Variability in “Plan B” Provision Among Catholic Hospitals in Oregon: Ramifications and Grounds for Allowing Conscientious Provision of Emergency Contraception to Rape Victims in Catholic Hospitals

Abram Brummett – Oakland University School of Medicine; Victoria Whiting – University of Colorado - Denver

Abstract: 33% of acute-care hospital beds in Oregon are in Catholic facilities, one of the highest percentages in the country. While many Catholic hospitals allow the emergency contraception (EC) drug levonorgestrel (best known by the brand name “Plan B”) to be prescribed as part of standard of care for rape victims per American College of Obstetricians and Gynecologists (ACOG) recommendations, some prohibit it based on institutional conscience given the belief that it may act as an abortifacient. Since the moral permissibility of levonorgestrel is an open question within Catholic teaching per the Ethical and Religious Directives for Catholic Health Care Services (ERDs), the ongoing reasonable internal disagreement on this issue can serve as the basis for Catholic hospitals to accommodate physicians and other prescribers who feel compelled by conscience to provide EC to rape victims. Currently, U.S. legal asymmetries protect conscientious objection (CO) in health care, but not conscientious provision (CP). Catholic hospitals can sanction and even fire physicians who provide EC. Importantly, we only advocate for prescription of levonorgestrel to rape victims in Catholic facilities when one of the established protocols for pregnancy testing have been performed to meet the requirement of “appropriate testing” per the ERDs. Ramifications of barriers to EC access will also be identified.

Keywords: conscientious objection, conscientious provision, emergency contraception