Friday, January 15, 2016

An Epiphany

This post is not about magi. It's about a revelation that is changing or might change my career.

Last time I posted asking whether you knew what Catholic teaching said about contraception. You may have been surprised to discover (or rediscover) that the Church has only said contraception is illicit within marriage. Although there have been many occasions to broaden this proscription, the Church has not done it.

I learned this at a local CMA guild event. Myself, a few other residents and a few attendings of various stripes (pediatrics, psychiatry, OB) gathered at the convent of the Religious Sisters of Mercy (who included pharmacists, a med student, two nurses, and one of the attendings). The topic, ostensibly, was birth control in the mentally ill. I went because I had patients like that on a PAG rotation in med school, and I have patients like that today.

But the conversation broadened to what Catholic teaching is on contraception outside of marriage. The facilitator pointed out that it has never been defined, although he stressed the issue of prudence in preventing promiscuity.

We were all terrified, because none of us had ever realized this. One of the pediatric attendings thought that we should never discuss this--her "Catholic" hospital was already handing out terrible would it be if they started handing out hormonal birth control! She was afraid that one of the nation's largest "Catholic" pediatric hospitals would suddenly start handing out birth control if they were better educated on Catholic teaching. How sad!

At the same time as I felt sad and afraid, I was also tempted to shrug. Why would a marginally Catholic institution that already doesn't care about God's will suddenly care about God's will when given new ground? A "Catholic" hospital that doesn't want to follow in God's footsteps will not care about "prudence" that would want to protect pediatric patients from promiscuity (or STDs, pregnancy, statutory rape, etc).

Still, argued the pediatrician, if we can keep the real boundaries of the teaching quiet, we can keep hormonal birth control from harming a few lives (in spite of the Catholic hospital).

I asked myself whether I should talk about this with others at all. Would I only create situations where people would be imprudent?

I decided to post about it because if we don't articulate what the teaching really is, we get pharisaical about it. We draw large margins of safety around established rules, which are burdensome and nonsensical. I found a few unfortunate examples of people who believed that all use of contraception is mortally sinful. (Although I have heard recent challenges to the Peoria protocol from the Linacre, so stay tuned.)

I feel like this is a big shift in my understanding of what makes up the culture of death. Contraception is not in the category of objective evil all the time, at least we don't know that it is. It's not per se like abortion*, against which I must fling my whole self because I understand it to be the taking of a human life. Granted, it still is contributing to the horrible idea that sex and procreation are totally different things, and that sexual life is for the self-satisfaction of two consenting individuals. It's still chemicals women don't always need. It's still a bandaid most of the time. But it's now a crutch without which some of us could be thrown into worse chaos.

If only I had a big glowing orb in the sky to tell me where to go.

*By this I mean that the act of using a contraceptive is not known to be objectively evil. Post-fertilization effects are akin to abortion.


  1. So another way of posing the question, if I understand it correctly, is:

    Does the use of (non-abortifacient) contraception compound or mitigate the sinfulness of extramarital sexual relations?

    1. Basically. Because I want to ask the question every time, the answer I want will have lots of qualifiers.