UK Catholic Leader Clashes With Gov't Rules on 'Morning-After Pill'

By Patrick Goodenough | July 7, 2008 | 8:05 PM EDT

( - Access to the "morning-after pill" has become a political issue in the United States, and now a Catholic leader in Britain is taking a stand against government regulations requiring doctors who object to providing "reproductive services" to refer patients to another physician.

Cardinal Cormac Murphy-O'Connor, head of the Catholic Church in England and Wales, instructed a private Catholic hospital in north London that it could not refer patients for abortions; for amniocentesis in cases where the test for abnormalities is used to determine whether to end the pregnancy; or for contraception - especially where the birth control is or may be abortifacient.

Pro-lifers who believe that human life starts at the point of fertilization regard the morning-after pill (MAP) as an abortifacient, because one of its functions is to impede implantation of the embryo in the lining of the womb.

Murphy-O'Connor recently sent a letter to the administration of the Hospital of St. John and St. Elizabeth, after receiving a report from a senior Catholic lawmaker whom he had asked to investigate complaints that the facility was not upholding church teaching.

The problem looked set to worsen when the hospital began to allow doctors to operate medical services at the hospital under the government's National Health Service.

The cardinal is the patron of the hospital, which was established in 1856 to serve the sick and the dying "in accordance with the spiritual and ethical principles of Roman Catholic teaching and traditions." The hospital has become popular with some celebrities.

Murphy-O'Connor told the hospital to revise its code of ethics to make it clear that staff should neither recommend "unacceptable" procedures or treatments, nor arrange for them to be done elsewhere, nor do anything intended to set into motion a move to have them done elsewhere.

He acknowledged that there were tensions between Catholic doctrine and contemporary medical practice and the expectations and attitudes of many patients, Catholic or otherwise.

But it must be made clear, the churchman said, that a Catholic hospital cannot offer patients "the whole range of services routinely accepted by many in modern secular society as being in a patient's best interest."

St. John and St. Elizabeth says it does not carry out abortions or prescribe contraceptives, including the "emergency contraceptive" MAP, but that it is obliged to refer people to other facilities.

According to the U.K. regulatory body, the General Medical Council (GMC), doctors who feel unable to offer treatment for religious or ethical reasons are obliged to inform patients of their right to see another doctor.

A new draft of the regulations, expected to be introduced soon, goes further, adding "where it is not practicable for a patient to make such arrangements themselves, you must ensure that arrangements are made for another suitably qualified colleague to take over your role so that the patient's care does not suffer."

In the U.S., the MAP marketed as "Plan B" was approved by the Food and Drug Administration seven years ago and remains controversial.

A number of states have debated or are debating making access easier or more difficult. Some have passed laws requiring hospital emergency rooms to provide patients who have been sexually assaulted with the MAP.

The issue is expected to feature in several political races this year.

Senator Hillary Rodham Clinton (D-N.Y.) last month vowed to block President Bush's new appointee to head the FDA over the issue, accusing the FDA of "dragging its feet" over an application to make Plan B available over the counter.

In a "mystery caller"-type survey several years ago, the advocacy group Catholics for a Free Choice (CFFC) discovered that not all of the almost 600 Catholic hospitals in the U.S. were upholding church teaching when it came to dispensing the MAP.

It said five percent of the hospitals said they would provide it on request, another 23 percent said they would dispense it in the case of rape, and 55 percent of the hospitals refused to provide it to patients under any circumstances.

Of the hospitals that refused to dispense the MAP, 53 percent refused to provide a referral, CFFC reported.

The group reported early this year on a follow-up survey, focusing on the states where laws not require emergency rooms to provide the MAP to rape victims - California, New Mexico, New York and Washington State.

It said that for Catholic hospitals in those states, the MAP was reported to be unavailable for sexual assault patients 35 percent of the time.

"Among the respondents to the mystery caller survey, only about half (53 percent) gave the caller the name and telephone number of another facility where [Plan B] might be available," CFFC said.

Although Catholic teaching on the MAP is clear-cut, there appears to be a loophole in the case of rape.

According to Catholic health care service guidelines called the Ethical and Religious Directives, a woman who has been raped "should be able to defend herself against a potential conception from the sexual assault."

They continue: "If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization.

"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."

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Patrick Goodenough
Patrick Goodenough
Spencer Journalism Fellow