Question by Fr. John Bonaventure Quaidoo:
Does a (Catholic) gynecologist who prescribes contraceptives or who practises IVFs as part of his or her work commit a sin? What about mixed HIV-status couples who use condoms in order to prevent HIV transmission? Do they sin in doing that?
Answer by Bishop Joseph Osei-Bonsu:
Contraception refers to the various means used during sexual intercourse between a man and a woman to prevent the sexual act from resulting in the conception of a new life. Specifically, contraception refers to all the means used to stop the male seed from fertilizing a female egg.
Contraception can take various forms. Apart from a person abstaining from heterosexual intercourse, there are physical (condoms), chemical (pills), and surgical (vasectomy, hysterectomy, tubal ligation) means to prevent conception. Since in using physical, chemical, and surgical means there is the need for some kind of human intervention into the natural, biological processes of the human body, such means have been described as artificial means of contraception or birth control. Those means of contraception or birth control which do not require any kind of manufactured device or other technological means of human intervention to be effective are referred to as natural means of birth control.
The purpose of human heterosexual intercourse is undoubtedly to propagate the human race. It is intended to produce a child. Until the twentieth century, it was the teaching of the Church that the primary purpose of human sexual activity in the context of marriage was procreation. Thus, contraception was seen to be morally wrong. It was held that apart from the procreative purpose, sexual intercourse also had a unitive meaning and value. The unitive meaning here means that it refers to a specific type of physical union, the sexual union of a man and a woman in natural intercourse, in the type of act that is inherently ordered towards procreation.
By 1965 almost all Christian churches, including the Roman Catholic Church, agreed on at least two things regarding human sexual activity. One was that the unitive meaning and value of heterosexual intercourse was enough moral justification for a married couple to engage in such activity. The other was that married couples had both the right and the duty to limit the number of children that they could care for responsibly, given their real-life circumstances. Responsible parenthood thus became an important consideration in discussing this topic.
Almost alone among the Churches, however, the Roman Catholic Church, at least in its official teaching, continued to insist that artificial means of contraception were contrary to reason and the moral law. It was the view of the Church that only natural means of family planning were morally acceptable and even in this case there had to be serious reasons. This was in spite of the fact that the techniques of natural family planning had improved to an effectiveness rate of 95 percent or more for those able to follow these methods faithfully.
The main reason for the Church’s continued opposition to artificial contraception was the claim that the procreative and unitive meanings of human sexual activity were inseparably connected to one another and willed by God to be inseparable. The claim was based on an understanding of marital love, drawn from a view of the Divine Love, according to which the chief characteristic of such love was total, unconditional, self-donation; on this view, the gift of self in sexual intercourse was understood to be both a sign and a concrete realization.
The argument advanced by Pope Paul VI in his encyclical letter, Humanae Vitae (On Human Life, July 1968), and reemphasized and developed by Pope John Paul II in various addresses, is both subtle and complex. Both popes accepted the need for responsible parenthood. Both popes continually warned against the terrible personal and social consequences of a contraceptive mentality and the widespread use of artificial contraceptive techniques. They maintained that only the practice of natural family planning respected the mutual love, freedom, and human dignity of the couple.
Some people have questioned why every single act of sexual intercourse must remain open to the possibility of procreation in a relationship that has already accepted and is living the marital vocation of parenthood. Even though the natural family planning method seems to have many physical and personal advantages over artificial means of birth control, it is not easy for couples to learn it or disseminate it. It has also not been proven to be workable without a high degree of motivation on the part of both husband and wife. Consequently, the techniques of the method, unfortunately, are not widely known nor commonly taught.
This briefly is the Church’s teaching on contraception. As things stand now, a Catholic gynecologist who prescribes contraceptives as part of his or her work with the intention of preventing conception is going against the teaching of the church.
II: In Vitro Fertilization
We now look at In Vitro Fertilization (IVF) or artificial insemination, which is a technique used to impregnate women who are physically capable of conceiving and bearing a child but who cannot do so through sexual intercourse, usually because their husband is sterile or impotent. Fresh semen is obtained from the husband (if he is impotent) or from some other male donor (if the husband is sterile) and is introduced by a syringe into the woman’s vagina or cervix during the middle of her menstrual cycle. The semen may also have been previously frozen and stored in a sperm bank.
The process of In Vitro Fertilization (IVF) with Embryo Transfer (ET) bypasses the fallopian tubes and effects fertilization through technology. In this process, the ovum is removed from the ovary immediately before ovulation and is placed in a culture medium contained in a special dish along with sperm from the husband or another man. It is then transferred to the uterus. After a number of days it may implant, and if so, it matures over the next nine months.
The Position of the Catholic Church on Artificial Insemination
The Church’s teaching on artificial insemination can be summarized in three principles:
Human procreation must take place in marriage.
According to the teaching of the Catholic Church, a child should be the fruit of conjugal love expressed in sexual intercourse that takes place within marriage. According to God’s plan, three elements are required here: there must be love between a man and a woman; the couple must be married; and their love must be expressed through sexual intercourse.
Generation of new person should occur only through an act of intercourse performed between husband and wife.
According to the Church, using the gametes of a third person in order to have sperm or ovum available is a violation of the commitment of the spouses to each other and is also a grave lack with respect to that essential property of marriage which is its unity. The sexual act is an act that is inseparably corporal and spiritual. It is in their bodies and through their bodies that the spouses consummate their marriage and are able to become father and mother. The fertilization of the new human person must not occur as the direct result of a technical process which replaces the marital act.
Using the sperm or ovum of a third party is not acceptable.
According to the Church, techniques that entail the separation of husband and wife by the involvement of a person other than the couple (donation of sperm or ovum, surrogate uterus) are gravely immoral. These techniques (heterogenous artificial insemination and fertilization) infringe the child’s right to be born of a father and mother known to him and bound to each other by marriage. They betray the spouses’ right to become a father and a mother only through each other.
Techniques involving only the married couple (homogenous artificial insemination and fertilization) are perhaps less reprehensible, yet remain morally unacceptable. They dissociate the sexual act from the procreative act. The act which brings the child into existence is no longer an act by which two persons give themselves to one another, but one that entrusts the life and identity of the embryo into the power of doctors and biologists. The introduction of a third person is a violation of the rights of the child; it deprives him of this filial relationship with his parental origins and can hinder the maturing of his personal identity.
It is clear from the foregoing that a Catholic doctor who practises in vitro fertilization also goes against the teaching of the Church.
The Suffering Caused by Infertility in Marriage
It is natural for married people to want to have children. This desire can be even stronger if the couple is affected by sterility which appears incurable. Nevertheless, marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se ordered to procreation. A child is not something owed to one, but is a gift, the most gratuitous gift of marriage, and is a living testimony of the mutual giving of his parents.
Whatever its cause, sterility is certainly a difficult trial. Spouses who still suffer from infertility after exhausting legitimate medical procedures should unite themselves with the Lord’s Cross, the source of all spiritual fertility. Sterile couples must not forget that even when procreation is not possible, conjugal life does not for this reason lose its value. Physical sterility, in fact, can be for spouses the occasion for other important services to the life of the human person, for example, adoption, various forms of educational work, and assistance to other families and to poor or handicapped children (cf. Catechism of the Catholic Church 2379).
III: Use of the Condom to prevent the Spread of HIV/AIDS
Finally, we come to the last part of the question that has to do with whether or not mixed HIV-status couples who use condoms in order to prevent HIV transmission commit a sin. Let us take a case where a man and a woman are properly married. If the man, for example, should come down with HIV/AIDS, can the condom be used in this case to prevent the woman from contracting the disease? The use of the condom in this case is not for contraception but to stop the transmission of HIV/AIDS. Recommending the use of condoms as a necessary HIV/AIDS prevention is extremely important. Some Roman Catholics are sometimes unsure whether or not condom use could ever be considered morally right. But we should be aware that Catholic moral theologians have been nearly unanimous in arguing not only that the Catholic tradition is not per se opposed to their use for disease prevention, but that Roman Catholic principles actually help to convey the moral legitimacy of their use. Indeed, Pope Benedict XVI has said the use of condoms is acceptable “in certain cases” and this will be one of them. His comment on this matter is found in a book-length interview with a German journalist, Peter Seewald, and published in the book, Light of the World: The Pope, the Church, and the Signs of the Times. According to Pope Benedict, in such a situation, using a condom to reduce the risk of HIV infection “can be a first step in the direction of moralisation, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants”. We can say that if the intention is to prevent transmission of the virus, rather than prevent contraception, that is of a different moral order and such couples do not go against the teaching of the Church in using the condom in this case.
For further explanations or enquiries, you may contact the author, Most Rev. Joseph Osei-Bonsu, Catholic Bishop of Konongo-Mampong, on this number: 0244488904, or on WhatsApp (with the same number).