Guidelines for Catholic Hospitals Treating Victims of Sexual Assault

GUIDELINES FOR CATHOLIC HOSPITALS TREATING VICTIMS OF SEXUAL ASSAULT

Board of Governors of the Pennsylvania Catholic Conference

September 23, 1998

One of the most violent and traumatic crimes is that of sexual assault. As a presence of Christ's healing, Catholic hospitals are called to treat persons who have been sexually assaulted with compassion, sensitivity, and respect. In caring for victims of sexual assault, Catholic hospitals are committed to quality holistic care by meeting their physical, psychological, emotional, social and spiritual needs.

The moral principles guiding catholic health care policies include a respect for (a) the sacredness of human life and (b) the procreative end of sexual intercourse. The deliberate destruction of an innocent living human fetus — no matter how conceived — is unjustified. Sexual intercourse involved in the act of rape, on the other hand, is an unjust assault and a non-consensual act. Therefore, appropriate means may be used in treating the rape victim to prevent conception. These means, as used, may not have the effect of an abortifacient.The first consideration in sexual assault cases should be for the total well-being of the person.Services of a chaplain or other suitable counselor should be made available.
The victim should be treated with respect and compassion.
No judgment on the victim's responsibility should be stated or implied, by word or by action.
Medical interventions are appropriate as long as there is no anticipated effect of an abortifacient.
The privacy and dignity of the person must, at all times, be respected.Since the sperm in the case of rape is the result of unjust aggression, steps may be taken to prevent conception and that may include treatment of the victim with medications which prevent ovulation, sperm capacitation, or fertilization.
Any medical procedure, the purpose and/or effect of which is abortive, is never permissible. This includes any treatment which has as its purpose or direct effect the removal, destruction or interference with the implantation of a fertilized ovum. Hygienic procedures, including vaginal douching, are morally permitted since they are not abortifacient in effect. These guidelines include a sample protocol to use to determine if contraceptive intervention is clinically indicated and which protocol is designed to determine that such intervention would be truly contraceptive, and not abortifacient.If the pregnancy test is positive, no antiovulant drugs may be used.
If the pregnancy test is negative, then needed clinical determinations would be based on the following:
A menstrual history provided by the victim.
Hormonal levels as determined by a blood test to categorize the timing of the woman's ovulatory cycle, and
Results of a urine test which is a reliable guide to the prediction of ovulation.
If the urine test is negative, that may be an indication that the LH surge has not been initiated, and a contraceptive intervention would be appropriate.

If the urine test is positive, that would indicate the hormonal shift that leads to ovulation has begun. The use of a contraceptive steroid intervention could be abortifacient and is therefore not permitted, even though there might be no evidence that conception has occurred.

If the pregnancy test is negative, it is essential that hospital personnel question the patient to ascertain the time of ovulation within the menstrual cycle.
If the patient has just ovulated, an anti-ovulant drug may not be administered. The use of a contraceptive steroid is permissible only to prevent ovulation.Prophylaxis for venereal diseases may be implemented. Legal procedures should be followed when they do not conflict with the moral standards.Specific circumstances of the sexual assault should be ascertained and recorded.
Physical evidence of sexual assault should be gathered by means of swabs, smears, aspirations and other standard procedures.
Visual and tactile evidence of trauma should be noted, recorded, and treated.
Material evidence of sexual assault from clothing, hair, and other sources should be retained as evidence.The above guidelines are given primarily from a moral perspective. No judgment is made or implied concerning the acceptable medical regimen or legal protocol. A medical protocol consistent with these guidelines is attached. Catholic hospitals should give careful consideration to adopting the form of protocol, but if not, then one which is fully consistent with these guidelines.
Catholic hospitals, to the extent they have the capability of providing treatment, accept victims of sexual assault. It is strongly recommended that the sexually assaulted person be advised of these standing policies, particularly the ethical restrictions which prevent Catholic hospitals from using abortifacient procedures.

Original: August 6, 1980

Reaffirmed: August 5, 1987

Revised: September 9, 1992

Revised: September 23, 1998

Used with permission of the Pennsylvania Catholic Conference