Abstract
The morality of contraception has not always been clear to many Catholics. Although the popes have been clear in their teaching that it is a grave evil, many theologians, priests, and Catholics either deny this teaching or, at least, are skeptical as to its truth. Many health-care providers seem unclear concerning the evil of this practice also. Many do not seem interested in discovering the possible good moral fruits of the practice of natural family planning. To understand the essential evil of contraception and how it differs from natural family planning in both theory and practice first requires a clear delineation of the sources for determining Catholic moral action. These are the object, circumstances, and intention. Each is objectively determined by the relationship of the act in question to an objective human nature which can be discovered by reason alone. To be good, all three of these factors must conform to human nature. The sexual act is evil while using artificial pills or devices to preclude birth and no circumstances or intention can justify one in doing such use. This not only denies children, but also precludes total self-giving love from being expressed in such an act. It has the further result of introducing self-fulfillment as the primary value into the most important natural act of all, the one which leads to human life. Natural family planning is not a form of contraception and so it is objectively completely different in its moral nature. The human decision to refrain from the sexual act is not contraception. When undertaken in the right circumstances and for the right intention, natural family planning is an objective cooperation with the justice due to the Creator in the transmission of life and not a denial of his rights. A physician who would assist in the performance of the sexual act in which the possibility of birth is excluded by prescribing some artificial means to preclude birth would be cooperating with the evil of contraception. One could not do this with a correct conscience.
The Theory of Morality of Contraception and Natural Family Planning
Ever since Paul VI issued Humanae Vitae on July 25, 1968, the Catholic Church has been rocked by theological controversies on what had once been a monolithic moral theology. Anglicans like John Henry Newman and Henry Edward Manning had “come to the Tiber” because they found the bedrock of papal authority there, something missing in the Anglican Church. As soon as Humanae Vitae was issued, it was met with loud and constant dissent even by those charged with the formal teaching of Catholic doctrine in academic institutions.Footnote1 The clamor has not dissipated even today when it is clear that this teaching will not change. The condemnation of contraception has entered public discourse in the United States healthcare community over the proposed federal mandate to require healthcare providers to pay for contraception, even religiously based institutions whose teaching is against contraception. Even within the Church, John Paul II's encyclical Veritatis Splendor was met in the 1990s by angry disavowal largely based on the suspicion that all it was about was the continued insistence on the moral evil of contraception. Bernard Haring one of the most famous Catholic moralists after Vatican II and a famous dissenter from Humanae Vitae took John Paul's purpose in writing Veritatis Splendor to simply be a reaffirmation of a papal teaching which was wrong and wrote at the time:
After reading the new papal encyclical carefully, I felt greatly discouraged. Several hours later I suffered long-lasting tremors of the brain, and looked forward hopefully to leaving the Church on earth for the Church in heaven. After regaining my normal brain function, however, I have a new feeling of confidence, without blinding my eyes and heart to the pain and brain-convulsions that are likely to ensue in the immediate future (Haring Citation1993).
How One Determines Right From Wrong
First, it is important to note that one cannot understand how contraception differs from NFP unless one understands the moral determinants which the Church has used since Thomas Aquinas (Summa Theologiae, I–II, q. 18), to define the moral goodness or evil of an action. This evaluation involves three moral determinants which descend from more general to more specific.
The first is the object of the act. Objects are good, evil, or indifferent. They are what the act is about. They go beyond mere physical description. For example, taking innocent human life specifies the object of murder. Taking what belongs to another against the reasonable will of the other specifies theft. The Ten Commandments generally specify the moral objects.
In addition to the object, the individual condition in which the act is found may add a further judgment which makes it accord with reason or not. For example, a murder may be done in a church which changes the moral nature of the deed from mere murder to sacrilegious murder. This is more against the first commandment than the fifth. The amount of the theft may actually place it in the species of the sin of theft or make it as almost nothing. These are called the circumstances. Some change nothing about the moral nature of an act. Others can completely change it to have a different moral meaning.
The narrowest consideration and the last morally constituting qualification is the personal reason the agent has in performing the action. This is called the intention. Though an act may be morally indifferent from the point of view of the object and the circumstances, each intentional action (versus something done absentmindedly) can be judged to be “in accord with” or “against” human nature. A wicked intention can change an act which is objectively good and which has good circumstances into an evil action. The classic example is giving alms for the sake of vainglory instead of to alleviate the condition of the poor. In other words, it would profit the recipients but not the agent of such an action.
For an action to be morally good, all three of the moral determinants must be good. So the moral object must be good or indifferent in itself, done in good circumstances, and with a right intention. If any of these are lacking, the action will be evil. If an object is evil, as is the case with contraception, the fact that good may result from it and be done with a good intention cannot make it good. This teaching can be found clearly in the Catechism of the Catholic Church, numbers 1750–1756. It is constant Catholic doctrine.
The Moral Good of Marriage and Sexuality
The traditional Catholic teaching on the goods of marriage relates the marital act to the nature of God, the world, and the couple. The Thomistic teaching is quite succinct. For St. Thomas, the very nature of the seed and the womb contain the potential for life and has that as their obvious physical purpose. However, since man has a rational, spiritual soul which cannot be reduced to the material world, the creation of the soul must be the direct result of an action on the part of God. This is because the seed is potentially a man and man has a natural potential to see God, St. Thomas quotes Aristotle: “Hence the Philosophy says in the Politics that in man's semen there is something divine, inasmuch as it is man potentially; therefore lack of order in regard to the discharge of semen is a lack of order in regard to the life of man in proximate potency.”Footnote3
St. Thomas did not have the access to the biological facts as we know them today so he is not maintaining that there is a sort of embryo hidden in the seed. He is rather reflecting on the power of the human life force which is expressed in both the active life of the seed and the receptive nurturing power of the womb. Each of these forms the natural climate for the moral participation of the parties in the conjugal act. In fact, the basic reason why this act must be between two consenting adults of the opposite sex is precisely because this action is always beyond the physical order since it is oriented to the creation of a spiritual reality, a human soul. Though the participants in the conjugal act supply the matter from which a human being comes to exist, God must directly create every human soul. The participation of the parties does not end with the existence of a human being but must also continue through the formation of the child morally. This is also the natural reason why the marriage must be monogamous and indissoluble. The formation of children is so deep that a lifelong commitment and certainty of parenting are necessary.Footnote4
John Paul II reflects the fact that this act is never purely biological. In Familiaris Consortio he clearly teaches that this participation must be more, for it must involve lifelong giving and also never be artificially separated from the procreation and education of children:
“Consequently, sexuality by means of which man and woman give themselves to one another through the acts which are proper and exclusive to the spouses is by no means something purely biological, but concerns the innermost being of the human person as such. It is realized in a truly human way only if it is an integral part of the love by which a man and woman commit themselves totally to one another until death. The total physical self-giving would be a lie if it were not the sign and fruit of a total personal self-giving, in which the whole person, including the temporal dimension is present: if the persons were to withhold something or reserve the possibility of deciding otherwise in the future, by this very fact he or she would not be giving totally.”
This totality which is required by conjugal love also corresponds to the demands of responsible fertility. This fertility is directed to the generation of a human being, and so by its generation of a human being and by its nature it surpasses the purely biological order and involves a whole series of personal values.Footnote5
The Creator himself must directly cause the existence of every human soul as the form of man. He has chosen to do this by means of the physical element supplied by the parents. The human conjugal act must respect and include the possibility of the Divine choice to create a human soul (and therefore a human being). Creation is a Divine right. If this right is denied, then the act is in itself evil by object. The act itself is disordered if the participation of the One who creates the soul is precluded. Moreover, since the authentic goodness of this act includes the right of the Creator to confer life which is exclusively his gift, use of the sexual act in which procreation and education of children, unity or both is excluded is contrary to the nature of the relationship and is automatically contrary to real love. The statement “I love you because you are good in your own right” (which includes in the “you” the potential for being a co-creator with God), is changed in the ethical order to “I love you because you make me feel good” (at its best, this could be construed as mutual support). However, in this, utilitarianism is introduced into the objective relationship even if the parties do not will it. The fact that they have willed to deny one of the goods makes each of the parties an object of use by the other. This is a consequence of contraception. By artificial means, couples, sometimes for the best motives in the world, deny the rights of the Creator in the act. Sex then becomes a means in which one self uses another.
Once one has introduced utilitarianism into the relationship then the parties are dehumanized. In Gaudium et Spes, number 24.3 Vatican II teaches that because man though physical, has a rational soul there are two characteristics of the morality of human persons. First, no person may be an object of use, every person must be a subject of love and second, a person only realizes their ultimate potential as a human person as a sincere gift of themselves to another.Footnote6
John Paul II invokes this text and norm in his explanation of human sexuality in his Wednesday audience discourses on Theology of the Body: “The truth about man, which the Council's text explains […] has two main emphases. The first affirms that man is the only creature in the world that the Creator willed ‘for its own sake’; the second consists in saying that this same man, willed in this way by the Creator ‘from the beginning,’ can only find himself through a disinterested gift of self.” (Paul Citation2006)
Dr. Conrad Baars reflects on the possible fruits of turning people into objects of use in the practice of birth control when he explains his experience with the French in the concentration camp of Buchenwald. He was sent by the Nazis when they captured him for helping allied flyers to escape from the Netherlands where he studied as a young man during World War II. He demonstrates the disastrous moral effects on respect for persons which the contraceptive mentality causes. When persons become objects of use, then it logically follows that one may starve another to death for the sake of saving one's own life. The French were being forcibly denied food by the Communists so that the Communists could eat.
Once on the battlefields of World War I, now in the concentration camps of World War II, France paid the price for taking the lead in one of the most successful campaigns in modern history some one hundred and twenty five years earlier: the campaign of birth control. Successful their campaign had been, because birth control appeals so much to the selfish element in every human being. It eliminates the responsibilities and duties of love, it decries the consequence of romance, and it educates young people in their own selfish pleasures. France, by destroying the morality of its youth, had led the way to the destruction of its own existence; it had removed from its children the backbone of perseverance against evil. They had nobody to blame but themselves, not even their executioners, the Communists, who were only supporting Malthus' theory that the mad, rabbit-like multiplication of members of the human race would cause a disastrous exhaustion of the world's food supply. (Baars Citation1996)
This relationship is not destroyed but is spoiled by the original sin. The integrity by which Adam and Eve could experience a union without manipulation was caused by the fact that they were both in the state of grace or union with the Trinity. When this was lost, they sought to fill their need for the infinite with extortion of the freedom of the other. The body becomes for them a means of domination of oneself over another.
But this is not what the body was created to be. Christ calls the man of lust and domination back from the lustful look to understand that when physical things are used just for pleasure and domination then the body is a good which is not sufficiently appreciated. Instead, he wished to redeem the body (Rom. 8:23) and so marriage, and return it to its original dignity in giving the parties back grace. For this to be true, the parties must control their experience of pleasure according to the goods of marriage. Ethos must redeem Eros again. This is what happens in the sacrament of the New Testament. “It is therefore indispensable that ethos becomes the constitutive form of eros” (Paul Citation2006: vol. 48, 1, 319).
In the sacrament of the New Testament which is marriage, Christ adds to the original meaning, in which the relationship of the parties expressed the union of God with the world, the relationship of Christ loving the Church by offering His body and dying on the cross for her. The couple acts as priests to each other and to their children. Their relationship must now also mirror Christ and His Church. Again, the good of bringing human beings to heaven by the procreation and education of children is central to this experience. “So great and splendid is the educational ministry of Christian parents that St. Thomas has no hesitation in comparing it with the ministry of priests: ‘Some propagate and guard spiritual life by a spiritual ministry: this is the role of the sacrament of Orders; others do this for both corporal and spiritual life, and this is brought about by the sacrament of marriage, by which a man and woman join together in order to beget offspring and bring them up to worship God’ ” (Thomas Aquinas, Summa contra Gentiles, IV, 58) (Paul Citation1981: 38).
Children then are a necessary part of the marriage relationship whether that relationship is embraced in the time before the sin, in the time of the natural law, that of the Old Testament, or that of the New Testament. Though one does not have to have the intention to have a child in every conjugal act, one cannot exclude children altogether, and every conjugal act must be open to life. Also, since human life is such an essential part of this relationship, though one may space births, one should not do this without a grave reason such as is the case when pregnancy may involve a threat to the life of the mother.
The attempt to space children or preclude them from the relationship altogether, for example, because one thinks there may not be enough food in the world, is seriously flawed. When pleasure enters the relationship as the only real good, children become an object of use. “No child but a wanted or planned child” means “No child but one which is convenient to me.”
Natural Family Planning vis-à-vis Contraception
The Church has always permitted couples for grave reasons to space births of their children. Though this does involve having sex without the natural result of a child, it is not the same as contraception. There are, in fact, six basic reasons why NFP is morally different in object from contraception. There are a number of differences between using contraception and NFP which show the difference in the moral object. NFP is person oriented because it recognizes that sexuality must involve life and self-giving to a person; contraception is pleasure oriented because it respects neither of these realities. NFP is not a method of contraception because it is not utilitarian since it respects procreation, education of children and unity of the parties; contraception is merely a method to insure the maximum pleasure to the maximum number of people because it separates the procreative from the unitive meaning of the act. NFP affirms both the subjective and the objective because it conforms to the order which the Creator himself has placed in the woman's cycle; contraception is subjective only because it respects no other law or order but the selfish desires of the individual. NFP respects divine providence in the act itself as it is open to the order of providence with the possibility of parenthood: contraception simply seeks to deny the role of providence and uses a technique created by man's industry to frustrate its designs. NFP is morally good by object when it flows from the personal affirmation of love and so is an exercise demanding self-control and the development of the virtue of chastity through periodic continence; contraception is simply directed against conception and demands no human self-control. In NFP, the natural and personal orders unite in intimate communion, because in respecting the rights of the Creator, the couple goes beyond the mere physical expression of love to a spiritual willing of the person for his own sake. In self-control they give disinterested gift of the self to the other; in contraception, the couple reduces love to its physical expression which, in satisfying the desires of one of the parties denies the whole idea of gift of self to another. Their action is completely self-absorbed. For all these reasons, though using contraception and using NFP look the same, they are completely different in moral object. In using NFP, the couple base their decision on the order which God himself has placed in the woman's cycle. In using contraception, the couple recognizes no external law or control on their choice. The only criterion is what they perceive as needed to satisfy their subjective need of the moment. The rights of the Creator are neither referenced nor respected. For this reason using NFP is good in object, using contraception is intrinsically evil.
Of course, the intention and circumstances must also be good. The circumstances would mean that there must really be a grave reason for practicing NFP. Marriage is ordered to children and all things being equal couples should not space births for trivial reasons. Responsible parenthood would of course include some assurance that one could support and basically educate one's children. However, trivial reasons would include things like having a bigger house, another car, or some such thing. Grave and serious reasons would include things like the mother's life being threatened by another pregnancy.
As to intention, this is much harder sometimes to discern. A right intention would include the love of the parties for each other and the willingness to observe the recourse to natural biological changes of the cycle as practicing the virtue of temperance so that the conjugal act would not be an obligation but a choice. Choice would, in this case, be for self-mastery so that the relationship between the spouses might truly be a personal expression of the union of the total self including the body and the spirit.
It should be apparent from these considerations that NFP and contraception differ morally. The one affirms the good of the human persons because it affirms the proper order in divine providence of respecting the rights of the Creator in the creative process. It is God himself who placed infertile times into a woman's cycle. The couple control themselves according to nature as God has created it. In contraception, neither Creator nor the persons are considered. The only real consideration is the greatest convenience or pleasure to the parties. Persons become objects of use instead of subjects of love. In this the predictions of Paul VI in 1968 seem prescient. He predicted that if contraception is looked on as morally good that there will be no moral fiber inculcated in the young for the resistance of evil or self-mastery; women will be devalued; and an undue authority will be given to the state which affects the freedom and development of authentic family life.
Responsible men can become more deeply convinced of the truth of the doctrine laid down by the Church on this issue if they reflect on the consequences of methods and plans for artificial birth control. Let them first consider how easily this course of action could open wide the way for marital infidelity and a general lowering of moral standards. Not much experience is needed to be fully aware of human weakness and to understand that human beings—and especially the young, who are so exposed to temptation—need incentives to keep the moral law, and it is an evil thing to make it easy for them to break that law. Another effect that gives cause for alarm is that a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires, no longer considering her as his partner whom he should surround with care and affection.
Finally, careful consideration should be given to the danger of this power passing into the hands of those public authorities who care little for the precepts of the moral law. Who will blame a government which in its attempt to resolve the problems affecting an entire country resorts to the same measures as are regarded as lawful by married people in the solution of a particular family difficulty? Who will prevent public authorities from favoring those contraceptive methods which they consider more effective?Footnote7
The Practice of Contraception Versus Natural Family Planning
The moral nature of contraception is completely contrary to the nature of man. How would the practical use of contraception differ from that of NFP? How can the practical use of NFP contribute to the promotion of the moral dimensions of marriage?
NFP is a scientific method of observing the physiologic and biologic markers through the menstrual cycle of a woman so as to be aware of the fertile and infertile times throughout each cycle (Kippley 1997). NFP (sometimes known as fertility awareness) has several models, all of which are effective and each has its own supporters. There is the sympto-thermal method (STM) using cross-checks between temperature, mucus, and cervical changes. There is the Billings Ovulation method, which is a mucus only method. There is the Marquette method, which is the STM with use of the Clear Blue Easy Fertility Monitor. There is the Creighton Model championed by Dr. Thomas Hilgers at the Pope Paul VI Institute in Omaha, NE, USA which is a modified Billings, or mucus only method, but more of a medical model with the most consistent methodological charting system and more for women who are trying to conceive, but can be used to postpone pregnancy. There are also the Family of Americas and Northwest Family services models. They all teach how to recognize the one hundred hours (on average) (Kippley 1997, 79–80) per month of the fertile window consistently so that the married couple, through prayer and discernment with the aid of the Holy Spirit, can choose to engage in marital relations or not, depending on their decision to practice responsible parenthood, during the fertile window, or to abstain so as to postpone pregnancy during that cycle.
NFP methods are natural (no artificial devices, products, drugs, or techniques). They are ninety-eight to ninety-nine percent effective when used properly and well learned. They do not separate the procreative and unitive aspects of the marital act. They are in concert with being open to life and love (babies and bonding) according to God's plan. They are easy to learn and use. They are inexpensive (sometimes even free). They are readily available (there are online courses and many instructors throughout all the USA and the world and supported by the Diocesan Development Program which oversees all NFP courses and instructors). They are “green” (no drugs, hormones, or devices, no chemical byproducts going into the soil, water systems or waste systems to harm the environment).
Contraception, on the other hand, is by the nature of its very word- “against life.” It is a willing that a life not exist, or come into existence. It separates the procreative and unitiveFootnote8 meanings of the conjugal act; it destroys the union of life and love, the very essence of our existence and created being.
Information on the various means of contraception is helpful in determining the difference in moral object between NFP and contraception. There are many methods of contraception. The most commonly used in the USA is sterilization, either a tubal ligation or occlusion of the female fallopian tubes or a vasectomy or ligation and cutting of the vas deferens of the male. They are ninety-nine percent effective (Trussell Citation2007) and destroy the God given fertility and normal anatomy of the female or male. They do have failure rates and, in females, increase the risk of an ectopic (fallopian tube) pregnancy which can be fatal. These methods are most commonly used in women over the age of thirty-five years. The next most common method is hormonal contraception for which there are pills, patches, injections, and vaginal rings. They have a failure rate of about one to two percent and again they treat fertility as a disease and suppress the natural fertile cycle of the female. They have three mechanisms of action: (1) suppress ovulation; (2) modify vaginal mucus to suppress sperm migration; and (3) thin the lining of the uterus which may prevent implantation of an already fertilized egg (embryo; baby).
There is much documentation in scientific literature which goes beyond the scope of this paper; however, it would not be complete to not mention some of the risks and where to find them. There is an increased risk of breast cancer, cervical cancer, heart attack, stroke, venous thrombosis (blood clots in the legs which can travel to the lungs), liver tumors, gall bladder disease, and altered lipid profiles which can lead to increased risks of cardiovascular disease. All of these are contained in the very package inserts of the products themselves, the Physicians' Desk Reference and most effectively in Dr. Chris Kahlenborn's synopsis “Abortion: Breast Cancer” (Kahlenborn Citation2000). There are also references in The Lancet 2003 (Smith et al. Citation2003, 1159–67) and Mayo Clinic proceedings 2005 (Kahlenborn et al. Citation2006, 1290–1302) and on the website of the Breast Cancer Prevention Institute of Dr. Angela Lanfranchi.
Further, the hormonal contraceptives do not protect against sexually transmitted diseases, and, in fact, probably increase them as a result of encouraging more promiscuous sexual activity with more frequency with more partners increasing one's exposure to infections carried by those different partners (Baeten et al. Citation2001, 380–5). Of course, there are problems with the intrauterine device (plastic devices some with hormones) inserted inside the women's uterus as a foreign body which can increase the risk of perforation, infection, and ectopic pregnancy and can have an abortifacient effect (Caliskan et al. Citation2003, 150–5; Xiong et al. Citation1995, 23–34). Most women are not told the truth about these side effects because they are considered to be rare (maybe one to two percent), but when twelve million women are using the hormonal contraceptives in any given year, that number can be significant. There have also been deaths reported every year in younger healthy women secondary to blood clots from these potent steroid hormones, especially the patch, which is still available! (Contraceptive Technology 2004).
Only about one percent of the US population is estimated to use NFP (Fehring Citation2011). Some surmised reasons would be lack of awareness; lack of promotion by healthcare providers (they do not teach this in medical schools or residencies); and when was the last time a gynecologist discussed NFP with any of our female patients on an office visit?; lack of value financially (no one will make any money on these methods, whereas the Pill is a billion dollar business for pharmaceutical companies!); lack of education (not taught, even in many Catholic schools); lack of confidence that it works; lack of faith many Catholics including theologians do not accept Church teaching on contraception as intrinsically evil; lack of support by other Christian churches (until 1930 all Christian churches taught the intrinsic evil of contraception, but the Lambeth Conference changed all that);Footnote9 lack of NFP information in the scientific media and social media.
We need to restore the values of life and love in our culture. We need to resist the cultural attempts at re-defining family, marriage, and the beginning of life. We need to open ourselves to the truth of God's plan for us as His beloved children. We need, as a Catholic Church, to fearlessly proclaim the truth, regardless of cost, but with love and compassion. We need to stop the perception that fertility is a disease or that children are a burden. We hope that these issues become more of an issue in the public forum so that more people learn of God's plan for life and love.
The use of contraception is completely different morally and practically from that of NFP. These facts should provide an important resource to convince the Catholic medical community that they would be cooperating in evil to prescribe or recommend any procedure which exhibits the nature of contraception. Instead, if there is a judgment that a couple should not have a child because perhaps another pregnancy would compromise the life of the mother, then the appropriate Catholic action would be to recommend NFP. This would include recourse to good courses in the practical means to do it. The same would be true of Catholic institutions. If individual medical professionals must not cooperate in this evil, then this is even truer for the institutions which represent the Church.
Notes
1 Cf., for example, James Cardinal Stafford (Citation1968).
2 Cf., for example, Humanae Vitae, 17.
3 Thomas Aquinas, De Malo, 15, ad corp.: “Unde et philosophus in sua politica dicit in semine hominis esse quiddam divinum, in quantum scilicet est homo in potentia.”
4 Thomas Aquinas, Summa contra Gentiles, III, c. 123.
5 John Paul II, Familiaris Consortio, 1981, 11.
6 Vatican II, vol. 1 (Costello Publishing Co, 1954), 24:3: “It follows, then, that is man is the only creature on earth that God has wanted for its own sake, m man can fully discover his own true self only in a sincere gift of himself.”
7 Pope Paul VI, Humanae Vitae, 17.
8 Catechism Catholic Church: Ligouri Pub: 1994: 2370.
9 Lambeth Conference.org: 1930: Resolution 15.
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