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June 24, 2010Before the Next After-Sex Pill
Moral, theological, and ethical questions behind ‘ella,’ a new pill to prevent pregnancy.
Medical experts, pro-life advocates, and women’s groups are once again debating the moral questions raised by so-called “morning-after” pills. On June 17, an advisory panel recommended that the FDA approve an emergency contraceptive known as “ella” for prescription use. Ella differs from Plan B, an emergency contraceptive FDA-approved for over-the-counter use, because it is effective for up to 120 hours after a woman has unprotected sex, while Plan B is only effective up to 72 hours after sex.
The controversy over ella centers on scientific uncertainty about its mechanism of action—whether it only delays ovulation, thereby preventing fertilization altogether, or whether it might also prevent implantation of a fertilized egg. The manufacturer has conducted studies showing that ella can delay ovulation. They have neither studied, nor do they plan to study, whether ella can also prevent implantation.
Because ella is a close chemical relative to RU-486, a pill that can terminate an early pregnancy, pro-life groups oppose FDA approval of ella because of its potential capacity to prevent implantation. Advocates for ella argue that the FDA should take a “just the facts” approach that solely evaluates whether the drug is safe and effective for its intended and studied use—preventing pregnancy after unprotected sex by delaying ovulation.
Given the potential for ella to prevent implantation, it makes sense for pro-life groups to oppose the drug’s approval. But in reading news coverage of the debates, I was struck by the tenuous nature of moral arguments centered on inconclusive scientific data. Both opponents and proponents of ella are focused on what science hasn’t yet made clear—whether or not the drug can prevent implantation. Without that crucial bit of knowledge, the ethical debate is reduced to the two sides stating and restating their competing interpretations of scientific data. Such a debate is unlikely to change anyone’s mind or lead to consensus.
I became interested in reproductive ethics for very personal reasons: Eight years ago, my husband and I underwent preimplantation genetic diagnosis (PGD, which is in vitro fertilization with genetic screening) to try to conceive a child who would not inherit my disabling bone disorder. In an e-mail discussion at the time with a theologian friend about the ethics of PGD, we explored theological perspectives on whether fertilized eggs have the moral status of human beings. Some theologians use scientific criteria to inform those views. For example, some argue that during the time after fertilization when it is possible for embryos to split and form twins, an embryo cannot be classified as a human being because it is potentially several people, rather than a single, unique person.
After several e-mails in which my friend and I tossed bits of scientific minutiae about embryonic development back and forth, he suggested that science provided an insufficient framework for examining the moral status of embryos. Approached from a scientific perspective, the question of whether a fertilized egg is a human being can be answered in different ways depending on the information we have and how we interpret it. The more important question, my friend argued, is whether we approach embryos reverently, as gifts whose worth is determined by the nature of the God who gives them, or empirically, as bits of flesh whose worth is determined by our scientific understanding of their particular traits at particular times.
Medical technology perpetually offers us new ways to have or not have babies and determine what kind of babies we do have. The vital questions raised by reproductive technology both incorporate and go beyond scientific data about how human bodies and medical science work. These questions have to do with our bodies as both mortal flesh and the dwelling places of those made in God’s image, and our status as both God’s dependent creatures and God’s beloved children. They have to do with intentions, world view, and context.Answering such questions requires significant reflection and engagement, which may not be easy, but holds potential for our culture to actually decide on some acceptable guidelines for reproductive medicine, rather than opposing sides continually talking past each other, trading different interpretations of unclear scientific data.
Ellen Painter Dollar is a writer who focuses on Christian reproductive ethics and disability theology. She is writing a book for Westminster John Knox Press (forthcoming in 2011) about the ethics and theology of assisted reproduction and genetic screening. She blogs at ChoicesThatMatter.blogspot.com and Five Dollars and Some Common Sense.
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Comments
A new human GENETIC life starts at conception - from there on it only gets bigger and more complex but is still unique and DIFFERENT from both parents - a new life.
The fact than some embryos can split into two twins makes it even MORE sacred - not less - I understand that they wonder when God gives the soul as if that is the start of life. God could put two souls in the fertilized egg knowing it would split. Some have argued that that is when the baby takes it's first breath like Adam, but that is a stretch, not a good parallel. Adam's formation is not clearly spelled out in scripture.
Until we KNOW if this new pill prevents implantation the way an IUD does, it should be avoided because it may kill a human being. Just like you wouldn't destroy a building if you thought there might be someone inside.
Posted By: Paul | June 24, 2010 6:20 PM
This is such a difficult topic because it is emotion-packed and so very personal. There are those who claim that even the birth control pill, that is so commonly used, can prevent implantation of a fertilized embryo, rather than merely preventing ovulation, so this question of morality and ethics goes way back to the introduction of the "Pill".
God alone knows for sure what the final answer is about this new product and any other birth control choice, but we should probably be very cautious about tampering with His creation of human beings, whether for convenience, for fulfillment, or for any reason.
Posted By: Suzy | June 25, 2010 8:42 AM
Thank you for taking this question beyond black and white. It is, as you say, complex. It's helpful for me to read some of the dimensions of that complexity, as you've laid out here.
Posted By: Sheila | June 25, 2010 8:50 AM
An unborn child has all the required genes to become fully developed at the time of conception, so scientifically they have to be called humans.
So it is black and white as far as the Bible is concerned, until research proves beyond a shadow of a doubt that this Ella pill does not stop implantation of a human then it is not to be used (atleast not by any professing Christian).
Also the regular birth control pill and Depo Provera shots/implants have been proven to sometimes prevent implantation, so these should not be used either, along with the IUD. Many women are still unaware about the regular birth control pill and Depo Provera causing chemical abortions because their doctors do not tell them this.
So really the only safe things to use are condoms and diaphrams or a combination of both
Posted By: Anonymous | June 25, 2010 9:57 AM
Since Ella is not known if it stops implantation of a human in the womb it should not be taken until proven otherwise.
But an even bigger problem is that most Americans are not aware that the Pill and other chemical "contraceptives" cause millions of "non-surgical" abortions each year in the early weeks of pregnancy. If you are using the Pill, Depo-Provera or Norplant, you need to know the truth about how these products work.
Most women take these "contraceptives" because they don't want to have a baby. But how many women know they can have BREAKTHROUGH OVULATIONS and become pregnant while using these "contraceptives?" Very few! And how many of these women know that if they become pregnant after a BREAKTHROUGH OVULATION, these "contraceptives" will almost always kill any son or daughter they've conceived?
Most people don't know the real facts about how "contraceptives" work. And because of this lack of knowledge, most women are not aware that they may be having BREAKTHROUGH OVULATIONS, and conceiving children that are killed very early in the pregnancy. Women using these "contraceptives" almost never perceive that they have become pregnant, or that chemicals have killed their tiny baby.
I recommend this website to learn more:
www.prolife.com/BIRTCNT.html
Posted By: Linda | June 25, 2010 10:08 AM
Ellen, Thanks for a thoughtful guide to help us navigate these waters.
Posted By: amy Julia | June 25, 2010 10:24 AM
It is very understandable to get upset at the prospect of an unintentional abortion, but I do not believe that this pill causes an abortion at all. There is a two step process to a pregnancy first the fertilization of the egg by sperm, and secondly the implantation of the fertilized egg. I takes both actions for a pregnancy to occur; if we are to say that the prevention of the implantation of the egg is an abortion we would also have to come to the conclusion that wearing a condom also aborts a baby because it prevents fertilization of the egg. Both steps are necessary for a pregnancy; there is no life in a fertilized egg until it receives the nutrients from the the body of its host(mother). The act of a life being formed can not happen until the fertilized egg connects with its host; in fact there is no way of knowing how many fertilized eggs do not connect with its host thereby some get passed into the stool; we do not refer to this as a miscarriage because life had yet to be formed.
Posted By: J.R. | June 25, 2010 7:06 PM
J.R. - you are gravely mistaken. Immediately after conception, the baby has a unique DNA pattern (different from either the mother and the father) and begins to divide into multiple cells. If it fails to implant, it's an early miscarriage - although you'll never know it and you may have your period as normal. These children, known to God alone, are a great mystery and you might consider not recklessly interfering in God's plan, but rather "be fruitful and multiply" - his first command to us - and let God take care of the rest.
http://www.gynob.com/concepti.htm
Posted By: LUKE1732 | June 26, 2010 7:31 PM
Sometimes I think I'm the only Christian who doesn't believe life necessarily begins when a sperm cell fertilizes an egg cell. Maybe I've missed something, but I don't see any evidence of it in the Bible other than Job's comment that God knit him together in his mother's womb. But it doesn't elaborate on WHEN that happened. Was it in the first 24 hours? In the third month? In the ninth month? At what point did what God wove become a person? God created Adam out of dust, but the dust was not a person until it BECAME Adam.
A collection of cells that has not yet developed a nervous system knows nothing and feels nothing. It has no consciousness. It cannot survive in the outside world. How then is this a human being? Just because it CAN become a human being doesn't mean it IS one yet. I understand the ancient Jews believed life began at birth, not at fertilization. Why exactly do we think it begins at fertilization?
Supposedly, some very high percentage of fertilized embryos never implant anyway. Why would God create souls for all those doomed cells to begin with? Where do all those souls go? If estimates are correct, there are almost as many of these spontaneously aborted cells as there are living human beings!
I'm not trying to be obtuse here. I just don't see any mention of contraceptives or abortifacents in the Bible even though they were used at the time, and besides that verse in Job, I haven't found anything that can be construed as indicating that a sperm and an egg become a full-fledged human being from day one.
Posted By: Anonymous | June 27, 2010 2:48 AM
Honestly, this whole debate infuriates me.
Would you rather a woman not have access to these products, subsequently become pregnant, and have an abortion later anyway - when the child has nerves, feelings, and sentience? When she is then, very obviously, killing a very much alive and formed being because she was not given other options to begin with?
We're defending the rights of cells? Really? Let's be serious: a woman who has decided to have an abortion is not going to be swayed by all the rhetoric on sites like these. Call me crazy, but I'd rather run the risk of preventing the implantation of a few cells with no cogniscance than the eventual abortion of an actual fetus. If I had to choose, I'd rather a woman sacrifice a few cells - cells that are not sentient, are incapable of feeling pain, etc - than a living, breathing, forming baby.
It's hypocritical dichotemies like this one that drive women to the desperate decision to get an abortion in the first place. If you take all of a woman's options away, what else is she left with?
The lesser of two evils, folks....come on, now...
Posted By: Anony | June 27, 2010 8:02 AM
Re: Anony
Remember the TWO moral questions posed here: Is it right for a Christ-follower? Should it be legal in a free, secular society? The answers may differ!
Most comments above reflect on personal use, not the legality. I can avoid hormonal BC due to my personal convictions while acknowledging that it is a totally rational option for most women.
Posted By: Stacey | June 27, 2010 9:37 PM
Thanks for bringing this to my attention. I had not even heard of "Ella" and its existence certainly raises serious moral issues that Christians should grapple with. I appreciate your even-handedness and desire to get more facts before making a judgment about this. It's the kind of balanced approach I have come to expect from reading your blog -- which is a service to us all.
Posted By: Jana | June 28, 2010 2:36 PM
Seems to me no one is addressing the MORALITY of having sex under the wrong circumstances, thus preventing the need for this type of medication. Not talking about rape, talking about a woman old enough to know better and going ahead and doing the nasty anyway.
Posted By: Anastasia | June 30, 2010 11:50 AM
It seems to me, the question we as Christians should examine in relation to this product, is: Why would you want to terminate an embryo in the first place? As noted by another comment, this type of pill would most likely be used to cover-up having sex before marriage, which is wrong from a Biblical perspective anyway. The deeper issue of MORALITY should then be the first issue we, as the bride of Christ, need to address.
Posted By: Jennifer | July 6, 2010 10:12 PM