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Treatment of Victims of Sexual Violence (I)

May 8, 2013

Imagine, if you would, a female victim of sexual violence placed before a physician who, perhaps, operates in an emergency setting. Potential consequences of sexual violence can include impregnation and this concerns she who has experienced assault. I wonder of the extent to which readers are familiar with how Catholic moral tradition engages with such a scenario.

Consider Directive 36 of the Ethical and Religious Directives for Catholic Health Care Services. The Directive states, among other things, that “a female who has been raped should be able to defend herself against a potential conception from the sexual assault … [that] she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization.”

If interest exists, I would like to reflect upon considerations of apparent moral impact surrounding the administering of emergency contraceptive measures. I anticipate four posts. The first two will surround administering emergency contraception for the purposes of preventing pregnancy (in the first of these, I would reflect upon emergency contraception in the context of self-defense and, in the second, would reflect upon the abortifacient potential of emergency contraceptive measures and how that potential impacts moral assessment). In the third post, I would reflect upon the moral impact of administering emergency contraception for the purposes of impeding implantation and, in the fourth, I would conclude by identifying some protocol which have been established; protocol which strives toward care of the victim by conscious application of Catholic moral teaching.

So … emergency contraception as self-defense.

Timothy O’Connell, in his Principles for a Catholic Morality, observes that moral assessments of human action consider not only the sort of act preformed, but also the intention of the acting person and the extent to which relevant circumstances alter moral quality. He or she who provides a neighbor transportation, for example, but fails to mention the neighbor being coaxed into the vehicle by gunpoint, fails to impart a significant element of the human action.

Recognizing these various fonts, Martin Rhonheimer argues — in Ethics of Procreation & the Defense of Human Life: Contraception, Artificial Fertilization and Abortion — that those under even the threat of sexual violence can, in principle, employ measures that act against the possibility of pregnancy. Such use lies outside the scope of the norm prohibiting artificial methods of regulating birth; the ethical context, Rhonheimer contends, is entirely different. Particular circumstances in the Balkans had provided Rhonheimer a context to reflect upon those under threat of sexual violence and when Germain Grisez was questioned about those under similar threat, in Contraception … Is it Always Wrong?, he responded that those stripped of consent are under no obligation to suffer the results of an unjust attack. Potential results of sexual violence include impregnation and one who seeks to prevent pregnancy following assault does so in self-defense.

Catholic moral tradition, surrounding artificial methods of regulating birth, is informed by the conviction that when sexual acts within marriage can include both a unitive and a procreative dimension, neither may rightly be separated from the other (Humanae vitae, paragraph 12).  When, in 1997, the Pontifical Council for the Family issued the Vademecum for Confessors Concerning Some Aspects of the Morality of Conjugal Life, listen to their language: “The Church has always taught the intrinsic evil of contraception, that is, of every marital act intentionally rendered unfruitful (paragraph 24, emphasis added). Those operating within the framework of this tradition are thus able to say what the Ethical and Religious Directives have in Directive 36.

As Nicanor Pier Giorgio Austriaco writes, in Bioethics & Beatitude: An Introduction to Catholic Bioethics, a victim of sexual violence is “not choosing to sterilize a freely chosen sexual act. She is not choosing the unitive dimension of sex while simultaneously rejecting its procreative dimension. Indeed, properly speaking, she is not choosing at all”. In receiving an emergency contraceptive measure, she can choose to “defend herself from a further violation from her rapist and the further perpetuation of an unjust act of sexual violence”.

Kevin O’Rourke, in an 1998 Health Progress article entitled “Applying the Directives: The Ethical and Religious Directives Concerning Three Medical Situations …” observes that “some are surprised to realize that the teaching of the Church allows a [victim of sexual violence] to use contraceptive medication [even though] such medication is prohibited for married women who have engaged in intercourse with their husbands. A woman who has consented to intercourse accepts a responsibility [to maintain] the intrinsic significance of love and procreation [in her interaction with her husband]. The rape victim, however, has no such responsibility because she has not consented to the sexual act.”

In short, the norm prohibiting artificial methods of regulating birth has a particular scope. Victims of sexual violence, in seeking to prevent a pregnancy from resulting from an assault experienced, exist outside that scope. Victims who self-defend in such a way, in principle, do so legitimately.

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