A correction: it seems as though my previous description of the pope’s statement on condoms as “good news” was inaccurate–primarily because it turns out it is not “news” at all.  While the pope himself has led us to believe that the church considers condom-use to be “intrinsically evil” even to halt the spread of a devastating and fatal disease like HIV, it turns out that there has never been any official teaching on condoms.  In other words, Benedict has not said anything newsworthy because, contrary to what we have been led to believe, the church never “officially” classified condom-use to prevent the spread of disease to be intrinsically evil.

Contrary to my earlier speculation that condom-use does not meet the criterion of “double-effect,” it seems that this is precisely how condom-use is justified.  I must admit that I am more than a bit confused either on what exactly the principle of double effect specifies or what exactly condoms do! While it is certainly to possible to intend only to prevent the spread of HIV, and while it is not technically true that the contraceptive side-effect of condom-use is the means to the good end of disease prevention, I am still somewhat dissatisfied by this logic.

Perhaps you all can help me out: I am not sure if it is really accurate to speak of contraception as being a mere side-effect of condom-use.  I accept that contraception may not be what is primarily intended. However, in the case of sexually transmitted HIV, it seems as though the mechanisms of transmission and the mechanisms of conception, though not identical in theory, are nonetheless inextricably bound up with one another in such a way that it seems inaccurate to speak of contraception as the mere “side-effect” of the condom’s disease-preventing abilities.  In other words, we can separate disease prevention from contraception only in the abstract realm of theory–in reality, there is no way to prevent HIV without also preventing conception, especially in light of the fact that sperm itself can transmit HIV.

Perhaps I am uncomfortable with the principle of double effect itself.  If we go back to Aquinas’ articulation of the principle, which he uses to justify killing in self-defense, we see that he speaks of the possibility of an act having two effects, one intended and one unintended.  Since, for Aquinas, “it is natural to everything to keep itself in being, as much as possible,” the intention of self-preservation is therefore lawful, as long as a person uses only as much violence as necessary in order to keep herself alive.  Interestingly, Aquinas does not think biblical commands to “turn the other cheek” override the natural desire and right to keep on living–how to understand self-defense with respect to such commands is something we are still wrestling with and I suspect there is no easy answer to this question…

So perhaps we should examine the church’s application of the principle of double effect to the case of condoms in light of Aquinas’ use of this principle to justify killing in self-defense.  Can we justify self-defense without resort to the principle of self-defense?

My second dissatisfaction lies in the question of how we describe a given act.  For Aquinas, it was not sufficient to merely look at the act of killing itself.  To just look at the act of killing (the blow to the head, the thrusting of a sword, etc) would not provide enough data to know what was really going on.  Killing someone by striking them on the head with a sharp object could be murder, it could be manslaughter, it could be self-defense.  It is important to adequately describe an act because, if we lack an adequate sense of what a given act is, we cannot provide a moral description of this act.  In Aquinas’ thinking, it is possible to apply the principle of double effect to killing only because “killing” is something that has already been determined to be a morally indeterminate type of act–it could be evil; it could be just.   Even this determination (that killing is not always evil) is something that is the product of a given ethos and rationality–it is not self-evident, but is itself the product of moral judgement.  The fact that this seems self-evident or obvious does not of course mean that it actually is so, of course.  In fact, as I alluded to earlier, this is a contested claim within Christianity itself, as some groups claim that killing is never justified, even in the case of self-defense.

To return to the case of condoms, it seems as though we are allowed to look beyond “the act itself” to the circumstances and intention of the act in order to determine “what is really going on.”  In other areas of the church’s sexual teaching, however, it seems as though intention, circumstance, and outcome are deemed irrelevant to moral description.  So my question is, is there a discernible and coherent moral logic operating behind the magisterium’s determination that condom-use and killing are acts that cannot be fully described without reference to intention, circumstance, and effect while acts like homosexual sex and artificial contraception can in fact be adequately described in themselves?

I am asking here not for the content of church teaching (that both acts are forms of sex in which “sex” has been made intentionally non-procreative) but about the underlying logic of this criteria?


16 thoughts

  1. In regards to your first comment, it doesn’t matter in the principal of double effect whether the two things (the one willed, and the one caused accidentally) are “inextricably bound up with one another in such a way that it seems inaccurate to speak of contraception as the mere “side-effect” of the condom’s disease-preventing abilities”–it only matters whether you can will one without the other. If HIV was transmitted through reproduction itself, then I think the problem you are raising would be a bigger challenge. But one could say that a physical barrier is needed to stop fluids from being transmitted, and golly gee willikers I wish there was a type that would let sperm through as well–but until then I guess I will have to bear the consequences. If for instance, a woman faced a life-threatening condition ON ACCOUNT OF REPRODUCTION (as Meg mentioned in the thread on my post below) you would have to will contraception itself in order to will her health.

    1. yea. I hear what you’re saying and I agree that seems to be the logic, but it just feels wrong to me. Also, I don’t think that’s scientifically true. Recently, researchers have found out that HIV is spread by the sperm itself and not just the surrounding fluids. http://www.sciencedaily.com/releases/2009/10/091026093715.htm

      I think I am also hesitant about that line of thinking because it seems to turn the “will” into a type of magical thinking: “oh how I wish I could bomb that city without killing the children sleeping within those walls” becomes justification for dropping on a bomb on a location where is it at least possible “innocent” people are….

      It’s like using NFP and having sex only on non-fertile days and saying, “oh, I wish it were possible for us to get pregnant on this day.” It seems to separate will from knowledge–more precisely the responsiblity to know EXACTLY WHAT OUR WILLING INVOLVES….

      1. I completely agree that the logic is in general kind of whack–and really only helpful in a few type of cases–and is easy to twist given how you set up the premises. You’re right about the magical will that seems to shift around.

        Also, it is now apparent to me that I lack a basic biological understanding of sex/HIV/men/myself. I’m going to spend the next couple of hours on wikipedia.

      2. I really appreciate your attempt to engage scientific evidence (re: sperm transmission of HIV) to inform your argument here. Although I would suggest that the Science Daily article and the associated peer-reviewed journal article may be a bit misleading. While there is still scientific uncertainty about the exact mechanisms involved in HIV transmission between sexual partners, the article only implies that spermatozoa may play a greater role in this process than current evidence suggests, and this study was done entirely outside of the human body (i.e., basic science research). I would not undermine the potential significance of this to developing new drugs/methods for prevention, but I have to be skeptical about how we use this knowledge to inform the discussion. This is especially true given that there is epidemiological evidence (for example, see AIDS 16 April 1999 p. 645-) to suggest that contraception and HIV transmission are not intrinsically bound (e.g., sperm-washing and artificial insemination or in vitro fertilization has allowed many discordant couples (males who are HIV-positive and females who are HIV-negative) to have children who are HIV-negative. This of course leads us to other issues of IVF, and in this regard, I recognize that my concern about the intrinsically bound nature of contraception and HIV transmission is moot for some who have particular understandings about means of procreation.

        Your discussion has made me question another dimension of circumstance—that is, privilege. For example, sex workers who use sex as a means to survival and/or people with limited access to HIV treatment services if one contracts HIV in the process of trying to conceive. To be honest, I’m not sure how well church teachings convey possible exceptions to “rules”. I guess my concern with this is that people who are already marginalized in our society then feel unable to meet arguably unreasonable standards.

      3. Art–I think you are right to draw attention to the complexity of drawing upon the latest scientific findings to make ethical decisions. I would definitely need to do more research before I could say just what exactly is going on with regards to sperm and HIV. That said–I think the article I linked to was somewhat of a revision to the 1999 position you mention about sperm-washing and the like. (again, i’m not certain, this is just what I gleamed from that one article.)

        I really like what you say about privilege. I know a friend who did public health work with indigenous women in Central America. The women were Catholic and there was a great stigma placed upon both condoms and artificial contraception–a stigma due in large part to church teaching. Because in that village, childbirth was very dangerous (both in the fact that many women died because of it and in that it took a very large toll on women’s physical health) and there was great poverty so it was quite difficult to feed a large family, public health workers tried to teach NFP to these women as a solution.

        The women had no difficulty understanding or implementing NFP; however, their husbands were often unwilling to cooperate. In other words, they thought they should be able to have sex with their wives whenever they wanted and thought it an affront to their masculine dignity for their wives to say no to either their sex or their children.

        So, going back to a theme of these discussions, we see that church teaching doesn’t really “work” for these women–the burden of sexual morality falls disproportionately on the backs of women just as women bear a disproportionate share of the dangers of sex. While of course the church would probably (I hope) condemn the behavior of these men, the church provides no moral way for these women to resist this oppression! This is the problem.

        In my opinion, we are then left with the worst possible scenario: not a truly mutual and life-giving sexual relationship between the spouses, not a respect for the bodies of women (or the children whom they are unable to feed and protect from the ravages of poverty), not an empowerment of women to fight back against marital tyranny. NFP may work well for privileged women who are better positioned to choose a “good” mate (they have the social, political, economic, and educational capital to not have to use their sexuality as a way to survive, or to marry out of financial need…in other words, they are more likely to be able to marry “for love), but it doesn’t really make sense for women who live in a culture in which they are not able to say “no” to their husbands.

        Again, we may ask why, when it comes to killing, the catholic ethical tradition has been so good at building an ethics of imperfection–in fact, when the church talks about war, it’s fundamental premise seems to be that the fact that some people are sinful changes the way we must think about killing–but when it comes to sex the thinking is exactly the opposite. That people are sinful means that we must sometime kill them; but the fact that husbands are sinful does not change a thing. Or, to speak directly to your excellent example of the prostitute–the fact people are forced to sell their sexuality for money due to sinful economic, social, and political structures does not change a thing. The ethical burden falls on the weak.

  2. …and then it wouldn’t be justified via the principal of double effect.

    This is not to say that I think the PDE is the end-all of ethical argumentation. But it’s one tool that helps us figure out how we can live in a real world where we can’t help but “cause” evil and yet try to do good. Other than a few textbook cases (I create a prescription drug, but inevitably people will die of side effects. Can I still put it on the market?) I think most are too messy to be confident about how to analyze–as Sonja mentioned on the first Pope-condom post, “act” and “intent” can be defined so differently, particularly if we are talking about “acting” and “refraining from acting.”

    Anyhow, all of this is hypothetical for me, because I think condoms are good and am supported by my church in doing so. But studying with Catholics has certainly honed my analytical skills!

  3. All of which clarifies that “double-effect” is just a way for people to have their cake and eat it too, morally speaking. I’ve never been a fan.

  4. Great work on this blog, yall.

    A few things. First, I recently read a very tempting review of Elizabeth Anscombe’s old book “Intention,” which tries to clarify this action-theory stuff in a sensible way. It’s old, but apparently a classic in the field. Of course, I haven’t read the book yet. So that’s a half-recommendation. The Stanford Encyclopedia of Philosophy has a long entry on Action (also on Anscombe). It’s online.

    2. I think you’re right that the analysis of “objects” in moral theory (e.g. killing, wearing a condom in sex) is at times fuzzy. In part, I trust in the idea that most of us have a decent bullspit meter, so the NFP couple who “wishes” they were more fertile on certain days rings hollow. That’s not rigorous philosophy, but some things you just know when you see them.

    Also, I agree that naming acts always carries moral analysis into the double effect. So I find that “killing” violates human dignity per se, thus it’s immoral. Aquinas did not. The Catholic sexual ethical tradition finds that sex acts that intentionally decouple sex from its procreative end are immoral. Plenty of folks do not. One big problem that I find in trying to teach ethics is that the tradition seems stronger or more vocal with the “these acts are immoral per se” part and weaker on the “why” part. The result is a rule-based ethic of obedience alone, which doesn’t really appeal to anyone. I’m getting off on a tangent, so that’s enough of that.

    3. Katie, have you thought about the analogy of oral contraceptives? (I’m just now realizing that this might not be as authoritative as I always thought, but going on anyway…) If taking the Pill results in some kind of health benefit, then its contraceptive effects can be tolerated. It becomes an act which is no longer immoral. This can even be permitted if the contraceptive mechanism is really “tied into” to the health benefit, like in endometriosis (I think). Like Erin said, as long as you can will one without willing the other. It’s always seemed to me that condoms and STDs were very analogous to oral contraceptives for medical reasons, so it was bewildering that the HIV question hung unanswered for so long.

    4. One quirky thing is that I’ve always understood the double effect to result in an evaluation of the action as morally permissible, not some “shades of black” justification of the lesser of two evils. Here we have the lesser of two evils. I think this condom stuff is still longing for clarification.

    5. Finally, it seems the Catholic moral tradition is in something of a double-bind. Either artificial contraception is an intrinsic evil in the object (apparently not), or it’s an immoral intention. If it’s an intention question (“I intend to sever sexuality from its reproductive potential”), then I think NFP is subject to that same standard, and can’t be moral to delay pregnancy. The only way out of that is really awkward… something like “I intend to *artificially* sever sexuality from reproduction” but that seems not to make much sense.

    I have a lot more to say. I’m starting a parallel blog to give the man’s perspective on theology. It’ll be called Men And Guys In Serious Theology: Examining, Resolving Issues Ultimately, Mannishly. I’m trying to come up with a witty acronym.

    1. John,
      Thanks so much for your great comments. And I look forward to reading the “more” you have to say!

      I really like what you say in number 5 about the “double-bind,” and I think the fact that I thought church teaching considered artificial contraception “instrinsically evil in the object” is EXACTLY why I got so excited when I first heard about the pope’s statement (see “The Pope Changes His Mind on Condoms?”. But as you pointed out with your discussion of NFP, it seems as though what is intrinsically evil is not the severing of sex from procreation but the intention to do so. And yes, your recognition of the awkwardness of how this plays out with regard to NFP is spot-on.

      1. Good point, John and Katie. I had forgotten that intent, and not mere physical structure, is indeed factored into determining whether to deem a given act “contraceptive.” A sterile couple, for instance, is still permitted to marry even though no sex they have could possibly be procreative; in this sense, they are rather like the couple who practices NFP (or at least they are like them at certain times of the month).

    2. also, John, my reservations extend beyond its use (or lack of use) in adjudicating issues related to sexual morality. I am especially worried about the way PDE gets used to justify the killing of “non-combatants” in war as something that can be either casually dismissed or, if acknowledge as “sad” is never acknowledged as “wrong” and is even less acknowledged as “wrong” in a way that calls the “justice” of the war itself into question.

      My beef with “intrinsic evil” also extends beyond the sexual–just as it tends to amp up the perceived evilness of certain sex acts, it also serves to diminish or mute the evil of those evils which are only “circumstantial.” Again, I am thinking primarily of war–the fact that, according to Catholic tradition, people can be lawfully killed in war, somehow makes it less bad when people are non-lawfully killed in war. I think Caveny wrote a piece about this in America a while back.

      1. I agree totally about the problem with the category of “intrinsic evil,” Katie; do you remember Cathy Kaveny’s America article, “Intrinsic Evils and Political Responsibility”? A really excellent essay.

        Also, I think that defenses of the category of intrinsic evil oddly parallel defenses of textual foundationalism (that words have meaning because the refer to real things “out there,” rather than that they have meaning because of their relation to other words in a language); in each case, defenders protest that morals (or words) will just become “whatever we want them to be,” and all hell will break loose. (I myself still don’t understand how textual non-foundationalism can work theologically, but I am pretty convinced about how words have meaning; by extension, I am persuaded by the position that “intrinsic evil” makes no sense.)

  5. Another thought: You mentioned, Katie, that sperm itself can transmit HIV. I agree with you that PDE really starts to break down here, and in fact we just recently saw it break down in a similar situation: that of a woman whose actual pregnancy is life-threatening (e.g., the Phoenix case earlier this year). What complicated that case, as I think Kevin Rourke or Ladislaw Orsy had pointed out, was that there was not any clear threat to her life *other* than the pregnancy *itself*–no cancerous uterus or inflamed fallopian tube to shove the blame onto so that PDE could be applied. As I understand it, the hospital’s ethics board ultimately decided that the placenta could be labeled the “pathological organ” (can’t believe we’re still talking that way, honestly) so that an “indirect abortion” could be carried out.

    This same problem also arises in cases of ectopic pregnancies, where you have a debate over whether the drug methotrexate can be used to “dissolve” the pregnancy, leaving the tube intact. Some say no, because you’re clearly attacking the embryo. Some say yes, because you’re actually only dissolving the tissue that allows the embryo to adhere to the wall of the tube. And still others respond that, it’s unclear exactly “whose” tissue that is–whether it belongs to the mother or whether it’s properly part of the embryo. And it’s at that point in the debate when I want to claw my eyes out and say, “Don’t you think this might be a bad way of thinking about this?” (Funny, I never hear the illustration of an ectopic pregnancy in which the embryo has attached to some vital organ in the abdomen.)

    Anyway, all this is to say yuck. I agree with Erin that PDE is an important tool for making real moral decisions, but I agree with Katie that the damage it seems capable of inflicting is so troubling that it almost seems worth throwing out. Didn’t Richard McCormick have a book that addressed this topic? Something like, “Doing evil that good may come.”

  6. I don’t study moral theology, and so may not fully understand the issues at stake here. As a student of Christian asceticism, however, I have a suggestion which may prove useful to your discussion.

    Rather than attempting to interpret the Pope’s comments as an application of the Principle of Double Effect, implying that the use of condoms by HIV-infected prostitutes is morally legitimate (which indeed seems to create an unsolvable dilemma), it may be better to interpret them as the description of an asceticism.

    By “asceticism,” I mean actions based not on a determination of what is morally right and wrong, but concrete steps toward the goal of attaining a particular state (which may be a moral state) made in full awareness of and negotiation with the realities of the human situation, i.e. stubbornly persistent concupiscence and repeated sinfulness, weakness, oppression, etc. From this perspective, one’s actions are not simply right or wrong: they are a long staircase of choices and behaviors in which one’s actions may remain objectively evil for a long time while the dispositions and habits of virtue and holiness are being slowly fostered; similarly, one’s actions may be objectively right while remaining tainted with selfish or malicious motives or feelings. Further, it may well be that an “evil” act along the way inadvertently and providentially ends up contributing to greater virtue. Complete holiness in both action and the sundry involved dispositions is a distant goal rarely attained – only, in the end, by grace. What are of concern here are psychological states and concrete habits.

    Interpreted thusly, the use of a condom by an HIV-infected prostitute need not be a morally legitimate act; it may remain morally evil while yet indicating a growing awareness of and willingness to act upon the danger to others’ lives posed by one’s actions. This is a small but positive step towards the final goal of moral goodness for the prostitute in question, other steps toward which would include a full recognition of and commitment in action to the divinely-created nature of human sexuality, demanding the setting aside of prostitution and artificial contraception, and (of course) the assistance from other possibly necessary to make such a concrete choice possible.

    This proposal seems to be in line with the statements by the Pope and Fr. Lombardi that the condom is in this case “a first step in the direction of a moralization, a first assumption of responsibility” and “the first step of taking responsibility, of taking into consideration the risk of the life of another with whom you have a relationship.”

    If I’ve missed any part of the discussion that already makes these points, I apologize for the repetition.

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