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It behooves priests and teachers in the Church
to make the teaching on contraception
understandable to the average Catholic in the pew.
Contraception and NFP:
Explaining the difference
By Patrick Norris
n Perhaps one of the greatest catechetical failures of recent history has been the inability of many teachers in the Catholic Church to teach convincingly on the matter of family planning. Based on the abundance and constancy of magisterial teaching on this issue, one cannot but conclude that the Church's instruction on family planning is rather significant.1 Yet, many if not most Catholics fail to grasp the essential moral difference between the use of natural family planning (NFP) and artificial contraception. Consequently, many Catholics adopt family planning practices contrary to Church teaching. A former parishioner recently wrote me concerned over the fact that many of the high school juniors in her daughter's confirmation class openly rejected the Church's teaching on contraception. To modern Catholics, the subtleties of fine theological distinctions often seem to be either incomprehensible abstractions or mere semantics. Pope Paul VI recognized that the highly complex and nuanced nature of the teaching and the difficulty involved in intellectually assenting to such truth required the help of God's grace. In asking priests to believe and teach the conclusion of Humanae vitae, he stressed that their obedience to the teaching flowed more from a trust in the light of the Holy Spirit guiding him in his decision than from the intrinsic reasoning of the teaching.2
In my experience of preparing couples for marriage and teaching courses on reproductive health issues to students in a Catholic medical school, I have encountered similar difficulties in helping people understand the wisdom of the Church's teaching. Of course, part of people's reluctance to embrace the teaching results from current societal norms and practices which have completely disassociated the values of sexual intercourse into three distinct and separable realities: reproduction, intimacy, and recreational pleasure. Thus, the Church's teaching on marriage and family planning is foreign to the modern world view. However, attempts to alter this world view are often frustrated by a common inability to provide a coherent and convincing explanation of the teaching. Often this inability results from a lack of sound analogies which would offer a means by which people could better understand the truth of the Church's teaching.
In the moral life, we often understand more complex realities by relating them to simpler things we do understand. This was Christ's great insight in his use of parable and story. In this article, I will borrow from and expand upon an analogy which Lawler, Boyle and May have used to help assist people understand the difference between NFP and artificial contraception.3 Specifically, I will focus not only on the issue of the moral object as they did, but expand the analogy to include intentionality and circumstances. The analogy which they used and I have adapted emerges from the field of bioethics: allowing to die (i.e., use of ordinary/extraordinary means) is to euthanasia as natural family planning is to artificial contraception. The reason for using this analogy is that in my experience, Catholics more readily recognize and agree that there is an essential moral difference between allowing a patient to die and euthanasia in contrast to NFP and contraception.
Clarifying terms
A couple of preliminary remarks are in order. First, the terms NFP and artificial contraception by their very nature lead to some of the confusion in the minds of the faithful. Specifically, people assume that NFP is acceptable because it is "natural," while contraception is illicit because it is "artificial." Yet, the acceptability of NFP versus contraception in no way relates to the "natural" or "artificial" manner of family planning. To maintain this results in what has been termed a "physicalist" approach to the issue. Opponents of the Church's teaching on contraception frequently cite this "physicalism" as the reason for their dissent.4 If this were the justification of the Church's teaching, such a critique would have merit. However, the Church's opposition to contraception flows from the intrinsic purpose of the very act of contraception. The Church understands that contraception acts against the good of procreativity and deliberately separates the unitive and procreative meanings of marriage.5 Therefore, in explicating Church teaching, one must be careful to indicate not only what the Church teaches, but what the Church does not teach.
Evaluating a moral action
A second preliminary remark pertains to moral methodology. In traditional moral theology, one determines the moral acceptability of an action by examining the moral object, the intention, and the circumstances. The moral object involves what am I doing in the very action being performed. The intention examines the overall reason or reasons for performing the action. Finally, the circumstances of a situation may influence the moral acceptability of performing an action.6 An action is morally acceptable if and only if the moral object is morally good or neutral and the ultimate intention of the agent is virtuous and in accord with the circumstances of the case. Thus, one must not only do the right thing, but one must do it for the right reason. In particular, one can never transform an inherently evil action into a virtuous one because of one's ultimate intention or the circumstances of the case.7
Making the teaching more
understandable through analogy
The above understanding of a moral action has been helpful in determining the acceptability of decisions made at the end of life. Life is an intrinsic and instrumental good that we have a general obligation to preserve. But the obligation to preserve the good of life is not absolute depending on the nature of the treatment required to maintain life. In appropriately allowing a person to die, one recognizes that at times there may no longer be a moral obligation to maintain the good of human life if the treatment necessary to maintain the good of human life offers no reasonable hope of benefit or involves excessive burden.8 In this case, the moral object involves the avoidance of inappropriate treatment by means of the withholding or withdrawing of treatment with the foreseen but unintended side effect that the patient may die. As such, the moral object is good because one does not have a positive obligation to maintain life through the use of extraordinary means. The overall intention is to avoid needless pain or suffering which results from the treatment. One presumes that the circumstances are such that the treatment truly is ineffective or gravely burdensome. People recognize this decision as being morally sound.
Consider a slight modification of the above situation. A husband requests that physicians withdraw ineffective or overly burdensome treatment from his wife. However, the husband wants treatment stopped because he has a paramour waiting in the wings and wants his wife out of the way so that he will be free to marry.9 Thus, he has committed Eliot's greatest treason, to do the right thing for the wrong reason. Thus, even though the moral object of removing treatment is appropriate (i.e., the criteria for removing life-support have been satisfied), the ultimate intention of the husband renders the action immoral.
A further nuance to this discussion occurs when one withholds life support for the right reason, but one has non-maliciously but nevertheless incorrectly assessed the burdens and benefits of a treatment. Whether a treatment is extraordinary or ordinary is a judgment call because one assesses the burdens and benefits of treatment in light of the patient's particular circumstances. Thus, no treatment is "ordinary" in and of itself. However, there may be times when it is so clear that the circumstances do not satisfy the criteria for the withholding or removal of life support. Consequently, even though the moral object of removing treatment is not intrinsically evil nor does the person have an evil intention, circumstances make the overall action morally inappropriate.10
Finally, one must evaluate active euthanasia wherein one directly kills the patient to relieve suffering. This may involve a lethal injection, the use of a gun, and so forth. In this case, the ultimate intention to relieve suffering is noble but the moral object involves an intrinsic evil, the direct killing of an innocent person. Active euthanasia involves a positive action against the basic good of life rather than merely a choice not to promote or preserve it. Regardless of the ultimate good intention of compassion, euthanasia cannot be transformed into a virtuous action.
The four situations presented above provide unambiguous examples of right and wrong with regard to the preservation of the basic good of life. Consequently, if it can be shown that the uses of NFP and contraception are analogous in concept to the above examples, one can demonstrate more effectively the wisdom of the Church's teaching on the procreative good.
Procreativity is a special good of the human person.11 Like other basic goods we have a "negative" obligation not to act against it. However, we do not always have a positive obligation to actualize it. Thus, Pope Pius XII stated that: "There are serious motives, such as those often mentioned in the so-called medical, eugenic, economic and social indications, that can exempt for a long time, perhaps even the whole duration of the marriage, from the positive and obligatory carrying out of the act."12 This has been the papal justification for utilizing NFP. People do not have an absolute obligation to actualize the procreative good, and to have intercourse during infertile times is considered acceptable because the act in its very nature remains open to the procreative good although per accidens, it is not. This is similar to the use of various treatments wherein one has a general obligation to preserve and protect the basic good of life even though at times one is not required to preserve life at all costs. Thus, by not utilizing extraordinary means, one remains open to the good of life even though per accidens, the person will die as a result of not using the life-sustaining treatment.
Considering four analogous cases
First, consider the case when a couple resorts to periodic abstinence for eugenic, economic, or social reasons in accord with the teaching originally articulated by Pius XII. Herein, the couple recognizes that at times, one may not have a positive obligation to actualize the procreative good. The moral object involved in NFP is having intercourse during infertile times which expresses the appropriate love and intimacy of a married couple. This is a good moral object. The troublesome question though involves the ultimate intention of the couple. Is it to act against the procreative good? Just as one need not intend the death of a patient in withholding ineffective or gravely burdensome treatment, one need not intend to negate the procreative good in choosing not to actualize it. Instead one recognizes that circumstances may be such that one does not have a positive obligation to actualize the procreative good in light of sound family planning.
Next one considers the case when a couple utilizes the method of NFP. However, they possess what has been termed a contraceptive mentality. Even though the moral object of periodic abstinence may be acceptable, their minds are set intentionally against the good of children and the selfless and loving expression that marital intercourse should involve. Although this may occur rarely, like the case of removing life support from the patient with the intent to kill, this may occur.
The third situation would involve the use of NFP but without proper circumstantial justification. Pius XII indicated that:
if according to a rational and just judgement, there are no similar grave reasons of a personal nature or deriving from external circumstances, then the determination to avoid habitually the fecundity of the union while at the same time to continue fully satisfying their sensuality, can be derived only from a false appreciation of life and from reasons having nothing to do with proper ethical laws.13
In this case, the couple is open in general to children but have misevaluated the circumstances. Thus, consider a couple with a combined income of $150,000 with no debt who choose not to actualize the procreative good because of "financial reasons" versus a couple on welfare who choose to use NFP. The former couple is like the patient or family who have incorrectly evaluated the burden and benefit of a life sustaining intervention. The latter couple on the other hand has merely recognized the limitations of their current economic means.
Finally, when a couple resorts to the use of contraceptives to prevent pregnancy, the action itself violates the procreative good. The moral object of the act is to frustrate the procreative good and thereby violate the full truth of the sexual act. Therefore, no matter how well intentioned the couple, the use of artificial contraception or sterilization in order to prevent pregnancy is intrinsically problematic.14 Thus, the couple using contraception may be trying to achieve a similar ultimate goal of family planning as the couple using NFP. However, the use of contraception in and of itself betrays an opposition to the procreative good. This is clearly similar to the case of euthanasia wherein one's ultimate goal of relieving suffering is noble but the means used to achieve the goal are intrinsically wrong.
A final similarity
In foregoing life sustaining treatments, one still remains open to the good of life. For example, if one removes a ventilator from a terminally ill patient, and the patient unexpectedly continues to breathe spontaneously, one does not subsequently attempt to smother the patient. That is, in removing treatment one does not hope that the patient dies but that a burdensome treatment be lifted from him or her. Likewise, in NFP, one always remains open to the procreative good even though it may not be actualized. One remains open to the possibility of new life. If pregnancy were to occur, one would welcome and cherish the gift of new life. Consequently, just as allowing a patient to die is ethically justified only when people have the appropriate intention and it occurs under acceptable circumstances (i.e., the appropriate criteria are met), so it is for couples practicing NFP. Similarly, just as euthanasia represents an intrinsic evil because it violates the basic good of life, contraception is intrinsically evil because it directly acts against the basic good of procreativity. By evaluating intentionality and circumstances, I have expanded on the analogy proposed by Lawler, Boyle and May. By probing more deeply into the analogy, it becomes clear that the reason for the acceptability of NFP is not that one is simply using a "natural" means. The use of NFP does not necessarily guarantee ethical acceptability. This is analogous to the fact that allowing a patient to die does not mean it is acceptable merely because one is not doing something or that one is allowing nature to take its course.
The Church's teaching as promoting integral well-being
The effort to develop sound analogies to help to distinguish between NFP and contraception is not merely an academic exercise. The Catholic Church's teaching is not meant as an arbitrary edict created to make people's lives burdensome. Rather, the Church teaches that actions are good or bad precisely because they can substantially benefit or harm the person, couple, family, or society as a whole. Thus, in promoting the use of NFP as an ethical means of family planning, the Church recognizes it to be a safe, inexpensive and extremely effective way of planning one's family as some recent scientific evidence from the World Health Organization has indicated.15 Moreover, it enhances communication and total sharing between couples. This is in contrast to forms of contraceptive methods, some of which we refer to as "barrier methods." What does such language say about their effects on one of the most intimate and self-giving expressions of human relationship? Moreover, the many side effects of contraceptive techniques may injure people. Finally, the use of contraception can lead to an anti-children mentality which leads to the use of abortifacients or to surgical abortion when contraceptives fail.16
Today, the children of the generation of parents who first widely dissented from the Church's teaching against contraception are of child-bearing age. Societal views of sexuality, dissent within the Church, and a lack of clear teaching and direction in catechesis has relegated the Church's teaching on family planning to the status of an antiquated belief in the eyes of many in this new generation. Often, Catholics form their consciences not so much in opposition to Church teaching but rather in ignorance of it. As preachers and counselors, we sometimes seem reluctant to preach or teach about the issue. Primarily, this comes from a fear of alienating couples who have already made their choice on the matter. But it also results from a sense that the Church's teaching seems insufficiently convincing. Additionally, while many people who accept the Church's teaching do so out of a sense of loyalty to the Church or in deference to the teaching authority of the magisterium, it would be better if they also assented to the theological truth contained in the teaching. Hence it behooves priests, counselors, and teachers in the Church to make the teaching on contraception understandable to the average Catholic. Helpful analogies will not eliminate totally the misunderstanding or doubt regarding the Church's teaching on contraception. However, we owe it to the faithful to start to develop creative images to make the theological positions of the Church more understandable. What is at stake is not just the passing on of theological tradition. If we are true to the Church's message, much weighs in the balance, namely the well-being of couples, families and society as a whole. n
1 Pope John Paul II recently affirmed this teaching, see Evangelium vitae, no. 13. J. Ford and G. Grisez assert that the teaching is not only important but is in fact infallible. See their article "Contraception and the Infallibility of the Ordinary Magisterium," Theological Studies 39 (1978): 258-312.
2 Humanae vitae, no. 28.
3 R. Lawler, J. Boyle, and W. May, Catholic Sexual Ethics: A Summary, Explanation, & Defense (Huntington, IN: Our Sunday Visitor, 1985), 161-163.
4 For example, see Charles Curran, Issues in Sexual and Medical Ethics (Notre Dame, IN: University of Notre Dame Press, 1978), 38-39.
5 Utilizing his personalist approach to morality, John Paul II has emphasized the effect that contraception has on the unitive and procreative aspects of marriage by examining the innate language that expresses total reciprocal self-giving and how contraception distorts the inner truth of that conjugal love. (Familiaris Consortio, n. 32). This personalist/spiritual approach to the issue has great merit, but unfortunately its philosophical undergirding often is too abstract for the average person to grasp.
6 In cases where an action has a good and bad effect, a morally good or neutral moral object and a good intention help to satisfy the first three reqiuirements of the principle of double effect. However, for an action to be acceptable, the fourth criterion must also be satisfied. Specifically, there must be an acceptable proportion between the good effect and bad effect of a given moral action. Thus, circumstances may dictate that one refrains from an action which is intrinsically good but circumstantially unacceptable.
7 John Paul II, Veritatis Splendor, no. 81.
8 National Council of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, no. 57.
9 I was once consulted on a case like this, so it is not merely theoretical.
10 An example would be the case of Baby Doe in Indiana in 1983 when parents chose not to authorize beneficial and not overly burdensome treatment for a child with Down Syndrome.
11 See Germain Grisez, The Way of the Lord Jesus, vol. 1, (Chicago: Franciscan Herald Press, 1983), 124.
12 Pius XII, "Address to Italian Catholic Union of Midwives," October 29, 1951, no. 36.
13 Ibid.
14 A woman who uses "contraceptive" pills to combat excessive or irregular bleeding does so legitimately in accord with the principle of double effect. The foreseen but unintended evil effect is to render the women temporarily sterile. The moral object of the act is to treat a disease. See T. O'Donnell, S.J. Medicine and Christian Morality (New York, NY: Alba House, 1976), 118-19.
15 R. Ryder, "'Natural Family Planning': Effective Birth Control Supported by the Catholic Church," British Medical Journal 307 (1993): 723-26.
16 Lawler, Boyle, and May, Catholic Sexual Ethics, 164-65.