Is Birth Control Pill okay for VALID Medical (non-contraception) Reasons?

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BrendenDenis

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Although the Church says it is wrong to use artificial birth control, including the pill, would it be acceptable in this scenario:

A woman has a health concern that causes excessively long and excessively heavy periods. So excessive that there are concerns about physical weakness, blood loss, hemorrhaging and other problems. To have better control of her periods, doctors prescribe the birth control pill. Even without the birth control pill, the woman’s fertility may be in question. The woman may or may not be sexually active.

My initial response would be “yes, it would be okay” as we should look at the intention of the act instead of the act itself. To draw comparisons:

The Church opposes euthanasia or anything to done to intentionally speed up death. The administration of high doses of morphine to hasten death is not moral. But, if it is done to ease pain and the hastening of death is an undesired consequence, it is permissible.

The Church opposes the intentional killing of an unborn child. Surgery to kill the child, aka abortion, is not moral. Surgery on the mother, ie uterine cancer treatments, that happens have the death of the child as undesired and otherwise avoided consequence is permissible.

In this scenario, the birth control pill is taken for medical reasons with contraception (or the rare chance of a chemical abortion) being an undesired consequence.

Would my initial analysis of the issue and green light to the birth control pill in this scenario correct. The traditional leaning side of me, says “no.” So, before I make a final decision I want other people’s views
 
In that case, it should not even be referred to as the birth control pill but rather as drug X, basically whatever substance is needed for actual, medical reasons, in which case yes, it can be moral to take that substance. It is, however, wrong to say that in such cases “birth control” is permitted. What is permitted is, correctly, the same substance which is used for birth control but in that case, it is used for a different purpose, and birth control is not an intended purpose.
 
The principle is called “double effect” – the Modern Catholic Dictionary defines it as follows:

The principle that says it is morally allowable to perform an act that has at least two effects, one good and one bad. It may be used under the following conditions: 1. the act to be done must be good in itself or at least morally indifferent; by the act to be done is meant the deed itself taken independently of its consequences; 2. the good effect must not be obtained by means of the evil effect; the evil must be only an incidental by-product and not an actual factor in the accomplishment of the good; 3. the evil effect must not be intended for itself but only permitted; all bad will must be excluded from the act; 4. there must be a proportionately grave reason for permitting the evil effect. At least the good and evil effects should be nearly equivalent. All four conditions must be fulfilled. If any one of them is not satisfied, the act is morally wrong.

The situation you described was as follows:

A woman has a health concern that causes excessively long and excessively heavy periods. So excessive that there are concerns about physical weakness, blood loss, hemorrhaging and other problems.
  1. The doctors wish to treat that condition through the use of hormonal therapy to regulate her menstrual flow.
  2. The hormonal therapy is (presumably) effective in doing so. Concerns for physical weakness, blood loss, hemorrhaging, etc., are alleviated through that therapy.
  3. As a side effect of this therapy, her ovaries may not produce eggs; if they do produce eggs, there is likely to be a change in the mucous that would prevent sperm from contacting the eggs (if she is sexually active), and there is the likelihood that a fertilized blastocyst would not be able to implant itself in the uterine wall (if fertilization occurs). These are not intended effects of the hormonal therapy, but are undesired side effects. There is no other therapy available that would have the desired effect of regulating menstrual flow without the corresponding side effect of impeding fertilization / implantation.
  4. Proportionality. The evil potential consequence is that could occur is that a blastocyst might not be able to implant, thus causing him/her to die. Is the risk of not using this therapy potential loss of life of the woman? (In other words, is the good achieved proportionate to the evil?) You did not indicate that her life was in danger, but you did indicate that there is a threat to her health.
Bottom line is that it is likely acceptable under the principle of double effect, particularly if the risk to her health is severe (and not just trying to avoid discomfort). It would probably be advisable for her to not have sex during the period of time during her cycle when she would be fertile, in order to minimize the possibility of fertilization (and likely loss of a blastocyst if one is created as a result of sexual activity during that time).

More importantly, though, I agree with the previous poster that I would probably prefer to call this “hormonal therapy” rather than “use of the birth control pill for non birth control reasons”

And considering the risks involved with hormonal contraceptive pills (outside of their abortifacient and contaceptive properties), I think I would try to research to find if there was some alternate therapies out there that would work without the corresponding risks to the mother’s health.
 
chevalier said:
In that case, it should not even be referred to as the birth control pill but rather as drug X, basically whatever substance is needed for actual, medical reasons, in which case yes, it can be moral to take that substance. It is, however, wrong to say that in such cases “birth control” is permitted. What is permitted is, correctly, the same substance which is used for birth control but in that case, it is used for a different purpose, and birth control is not an intended purpose.
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Exactly. And its contraceptive effect is an unintended side effect. It’s okay to permit a bad side effect if the circumstances justify it, as per St. Thomas’ principle of double effect.

On a practical level, the pill can be dangerous and has been linked to higher cancer risk. There ought to be some other treatment available that a competent doctor could prescribe - but no, being on “the pill” for serious medical reasons is not immoral.
 
markomalley said:
The principle is called “double effect” – the Modern Catholic Dictionary defines it as follows:

The principle that says it is morally allowable to perform an act that has at least two effects, one good and one bad. It may be used under the following conditions: 1. the act to be done must be good in itself or at least morally indifferent; by the act to be done is meant the deed itself taken independently of its consequences; 2. the good effect must not be obtained by means of the evil effect; the evil must be only an incidental by-product and not an actual factor in the accomplishment of the good; 3. the evil effect must not be intended for itself but only permitted; all bad will must be excluded from the act; 4. there must be a proportionately grave reason for permitting the evil effect. At least the good and evil effects should be nearly equivalent. All four conditions must be fulfilled. If any one of them is not satisfied, the act is morally wrong.

The situation you described was as follows:

A woman has a health concern that causes excessively long and excessively heavy periods. So excessive that there are concerns about physical weakness, blood loss, hemorrhaging and other problems.
  1. The doctors wish to treat that condition through the use of hormonal therapy to regulate her menstrual flow.
  2. The hormonal therapy is (presumably) effective in doing so. Concerns for physical weakness, blood loss, hemorrhaging, etc., are alleviated through that therapy.
  3. As a side effect of this therapy, her ovaries may not produce eggs; if they do produce eggs, there is likely to be a change in the mucous that would prevent sperm from contacting the eggs (if she is sexually active), and there is the likelihood that a fertilized blastocyst would not be able to implant itself in the uterine wall (if fertilization occurs). These are not intended effects of the hormonal therapy, but are undesired side effects. There is no other therapy available that would have the desired effect of regulating menstrual flow without the corresponding side effect of impeding fertilization / implantation.
  4. Proportionality. The evil potential consequence is that could occur is that a blastocyst might not be able to implant, thus causing him/her to die. Is the risk of not using this therapy potential loss of life of the woman? (In other words, is the good achieved proportionate to the evil?) You did not indicate that her life was in danger, but you did indicate that there is a threat to her health.
Bottom line is that it is likely acceptable under the principle of double effect, particularly if the risk to her health is severe (and not just trying to avoid discomfort). It would probably be advisable for her to not have sex during the period of time during her cycle when she would be fertile, in order to minimize the possibility of fertilization (and likely loss of a blastocyst if one is created as a result of sexual activity during that time).

More importantly, though, I agree with the previous poster that I would probably prefer to call this “hormonal therapy” rather than “use of the birth control pill for non birth control reasons”

And considering the risks involved with hormonal contraceptive pills (outside of their abortifacient and contaceptive properties), I think I would try to research to find if there was some alternate therapies out there that would work without the corresponding risks to the mother’s health.
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Great answer!
 
markomalley said:
  1. Proportionality. The evil potential consequence is that could occur is that a blastocyst might not be able to implant, thus causing him/her to die. Is the risk of not using this therapy potential loss of life of the woman? (In other words, is the good achieved proportionate to the evil?) You did not indicate that her life was in danger, but you did indicate that there is a threat to her health.
.
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How many women die of heavy periods? I’ve never heard of this before, as a cause of death. Is it really the official position of the church that this particular drug X is acceptable for married women when we know it can cause abortion? I am having trouble with this but will always trust the church. I just wish I understood why it was ok to flush babies down the toilet to treat a non life threatening condition that can probably be treated another way.
 
karbear said:
How many women die of heavy periods? I’ve never heard of this before, as a cause of death. Is it really the official position of the church that this particular drug X is acceptable for married women when we know it can cause abortion? I am having trouble with this but will always trust the church. I just wish I understood why it was ok to flush babies down the toilet to treat a non life threatening condition that can probably be treated another way.
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Naturally, if this route of treatment was taken by a married woman she’d have to abstain from intercourse, because said intercourse would be contraceptive.
 
I am not a MD but a lorry-driver so I am not the one say about treatment. All answers was great and left me with very little to add. I would however like to add this. It is not so much a answer but a question to an answer all ready given. Drugs with Benzodiazepine also have doubble effect. They calm you but also make you feel good I have heard. Is that also a side-effect that is OK? Because if it is,we have a major problem. People will start taking remedy to enjoy or have use of the side-effect. How can we controll that?
 
Lonely_guy said:
I am not a MD but a lorry-driver so I am not the one say about treatment. All answers was great and left me with very little to add. I would however like to add this. It is not so much a answer but a question to an answer all ready given. Drugs with Benzodiazepine also have doubble effect. They calm you but also make you feel good I have heard. Is that also a side-effect that is OK? Because if it is,we have a major problem. People will start taking remedy to enjoy or have use of the side-effect. How can we controll that?
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I am not personally familiar with Benzodiazepine so I can’t speak with any authority on that. In general, the four steps that I cited in post #3 above would apply. If you are intending to do good, but an evil comes along with the good as an unintended consequence, and the good outweighs (or at least matches) the unintended evil, then it is permissible as a result of the principle of double effect.

But the problem is that since we are talking about the specific effects of a specific psychoactive drug, I don’t think it would be appropriate to go into specifics like that on an Internet forum (just as I wouldn’t personally go into the merits of estrogen/progesterone combination pills versus progesterone only pills for dealing with the condition described in the OP…that falls into the category of medical advice, which is a no-no). It would be better to get specific advice on that specific medication by talking with both your doctor and your spiritual adviser, who would both be far more familiar with the specifics of the medication and the state of your soul.

The one thing I will comment on, though, is your statement: People will start taking remedy to enjoy or have use of the side-effect. If the intent of people is to do something as an excuse to have the undesirable consequence, then the principle of double effect does not apply in any way. From a legal perspective, that kind of thing can be controlled via laws and acceptable medical ethics training for the physicians who prescribe the drug. From the perspective of individual morality, the individuals who are misusing the drug should have had their consciences properly formed as children. As adults, they could be educated, but that can only go so far. Thus, legal sanctions might be the only way to reduce the incidence of abuse.
 
Lonely_guy said:
I am not a MD but a lorry-driver so I am not the one say about treatment. All answers was great and left me with very little to add. I would however like to add this. It is not so much a answer but a question to an answer all ready given. Drugs with Benzodiazepine also have doubble effect. They calm you but also make you feel good I have heard. Is that also a side-effect that is OK? Because if it is,we have a major problem. People will start taking remedy to enjoy or have use of the side-effect. How can we controll that?
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I suppose the answer is common sense. There is nothing wrong with actually using alcohol, within limits, to lift someone’s mood. What’s wrong is lack of moderation, especially when intoxication is the intended effect, in which case, as far as I know, it’s grave matter (not on account of immoderation, though, but abdication of the use of reason).
 
karbear said:
Is it really the official position of the church that this particular drug X is acceptable for married women when we know it can cause abortion? I am having trouble with this but will always trust the church. I just wish I understood why it was ok to flush babies down the toilet to treat a non life threatening condition that can probably be treated another way.
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The Church does not have an “official position” on this.

The Church states that theraputic means necessary to treat a disease may be used even if their side effect is sterlity. That is in Humanae Vitae. Hence, one may take chemo or radiation for cancer, even though it will cause sterility in most cases. One may have a hysterectomy for a damaged or cancerous uterus, even though the side effect is sterility. One may take hormones to treat female problems even if the side effect is sterility.

However, the Church does not directly address treatments that are abortifacient. We do know that under the Principle of Double Effect, a treatment can be pursued even if it may cause the death of the child if the reasons for pursuing it are propotionally grave. For example, St. Gianna Molla chose not to be treated for cancer while pregant. She could have chosen to be treated for cancer, licitly, even if it could have harmed or killed her child. What one then has to ask is whether or not a “heavy period” is a proportionally grave reason to receive treatment that may be abortifacient. I think the situation becomes more complex in that hormones in contraceptives might be abortifacient, but they might not be. You don’t really know. You are also talking about a woman who is not currently pregnant and may only theoretically get pregnant at some unspecified time in the future versus a situation in which an operation or drug is needed while a woman is actually already pregnant.

I think that one must look at both the propotionality of the situation AND the very remote possibility of pregnancy and that it is a possible future occurrence and not an actual condition at the time she takes the medication.

Moral theologians come down on both sides of whether it is moral. I have vaccillated between the two sides. I think, in the end, it is situation specific as to whether or not the Principle of Double Effect can legitimately be employed.
 
1ke said:
This is NOT accurate. See Humanae Vitae.
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I see what you’re saying in light of the other posts: that it constitutes a valid treatment which happens to have the side effect of sterility, and is not a contraceptive act. However, I still worry about the abortifacient factor…
 
When a woman takes hormonal birth control pills, she stops having menstrual cycles. She does not have a period - she has some bleeding but it is a “fake” period.

The best thing for the woman in question is to find a doctor who will actually treat her illness or help he cope with the natural function of her body.
 
karbear said:
How many women die of heavy periods? I’ve never heard of this before, as a cause of death. Is it really the official position of the church that this particular drug X is acceptable for married women when we know it can cause abortion? I am having trouble with this but will always trust the church. I just wish I understood why it was ok to flush babies down the toilet to treat a non life threatening condition that can probably be treated another way.
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Heavy periods can cause anemia that if it is bad enough can cause other problems like irregular heartbeat. See this.
 
WoundedIcon said:
I see what you’re saying in light of the other posts: that it constitutes a valid treatment which happens to have the side effect of sterility, and is not a contraceptive act. However, I still worry about the abortifacient factor…
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Taking pain pills can also make it more likely that a miscarriage will occur, but no one requires women taking pain pills to abstain from sex do they? Lots of things can give rise to a higher possibility of miscarriage and that chance of side effect has to be weighed in relation to the benefit of the medicine.
 
I think the medical doctors should find out why she is having heavy enough bleeding to cause those problems, also she can take iron supplements, she may need a D & C.🙂
 
WoundedIcon said:
Naturally, if this route of treatment was taken by a married woman she’d have to abstain from intercourse, because said intercourse would be contraceptive.
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I have read many posts on this question. I have read many answers.

Bottom line this post is totally accurate.
 
jmjconder said:
I have read many posts on this question. I have read many answers.

Bottom line this post is totally accurate.
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The Church says otherwise. If not then I suggest you go get a list of all the possible foods/drugs a woman can take that can affect her fertility/possibility of miscarriage so that we can know all the things women are not allowed to eat/drink if they want to have sex.

Here is an example:
alcoholism.about.com/cs/preg/a/blbmj030816.htm
They found that use of NSAIDs during pregnancy increased the risk of miscarriage by 80 percent. The risk was much higher when NSAIDs were taken around conception or were used for longer than a week. Taking account of other factors, including drinking alcohol or coffee, did not change the results.
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This is even worse than the risk associated with the pill and if your statement held true no woman taking NSAIDs could have sex.

guardian.co.uk/society/2011/sep/06/ibuprofen-warning-to-pregnant-women
Women who take even a small dose of painkillers such as ibuprofen early in their pregnancy more than double their risk of suffering a miscarriage, research shows.
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I understand that for someone like the example presented help and relief really is needed. I don’t know much about medicine nor pills and so on but this could be the “Pandora’s box” as I understand the question. It may lead to misuse of a number of drugs that are meant to a specific illness but can also be used to other things. I did a bit of research and I came up with more then one hundred different substances with more then one use. And there are other treatments that uses the same type of medication. We are all human and because of that weak. One moment of weak faith and we may do something we should not do. But I understand this dilemma and also the fact that I don’t know enough to say yes nor no. I am just concerned about what may happen if one thing is suddenly OK even though it really is not.
 
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