Report on the Ethics of Contraceptive Use

Wikis > Report on the Ethics of Contraceptive Use

Registered Members (so far) of the Advisory Committee with editorial rights: Prof Giuseppe Benagiano (Rome); Prof Mark Joseph Calano (Manila); Dr Luca Badini Confalonieri (London); Prof Roger Burggraeve (Leuven); Prof Ricardo Chica (Cartagena, Bolivia); Ass. Prof Kathryn Lilla Cox (Collegeville); Prof Christine Gudorf (Miami); Prof Jan Jans (Tilburg); Prof Paulachan Kochappilly (Bangalore); Prof Michael Lawler (Creighton); Prof Gerard Loughlin (Durham, UK); Prof Dietmar Mieth (Tübingen); Dr Irina Pollard (Sydney); Dr Christina Richie (Boston); Prof Todd Salzmann (Creighton); Prof Joseph Selling (Louvain); Prof David Stronck (California State University, East Bay); Dr Agneta Sutton (London); Dr John Wijngaards (London). More members are welcome. Share your knowledge, insight and judgment.

The Ethics of Using Contraceptives: State of the Question

Almost 50 years ago, the Pontifical Commission on Birth Control finally agreed on a report which the Pope had requested concerning whether artificial contraceptives can ever be an ethical choice. After three years of study and deliberations, the commission argued affirmatively. Our purpose is to produce a concise document that reports on whether the judgement of contemporary Christian scholarship has changed since that 1966 report. The Key Question we are trying to answer is:

Is there a consensus among contemporary Christian scholarship that married Christian couples may use contraceptives in certain circumstances?

THIS IS THE FIRST STAGE: Data Gathering

Please contribute your answers to as many of the questions below as you can (questions are highlighted in red), explaining briefly what you think the correct arguments are, and providing references to published material (if relevant). Feel free to express disagreement with suggestions made by others – discussion is often helpful. Please make sure to sign your contributions by leaving your name between square brackets, e.g. [John Wijngaards].

[Cristina Richie]: the key question is “Is there a consensus…that Christian parents may use contraceptives?” To clarify: is the concern parents, or married couples? The answer, I believe will change the methodology and scope of this report.

If the report is aimed at the ethics of contraception for “parents”, the document will imply that a married couple would not/ should not start to use contraception until after they have conceived and had a live birth. If “the couple” is intended, then the report will consider if childless, newly married couples may consider contraception to space their first, and any subsequent children.

I recommend changing the working of the key question from “parents” to “couples” or “married couples”.

[Luca Badini]: I agree, and I have changed the key question. Ideally, the report should tackle the morality of contraception both inside and outside marriage. But we can start by focusing on marriage to begin with, while leaving open the possibility of exploring the ethics of contraception with regard to pre- and extra-marital sexual activity.

Introduction

[Luca Badini] The Catholic Church’s official ban on artificial contraception is based on one single argument advanced by Pope Paul VI in his encyclical Humanae Vitae. The argument starts from the biological fact that a causal link exists between (marital) vaginal sexual intercourse and conception. It then infers from this fact that “each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life” (HV §11). Not doing so would mean going against the biological “laws of conception” created by God: “an act of mutual love which impairs the capacity to transmit life which God the Creator, through specific laws, has built into it, frustrates His design which constitutes the norm of marriage, and contradicts the will of the Author of life” (HV §13). Therefore, the argument goes, the use of artificial contraceptives is always “intrinsically wrong” and cannot even be justified by appeals to the principle of the lesser evil (HV §14).

In this connection, it is important to recall HV’s contention that such an argument, based as it is on an interpretation of the biological evidence of human reproduction, is grounded in the “natural law” and therefore, by definition, is accessible to and can be assessed by all rational people: “We believe that our contemporaries are particularly capable of seeing that this teaching is in harmony with human reason” (HV §12).[1]The encyclical refers to such laws variously as “the precepts of the natural law” (§11), “the laws written into the actual nature of man and of woman” (§12), “specific [biological] laws” concerning the transmission of life (§13), and “the laws of conception” (§13). Incidentally, this interpretation of the biological evidence which affirms that every act of sexual intercourse must remain open to the possibility of procreation is also the basis for the absolute rejection under any circumstances of the morality of masturbation, homosexual relationships, and in vitro fertilisation, among other things.

Should the papal interpretation of the biological evidence turn out to be mistaken, the conclusions that have been drawn from it will need to be revised. Accordingly, the report will assess first and foremost the validity of the papal interpretation of the biological evidence.

However, Humanae Vitae does also advance another argument of a different kind. Pope Paul VI stated that the reason he rejected the final report of the Pontifical Commission on Birth Control was because “certain approaches and criteria for a solution to this question had emerged which were at variance with the moral doctrine on marriage constantly taught by the magisterium of the Church” (HV §4). This is a distinctively “intra-Catholic” argument which can only be accepted as valid if the following can be demonstrated:

  1. there has been an uninterrupted “magisterium” in the Catholic Church throughout its history;
  2. whatever has been consistently taught by such a magisterium throughout the centuries is infallible;
  3. the immorality of artificial contraception is an example of just such a teaching which has consistently been taught by an official magisterium throughout church history.

The danger here is to regard past teachings by church authorities as correct simply on the basis of whether they have been consistent throughout history, rather than whether the arguments supporting them are sound. In essence, it is an argument from authority: contraception cannot be morally licit, because previous popes have said it is not. And a similar belief is stated later in the encyclical, where Paul VI reminds all Catholic priests that “the pastors of the Church enjoy a special light of the Holy Spirit in teaching the truth. And this, rather than the arguments they put forward, is why you are bound to such obedience” (HV §28).

The appeal to a supposed tradition of consistent teaching by church authorities is in tension with the claim that the immorality of artificial contraception is based on the “natural law” of the biology of human reproduction and can therefore be grasped by any rational person, whether or not they are Catholics. The tension results from the potential contradiction between those two “authorities”: on the one hand what the “natural law” evidence from (evolutionary) biology suggests, as we will see, and on the other what a supposedly consistent tradition of Catholic teaching has been saying throughout church history about the meaning and purpose of sexual activity.

In this connection, it is important to underline that, according to the methodology of mainstream Catholic theology which is adopted here, the authority of any tradition within the Catholic Church does not rest simply on the status of the teacher, but on the quality of the evidence (scriptural, traditional, scientific and “natural”) adduced. Accordingly, past pronouncements by church authorities on contraception or on the meaning and purpose of sexuality have to be evaluated on the basis of whether their arguments are still valid, and in particular whether they are in agreement with the evidence from the bible, tradition, sciences, and nature.

Methodology

The need for moral judgements to be based on evidence

Value judgements, understood as judgements about the moral worth of actions or omissions need to be based on evidence.[2]Bernard Lonergan, SJ, Method in Theology (New York: Herder & Herder, 1972) pp. 36-41. Moral insight is dependent on a knowledge of the relevant facts (e.g. moral insight on contraception is dependent on knowledge of the relevant medical facts on the biology of human reproduction). It is also dependent on a knowledge of the specific facts of a given situation, including all the concrete circumstances that are relevant for making responsible decisions. Because knowledge of all of these sets of facts is, in principle, open to anybody, so is the resulting moral insight.

Affirmations concerning e.g. the purposes of marriage, of sexuality within marriage, the optimal family structure to educate children, and so on, need always be backed by supporting evidence from peer-reviewed studies in the relevant disciplines (e.g. biology, psychology, and sociological). Without some kind of evidence, it is impossible to say whether one’s conclusions are correct.

Please write below whether you agree or disagree with this approach, and why. Please also provide key references (if any). Should you prefer a different wording or formulation, please feel free to add it below.

Answers:

[L. Badini]: I agree with the approach outlined. It has been advanced in one way or another by several moral theologians. I can think of the following quote by Joseph Fuchs SJ:

“Anyone who wishes to teach right behavior in international politics, change in tribal marriages, the correct realization of human sexuality in different phases, situations and cultures, etc., must be very competent in all these matters of human reality. It is clear that Christians as such, and the people involved in the church’s magisterium as such, have no privileged competency with regard to such questions […]. If one wishes to give moral instructions and teachings concerning such human realities, inasmuch as they are human, one must acquire sufficient competence, receiving information from others who are more competent”.[3]Josef Fuchs, Christian Morality: The Word Becomes Flesh (trans. Brian McNeil; Washington DC: Georgetown University Press, 1987), p. 115, cited in Mark E. Graham, Josef Fuchs on Natural Law (Washington DC: Georgetown University Press, 2002), p. 163, but consult also pp. 162–6 and 183–5.

[Ricardo Chica]: I agree and would add an implication concerning scientific evidence. HV is a case in point of the more general difficulty that ecclesiastical teaching has in coming to terms with scientific rationality, a residual from one century old antimodernism, which is preventing ecclesiastical authorities to enter into a meaningful dialogue with current science. HV has become exactly what Cardinal Suenens begged his colleagues to avoid: a new Galileo affair. This is so at least in three directions in which current science is critical of HV: biology (the stochastic nature of the link intercourse-conception); economics (overpopulation builds into a vicious circle with poverty and environmental depletion/degradation of horrifying consequences for areas caught in poverty traps, consequences that preannounce the global impact of overpopulation); social sciences (women levels of education and economic independence are correlated and interact positively with their use of contraception). Following Bernard Lonergan, eschewing scientific evidence and reasoning concerning issues such as these is equivalent to trying to convince the faithful to commit to a moral judgement without the necessary previous stages/conditions of being attentive to the relevant information, being intelligent in understanding its meaning and being rational in evaluating this understanding’s correspondence to reality. Asking modern subjects to suspend their human cognitive and moral activity in this way for the sake of just tradition and authority, has become (given the terrible pastoral and social consequences of HV) very much the new Galileo affair so dreaded by Cardinal Suenens.

The Purposes of Sexual Activity

What are the purposes of sexual activity in general? What does the evidence of sound psychological and sociological studies suggests in this regard?

Answers:

[Irina Pollard]: The Socialization of Human Sexuality – Evolutionary Perspective:

It is generally accepted that the socialisation of human sexuality is strongly influenced by evolution. Human sexuality requires to be studied within the context of our evolutionary history, individual genotype and environmental development. This is because natural selection has uniquely incorporated a flexible strategy of behaviours that rely on cerebral control rather than strictly hormonal command. The extent to which our behaviour follows the dictates of our genes, or is the expression of conscious resourcefulness of our thinking brains, is not known, but is the subject of much scientific interest and controversy. The opportunistic switch from instinctive hormonal to cerebral control provided the human species the ability to accommodate change and, eventually, the capacity for judgment, spontaneity and free will. Perhaps the most striking characteristic of this evolutionary acquired flexibility in Homo sapiens’ development has been the socialisation of sexuality. Because we are a socialized species, the assumption that the purpose of human sexuality is purely reproductive, is false. Human sexuality serves other essential purposes such as communication, bonding, touching, self-esteem and social organization. Obviously, human sexuality has a greater social significance than just the transmission of genotype, as even a cursory study of the history of contraception reveals. For thousands of years humans have tried to prevent pregnancy. Pregnancy prevention, as practised in early societies, included various substitutes for heterosexual intercourse, prolonged lactation, delayed marriage, celibacy, withdrawal, the use of herbal abortifacients, vaginal pastes and menses-inducing tampons. Importantly, socialized sexuality in this context reminds us of our varied cultural heritages. Writings over the last few hundred years have forcefully demonstrated evolving socially acceptable views of what was deemed to be ‘masculine’ or ‘feminine’ and these represented a natural continuum of alternative phenotypes (the characteristics of an organism resulting from the interaction between its genetic makeup and the environment). A substantial body of evidence suggests that the processes of natural selection have, and still are, shaping human sexual behaviour beyond the capacity to reproduce. The academic consensus is that the socialization of our sexuality was, and still is, strongly influenced by our evolution.[4]I. Pollard ‘Bioscience Ethics’ (Cambridge: Cambridge University Press, 2009), p.35. Also P. Gray and J. Garcia, Evolution and Human Sexual Behaviour (Harvard University Press 2013).

[Cristina Richie]: In general, a survey of scripture, theology, and Catholic teaching provides a wide variety of meaning for sexual activity. In addition to procreation, Scripture records sex as a use for comfort at the loss of a child [Gen. 4:25; 2 Samuel 12:24]; pleasure [Song of Songs]; consummation of marriage [Gen. 29:21-23]; with the aid of aphrodisiacs [Gen. 30:14-16]; as rape [Gen. 34]; and connected to “idolatry” [Rom. 1:18-32].

Augustine took a strict stance towards sexual intercourse. It was only blameless when it was directed at procreation. (Augustine, On the Excellence of Marriage. In Hunter DG (ed) Marriage and Virginity (Works of Saint Augustine: A Translation for the 21st Century) Hyde Park: New City Press, 1997: ch. 10 sec. 10).

Near the start of the 20th century, the Code of Canon Law indicated that procreation was the primary end of conjugal life, however, it also included “mutual support” and the remedying of concupiscence as “secondary and subordinate” to procreation, highlighting the variety of uses of sexual activity within a marriage (Code of Canon Law, Washington, DC: United States Conference of Catholic Bishops, 1918: preliminary notions art. II sec. 1).

It might also be noted that the Code of Canon Law stated that sterility “renders the marriage neither invalid nor illicit”, therefore childless couples would have sterile intercourse, with the emphasis solely on the secondary aspect of marriage (Code of Canon Law, 1918: ch. IV, art. II 137 sec. 3).

In 1930, in Casti Connubii maintained that procreation was the primary end of intercourse, but lauds the secondary ends “such as mutual aid, the cultivating of mutual love, and the quieting of concupiscence which husband and wife are not forbidden to consider” (Pope Pius XI, Casti Connubii 1930: no. 59). Again, this demonstrates the variety of uses of sex and led the way for greater endorsement of the place of the sexual relationship in marriage apart from procreation.

Gaudium et Spes was the first magisterial teaching to place the two ends of intercourse as equal instead of subordinate. The integrity of conjugal intercourse entails the “inseparable connection, willed by God [… with] two meanings: the unitive meaning and the procreative meaning, as held by Church tradition” (Paul VI, Encyclical Letter on the Church in the Modern World: Gaudium et spes Washington, DC: United States Conference of Catholic Bishops, 1965, 48-52). Because the two ends are inseparable for all couples at all time, even sterile, infertile, and menopausal couples experience “procreation”.

Both marriage and sexual intercourse are unitive and procreative by nature. They are, by design, inseparably unitive and procreative; they do not require any additional outcomes- like conception- to be validated as such. The procreative aspect of marriage manifests in generativity, which is the fruit of the marriage [sanctification; personal growth; patience; compassion], and the procreative aspect of intercourse can include biological children, but also other forms of “reproduction” (Katheryn Lilla Cox, “Toward a Theology of Infertility and the Role of Donum Vitae”, Horizons 40 (2013): 28–52, at 44). All couples will eventually become infertile due to age, yet sexual intercourse remains “procreative” because “love’s fecundity is a reality totally different from biological fertility” (Bernard Haring, Free and Faithful in Christ: Moral Theology for Priests and Laity Vol. II. New York: Seabury Press, 1979, 516)

Theologians reflecting on the purpose and use of sex have also included justice and pleasure: Margaret Farley, Just Love: A Framework for Christian Sexual Ethics (New York: Continuum, 2006); Christine Gudorf, Body, Sex and Pleasure: Reconstructing Christian Sexual Ethics (Cleveland, OH: Pilgrim, 1995).

The Relationship between Sex and Procreation

The Psychological and Sociological Evidence

In light of 2.1, what is the relationship between sex and procreation? What does the evidence of sound psychological and sociological studies suggests in this regard?

Answers:

[L. Badini]The “Global Study of Sexual Attitudes and Behaviors” provides a large amount of empirical evidence about the meaning that people give to sexual activity. One finding among many others:

“Sex in companionate relationships [“companionate” marriage is the marriage which “emphasizes equality between intimate partners”, p. 146] tends to value positively sexual competencies, interests, and performance between intimate sex partners. In other words, sex in companionate relationships serves not only reproductive purposes, but also expresses the quality of the relationship”.[5]Laumann et al., “A Cross-national Study of Subjective Sexual Well-being Among Older Women and Men: Findings from the Global Study of Sexual Attitudes and Behaviors,” Archives of Sexual Behavior 35, 2 (2006), pp. 143-59, at 158. The paragraph continues thus: ‘Male-centered regimes, where sexual behavior is more oriented towards reproduction, tend to discount the relational meaning of sex and the importance of sexual pleasure for women’.

The Biological Evidence

The heart of the argument of Humanae Vitae (henceforth HV) is a particular interpretation of the biological evidence concerning the relationship between sex and procreation. HV observes that the biological relationship which exists between sex and procreation is statistical, direct and causal. It then goes on to interpret this fact as implying that when moral agents have sex they must always intend to procreate, and can never separate that intention from the sexual act itself. Its key affirmations are as follows:

“The fact is, as experience shows, that new life is not the result of each and every act of sexual intercourse. God has wisely ordered laws of nature and the incidence of fertility in such a way that successive births are already naturally spaced through the inherent operation of these laws. The Church, nevertheless, in urging men to the observance of the precepts of the natural law, which it interprets by its constant doctrine, teaches that each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life.

[This] is based on the inseparable connection, established by God, which man on his own initiative may not break, between the unitive significance and the procreative significance which are both inherent to the marriage act.

The reason is that the fundamental nature of the marriage act, while uniting husband and wife in the closest intimacy, also renders them capable of generating new life—and this as a result of laws written into the actual nature of man and of woman”.[6]Humanae vitae par. 11-12; see also Michael J. Barberi and Joseph Selling, “The Origin of Humanae Vitae and the Impasse in Fundamental Theological Ethics,” Louvain Studies 37 (2013): 364–89.

Is HV‘s inference of a specific moral duty from the biological facts of human reproduction warranted? What can be said about the relationship between sex and procreation on the basis of what we know of the biology of reproduction?

Answers:

[Luca Badini]: Bernard Lonergan SJ offered the following observations concerning the interpretation of those biological facts:

While the Encyclical acknowledges the “unitive sense” of marital intercourse, it claims that inseparable from it there is a “procreative sense.” [O]n contemporary biology, if insemination may be said to be inseparable from normal intercourse, conception cannot be said to be inseparable from insemination. The discharge of two million spermatozoa into the vagina does not mean or intend two million babies. Most of the time it does not mean or intend any babies at all. The relationship of insemination to conception is not the relation of a per se cause to a per se effect. It is a statistical relationship relating a sufficiently long and random series of inseminations with some conceptions.

So there arises the question whether this statistical relationship of insemination to conception is sacrosanct and inviolable. Is it such that no matter what the circumstances, the motives, the needs, any deliberate modification of the statistical relationship must always be prohibited? If one answers affirmatively, he is condemning the rhythm method. If negatively, he permits contraceptives in some cases. Like the diaphragm and the pill, the menstrual chart and the thermometer directly intend to modify the statistical relationship nature places between insemination and conception.

[M]arital intercourse of itself, per se, is an expression and sustainer of love with only a statistical relationship to conception.[7]Bernard Lonergan, private letter dated September 6, 1968, Lonergan Archives, available at http://www.bernardlonergan.com/, document number 24070DTE060 / A2407.

See also the 2008 article by Todd Salzman and Michael Lawler.[8]Todd A. Salzman and Michael G. Lawler, Experience and Moral Theology: Reflections on Humanae Vitae Forty Years Later, INTAMS Review 14 (2008) 156-169, available at http://www.natural-law-and-conscience.org/readings/salzman1.asp

[Cristina Richie]: Biologically, a woman’s fertile periods are limited. Women are fertile from first menarche to menopause. Most women begin menstruating between the ages of 11-15, with a mean of 13 years old [Tarhane, Sonal, and Arti Kasulkar, “Awareness of adolescent girls regarding menstruation and practices during menstrual cycle,” Panacea Journal of Medical Sciences 5, no. 1 (2015): 29-32.] Menopause has three gradual phases: premenopause, perimenopause, and postmenopause. Although it varies from woman to woman, one study placed women ages 30 and 48 in the premenopausal category, women ages 48 to 59 inclusive as perimenopausal, and woman 60 and older as postmenopausal. (Slemenda, Charles, Christopher Longcope, Munro Peacock, Siu Hui, and C. Conrad Johnston, “Sex steroids, bone mass, and bone loss. A prospective study of pre-, peri-, and postmenopausal women,” Journal of Clinical Investigation 97, no. 1 (1996): 14-21, at 14). Female fertility begins to decline in the 20’s, and sees drops until full menopause. Women rarely become pregnant after 50 and even women 35 and older are considered at lower risk for conception.

Between first menses and menopause women are physically fertile and can potentially become pregnant. However, “during the average woman’s menstrual cycle there are six days when intercourse can result in pregnancy; this ‘fertile window’ comprises the five days before ovulation and the day of ovulation itself.” The average menstrual cycle is 28 days long. (Wilcox, Allen J., David Dunson, and Donna Day Baird, “The timing of the “fertile window” in the menstrual cycle: day specific estimates from a prospective study,” BMJ 321, no. 7271 (2000): 1259-1262, at 1259.)

Women are also unable to conceive during lactation and pregnancy, although rare exceptions occur (World Health Organization, “Infertility Definitions and Terminology,” 2013).

Therefore we see that women have the potential to conceive for approximately 6 out of 28 days, over a period of less than 50 years [in reality, closer to 25 years], minus any time that they are pregnant or lactating.

Statistically, therefore conception is the exception and not the rule for intercourse, given that women are infertile for 22 days a month; before menstruation and after menopause; and while pregnant or lactating.

 

The Argument from Tradition and Authority: The Church has Always Condemned Artificial Birth Control

One of the arguments advanced by HV was that

“The conclusions at which the [Pontifical Commission on Birth Control] arrived could not, nevertheless, be considered by us as definitive… above all because certain criteria of solutions had emerged which departed from the moral teaching on marriage proposed with constant firmness by the teaching authority of the Church.[9]Pope Paul VI, Humanae vitae §6.

Is there, in your opinion, sufficient evidence to support this claim? Why? Specific key references?

Answers:

[Luca Badini]: With regard to past views on contraception, the go-to work remains the lengthy volume by John Noonan on the history of Christians’ understanding and evaluation of contraception.[10]Noonan, Contraception: A History of Its Treatment by the Catholic Theologians and Canonists (London: Belknap Press of Harvard University Press, enlarged edn., 1986.

Of course, the length of time a given teaching as been upheld by church authorities (or Christians more generally) is only an indication, not a warranty, of whether or not it is correct.[11]“Already Tertullian contended that consuetudines [customs] in the Church had to be examined in the light of truth: Dominus noster Christus veritatem se, non consuetudinem, cognominavit [Our Lord Christ designated himself, not as custom but as truth; De virginibus velandis, I.I]. The phrase was taken up by St. Cyprian and was adopted by the Council at Carthage in 256. In fact, ‘antiquity’ as such might happen to be no more than an inveterate error: nam antiquitas sine veritate vetustas erroris est [for antiquity without truth is the age old error], in the phrase of St. Cyprian ( Epist. 74.9). St. Augustine also used the same phrase: In Evangelio Dominus, Ego sum, inquit, veritas. Non dixit, Ego sum consuetudo [In the Gospel the Lord says – ‘I am the truth .’ He did not say – I am custom; De baptismo, III. 6.9].” Georges Florovsky, “The Authority of the Ancient Councils and the Tradition of the Fathers”, ch. VI of The Collected Works of Georges Florovsky, vol. I, Bible, Church, Tradition: An Eastern Orthodox View (Vaduz, Europa: Buchervertriebsanstalt, 1987), pp. 93–103 (98–9), available at http://jbburnett.com/resources/florovsky/1/florovsky_1-6-auth-councils.pdf.

The arguments supporting such a teaching also need to be examined. In the specific case of contraception, we see that historically the positions forbidding it as morally illicit were based on a mistaken understanding of the biology of human reproduction, or on an evaluation of sexual activity in general as always sinful unless engaged into for the purposes of procreation.[12]Medieval theologians, including Popes, condemned any loss of male sperm as homicide. This was based on the mistaken assumption, derived from Aristotle, that the whole future human being was contained in male sperm – see “The False Doctrine of Male Superiority by Nature” in five diagrams by John Wijngaards. See especially diagram five. This can also be seen in, for instance, the thinking of Thomas Aquinas, Summa Contra Gentitles III 122 – see text and discussion here: http://www.natural-law-and-conscience.org/readings/excerpts_cg.asp.  [Wijngaards, 14 April]

Regardless of the continuity of church teaching and belief of the history up to the first half of the twentieth century, sociological evidence shows that for several decades now the majority of Christians does not believe in (or practices) the old ban on contraceptives.

The Argument from the Sensus Fidelium: Christians Worldwide Are Using Contraceptives

In spite of Humanae vitae, the vast majority of Catholics in developed countries around the world have decided to use artificial means of contraception in their married lives.[13]2014 Univision Poll of more than 12,000 Catholics worldwide, see here (78% of the more than 12,000 Catholics who were surveyed worldwide “support the use of contraceptives”); additional results from recent polls are also available here. This suggests that the sensus fidelium has rejected the validity of this particular teaching.[14]A 2014 report on the sensus fidei by the International Theological Commission can be found here.

[Cristina Richie]: The sensus fidelium is likewise indicated by a survey which showed that an estimated 98% of U.S. Catholic woman have used contraception (Jones, Rachel K. and Joerg Dreweke, “Countering Conventional Wisdom: New Evidence on Religion and Contraceptive Use,” Guttmacher Institute (April 2011): 1-8, at 4).

Is this, in your opinion, a significant fact? If so, why?

Answers:

Michael Lawler, Dietmar Mieth, Todd Salzman all agree that “Forty years of non-acceptance that goes into very considerable detail should suffice to consider a revision” of HV’s ban on artificial contraceptions.[15]Dietmar Mieth, “Humanae Vitae: A Global Reassessment after Forty Years. Considerations beyond the Birth-Control Controversy”, Concilium 1 (2008), quoted approvingly by Lawler and Salzman, “Experience and Moral Theology”.

Any Other Arguments that Need to be Considered?

Which argument? Key references?

Answers:

[John Wijngaards]: Natural Law. Traditional Treatises on Moral Theology always give as the key reason why artificial birth control is intrinsically evil the fact that it is presumed to go against Natural Law, i.e. the express will of God the Creator.[16]See for instance the classic Manuale Theologiae Moralis by M. Pruemmer OP,  Freiburg 1936, vol. III, pp. 508-511:  “peccatum contra naturam, contra voluntatem Creatoris . . . Post peccatum homicidii, quo natural humana iam in actu existens destruitur, huiusmodi genus peccati videtur secundum locum tenere, quo impeditur generatio humanae naturae” [= “a sin against nature, against the will of the Creator . . . After homicide which destroys a human nature that already exists, this kind of sin seems to take second place as it impedes the genration of human nature”]. For a modern classic see Thomas Pazhayampallil, Moral-Canonical-Liturgical Pastoral Guide according to the new Code of Canon Law, Bangalore India 1980, vol II, pp. 724-743; text online here: http://www.natural-law-and-conscience.org/readings/pazhay.asp. Paul VI in Humanae Vitae 1968 also explicitly refers to Natural Law as the reason why artificial birth control is forbidden:

“Parents are bound to ensure that what they do corresponds to the will of God the Creator. The very nature of marriage and its use makes His will clear . . . God has wisely ordered laws of nature and the incidence of fertility in such a way that successive births are already naturally spaced through the inherent operation of these laws. The Church, nevertheless, in urging men to the observance of the precepts of the natural law, which it interprets by its constant doctrine, teaches that each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life.”[17]Humanae Vitae par 10-11; online text here: http://www.natural-law-and-conscience.org/readings/humanae_vitae.asp.

A theological assessment must therefore of necessity also explicitly deal with the argument of Natural Law. This raises the question: “What is Natural Law?” In my view, by giving human beings the ability to reason and to discern good and evil in conscience, the Creator has made what is ‘natural’ for human beings or not dependent on the judgment of human conscience. In this we would return to the views of Albert the Great and Thomas Aquinas.[18]See http://www.natural-law-and-conscience.org/readings/diagram_albert.asp and http://www.natural-law-and-conscience.org/readings/diagram_natlaw.asp respectively. This is worked out brilliantly in Columba Ryan, “The Traditional Concept of Natural Law: An Interpretation”, in Illud Evans (ed.), Light on Natural Law, London 1965, pp. 13-37. See also Charles Curran:

“The encyclical on the regulation of birth employs a natural law methodology which tends to identify the moral action with the physical and biological structure of the act.
[T]he moral conclusion of the encyclical forbidding any interference with the conjugal act is based on “the intimate structure of the conjugal act” (Humanae Vitae n. 12). The “design of God” is written into the very nature of the conjugal act; the person is merely “the minister of the design established by the Creator” (Humanae Vitae n. 13).  [T]he concept of natural law employed in traditional ethics tends to define the moral act merely in terms of the physical structure of the act. In contemporary theology such an understanding of natural law has been severely criticized. Newer philosophical approaches have been accepted by many Catholic thinkers. Such approaches logically lead to the conclusion that artificial contraception can be a permissible and even necessary means for the regulation of birth within the context of responsible parenthood.”[19]Theologians and Humanae Vitae, Sheed & Ward, New York, 1969, pp 156-172.

[Cristina Richie]: “The natural law, if broadly understood and ecologically revised, may suggest the [re]ordering of nature which warrant family planning in marriage,” writes Drew Christiansen (“Learn a Lesson from the Flowers: Catholic Social Teaching and Global Stewardship,” in The Challenges of Global Stewardship: Roman Catholic Responses edited by Maura Ryan and Todd David Whitmore (Notre Dame: University of Notre Dame Press, 1997, 19-37, at 23). By appealing to logic and creative innovations of humankind, contraception can be subsumed under progress, and therefore find resonance with Thomistic understandings of natural law (Salzman and Lawler, 2008: 102-123).

[Luca Badini]: Health Issues with the Rhythm Method: The “rhythm” method of family planning recommended by HV appears to carry increased risks of serious congenital anomalies.[20]Irina Pollard, “Fertility Awareness: The Ovulatory Method of Birth Control, Ageing Gametes and Congenital Malformation in Children”, in Bioscience Ethics (Cambridge: Cambridge University Press, 2009), pp. 90-105.

[John Wijngaards]: The Suppression of Independent Academic Research: After Pope John Paul II completed a five-month series of lectures on human sexuality, marriage, and the regulation of births, on November 28, 1984, the Osservatore Romano printed a front page editorial by Archbishop (later Cardinal) Edouard Gagnon, propresident of the Pontifical Commission for the Family. It stated:

“Today … it is no longer possible to have doubts about the authoritative doctrine of the Church [of Humanae vitae] and about the unacceptability of dissent.” Some theologians were “happy to find in a certain popular resistance to the encyclical a good opportunity to propagandize their own ideas on the autonomy of the individual conscience.” But the Pope’s campaign to end doctrinal confusion is “the only way out” of society’s crises, and sustain “with a solid doctrine” the efforts of people fighting “in defence of life and the institution of matrimony.”[21]??????????? (London Free Press, Jan. 19, 1985).

Addressing a Conference on Natural Family Planning, Pope John Paul II stated:

“What is taught by the Church on contraception does not belong to material freely debatable among theologians.” Those who argue otherwise “in open contrast with the law of God, authentically taught by the Church, guide couples down a wrong path.”[22]Prairie Messenger, June 15, 1987; Osservatore Romano, June 6, 1987.

[Cristina Richie]:Conscience: The “sanctuary of conscience,” whereby a Catholic must necessarily follow their conscience, is a Thomistic teaching that can justify use of artificial contraception (Aquinas, Thomas. Summa Theologia, 2nd Edition. Translated by Fathers of the English Dominican Province. Edited by Kevin Knight. Online Edition 2008. Prima Secundæ Partis, q. 19, article 5, 6). This both releases the faithful from following magisterial teachings and places the responsibility of decision within the conscience of the individuals. If a woman or man were convinced that the morally right action would include limiting procreation by artificial means, they would be obligated to follow their well-formed and informed conscious to take preventative measures.

The Majority Report
[Cristina Richie] Although the Church has historically held that artificial contraception is disordered, for a period in the 1960’s the traditional view was in limbo as Church-appointed theologians reconsidered contraception in the modern world. During Vatican II, Pope Paul VI commissioned a study on the Church’s teaching on artificial contraception. Vatican II met over a period of three years from 1962-1965 and produced several influential documents. One paper that was written, but not accepted or endorsed by the Pope, was Responsible Parenthood, the Majority Report of the Birth Control Commission.

This document on the nature of procreation and intercourse in marriage favored the couple’s option to choose whether or not to use artificial contraception and put a premium on procreation in the context of the marital relationship overall instead of evaluating each individual sexual act, as Augustine and the previous documents had (Majority Report of the Birth Control Commission, Responsible Parenthood. Available at: The Tablet, “The Birth Control Report”, 22nd April 1967, at http://archive.thetablet.co.uk/article/22nd-april-1967/21/the-birth-control-report part 1 ch. III). The authors proposed that “the regulation of conception by using means, human and decent, favoring fecundity in the totality of married life and toward the realization of the authentic values of a fruitful matrimonial community” could be beneficial for both the couple and society (Majority Report of the Birth Control Commission, 1966: part 1 ch. III). When couples choose for themselves if family planning could enhance their relationship as committed Christians, then they would be liberated to serve the world and the Church in other ways (Majority Report of the Birth Control Commission, 1966: part II ch 1).

After studying the issue, and hearing the testimony of married couples, the draftsman of the Majority Report—representing 15 out of the 19 theologians— wrote, “we have to educate the people to assume responsibility and not just to follow the law” but also follow their conscience. The statement asked the magisterium to permit couples themselves to make decisions about the contraception they use- either natural or artificial. The option for contraception would give “married life its unitive value, and do so in service of its procreative function” (Majority Report of the Birth Control Commission, 1966: part II ch 1). However, the Vatican rejected the majority findings and promulgated Humanae Vitae instead (Congregation for the Doctrine of the Faith, Humanae Vitae. Washington DC: United States Conference of Catholic Bishops, 1968).

The Double Effect
[Cristina Richie] James Keenan summarizes the principle of the double effect as having four components:

  • 1. The object of the action must be right or indifferent in itself; it cannot be intrinsically wrong.
  • 2. The wrong effect, though foreseen, cannot be intended.
  • 3. The wrong effect cannot be the means to the right effect.
  • 4. There must be proportionate reason for allowing the wrong effect to occur.[23]James Keenan, “The Function of the Principle of Double Effect,” Theological Studies 54, no. 2 (1993): 294-315, at 300. He cites Richard McCormick, “The Principle of Double Effect,” in How Brave a New World? (London: SCM, 1981), 413-29.

The principle of the double effect can be applied to the use of barrier forms of contraception (condoms, both male and female) to prevent transmission of human immunodeficiency virus [HIV]. We need not assume that condoms would be used by non-married couples, thus simplifying the morally salient features to a matter of life or death for lawfully, sacramentally wedded couples.

James Keenan, S.J., is the most recognizable Catholic writer on the subject of condom use to contain HIV. Along with Jon Fuller, he points out that in the case of HIV serodiscordant couples [where one partner is infected and the other is not] “the use of a condom can be seen… as a means to prevent the ‘transmission of death’ or ‘potential death to another.’” Using the double effect, condoms lend support to the use of barrier contraception, which also has second and simultaneous effect of preventing conception. (Jon Fuller and James Keenan, “Church Politics and HIV Prevention: Why is the Condom Question So Significant and So Neuralgic?” in Between Poetry and Politics, Essays in Honour of Enda McDonagh, Linda Hogan and Barbara FitzGerald eds. (Dublin, Columba Press, 2003), 158-181, at 176.)

The double effect may also be applied to other cases of deadly sexually transmitted disease like human papillomavirus [HPV], which causes cervical cancer (M. Schiffman, P.E. Castle, J. Jeronimo, A.C. Rodriguez, S. Wacholder, “Human Papillomavirus and Cervical Cancer,” Lancet 370, no. 9590 (2007): 890-907.) and Ebola, which has an extremely high fatality rate. (Lenny Bernstein and Joel Achenbach, “Sex in a Time of Ebola,” The Washington Post, 8 October 2014, at http://www.washingtonpost.com/news/to-your-health/wp/2014/10/08/sex-in-a-time-of-ebola/)

The minus malum principle
[Cristina Richie] The use of barrier forms of contraception can also be accepted under the minus malum principle, or the principle of lesser evil, in the case of an unmarried HIV serodiscordant couple. While it may be considered wrong that the couple is engaged in conjugal activity, it would be even worse to have pre-marital intercourse and not protect the uninfected partner from HIV transmission. Therefore, the “lesser evil” is to use a condom in unmarried sex, rather than have unmarried sex without a condom and risk HIV infection.

Citing Precedence: the case of anovulant drugs and women missionaries
[Cristina Richie]: Women are at risk for rape in all countries and societies. Statistics show one in six women have been raped in their lifetime [Patricia Tjaden and Nancy Thoennes, Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey: Research in Brief (Washington, DC: National Institute of Justice, US Department of Justice, 2006), 13]. If a woman were to conceive as a result of the rape, the child would not be born within a stable marriage with two parents who are committed to each other. Conception from rape is even more complicated when the woman is religiously dedicated and will not marry while continuing her vows. While Catholic teaching emphasizes the need to keep the unitive and procreative aspects of sexual intercourse together, there have also been cases where this is subordinate to the need to protect women from pregnancy.

Aline H. Kalbian recorded that during the 1960’s, in the face of an unwanted and unjust pregnancy, Catholic nuns in the Belgian Congo “were given anovulant drugs by doctors on the missions in order to ward off pregnancy which might otherwise result from rape, which was a constant threat in that chaotic episode.” [Aline H. Kalbian, Sex, Violence, and Justice: Contraception and the Catholic Church (Washington DC: Georgetown University Press, 2014), 117.] In this case, Catholics accepted—and provided—contraception as a necessary medical step to prevent possible pregnancy. The dual suppositions that pregnancy can be harmful and that contraception is a necessary preventive measure are highlighted in this case. We might use casuistry to extend the voluntary use of contraception for any woman at risk for pregnancy due to rape, which is, unfortunately, all women.

Citing Precedence: the case of contraception for the mentally disabled
[Cristina Richie]: In 1986, Lisa Cahill examined several articles on sterilization and mental disability in the journal Theological Studies. [Lisa Sowle Cahill, “Sexual Ethics, Marriage, and Divorce,” Theological Studies 47 (1986): 102-117, at 112.] She points out that Edward Bayer and Marcelino Zalba “advance the argument that the natural (‘intrinsic’) relation of sexual activity to procreation and to the welfare of the species can be deliberately severed when certain circumstances are present in combination: violence and injury (including danger of pregnancy) to the total personal welfare of a woman.” Bayer and Zalba focused on sterilization for mentally incompetent women, where a pregnancy and childbirth [or abortion] would constitute an emotionally and physically distressing event for the woman, and where she would be unable to care for the child if born. [See Edward J. Bayer, “Sterilizing the Severely Retarded Woman: Is It Morally Different from Contraceptive Sterilization?” Ethics and Medics 10, no. 3 (1985): 3-4. See also a supportive discussion of Bayer’s general position by Thomas J. O’Donnell, “‘Defensive’ Sterilization for the Severely Retarded: Follow-up,” Medical-Moral Newsletter 22 (1985): 5-8. And also Bayer’s earlier article, “Defensive Sterilization for Severely Retarded Women: A Moral Option?” Medical-Moral Newsletter 21 (1984): 5-8.] While involuntary sterilization for mentally disabled persons is hotly debated in bioethics, there are less drastic forms of very effective, less-invasive, temporary contraception, such as intra-uterine devices [IUDs], which would respect the principle of totality, and also protect a woman from gestating a child that she could not care for. We might use casuistry to extend the voluntary use of contraception for any woman who would be distressed by pregnancy or childbirth, or any woman or man who is unable [physically, emotionally or financially] to care for a child.

Has the Teaching Authority in recent decades suppressed the assessment of the arguments and relevant facts surrounding the use of contraceptives? If so, how was this done?

– by silencing Catholic academics? EXAMPLES?

[Cristina Richie]: In Anne Patrick’s Liberating Conscience she “contests certain magisterial exercises of authority, like the removal of Charles Curran from his teaching post at the Catholic University of America because of his stand on contraception.” Quoted in Lisa Cahill “James M. Gustafson and Catholic Theological Ethics,” Journal of Moral Theology 1, no. 1 (2012): 92-115, at 111. See Anne Patrick, Liberating Conscience: Feminist Explorations in Catholic Moral Theology (New York: Continuum Publishing Co., 1996).

– by requiring loyalty to the official teaching from all academics holding positions in Catholic institutions? EXAMPLES?

– by suppressing the free expression of dissenting views in Catholic publications? EXAMPLES?

– in any other way? EXAMPLES?

The Medical and Socio-Economic Consequences of the Lack of Access to Artificial Contraceptives in Developing Countries:

What are the medical, social, and economic consequences of the lack of access to artificial contraceptives for poor people, and especially women, in developing countries?

[Christine Gudorf] In addition to the increased maternal mortality and morbidity that accompanies lack of accesss to contraception for spacing purposes in many nations, parental aspirations for children in the contemporary world economy ncreasingly require longer years of education which is in many nations the responsibility of parents. Larger families divide parental resources into smaller portions, limiting children’s access to education. In addition, since the 1970s worker salaries in most of the world have stagnated or lessened in terms of buying power, requiring more and more married women to work outside the home to support the family, reducing the time and energy that mothers have to expend on children.

Maternal mortality
[Cristina Richie] Contraception is a basic form of preventive medicine that can save women’s lives. According to the World Health Organization [WHO], approximately 800 women die from preventable causes related to pregnancy and childbirth each day and an estimated 80% of all maternal deaths are traced to severe bleeding, infections, high blood pressure during pregnancy and unsafe abortion. [The World Health Organization, “Maternal Mortality,” May 2012, at, http://www.who.int/mediacentre/factsheets/fs348/en/index.html]. Young women ages 15-19 are at risk for maternal mortality at an average of 52 deaths per 100,000 births. In parts of Sub-Sahara Africa the numbers reach into the hundreds. Furthermore, the United Nations reported that in 2010 there was an average of 210 material deaths per 100,000 live births, with parts of Africa experiencing 500 deaths per 100,000 live births. [The United Nations, The Millenniums Development Goals Report (New York: The United Nations, 2013), 33; 28]. A woman’s lifetime risk of maternal death is 1 in 3800 in developed countries, compared to 1 in 150 in developing countries [WHO].

Conclusion: The Ethics of Using Contraceptives

In light of all preceding sections (1-5), but in particular of sections 4 and 5, what can be said about the morality of using contraceptive means?

The consensus of contemporary Catholic scholarship is that Christian parents may responsibly use contraceptives in certain circumstances.

Is this correct? Incorrect? Better formulation? Other comments? Key references?

Answers:

[Cristina Richie]: I believe a more accurate formulation is, “The consensus of contemporary Catholic scholarship is that Christian couples may responsibly use contraceptives in certain circumstances.” As I state above in section 1, “parents” implies that a married couple would not/should not start to use contraception until after they have conceived and had a live birth.

[Cristina Richie]: Other comments- The moral discretion of each couple should determine the use of contraception. Catholic theology and theologians concur that in some cases contraception is acceptable, and in some cases it borders on an imperative [i.e. to prevent HIV transmission from one spouse to another, to prevent the birth of a severely disabled child, to prevent vertical transmission of HIV from mother to child, or to prevent medical or other hardships that a pregnancy would entail for the woman, couple, or family.

Related Issues

Specific Circumstances

It is common knowledge that if one spouse is HIV positive, this virus can easily be transmitted to the other spouse through an act of sexual intercourse. The use of a condom would in this case severely lessen that possibility and could provide protection for the spouse who is not infected. Accordingly, in the case of a couple who has decided to have marital intercourse despite one spouse being HIV positive, the use of condoms is morally better than having unprotected sex.

Please write below whether you agree or disagree with this approach, and why. Please also provide key references (if any). Should you prefer a different wording or formulation, please feel free to add it below.

Answers:

The Ethics of Sexual Activity

In light of section 2, what can be said about the ethics of sexual activity more in general?

Margaret Farley has suggested that the same criteria be used to evaluate the morality of sexual activity as they are used to evaluate the morality of any other human endeavour. Specifically, she highlighted several conditions or norms for the correctness of sexual activity and relationship: ‘do no unjust harm, free consent, mutuality, equality, commitment, fruitfulness, and social justice’.[24]Margaret Farley, “Same-Sex Relationships and Issues of Moral Obligation”, Anglican Theological Review 90, 3 (2008), pp. 541-47. A similar position is argued by Marvin M. Ellison in his recent book Making Love Just. Sexual Ethics for Perplexing Times.[25]Marvin M. Ellison, Making Love Just: Sexual Ethics for Perplexing Times (Minneapolis: Fortress, 2012), 176 pp.

[Cristina Richie]: Sexuality activity has a plurality of meanings and outcomes beyond biology. These can be affirmed and celebrated within marriage. Contraception can facilitate the other, more symbolic meaning of sexual activity, such as love, play, comfort, celebration and companionship.

The Issue of Consultation

If moral insights, especially on matters considered to be of “natural law”, are in principle open to anybody, then the process for reaching a moral judgment on those matters should be open to anybody. It is not the exclusive prerogative of the clergy or the episcopal hierarchy to propose moral insights. The laity, and particularly experts in the relevant disciplines, have an equal right of participation in the deliberative and decision-making processes to reach a formal statement on those matters.

Please write below whether you agree or disagree with this argument, and why. Please also provide key references (if any). Should you prefer a different wording or formulation, please feel free to add it below.

Answers:

[Cristina Richie]: Agreed. Furthermore, the principle of subsidiarity discourages higher-level authorities making decisions if a lower-level is efficacious. Subsidiarity demands justification for the intervention of higher authorities((Richard Gallardetz, “The Ecclesiological Foundations of Modern Catholic Social Thought,” in Modern Catholic Social Teachings: Commentaries and Interpretations, Kenneth Himes, ed. (Washington DC: Georgetown University Press, 2005), 72- 98, at 93.] The most foundational level of decision-making in contraceptive use are the two parties engaged in intercourse. Only they should decide if, when, and how to use contraception. By virtue of their baptismal vows, we can expect the Spirit to guide them in this, and other, matter of life.

Any Other Related Issue that Needs to be Considered?

Any related issue(s)? Key references?

Answers:

 

References   [ + ]

1. The encyclical refers to such laws variously as “the precepts of the natural law” (§11), “the laws written into the actual nature of man and of woman” (§12), “specific [biological] laws” concerning the transmission of life (§13), and “the laws of conception” (§13).
2. Bernard Lonergan, SJ, Method in Theology (New York: Herder & Herder, 1972) pp. 36-41.
3. Josef Fuchs, Christian Morality: The Word Becomes Flesh (trans. Brian McNeil; Washington DC: Georgetown University Press, 1987), p. 115, cited in Mark E. Graham, Josef Fuchs on Natural Law (Washington DC: Georgetown University Press, 2002), p. 163, but consult also pp. 162–6 and 183–5.
4. I. Pollard ‘Bioscience Ethics’ (Cambridge: Cambridge University Press, 2009), p.35. Also P. Gray and J. Garcia, Evolution and Human Sexual Behaviour (Harvard University Press 2013).
5. Laumann et al., “A Cross-national Study of Subjective Sexual Well-being Among Older Women and Men: Findings from the Global Study of Sexual Attitudes and Behaviors,” Archives of Sexual Behavior 35, 2 (2006), pp. 143-59, at 158. The paragraph continues thus: ‘Male-centered regimes, where sexual behavior is more oriented towards reproduction, tend to discount the relational meaning of sex and the importance of sexual pleasure for women’.
6. Humanae vitae par. 11-12; see also Michael J. Barberi and Joseph Selling, “The Origin of Humanae Vitae and the Impasse in Fundamental Theological Ethics,” Louvain Studies 37 (2013): 364–89.
7. Bernard Lonergan, private letter dated September 6, 1968, Lonergan Archives, available at http://www.bernardlonergan.com/, document number 24070DTE060 / A2407.
8. Todd A. Salzman and Michael G. Lawler, Experience and Moral Theology: Reflections on Humanae Vitae Forty Years Later, INTAMS Review 14 (2008) 156-169, available at http://www.natural-law-and-conscience.org/readings/salzman1.asp
9. Pope Paul VI, Humanae vitae §6.
10. Noonan, Contraception: A History of Its Treatment by the Catholic Theologians and Canonists (London: Belknap Press of Harvard University Press, enlarged edn., 1986.
11. “Already Tertullian contended that consuetudines [customs] in the Church had to be examined in the light of truth: Dominus noster Christus veritatem se, non consuetudinem, cognominavit [Our Lord Christ designated himself, not as custom but as truth; De virginibus velandis, I.I]. The phrase was taken up by St. Cyprian and was adopted by the Council at Carthage in 256. In fact, ‘antiquity’ as such might happen to be no more than an inveterate error: nam antiquitas sine veritate vetustas erroris est [for antiquity without truth is the age old error], in the phrase of St. Cyprian ( Epist. 74.9). St. Augustine also used the same phrase: In Evangelio Dominus, Ego sum, inquit, veritas. Non dixit, Ego sum consuetudo [In the Gospel the Lord says – ‘I am the truth .’ He did not say – I am custom; De baptismo, III. 6.9].” Georges Florovsky, “The Authority of the Ancient Councils and the Tradition of the Fathers”, ch. VI of The Collected Works of Georges Florovsky, vol. I, Bible, Church, Tradition: An Eastern Orthodox View (Vaduz, Europa: Buchervertriebsanstalt, 1987), pp. 93–103 (98–9), available at http://jbburnett.com/resources/florovsky/1/florovsky_1-6-auth-councils.pdf.
12. Medieval theologians, including Popes, condemned any loss of male sperm as homicide. This was based on the mistaken assumption, derived from Aristotle, that the whole future human being was contained in male sperm – see “The False Doctrine of Male Superiority by Nature” in five diagrams by John Wijngaards. See especially diagram five. This can also be seen in, for instance, the thinking of Thomas Aquinas, Summa Contra Gentitles III 122 – see text and discussion here: http://www.natural-law-and-conscience.org/readings/excerpts_cg.asp.  [Wijngaards, 14 April]
13. 2014 Univision Poll of more than 12,000 Catholics worldwide, see here (78% of the more than 12,000 Catholics who were surveyed worldwide “support the use of contraceptives”); additional results from recent polls are also available here.
14. A 2014 report on the sensus fidei by the International Theological Commission can be found here.
15. Dietmar Mieth, “Humanae Vitae: A Global Reassessment after Forty Years. Considerations beyond the Birth-Control Controversy”, Concilium 1 (2008), quoted approvingly by Lawler and Salzman, “Experience and Moral Theology”.
16. See for instance the classic Manuale Theologiae Moralis by M. Pruemmer OP,  Freiburg 1936, vol. III, pp. 508-511:  “peccatum contra naturam, contra voluntatem Creatoris . . . Post peccatum homicidii, quo natural humana iam in actu existens destruitur, huiusmodi genus peccati videtur secundum locum tenere, quo impeditur generatio humanae naturae” [= “a sin against nature, against the will of the Creator . . . After homicide which destroys a human nature that already exists, this kind of sin seems to take second place as it impedes the genration of human nature”]. For a modern classic see Thomas Pazhayampallil, Moral-Canonical-Liturgical Pastoral Guide according to the new Code of Canon Law, Bangalore India 1980, vol II, pp. 724-743; text online here: http://www.natural-law-and-conscience.org/readings/pazhay.asp.
17. Humanae Vitae par 10-11; online text here: http://www.natural-law-and-conscience.org/readings/humanae_vitae.asp.
18. See http://www.natural-law-and-conscience.org/readings/diagram_albert.asp and http://www.natural-law-and-conscience.org/readings/diagram_natlaw.asp respectively. This is worked out brilliantly in Columba Ryan, “The Traditional Concept of Natural Law: An Interpretation”, in Illud Evans (ed.), Light on Natural Law, London 1965, pp. 13-37.
19. Theologians and Humanae Vitae, Sheed & Ward, New York, 1969, pp 156-172.
20. Irina Pollard, “Fertility Awareness: The Ovulatory Method of Birth Control, Ageing Gametes and Congenital Malformation in Children”, in Bioscience Ethics (Cambridge: Cambridge University Press, 2009), pp. 90-105.
21. ??????????? (London Free Press, Jan. 19, 1985).
22. Prairie Messenger, June 15, 1987; Osservatore Romano, June 6, 1987.
23. James Keenan, “The Function of the Principle of Double Effect,” Theological Studies 54, no. 2 (1993): 294-315, at 300. He cites Richard McCormick, “The Principle of Double Effect,” in How Brave a New World? (London: SCM, 1981), 413-29.
24. Margaret Farley, “Same-Sex Relationships and Issues of Moral Obligation”, Anglican Theological Review 90, 3 (2008), pp. 541-47.
25. Marvin M. Ellison, Making Love Just: Sexual Ethics for Perplexing Times (Minneapolis: Fortress, 2012), 176 pp.