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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
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