Question about "preventive" sterilization

[josea]

Dear all,

Let me ask you a theoretical question that will help me to put in order my thoughts.

We know that the Church teaches that preventive sterilization is immoral (considered it as direct sterilization) and that a woman to whom a putative new pregnancy would kill is not allowed to have her reproductive organs removed. The reason to forbid this “preventive sterilization” is that the reproductive organs are healthy (?) and the life threatening danger comes only when the reproductive function would be activated by marital relations.

The prohibition of this “preventive sterilization” relies on the fact that the organs are in good health and only are dangerous when a pregnancy occurs. Because these organs are not an actual danger for the woman they can not be removed.

Now, this woman practices NFP and one day for whatever reason (it is not important for the example) the woman gets pregnant. She would certainly die if pregnancy is allowed to continue.

Does this mean that NOW the reproductive function is an actual danger for the woman and can be removed? Remember that the reason to allow the removal of the uterus is its actual risk for the health of the woman and this situation is certainly a risk.

I know that this would be an abortion and the Church also teaches that evil can not be done that good can come from this action but considering that the Church forbids preventive sterilization makes very difficult decisions after something as an unpredicted pregnancy occurs.

Should this woman now die before sinning?

Should the removal of the uterus be performed?

Why should the Church allow this situation to occur if a preventive sterilization could have “solved” the problem?

Regards,

Jose

 

[manualman]

I’ll admit fully that this one is WAY over my head.

But it sounds to me like those tempting voices have been whispering to you again, josea! Pray and be watchful!

To the subject, you raise an interesting question. To wit, does the situation you describe mimic the moral situation of ectopic pregnancy, thus becoming moral under the principle of double effect?

1. The goal of saving the mother’s life in the face of a probably fatal situation would be a morally good intent.
2. The removal of a uterous to acheive #1 above would be morally nuetral.
3. The death of the child is an unwanted, but unavoidable side effect.
4. The undesired, but unavoidable death of the child is still a better outcome than the death of them both.

The above assumes, of course that it is the uterus that threaten’s the mother’s life. That’s an awfully big assumption. Somebody with adequate medical competence needs to determine if the DIRECT threat to the mother’s health is the baby itself or a malfunctioning part of her own anatomy.

This gets mighty dicey as it can get tempting to disguise a direct abortion via semantics in part #2 above. I’d not feel comfortable at all saying the above reasoning is adequate to justify this act. Needs more medical knowledge than I have.

 

[felra]

josea:

Dear all,

Let me ask you a theoretical question that will help me to put in order my thoughts.

We know that the Church teaches that preventive sterilization is immoral (considered it as direct sterilization) and that a woman to whom a putative new pregnancy would kill is not allowed to have her reproductive organs removed.

Now, this woman practices NFP and one day for whatever reason (it is not important for the example) the woman gets pregnant. She would certainly die if pregnancy is allowed to continue.

Does this mean that NOW the reproductive function is an actual danger for the woman and can be removed? Remember that the reason to allow the removal of the uterus is its actual risk for the health of the woman and this situation is certainly a risk.

Why should the Church allow this situation to occur if a preventive sterilization could have “solved” the problem?

Regards,

Jose

Welcome back josea.

The reason that the Church does not allow direct sterilization (“preventative sterilization” as you refer to it) because this is not a treatment of an existing health problem. The health risks to mother and/or child associated with a future pregnancy are potential health risks and are 100% preventable with the moral option of marital abstinence/continence.

**2297 **Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and *sterilizations *performed on innocent persons are against the moral law. (CCC)

**2399 **Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception). (CCC)

Equally to be excluded, as the teaching authority of the Church has frequently declared, is direct sterilization, whether perpetual or temporary, whether of the man or of the woman. (HV 14)

 

[LittleDeb]

josea:

Now, this woman practices NFP and one day for whatever reason (it is not important for the example) the woman gets pregnant. She would certainly die if pregnancy is allowed to continue.

Does this mean that NOW the reproductive function is an actual danger for the woman and can be removed? Remember that the reason to allow the removal of the uterus is its actual risk for the health of the woman and this situation is certainly a risk.

I am not sure how to answer this since I have a problem with the term, “certainly die if…” Life happens. So does death. I once nearly died from an allergic reaction. Well that is my life. I won’t live in a bubble to “protect” me.

I don’t hold to the idea that the uterus is the problem. I know that our entire bodies as a whole have a lot more to do with our lives being in danger during and after pregnancy. The idea of preventative sterilization seems similar to having me live in a bubble.

In theory, yes this situation is plausible but in actuality it takes God out of the picture. There is an article here on Catholic.com called, “That Celibate Bachelor was Right!” that really addresses what I mean. I used to hold to a lot of these ideas of “what if?..” Then I decided that playing the what if game only led me away from the will of God.

 

[josea]

manualman:

But it sounds to me like those tempting voices have been whispering to you again, josea! Pray and be watchful!

Dear Manualman,

Thanks for the answer. It is true that I am again thinking about this issue. What I find really disturbing is that for me is that it is the only teaching from the Catholic Church where I do not see the logic behind!

I see why masturbation, homosexuality, adultery, stealing, murder, cloning, artificial reproduction, etc… are sins.

But I can not understand the logic of the considering “preventive sterilization” as direct sterilization when:

1.  the reproductive function can not be used anymore anyways

2.  other operations as preventive mastectomy are performed in patients with risk of developing cancer (being the organ healthy when the operation is performed)

3.  the consequences of a pregnancy (no matter how and why) could be lethal for the woman

Sorry, although I accept the teaching I do not see any logic behind.

Jose

 

[felra]

What I find really disturbing is that for me is that it is the only teaching from the Catholic Church where I do not see the logic behind!

But I can not understand the logic of the considering “preventive sterilization” as direct sterilization when:

1. the reproductive function can not be used anymore anyways

In prudence and concern for the welfare of the mother the couple is choosing to limit the chance of future pregnancy.
other operations as preventive mastectomy are performed in patients with risk of developing cancer (being the organ healthy when the operation is performed)
Three things condition the moral permission of surgical operation requiring an anatomical or functional mutilation;

1. that the preservation or functioning of a particular organ provokes a serious damage or constitutes a threat to the complete organism [that is the principle of totality];
2. that this damage cannot be avoided, or at least notably diminished, except by the amputation in question and that its efficacy is well assured; and
3. that it can be reasonably foreseen that the negative effect, namely, the mutilation and its consequences, will be compensated by the positive effect: exclusion of a damage to the whole organism, mitigation of the pain, etc.

http://www.ewtn.net/library/PROLENC/ENCYC102.HTM

The above conditions are not met for potential serious health risks associated with future pregnancy.
the consequences of a pregnancy (no matter how and why) could be lethal for the woman

In and of itself, the reproductive organs and procreative potential (the procreative good) is of its very nature always good. To perform “preventative” (direct) sterilization with the sole intent of preventing future pregnancy one must deny that procreation is a good, or assert that it is sometimes permissible to act directly against a basic human good. This violates the principle of moral conscience:

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Some rules [of moral conscience] apply in every case:

- One may never do evil so that good may result from it; (1789 CCC)

Sorry, although I accept the teaching I do not see any logic behind.

Jose
I hope that this brief synopsis helps to make the logic clearer.

Addendum: FYI:

“In the first year following the procedure, your chance of becoming pregnant is less than 1 percent. Over time, the ends of your fallopian tubes could fuse back together and make it possible to become pregnant. This is more likely to occur in women who have the surgery performed early in their reproductive years.”

http://www.cnn.com/HEALTH/library/WO/00047.html

 

[josea]

Dear felra,

To me:

1. that the preservation or **functioning **of a particular organ provokes a serious damage or constitutes a threat to the complete organism [that is the principle of totality];

The functioning of the reproductive organs can provoke the serious damage and constitute a threat to the complete organism.

1. that this damage cannot be avoided, or at least notably diminished, except by the amputation in question and that its efficacy is well assured;

How can the damage be avoided in the case of a cancer risk if no preventive mastectomy is performed? Only waiting for the tumor to appear?

In our case is clear: no having sex anymore! That is the central point here. But how can a medical condition depend entirely on the free will of a person if we could assure that death will not happen by a simple operation?

1. that it can be reasonably foreseen that the negative effect, namely, the mutilation and its consequences, will be compensated by the positive effect: exclusion of a damage to the whole organism, mitigation of the pain, etc.

Without any doubt! **What is the negative effect here when the reproductive function can not be used anymore anyway? **

Is anxiety of getting pregnant not a psychological suffering? Would the intervention mitigate that pain? Or is only considered painful what directly affects our direct pain receptors?

Felra, I remind you this in not about contraception, the operation does not have to be considered as an evil act.

Regards,

Jose

 

[felra]

Dear felra,

To me:

1. that the preservation or **functioning **of a particular organ provokes a serious damage or constitutes a threat to the complete organism [that is the principle of totality];
   The functioning of the reproductive organs can provoke the serious damage and constitute a threat to the complete organism.

The *potential *health risks associated with a future pregnancy are 100% preventable through marital continence, which may be the only loving moral option facing some couples.

1. that this damage cannot be avoided

, or at least notably diminished, except by the amputation in question and that its efficacy is well assured;

How can the damage be avoided in the case of a cancer risk if no preventive mastectomy is performed? Only waiting for the tumor to appear?

The “damage” of assessed potential serious/lethal health risks associated with a future pregnancy are wholely (100%) preventable by other moral means (abstinence if need be), so amputation is not necessary (unlike cancer, there is nothing to “abstain” from that would offer 100% avoidance of recurrance).

In our case is clear: no having sex anymore! That is the central point here

. But how can a medical condition depend entirely on the free will of a person if we could assure that death will not happen by a simple operation?
The only 100% assurance of no future pregnancy is either by: 1) complete abstinence, 2) castration (removal of the testes or ovaries).

Properly used, NFP is 99% effective, tubal ligation is only 99% effective, other forms of ABC are less than 100% effective.

“In the first year following the procedure, your chance of becoming pregnant is less than 1 percent. Over time, the ends of your fallopian tubes could fuse back together and make it possible to become pregnant. This is more likely to occur in women who have the surgery performed early in their reproductive years.”

cnn.com/HEALTH/library/WO/00047.html

1. that it can be reasonably foreseen that the negative effect, namely, the mutilation and its consequences, will be compensated by the positive effect: exclusion of a damage to the whole organism, mitigation of the pain, etc.

Without any doubt! **What is the negative effect here when the reproductive function can not be used anymore anyway? **

Is anxiety of getting pregnant not a psychological suffering? Would the intervention mitigate that pain? Or is only considered painful what directly affects our direct pain receptors?

All three criteria/conditions have to be met:

Three things condition the moral permission of surgical operation requiring an anatomical or functional mutilation

**
**

 

[felra]

(continued):

Felra, I remind you this in not about contraception, the operation does not have to be considered as an evil act.

Jose

The operation as you describe (intentions aside) *"**has the sole immediate effect of rendering the generative faculty incapable of procreation, is to be considered direct *sterilization". It is all about contraception and is considered an immoral act.

In response to its query on sterilization

, the Vatican Congregation for the Doctrine of the Faith’s statement of March 13, 1975 replied to the United States National Conference of Catholic Bishops as follows:

“Any sterilization, that is, of its own nature and condition, has the sole immediate effect of rendering the generative faculty incapable of procreation, is to be considered direct sterilization, as the term is understood in the declarations of the pontifical magisterium, especially of Pius XII. Therefore, notwithstanding and subjectivity right intention of those whose actions are prompted by the care of **prevention **of physical or mental illness which is foreseen or feared as the result of pregnancy, such sterilization remains absolutely forbidden to the doctrine of the church. And indeed the sterilization of the faculty itself is forbidden for an ever graver reason than the sterilization of individual acts, since it induces a state of sterility in the person which is almost always irreversible.”

http://www.ewtn.net/library/PROLENC/ENCYC102.HTM

 

[TAS2000]

But how can a medical condition depend entirely on the free will of a person if we could assure that death will not happen by a simple operation?

Well, this is akin to saying that we can avoid the risks of death from lung cancer by freely choosing to not smoke, OR by choosing to have our lungs removed and replaced by mechanical lungs so that we can continue to smoke. It is a free choice. We have no right to sex. We have no right to smoke. We could choose to smoke with no bad side effects if we have the ficticious operation.

 

[TAS2000]

In the fictions example you first cited, if pregnancy occurred, and that pregnancy was certain to cause the mother’s death due to the uterus (for whatever medical reason) and the only effective treatments available would also cause the death of the baby, that would fall under double effect. It is essentially the same (morally) as a tubal ectopic, where the tube is removed and the baby with it.

However, the other subject, “preventive” sterilization is not. There is a way to avoid it: abstinence. It is a tough cross to bear, but we were never promised it would be easy. If you had chosen the single or priestly life, then you would be expected to remain celibate. True, you choose marriage and expected to be able to have sex, but we don’t always get what we want.

My friend’s brother was a football player, already had scholarships to college, scouts from the NFL checking him out, the whole nine yards. Then he broke his neck in a game. He is now a quad, with almost no feeling or control below the neck. He was 18. This isn’t what he chose, but it is what he has to bear. (BTW, they cancelled his scholarships since he couldn’t play ball anymore.)

You can’t see why you should have to abstain; he can’t see why he had to be paralyzed. The chances of finding a cure for him are probably about the same as finding a cure for your wife’s condition. Life isn’t fair. But that doesn’t mean we can do things that are morally wrong to try to make it better. Others may not see why fetal stem cell research is bad, because it has the potential for good ends. But, just because they can’t see it, doesn’t make it right.

Try to hold fast to the truth in the midst of the self-doubts and morally bankrupt worldly advice you are sure to have. The time here on earth is nothing compared to an eternity in heaven. Your trails here will be rewarded there.

 

[KCT]

josea:

Sorry, although I accept the teaching I do not see any logic behind. Jose

To me, that’s where faith comes in. If I understood everything 100%, there’d be no reason to have faith.

I think God leaves us some space to fill with faith, not w/ certainties.

—KCT

 

[manualman]

I’m with you. I remember your old posts and the tough spot you live in. May our merciful God grant you the peace and grace you need to find peace in His will!

Prayers for ya. Going…up.

 

[Seatuck]

We live in an age with advanced methods of natural family planning including periodic or permanent abstinence as well as the major breakthroughs in medicine for high risk pregnancies. I understand the concern but sterilization cannot be allowed.

 

[my_agatha]

What is “strictly therapeutic” supposed to mean, anyway?

 

[josea]

Thanks for your posts!

No, it is not the same a “preventive sterilization” as to remove the lungs to be able to smoke. Sex is not only meant for procreation. But if the reproductive function can not be used anymore why is not licit just to remove it to fulfill the other unitive part of marriage?

By the way… to the person talking about lungs and tobacco: If such operation would exist do you think it would be illicit? Probably it would safe the life of a person that by no means can stop smoking. Or just think about all the operations people are subjected where parts of the body are removed, for instance the stomach in order to fight obesity. The stomach is a healthy organ! Why can it be removed without problem?

I seriously do not understand. “Preventive sterilization” is not performed to avoid children: THE CHILDREN WILL NOT COME NEVER ANYWAYS! The reproductive function of that woman in unhealthy (otherwise it will not kill her) and therefore should be switch off without moral problems.

But… well… I go on accepting the teaching although I do not really understand it. It simply does not make sense to me.

Jose

 

[stadre]

josea:

Thanks for your posts!

No, it is not the same a “preventive sterilization” as to remove the lungs to be able to smoke. Sex is not only meant for procreation. But if the reproductive function can not be used anymore why is not licit just to remove it to fulfill the other unitive part of marriage?

By the way… to the person talking about lungs and tobacco: If such operation would exist do you think it would be illicit? Probably it would safe the life of a person that by no means can stop smoking. Or just think about all the operations people are subjected where parts of the body are removed, for instance the stomach in order to fight obesity. The stomach is a healthy organ! Why can it be removed without problem?

I seriously do not understand. “Preventive sterilization” is not performed to avoid children: THE CHILDREN WILL NOT COME NEVER ANYWAYS! The reproductive function of that woman in unhealthy (otherwise it will not kill her) and therefore should be switch off without moral problems.

But… well… I go on accepting the teaching although I do not really understand it. It simply does not make sense to me.

Jose

You are missing that the reproductive function can be used if it is possible for her to get pregnant. The children will come if God wills them. You may use NFP (which is a more reliable form of avoiding a pregnency) which respects that while intercourse is unitive and pleasurable, the unitive aspect also relies on its procreative part. That’s right–part of what makes it unitive is that pregnancy is possible and the couple is still open.

(And what about the risks of the procedure? A friend was seriously considering a tubal. She figured that she could go to confession afterward. I asked her to consider that something could go wrong during the procedure. She has no desire for more children at this time and they are completely abstaining until such a time that they are open enough to accept the minute
possibility of pregnancy that comes with NFP use.)

I pray that you (and all) continue following the Church’s teaching while praying for understanding. God bless.

 

[felra]

josea:

I seriously do not understand. “Preventive sterilization” is not performed to avoid children: THE CHILDREN WILL NOT COME NEVER ANYWAYS! The reproductive function of that woman in unhealthy (otherwise it will not kill her) and therefore should be switch off without moral problems.

But… well… I go on accepting the teaching although I do not really understand it. It simply does not make sense to me.

Jose

You may do yourself a favor to develop your understanding and appreciation of the theology of the body which underlies the reasons for “why not” to any form of contraception for whatever subjectively compassionate reason. Otherwise you run the risk of leaving yourself mentally teased, tormented and otherwise vulnerable to self-deception, frustration or even bitterness in the long-run. Here are a few book recommendations along these lines:

Life-Giving Love : Embracing God’s Beautiful Design for Marriage
by Kimberly Hahn, Scott Hahn

Theology Of The Body For Beginners – by Christopher West

Love and Responsibility
by Pope John Paul II, et al

Catholic Sexual Ethics: A Summary, Explanation, & Defense by Ronald Lawler, et al

Marriage - The Mystery of Faithful Love
Author: Dietrich von Hildebrand

The Conjugal Act as a Personal Act
Author: Donald Asci

 

[josea]

felra:

You may do yourself a favor to develop your understanding and appreciation of the theology of the body which underlies the reasons for “why not” to any form of contraception for whatever subjectively compassionate reason. Otherwise you run the risk of leaving yourself mentally teased, tormented and otherwise vulnerable to self-deception, frustration or even bitterness in the long-run.

But… felra, I am not talking about contraception. I am talking about amputation of a part of the body that can be dangerous for the rest, as done in case of obesity by removing an healthy stomach.

jose

 

[TAS2000]

No, it is not the same a “preventive sterilization” as to remove the lungs to be able to smoke. Sex is not only meant for procreation. But if the reproductive function can not be used anymore why is not licit just to remove it to fulfill the other unitive part of marriage?

And smoking is not meant only to cause to lung cancer. No one smokes because they WANT cancer. They want the enjoyment part, but not the “side effect”. Similarly, eating is not meant merely to provide sustenance. It is enjoyable, and can have a wide range of experiences. Yet for some people, it can lead to “side effects” like obesity, chronic heartburn, severe allergic reactions, and other problems. In your case, you want the “good” effect of sex, without the undesired “side effect”. It may not be a perfect analogy, but it is close enough to get the point. You said you couldn’t see how a personal choice was relevant to a medical condition. It is very relevant. Actions have consequences. If I know I will get cancer from smoking, but choose to smoke, then I am responsible for causing the cancer. If there was a fictional lung removal surgery to prevent the cancer, that wouldn’t make it right.

By the way… to the person talking about lungs and tobacco: If such operation would exist do you think it would be illicit? Probably it would safe the life of a person that by no means can stop smoking. Or just think about all the operations people are subjected where parts of the body are removed, for instance the stomach in order to fight obesity. The stomach is a healthy organ! Why can it be removed without problem?

You are operating on the false idea here that these things ARE right because they would be commonly accepted. You don’t feel that way about the sterilization. You know that it is wrong in the church’s view, but you also know that hundreds of thousands of people have done it. That doesn’t make it right. Preventive removal of the lungs before lung cancer exists would not be a licit choice. Similarly, removal of the stomach to pre-empt obesity would not be licit. Removal of functioning organs before the problem exists used to be called mutilation.

I seriously do not understand. “Preventive sterilization” is not performed to avoid children: THE CHILDREN WILL NOT COME NEVER ANYWAYS! The reproductive function of that woman in unhealthy (otherwise it will not kill her) and therefore should be switch off without moral problems.

If there were no possibility of pregnancy, then there would be no need for sterilization. Clearly, the possibility DOES exist, or you wouldn’t be worried about it. The real problem is that you have been told such a pregnancy would be fatal. You want to avoid that possibility. There are ways to do that. NFP can be 99% effective. Abstinence is 100%. Some forms of artificial contraception can be 99% effective (tubal ligation, etc). Some can be 100% (total removal of all reproductive organs). God calls us do what is right. Not what is easy.

You may also want to consider all the horrible side effects that sterilization has. You would really just be swapping one set of problems for another.

There is a poster over in the family forums, rayne89, who has a similar problem. She also has serious health risks such that she will die from another pregnancy. She has been using NFP for something like 9 years. It isn’t easy. I’ll ask her if she will consider joining this thread. She may be able to offer you some encouragement.