Thursday, January 3, 2013

Hobby Lobby: Ethical or Confused?

Amidst the many frenzied, pro-Hobby Lobby statements swirling around the internet lately, Janaury 5th is now being called "Hobby Lobby Shopping Day."   Suddenly, if you want to be a good Christian, you should be taking a moral stand on Saturday by buying some craft supplies!  Well before rushing out to buy stuff that you probably don't even need, have you considered that the Hobby Lobby case is not as cut-and-dried as it appears to be?

But first, a few disclaimers:  

1. As a Libertarian, I'm not a fan of government imposing health insurance regulations on private businesses.
2. I believe that the Tenth Amendment to the Constitution is quite clear that any and all powers that are not delegated to the Federal government, elsewhere in the Constitution, are reserved to the States. Thus the health insurance issue being handled at the Federal level is a clear Constitutional violation, and would be more appropriately handled at the state level.
3. I am pro-life.

So it sounds like I should be totally supportive of Hobby Lobby's "brave moral stand," right?

No actually - the more I've read about it, the more it seems to me that their stand is illogical, hypocritical, and actually not pro-life at all - according to their own definitions, anyway.

Hobby Lobby has gone to court over their moral objection to emergency contraceptive drugs, labeling them as "abortion-inducing." But emergency contraception is, as the name suggests, simply contraception.  Contraception = preventing conception.  The primary mechanism of these drugs, like regular birth control pills, is simply to inhibit ovulation which would obviously prevent fertilization.  This may be confusing as many lack a fundamental understanding of how conception actually works and do not understand how a pill taken hours or even days after sex could possibly prevent conception.   And that's okay, you're not supposed to be an expert on these things unless you're a nerd (*cough* like me) who researches stuff like this.  However, that Hobby Lobby is either unaware or pretends to be unaware of the similarities between regular hormonal birth control pills and emergency birth control pills is irresponsible at best and dishonest at worst. 

First, let's look at how normal hormonal contraceptives are designed to work, such as in the commonly used "Pill."  The combined pill is taken once daily: for the first 3 weeks a pill providing synthetic estrogen and progestin is taken; for the final week an inactive placebo pill is taken.   In oversimplified terms, during the first 3 weeks, the hormones in the Pill primarily work to prevent the ovulation process from taking place.  If the ovaries do not release an ovum (egg), then it is impossible to conceive. In the last week, the inactive pill serves no purpose other than to reinforce the daily habit of taking a pill.  During this time since she is no longer receiving any hormones, the woman sheds the uterine lining, like a normal menstrual period.

A second type of birth control pill is the progestin-only pill, also known as the mini pill.  Because it does not contain estrogen, it does not consistently prevent ovulation and relies more on thickening cervical mucous to prevent sperm from reaching an ovum.

During a woman's normal cycle (ie, when not using hormonal pills), the uterine lining begins slowly building up again after the end of menstruation.  This processed might be altered while taking hormonal pill; because of the synthetic hormones inhibiting the natural ovulation cycle, it is possible that the thickening process is affected resulting in a thinner endometrium (uterine lining).  This is only a problem if ovulation does take place (a greater possibility with the progestin-only pill), making conception possible.  If this happens, the fertilized egg (zygote) may reach the uterus to find the endometrium is not thick enough for successful implantation.   Many brand names like Alesse, Loestrin, Ortho-Cyclen, Yasmin, and Ortho Micronor clearly acknowledge this possibility in their drug facts.      

But Hobby Lobby is not concerned about the possibility of these drugs interfering with implantation.  In a statement released by their attorney group in September 2012:
The Green family has no moral objection to the use of preventive contraceptives and will continue its longstanding practice of covering these preventive contraceptives for its employees. 
In other words, the Hobby Lobby owners feel that regular hormonal pills, patches, implants, etc, are preventive contraceptives that raise no moral issues for them.  

The statement continues by specifying which hormonal drugs that they do object to:
However, the Green family cannot provide or pay for two specific abortion-inducing drugs. These drugs are Plan B and Ella, the so-called morning-after pill and the week-after pill.
So let's look at the implied claim that these drugs are abortion-inducing in a way that regular hormonal contraceptives are not.  First, the Plan B pill: according to the manufacturer, Plan B works similarly to regular hormonal contraceptives.  How is this possible, since it is used after the fact?  The answer lies in the simple fact that conception can take place several days after sexual intercourse.  That's right, sperm can live in a woman's body for up to 5 days before actually fertilizing an ovum.  This is why the Plan B can be effective at preventing conception even taken 72 hours after intercourse.  Like regular contraceptive pills, the primary mechanism of Plan B is to inhibit ovulation.  It can also alter transport of sperm and/or ova in the fallopian tube prior to fertilization (this would decrease the likelihood of conception if ovulation does take place).

The charge of Plan B being an "abortion-inducing drug" seems to based on the drug's potential to thin the uterine lining, which could possibly interfere with implantation in the event of both ovulation and conception taking place.  Go back a few paragraphs...this is exactly what can happen with regular hormonal birth control too.  And breaking this down logically: taking a pill every day for 3 weeks that can interfere with your uterine lining is probably going to affect that lining a lot more than a pill you take once (or twice) mid-cycle.  At least a woman who is not on regular pills will have had her uterine lining thickening normally, without any hormonal interference, ever since the end of her last period.  Taking Plan B may affect its continuing thickening but will not have had any affect on the entirety of her cycle the way the daily Pill might.  

The other pill mentioned in Hobby Lobby's statement is Ella, which is also a morning-after pill, not the "week-after pill" as they incorrectly suggest.  It can be taken up to 5 days after intercourse, while Plan B can be taken up to 3 days after intercourse.  Ella is a synthetic progesterone agonist/antagonist which is intended to either prevent or postpone ovulation.  It differs from other hormonal methods because in clinical trials, it was shown to be effective at delaying ovulation even once the ovulation process had started [for the nerds: it delays ovulation by 5-9 days even if the LH (lutenizing hormone) peak that triggers ovulation has taken place].   As with the other hormonal methods we've already examined, Ella can also have an affect on the thickness of the uterine lining and implantation. 

The bottom line is, because both Plan B and Ella have the potential to thin the uterine lining and interfere with implantation, if their primary mechanism of preventing/delaying ovulation fails, it is perfectly reasonable for Hobby Lobby to have a moral objection to these drugs.  However, since regular hormonal birth control has just as great a (and perhaps even greater) chance of affecting the uterus and implantation, Hobby Lobby's position of support for regular hormonal contraceptive violates the very beliefs they are supposedly upholding.  It is strangely ironic that people will be turning out on January 5th to applaud Hobby Lobby for taking a stand against "abortion-inducing drugs" when the company has also inconsistently announced their financial support and moral approval of other drugs that are equally "abortion-inducing."