“Emergency contraception” and prevention of pregnancy after sexual violence

“Tragičan događaj spolnoga nasilja i njegove dramatične posljedice obvezuju čitavu društvenu zajednicu, a nadasve liječnike i liječničko osoblje, na poštivanje, suosjećanje i skrb za cjelovito dobro oštećene osobe. Već desetljećima posebnu medicinsko moralnu pozornost u tretmanu žrtve izaziva pitanje prevencije trudnoće nakon silovanja: je li takav postupak opravdan i jesu li današnja sredstva, metode i procedure, poznate kao “hitna kontracepcija”, kadre postići željeni cilj? Pitanja su međusobno duboko povezana, na način da će moralni sud ovisiti o naravi, odnosno mehanizmu djelovanja hitne kontracepcije. U traženju najprikladnijeg odgovora autor prije svega iznosi načelne argumente i razloge zbog kojih uporaba kontracepcije prije i poslije spolnoga nasilja nije u suprotnosti sa stalnim naučavanjem Katoličke crkve o kontracepciji. Prezentira potom, vrlo kratko i u bitnim crtama, temeljne informacije o hitnoj kontracepciji kao što su definicija i indikacije za njezinu uporabu, metode i mehanizam njezina djelovanja te različita mišljenja i stavovi s obzirom na mehanizam njezina djelovanja. Budući da su svoje mišljenje o opravdanosti i mogućnosti prevencije trudnoće nakon silovanja iznijele i neke crkvene institucije, analiziraju se glavni naglasci, opća usmjerenja, ali i dvojbene tvrdnje i procjene nazočne u njihovim dokumentima. Konačno, analiza različitih praktičnih prijevoda - od kojih su neki moralno vrlo upitni - jasnih smjernica sadržanih u tim dokumentima, ukazuje na činjenicu da još uvijek ne postoji posvema zadovoljavajuće i moralno prihvatljivo praktično rješenje teorijski opravdanog načela o uporabi kontracepcije nakon spolnog nasilja. Nesigurnost vezana uz stvarno djelovanje “hitne kontracepcije” i realna situacija žrtve nakon spolnog nasilja dva su snažna čimbenika, koja potiču i zahtijevaju daljnja istraživanja kako se ne bi došlo u sukob s temeljnim postavkama jedne dosljedne etike života, posebno načelom o svetosti i nepovredivosti ljudskoga života, bez obzira na okolnosti njegova začeća.Tragic incident of sexual violence and its dramatic conse- quences oblige the whole social community, and above all doctors and medical staff, to respecting, sympathy and care for the entire welfare of the injured person. For decades the issue of prevention of pregnancy after rape has been giving rise to medical and moral attention in the treatment of the victim, raising the questions Is such a practice justified and are the modern means, methods and procedures, known as “emergency contraception”, able to achieve the desired goal? The issues are deeply interconnected in the way that moral judgement will depend on the nature, i.e. on the performing mechanism of emergency contraception. In trying to find the most appropriate answer the author first presents principled arguments and reasons why the use of contraception before and after sexual violence is not in contradiction with the permanent teaching of the Catholic Church on contraception. Then he briefly presents the basic information on emergency contraception as it is the definition and indication for its application, the methods and mechanism of its effects as well as various opinions and attitudes regarding the mechanism of its effects. Since some church institutions have put forward their opinion on justification and possibilities of prevention of pregnancy after rape, the main emphases, general orientations, but also some dubious statements and assessments present in their documents, are being analyzed. Finally, the analysis of various practical translations, some of which are morally very disputable, and of some straightforward instructions included in those documents, indicate that there is no satisfactory and morally acceptable solution of that theoretically justified principle on the use of contraception after sexual violence. Uncertainty related to the real effect of “emergency contraception” and the actual situation of the victim after sexual violence are two powerful facts that pursue and require further investigations to avoid conflict with the fundamental postulates of the ethics of life, especially with the principle about the sacredness and inviolability of human life, regardless of the circumstances of its conception