinformation and misunderstanding have created a contradictory public health picture when it comes to emergency contraception. In some ways, it’s become more accessible. In 2010, the U.S. approved a longer-acting French variant of Plan B, known as Ella, and there are scattered experiments in convenient delivery, from a birth-control vending machine at Shippensburg University in Pennsylvania to a new bike messenger service in London, both of which caused minor news sensations. The annual “Back Up Your Birth Control” campaign has been promoting the line “EC=BC,” emphasizing that emergency contraception is birth control, not abortion — just in case that is a barrier for women who are considering taking it. And the Center for Reproductive Rights’ petition did manage to lower the age restriction from 18 to 17.

But there are more disturbing suggestions that misinformation is triumphing. A recent Boston Medical Center study found that many pharmacists were still often misinformed about the age requirement and were even more likely to wrongly refuse emergency contraception to 17-year-olds in low-income neighborhoods, where the rate of unintended pregnancy is higher. In Honduras, the Supreme Court upheld the criminalization of emergency contraception, which means women who use it could be jailed. Personhood initiatives, which oppose the morning-after pill, have so far failed in Colorado, Mississippi and Oklahoma, but they’ve introduced false doubts by providing even more opportunities for pundits and candidates to say “the morning-after abortion pill.”

It’s a problem that dates back decades: When, throughout the ’90s, the U.S. considered approving a French chemical abortion pill known as RU-486, it was widely called the “morning-after abortion pill,” including, often, in the New York Times. The distinction wasn’t pressed by the pro-choice community itself. “At the time, the prevailing medical wisdom was that there is a continuum rather than a bright line between EC and mifepristone,” said Gloria Feldt, who was president of Planned Parenthood at the time, with the benefit providing more options for women who did not wish to be pregnant. “It was also assumed that a formulation of mifepristone would eventually be made for use as a true ‘morning-after’ pill.” The widespread belief, she recalled, was that a chemical abortion pill would “solve all the abortion debate problems and guarantee privacy.”

Another problem was that although doctors and non-professionals had been giving women high dosages of regular birth control pills for decades as a form of emergency contraception, the science of exactly how emergency contraception worked remained unclear. The medical definition of pregnancy remains “implantation of a fertilized egg,” but let’s say you believe, as the Catholic Church does, that fertilization itself creates a human life. Anti-choice advocates obsess over what would happen if a woman who took emergency contraception did happen to ovulate anyway and an egg potentially was fertilized, which is enough reason for some of them to call postcoital contraception “abortion.” They have claimed that hormonal contraception makes the lining of the endometrium inhospitable to a fertilized egg, constituting “murder.” Even the official packaging for Plan B, the single-step version of emergency contraception, suggests that “in addition” to blocking ovulation and fertilization, “it may inhibit implantation (by altering the endometrium).”

Except that we now know it doesn’t, even if you walk down the path of remote maybes, which requires you to believe that a zygote, which may not implant for unknowable reasons, has the same rights as a living woman who doesn’t want to be pregnant. As Princeton’s Kelly Cleland pointed out recently, “The science has evolved considerably in the last 13 years. Newer evidence, published since the Plan B label was approved, provides compelling evidence that levonorgestrel EC (LNG EC) works before ovulation, but not after.” The International Consortium for Emergency Contraception and the International Federation of Gynecology & Obstetrics also note that two new studies have shown conclusively that if a woman has ovulated and an egg has been fertilized, it’s too late for emergency contraception to work. They recommended that the language on the product labeling be changed.

Of course, scientific evidence has rarely had much place in this debate. In the meantime, even the most non-ideological news sources keep making the mistake alongside the ideologues. Last week, a furor erupted after the Associated Press reported that “Women seeking to take emergency contraception like the so-called ‘morning after’ pill would have to do so in the presence of a doctor under a bill before the Alabama legislature.” That is, until Erin Gloria Ryan from Jezebel read the actual bill and saw that it was, in fact, a law meant to limit chemical abortion, not emergency contraception. (A spokesperson for the AP said a correction was being prepared). “The confusion over this issue is probably one of the reasons emergency contraception hasn’t had as positive an impact as hoped when it comes to lowering the abortion rate,” wrote Amanda Marcotte at RH Reality Check. “If women think it is some kind of abortion-ish thing, they probably think taking it is a big deal, instead of thinking of it more like taking the pill, since it’s basically the same thing.”

But talk about moved goalposts. If ’90s-era advocates had hoped that the ability to end a pregnancy in the safety of your home with RU-486 — the actual abortion pill, not the morning-after one — would defuse the abortion debate, their more recent counterparts hoped to take it to the next technological level by providing “tele-med” abortions. They would involve doctors seeing a woman over webcam with a nurse practitioner physically present, helping women in remote areas with ever-dwindling options for safe abortions to access them. But four states have already passed requirements meant to undercut these options by forcing a doctor’s presence, and the bill the Associated Press misreported was aiming to add Alabama to the list. All in all, there have been fewer gamechangers, and more cases of one step forward, two steps back.

1in3Campaign.org: Ana Laura from Advocates for Youth on Vimeo.

The Bills discussed are…

SB 92- Which prohibits insurance plans offered in the State Exchange in Wisconsin from offering abortion.

SB 237- Which is a repeal of the Healthy Youth Act.

SB 306-  Which is two fold.  One, it redefines what informed consent is, and two, it prohibits telemedicine in the case of abortion services.

The cardinal, in an ecclesiastical lift worthy of Samson, invokes the Declaration of Independence to prove that freedom of religion is “God-given.” With that jawbone, the cardinal smites the Philistines of insurance coverage for contraceptives, which he misleadingly refers to as “abortion-inducing” drugs.

He hopes the readers will accept his point of view that drugs that prevent pregnancy cause abortions. Most people, faithful or not, do not accept the theology that a woman can have an abortion before she is pregnant.

He hopes his faithful Catholic readers will forget the First Commandment (which forbids “religious freedom” outside Jehovah) in his defense of the First Amendment. And he hopes that readers will accept his explanation of the Bill of Rights.

When he says “Catholics and other people of faith and good will are not second-class citizens,” he invokes a constitutional interpretation under which a woman employed by self-insured employers (most people) or a business owned by someone who objects to contraception or a religiously affiliated insurance company can be denied the guaranteed preventive care coverage that other citizens have been granted.

Dolan asks readers to accept a First Amendment under which people of faith are not second-class citizens – unless, of course, they are women.

United for Religious Freedom
A Statement of the Administrative Committee
Of the United States Conference of Catholic Bishops
March 14, 2012
The Administrative Committee of the United States Conference of Catholic
Bishops, gathered for its March 2012 meeting, is strongly unified and intensely focused
in its opposition to the various threats to religious freedom in our day. In our role as
Bishops, we approach this question prayerfully and as pastors—concerned not only with
the protection of the Church’s own institutions, but with the care of the souls of the
individual faithful, and with the common good.
To address the broader range of religious liberty issues, we look forward to the
upcoming publication of “A Statement on Religious Liberty,” a document of the Ad Hoc
Committee for Religious Liberty. This document reflects on the history of religious
liberty in our great Nation; surveys the current range of threats to this foundational
principle; and states clearly the resolve of the Bishops to act strongly, in concert with our
fellow citizens, in its defense.
One particular religious freedom issue demands our immediate attention: the nowfinalized rule of the U.S. Department of Health and Human Services that would force
virtually all private health plans nationwide to provide coverage of sterilization and
contraception—including abortifacient drugs—subject to an exemption for “religious
employers” that is arbitrarily narrow, and to an unspecified and dubious future
“accommodation” for other religious organizations that are denied the exemption.
We begin, first, with thanks to all who have stood firmly with us in our vigorous
opposition to this unjust and illegal mandate: to our brother bishops; to our clergy and religious; to our Catholic faithful; to the wonderful array of Catholic groups and
institutions that enliven our civil society; to our ecumenical and interfaith allies; to
women and men of all religions (or none at all); to legal scholars; and to civic leaders. It
is your enthusiastic unity in defense of religious freedom that has made such a dramatic
and positive impact in this historic public debate. With your continued help, we will not
be divided, and we will continue forward as one.
Second, we wish to clarify what this debate is—and is not—about. This is not
about access to contraception, which is ubiquitous and inexpensive, even when it is not
provided by the Church’s hand and with the Church’s funds. This is not about the
religious freedom of Catholics only, but also of those who recognize that their cherished
beliefs may be next on the block. This is not about the Bishops’ somehow “banning
contraception,” when the U.S. Supreme Court took that issue off the table two
generations ago. Indeed, this is not about the Church wanting to force anybody to do
anything; it is instead about the federal government forcing the Church—consisting of its
faithful and all but a few of its institutions—to act against Church teachings. This is not a
matter of opposition to universal health care, which has been a concern of the Bishops’
Conference since 1919, virtually at its founding. This is not a fight we want or asked for,
but one forced upon us by government on its own timing. Finally, this is not a Republican
or Democratic, a conservative or liberal issue; it is an American issue.
So what is it about?
An unwarranted government definition of religion. The mandate includes an
extremely narrow definition of what HHS deems a “religious employer” deserving
exemption—employers who, among other things, must hire and serve primarily those of their own faith. We are deeply concerned about this new definition of who we are as
people of faith and what constitutes our ministry. The introduction of this unprecedented
defining of faith communities and their ministries has precipitated this struggle for
religious freedom. Government has no place defining religion and religious ministry.
HHS thus creates and enforces a new distinction—alien both to our Catholic tradition and
to federal law—between our houses of worship and our great ministries of service to our
neighbors, namely, the poor, the homeless, the sick, the students in our schools and
universities, and others in need, of any faith community or none. Cf. Deus Caritas Est,
Nos. 20-33. We are commanded both to love and to serve the Lord; laws that protect our
freedom to comply with one of these commands but not the other are nothing to
celebrate. Indeed, they must be rejected, for they create a “second class” of citizenship
within our religious community. And if this definition is allowed to stand, it will spread
throughout federal law, weakening its healthy tradition of generous respect for religious
freedom and diversity. All—not just some—of our religious institutions share equally in
the very same God-given, legally-recognized right not “to be forced to act in a manner
contrary to [their] own beliefs.” Dignitatis Humanae, No. 2.
A mandate to act against our teachings. The exemption is not merely a
government foray into internal Church governance, where government has no legal
competence or authority—disturbing though that may be. This error in theory has grave
consequences in principle and practice. Those deemed by HHS not to be “religious
employers” will be forced by government to violate their own teachings within their very
own institutions. This is not only an injustice in itself, but it also undermines the effective
proclamation of those teachings to the faithful and to the world. For decades, the Bishops have led the fight against such government incursions on conscience, particularly in the
area of health care. Far from making us waver in this longstanding commitment, the
unprecedented magnitude of this latest threat has only strengthened our resolve to
maintain that consistent view.
A violation of personal civil rights. The HHS mandate creates still a third class,
those with no conscience protection at all: individuals who, in their daily lives, strive
constantly to act in accordance with their faith and moral values. They, too, face a
government mandate to aid in providing “services” contrary to those values—whether in
their sponsoring of, and payment for, insurance as employers; their payment of insurance
premiums as employees; or as insurers themselves—without even the semblance of an
exemption. This, too, is unprecedented in federal law, which has long been generous in
protecting the rights of individuals not to act against their religious beliefs or moral
convictions. We have consistently supported these rights, particularly in the area of
protecting the dignity of all human life, and we continue to do so.
Third, we want to indicate our next steps. We will continue our vigorous efforts at
education and public advocacy on the principles of religious liberty and their application
in this case (and others). We will continue to accept any invitation to dialogue with the
Executive Branch to protect the religious freedom that is rightly ours. We will continue to
pursue legislation to restore the same level of religious freedom we have enjoyed until
just recently. And we will continue to explore our options for relief from the courts,
under the U.S. Constitution and other federal laws that protect religious freedom. All of
these efforts will proceed concurrently, and in a manner that is mutually reinforcing.Most importantly of all, we call upon the Catholic faithful, and all people of faith,
throughout our country to join us in prayer and penance for our leaders and for the
complete protection of our First Freedom—religious liberty—which is not only protected
in the laws and customs of our great nation, but rooted in the teachings of our great
Tradition. Prayer is the ultimate source of our strength—for without God, we can do
nothing; but with God, all things are possible.

CAN we still be arguing about a woman’s ability to control her own fertility? Almost 50 years ago in Griswold v. Connecticut, the Supreme Court struck down state restrictions on contraception because they violated a right to privacy. But the issue has not gone away. Rick Santorum injected it into the presidential race by indicating that Griswold should be overturned so that states could ban contraception altogether. And the Senate just voted down a Republican effort to allow employers and health insurance companies to refuse coverage for contraceptives if they had moral or religious objections.

Why are issues that the courts decided so long ago still unresolved? Maybe it is time to recognize that law alone is not enough to effect social change. It must be linked to social activism on behalf of women’s rights.

I should know. Fifty-five years ago, I had an opportunity to take a stand in favor of the right of women to control their fertility — and I did so through the courts.

It was 1957, and fresh out of the University of Wisconsin I enrolled in the Yale Law School — one of only six women in my graduating class. In my second year at Yale, several of our professors asked my husband and me to join a lawsuit challenging Connecticut’s birth-control law, which outlawed the sale and use of contraceptive materials and prohibited a doctor from prescribing birth control even to married women. One goal of the lawsuit was to remove the statutory obstacle to opening Planned Parenthood clinics in Connecticut so that poor families could have access to family-planning services.

I immediately agreed to join the case. Others did as well, but my husband and I were the only ones to use our real names. Because people used pseudonyms, the lead case came to be called Poe v. Ullman, but there was a companion case called Trubek v. Ullman. Poe raised a variety of grounds for challenging the statute and eventually landed in the Supreme Court.

I was proud to put my name on the case. To serve as a plaintiff, though a largely passive role, suited my vision of my future as a social justice lawyer. I supported Planned Parenthood. I believed women should have access to birth control so they could have both a career and a family. I wanted those things for myself. I was no sexual radical: I was married, a “good girl” uninterested in sexual freedom, and I thought of abortion as frightening. But I was planning to have a family and a career as a lawyer. I believed I should be free to choose the timing of my children’s births so I could do both.

Poe was thrown out by the Supreme Court on a technicality. To force the issue, Planned Parenthood opened a clinic, leaving the state with no choice but to close it down. This landed the issue back in the Supreme Court — this time with different plaintiffs, as Griswold v. Connecticut — which found the statute an unconstitutional intrusion on marital privacy.

The privacy argument in Griswold led to the legalization of contraception. But it also had a much larger impact: the privacy doctrine played a central role in Roe v. Wade (1973), which declared some barriers to abortion unconstitutional; was used by the court in Lawrence v. Texas (2003), which struck down bans on consensual same-sex sexual activity; and has been cited in state court decisions upholding same-sex marriage.

We can celebrate Griswold, Roe and all the cases that stemmed from the Poe litigation. They are important landmarks in American jurisprudence. But as I look back I am dismayed by how few of the issues I was fighting for at the time of Poe are resolved. To be sure, we have important rights and more legal privacy. But we still have not provided all the support women need to combine rewarding careers and healthy families. Planned Parenthood is under siege and poor women who are seeking comprehensive reproductive care are still at risk. Presidential candidates can get away with saying that all contraception should be outlawed. Comprehensive child care services are difficult to locate, and fully financed family and medical leave is still controversial.

In short, we won the legal battle but not the war. Women are still not guaranteed control over their lives, because the necessary social supports were never secure. The initial goal of Griswold was to help women — and even though the precedent has helped with same-sex marriage laws, those initial needs, especially of poor women, have been left largely unmet.

The universal coverage plan outlined in President Obama’s Affordable Care Act is a good step forward, and we should do all we can to ensure it. Perhaps if activism had been linked to the lawsuits, the aims I fought for would have been secured, and we would be spared the spectacle of Republican candidates threatening, yet again, a woman’s right to control her own fertility.

Route 51, Wisconsin Public Radio regional talk show, can be heard from 5:00 to 6:00 p.m. Thursdays on the Ideas Network stations WLBL 91.9 FM Wausau, WLBL 930 AM Auburndale/Stevens Point, WHBM 90.3 FM Park Falls, WHAA 89.1 FM Adams/Wisconsin Rapids and for those with a high definition radio, on WHRM 90.9-3 HD

Early Wednesday morning the leadership of the Wisconsin State Assembly scheduled every anti-women’s health bill, available for scheduling, next Tuesday — the last day of session.

SB 237/AB 337 repeals the Healthy Youth Act

SB 92 bans private insurance coverage of abortion

SB 306/AB 371 which adds criminal penalties for abortion providers

Throughout this legislative session, women’s health care has been under attack unlike any time in recent history.  This final push to enact these three additional barriers to women’s health that are overwhelmingly opposed by the medical community and community at large is politics at its worst.

But Legislative leaders still have a chance to make it right and stop this attack on women’s health care access.  We are asking our supporters to contact the members of the Assembly Rules Committee – who decide what bills get voted on (or not) in the Assembly.

Please contact the Assembly Representatives below ask them NOT to move forward with votes on the aforementioned bills. 

We recommend that you call as yourselves and not as a board member or representative of Planned Parenthood.  If you are a Republican supporter, we also ask that you make that known to these legislators or their staff.

Majority Members of the Assembly Rules Committee:

RALLY INFO

A coalition of organizations who support women’s health are coming together to hold a rally on Tuesday when the Assembly is in session.  The event can be found here on FaceBook https://www.facebook.com/events/335946803124736/.   Details also follow below.

                Women Watch, Women Rally, Women Vote: Mad as Hell Rally!

Last day of the Wisconsin legislative session
Tuesday, March 13

12noon-1pm

State Capitol, Madison

Kopsa wrote about the appeal for RH Reality Check, and we thought it was a great piece.

Contact: Jackie Bodden (608)348-9766
Lon Newman (715)675-9858 ext 329

Statement of Jackie Bodden, President of the Wisconsin Family Planning and Reproductive Health Association (WFPRHA) and Lon Newman, Public Affairs Chair

“Today, President Obama stood behind medical evidence and the constitutional rights of women by guaranteeing that birth control will be covered as preventive service under the Affordable Care Act,” said Jackie Bodden, Reproductive Health Nurse Practitioner and WFPRHA President.

“The President announced a compromise that is acceptable to the Catholic Health Association and to family planning providers and advocates.” Bodden said the recommendations of the Institute of Medicine that the Department of Health and Human Services commissioned were followed in the decision announced today. “Contraception is basic preventive health care and it will continue to be available to improve women’s health for generations,” Bodden said; revisiting remarks she made a few weeks ago after the US Conference of Catholic Bishops began to question the preventive care package regulations.

“President Obama stood for preventive care, for religious freedom, and for reproductive privacy rights today,” said Lon Newman, WFPRHA Public Affairs chair. “He gave religious leaders what they were looking for: an exemption for churches and an exemption from being required to offer or to pay for health services they object to.”

Bodden said that WFPRHA members appreciate the importance of constitutional protections for our individual rights of speech, religious belief and conscience because we serve so many women of so many cultures and religions.

The announcement will not change access to these services in Wisconsin very much, Newman said, because Wisconsin is a state which already requires contraceptive coverage without an exemption to religiously-affiliated employers. “. . . but our first amendment rights and our right to reproductive privacy – including access to confidential preventive health care has been affirmed and strengthened by the President’s announcement today.”

–30–

WASHINGTON— The United States Conference of Catholic Bishops (USCCB) sees initial opportunities in preserving the principle of religious freedom after President Obama’s announcement today. But the Conference continues to express concerns. “While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them,” said Cardinal-designate Timothy Dolan, president of USCCB.

“The past three weeks have witnessed a remarkable unity of Americans from all religions or none at all worried about the erosion of religious freedom and governmental intrusion into issues of faith and morals,” he said.

“Today’s decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction,” Cardinal-designate Dolan said. “We hope to work with the Administration to guarantee that Americans’ consciences and our religious freedom are not harmed by these regulations.”

—

The Obama administration’s policy will make sure women of all faiths who work at religiously affiliated hospitals, universities, and service organizations can get contraceptive coverage. It guarantees that women will encounter no barriers from their bosses or insurance plans in getting birth control without a copay.

“Today’s announcement makes it clear that President Obama is firmly committed to protecting women’s health,” Keenan said. “Unfortunately, some opponents of contraception may not be satisfied. These groups and their allies in Congress want to take away contraceptive coverage from nurses, janitors, administrative staff, and college instructors—and that agenda is out of touch with our country’s values and priorities. We will continue to fight on every front to support women’s access to birth control as politicians in Washington, D.C. try to take it away.”

Keenan also noted that her organization is committed to ensuring that the policy is implemented fully and fairly, so that women receive this basic health-care benefit without unnecessary barriers.

Keenan also said her organization is mobilizing against legislative attacks, including an amendment offered by Sen. Roy Blunt (R-Mo.) to the transportation bill that is expected to be voted on as early as next week. Although the Obama administration’s policy already exempts churches and other places of worship from the contraceptive requirement, the Blunt amendment is a far-reaching and extreme proposal. It would completely undo the no-cost birth control policy, which would ensure that virtually all women would get their prescription birth control covered without a copay. The amendment would also go so far as to allow insurers to deny coverage for any service they oppose based on personal views.

Contact:
Ted Miller, 202.973.3032

On November 2, 2011, Catholics for Choice president Jon O’Brien testified before the US House of Representatives Committee on Energy and Commerce Subcommittee on Health. In his testimony, Jon O’Brien showed how Catholics support the recently enacted healthcare reforms and the recommendation that contraception be included in fully covered benefits for all American employees. He noted, “I firmly believe the requirements under the Affordable Care Act, and the slate of regulations being created to implement it, infringe on no one’s conscience, demand no one change her or his religious beliefs, discriminate against no man or woman, put no additional economic burden on the poor, interfere with no one’s medical decisions, compromise no one’s health—that is, if you consider the law without refusal clauses.”

Under a cloak of reverence for religious freedom, the bishops say reproductive health care must be denied.  As do the rights to millions of American women, millions of people of other religious faiths, and even to millions of American Catholics – most of who disagree with the archbishop.

Before we ask President Obama to reverse his administration’s decision, there are some troubling questions we should ask the bishops and ourselves lest we destroy religious freedom in the name of preserving it:

• A patient who takes birth control pills, under the USCCB’s code of conscience, with the intention of preventing pregnancy commits a sin. If that same patient takes the same prescription for another health purpose, it is permissible. Is there any way that respects a patient’s right to privacy that also enables insurance companies and employers to deny birth control pills to prevent pregnancy while it permits them for regulation of menstrual cycles?
• In Wisconsin, we have a Medicaid family planning program to prevent unintended pregnancy. It has been very successful. It saves taxpayer dollars by reducing unwanted pregnancies and abortions among participants. Medicaid payment records show that many Catholic hospitals, clinics, physicians, and pharmacists are participating in the program.  These institutions provide birth control services and receive public insurance (tax) dollars in payment. There is no reason for the bishops to wait to exercise their conscience “rights.” They could stop accepting payment for family planning services now. Why wait?
• Many people of sincere faith disapprove of childhood immunizations even though they are, like family planning, on the top ten list of major public health benefits.  Under the religious exemption based on an employer’s conscience that the USCCB is asking for, an employer with a conscientious objection to immunization might deny its employees’ children insurance coverage for measles, mumps, polio, Pertussis, and rubella vaccines.  What would be the public health impact on children when so many are not immunized?
• Many Catholic employers throughout the country have family planning and birth control coverage in their insurance policies right now. Is there a reason to wait for ACA permission to exclude contraceptive care from the insurance coverage of their employees? If the bishops implement the limits on insurance coverage they are asking for in their own clinics and hospitals and pharmacies — which even though they haven’t, they say they must — will these employees continue to provide birth control and family planning services to patients and receive insurance reimbursement while they no longer have insurance coverage for that care themselves? Will employees be forced to seek out non-sectarian health care and pay for it out-of-pocket?
• In Cardinal-designate Dolan’s former diocese, there is a nettlesome question of who is an employee of the archdiocese and who is not. Today, diocesan attorneys will argue that sexual assault claims against priests working in diocesan religious orders should be thrown out because the priests were not employees. The bishops need to clarify how they are accountable and responsible for the sexual health and morality of the employees of these separately-incorporated religious affiliates – until they engage in criminal sexual behavior.

Those of us who revere the constitution and the individual right to exercise freedom of religion enabled by the separation of church and state must stop the mass media procession that is now engaged in a responsive reading from the archbishop’s hymnal. These sounds you hear are not the chimes of freedom.

The Etter Health Center at Shippensburg, a public school of 8,300 students in Appalachia’s scenic Cumberland Valley, provides the Plan B One Step emergency contraceptive along with condoms, decongestants and pregnancy tests.

The pill is available without a prescription to anyone 17 or older, and the school checked records and found that all current students are that age or older, spokesman Peter Gigliotti said.

The machine was installed after a request from the student association. The pill’s availability in a vending machine appears to be rare, if not unprecedented.

The idea started when Shippensburg conducted a survey about health center services several years ago, and 85 percent of the respondents supported making Plan B available, he said.

“The machine is in a private room in our health center, and the health center is only accessible by students,” Gigliotti said in a statement. “In addition, no one can walk in off the street and go into the health center. Students proceed to a check-in desk located in the lobby and after checking in are granted access to the treatment area.”

Taking Plan B within 72 hours of rape, condom failure or just forgetting regular contraception can cut the chances of pregnancy by up to 89 percent. It works best if taken within 24 hours.

Some religious conservatives consider the emergency contraceptive tantamount to an abortion drug. A spokeswoman for the National Right to Life Committee did not immediately respond to a request for comment.

Jessica Sheets Pika, a spokeswoman for the National Campaign to Prevent Teen and Unplanned Pregnancy, said that “if the health center is manned 24/7, that sounds like it’s a sufficient protection.”

“But if there’s a chance that people under 17 are able to access it, that’s a problem,” she added.

The drug isn’t covered or subsidized by the school. Its price at the vending machine is set by the school’s cost to the pharmaceutical company and is less than at off-campus pharmacies.

Previous research from the Guttmacher Institute found large variations in rates of unintended pregnancy across states. Nationally, rates of unintended pregnancy are higher among black and Hispanic women than they are among white women, and poor women have much higher rates of unintended pregnancy than those with incomes of at least 200% of the poverty line. Young women and unmarried women also experience relatively high unintended pregnancy rates. Given these disparities, Kost and her colleagues sought to examine whether a state’s demographic and socioeconomic composition was related to variations in rates across states.

The authors did not find a relationship between the proportion of women at risk of unintended pregnancy in the state who are contraceptive users and levels of unintended pregnancy after controlling for demographic or socioeconomic characteristics within each state. They explain that this finding is not surprising. “It does not mean that contraceptive use has no relationship to unintended pregnancy,” says Dr. Kost. “It means that the relationship between contraceptive use and unintended pregnancy does not differ across states.” The authors speculate that what does differ among states is “the extent to which vulnerable populations have access to insurance and Medicaid, and hence to contraception and other family planning services.”

These findings, according to the authors, suggest that efforts to expand insurance and Medicaid coverage among groups with high levels of unintended pregnancy merit examination as ways to lower rates. Understanding variations in unintended pregnancy by state is crucial to helping policymakers and program planners design interventions that most effectively reduce unintended pregnancy.

“Variation in State Unintended Pregnancy Rates in the United States” is currently available online and will appear in the March 2012 issue of Perspectives on Sexual and Reproductive Health.

For more information on this topic, click here for Facts on Unintended Pregnancy in the United States.

The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.

Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation. We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.

Our only goal for our granting process is to support women and families in the fight against breast cancer. Amending our criteria will ensure that politics has no place in our grant process. We will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants, while maintaining the ability of our affiliates to make funding decisions that meet the needs of their communities.

It is our hope and we believe it is time for everyone involved to pause, slow down and reflect on how grants can most effectively and directly be administered without controversies that hurt the cause of women. We urge everyone who has participated in this conversation across the country over the last few days to help us move past this issue. We do not want our mission marred or affected by politics — anyone’s politics.

Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work. We ask for the public’s understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve.

We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern.

On Tuesday we told you about the bishops’ campaign to contest the decision to make no-copay contraceptive coverage available to employees, including those working for Catholic institutions. This Department of Health and Human Services ruling was an important victory for the many women and men who need this coverage, especially during these tough economic times. With your help, this victory will actually reach the pocketbooks of American workers.

Right now, the Catholic voice reaching the White House is almost exclusively coming from conservative Catholics, including the US bishops and their allies. The media is continuing this misconception by running these reactions as a reflection of a monolithic Catholic outrage. These protests are not on behalf of employees’ conscience rights, and do not reflect most Catholics’ convictions or practice related to contraception. We need to speak up now and let the administration know that US Catholics support the right to choose contraception, just as they support no-copay coverage for employees’ contraception.

We need you to call and e-mail the White House today with a simple message: the bishops do not speak for me on contraceptive coverage.

Use our action center here to contact the White House today.

Remember to include a personal story in your e-mail to the White House. Your voice is needed now more than ever to preserve this great advance for the well-being of US workers.

We are also looking to share your stories as part of a campaign bring a different vision of Catholics into the spotlight: the experiences of Catholics like you who believe this contraception coverage supports employees’ freedom of conscience and should be available to all Americans, regardless of their employer.

Share your story to help combat the myth that contraceptive coverage is anti-Catholic.

Share your story online and send this link to others you know. There is no more effective way to educate policymakers and the media about the widespread Catholic support for equitable access to contraception.

If you would like more information, please contact Marissa Valeri at activists@catholicsforchoice.org or by phone at (202) 986-6093.

Thank you for taking action with Catholics for Choice. Please forward this alert to your friends, family, colleagues or any others who may be interested in getting active on this important issue.

Thanks for the fact check on the South Carolina Gingrich-versus-Romney ad ["Gingrich’s ‘Baloney’-filled Attacks on Romney," Jan. 11]. Confusing the public about emergency contraception pills (ECP) is deliberate, pervasive, and routinely served by opponents of contraception.

Although fact-checking the fact-checking seems tedious sometimes, it is important to explain that available research on Plan B One-Step (“the morning after pill”) shows that it prevents pregnancy by preventing ovulation and/or fertilization.

Ron Hamel, a Catholic ethicist publishing the conclusions of five years of scientific review in the January-February 2010 issue of Health Progress, said: ” … virtually all of the evidence in the scientific literature indicates Plan B has little or no post-fertilization effect, that is, it has little or no effect on the endometrium that would make it inhospitable to implantation. Its mechanism of action is to disrupt ovulation.”

One objection frequently repeated by Plan B opponents is that there is language in the pill package that the drug may prevent implantation. However, Nicanor Pier Giorgio Austriaco, a priest, theologian, and scientist also studied the active drug’s effects and determined that it has no post-fertilization effect. On the argument of labeling, he stated that: “ … labels mean nothing without the scientific data to back up their claims.”

These conclusions are reinforced in the 2010 World Health Organization’s fact-sheet on levonogestrel (LNG) which states: “… LNG ECP use does not prevent a fertilized egg from attaching to the uterine lining.”

The important answer to the question on emergency contraception is that there cannot be an abortion before there is a pregnancy; therefore, preventing unwanted pregnancies prevents abortions. But even if you believe pregnancy is the same as fertilization, you no longer have to put up with the warmed-over baloney that Plan B is an “abortion pill.”

Thanks, again, for your excellent work.

Lon Newman
Executive director, Family Planning Health Services
Wausau, Wisc.

Health Progress

January-February 2010

Volume 91, Number 1

Thinking Ethically About Emergency Contraception

Critical judgments require adequate and accurate information.

BY RON HAMEL, Ph.D.

The controversy over the use of emergency contraception in Catholic hospitals for victims of sexual assault continues to be played out in various forums — in the literature, state legislatures, pharmacies, professional groups, state Catholic conferences, dioceses and Catholic hospitals themselves.

At its heart is whether medications used for emergency contraception have an abortifacient effect, that is, whether they prevent the implantation of a fertilized egg by altering the lining of the endometrium. On the belief that they do have such an effect, some either object to or prohibit their use in Catholic hospitals or agree to their use only in conjunction with testing for ovulation to ascertain whether the woman is at or around the time of ovulation (and, therefore, could become pregnant).¹ Obviously, for women who have been subjected to a sexual assault and who seek assistance at a Catholic hospital, much hinges on accurately understanding how these hormonal medications work.

Unfortunately, such understanding is not always in play. In many instances, critics base their moral judgments on prevailing beliefs or assumptions about mechanisms of action that may be based on drug manufacturer labeling, or on outdated scientific literature, or on mere supposition. Researchers have been virtually certain that the drugs prevent or disrupt ovulation, but they have generally been uncertain about other possible effects on sperm, cervical mucus, the process of fertilization and on the endometrium. Yet manufacturers and others typically list these specific effects as possible mechanisms of action.

But are such beliefs and assumptions about emergency contraceptives accurate and adequate? This is a critical question, for women who have been sexually assaulted and for the Catholic hospitals that care for them.

One of the well-known truisms in ethics is that good moral judgments depend in part on good facts. Absent adequate and accurate information, there is an increased possibility of a faulty analysis and, therefore, of an erroneous judgment. In addition, the moral judgment itself might be seen to lack credibility either because its basis is unclear or because it seems to fly in the face of reputable data.

Take one example. In late February 2007, in a LifeSiteNews interview, Bishop Elio Sgreccia, the then-president of the Pontifical Academy for Life, reaffirmed the academy’s 2000 statement that the “morning-after pill” is abortifacient and that physicians and Catholic hospitals are prohibited from administering it, even in cases of sexual assault.² Unfortunately, the 2000 statement employed the generic term “morning-after pill,” which can refer to a variety of medications with different mechanisms of action, and the statement made no reference to scientific literature substantiating its claim that the pill is abortifacient. In addition, the comment in the 2007 interview seemed not to take account of recent scientific literature on how these medications work, particularly in the case of levonorgestrel, also known as Plan B, the current standard treatment for women who have been sexually assaulted. Yet after the interview, despite the lack of evidence, some described both the bishop’s comment and the Pontifical Academy’s statement as “authoritative.”

GOOD FACTS ARE NECESSARY FOR GOOD ETHICS
What, in fact, do we find if we look at the scientific literature on how Plan B, a progestin-only form of emergency contraception, works?

Over the past five years, CHA staff have collected, reviewed and summarized the great majority of articles on emergency contraceptive medications’ mechanisms of action — both for combination drugs (such as Preven) and Plan B.³ In addition, CHA obtained two independent analyses of the literature — one by an ob-gyn and the other by a pharmacist. The reviews concluded that virtually all of the evidence in the scientific literature indicates Plan B has little or no post-fertilization effect, that is, it has little or no effect on the endometrium that would make it inhospitable to implantation. Its mechanism of action is to disrupt ovulation.

In a thorough review of the scientific literature, Fr. Nicanor Pier Giorgio Austriaco, OP, Ph.D., a priest, theologian and scientist, wrote in the Winter 2007 issue of The National Catholic Bioethics Quarterly:

Studies published in the past few months provide mounting evidence that levonorgestrel has little or no effect on post-fertilization events. In other words, given the limitations of scientific certitude, they suggest that Plan B, when administered once, is not an abortifacient. These human studies correlate well with earlier findings in rodents and monkeys that convincingly showed that the postcoital administration of levonorgestrel in amounts several times higher than typical doses given to women does not interfere with the post-fertilization processes required for mammalian embryo implantation. The evidence also addresses what until now has been a nagging, unanswerable question for pharmacologists: Why would levonorgestrel, a progesterone agonist that mimics the effect of progesterone, prevent implantation, when progesterone produced from the corpus luteum immediately after ovulation actually promotes implantation by converting the endometrium to deciduas? Answer: It does not.⁴

Several months later in the Autumn 2008 issue of the quarterly, responding to his critics, Fr. Austriaco offered an even more detailed argument in support of his conclusion.⁵ If Plan B is abortifacient, the author observes, it can have this effect in three primary ways. The first is by increasing the rate of ectopic pregnancies. However, he notes that the “combined data from five clinical trials with nearly six thousand women showed that the rate of ectopic pregnancies in women who have used Plan B is 1.02 percent as compared to the overall national ectopic pregnancy rate between 1.24 percent and 1.97 percent. In light of this finding, it is unlikely that Plan B increases the ectopic pregnancy rate … .”⁶

The second way in which Plan B could be abortifacient is by preventing implantation of an embryo. Fr. Austriaco noted that there are three ways in which this could occur. One is by altering the lining of the endometrium, making it inhospitable to implantation. “[M]orphological and biochemical analyses of endometrial biopsies of women who had taken Plan B eight or nine days prior to the biopsy have revealed that the drug does not dramatically alter the structures of this tissue. This suggests that the drug does not compromise endometrial development.”⁷

Another way in which the drug could make the endometrium inhospitable is by disrupting the function of the corpus luteum which releases hormones that are necessary for the proper development of the endometrium, including making it receptive to an embryo. After reviewing the scientific literature, Fr. Austriaco concluded that “[T]ogether, these data suggest that the risk of a post-fertilization effect from this mode of action for any particular individual woman, if it is real, would be vanishingly small.”⁸

The final manner in which Plan B could prevent implantation is by directly interfering with the implantation process itself. Fr. Austriaco replied: “[O]ne study that directly tested the ability of human embryos to implant on endometrial tissue exposed to LNG — though grossly immoral — does not support this mode of action for Plan B.”⁹ Two other recent studies confirm this conclusion.¹⁰

A third way in which Plan B could be abortifacient is by destroying an already implanted embryo. With regard to this possibility, Fr. Austriaco wrote: “[A] report from the FDA shows that Plan B does not increase the rate of pregnancy loss or the frequency of fetal abnormalities once a pregnancy has been established.”¹¹

Fr. Austriaco concluded his article: “[I] stand by my earlier conclusion: In light of the available scientific evidence and given the inherent limitations of the studies, it is unlikely that Plan B is an abortifacient.”¹²

What about the manufacturer’s label which claims that one of the drug’s mechanisms of action is to prevent implantation of a fertilized egg? Many appeal to the manufacturer’s label in their arguments against the use of Plan B. In Fr. Austriaco’s judgment, “labels mean nothing without the scientific data to back up their claims.”¹³

MORAL CERTITUDE, NOT ABSOLUTE CERTITUDE
While the preponderance of scientific evidence strongly suggests that Plan B does not have an abortifacient effect, the evidence stops short of providing absolute certitude. But is absolute certitude needed?

In the Catholic moral tradition, what is required of an agent when he or she makes a moral judgment is that he or she have moral certitude about the correctness of the action. In the words of Thomas Slater, SJ, author of a manual of moral theology: “In order to act lawfully and rightly, I must have at least moral certainty of the imperfect kind that the proposed action is honest and right. This degree of certainty will be sufficient, for ordinarily no greater can be had, as we have just seen. It is also required for right action; for if I am not at least to this extent morally certain that my action is right, I am conscious that it may be wrong.”¹⁴

What is meant by moral certitude? Moral certitude means that the agent has excluded all reasonable possibility of error. It stands between mere probability, where alternative opinions are equally plausible, and absolute certainty, where any theoretical possibility of error is not only excluded, but is impossible. Again, in the words of Fr. Slater:

Certainty in general is a firm assent of the mind to something known, without the fear of mistake. In mathematics and in other branches of exact science we can often attain absolute certainty, which rests on the evident truth of the principles which are employed to arrive at it. … In the science of morality we have frequently to be content with a lower degree of certainty than this; there is often some obscurity about the principles to be applied, and human acts are not the matter of necessary and unvarying law. We have to be content with what is called moral certainty. … I may be conscious that mistake is possible but not probable, as when a man has been condemned on evidence which has satisfied a jury of intelligent men. In such cases if there can be no prudent doubt about the justice of the verdict I have moral certainty of an imperfect but real kind. … Ordinarily greater certainty cannot be obtained in human affairs. … If I have this imperfect moral certainty that my action is right, I am justified in acting … .”¹⁵

How does moral certitude play out with regard to emergency contraception, and Plan B in particular? The first consideration deals with Plan B’s mechanism of action. Is there sufficient moral certitude that Plan B is not abortifacient? In other words, do the results of scientific research on how Plan B works rise to the level of moral certitude? Given the mounting evidence from the scientific literature that Plan B does not prevent implantation, there does seem to be moral certitude, of the imperfect kind, about the mechanism of action. It is, of course, theoretically possible that all of the studies that have been done could be mistaken, but this is not likely. Hence, if these scientific studies are correct, then Plan B is consistent with Directive 36 which states that a woman who has been sexually assaulted may be “treated with medications that would prevent ovulation, sperm capacitation, or fertilization.”¹⁶ Thus its use would not be prohibited by what follows in Directive 36: “It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.”¹⁷ Targeting implantation is not the purpose or direct effect of Plan B. Rather, its purpose and direct effect is to interfere with ovulation.

Second, is there moral certitude that a fertilized ovum will not be destroyed? Some argue that in order for moral certitude to be present, the woman who has been sexually assaulted must undergo an ovulation test to ensure that she is not at or around the time of ovulation such that she could become pregnant from the rape. For example, one advocate of ovulation testing says: “[C]atholic hospitals must have moral certitude that the possibility of an abortion is excluded. The ovulation test provides this certainty. … Therefore, moral certitude can be achieved only through the administration of the [luteinizing hormone] test. To administer emergency contraception when there is insufficient information as to its effect on the specific patient in question is not only morally illicit but medically unsound.”¹⁸

Given what has been said about Plan B’s mechanism of action, such testing is not required to achieve moral certitude. Furthermore, moral certitude in these situations is strengthened by the fact that the incidence of a pregnancy after rape is between <1 percent and 5 percent. Typically the estimate is put at about 3 percent.¹⁹ Given the scientific evidence regarding Plan B’s mechanism of action and the high probability that there is no fertilized egg present subsequent to the sexual assault, the requisite moral certitude exists that a fertilized ovum would not be destroyed by the administration of Plan B.

Finally, it is generally maintained in textbooks of moral theology that when human life is involved, one should always take the safer course. This is sometimes illustrated by the example of the hunter in the woods who sees movement behind bushes. Is the hunter free to shoot, believing that the movement results from a deer? The response in the manuals is no, because the movement could be caused by another hunter. Unless the hunter can resolve his doubt, the hunter must take the safer course and not shoot. This example might suggest that Catholic hospitals must not use emergency contraceptive medications at all in the belief that they might have an abortifacient effect — or, at least, that hospital personnel do as much as they can to reduce the possibility there might be an egg present that could be or might have been fertilized. They would do this by testing for ovulation.

In the situation under consideration, if there were a likelihood that a fertilized egg were present and if there were a likelihood that Plan B has an abortifacient effect, then the example and the obligation to take the safer course would be applicable. However, neither of these conditions is the case, because there is virtually no evidence that Plan B is abortifacient and, in cases of sexual assault, there is a very high probability that there is no fertilized egg present.²⁰ Hence, there does not seem to be an obligation to take the safer course. If one were obliged to take the safer course in these situations, in order to be consistent, one would also have to take the safer course in many of life’s other activities (e.g., driving one’s car, flying in a plane) as well as in the practice of medicine generally (e.g., agreeing to a surgery with a 25 percent risk of dying, undergoing chemotherapy that could have a lethal effect).

The administration of emergency contraception to women who have been sexually assaulted is a matter of utmost seriousness since it touches on human life. It is also a matter of utmost seriousness because it touches on the well-being of women who have been subjected to one of the most heinous of crimes. Any decision about whether or not to permit the dispensing of emergency contraceptive medications in Catholic hospitals and about the protocols for their administration has profound consequences.

Those who make such decisions, whether bishops, hospital executives, emergency room physicians, nurses or others, have a grave moral obligation to take seriously one of the first rules in making good ethical judgments, namely, to obtain adequate and accurate information about the matter at hand. To do any less is not only to shortchange the moral process, but also to risk significant harm to others. And once the best possible information is obtained, those making the decisions need to keep in mind that the use of emergency contraception for women who have been sexually assaulted is a matter about which moral certitude is sufficient. Given what is currently known about Plan B from scientific research, Catholic hospitals can respond with sensitivity, compassion and assistance to women who have been raped and are in need of care, while being confident that they are also remaining true to Catholicism’s fundamental commitment to respect for human life.

NOTES

1. If ovulation testing determines that the woman is at or around the time of ovulation, generally emergency contraception would not be administered out of concern that a possible abortifacient effect of the medication could result in the loss of an embryo.
2. Pontifical Academy for Life, “Statement on the So-Called ‘Morning-After Pill,’” (October 31, 2000), http://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/
   rc_pa_acdlife_doc_20001031_pillola-giorno-dopo_en.html
3. For information about the mechanism of action of emergency contraceptive medications generally: www.chausa.org/ECmedicationsReview; for information about Plan B’s mechanism of action: www.chausa.org/LevonorgestrelReview.
4. Nicanor Pier Giorgio Austriaco, “Is Plan B Abortifacient? A Critical Look at the Scientific Evidence,” The National Catholic Bioethics Quarterly 7, no. 4 (Winter 2007): 707.
5. Nicanor Pier Georgio Austriaco, “Colloquy: More on Plan B — Fr. Austriaco Replies,” The National Catholic Bioethics Quarterly 8, no. 3 (Winter 2008): 421-25.
6. Austriaco, 422.
7. Austriaco.
8. Austriaco, 423.
9. Austriaco.
10. Chun-Xia Meng et al., “Effect of Levonorgestrel and Mifepristone on Endometrial Receptivity Markers in a Three-Dimensional Human Endometrial Cell Culture Model,” Fertility and Sterility 91, no. 1 (2009): 256-64; Natalia Novikova et al., “Effectiveness of Levonorgestrel Emergency Contraception Given Before or After Ovulation: A Pilot Study,” Contraception 75, no. 2 (2007): 112-18. The immoral, but important study to which Austriaco refers is P.G.L. Lalitkumar et al., “Mifepristone, But Not Levonorgestrel, Inhibits Human Blastocyst Attachment to an In Vitro Endometrial Three-Dimensional Cell Culture Model,” Human Reproduction 22, no. 11 (2007): 3031-37.
11. Austriaco.
12. Austriaco, 424.
13. Austriaco, “Is Plan B Abortifacient?”, 707.
14. Thomas Slater, SJ, A Manual of Moral Theology, (New York: Benziger Brothers, 1925), 1:31.
15. Slater, 1:31-32.
16. United States Conference of Catholic Bishops, The Ethical and Religious Directives for Catholic Health Care Services, (Washington, D.C.: USCCB, 2001), Directive 36.
17. United States Conference of Catholic Bishops.
18. Marie Hilliard, “Dignitas Personae and Emergency Contraception,” Ethics and Medics 34, no. 2 (February 2009): 4.
19. Melisa M. Holmes, et al., “Rape-Related Pregnancy: Estimates and Descriptive Characteristics from a National Sample of Women,” American Journal of Obstetrics and Gynecology 175 (August 1996): 320.
20. Gerald McShane, et al., “Pregnancy Prevention after Sexual Assault,” in Peter Cataldo and Albert Moraczewski, eds., Catholic Health Care Ethics: A Manual for Ethics Committees, (Boston: The National Catholic Bioethics Center, 2001), 11, 16-17.

RON HAMEL is senior director, ethics, Catholic Health Association, St. Louis. Write to him at rhamel@chausa.org.

President Obama listened to all of the women and men who called, e-mailed and wrote to the White House to express their support for family planning decisions staying in the hands of women. In so doing, he remained true to the original vision of the Affordable Care Act (ACA) and refused to bend the knee to intense lobbying from the United States Conference of Catholic Bishops, the Catholic healthcare industry and other special interests who wanted him to expand a refusal clause that would have denied millions of women access to affordable family planning.

The president of Catholics for Choice, Jon O’Brien, said, “The bishops pulled out all the stops in their campaign against women’s access to contraception. The Obama administration stood with those who support religious liberty and believe in giving women the freedom of conscience to make their own reproductive health decisions.

“While the refusal clause that is contained in the legislation is still too expansive, denying many women, as it does, affordable access to contraception, we are relieved by this announcement. Catholics for Choice and our colleagues in the reproductive rights movement expended a huge amount of energy and resources mobilizing the public to take action on this pivotal issue. In the final analysis, this was a victory for common sense and scientific advice in the interests of the common good.

“The battle over this issue is a warning about what is to come, especially as the bishops are playing the victim card in their pleas for special treatment and their false assertions about alleged attacks on religious freedom. The president and Congress will need to get real about what is going on, and remember that this coming November the electorate will not be listening to the bishops, so neither should they.”

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Catholics for Choice shapes and advances sexual and reproductive ethics that are based on justice, reflect a commitment to women’s well-being and respect and affirm the capacity of women and men to make moral decisions about their lives.