Condoms, AIDS & Catholic ethics

...Similar views, expressing a siege mentality in approaching the modem world, can be found in pronouncements from other church leaders, though couched in less apocalyptic terms...

...This is an astonishing mindset, and one that is frightening in a man who influences church teachings...

...A lesser hurt, a lesser damage, a lesser violation has always been considered morally acceptable when the alternative is much worse--and surely the use of a condom is less wrong than infecting another person with a lethal disease...

...Nature for the Greeks was something objec- tive and living which served as the measure for determining right and wrong...

...A biblical fundamentalist does not consider the context of a scriptural passage (its literary mode, purpose, relationship to other passages, or to the whole work in which it appears), and consequently may adopt interpretations that are both dogmatic and irrational...

...Faust, Mephis- topheles, the Antichrist, Wagner, Marxism, modernity, utilitar- ianism, nihilism: Caffarra resorts to these names and concepts again and again in his commentary on sexuality, the family, and the modem world...

...Democratic values and respect for diversity are viewed with suspicion...

...Conception is not the same as infection, and protecting against one is different from protecting against the other...

...Moreover, the moral quality of a decision to protect one's partner from infection would not be affected by changing the material facts...

...Some Catholic leaders are so careless as to appear to describe the condom itself as "intrinsically evil...

...for him it is a struggle between good and evil...

...The use of condoms for that purpose appears fully justified within the Catholic natural law tradition...

...One way to continue human life in threatened areas is to permit couples in the first period of their marriage to make use of the condom until they can be certain that they are free of infection, and only then to start their families...

...Physicians' directives were right when they restored nature to proper functioning or prevented illness in the sense of bodily imbalance...

...As the example just cited shows, it is easy to imagine circum- stances in which the contraceptive effect is recognized but regret- ted...

...in fact, it is generally more respectful of the body's natural mechanisms...

...The hemophiliac never knows whether a transfusion will contain a virus which escaped through a blood test's window of vul- nerability...

...Right meant harmony with nature...

...The next, my tools undergo transformations...

...For centuries moral theology tracts Timothy Hodor The Rag Man in the Vatican Like Michelangelo In the Sistine Chapel, I lie on my back, Trying to connect God to man: Sometimes I feel an arm's length from God, Yet, my scaffolding's shaky...

...188: Commonweal it in essentials--is rooted in classical Greek philosophy and shares with it an approach to morality that is dependent upon a concept ofphysis or natura...

...Both have strenuous displays of swordsmanship choreographed by cinema's greatest 192: Commonweal...

...The phrase "intrinsically evil" is properly used only to describe the most repugnant acts, so repugnant that they could never bejus- rifled, no matter what the circumstances, or no matter what ben- eficial consequences might result from performing them...

...then an application of the theory to the case of condom use, with special attention to the basic approach followed by ultraconservative thinkers who now exercise great influence in the Vatican...

...Removing an infected uterus, for example, may bring about permanent infertility, but unless that result is directly intended the procedure is acceptable under natural law theory as it is understood by both conservative and progressive interpreters...

...And there is in fact an ideology at work here, one held by some theologians and others who occupy influential positions in the church...

...In societies where the AIDS virus has created a plague, it becomes yet more irrational to view the use of condoms as always evil, and "intrinsically" so, without regard to intention, circum- stance, and/the character of the act...

...What is morally right is based not solely on whether the intention of the actor was good but on something more objective, a natural order that exists "out there" and can be studied to discern what may or may not be done to live and act in accord with it...

...This argument concludes that, in some cir- cumstances, condom use qualifies as a right, sensitive, respectful, and nonmaleficent act...

...And yet, referring to the document, Cardinal John Krol and Archbishop Anthony Bevilacqua said that "some have even sug- gested that Catholic moral teaching on the use of contraceptives may no longer be as firm as it was in the past...

...Nature, in the sense of the body's natural balance and proper function, was the standard of moral right and wrong...

...The bishops clearly want to do something...

...Nature was considered the seat of divinity as well as morality...

...Therapeutics aimed at restoring the balance of nature's proper functioning...

...One day, I paint smooth strokes of religion and afterlife...

...One approach to the moral question is to bring into play the classical principle of double effect...

...In my view, the church's credibility and intel- lectual integrity are at risk...

...People who use the "natural" birth control method, he believes, will keep a child that happens to be conceived, but if contraceptive technologies are used, an unexpected pregnancy is terminated by abortion...

...wrong was a violation of nature or a lack of harmony...

...It said nothing, for example, about the situation of a faithful husband or wife accidentally exposed to and infected by the HIV virus...

...In the case of condom use, fundamentalist stands also inhibit important efforts to control the spread of AIDS...

...killing in self-defense, however tragic, is morally justifiable and not punishable at all...

...The classic concepts ofphysis and natura lend themselves to widely different understandings, so that, historically, natural law theory has rallied forces for both revolutionary change and reactionary intransigence...

...It is the case of Monsignor Carlo Caffarra, a close consultant of Pope John Paul II and widely considered to be his "point man" on matters of sexual morality 22 March 1991:191 and the family...

...In such circumstances, protection against the spread of AIDS becomes extraordinarily difficult...

...Beyond question, so are human lives, perhaps in great numbers...

...they "belong to the culture aligned with death and make death man's friend instead of his principal enemy...

...In some sexual relations the condom use itself, as well as the overt, direct, and exclusive intention, is to protect another person from death, or to preserve one's own health, while main- taining family unity through marital intimacy during a difficult time...

...But pulling the trigger of a deadly weapon in order to commit murder and pulling the same trigger of the same gun in self-defense against a murderous assailant, though physically identical and employing the same device, are not the same...

...It seems conceivable that the episcopal authors of the statement were influenced by their acceptance of pluralism, reflected in the abandonment many years ago of church efforts to keep on the books state laws forbidding the sale of contraceptives...

...To address the question requires, first, a quick review of the elements of that theory...

...Only when preventive and rebalancing measures failed did the Greek physician prescribe a pharmacon or drug, and only when drugs failed was cutting or surgery considered morally right...

...The Italian Iff director has mounted Hamlet on stage more than once, and Rappeneau has declared in interviews that a filming of Cyrano de Bergerac had long been a dream of his...

...The motor driving the corrupt empire, in Caffarra's view, is technology...

...t a confidential meeting last year, I consulted with a large number of Catholic bishops and other church leaders from Africa and Latin America who were gathered to explore ways in which the church could help with the AIDS crisis...

...The law of the machine, which is the law of matter," he believes, "is being applied by man to himself and it will reduce him to slavery...

...JAMES F. DRANE CONDOMS, AIDS & CATHOLIC ETHICS OPEN TO THE TRANSMISSION OF DEATH...

...It is not a Catholic notion that past blameworthy actions narrow the range of permissible future moral choices...

...It is interesting that the phrase is most often used in matters of sex- uality: not for nuclear war, not for willful large-scale destruction of the environment, not for the death penalty...

...The argument may hold little fascination for people not affected by Vatican authority--except that the stakes involved in a successful resolution of the question are extremely high...

...In their words, "it is never morally per- missible to employ an intrinsically evil means to achieve a good purpose...

...If an infected person is going to go on having otherwise licit sexual relations, then the lesser evil would be protective sex...

...Once it is recognized that circumstances enter into the definition and the moral evaluation of actions, then for pers~ with every right to have sexual relations, condom use is not merely justifiable but obligatory...

...How can a piece of latex be intrinsically evil...

...uch arguments, however cogent they may appear to many lay Catholics, have not won acceptance or even acknowledgment at the Vatican or, to my knowledge, from many in the Catholic hierarchy...

...Not to expose another person to harm is the right thing, even if one's own exposure came about through use of a nonsterile needle in drug abuse, or through sexual contact with a male or female prostitute...

...But the act is different: different elements of the behavior constitute its definition...

...Mainstream Catholic ethics---or, more properly, the natural law tradition in morality, since many who are not Catholic follow JAMES F. DRANE is professor of clinical medical ethics at Edinboro University of Pennsylvania...

...But, given the dominance in the Vatican of highly conservative approaches to sexual ethics, they know that their options are very limited...

...And yet just such irrationality has become identified with the Catholic church in many people's minds because of uncareful pronouncements on sexual matters...

...So-called safe sex practices are at best only partially effective...

...Murder is always wrong and in some cultures punishable by death...

...If circumstances or context alter act description and definition, and they do, then moral eval- uation also changes...

...Along with intention, circumstance (including consequences) is all important for the description and definition of acts and their moral evaluation...

...If someone has already decided to take another person's life, it was always considered proper (for example) to encourage killing his cow or setting his barn afire instead...

...They were inquiring (and I am here trying to answer) whether the threat of AIDS creates circum- stances in which the use of condoms in marital intercourse may sometimes be justified within the context of Cathofic moral theory...

...And just as a person, throughout many years of a marriage, may know many aspects of a spouse's personality without ever grasping some central fact of his or her nature, so may a director be able to understand and illuminate odd comers and byways of a familiar text but also neglect to give his production a finn center...

...He heads an institute founded by the pope at the Lateran University dedicated to research on family matters...

...Catholic priests and theologians who disagree with his view he calls "priests and theologians of the corrupt empire...

...They prescribed with authority over every aspect of their patients' bodily lives: food, drink, rest, work, sexual relations, bodily excretions, exercise, sleep, living conditions, and even emotional and psychic states...

...significant example of extremism in high places has been cited in these pages earlier (Bernard Hiiring, "Building the Creative Conscience," Commonweal, August 11, 1989...

...have provided examples of choosing the lesser of two evils...

...SCREEN TWO SWASHBUCKLERS 'C ANO' & 'HAMLET' l ~ ranco Zeffirelli and Jean-Paul Rappeneau have obvi- ously been living for a long time with the classic plays that they have turned into films...

...Such a factual presentation should indicate that abstinence out- side of marriage and fidelity within marriage are the only morally correct and medically sure ways to prevent the spread of AIDS...

...In both Greek philosophy and Catholic ethics--and more recently among some environmentalists--this standard applies as well outside medicine...

...In the case of AIDS there is no procedure, medical or surgical, which can cure the disease, only a procedure to prevent its spread...

...My mind conceives a picture on the wall: It's the Last Judgment...

...I lose hold of faith and the future, But continue to work--to paint over Or to touch up my beliefs...

...The notion that a condom is a condom and no context would ever justify its use reflects the same mindset which insists that God is a rock, and that a rock is a rock: a mindset far removed from the Catholic tradition...

...It follows that he levels an absolute condemnation against any technological means of family limitation...

...In such a situation, educational efforts, if grounded in the broader moral vision outlined above, could include accurate information about prophy- lactic devices or other practices proposed by some medical experts as potential means of preventing AIDS...

...To say that marital acts performed by such persons must be "open to the transmission of life" is to require that they must also be open to the transmission of death...

...Diffusing information about the use of condoms to prevent HIV infection not only increases homosexual relations but actually serves to spread AIDS--a truth, for Caffarra, that is never mentioned in the media, and "woe to him who mentions it...

...In some of the African dioceses, HIV infection affects as many as 25 percent of the population, and AIDS has already devastated or threatens to devastate both church and society...

...Birth con- trol, reproductive technologies, abortion are lumped together...

...technology, for example, is judged right and good according as it promotes nature, brings nature to fulfillment, respects nature's functioning, or imitates nature...

...For that matter, is it possible to describe a loving and love- affirming sexual act with a condom between a married man and wife in the circumstances described here as intrinsically evil that is, to place it in the same category with acts that are unimaginably and irredeemably evil...

...Consider the relatively moderate statement, "The Many Faces of AIDS: A Gospel Response," issued in 1987 by the administrative board of the United States Catholic Conference, and some of the reactions it engendered...

...It is not possible, I suggest, in any assess- ment faithful to the natural law tradition grounded in rational analysis of behavior within a context...

...Its section on preventing the spread of AIDS contained the following modest paragraph: Because we live in a pluralistic society, we acknowledge that some will not agree with our understanding of human sexuality...

...Needless to say, this hypothetical situation is duplicated many times over in real life...

...The unreasonableness of the prohibition on condom use is evident enough in the case of the hemophiliac marriage or the accidentally infected health-care worker...

...But the husband understands his obligation not to infect another person, and the wife knows her right to protect her own life...

...We are not promoting the use of prophylactics, but merely pro- viding information that is part of the factual picture...

...Both of these adaptations are handsomely mounted, well acted, and filled with inventive business...

...Such stands serve to undermine the reasonableness of religion at a time when the church must compete with a host of secular meaning systems...

...Obviously, the condom is the same...

...They have a child and would like to have another...

...Again and again he refers to the modem tech- nological world as the "corrupt empire," a phrase reminiscent of the rhetoric of Ronald Reagan---except that Caffarra wraps both Marxist and capitalist societies in the same diabolical cloak...

...Even traditionalists who continue to consider condom use evil, regardless of intention and circumstances, must take into account the moral obligation to prefer a lesser evil when the choice is between two evils...

...As already noted, however, the consequences that may follow from applying a fundamentalist ethics to the case of condom use for prevention of AIDS infection are simply unacceptable...

...Monsignor Caffarra sees the church as involved in a death struggle with the modem world...

...My face hangs like tattered dough...

...They do not take into account either the real values that are at stake or the fundamental good of the human person...

...In any case, the statement in no way departed from official teaching on sexual morality...

...His viewpoints on a range of issues came through clearly in a long personal interview (three full pages of small print) published in the Chilean newspaper El Mercurio last April...

...Broadly o analyze these facts in a hypothetical context, imagine the case of a hemophiliac man who may become infected with the HIV virus through a needed blood transfusion...

...For them, condom use is the only way to prevent infection of the wife or a fetus while nourishing their love and satisfying their sexual needs...

...To hold that the only acceptable alternative is sexual absti- nence condemns a person already under sentence of death to abjure not only the pleasures of sex but the consolation of total intimacy in a time of ultimate stress, and to require the same of his or her partner in marriage...

...But preventive medicine is as valid as therapeutic medicine...

...applied to certain situations, over the years it has provided uncontested justification for needed medical procedures that would not otherwise be allowed...

...The interpretation ofphysis in matters having to do with the body and its functions was the domain of Greek physicians, who were also moralis[s...

...This is at best an abuse of language, and a serious one...

...For persons infected with the AIDS virus, the act of protecting a partner from deadly harm is a right act which has two effects...

...when they are seen to be permeating the church, frightened traditionalists direct their ener- gies not to dialogue with faithful Catholics who cannot in con- science accept their radically negative evaluations, but to simple repression...

...It is my hope that this comment on Catholic moral theory, setting forth as it does the possibility of justifying condom use in certain situations, will help some friends in Africa and Latin America to do what common sense indicates they must, in their oftentimes tragic circumstances...

...I turn away from the ceiling...

...If a vaccine or a cure for AIDS is found and made available globally, there will be plenty of time for further academic analyses of sexual morality in pro- fessionaljoumals...

...Murder involves much more than killing...

...it is bad when it violates or destroys the natural order...

...Both he and his wife need sexual intimacy to maintain their marriage and family...

...To speak of using contraception to avoid abortion makes no sense, for the two are inseparable: "Contraception is the first step toward abortion...

...The very continuation of life in some dioceses is threat- ened because young people are afraid to marry or to start a family for fear that they or a parmer might carry the disease...

...The device used in both cases is the same, just as the weapon may be the same in acts of self- defense and murder...

...The Catholic tradition, both in biblical exegesis and moral philosophy, requires consideration of context and rejects mindless, unreflecting, literal interpretation...

...Contemporary European culture he refers to as "the great lie...

...Caffarra's views on AIDS are predictable.9 Like all other tech- nologies which "interfere with nature," condoms are evil...

...to go against nature vio- lated both religion and ethics...

...Basic medicine was preventive medicine...

...that they will not refrain from the type of sexual or drug-abuse behavior that can transmit AIDS...

...in some circum- stances, it enhances and strengthens physis and natura in the sense of supporting nature's own preventive strategies--when ordinarily protective immunological mechanisms are too weak to create their own barriers against infection...

...Condom use too removes or inhibits transmission of an infectious agent...

...Even if unmarried persons have decided to have sexual relations and one is infected, it would be doubly wrong not to use a condom...

...They know that, especially in the absence of testing, the use of condoms has proved to be the most plausible means of preventing the spread of AIDS...

...all are symbolic of the evil modem culture...

...Acceptance of this basic natural law approach does not preclude disagreement on its application...

...Does the church, which rightfully prides itself as standing on the side of life, stand by and observe the dissolution of life in parts of Africa and Latin America...

...For now, something has to be done to control the spread of AIDS...

...In these communities, some of the poorest in the world, even testing for AIDS has been too expensive for national health-care budgets until recently, and even now is not available in some rural areas...

...Achieving these ends through condom use prevents con- ception as well as infection, but so do certain medical procedures long accepted as entirely licit...

...The bishops of metropolitan Washington, also in response to the statement of the administrative board, issued their own statement condemning condoms absolutely...

...My whole life, I've drained myself, Reaching to unite human fingers of concrete To immortal palms of abstraction...

...It is possible only for ide- ologues or their too-faithful disciples...

...It might be called ethical fundamentalism...

...We recognize that public educational programs addressed to a wide audience will reflect the fact that some people will not act as they can and should...

...They did so because all these elements (res non naturales) could cause illness, which the physician was obliged to prevent and sometimes cure...

...One fragment of a complex human behavior does not define the whole behavior...

...they are not antilife nor do they harbor a "contraceptive mentality...

...Thousands of health-care workers are exposed to HIV infection by accidental sticks and splashes, and they need to protect their spouses until they are sure about their own HIV status...

...From its silence it would appear to follow that Catholic couples in such circumstances are required to choose between perpetual celibacy and a high risk of fatal infection...

...If a biblical text says that "God is a rock," the fundamentalist if pressed for interpretation may insist on a literal meaning: "If it says, 'God is a rock,' who are you to say oth- erwise...

...One must look to church politics and to the grip of radically fundamentalist views in some quarters to explain this scandal...

...All this accords with the prism of categories--black and white, good and evil, God or the devil--through which he sees the world...

...God has already dug His fingers through my soul...

...Used as a temporary protection against possible infec- tion, it serves as preventive medicine, as well as the only plausil~le and practical way to help assure that chddren, when they do come, remain uninfected...

...The condom in such situations is not an antiprocreative device but the precise opposite...

...Using a condom to prevent the spread 190: Commonweal of infection may superficially appear to be the same act as using a condom with contraceptive intent...