Plan B: What is the Big Deal?

A few weeks ago, one of my classes held a panel on the topic of emergency contraception, otherwise known as Plan B.  During the discussion, one of my classmates said that Plan B does not work if the woman is pregnant.  The facilitator replied to this by saying that since this is true, Plan B is not an abortifacient.  How could this be, though?  How could it be said that Plan B is not an abortifacient, knowing that one of the mechanisms of action of the morning after pill is to prevent the implantation of a newly formed embryo?  I will highlight the main objections to the claim that Plan B can induce a very early abortion and subsequently provide the rationale for why these objections are not accurate.

Question:  Is the morning after pill, Plan B, an abortifacient?

Objection 1:  The medical definition of pregnancy involves both conception and implantation.  Therefore, we should not treat a newly conceived embryo as human since we do not even define a woman as being pregnant until after implantation.

Objection 2:  We can’t really know when exactly a new human life is created.  How many genes have to anneal before we call it “human”?  As a result, it is nonsense to speak of a newly created embryo as a human being.

Objection 3:  Science has nothing to say on the morality of Plan B.  You should not push your personal convictions on others who do not believe that life begins at conception.

Objection 4:  Only a few cells maximum are lost with the use of Plan B.  A few cells cannot possibly be considered humans worthy of any rights.

Before I begin my responses to the above objections, I want to define a couple of terms that I will use in the next few paragraphs:

Human Being:  A unique member of the species Homo sapiens (involves some science, namely human embryology).

Person:  An individual who is deserving of rights and protection (involves ethical/philosophical issues).

Reply to Objection 1:
I agree that the medical definition of pregnancy involves both conception and implantation.  However, this definition has nothing to do with scientific development or knowledge.  In 1963, the U.S. Department of Health declared that anything that impairs life between the moment of fertilization and completion of labour is to be considered an abortion.  Two years later, the American College of Obstetricians and Gynecologists (ACOG) defined conception as the implantation of  a fertilized ovum, not the moment of fertilization.  Why the change?  Well, the ACOG’s reason was that pregnancy could not be detected before implantation.  In the 21st century, however, a pregnancy can be detected before implantation but the ACOG still does not correct its definition.

What other reason could there be then?  In 1964, at the Second International Conference on intra-uterine contraception, a Planned Parenthood physician recommended that scientists not disturb individuals with the fact that some contraceptive drugs and devices can induce an early abortion.  He also said that if the medical community declared that pregnancy (and thus, life) begins at implantation, then members of other faculties, namely judges and theologians, will oblige.  Whereas the ACOG’s decision may be independent of the statements of this Planned Parenthood physician, it does highlight that the redefinition of pregnancy had nothing at all to do with new scientific discoveries.

Reply to Objection 2:
This objection I refer to as the “We don’t really know, so what could it hurt?” objection.  Just like no one can say when a soul enters a human, no one can say for certain at what precise moment a new person comes into existence.  However, we are not talking of personhood just yet.  What we do know is that a new human being comes into existence once a sperm cell joins with an ovum.  This moment, which occurs before the annealing of any genes, begins a continuous process that, if not impeded and barring any errors, will result in a newborn approximately 9 months later.  Therefore, the whole debate involving annealing of genes is not very relevant since this process is just part of the continuous development that occurs after the moment of conception.

Reply to Objection 3:
I would like to use a quote for this objection from an embryologist, who, last time I checked worked in the field of biological sciences:

from the moment when the sperm makes contact with the oocyte, under conditions we have come to understand and describe as normal, all subsequent development to birth of a living newborn is a fait accompli. That is to say, after that initial contact of spermatozoon and oocyte there is no subsequent moment or stage which is held in arbitration or abeyance by the mother, or the embryo or fetus. Nor is a second contribution, a signal or trigger, needed from the male in order to continue and complete development to birth. Human development is a continuum in which so-called stages overlap and blend one into another. Indeed, all of life is contained within a time continuum. Thus, the beginning of a new life is exacted by the beginning of fertilization, the reproductive event which is the essence of life.

Adapted from C. Ward Kischer, “When does human life begin:  The final Answer”

In essence, what this is saying is that from a scientific point of view, human development does not have any breaks, but is a continuous process from fertilization.  In other words, a human being at fertilization is the same human being at the fetal stage, which is the same human being at the newborn stage, which is the same human being at the toddler stage and so on.  A human being may look different at the different stages of development (I don’t see too many 1 year-olds that look like 80 year-olds) but fundamentally that unique human being at fertilization is the same as in any other stage of development.  As a result, because there is no break during development where we can say “now it is human” we have to consider that at all stages of life, beginning at fertilization, a unique human being is present.

Reply to Objection 4:
Here is where we get into the philosophical/ethical issue of personhood.  We can debate about when human life begins and should we consider an embryo a unique member of the species Homo sapiens.  However, if embryos should not be considered as persons then there is nothing wrong with their destruction.  The first few objections dealt with the issue of considering embryos as human beings, but should these human beings be considered persons?

For the answer to this question, let’s go back through history and see the times when human beings were not considered persons:

• “In the eyes of the law…the slave is not a person.”, 1858
• “An Indian is not a person within the meaning of Constitution.”, 1881
• “The statutory word ‘person’ did not in these circumstances include women.”, 1909
• “The Reichsgericht itself refused to recognize Jews..as ‘persons’ in the legal sense”, 1936

Essentially, good things do not happen when a class of human beings are not considered person.  “But Danny!  But Danny!” you may say, “All of these examples are of actual humans not of some insignificant cells.”  Yes, all of the examples above involve human beings with many more cells than an embryo.  However, I have a few questions:  Are your human rights contingent on any factor?  The fact that you are more developed than an embryo, does that mean you are more worthy of human rights?  Does this mean that you have more rights than a newborn?  A toddler?  An adolescent?  Do you truly believe that your human rights are present because of some quality or function that you have at the moment?  Or, could it be that you possess human rights simply for the fact that you are a unique human being?  As the Universal Declaration of Human Rights states:

…recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world

We have human rights because of the fact that we are human beings.  The embryo is a human being and thus worthy of human rights.  In the end, that is the big deal with Plan B and any other contraceptive drug/device that acts as an abortifacient:  They can rob a human being of its rights, especially the right to life, from the very beginning.  An embryo may just look like a clump of cells, but the good thing is that personhood does not depend on appearance, only reason, which hopefully I have shown through this post.

Danny is a third year pharmacy student at the Leslie Dan Faculty of Pharmacy in Toronto, Ontario.