5.31.2006

NFP and Embryonic Death

The Journal of Medical Ethics:
"Given certain plausible empirical assumptions, the rhythm method may well be responsible for a much higher number of embryonic deaths than some other contraceptive techniques."

I have read other sources on this argument before, and have related it to others in my many writings and arguments against all forms of contraception. I have long criticized the Roman Catholic approval of NFP (natural family planning) as hypocritical on a theological level, regardless of any abortifacient arguments. In addition, I believe the scientific assumptions made in this
research article are quite plausible, given the moderate knowledge of human reproductive physiology I have. The paper was published in the Journal of Medical Ethics (one of the British Medical Journal's publications).

As with the "unproven" assumptions we have showing hormonal birth control (the Pill, etc.) to have an abortifacient component, why would anyone knowingly employ a method of family planning which may lead to increased risks of death for the unborn?

Of course most of you know that according to my position this is a moot point. Regardless of the abortifacient nature of all the favored methods of family planning, ALL FAMILY PLANNING is against God's Word. My position does, however, allow for the potential application of ethical principles (casuistry) according to the Lutheran ethic of "conflicting absolutes," which leads us to choose the lesser evil and throw ourselves on the mercy of Christ.

Caspar

UPDATE: In response to his critics, the author of the article in the Journal of Medical Ethics has posted a reply on the British Medical Journal website. The reply gives further official documentation to his argument and does a good job of answering the most common objections voiced to his original article.

12 comments:

SUZANNE said...

If you think that Catholics shouldn't be allowed to plan sexual activity according to NFP, then all pro-life Christians have the moral obligation to NOT have sex when defective zygotes are a higher possibility. It cuts both ways.

Conception is a matter of chance. We are not obliged to conceive genetically perfect children. What about people who have deadly diseases whose offspring have a high degree a likelihood of dying. Should they be prevented from conceiving too?

The pro-aborts are losing sight of the fact that there's a different between going out of one's way to kill a newly conceived human, and letting nature take its course. Humans have the right to let nature take its course. Sometimes parents let nature takes its course for terminally ill children where there is practically no hope for survival. What is the difference with a genetically weak zygote?

Anonymous said...

It is my understanding that NFP may be associated with increased miscarriage because conception is occuring with weak or genically defective sperm. Stronger, healthy sperm are not present in the woman's body during ovulation bcause the couple has refrained from intercourse. How is this different from a couple having relations, and then the husband going on a business trip?

I don't see how ignorance of one's biology absolves the second couple, while the NFP couple is commiting sin.

Mary

Rebellious Pastor's Wife said...

First of all, this article is a Literature Review, which means it is a resource for explaining what the scientific literature says, but is not the actual scientific literature, even though it is in a scientific journal. A scientific article lays out the data from the study, and while it interprets, gives enough information to allow an educated person to determine whether or not they are misinterpreting the data, too. This often happens based on who funds the data, any biases the researcher might have, and statistical error. It's put in a journal so that other colleagues can respond to it.

But as far as the literature review article itself, by saying that a study on the Rhythm Method applies to all NFP is like saying that a study on the fur quality of Lhasa Apsos would apply to my German Shepherd. Might be a few similarities...but not really.

This article is referring to the Rhythm Method, one form of natural family planning, but one that is rarely utilized anymore. The Rhythm Method operates on the false premise that the woman will ovulate on the same day of every month...so the "old ovum" theory might be valid because this is simply not the case.
The methods utilized for conception by most people who practice natural family planning and who are trying to conceive are very different from the rhythm method. Instead for the purpose of getting pregnant, they rely on a combination of physical signs and the calendar...but the period where they abstain is fairly short...in fact, phase 1 is basically the exact length of my period. The period when sex is okay is from day 6 onward until the next period. Some methods such as sympto-thermal utilized by Couple to Couple League recommend every other day during phase 2 (simply from day 6 to 3 days after the temperature rise and fertile mucus has declined), so that fertile mucus can be monitored, but the "mucus only" method that is put out by Pope Pius the VI Foundation doesn't even require that....sex can happen every day (including phase 1)....when a couple is open to pregnancy, then there are no limitations, just a different way of training for monitoring mucus.
As I said before, if we are not talking about a method that tries to target a few days in the cycle, as the rhythm method does, I can't see how there would be more miscarriages because of the eggs position in the uterus. The only thing that I would say, is because of the sheer act of trying...maybe a partially viable egg just has more chance of being fertilized because the couple is participating in an act of union more often than they normally would because they are focused on creating a baby, so more sperm are present.

I don't see how you can have an objection to a couple using the signals that their bodies have in order to be MORE open to the blessings that God has for us. I understand why you don't think we should block it. The Rhythm Method is considered fairly primitive, the modern methods used by Catholics and others have such an insignificant period of abstaining that other than checking the signs, it bears almost no difference to "just being open."

In fact, there is a longer abstention time in Leviticus where a woman is unclean for 7 days when she has her discharge. There are various interpretations of this where this can mean "not until 7 days after its over." which would probably put her right near the day of ovulation and most likely to be fertile. And the more likely interpretation, 7 days after it starts...starts sounding an awful lot like NFP.

Pr. David Rufner said...

Suzanne, Marry, and RPW, thank you for your comments.

Caspar, while I have no objection to this story/article being posted here I must say I am disappointed at what considerations and comments weren't made and some that were:

1. While this was written in the Journal of Medical Ethics, it was written by an economist, Bovens, conjecturing based upon "certain plausible empirical assumptions..." (an odd and potentially spurious phrase that must forever be pushed uphill while never arriving - Sisyphus). This would have been particularly helpful for the reader who will read the quoted sound-bite, and form from it certain assumptions about the veracity of the argument while never going on to read the original document.

2. The author writes concerning the 'Rhythm Method'. Rhythm Method just isn't used anymore. It was certainly a precursor of sorts to modern NFP, but one who chooses to argue in this day and age against the Rhythm method (particularly in a published journal) raises a red flag or two cautioning the discerning reader to watch out for the straw man that may very likely follow.

3. The author has clearly taken little time to even investigate and learn about what the best/most current understanding is of human reproductive physiology. While there are most certainly depths of knowledge and comprehension that will forever be best understood and propagated by experts in the field, there is a great deal that is accessible and must be accessed by someone taking the time to publish such a paper as Mr. Bovens. I would also extend that same responsibility to anyone posting on this blog. Thankfully, in this regard, we are saved by Dr. Mark Whitty who took the time to respond from a medical perspective to Bovens little experiment with “a few relatively innocent assumptions” (we might all recall what our parents taught us about assumptions). Dr. Whitty’s response can be found at http://jme.bmjjournals.com/cgi/eletters/32/6/355. It represents a response that does not rely on assumptions but is grounded in actual scientific findings (something Bovens article can hardly be accused of). Furthermore, it represents the type of fair-handed information and response that I’d hope would accompany future posts like the current one.

4. The author undercharacterizes/mischaracterize our Catholic brothers and sisters and pro-lifers (you and me) as somehow being fundamentalist anti-embryonic-deathers. Why do I say it like that? Because he references and agrees with one John Harris in suggesting that if IVF, for instance, were ever to get to the point where there was less embryonic death than natural intercourse then out of honesty we anti-embryonic-deathers would have to switch to IVF. In this line of argument the author tips his hand as to either how little he understands our stance upon and position “pro” those things that the Lord God has called good (marriage, intercourse within marriage, procreation and children), or he demonstrates the lengths to which he will purposefully misrepresent our position in order to make the out workings of our position look so doggedly simpleminded and ridiculous. Regardless of which he does here it is incumbent upon us to recognize these things ourselves and point them out prior to using this as a platform making one’s case further against NFP.

5. You refer to the assumptions made by this author and the concerns over “The Pill” to both be unproven assumptions. Let me here offer a distinction that you don’t. L. Bovens assumptions are not only unproven as you say, but some are even discredited by Dr. Whitty’s references to published and accepted understanding of physiology. This is in sharp contrast with what you propose are unproven assumptions about the Pill. About the Pill we can definitively say that a) the Pill causes thinning of the endometrial lining in the weeks leading up to the normal time of ovulation in contrast with the bodies normal function of building and enriching the endometrial lining during this time, and b) that there has always been breakthrough ovulation for women on the pill at a rate that is now higher with the advent of lower-dosage pills. From the combination of these two facts comes the concern of the Pill and the reasonable assumption that at least at some rate there is embryonic (read ‘human child) loss (even if it is not huge). This puts your “unproven assumptions” over the Pill and NFP in entirely different camps while you have lumped them together.

+PDR

Caspar said...

I don't have much time right now. I'm on vacation this week and have only jumped on my parents' computer for a few moments to check e-mail and such.

1. The author of the study in question appears to be referring specifically to NFP, although he uses the more generic and scientific term of the "rhythm method." NFP is not the term one would expect to be used in a scientific journal. I do understand the distinction made by NFP proponents between what has always been called the "rhythm method" and the more advanced methods commonly called "NFP."

2. Unproven assumptions are all the same. If it hasn't been proven, one must take it all with a grain of salt. As a biology major with special emphasis on human physiology, and as a health professional who took his human physiology, pharmacology, etc., courses with medical and public health students and the University of Michigan, I do not speak from a lack of practical knowledge. The assumptions we have regarding hormonal birth control and NFP are in the same camp, regardless of what you may think. Again, unproven assumptions are all equally unproven. Some may be more believable than others depending on one's perspective and bias, but until proven they are all simply theories.

As a well-informed and educated health professional, I find the arguments made to be of as much merit as our arguments against hormonal birth control.

But, again, this is a moot point for me, since as you know I am 100% against ALL forms of family planning for purely theological reasons.

Until later,

Caspar

Devona said...

Pr. Rufner, I really liked your point #4.

I've been chasing a puppy around, and a toddler, so I'm really scatter brained right now. But I'm really glad you offered your insights. Thanks.

Pr. David Rufner said...

Caspar,

I am bewildered that you are unwilling to qualify different kinds of assumptions. Our legal system, for one, makes these distinctions daily - the differentiation between founded and unfounded - people often found guilty or innocent by the presence or absence of corroborating evidence - no smoking gun.

Dr. Whitty makes quick work of showing by published, peer reviewed, currently accepted science that Bovens work rests on unfounded assumptions while the concern over The Pill, for instance, is based on an assumption that rests securely on a track record of fact. Are all unproven assumptions unproven? By definition yes. Yet a quick test of the underpinnings of the assumptions leads all of us to make determinations as to whether the assumptions need further looked into.

Caspar said...

Pr. Rufner,

I believe Dr. Whitty is overzealous in his refusal to accept the possibility that the general point of this article may be valid. Dr. Whitty's wordy response concentrates on what is wrong with the article but does not admit the potentiality of even an ounce of truth.

All unproven assumptions are unproven, and therefore untried. For the legal metaphor you suggest to be worked out, one must put these assumptions to the test, which will not likely happen. There is no incentive for researchers to further test these hypotheses. As I said before, unproven assumptions are all equally unproven. Some may be more believable than others depending on one's perspective and bias, but until proven they are all simply theories. Reasonable people can obviously disagree on the veracity of the assumptions.

I presented the article as food for thought, given the proven assumption that it is a moot point for me :-) ALL FAMILY PLANNING is against the perfect will of God, regardless of the truth or falsity of this particular scientific argument. I have no interest in wasting my time defending it. Readers may take it for what they think it's worth. What I think it's worth is the fact that it represents a possibility, though unproven, that NFP is not as innocent as it may appear to those who make the natural law argument in its favor. It is not "natural," but rather strives against nature, considering the natural urge to procreate to be something which can be subdued without harm at the point in a woman's cycle when it is the strongest and most natural.

As Luther says:

"...it is just as necessary as the fact that I am a man , and more necessary than sleeping and waking, eating and drinking, and emptying the bowels and bladder. It is a nature and disposition just as innate as the organs involved in it. ...wherever men try to resist this, it remains irresistible nonetheless and goes its way through fornication, adultery, and secret sins, for this is a matter of nature and not of choice... For the Word of God which created you and said, 'Be fruitful and multiply,' abides and rules within you; you can by no means ignore it, or you will be bound to commit heinous sins without end."

--Martin Luther [LW 45, p. 18]

Augustine also vehemently criticized the "natural family planning" of the Manichees, who advised their "Auditors" to avoid procreation by observing the fertile period.

"In the history of the thought of theologians on contraception, it is, no doubt, piquant that the first pronouncement on contraception by the most influential theologian teaching on such matters should be such a vigorous attack on the one method of avoiding procreation accepted by twentieth-century Catholic theologians as morally lawful."

Contraception: A History of Its Treatment by the Catholic Theologians and Canonists, by John T. Noonan, Jr., Belknap Press of Harvard University Press, Cambridge, Massachusetts, 1966

For more details on my theological arguments against NFP, read onward here

I have no need of this insignificant scientific argument from the Journal of Medical Ethics to make my case against NFP. It was simply presented for your consideration, negative or positive, with my personal opinion appended to the links. Regardless, NFP seeks to limit procreation. It doesn't matter how "natural" you may think it is, it is FAMILY PLANNING just the same. It is against the will of God to modify or arrange your sexual experiences in order to divorce them from the possibility of procreation.

I am not one bit surprised at the emotionally defensive response this article has elicited, given the investment many have in NFP. It is, of course, the last thread of rope most Christians hang onto before finally submitting to God as the sole author of life who does not create where He cannot sustain. Why wouldn't one expect it to be vehemently defended?

Cordially,

Caspar

Eric Phillips said...

My wife had already pointed out to me the way this article cooks its numbers by restricting itself to the rhythm method and ignoring current NFP. Now from Dr. Witty's comments I learn that the very idea that an old ovum or sperm has a higher chance of miscarriage is unproven. That doesn't leave much left of Bovens' article, I'm afraid.

And quotations from Luther and Augustine (esp. old ones that, as I have demonstrated elsewhere, do not even prove Caspar's point _theologically_ let alone medically) don't make the article any stronger.

Anonymous said...

To all you Lutheran pastors who denounce family planning: If you were self-employed and had to pay for your own health insurance, do you think your opinions on family planning would change???? You pastors have all your insurance paid for by your employer, so you don't have to give one iota of thought to the cost of an expensive maternity rider on your insurance policy. In this world it takes lots of health insurance to deliver and raise children. Get real.

Caspar said...

Anonymous,

If you are going to criticize pastors who teach what the church has always taught, you might at least not hide behind anonymity. The law these pastors are charged with preaching the Law that convicts them just as much as it does you and me. If pastors only preached the law in such a way that it was something they and others could follow, they would not be preaching God's Word, and we would not realize our great need for the Savior of the world.

For the moment, forget what else you have read on this blog, and listen to what Martin Luther has to say about your concerns:

"Although it is very easy to marry a wife, it is very difficult to support her along with the children and the household. Accordingly, no one notices this faith of Jacob. Indeed, many hate fertility in a wife for the sole reason that the offspring must be supported and brought up. For this is what they commonly say: “Why should I marry a wife when I am a pauper and a beggar? I would rather bear the burden of poverty alone and not load myself with misery and want.” But this blame is unjustly fastened on marriage and fruitfulness. Indeed, you are indicting your unbelief by distrusting God’s goodness, and you are bringing greater misery upon yourself by disparaging God’s blessing. For if you had trust in God’s grace and promises, you would undoubtedly be supported. But because you do not hope in the Lord, you will never prosper. [Luther's works, vol. 5: Lectures on Genesis, page 332]

You, the pastors who preach against family planning, and I myself ALL fall far short of the trust demanded of us by God's Word to "be fruitful and multiply." If you want a Law you can follow without failing, become Muslim or Morman, or any of the many other false religions out there.

Thank you for helping me to make the point I'm always trying to get across in these discussions!

Caspar

Caspar said...

Bovens does a pretty good job of responding to all the above arguments in a reply he posted yesterday on the British Medical Journal site:

A Reply to My Critics.