The following statement from prolife Ob/Gyns was issued in January 1998, and sent to me in light of my booklet Does the Birth Control Pill Cause Abortions? I disagree with their conclusion, as reflected in the current revision of my booklet. Following the physicians' statement, I've included some pertinent comments about it from that booklet revision.
Birth Control Pills: Contraceptive or Abortifacient?
Currently the claim that hormonal contraceptives [birth control pills, implants (norplant), injectables (depoprovera)] include an abortifacient mechanism of action is being widely disseminated in the pro-life community. This theory is emerging with the assumed status of "scientific fact," and is causing significant confusion among both lay and medical pro-life people. With this confusion in the ranks comes a significant weakening of both our credibility with the general public and our effectiveness against the tide of elective abortion.
This paper is meant to provide some clarifying information on the issue based on current knowledge and experience regarding the mechanism of action of hormonal contraceptives. It has been compiled in consultation with, and by cooperative effort of, several practicing obstetrician-gynecologists, perinatologists, and reproductive endocrinologists (all among the undersigned), each being a physician committed to the sanctity of human life from conception.
We begin with the recognition that within the Christian community there is a point of view which holds that artificial birth control per se is wrong. We would consider this a personal matter of conscience and belief, and this paper is not intended to argue for or against this issue.
In this discussion we accept the time honored definition that conception occurs when a sperm penetrates an egg. Disruption of the fertilized egg after this point represents abortion. We consider fertilization, not implantation, to be the beginning of human life.
Most literature dealing with hormonal contraception ascribes a three-fold action to these agents. l) inhibition of ovulation, 2) inhibition of sperm transport, and 3) production of a "hostile endometrium," which presumably prevents or disrupts implantation of the developing baby if the first two mechanisms fail. The first two mechanisms are true contraception. The third proposed mechanism, IF it in fact occurs, would be abortifacient. (Note: the developing baby at the time of implantation is called a "blastocyst," and will be referred to as such in this paper. " Endometrium " is the lining of the uterus into which the blastocyst implants.)
The entire "abortifacient" presumption, therefore, depends on "hostile endometrium" actually being hostile to the blastocyst, resulting in the loss of blastocysts that would otherwise prosper and grow. Since there are no scientific studies demonstrating the validity of this presumption, abortifacient proponents appeal to the writings of scientists and clinicians involved in the production or study of these contraceptive products. Nearly all of these sources freely use the term "hostile endometrium" to describe the changes which occur in the uterine lining when these medications are used. And most make the presumption that these changes contribute to birth control effectiveness. On the surface, this would seem to be nearly incontrovertible evidence that the "pill" is, at least occasionally, an abortifacient.. However, we again emphasize that there are no scientific studies that we are aware of which substantiate this presumption.
Let us examine this "abortifacient presumption" by asking several questions:
l) What is meant by the term "hostile endometrium?" Where did it come from?
Is it actually "hostile?" The term "hostile endometrium" originated as a descriptive term for the less vascular, less glandular, thinner lining of the uterus produced by these hormones. The early pill literature from the late l950's established the descriptive term. Over time, the descriptive term "hostile endometrium" progressed to be an unchallenged assumption, then to be quasi-scientific fact, and now, for some in the pro-life community, to be a proof text. And all with no demonstrated scientific validation.
All pill manufacturers list this "hostile endometrium" presumption in their drug literature, implying it is a safeguard against pill failure. (Each company's literature says essentially the same thing as they comply with FDA labeling requirements) Understandably, their literature has a marketing agenda. However, to our knowledge, not one company will offer data to validate the "hostile endometrium " presumption. It should be noted that intertwining histologic fact (changes in endometrium) with presumptive action (makes the endometium hostile) leads to a conclusion compatible with pill marketing strategies, but not necessarily compatible with truth.
The fact that scientific authors in general all use the term "hostile endometrium" to refer to pill induced changes to the lining of the uterus adds nothing to establish the validity of the presumption that these changes cause loss of blastocysts. They are simply using long established descriptive terminology standard in the literature
2) Does the blastocyst require a "friendly endometrium" to thrive, or even to survive?
The nature of the blastocyst is important to this discussion. There is much we do not understand about the role of the blastocyst in implantation. But we do know it has an invasive nature, with the demonstrated ability to invade, find a blood supply, and successfully implant on various kinds of tissue, whether "hostile," or even entirely "foreign" to it's usual environment.-decidualized (thinned) endometrium, tubal epithelium (lining), ovarian epithelium (covering), cervical epithelium (lining) , even peritoneum (abdominal lining cells).
The presumption that implantation of a blastocyst is thwarted by "hostile endometrium" is contradicted by the "pill pregnancies" we as physicians see. Pill company literature estimates 3 to 5 pregnancies per l00 women per year for pill users. Many of these women take the "pill" an additional month or two before finding out they are pregnant. These pregnancies generally progress with no more difficulty than non-pill pregnancies. To our knowledge, there are no studies showing that the spontaneous abortion rate in these cases is any greater than in pregnancies with a "friendly endometrium."
The blastocyst regularly and successfully implants on tubal ciliated epithelium (commonly referred to as tubal, or ectopic, pregnancies) Approximately 1% of pregnancies in the USA are tubal pregnancies. The tubal epithelium is a tissue with an entirely different function and structure than the endometrium. Unlike endometrium, it has no glands with secretions, no rich vascular stroma Yet these pregnancies implant and generally thrive until interrupted by treatment or rupture of the fallopian tube due to size constraints.
3) Is there actual clinical evidence of early miscarriage in pill users?
The typical clinical picture of spontaneous abortion (heavy bleeding, severe cramping, passage of tissue is rarely, if ever, seen by most practicing physicians dealing with pill pregnancies, and is not substantiated in any literature we are acquainted with. The "hostile endometrium is abortifacient" proponents theorize that the losses are pre-implantation, and thus would have no tell-tale clinical or laboratory findings. However, since the actual rate of demonstrable ovulation for women on the pill roughly approximates the pregnancy rate for women on the pill, this type loss would seem extremely unlikely
4) What is the conception rate for women on hormone contraception?
It is impossible to say. Ovulation suppression rates vary from about 95% with the combined 35 mcg estrogen pill to about 50% with the minipill or norplant in place 3-4 years. Cervical mucus factors enter in. Most pill literature estimates 3 to 5% pregnancies per year for combined OCs, less for depoprovera, more for norplant, and minipills.
One may get an idea of the frequency of conception on hormonal contraceptives by considering the ectopic (tubal) pregnancy rates. The ectopic rate in the USA is about 1% of all pregnancies. Since an ectopic pregnancy involves a preimplantation blastocyst, both the "on pill conception" and normal "non pill conception" ectopic rate should be the same- about l% (unaffected by whether the endometrium is "hostile" or "friendly.") Ectopic pregnancies in women on hormonal contraception (except for the minipill) are practically unreported. This would suggest conception on these agents is quite rare. If there are millions of "on-pill conceptions" yearly, producing millions of abortions, (as some "BC pill is abortifacient" groups allege), we would expect to see a huge increase in ectopics in women on hormonal birth control. We don't. Rather, as noted above, this is a rare occurrence.
5) Is it possible that hormonal contraceptives may be responsible for the loss of blastocysts in some instances? In Medicine, anything is possible. Does the known medical information suggest that "on-pill" conceptions have a higher rate of blastocyst loss than normal "non-pill conceptions?" We believe the answer is "No."
There are l,200,000 medical and surgical abortions of unborn babies that take place every year in the United States. The "hormonal contraception is abortifacient" theory is not established scientific fact. It is speculation, and the discussion presented here suggests it is error. How happy the abortionists must be to find us training our guns on a presumption, causing division/confusion among pro-life forces, and taking some of the heat off the abortion industry. Ought we not rather be spending our energies to eliminate the convenience destruction of the innocent unborn?
l. We know of no existing scientific studies that validate the "hostile endometrium is abortifacient" theory.
2. There is regular successful implantation of the invasive blastocyst on surfaces a great deal more "hostile" than "hostile endometrium" (e.g., fallopian tube lining). "Hostile endometrium" is not a demonstrated clinical reality.
3. The almost total absence of reporting of ectopic pregnancies associated with hormonal contraception would indicate the rarity of actual conception by patients using these modalities. (Minipill and norplant apparently are less effective in preventing pregnancies and ectopics).
4. Many factors play a part in how a family plans and spaces their children. It is not the purpose of this paper to promote nor to oppose hormonal contraception. However, if a family, weighing all the factors affecting their own circumstances, decides to use this modality, we are confident that they are not using an abortifacient.
5) This paper is not meant to be the "final word" on this issue. If scientific study should validate that a hormonal contraceptive agent is partly abortifacient in its action, we would oppose that agent just as we oppose elective medical and surgical abortions.
We must constantly examine valid data as it becomes available in our effort to discern what is abortifacient vs what is appropriate birth control to be used or prescribed by those who hold to the sanctity of human life from the time of conception.
Co-signators (alphabetically) All signators are specialists in obstetrics and gynecology, and a number have sub-specialty recognition and/or are on the faculty of teaching hospitals or Universities. This information may be distributed freely to Crisis Pregnancy Centers or other individuals or groups who may have an interest in the subject matter.
Watson A. Bowes,Jr,MD,Professor,Maternal-Fetal Medicine,Chapel Hill,
Matthew J. Bulfin, MD, general OB-GYN, Ft. Lauderdale, Florida
Byron Calhoun, MD, Maternal-Fetal Medicine, Tacoma, Washington
Steve Calvin,MD,Asst. Prof Maternal-Fetal Medicine,Minneapolis, Minnesota
Denis Cavanagh, MD, Professor, Gynecologic Oncology, Tampa, Florida
Curtis Cook, MD, Maternal-Fetal Medicine, Asst Clin. Prof, Grand Rapid, Mi.
Susan A. Crockett, MD, Assistant Clinical Professor, San Antonio, Texas
Steven Cruikshank, MD, Professor OB-GYN, Dayton, Ohio
Joseph L. DeCook, MD, general OB-GYN, Holland, Michigan
Bill Dodds,MD,Reproductive Endocrinology, Asso.Clin. Prof,Grand Rapids,Mi R.
Don Gambrell, Jr., MD, Clinical Professor, Augusta, Georgia
David Hager, MD, Professor/Consultant OB-GYN, Lexington, Kentucky
Donna Harrison, MD, general OB-GYN, Berrien Springs, Michigan
Camilla Hersh, MD, Clinical Professor OB-GYN, Vienna, Virginia
Antony Paul Levitino, MD, .Asso. Prof,.OB-GYN, Rensselaer, New York
Joe McIlhaney, MD, Obstetrician-Gynecologist, Austin, TX
Gwendolyn Patterson-Hobbs, MD, OB-GYN Clinical Associate, Vienna, VA
William Stalter, MD, Associate Clinical Professor OB-GYN, Dayton, Ohio
Roy Stringfellow, MD, general OB-GYN, Colorado Springs, Colorado
Robert L. Weeldreyer, MD, general OB-GYN, Holland, Michigan
Randy Alcorn's response to physicians' statement above:
The following is excerpted from the revised 115-page version of Does the Birth
Control Pill Cause Abortions? (Available for $3.00 from Eternal Perspective
Ministries, www.epm.org/bcp.html, 2229
East Burnside #23, Gresham, OR, 97030; 503-668-5200.)
A strong statement against the idea that the Pill can cause abortions was issued in January 1998, five months after the original printing of this booklet. According to a January 30, 1998 email sent me by one of its circulators, the statement "is a collaborative effort by several very active pro-life OB-GYN specialists, and screened through about twenty additional OB-GYN specialists."
The statement is entitled "Birth Control Pills: Contraceptive or Abortifacient?" Those wishing to read it in its entirety, which I recommend, can find it at our EPM web page, at www.epm.org/articles/doctors.html. I have posted it there because while I disagree with its major premise and various statements in it, I believe it deserves a hearing.
The title is somewhat misleading, in that it implies there are only two ways to look at the Pill: always a contraceptive or always an abortifacient. In fact, I know of no one who believes it is always an abortifacient. There are only those who believe it is always a contraceptive and never an abortifacient, and those who believe it is usually a contraceptive and sometimes an abortifacient.
The paper opens with this statement:
Currently the claim that hormonal contraceptives [birth control pills, implants (Norplant), injectables (Depoprovera)] include an abortifacient mechanism of action is being widely disseminated in the pro-life community. This theory is emerging with the assumed status of "scientific fact," and is causing significant confusion among both lay and medical pro-life people. With this confusion in the ranks comes a significant weakening of both our credibility with the general public and our effectiveness against the tide of elective abortion.
The question of whether the presentation of research and medical opinions, such as those in this booklet, causes "confusion" is interesting. Does it cause confusion, or does it bring to light pertinent information in an already existing state of confusion? Would we be better off to uncritically embrace what we have always believed than to face evidence that may challenge it?
Is our credibility and effectiveness weakened through presenting evidence that indicates the Pill can cause abortions? I'll come back to this and related objections later, but I think we need to commit ourselves to discovering and sharing the truth regardless of whether it is well-received by the general public or the Christian community.
The physicians' statement's major thesis is this-the idea that the Pill causes a hostile endometrium is a myth:
Over time, the descriptive term "hostile endometrium" progressed to be an unchallenged assumption, then to be quasi-scientific fact, and now, for some in the pro-life community, to be a proof text. And all with no demonstrated scientific validation.
When I showed this to one professor of family medicine he replied, "This is an amazing claim." Why? Because, he pointed out, it requires that every physician who has directly observed the dramatic pill-induced changes in the endometrium, and every textbook that refers to these changes, has been wrong all along in believing what appears to be obvious: that when the zygote attaches itself to the endometrium its chances of survival are greater if what it attaches to is thick and rich in nutrients and oxygen than if it is not.
This is akin to announcing to a group of farmers that all these years they have been wrong to believe the myth that rich fertilized soil is more likely to foster and maintain plant life than thin eroded soil.
It could be argued that if anything may cause prolifers to lose credibility, at least with those familiar with what the Pill does to the endometrium, it is to claim the Pill does nothing to make implantation less likely.
The authors defend their position this way:
[The blastocyst] has an invasive nature, with the demonstrated ability to invade, find a blood supply, and successfully implant on various kinds of tissue, whether "hostile," or even entirely "foreign" to its usual environment-decidualized (thinned) endometrium, tubal epithelium (lining), ovarian epithelium (covering), cervical epithelium (lining), even peritoneum (abdominal lining cells) . . . . The presumption that implantation of a blastocyst is thwarted by "hostile endometrium" is contradicted by the "pill pregnancies" we as physicians see.
This is very similar to the argument of Dr. Struthers at Searle, the Pill-manufacturer. Unfortunately, it misses the point, since the question is not whether the zygote sometimes implants in the wrong place. Of course it does. The question, rather, is whether the newly-conceived child's chances of survival are greater when it implants in the right place (endometrium) that is thick and rich and full of nutrients than in one which lacks these qualities because of the Pill. To point out a blastocyst is capable of implanting in a fallopian tube or a thinned endometrium is akin to pointing to a seed that begins to grow on asphalt or springs up on the hard dry path. Yes, the seed is thereby shown to have an invasive nature. But surely no one believes its chances of survival are as great on a thin hard rocky path as in cultivated fertilized soil.
According to the statement signed by the twenty physicians, "The entire 'abortifacient' presumption, therefore, depends on 'hostile endometrium'." Actually this isn't true, since one of the apparent abortifacient effects of the Pill is what Dr. Leon Speroff and others refer to as peristalsis within the fallopian tube. This effect speeds up the blastocyst's travel so it can reach the uterus before it's mature enough to implant. Even if the endometrium was not altered to become inhospitable, this effect could still cause abortions. (It would be accurate to say that the abortifacient belief is based mainly, though not entirely, on the concept of an inhospitable endometrium.)
In fact, one need not embrace the term "hostile" endometrium to believe the Pill can cause abortions. It does not take a hostile or even an inhospitable endometrium to account for an increase in abortions. It only takes a less hospitable endometrium. Even if they feel "hostile" is an overstatement, can anyone seriously argue that the Pill-transformed endometrium is not less hospitable to implantation than the endometrium at its rich thick nutrient-laden peak in a normal cycle uninfluenced by the Pill?
A professor of family medicine told me that until reading this statement he had never heard, in his decades in the field, anyone deny the radical changes in the endometrium caused by the Pill and the obvious implications this has for reducing the likelihood of implantation. This is widely accepted as obvious and self-evident. According to this physician, the fact that secular sources embrace this reality and only prolife Christians are now rejecting it (in light of the recent attention on the Pill's connection to abortions) suggests they may be swayed by vested interests in the legitimacy of the Pill.
The paper states "there are no scientific studies that we are aware of which substantiate this presumption [that the diminished endometrium is less conducive to implantation]." But it doesn't cite any studies, or other evidence, that suggest otherwise.
In fact, surprisingly, though the statement sent to me is five pages long it contains not a single reference to any source that backs up any of its claims. If observation and common sense have led people in medicine to a particular conclusion over decades, should their conclusion be rejected out of hand without citing specific research indicating it to be incorrect?
On which side does the burden of proof fall-the one that claims the radically diminished endometrium inhibits implantation or the one that claims it doesn't?
The most potentially significant point made in the paper is this:
The ectopic rate in the USA is about 1% of all pregnancies. Since an ectopic pregnancy involves a preimplantation blastocyst, both the "on pill conception" and normal "non pill conception" ectopic rate should be the same-about l% (unaffected by whether the endometrium is "hostile" or "friendly.") Ectopic pregnancies in women on hormonal contraception (except for the minipill) are practically unreported.This would suggest conception on these agents is quite rare. If there are millions of "on-pill conceptions" yearly, producing millions of abortions, (as some "BC pill is abortifacient" groups allege), we would expect to see a huge increase in ectopics in women on hormonal birth control. We don't. Rather, as noted above, this is a rare occurrence.
The premise of this statement is right on target. It is exactly the premise proposed by Dr. Walter Larimore, which I've already presented. While the statement's premise is correct, its account of the data, unfortunately, is not. The five studies pointed to by Dr. Larimore, cited earlier, clearly demonstrate the statement is incorrect when it claims ectopic pregnancies in women on hormonal contraception are "practically unreported" and "rare."
This booklet makes no claims as to the total numbers of abortions caused by the Pill. But the statement signed by the twenty physicians affirms that if the Pill caused millions of abortions we would "expect to see a huge increase in ectopics in women on hormonal birth control." In fact, that is exactly what we do see-an increase that five major studies put between 70% and 1390%.
Ironically, when we remove the statement's incorrect data about the ectopic pregnancy rate and plug in the correct data, the statement supports the very thing it attempts to refute. It suggests the Pill may indeed cause early abortions, possibly a very large number of them.
Dr. Larimore's research, quoted earlier in the booklet:
Intrauterine Versus Ectopic Pregnancy Ratios
Dr. Walter Larimore is an Associate Clinical Professor of Family Medicine who has written over 150 medical articles in a wide variety of journals. Dr. Larimore, in a February 26, 1998 email to me, stated that if the Pill has no negative effect on the implantation process, then we should expect its reduction in the percentage of normal intrauterine pregnancies to equal its reduction in the percentage of extrauterine or ectopic (including tubal) pregnancies.
However, Dr. Larimore pointed out something highly significant--that published data from all of the studies dealing with this issue indicate that the ratio of extrauterine to intrauterine pregnancies among Pill-takers significantly exceeds that of non-Pill-takers. The five studies cited by Dr. Larimore show an increased risk of ectopic pregnancies in Pill takers who get pregnant is 70% to 1390% higher than non-Pill takers who get pregnant.
[The respective rates of increase in the five studies are 70%, 80%,
330%, 350% and 1390%. The studies, cited by Dr. Larimore in his email,
are as follows:
(1) "A multinational case-control study of ectopic pregnancy," Clin Reprod Fertil 1985;3:131-143;
(2) Mol BWJ, Ankum WM, Bossuyt PMM, and Van der Veen F, "Contraception and the risk of ectopic pregnancy: a meta analysis," Contraception 1995;52:337-341;
(3) Job-Spira N, Fernandez H, Coste J, Papiernik E, Spira A, "Risk of Chlamydia PID and oral contraceptives," J Am Med Assoc 1990;264:2072-4;
(4) Thorburn J, Berntsson C, Philipson M, Lindbolm B, "Background factors of ectopic pregnancy: Frequency distribution in a case-control study," Eur J Obstet Gynecol Reprod Biol 1986;23:321-331;
(5) Coste J, Job-Spira N, Fernandez H, Papiernik E, Spira A, "Risk factors for ectopic pregnancy: a case-control study in France, with special focus on infectious factors," Am J Epidemiol 1991;133:839-49.]
What accounts for the Pill inhibiting intrauterine pregnancies at a disproportionately greater ratio than it inhibits extrauterine pregnancies? Dr. Larimore, who is a member of Focus on the Family's Physicians Resource Council, believes the most likely explanation is that while the Pill does nothing to prevent a newly-conceived child from implanting in the wrong place (i.e. anywhere besides the endometrium) it may sometimes do something to prevent him from implanting in the right place (i.e. the endometrium).
This evidence puts a significant burden of proof on anyone who denies the Pill's capacity to cause early abortions. If there is an explanation of the data that is more plausible, or equally plausible, what is it?
Dr. Larimore came to this issue with significant vested interests in believing the best about the birth control pill, having prescribed it for years. When he researched it intensively over an eighteen month period, in what he described to me as a "gut wrenching" process that involved sleepless nights, he came to the conclusion that in good conscience he could no longer prescribe hormonal contraceptives, including the Pill, the minipill, DepoProvera and Norplant.
Dr. Larimore also told me that when he has presented this evidence to audiences of secular physicians, there has been little or no resistance to it. But when he has presented it to Christian physicians there has been substantial resistance. Why? Perhaps because secular physicians do not care as much whether the Pill prevents implantation and therefore tend to be objective in interpreting the evidence. Christian physicians very much do not want to believe the Pill causes early abortions, and therefore tend to resist the evidence. This is understandable. Nonetheless, we should not permit what we want to believe to distract us from what the evidence indicates we should believe.
Another section of the Pill booklet relevant to this issue:
"We shouldn't tell people the Pill may cause abortions because then they'll be held accountable"
I've had it said to me that as long as people don't know the Pill causes abortions, they're better off. If they do hear the truth and don't stop taking the Pill, one woman told me, by giving them this information I've made them more accountable, increased their guilt, and thereby done them a disservice.
Leviticus 5 and other passages dealing with unintentional and unknown sins fly in the face of this "ignorance is bliss" theology. The concept "if we don't know, we're not held accountable" isn't biblical. If it were true, it could be used to justify failing to warn people about sexual immorality, murder, or any other sin. It could be used to claim heathens are better off never hearing the gospel, because then they wouldn't be held accountable for rejecting it.
While it's true we take greater judgment on ourselves by rejecting truth that has been clearly presented, we will also be judged for what we haven't been told but is nonetheless true. It's not for us to withhold truth from our brothers and sisters because we think they won't listen. It's our sacred responsibility to speak up and try to persuade them, and hope and pray they'll listen. Furthermore, we will be held accountable for whether or not we've obeyed God by telling them the truth and giving them a chance to respond (Ezekiel 33:1-9).
Even the secular world recognizes it's an ethical mandate that physicians not withhold pertinent information from patients. A physician, pastor or anyone in an authoritative or guiding role might personally choose to take whatever risks he believes the Pill presents to a child. But that doesn't mean he should feel free to withhold information about such risks from those who trust him.
Dr. Walter Larimore, a highly respected and widely published medical researcher, teaches Family Medicine at the University of South Florida and is a member of Focus on the Family's Physician's Resource Council (PRC). In a November 1997 meeting, the majority of the PRC reached the preliminary conclusion that there is no direct evidence the Pill causes abortions, and further scientific study is needed. Dr. Larimore and Dr. William Toffler, professor at the Oregon Health Sciences University, are among the PRC minority that has given close attention to the research and is convinced that what we already know about the Pill poses significant risks to the lives of unborn children.
However, regardless of a physician's personal beliefs on this matter, it raises the critical issue of informed consent. In regard to the physician's responsibility to inform women of the possibility the Pill may cause abortions, Dr. Larimore stated to me in a February 26, 1998 email, "True informed consent requires detailed communication. If the physician fails to provide it this seriously jeopardizes a woman's autonomy. Further, if this information is consciously withheld, it is a breach of ethics."
Prolifers have long been critical of Planned Parenthood and the abortion industry for their consistent refusal to inform women of the development of their unborn children, or show them ultrasound images of those children, or fully inform them of the risks of abortion. "Abortion providers," who have personal and financial vested interests in the matter, often claim it's not in a woman's best interests to be presented with such information. Prolife physicians, who may have personal and financial vested interests in distributing the Pill, must likewise be careful not to rob women of the right to be fully informed of its potential abortive effects. It seems to me that to not practice informed consent regarding the Pill betrays a disrespect for a woman's intelligence, her moral convictions, and her ability to weigh the evidence and make her choice.
If a physician has evidence that the Pill does not cause abortions, he can present that to his patient as well. (I would like to see it myself.) What is the worst case scenario either way? If a physician makes a patient aware of evidence indicating the Pill may cause early abortions and later research indicates that evidence wasn't valid, what will have been lost? An informed decision has been made on all the available data. But if the physician fails to disclose to her the evidence and it turns out it was true all along, then he has withheld from his patient information that might have kept children from dying and kept his patient's conscience from being violated by a choice made in ignorance.
The "it's better not to say anything" philosophy puts too much emphasis on us and not enough on the two greatest commandments, loving God and loving our neighbor (Matthew 22:36-40). If we really love God we will want to know the truth so we can act in light of it. If we really love our neighbor, we will want him to know the truth so he can do the same. And if we really love our most vulnerable neighbors, the unborn children, we will want to protect and preserve them instead of imperil them through our silence. Jesus is the truth. Those who serve him are compelled to speak the truth, listen to the truth, and follow the truth in every arena of life, no matter how difficult or inconvenient.
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