Wednesday, March 7, 2012

Myths about Church teaching on contraception and the religious liberty at stake

I thought it worthwhile to transcribe portions of the February 16, 2012 appearance of Bishop William Lori before the Committee on Oversight and Government Reform. (View the entire hearing here.) I also included a quote from Rabbi Soloveichik. I'm sure all too few citizens watched the panel, so this may help dispel some of the ignorant comments out there about the Church. I'll throw in my own comments here and there, and bold emphasis is my own.

Blake Farenthold (to Bishop Lori) - The Catholic Church does not have a problem with contraceptives for medical purposes. So I would assume from that it wouldn't be morally objectionable to the Church to pay for those for medical purposes. I'm not trying to put you on the spot, I'm just trying to make sure I understand where the Church stands.

Bishop Lori - That would be my understanding also.
Notice in this first part something many people probably do not know––the Church is not opposed to contraceptive drugs, per se. The Church is opposed to using contraceptive medicine to deliberately compromise the sacredness of fertility in the marital act or to induce post-fertilization abortions, which the Church would consider the killing of a human person.1
Farenthold - And there are numerous organizations, both federally and private funding that make available free or low cost contraceptives throughout the country. I'm sure you're aware of that.

Bishop Lori - Yes, that's also my understanding.

Farenthold - So we've got a mandate here that really is a lot of much ado about nothing. If it were carefully crafted, the chances of somebody not able to get the care, or for that matter the optional contraceptives that they desire, is, for all practical purposes, nil.

Bishop Lori - Those services are very, very widely available and what we are talking about is a very narrow band. It is clearly a minority opinion, or a minority view. But we think it's one that ought to be protected.
The government's health care plan is by no means limited to contraceptive drugs for medical use alone. Medicinal use of otherwise contraceptive drugs, said the Bishop, is not against Catholic moral teaching.
Bruce Braley - A significant portion of women, 1.5 million, use the Pill exclusively for medical purposes other than contraception. They use contraceptives to treat severe menstrual pain, migranes, uterine fibroids, and endometriosis. Oral contraceptives also help prevent ovarian cancer. ... Do your religious teachings prohibit the use of contraception for health-related purposes, such as treating ovarian cancer?

Bishop Lori - I think Catholic moral theology is very nuanced. It recognizes that the same drug can operate in different ways and accomplish different things. If it is used to prevent birth, it is against our teaching. And so we have operated with a considerable–– with a lot more nuance than we're usually given credit for. Also observe, by the way, that 90% of all private health care plans give access to contraception. We're talking about a very narrow band, and for very specific purposes here.
Later, congresswoman Rosa DeLauro asked a version of the exact same challenge again.
Rosa DeLauro - There are so many studies, I'm not a doctor, I'm not a scientist, but there are medical studies today that show––and we can give you other citations––that women who do take the pill have a much lower risk of developing ovarian cancer. ... I have to ask each of you, are you morally opposed to allowing women who work in your facilities, many of whom are non-religious, non-whatever the denomination, that were not hired for a religious purpose, are you opposed to allowing them to take a pill or to get an IUD in cases where their lives depend on it? When we know that it could lower the risk of ovarian cancer?

Bishop Lori - [O]ur Catholic moral theology, as I've indicated, recognizes that the same drug can be used for different purposes with different effects, and our plans reflect that. So we should be given credit for the nuance and the understanding that we have already brought to the table. All the more reason for the government not to move in and try to force our hand now.
Here, again, Bishop Lori dispels the myth that Catholic teaching says these drugs should not even be used for medical purposes. I found it telling that different challengers asked basically the same question to the Bishop––won't the Church even let women use these medications for medical, non-contraceptive purposes? Bishop Lori did well to stay on point. While the Church is opposed to the barrier of contraception into the marital, sacramental representation of Christ and His bride the Church, medicinal use of certain drugs may be accepted.

It may also be worthwhile here to point out one of the comments of Pope Paul VI in his famous encyclical:

On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever. (Paul VI, Humanae Vitae, 15)
So for example, if a life-threatening operation had the unintended consequence of sterilizing a woman or a man, such could not be considered immoral. Fr. Francis Hoffman from Relevant Radio also pointed out the prudence of avoiding sexual relations during times when one is using contraceptives for medicinal purposes.

If a person is taking the birth control pill for other reasons, then during the time they're taking the pill they must refrain from marital relations. Because there are no proportionate reasons to put a conceived human embryo in danger of dying. So can you use it as a medicine for other reasons? Yes, but you must refrain from relations during that period. (Fr. Francis Hoffman, Relevant Radio, Feb. 28, 2012, MP3 archive)
(EDIT 8/17/14 TO ADD: Fr. Grondin at Catholic Answers has a detailed answer regarding proportionate reasons in which he states: "the Church does permit the use of the birth control pill to treat medical/health issues provided that contraception is neither the intention nor means by which the good effect is achieved." Read more.)

See evidence for the abortive potential of oral contraceptives below. Other Church statements related to Humanae Vitae's #15 include:

Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available. (USCCB, Ethical and Religious Directives for Catholic Health Care Services, 53)
An effect can be tolerated without being willed by its agent; for instance, a mother's exhaustion from tending her sick child. A bad effect is not imputable if it was not willed either as an end or as a means of an action, e.g., a death a person incurs in aiding someone in danger. For a bad effect to be imputable it must be foreseeable and the agent must have the possibility of avoiding it, as in the case of manslaughter caused by a drunken driver. (CCC#1737)

The circumstances, including the consequences, are secondary elements of a moral act. They contribute to increasing or diminishing the moral goodness or evil of human acts (for example, the amount of a theft). They can also diminish or increase the agent's responsibility (such as acting out of a fear of death). Circumstances of themselves cannot change the moral quality of acts themselves; they can make neither good nor right an action that is in itself evil. (CCC#1754)
I won't delve into specific case examples. Suffice it to say, I think this teaching surprised a number of the congressional interrogators, and probably would surprise many readers who think the Church perversely desires to deny women drugs even for medical purposes.

Also, notice DeLauro's appeal to certain contraceptives and their benefits to ovarian cancer. This amplifies the point I made yesterday (see U.S. government candidly admits oral contraception increases risk of cancer in women) about how the HHS' own scientific sources claim oral contraceptives reduce ovarian cancer risk, but increase breast, cervical, and liver cancer risk. Other studies warn of other medical risks to contraceptives. In December, Health Canada revealed a study that suggested that oral contraceptives containing drospirenone could greatly increase a woman's chance to develop a blood clot. Last year, doctors at the University of California claimed in their study that hormone-altering contraceptives contributed to memory loss. Last November, a study showed that persons in geographic regions using the Pill more often have a higher rate of prostate cancer, that men may possibly be exposed to the excess estrogen inducing the cancer. There are many, many articles and studies searchable online detailing severe negative side effects, short and long term, of using hormonal contraceptives. Regardless, even assuming the Pill was hypothetically totally safe, the Church could only condone its medicinal use, not its contraceptive use.

Patrick McHenry - Is this ruling by HHS, do you view this as an issue of contraception and abortifacients, or an issue of religious freedom and conscience protections?

Bishop Lori - We view it as an issue of religious liberty. We view it first of all and primarily at the level of principle. It is a question of government reaching into the internal governance of religious bodies and making a requirement contrary to Church teaching.
Some have tried to make this a "contraceptive" issue, but such cannot be reasonably argued. As Bishop Lori also pointed out in his opening statement, the principle of religious liberty would still apply even if this was, for example, the government trying to force Jewish institutions to serve ham against their religious beliefs.
Edolphus Towns - I'm trying to understand exactly what problems the Bishop has with the Administration's policy. That's what I'm really trying to understand. It's not clear to me.

Bishop Lori - Yes, well, the problems are at the level of principle and at the level of practicality. The principle is the government's reaching in and forcing us to do something. We might disagree inside of the Church. We might have our problems inside of the Church. But it's not for the government to weigh in and be the arbiter of those things. And secondly, many Church entities, such as the diocese of Bridgeport, which I can certainly speak about, they're self-insured. And so as a result, I am not only am I the employer, but also the insurer. And so certainly at the level of practicality, the new rule does nothing to help. And also there are religious insurers, there are individuals who have conscientious objections, and the rules do nothing for them. So we have problems on all those levels.
Towns then asked if purchasing insurance that covered contraception or abortifacients would be against Church teaching. Bishop Lori said yes. And then the Rabbi added this:

Rabbi Soloveichik - My concern here, congressman, is not what one particular Jewish organization might say about a particular prescription or procedure or whether their tenets are violated when they're forced to provide that. My concern is when Congress, or the Administration, comes in and says well, I see that there are some members of one faith who say this, some members of the other faith who say this, so we're going to unilaterally side with these people and force everyone, even over their objections, to violate their conscience. In general, a religious organization or a religious community should be free to define what the tenets of their faith are, and they should be listened to when they are told that a particular demand or mandate by the federal government violates those liberties.
Congressman Elijah Cummings attempted an ad populum argument.
Elija Cummings (to Bishop Lori) - If there's a woman who's, say, working for the Catholic entity, and she comes to you and she says, I want contraception, and it's something that I want. I've read surveys that said 98% of Catholic women use contraception. I'm just curious, what do you say to her?

Bishop Lori - When somebody comes aboard to work for the Church to begin with, the teaching is clear, the mission is clear. The teaching of the Church and all of its nuance is set forth and the terms of the plan are clear. Let's be clear that contraception is available in many different ways. Sometimes a couple in that condition, in that situation, might access it through a spouses plan. But 90% of all health insurance plans include it, plus there's Title 10, plus there are clinics. It can hardly be said that this is unavailable. It is available very, very widely. The issue here is forcing the Church to provide it directly or indirectly in contravention with the Church's teaching. And that's what we don't want to do. It's one thing when tax dollars pay for it. It's another thing when Church dollars pay for it.
First, in case you didn't know, the "98% of Catholic women" figure cited by Cummings has been proven a false statement (link fixed 4/6/13) based on the study in question's own figures. Second, Bishop Lori dispels the suggestion that if religious institutions in particular don't offer contraceptives for any reason in their insurance plans, that will somehow prevent availability to contraceptives. Of course, the idea is nonsensical. Cummings also attempted to appeal to "Catholics" who might agree with his side as a tool to justify forcing opposed institutions to submit to the government's demand. He presented a list of "Catholic" colleges that offer contraception in their insurance plans. The problem with his reasoning was twofold: 1) Many of the colleges he cited either had been forced by local governments to do so or only offered contraception for the aforementioned medical reasons. He failed to grasp that contraception is the act of sterilizing the marital act, not taking a "contraceptive pill," per se. And 2) Rabbi Soloveichik had already pointed out the flaw in Cummings premise––the government can't intrude into religious internal affairs, pick a side, and force the other side to comply. The idea, as is the HHS mandate, a violation of the first amendment to freedom from the government's establish of and freedom of the people's free exercise of religion.
Mike Quigley (to Bishop Lori) - Do you support this same policy that you have as it relates to the private sector? In other words, do you think that a fast food restaurant person, because of his moral objection, say to his employees, I'm not gonna provide birth control as well, or a larger corporation?

Bishop Lori - You know, if there is real religious liberty in our country, then churches, even if there is disagreement within those churches, have the God-given right to run their own institutions and their own internal affairs according to their teachings. And if there should be discussion within that church, or even dissent within that church, it is not for the government to reach in, and to decide or weigh in for one side or the other. ... The fact of the matter is, a lot of people like to work for the Catholic Church, it's one I can speak for, and because they like to work for mission. And because they understand that when they sign up to work for a diocese or a Catholic school or for Catholic charities, what the teaching is. We have an organized Magisterium with the Pope and the bishops. And sometimes people agree with it, sometimes they don't, but they love the mission, and they come and work. We have no trouble retaining and attracting people to work for us. We provide great healthcare plans. But you know under these rules, we might have the best healthcare plan in the world, but if even one of these so-called preventive services were not in our plan, we'd be fined $2,000 per employee.

Quigley - Bishop, getting to the question, do you believe that a private sector company, if the owner or the board have moral objections, the same moral objections you do, which I respect, do you think they have the right to deny offering contraceptive services?

Bishop Lori - I think that that freedom obtains right now. It already obtains. They can already do that.

Quigley - We're talking about legislation, Bishop. There's legislation right now [presumably the Blunt amendment that since lost a 51-48 vote in the Senate] proposed right now that would extend this to the private sector.
[If I understand correctly, it would actually not extend the right to the private sector to not offer contraceptions in their health care plans but preserve that right already extant in the private sector]

Bishop Lori - We're saying that this legislation should not do so [i.e. I think he means take away that right]. We've been able to have that freedom now and the world has not fallen in upon itself.
Here, I'd just like to point out Quigley's concern does not even begin to address the concerns of religious liberty brought by the panel. The Church's teaching on birth control long antedates even the existence of the United States. To argue that basic, First Amendment freedom, should be taken away on the basis that a non-religious institution may follow suit failed to grasp the issue of freedom altogether. Quigley's premise is that all contraceptives are "medical" products necessary in all insurance plans, but he did not substantiate that premise.
Ann Marie Buerkle - So let's establish that for the record, despite this accommodation [she raises quoted fingers here], the rule hasn't been changed. And it was a verbal as you mentioned. Nothing was put in writing which is always of concern. But I want to now ask each one of you, how would you see this rule, that has not been changed, that violates conscience rights, how do you see that affecting the missions of each on of your churches?

Bishop Lori - First of all, it [i.e. the "accommodation"] does not remove the mandate and as a result it's still a great intrusion to the freedom of our churches. And besides that, we think it violates The Religious Freedom Restoration Act because it substantially burdens our religious freedom by forcing us indirectly, but nonetheless forcing us to provide the so-called preventive services in violation of our teaching and it also is simply unworkable because many religious entities are self-insured, and as a result, we are not only the employer but the insurer, and so then it directly involves us in providing the prescribed services.
1For example, the FDA information sheet on the oral contraceptive Ella (ulipristal acetate) describes its mechanism of action this way: "When taken immediately before ovulation is to occur, ella postpones follicular rupture. The likely primary mechanism of action of ulipristal acetate for emergency contraception is therefore inhibition or delay of ovulation; however, alterations to the endometrium that may affect implantation may also contribute to efficacy." Essentially, that means one of the effective mechanisms of the drug is to alter the uterine wall such that the fertilized embryo, which the Church considers a human life, cannot implant into the uterine wall, thus killing it and expelling it from the body.

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