Contraceptive sterilization.

Catholics often ask what does the Church teach about contraceptive sterilization of a man or a woman? They may be confused, misled or ignorant about this Church teaching.

Pope Pius XII stated on October 29, 1951, in his address to the Congress of the Italian Association of Midwives, that

". . . sterilization which aims, either as a means, or an end, at rendering procreation impossible, is a grave violation of the moral law and therefore illicit."

Pope Paul VI, in his encyclical Humanae vitae (1968), condemned

"direct sterilization, whether of the man or of the woman, whether permanent or temporary."

The Sacred Congregation of the Doctrine of the Faith, in response to requests for clarification from American bishops, stated in 1977,

". . . any sterilization which, of itself, that is, of its own nature and condition, has the sole immediate effect of rendering the generative faculty incapable of procreation is completely forbidden." (1)

Competency of the Magisterium to teach

Pope Paul VI stated that the Church is competent to give authoriatative moral teaching on marriage. (2) This teaching is founded on natural law, illuminated and enriched by divine revelation. "It is in fact undisputed, as our predecessors have on numerous occasions declared, that Jesus Christ, when communicating to Peter and to the apostles his divine authority and sending them to teach his commandments to all nations (Mt 28: 18 - 19) constituted them guardians and authentic interpreters of the whole moral law, not only the law of the Gospel, but also of the natural law. (3)

The Magisterium and the formation of conscience

The judgement of conscience is a practical judgement which makes known what a person must do or not do, or which assesses an act performed by himself or herself. (4) The conscience is not free to determine moral norms; rather it applies the moral law in specific circumstances. It judges whether an action is right or wrong in the light of the natural law and the divine law. St. Paul says that conscience must be "confirmed by the Holy Spirit" (cf. Rom 9:1), and writes that the faithful must not "practise cunning and tamper with God's word" (2 Cor 4:2).

The faithful must inform their consciences in the light of the teaching of the Roman Pontiff and of the bishops throughout the world when they speak in union with and under the headship of the Pope. The Pope and bishops have the authority of Christ himself vested in them.

Infallibility

Infallibility was always present in the Church, even from apostolic times, and was frequently affirmed by the actions and declarations of the apostles (e.g., Gal 1:9). The doctrine of infallibility was defined by the first Vatican Council, and promulgated July 18, 1870. The doctrine defined that infallibility is

1. in the Pope personally and solely as the successor of Peter. This is the origin of the infallibility of `ex cathedra' teachings of the Pope.

2. In an ecumenical council subject to confirmation by the Pope.

3. In the bishops of the Universal Church teaching definitively in union with the Pope.

The Catholic Church has constantly and - in modern times - emphatically taught that contraceptive acts are objectively grave violations of the law of God. (5) Some argue that because Humanae vitae is not an `ex cathedra' teaching, Catholics are free to practise contraception. This is not true! (6)

As the Canadian bishops taught in the 1974 Statement on the Formation of Conscience, "For a believer, this teaching Magisterium (the college of bishops united with the pope) . . . cannot be just one element among others in the formation of his conscience. It is the definitive cornerstone upon which the whole edifice of conscientious judgement must be built." They then quoted Scripture, "You are built upon the foundation laid by the apostles and prophets, and Christ Jesus himself is the foundation stone." (Eph 2:20) "You are Peter and upon this rock I will build my Church" (Mt 16:18). (See also Vatican II, Lumen gentium, sections 22 and 23).

Dissent

The roots of the current dissent of some Catholic theologians and ethicists were visible already around 1900, in a movement called Modernism. Its earlier origins may be traced to Protestantism which found further strength in the philosophy of Kant and Hegel. It questioned many fixed truths and contended that truth is no more unchangeable than man himself. Everything, including truth, evolves!

These ideas surfaced with a vengeance after Vatican Council II. The modern dissenting `Catholic' theologian does not in fact "do" Catholic theology at all. He or she implicitly denies for example, that direct killing of the innocent is wrong, or that the Virginal Birth of Our Lord truly happened. Together, they behave as if they formed a second, autonomous, `magisterium,' at least equal to if not superior to the authority of bishops, including the Pope. (7) No wonder some laity are confused. Their constant challenges to Roman authority on this or that scriptural or theological point have obtained wide publicity in the daily press and in other media, which are only too glad to treat these controversies as serious challenges to Rome.

What about sterilization?

The new Catechism (1992) contains the following statement about sterilization (No. 2297):

". . . Except when performed for strictly therapeutic medical reasons, directly intended sterilizations performed on innocent persons are against the moral law." (8)

The phrase `strictly therapeutic medical reasons' is not defined. It is being used by some Catholic theologians and Catholic hospital authorities to justify contraceptive sterilization for psycho-social and other reasons.

The technically correct theological teaching is more precise. For the more detailed and true interpretation of #2297 one should resort to A Document About Sterilization in Catholic Hospitals, March 13, 1975, issued by the Vatican's Doctrinal Congregation in response to questions from the U.S. Conference of Catholic Bishops. This states:

Notwithstanding any subjectively right intention of those whose actions are prompted by the care or prevention of physical or mental illness which is foreseen or feared as the result of pregnancy, such sterilization remains absolutely forbidden according to the Doctrine of the Church. . . . The Church is not unaware of dissent against this teaching from many theologians. The Congregation, however, denies that doctrinal significance can be attributed to this fact, so as to constitute a `technological source' which the faithful might invoke and thereby abandon the authentic Magisterium and follow the opinions of private theologians who dissent from it.

Legitimate sterilization

Various legitimate pharmacological and surgical treatments which result in sterility and are not done with contraceptive intent are properly called indirect sterilization. In such cases, the infertility is foreseen as a side-effect, but it is not the purpose for which the treatments are given, nor their sole immediate effect. These treatments are examples of `double effect'. Morally acceptable procedures include:

1. Removal of ovaries or testicles because of cancer of these organs,

2. Removal of ovaries to reduce the level of estrogen in the body to inhibit or prevent the spread of breast cancer.

3. In some diseases, it may be necessary to give drugs which suppress the function of the ovaries or testicles in such cases as cancer of the breast or prostate.

4. Double vasectomy immediately prior to prostatectomy, in order to prevent epididymitis.

5. Removal of the uterus if it falls down and protrudes through the vagina.

Reversal of vasectomy and tubal ligation 

What are the chances of a woman having a live birth after she has had a reversal of tubal ligation? What are the chances of a man fathering a child after reversal of a vasectomy?

Modern texts of obstetrics/gynaecology tell us . . .

a) that approximately two thirds of women can given birth to a child after reversal of a tubal ligation. There is a risk of 2% of pregnancies being ectopic, that is, located in the fallopian tube. This would almost certainly result in fetal death and could be a risk to the life of the mother.

b) after reversal of a vasectomy, pregnancy occurs in 50 to 60% of couples followed by a physician for at least 2 years (if causes of infertility in the female are excluded and if semen was found in the male's vas at the time of the reversal of vasectomy). Successful reversal of contraceptive surgery depends on many factors including the experience and skill of the surgeon, how long the patient has been sterilized, and the presence and/or degree of the complications caused by pelvic inflammatory disease or by other diseases.

Dr. John Shea is a retired diagnostic radiologist and a Fellow of the Royal College of Physicians of Canada. He is a past president of the Catholic Doctors' Guild of Toronto and a co-founder of the Canadian Fellowship of Catholic Scholars.

(1) . Text of Doctrinal Congregation - "Statement on Sterilization," March 13, 1975 in Sterilization, Recent Declarations of Popes and Bishops, Second edition, 1996 (Life Ethics Centre, Toronto).

(2) . Encyclical Humanae vitae, Pope Paul VI, No. 4 July, 1968.

(3) . Ibid. No. 4.

(4) . Ibid. No. 6.

(5) . Ford and Kelly, Contemporary Moral Theology, Vol 2, p.258.

(6) . Ford and Grisez, The Teaching of Humanae vitae: A Defense. Ignatius Press, San Francisco. 1988.

(7) . Dossier. Vol. 2. No. 1. Jan-Feb, 1996. "Modernism," Gerard V. Bradley, p. 24-25.

(8) . Cf. DS 3722.