A Little Nuancing on Defunding Planned Parenthood

Rachel Held Evans raised some good questions:

"Anyone else caught in this tension?: I'm pro-life in the sense that I believe life begins in the womb [I would say "at fertilization"] and is worth protecting even before birth. However, 9 times out of 10, I find myself totally disagreeing with the pro-life movement's methods for protecting that life.

“For example, completely defunding Planned Parenthood with no plan to replace its other services (like offering affordable contraception, gynecological services, and prenatal care to underprivileged women), could actually lead to more abortions. Teaching abstinence-only education in public schools appears to be less effective than comprehensive sex-education at reducing the teen pregnancy rate. Simply voting for Republicans who want to make abortion illegal (even though they are very unlikely to do so and even though criminalizing abortion won't stop it from happening) without considering how other conservative social policies affect women most at risk for having abortions seems like an exercise in futility.

“And opposing coverage for contraception in insurance policies seems like a great way to increase rather than decrease unwanted pregnancies."

When Dr. Bill and I were coauthoring our book on contraception for the Christian Medical Association, some Christians opposed our talk of methods that did not risk human life. These people wanted us to speak only about abstinence and natural family planning (NFP). 

BTW, according to the "2014 State of Dating in America" report published by Christian Mingle, 61% of Christians said they would have sex before marriage. And fifty-six percent said that it's appropriate to move in with someone after dating for a time between six months and two years.

My husband and I abstained till marriage. I'm all for that, believe me. But if most or even many Christians aren't abstaining, how realistic is it to go with abstinence-only teaching in the broader culture? The folks who considered us liberal wanted us to avoid any talk of family planning other than NFP—which we argued is pretty unnatural in that it interrupts sexual fulfillment at the time of the month wives are physically most interested, and for some wives the only time they are interested.

Contraception prevents abortions. We saw that in Russia when women could not get access to contraception, so they used abortion as their chosen method. We met women who'd had five, six, seven, eight abortions.... The married Christians there begged us to bring them contraceptives.

Today, where are the Christians offering alternatives to abortion beyond abstinence and NFP? It's not enough to offer Pregnancy Resource Centers that leave contraception out of the mix. If we are truly against abortion, where is our plan to really prevent them? If we don't care about making contraception affordable and accessible, perhaps we are blinded by our own middle- and upper-class comfort that knows nothing of working three jobs to put food on the table.

Bioethics in the News This Week

Thanks to the Center for Bioethics and Human Dignity for flagging these and other stories in the news this week: 

Measles Outbreak Sets Record 
(Washington Post)The measles outbreak has reached a record for any year since the diseasewas eliminated in the US 14 years ago, with 288 cases of the potentiallydeadly infection reported in 18 states. The largest measles clusters are inOhio (138 confirmed cases), California (60) and New York (26), according to theCDC. Almost all have been brought by travelers, mainly Americans, whocontracted the infection abroad.

Orlando Woman Oldest-ever IVF Mom 
(Orlando Sentinel)A 46-year-old from Orlando has become the oldest woman to have a baby through IVFusing her own fresh biological eggs.

Researcher Behind Stem CellControversy Agrees Retraction 
(Science)After steadfastly defending her work against accusations of falsified data, thelead author on two controversial stem cell papers published in Nature hasreportedly agreed to retract one of them.

Women’s Contraceptive UseInfluenced by Education and Moral Attitudes
 (Medical Xpress)Nearly half of all pregnancies in the United States are unintended, andunplanned pregnancies are associated with poorer health and lower rates ofeducational and economic achievement for women and their children, according tothe CDC. But the desire to avoid pregnancy does not necessarily increasewomen’s use of contraceptives. Levels of prior sex education and moralattitudes toward contraception influence whether women use contraceptives.

E.U. Commission Rejects Plea toBlock Stem Cell Research Funding
 (Science)The European Commission today turned down a request by pro-life organizationsto block E.U. funding for research using embryonic stem cells.

Quanity, Not Quality: Risk ofSudden Cardiac Death Tied to Protein Overproduction
 (Science Codex)A genetic variant linked to sudden cardiac death leads to proteinoverproduction in heart cells, scientists report.  

Medicine of the Future? (New York Times)It’s a growing field: bioelectronics. Today researchers create implants thatcan communicate directly with the nervous system to fight everything fromcancer to the common cold. The idea is to manipulate neural input to delaythe progression of cancer, says a researcher who discovered a link between thenervous system and prostate tumors.

Iran’s Population Drive WorriesWomen’s Rights, Health Advocates 
(Reuters)Iran’s supreme leader has called for a population increase, in an edict likelyto restrict access to contraception that critics fear could damage women’srights and public health. In his 14-point decree, Ayatollah Ali Khamenei saidincreasing Iran’s 76 million-strong population would “strengthen nationalidentity” and counter “undesirable aspects of Western lifestyles.”

Bioethics in the News

The Center for Bioethics and Human Dignity has compiled some of the week's top bioethics stories: 

Why Chromosome Errors Are High in Women’s Eggs 
(News-Medical) Up to 60 per cent of eggs areaffected by errors in how their chromosomes divide, making it the leading causeof infertility. A new study provides a better understanding of why.

Biggest Ever Autism Study Probes Environment as a Cause 
(New Scientist)About 1% of US kids are affected by autism spectrum disorder (ASD). Rates inmany countries have risen sharply in recent years and researchers don’t know ifASD is prompted by something in the environment, increased awareness of thecondition and changes in diagnoses, or people having children later.

Some Cold Medicines May Have Higher-than-Expected Levels of aDecongestant
 (New York Times)AFT Pharmaceuticals of New Zealand says that when the nasal decongestantphenylephrine, or PE, was combined with the pain reliever acetaminophen, levelsof PE in the blood were two to four times as high as when the same dose of PEwas taken alone.

IBM’s “Watson” Attempts to Tackle the Genomics of Brain Cancer
 (Forbes)IBM and the New York Genome Center have announced a partnership to test whetherthe computer that won on Jeopardy can sift through the genomes of cancerpatients and help doctors pick drugs.  

Who Wins? Contraception and Corporate Rights (Reuters)The Supreme Court could dodge the issue of whether corporations have religiousrights to be exempt from covering contraception. The court could rule thatindividuals who own closely held companies, rather than the corporationsthemselves, can argue their religious rights have been violated.  

3-D Printing Promises Better Bionic Limbs for the War-Wounded
 (Wired)At the MIT Media Lab, a 27-year-old doctoral student is using 3-D printing andadvanced math to create a new kind of artificial limb he believes cansignificantly improve the lives of amputees. Three-D printing also saved astruggling trying to breathe by making possible the creation of a splint (CNN).

Mom Sues for Wrongful Pregnancy 
(ABC News)An Illinois woman is suing her doctor for “wrongful pregnancy,” claiming abotched sterilization procedure led to the birth of a daughter with sickle celldisease. The 40-year-old mom of three believed she couldn’t get pregnantbecause she thought her tube was tied.

Researcher Discovers Genetic Mutation in Moroccan Jews
 (Sun Sentinel)Progressive Cerebro-Cerebellar Atrophy (PCCA), affects dozens of Israelifamilies of Iraqi and Moroccan-Jewish descent. But that number may soon bereduced.

Mexican Cartel Member Investigated Over Organ-harvesting Claims 
(The Guardian)– Mexican authorities have captured an alleged drug trafficker from the KnightsTemplar cartel who officials say is being investigated on suspicion ofkidnapping and murdering children in order to harvest their organs for sale.  

New Cell Line Will Probably Accelerate Embryonic Stem Cell Research 
(Medical NewsToday) U-Dub researchers have created a line of human embryonic stemcells with the ability to develop into a far broader range of tissues than mostexisting cell lines.

Electric Brain Stimulation Rouses Some People from a MinimallyConscious or Vegetative State
 (Washington Post)People who have been in a minimally conscious state for weeks or even yearshave been temporarily roused using mild electrical stimulation. Soon after thestimulation was applied to their brains, 15 people with severe brain damageshowed signs of consciousness, including moving their hands and followinginstructions using their eyes. Two were able to answer questions for two hoursbefore drifting back into their previous uncommunicative state.

Mammograms: Worth Having? 
(Washington Post)The deadliest cancers may spread before they’re detectable on even the best mammogram;and some of the cancers that mammograms find will never harm patients. Until wecan distinguish harmless cancers from deadly ones, we’re compelled to treat allof them. Thus, some women get surgery, chemotherapy and other treatments forcancers that would never have hurt them.

China Bans Genetic Testing
 (GeneticEngineering & Biotechnology News) For nearly a half-century, Chinapromoted the growth of genetic testing to prevent and address birth defects. Lastmonth, China reversed course. China’s FDA posted a regulation that bannedgenetic testing.

A Surgical Procedure’s Risks, Unmentioned 
(New York Times)Many patients assume that, like prescription drugs, surgical procedures andinstruments undergo extensive testing and must be government-approved. It’s notnecessarily so. Yikes!

The Christian and Contraception: My Thoughts

My Tapestry post today: 

Because I coauthored The Contraception Guidebook (Zondervan/Christian Med. Assn), and contraception has been in the news lately, I have received some requests to add my two cents to the contraception conversation. It’s not my favorite topic, but I do have some opinions. And they are moderate, which tends to hack off those at both ends of the spectrum. But here goes.

·      Do I think contraception is of the devil? No. I think it is a gift from God. It can be abused, but that does not make it evil.  

·      Do I think all Christians who choose to use contraception lack trust in God? No.

·      Much oral contraceptive use is about something other than preventing babies. Ask any woman who is doubled over with cramps or has had a laparoscopy for endometriosis or has a serious acne problem or irregular periods. I went on the pill for a while after I lost my seventh pregnancy and then had an ectopic. I did so precisely because I held a high view of life—I didn’t want any more embryos to die in the tomb that was my uterus.

·      Does it bother me that Christians through the ages have generally opposed contraception? No. Some of the methods they opposed were downright unhygienic, and I would have opposed them, too. Does the Bible say anything on the subject? Not specifically. Yes, it says children are a gift from the Lord. But they are not the main gift or the only gift, and using contraception does not necessarily mean one is “refusing the gift.”

·      I see the purpose of marriage as oneness (“two shall become one”—see Genesis 1and Ephesians 5), not reproduction. Reproduction is a gift and a blessing, but not the end goal of marriage. If reproduction were the goal, I would expect to see Paul in 1 Corinthians 7 mentioning a focus on baby making in addition to what he says about sex meeting needs; and I would expect Song of Songs to have at least one reference to the potential for little Shulamites. But instead it's all about pleasure.

·      I think couples can choose to be childless without devaluing marriage or being out of God’s will. Just as some choose not to marry for the sake of the kingdom, people can determine that having children is not the best option for them, all things considered.

·      I think a lot of middle- and upper-class people lack compassion toward lower-class people on the issue of insurance coverage for contraception. Hormones usually require monitoring, and monitoring involves doctors. And doctors cost money. Not everyone has money.  

·      I think it’s offensive when men are the primary commentators on issues that primarily affect women for the same reason that women should not be the primary spokespersons for erectile dysfunction. The ones who have the periods, deal with the endometriosis and cramps, use the tampons and/or pads, take the pills, use the sponges or the Nuva rings…we should be the ones leading this conversation. I’m not at all suggesting men should not weigh in on the topic. But when men are the primary speakers here, they tend to have an instant credibility problem. This topic is one where we should see men and women partnering to speak.

·      When people do speak on the topic, they need to watch their rhetoric. Saying that women wanting insurance coverage for contraception are “helpless without Uncle Sugar coming in and providing for them a prescription each month for birth control because they cannot control their libido or their reproductive system without the help of government”—is offensive. I have taken the pill. I have wanted insurance to cover it. And I did not do either because my libido was out of control or I needed Uncle Sugar. I wanted insurance to cover it so I could afford to keep doing ministry. My insurance covered abortion. It seemed only fair, then, that it also cover meeting my pro-life reproductive needs as well.

·      I despise abortion.  Abortion rates go down when contraceptive use goes up. If we oppose baby-killing, it stands to reason that we should support preventing the creation of unwanted children. We are not enabling people. They are going to have sex, regardless, as the stats have shown. The question is whether they will also conceive. 

·      We should never assume that someone who uses contraception takes a low view of human life. In most cases of which I am aware, people use contraception because they have a high view. They want to avoid abortion, provide for their families, and give the children they do have their love and care. And such choices are not about devaluing life (or materialism, as some accuse).

·      Part of showing mercy to the poor or those less fortunate is helping impoverished people who wish to limit family size have the ability easily to do so.

·      I believe life begins at fertilization and that a zygote, being made in the image of God, is endowed with full rights of personhood. Doing unto others and speaking for those who can’t speak for themselves means defending the human who is too tiny and undeveloped to speak for him- or herself. It is far better to prevent the creation of an unwanted/unplanned pregnancy than to destroy one. The debate is not over when life begins. Even the secular medical books concede that human life begins when the DNA from male and female gametes align. The debate is over whether the fully human zygote is a person and thus has rights of personhood.

·      We cannot assert with confidence that the pill causes abortion. There are a lot of “more sure than right” dogmatic statements being thrown around about this. The same hormone required to make a woman ovulate is what prepares the uterine lining. So if breakthrough ovulation happens, the uterus is probably prepared—which explains why many of us have friends who conceived while on the pill and carried to term. My doctor friends tell me that if the uterine lining were improperly prepared in such cases, we would see a much higher incidence of “uterine attachment” issues with women who have conceived while on the pill. And we just don’t see that.

For my take on whether the pill causes abortion, see this post:   Aspire2 Blog: Does the Pill Cause Abortion?  And then this Tapestry post about pills and abortion. (The journal article a commenter referenced in the latter does not appear to exist.)

·      If Jesus is the TRUTH, we need to have higher standards of storytelling on this issue. But only if we want to be like him. (Sarcasm alert.)

·      Rhythm is actually an effective method when used diligently. (In countries where that’s the only viable option, it’s surprisingly more effective than in the USA.) But I still don’t really recommend it unless the couple is committed to “outercourse.” With the rhythm method, during the one time of the month when a woman typically experiences the most pleasure, intercourse is out. So if the couple is inactive at this time, she may live in a perpetual state of sexual frustration. Thus, it seems that the one method most Christians approve is the only one that expressly contradicts 1 Corinthians 7. Ironic.

·      What do I think about Plan B? It’s complicated. See this post:  Aspire2 Blog: Does Plan B Cause Abortion?

Humans made in the image of God have a responsibility to their Creator and their community to prayerfully seek wisdom about their family building options. Are you wrestling with questions about contraception in your own life? Pray with your spouse, committing your most intimate details to Christ. Do you need to show someone grace on this issue? We do find such a variety of people and opinions in God’s varied pattern book of people, don't we? "Be kind to one another, tenderhearted..." 

Contraception Bill Misses Mark

Have you been watching the healthcare issue as it relates to violationof conscience? 

The Department of Health and Human Services issued final rules oncontraceptive coverage in the Affordable Care Act at the end of June. TheNational Association of Evangelicals (NAE) has closely followed the policy’sdevelopment and advocated for strong religious freedom protections for thosewho object on religious grounds to include contraception in their companyhealth plans.

“The final rule still leaves many religious employers unprotected,”said Leith Anderson, NAE President. “The government should not compel any ofits citizens to violate their consciences.”

While most Christians are okay with the use of contraception, manyshare concerns that some of the drugs to be granted required coverage by healthinsurance policies are abortifacients. Manypeople of conscience also believe that the limited definition of “religiousemployer” in the rule sets a dangerous precedent. 

The final rule exempts churches from the mandate.Religious non-profits that object to the mandate may offer insurance policiesthat do not include contraceptive services. But the insurance companies orthird party administrators are required to provide the beneficiaries of thosepolicies free contraceptive services. Religious organizations that arestructured on a for-profit basis do not even receive this accommodation.

“With the administration digging in its heels andCongress unlikely to act, it is up to the courts to restore the constitutionalprotection guaranteed to all Americans under the First Amendment,” Andersonsaid. “We are encouraged that many of the lawsuits filed on behalf of religiousemployers are receiving a favorable hearing.”

TheNAE has joined friend-of-the-court briefs in several related cases,including Wheaton College and BelmontAbbey College v. Kathleen Sebelius, Stormans v. Selecky, O’brien v.U.S. Department of Health and Human Services and Gilardi v. U.S. Department ofHealth and Human Services.  

Bioethics News This Week

The Center for Bioethics and Human Dignity reportsthese news stories for the week:

Studies cast doubt on cancer drug as Alzheimer’streatment
Four independent research groups report that they failed to fullyreplicate the striking results published in a journal last year supporting thehypothesis that Bexarotene, a cancer drug, has potential to treat Alzheimer’s disease.  (Scientific American)

California puts tentative price on health policiesunder new law
California announced Thursday that 13 insurers hadbeen chosen to sell policies through the insurance marketplace— orexchange. (New York Times)

Mom technically dead, gives birth. 
Three-month-oldElayna Nigrelli has redefined what it means to be a miracle baby. She was bornwhile her mother was technically dead. The mom was later revived, and now bothmother and child are fine. (CNN)

A medical first: Doctors save Ohio boy by‘laser-printing’ an airway tube so he can breathe
Soundslike something out of speculative fiction, huh? Doctors have apparently usedplastic particles and a 3-D laser printer to create an airway splint to savethe life of a baby boy who used to stop breathing nearly every day. It’s thelatest advance from the booming field of regenerative medicine, making bodyparts in the lab. (AP)

Stem-cell cloner acknowledges errors ingroundbreaking paper
A blockbuster paper that reported the creation ofhuman stem cell lines via cloning has come under fire. An anonymous onlinecommenter found four problems in the paper, which was published online 15 Mayin the journal Cell. (Nature)



Stem-cell treatment restores sightto blind man
 An experimental stem-cell treatment has restored the sight ofa man blinded by the degeneration of his retinal cells. The man, who is takingpart in a trial examining the safety of using human embryonic stem cells(hESCs) to reverse two common causes of blindness, can now see well enough tobe allowed to drive. (New Scientist)

Vermont becomes third US state to legalize assistedsuicide
The Democratic Governor of Vermont signed into law a bill thatlawmakers adopted last week. Vermont follows Oregon and Washington inlegalizing assisted suicide. (AFP)

South America contraception up to 79%, middleAfrica 19%
The poorest countries in the world lag behinddeveloping countries in meeting the demand for modern contraception, U.S. researcherssay. (UPI)

Bioethics in the News

Stem Cell Research: Soon “stemcell shielding” may protect the body from the consequences of chemotherapy. (BBC News)

Contraception: A new study finds that IUDs are the best, most reliableemergency contraceptive for women. (ABC News)

End of Life: Argentina’s Senate has okayed a “dignified death” law to givethe terminally ill and their families more control over end-of-life decisions.(BBC News)

End of Life: An analysis of medical data suggests that kidney patients aresubject to more intensive medical care in their last month of life than arepatients with cancer or heart failure.  (American Medical News)

Organ donation:  A British lab is growing spare body parts, suggesting organ donation maysomeday be a thing of the past. (Daily Mail)

Overstated evidence: A review of databases found that most clinical trials for cancer, heart disease, and mental healthare too small to offer adequate medical evidence. (New York Daily News)

Coerced abortion: A woman in China asserts she wasdragged from her home and forced to have an abortion.  (CNN)

Contraception and Conscience

The subject of contraception has stayed in the center of the news this week. As well it deserved to.

It all started years ago with a mentality that went and still goes something like this: “You don’t like our morals? Hey —you don’t have to live by them. Go build your own hospitals and make your own rules.”

People spent millions on their religiously motivated hospitals, offering care as a practical application of a worldview that calls us to “do justice, love mercy and walk humbly with [our] God.” In Dallas denominational titles such as “Presbyterian” refer as much to major hospitals in the area as they do to churches.

But now some Christian-run hospitals hear, “Too bad. We’re going to impose our ethics on you and you have to abide by them, anyway. We’re going to force our morality on you, while insisting that no one can legislate morality (we use that line whenever your morals feel limiting to us)."

And the politicos are surprised at the pushback? Seriously?

If you know anything about the contraception book Icoauthored, you know I take a moderate position on the subject. And I’m disinclined to think the pill causes abortion—certainly not frequently.  I actually think a believer can in good conscience use contraception.

But I also believe in the legal right of those with more conservative views on the subject to operate within their own free consciences as they administer care. That should be a basic American value. I believe we call it religious liberty.

So the administration made concessions—necessary concessions that our liberties demand. They did right in making them.

But.

The whole issue raises a huge question that can’t go away with the concessions: You seriously considered it wise to trample on freedom of conscience for people seeking to “do good”?  As Peggy Noonan wrote in the Wall Street Journal, “If the church is forced to go against its conscience, religious liberty in America is not safe.

If religious liberty is not safe, you are not safe” That’s true across party lines. “Religious liberty should not be a partisan issue."

Amen, sister. A-a-amen!

Selfish or Wise?

Christianity Today's women's blog, her.meneutics, recently ran an article by Ellen Painter Dollar titled, "Why We Don't Use Natural Family Planning." She received lots of responses--some positive, some negative. Some of the "nays" came from commenters who believe people like her are being selfish and refuse to face what's difficult to follow God by allowing Him to decide how many kids they should have. Such accusations evoked a response from me. Here's what I wrote: I am so glad to hear that Sam Torode told The Times, “I am out of the business of trying to tell people what they should do." This is a 180-degree change from when he was featured with my co-author (of The Contraception Guidebook) on the FamilyLife Today radio program*. At that time the Torodes’ “NFP is the only way” approach struck me as arrogant and ungracious. This more humble approach seems more in line with the Spirit of Christ on such issues.I received a call several days ago from a guy trying to figure out if he should have a vasectomy in preparation for seminary. His wife has been told she should have no more children, and the combination of his ministry goals and her health issues suggested to them that a vasectomy may be a Spirit-led decision.I think it’s interesting that in 1 Corinthians 7, the apostle Paul suggests that some may choose to remain single for the glory of Christ. I think the same applies to limiting family size. Colossians also comes to mind: “Do all to the glory of God.” A missionary friend in China has limited his family size to three children, because he and his wife have already exceeded what is culturally acceptable there, and they could “lose a hearing” with their audience if they have more children. Couples going to seminary often avoid pregnancy so they can give single-minded devotion to preparing for ministry.People who say it would be tough to have another child may not be at all selfish or wrong-minded on the issue. They may be good stewards to “count the cost” before building the house.*When gathering the hyperlinks to post this on my blog, I discovered the FL Today radio program has since remixed the shows to delete the Torodes' involvement.

Contraception in the News

I got a call several days ago from a guy trying to figure out if he should have a vasectomy. That may sound like a strange phone call. But as the coauthor of a book on contraception, sometimes I find myself having odd conversations with complete strangers. At least they’re thinking through the issues! Today’s New York Times reported that a medical advisory panel has recommended to the government that the U. S. require all insurers to cover women’s contraceptives, making them free as part of the new health care law. Officials responded by saying they were inclined go with the panel’s counsel. If the government agrees, new requirements would kick in at the beginning of 2013. As expected, the news received mixed reactions. Generally, physicians and women’s groups cheered the news, while the Roman Catholic Church "booed." I fall somewhere in the middle. I believe in many cases contraception is just fine. It’s the stuff that destroys human life that I take issue with. And I hate to see our government covering that. About half of all U. S. pregnancies are unintended, and about 40 percent of these end in abortion. So more contraception means less unintended pregnancy and abortion. Except… the coverage would also include emergency contraceptives, including Plan B. (For more on that, go here.) If a woman has not yet ovulated, Plan B may be a good choice. But sometimes such contra-conception actually ends a pregnancy. In such cases can we really say it has cut down on the number of abortions? One panel member, Prof. Anthony Lo Sasso, a health economist at the University of Illinois at Chicago, disagreed with the recommendation. He said the report includes “a mix of objective and subjective determinations filtered through a lens of advocacy.”