Response to Dr. Sullivan's "Doubts" About Hormonal 'Contraceptives'"

Dianne N. Irving
copyright March 24, 2009
Reproduced with Permission

[[For a list of detailed scientific and philosophical references to my comments below, please see my articles:

1. Introduction

Oddly enough, several related issues involving the early human embryo and the use of various "abortifacients" that apparently had been laid to rest for several years are currently having a "rebirth", if you will. For example, if ovulation and fertilization have taken place, could the use of such "contraceptives" be abortifacient and also cause the death of this early developing human embryo either while still in the woman's Fallopian tube or when attempting to implant in her uterus?

It might also be noted that there have been a number of such articles recently that also attempt to resuscitate one dubious interpretation of the "principle of doubt". That is, it is claimed, if one has doubt as to whether or not there is truly a living innocent human being present, then it is morally acceptable to use hormonal contraceptives.

Thus there are two things that might be pointed out to those who are truly sincere about forming their consciences well. First, this version of the principle of doubt (Jesuitical) has historically always been in contradiction to another version (Dominican) - the latter being that formally accepted by the Roman Catholic Church. That is, if there is a doubt, then one may not do it. Second, many of these articles purposefully attempt to create "doubts" where in fact none exist in order to justify the use of hormonal contraceptives. One thus often comes across phrases such as "we just don't know", "it is still an open question", "the debates are not yet settled", "we can't be sure", "there is insufficient evidence", etc.

In a 2006 article that is currently being circulated again, Dr. Dennis M. Sullivan, an Evangelical bioethicist, quite pastorally and gently presents his own case, concluding that because there is still such disagreement about the scientific facts (and other "doubts"), such hormonal contraceptives could in good conscience be used ("The oral contraceptive as abortifacient: an analysis of the evidence", Perspectives on Science and Christian Faith, Vol. 58, No. 3, September 2006, pp. 189-195; available from

Although Dr. Sullivan makes some excellent and helpful points in his analysis, there are several of them that perhaps need a bit of clarification - especially if one is truly concerned about a "well-formed" conscience. My response will focus on just a few of the main points that Dr. Sullivan employs.

2. Dr. Sullivan's theses

Dr. Sullivan begins by noting the (apparent) basic unanimity among "Christians" who are opposed to abortion, since they hold that "human personhood begins at conception" - although they may be divided in their "ethical approaches" to hormonal contraception. He then adds that if hormonal contraceptives can be scientifically proven to be abortifacient, then Christians who hold that human personhood begins at conception would be morally opposed to the use of oral contraceptives. He then proceeds to "examine the scientific evidence" for any abortifacient effects of contraceptives, concludes that such effects are yet scientifically unproven and thus in doubt - and thus hormonal contraceptives may be morally used --, responds to some Roman Catholic "ethical arguments" involving the Principle of Double Effect, and suggests the final answer might be found in further research on early pregnancy factor (EPF).

3. Personhood

It is not scientifically true to claim, as Dr. Sullivan does, that human personhood begins only at "conception" (fertilization, sexual reproduction). The use of such naive "science" would be dangerous if used in any legal documents where such language would be exclusionary. Human beings, who are always simultaneously human persons (no academically indefensible "mind/body" splits!) are reproduced by both sexual (fertilization) and asexual methods (e.g., naturally occurring human monozygotic twins in vivo, the many different kinds of human cloning and other reproductive human genetic engineering methods in vitro). Further, many states already define "conception" as "beginning at implantation". Perhaps it would be more scientifically and philosophically accurate - and legally safer -- to state that human personhood begins when the material aspect of the human being begins - at his or her biological beginning.

4. Examining the science

Hormonal contraceptives have already been empirically determined to be abortifacient at least some of the time if breakthrough ovulation and fertilization have taken place. This is a scientific and medical fact that has been documented and known for a long time, and I would defer specifically to the excellent work of Drs. Wilks ( and Kahlenborn ( This scientific fact is even admitted and documented by the manufacturers of these contraceptives, and is included in the inserts for their drugs as well as on their websites. Dr. Sullivan himself actually admits this in his article: "There is no doubt that this is true at least some of the time. This should be obvious from the known 'failure' rate of the Pill cited earlier (0.1-5%)". It is also a scientific fact that some contraceptives result in either a thickening or a diluting of the cervical mucus, which would also cause any embryo still present in the Fallopian tube to reach the uterus either too late or too early in their biological development to successfully implant (and thus, die) - a scientific point that Dr. Sullivan fails to mention.

It would seem then that, although Dr. Sullivan later accuses Dr. Larimore of committing the petitio principii fallacy (where he implicitly assumes as true that which he would prove), Dr. Sullivan commits this fallacy himself. That is, in "examining the scientific evidence for an abortifacient effect" he only succeeds in "proving" his own assumption by means of denying what the scientific facts truly are to begin with. Denying such empirical facts by no means changes the reality of these empirical facts. Dr. Sullivan cannot legitimately insert his "Doubt" about something that is not, in fact, in doubt.

However, he proceeds to insert more Doubt by means of comparing this known failure rate with non-Pill users - i.e., "70% of fertilized ova fail to proceed to a full-term pregnancy". How Dr. Sullivan thinks that such a comparison is statistically or factually significant is seriously questionable. It would be like comparing apples and oranges. He seems to assume that any failures of fertilized ova to proceed to a full-term pregnancy (does he mean, implant?) happen for the same reasons and under the same circumstances and conditions with non-Pill users as those that fail to implant by Pill users. If these two scenarios are not equivalent, then any such "analysis" wouldn't even pass a t-test. E.g., for non-Pill users, by far most of these "failures" are caused by severe genetic abnormalities in the embryos themselves; in fact, many such embryos are not literally human (e.g., di- and tri-spermy entities, etc.). On the other hand, it could be legitimately argued that most of those embryos of the Pill users that fail to implant do so because of the adverse external conditions in the lining of the uterus and in the environment surrounding the probably-normal embryo still moving through the Fallopian tube and entering the uterus caused by these hormonal contraceptives. And this doesn't even take into consideration the dissimilar intentions involved: for the apples, the intention is to get pregnant; for the oranges the intention is to prevent pregnancy at all costs. (I would agree with Dr. Sullivan's astute observation, however, that "implantation" is not when a woman normally becomes pregnant -- as many medical and other professional associations want to claim --, but rather when the sperm fertilizes the oocyte while in the Fallopian tube).

For these and similar reasons, I do not find Dr. Sullivan's Doubts about the known science legitimate or reasonable.

5. Principle of Double Effect

Dr. Sullivan dismisses the arguments of Drs. Larimore and Stanford (not Roman Catholics) who attempt to apply the natural law Principle of Double Effect. It is my observation that indeed all three misinterpret this principle - and I would note that before Larimore and Stanford changed their minds their own studies were replete with the term "pre-embryo" - which term was formally rejected by the international scientific nomenclature committee on human embryology as unscientific and grossly misleading. (It is no secret that the term "pre-embryo" was enthusiastically embraced for years by many of those who wanted "scientific" justification for not only the use of abortifacients, but also for performing human embryo research, human cloning, human embryonic stem cell research, human embryonic genetic engineering, prenatal genetic diagnosis, the preparation and production of certain vaccines, etc.) Since the science involved in whether or not these contraceptives are capable of being abortifacient is clear - that is, they can and do cause the deaths of innocent living human beings - then one doesn't even have to employ the Principle of Double Effect. Such use of contraceptives would be ipso facto unethical.

Further, there are three conditions required to be investigated in order to determine the morality of a human action by applying the Principle of Double Effect: (1) the object of the will (i.e., the kind or nature of the human action performed) must be per se good or at least per se "neutral"; human actions that are per se evil may not be done - regardless of the intentions or the circumstances; (2) if the human action is per se good or per se "neutral", then one can consider the intentions of the agent; (3) one can then also consider the circumstances surrounding the action. In natural law philosophical ethics all three conditions must be met - not just any one of them. Just taking the first and most important condition, to knowingly and willingly kill an innocent living human being by the use of abortifacients is a human action that is per se evil - and thus may not be done, regardless of the intentions or the circumstances. It may not be done even when there is some doubt involved. And it should be noted that the Jesuitical version of the principle of doubt may not be legitimately applied to issues involving scientific or medical empirical facts.

6. The issue of "ethics"

This raises yet another issue that is probably not welcome to the discussion, but one that I honestly think must finally be raised - the issue of "ethics". Dr. Sullivan seems to sweep a very broad stroke when he implies some unanimity of "ethics" among Christian "social conservatives". Such universal unanimity simply doesn't exist. First, Dr. Sullivan often appeals to the secular bioethics principles of autonomy, justice and beneficence in his other articles, yet appears to be oblivious as to the very recent history of the "birth" of bioethics in 1978 by the U.S. Congress, the disastrous definitions of those very principles in the Belmont Report, the practical inability to apply this bioethics "ethics" in the hospital, clinics, etc. Such "ethics" can hardly be called a "Christian ethics". The point is that historically there are dozens of different kinds of ethics, each of which uses different ethical norms and metaphysical/epistemological/anthropological suppositions, and therefore each of which is far different and distinct from the ethics formally taught by the Catholic Church and which often run counter to those Catholic ethical principles. His mis-analysis of the use of the Principle of Double Effect, from natural law theory, is an example. Perhaps Dr. Sullivan is quite genuinely unaware of this diversion, as is especially evident when he makes the comment at the beginning of his article that, "Social conservatives have opposed all forms of abortion on absolutist grounds, allowing only rare exceptions where the life of the mother is truly at stake." This is hardly the position of the Catholic Church which firmly teaches that abortion may not be used even when the life of the mother is at risk. Other kinds of actions that are either per se good or per se "neutral" might be used, but since abortion is always per se evil it can never be morally acceptable. I realize that this is an area where many do not want to tred, and I respect Dr. Sullivan's obvious efforts at being "pastoral", but given what is at stake I do think it even more "pastoral" to let people on both sides of the "social conservative" aisle understand the inherent differences in the various "ethics" employed.

7. Early pregnancy factor (EPF)

Finally, Dr. Sullivan thinks that perhaps his scientific "Doubt" could be cleared up if we had more scientific data on exactly when the EPF could be detected. However, such data would still not contravene the already known scientific data that has already demonstrated that when ovulation and fertilization have occurred new living innocent human beings could be, and are, eliminated by various mechanisms proper to the biochemistry of such "contraceptives". Nor would such data still erase any "Doubts", because it is not only possible but probable that the newly formed embryo reproduced at the beginning of the process of fertilization (according to the Carnegie Stages of Early Human Embryonic Development) would not be immediately able to "chat" with the mother's immune system or cause the production of EPF yet. Therefore, detection of EPF would not provide an indubitable estimation of whether or not an embryo is already in existence (but not as yet causing the production of EPF).

In short, in all due conscience, I do not find the good Dr. Sullivan's analysis of hormonal "contraceptives" scientifically accurate, statistically probable, ethically reasonable or sufficient to endorse their use.