The Economist on birth control for nuns

He believed, he said, in birth-control. Pickerbaugh answered with theology, violence, and the example of his own eight beauties. Arrowsmith by Sinclair Lewis (1924)

Christmas comes but once a year, but reporters don't always have to wait until December 25 for their presents. Great stories, items that seem to write themselves, can appear at any time of the year. A report in the British medical journal, The Lancet, released on December 8 and entitled "The plight of nuns: hazards of nulliparity" is just such an early Christmas gift for reporters on a short deadline.

The Telegraph and the Guardian provide good examples of the first day coverage -- smart and concise summaries of the claims made by the article.  Religious Affairs Editor Martin Beckford of the Telegraph (one of the best religion writers in the UK) has a wonderful lede sentence for his story entitled: "Nuns should go on the Pill, says Lancet study."

A paper in The Lancet claims that Roman Catholic nuns pay a “terrible price for their chastity”, as not having babies puts them at greater risk of breast, ovarian and uterine tumours.

Health Editor Sarah Boseley of the Guardian covered the story equally well and opened with:

Nuns should be given the contraceptive pill to reduce the high death rates from breast, ovarian and uterine cancer that result from their childlessness, say scientists.

Each gives a straight forward, uncluttered summary of The Lancet article's claims. Both have strong pull quotes, and their stories could well be swapped between papers. Martin writes:

“Although Humanae Vitae never mentions nuns, they should be free the use the contraceptive pill to protect against the hazards of nulliparity [never giving birth] since the document states that ‘the Church in no way regards as unlawful therapeutic means considered necessary to cure organic diseases, even though they also have a contraceptive effect’.

“If the Catholic church could make the contraceptive pill freely available to all its nuns, it would reduce the risk of those accursed pests, cancer of the ovary and uterus, and give nuns’ plight the recognition it deserves.” ... It goes on: “Today, the world’s 94,790 nuns still pay a terrible price for their chastity because they have a greatly increased risk of breast, ovarian, and uterine cancers: the hazards of their nulliparity.”

The second day stories fleshed out the issues, offering scientific critiques of the research and alternative voices. A story from the Catholic News Agency that a number of other sources drew upon  cited one oncologist who said the study had more political significance than scientific value. The CNA led with this critique.

Karen Brauer, president of Pharmacists for Life International, said the argument was so poorly made that she initially thought the article was a parody.

“It’s that bad,” she told CNA on Dec. 8, adding that the claims were not only outlandish but unsupported by the evidence presented in the analysis.

However, the best of the second day stories was Katie Moisse's piece for ABC News, "Should Nuns Take the Pill for Health Reasons?" In addition to giving a crisp recounting of the article, she did that extraordinary thing of asking a nun what she thought of all this. And by concentrating on the basics of reporting, came up with a superior story.

...  according to Sister Mary Ann Walsh of the U.S. Conference of Catholic Bishops, nuns have the same access to medical care as any other woman – and that includes access to the pill.

“They’re presuming the church has some kind of authority over the medical care of nuns, which it doesn’t,” Walsh told ABC News. “A nun goes to a doctor for her medical care, and if that medical care requires a certain kind of medicine then that medicine is prescribed.”

Oral contraceptives can increase the risk of blood clots, a risk thought to be higher in some newer versions of the pill.

“The suggestion that all nuns should take contraception is rather sweeping and almost irresponsible,” said Walsh. “There are risks with the pill just as there are risks with doing nothing with regard to uterine and ovarian cancer.”

Walsh said the benefits of the pill in reducing cancer risk must be weighed against the side effects.

“A nun’s decision needs to be worked out between the nun and her doctor,” she said.

This is a great rejoinder to The Lancet piece as Sr. Mary Ann Walsh challenges several premises of the article -- that the Vatican micromanages nuns' health care choices or that nuns are forbidden to take the pill. It further raises the question whether the pill is a contraceptive device if it is taken by those living under a vow of celibacy.

I would contrast the ABC story with the treatment by The Economist. That story, entitled "Nuns and contraception: Praying for the Pill," strikes me as having an adolescent tone. While the Telegraph and Guardian avoided commentary and reported on the facts and ABC provided context, The Economist story seemed un-serious. It is little more than a bilious anti-Catholic rant.

It opens with a discussion of contraception, turns to politics, and opines on whether the church will give nuns the pill.

The Catholic church condemns all forms of contraception, a policy that Paul VI laid out in detail in Humanae Vitae in 1968. Over the subsequent decades it has had various brawls with secular authorities over the use of birth control pills. Most recently, America’s bishops have fought to keep Barack Obama’s health law from providing contraception free. The church has already won an exemption for women who work for a church, but it also wants to keep coverage from women who work for any Catholic institution, even if the women in question are not Catholics and the institution has a secular purpose, such as a school, say, or hospital. Given all this, it would seem unlikely that the church would want to give the Pill to its nuns.

It recounts the arguments of The Lancet story and closes with a smirk.

The Pill can help to counteract [the risks of cancer]. The overall mortality in women who use, or have used, oral contraception, is 12% lower than among those who do not. The effect on ovarian and endometrial cancer is greater: the risk of such cancers plummets by about 50%. Drs Britt and Short make a compelling medical case. But it is unlikely to sway the Church.

What was that about the Vatican not micromanaging the health care of nuns?

Yes, birth-control and the Catholic Church is a controversial issue, and the church should not be above criticism for its views. However, if you are advancing an argument supported by an attitude of condescension towards your target you had better be right. Otherwise you come off the fool -- as The Economist appears to have done in this story.

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