Divergent policies on emergency contraception.

THE CATHOLIC HIERARCHY in Australia has stated that women going to Catholic hospitals after being raped may not be referred to sexual assault units that supply emergency contraception (EC).

In response, a Melbourne doctor, Sally Cockburn, said that women who have been raped should not be taken to Catholic hospitals if that was to be the policy, and a rape crisis spokeswoman said it would be negligent not to offer the treatment.

However, in Hartford, Conn., women's advocates and the local bishop have been negotiating a compromise with local politicians so that a new law does not include a requirement that Catholic hospitals provide emergency contraception, but will allow some women to be prescribed the post-sex method of contraception at Catholic hospitals. Emergency contraception works best if taken within three days of unprotected sex. Catholic hospitals in Connecticut would contract out post-rape examinations and subsequent provision of EC. The archbishop of Hartford, Henry J. Mansell, said, "We are not opposed to emergency contraception for women who are victims of rape."

Catholic teachings allow for the use of EC. Often cited as a major obstacle to the provision of EC in Catholic hospitals is the Ethical and Religious Directives for Catholic Health Care Services--rules that govern the provision of services in all 600 U.S. Catholic hospitals.

Directive 36 addresses the use of EC after rape as a way of permitting "a female who has been raped [to] defend herself against a potential conception from the sexual assault." Thus, the directive permits the use of EC when a woman "is the victim of sexual assault" and "after appropriate testing there is no indication that she is pregnant." The guideline, while well-intentioned, is complex, if not confusing and ambiguous. Catholic ethicists within hospital systems and in the academic community are not in agreement regarding the implementation of the directive. Each Catholic hospital is free to interpret the directive and implement either a liberal or a conservative policy. Thus, the process is subject to theopolitical pressure, most often from conservative bishops and lay Catholic groups demanding strict application of Catholic teachings in Catholic hospitals. Sadly, recent surveys by Catholics for a Free Choice show that few Catholic hospitals provide EC, although the number is growing.