Was this a sin? Please let me know! :(

[fix]

Thanks Fix, Mosher, & CatherineW

Fix, I was avoiding your post only in that you are saying the exact same thing I am, probably in a better communication. When you say “the fact that some doctors act incorrectly does not mean there are no objective standards. All types of unjust situations arise each day, but none of them make formal participation in evil acceptable.” You are exactly correct. So the student, the doctor, and the patient are equal in that regard. Which is why all three have to be capable of acting independently as their own moral compass. The responsibility can not be passed from one to the other -as that in itself would violate an objective moral standard. It is simply not possible all will always act the same, and agree the same. In this example the doctor and patient manifested an action based on their individual moral compass. The student has not yet done that.

Now please consider the possibility these three people met in the communion line at Sunday’s Mass. Now the Priest must apply his moral compass.

Let me try to clarify my position:

1. We each have free will, yet that does not mean we may formally participate in another’s sin.
2. If one says I think it is good to rob a bank I canot say well I am pro choice on robbing banks. I personally would not do it, but let me get my car and drive you to rob one.
3. If a Catholic publicly declares robbing banks is acceptable if one claims it is so and says it over and over again and refuses correction from his priest and bishop, then denying him communion would seem to be just.
4. I want to repeat again that one cannot bind another to do evil. If a patient asks me for poison to kill their child, even though the state says it is lawful, I am bound to say no. That does not violate their free will. They have no right to an evil act.

 

[Texas_Roofer]

Let me try to clarify my position:

1. We each have free will, yet that does not mean we may formally participate in another’s sin.
2. If one says I think it is good to rob a bank I canot say well I am pro choice on robbing banks. I personally would not do it, but let me get my car and drive you to rob one.
3. If a Catholic publicly declares robbing banks is acceptable if one claims it is so and says it over and over again and refuses correction from his priest and bishop, then denying him communion would seem to be just.
4. I want to repeat again that one cannot bind another to do evil. If a patient asks me for poison to kill their child, even though the state says it is lawful, I am bound to say no. That does not violate their free will. They have no right to an evil act.

Thanks fix
To simplify the reply now discern the meaning of “formally” Given the doctor will actually deal with a continuum of circumstances. What is the definition of formal participation which separates the doctor’s actions from sin across all these circumstances?

 

[jmcrae]

Thanks fix
To simplify the reply now discern the meaning of “formally” Given the doctor will actually deal with a continuum of circumstances. What is the definition of formal participation which separates the doctor’s actions from sin across all these circumstances?

A Catholic doctor should not prescribe birth control pills. A Catholic pharmacist should not dispense them.

Nor should either one be put in a position where they have to stand there and watch while a non-Catholic does so.

They are heretics, and they are incorrect, but I have great admiration for JW doctors who will not stand by and watch a blood transfusion take place, and SDA doctors who will not stand there and watch while morphine is being handed out.

Misguided, they may be, but their example is one that our Catholic doctors and pharmacists ought to follow - caving in to society’s expectations just sends the message that the Church isn’t really serious when it teaches that artificial birth control is a mortal sin - otherwise, why would self-proclaimed “good” Catholics just stand there and watch, or even help push, while someone essentially flings himself or herself into the pits of Hell?

 

[fix]

Thanks fix
To simplify the reply now discern the meaning of “formally” Given the doctor will actually deal with a continuum of circumstances. What is the definition of formal participation which separates the doctor’s actions from sin across all these circumstances?

Good question. I am not an expert and I hope someone who is can answer intelligently for both of us.

This much I know from a Vatican document:

…The first fundamental distinction to be made is that between formal and material cooperation. Formal cooperation is carried out when the moral agent cooperates with the immoral action of another person, sharing in the latter’s evil intention. On the other hand, when a moral agent cooperates with the immoral action of another person, without sharing his/her evil intention, it is a case of material cooperation.

Material cooperation can be further divided into categories of immediate (direct) and mediate (indirect), depending on whether the cooperation is in the execution of the sinful action per se, or whether the agent acts by fulfilling the conditions — either by providing instruments or products — which make it possible to commit the immoral act. Furthermore, forms of proximate cooperation and remote cooperation can be distinguished, in relation to the “distance” (be it in terms of* temporal space* or material connection) between the act of cooperation and the sinful act committed by someone else. Immediate material cooperation is always proximate, while* mediate material cooperation* can be either proximate or remote.

Formal cooperation is always morally illicit because it represents a form of direct and intentional participation in the sinful action of another person.10 *Material cooperation *can sometimes be illicit (depending on the conditions of the “double effect” or “indirect voluntary” action), but when *immediate material cooperation *concerns grave attacks on human life, it is always to be considered illicit, given the precious nature of the value in question11.

A further distinction made in classical morality is that between active (or positive) cooperation in evil and passive (or negative) cooperation in evil, the former referring to the performance of an act of cooperation in a sinful action that is carried out by another person, while the latter refers to the omission of an act of denunciation or impediment of a sinful action carried out by another person, insomuch as there was a moral duty to do that which was omitted 12. Passive cooperation can also be formal or material, immediate or mediate, proximate or remote. Obviously, every type of formal passive cooperation is to be considered illicit, but even passive material cooperation should generally be avoided, although it is admitted (by many authors) that there is not a rigorous obligation to avoid it in a case in which it would be greatly difficult to do so…

catholicculture.org/docs/doc_view.cfm?recnum=6539

In the case of a physician writing a Rx for a medication to be used by the patient to contracept I would think the doctor is formally participating in that patient’s evil act. If I am wrong I hope someone can correct me.

 

[hasikelee]

Let me complicate the issue for you. Suppose I was a Medical doctor and asked to remove a fetus because of the mother’s medical complications and the possibly of her death was real and reasonable. I would refuse not because of her legal right in the US, but because I could not participate in an action which caused unwarranted death to the fetus. Now in this thread the birth control pills are not proven to be killing, or for that manner harming anybody. (see above section of post) Certainly an assumption can be made but is my assumption warranted superior to the known facts? I would say no. It simply is not my authority as a Catholic to say because you could use this to … Then I refuse you this medical service. (See I already discerned the issue)

If you are the attending physician, then who is asking you to remove her preborn baby? A lawyer? The mother? Is the mother or lawyer a doctor as well? And why would the abortion not cause harm to the mother? What is the mother suffering from that an abortion would not cause even more complication due to its invasive qualities?

And some forms of birth control do cause early chemical abortions. Also, you claim birth control does not harm anybody, but that is certainly up for dispute. Any hormonal replacement therapy has some negative affect on the patient, especially with long term use.

If a doctor deeply believes that his or her medical profession is for healing and not harm to the patient or secondary patient, then prescribing birth control or performing abortions is wrong for many other reasons before even getting to moral ones.

 

[Texas_Roofer]

Good question. I am not an expert and I hope someone who is can answer intelligently for both of us.

This much I know from a Vatican document:

In the case of a physician writing a Rx for a medication to be used by the patient to contracept I would think the doctor is formally participating in that patient’s evil act. If I am wrong I hope someone can correct me.

Thanks again
Unfortunately I could not access that web page, but was also able to read this at newadvent.org/cathen/01100a.htm actually now we do have a disagreement in that I do not see “intent” on the doctor’s behalf. See had patient X not requested this action would the doctor have hoped for opportunity to sterilize patient X? So in my view material cooperation is all that is left. Now per other posts I think every doctor has all material cooperation issues occurring daily due to the profession chosen. But in this specific example if the doctor provided adequate counseling then I see that as sufficient "while the latter refers to the omission of an act of denunciation or impediment of a sinful action carried out by another person, insomuch as there was a moral duty to do that which was omitted 12. "(- ibid). Please note that in post #10 & #18 formal participation is discussed, though using other words. In post #31 formal participation is accused but not known.

FYI another site I could not access, but would like to have read www.catholicdoctors.org.uk/books/contraceptbook.htm

 

[Texas_Roofer]

If you are the attending physician, then who is asking you to remove her preborn baby? A lawyer? The mother? Is the mother or lawyer a doctor as well? And why would the abortion not cause harm to the mother? What is the mother suffering from that an abortion would not cause even more complication due to its invasive qualities?

And some forms of birth control do cause early chemical abortions. Also, you claim birth control does not harm anybody, but that is certainly up for dispute. Any hormonal replacement therapy has some negative affect on the patient, especially with long term use.

If a doctor deeply believes that his or her medical profession is for healing and not harm to the patient or secondary patient, then prescribing birth control or performing abortions is wrong for many other reasons before even getting to moral ones.

Thank you but I do not understand your post. As the procedure sited was denied, who asked seems irrelevant? I am not a doctor but do not understand the medical cause and affect which seem to be read in the post.

 

[fix]

Thanks again
See had patient X not requested this action would the doctor have hoped for opportunity to sterilize patient X?

I do not see your point?

So in my view material cooperation is all that is left. Now per other posts I think every doctor has all material cooperation issues occurring daily due to the profession chosen. But in this specific example if the doctor provided adequate counseling then I see that as sufficient *"while the latter refers to the omission of an act of denunciation *or impediment of a sinful action carried out by another person, insomuch as there was a moral duty to do that which was omitted 12. "(- ibid). Please note that in post #10 & #18 formal participation is discussed, though using other words. In post #31 formal participation is accused but not known.

For a moment let us define the situation that commonly happens. A patient says to the physician I want a Rx for the pill because I do not want to get pregnant. The doctor hears the patient and agrees it is good she does not get prognant and hands her the Rx.

Now the doctor agrees with her intent and participates by giving her the means to obtain the drug to use to commit the evil act.

He is participating with her intent. The intent being to contracept. He aids her by giving her the means to achieve the desired end. Whether it is formal or a type of material cooperation it would seem to be illicit meaning sinful and gravely sinful at that.

Do you agree?

 

[Texas_Roofer]

I do not see your point?

For a moment let us define the situation that commonly happens. A patient says to the physician I want a Rx for the pill because I do not want to get pregnant. The doctor hears the patient and agrees it is good she does not get prognant and hands her the Rx.

Now the ***doctor agrees with her intent ***and participates by giving her the means to obtain the drug to use to commit the evil act.

He is participating with her intent. The intent being to contracept. He aids her by giving her the means to achieve the desired end. Whether it is formal or a type of material cooperation it would seem to be illicit meaning sinful and gravely sinful at that.

Do you agree?

In a case in which the doctor agrees is different than the OP condition. If he agrees with her intent the standard is met. If he disagrees even silently, requires reasonable counseling, and yet provides the Rx; I think the standards are not meet.

 

[fix]

In a case in which the doctor agrees is different than the OP condition. If he agrees with her intent the standard is met. If he disagrees even silently, requires reasonable counseling, and yet provides the Rx; I think the standards are not meet.

OK, I see the distinction you are making. I found this:

**Formal Cooperation.
** Formal cooperation occurs when a person or organization freely participates in the action(s) of a principal agent, or shares in the agent’s intention, either for its own sake or as a means to some other goal. Implicit formal cooperation occurs when, even though the cooperator denies intending the object of the principal agent, the cooperating person or organization participates in the action directly and in such a way that the it could not be done without this participation. Formal cooperation in intrinsically evil actions, either explicitly or implicitly, is morally illicit.

**Immediate Material Cooperation.
** Immediate material cooperation occurs when the cooperator participates in circumstances that are essential to the commission of an act, such that the act could not occur without this participation. Immediate material cooperation in intrinsically evil actions is morally illicit. There has been in the tradition a debate about the permissibility of immediate cooperation in immoral acts under “duress.” When individuals are forced under duress (e.g., at gunpoint) to cooperate in the intrinsically evil action of another, they act with diminished freedom. Following Church teaching, the matter of their action remains objectively evil, but they do not intend this object with true freedom. In such cases, the matter remains objectively evil as such, but the subjective culpability of the cooperator is diminished. Very recently, the Vatican has rejected the arguments of those who would apply this concept of duress to Catholic organizations as a way to justify their immediate material involvement in certain objectionable actions.

**Mediate Material Cooperation.
** Mediate material cooperation occurs when the cooperator participates in circumstances that are not essential to the commission of an action, such that the action could occur even without this cooperation. Mediate material cooperation in an immoral act might be justifiable under three basic conditions:

1. 
   *]If there is a proportionately serious reason for the cooperation (i.e., for the sake of protecting an important good or for avoiding a worse harm); the graver the evil the more serious a reason required for the cooperation;
   *]The importance of the reason for cooperation must be proportionate to the causal proximity of the cooperator’s action to the action of the principal agent (the distinction between proximate and remote);
   *]The danger of scandal (i.e., leading others into doing evil, leading others into error, or spreading confusion) must be avoided.
   ascensionhealth.org/ethics/public/key_principles/cooperation.asp

 

[mosher]

Good question. I am not an expert and I hope someone who is can answer intelligently for both of us.

Not necessarily. There are two possibilities. There are two types of participation:

Formal
Material

If the doctor prescribes the immoral medication of his own volition then it is a formal participation in the sin. If however, he is required to prescribe this medication then his participation is material.

The easies way to think of the difference between formal and material in this usage is that formal is “outright” whereas material is less obvious. If negative both are immoral acts it is just a matter of gravity.

Take for instance a clearer example to demonstrate the difference between formal and material in this context. Let us look at the case of the formal and material heretic.

A formal heretic is a person who teaches heresy in a public way. A material heretic is a person who does not publicly teach heresy but believes things that are heretical. This would be the difference between Martin Luther and your average protestant in his pew respectively.

With this in mind the situation of the OP is that the doctor had formal participation and the OP had material participation in the sin of the patient. Both of these are wrong in light the doctors act of commission and in the OPs act of omission. However, the culpability of the OP could have been mitigated based on the circumstance. So, the balance of culpability is on the head of the doctor and not the OP.

 

[hasikelee]

Thank you but I do not understand your post. As the procedure sited was denied, who asked seems irrelevant? I am not a doctor but do not understand the medical cause and affect which seem to be read in the post.

Who asked is relevant as I am wondering if you mean a supervisor asked the attending physician, or do you mean the mother requested it? (Per your statement)

Let me complicate the issue for you. Suppose I was a Medical doctor and** asked** to remove a fetus because of the mother’s medical complications and the possibly of her death was real and reasonable

My main point is that a doctor refusing to perform abortions to prescribe artificial birth control can do so very validly for reasons other than moral ones.

 

[fix]

Not necessarily. There are two possibilities. There are two types of participation:

Formal
Material

If the doctor prescribes the immoral medication of his own volition then it is a formal participation in the sin. If however, he is required to prescribe this medication then his participation is material.

The easies way to think of the difference between formal and material in this usage is that formal is “outright” whereas material is less obvious. If negative both are immoral acts it is just a matter of gravity.

Take for instance a clearer example to demonstrate the difference between formal and material in this context. Let us look at the case of the formal and material heretic.

A formal heretic is a person who teaches heresy in a public way. A material heretic is a person who does not publicly teach heresy but believes things that are heretical. This would be the difference between Martin Luther and your average protestant in his pew respectively.

OK, so in the case of the OP she handed a Rx knowing it was for contraception. Is it accurate to conclude such an action is immediate material cooperation and thus sinful? I do not wish to judge the soul of the OP I only want to understand the point clearly.

 

[jmcrae]

OK, so in the case of the OP she handed a Rx knowing it was for contraception. Is it accurate to conclude such an action is immediate material cooperation and thus sinful? I do not wish to judge the soul of the OP I only want to understand the point clearly.

Yes, it was material cooperation in the sin, which is grave matter.

However, full knowledge of the gravity of the sin was not present (hence, the question), and full consent of the will was not present - she felt compelled to cooperate in this action because it appeared to her to be part of her training and apprenticeship to become a doctor, and because the older, and presumably wiser, mentor asked her to do this.

That’s why I don’t think the OP committed a mortal sin in this instance - but she does need to develop a strategy to avoid this situation in the future, if possible, which is why it would be a good idea to mention it to her Confessor, anyway, and seek his guidance on this issue.

 

[mosher]

OK, so in the case of the OP she handed a Rx knowing it was for contraception. Is it accurate to conclude such an action is immediate material cooperation and thus sinful? I do not wish to judge the soul of the OP I only want to understand the point clearly.

I edited the post since your response to add further clarification. However, no it was not proximate in that the doctor could have handed the patient the Rx directly. My concern is not so much in the action but rather in the inaction of the OP.

In the action not only was it not proximate material cooperation but also in the circumstance there seems to be a limiting of freewill because of the principle of agency. Now, in this case and any case the principle of agency cannot be used to justify immoral actions but in some situations it can limit the freedom of the individual and thus mitigate culpability.

 

[mosher]

Yes, it was material cooperation in the sin, which is grave matter.

However, full knowledge of the gravity of the sin was not present (hence, the question), and full consent of the will was not present - she felt compelled to cooperate in this action because it appeared to her to be part of her training and apprenticeship to become a doctor, and because the older, and presumably wiser, mentor asked her to do this.

That’s why I don’t think the OP committed a mortal sin in this instance - but she does need to develop a strategy to avoid this situation in the future, if possible, which is why it would be a good idea to mention it to her Confessor, anyway, and seek his guidance on this issue.

The conclusion is correct but the premise is not. This is not proximate material cooperation (aka immediate) because the act could have been done without her with not difficulty.

 

[fix]

In the action not only was it not proximate material cooperation but also in the circumstance there seems to be a limiting of freewill because of the principle of agency. Now, in this case and any case the principle of agency cannot be used to justify immoral actions but in some situations it can limit the freedom of the individual and thus mitigate culpability.

What is the principle of agency and is this why it is licit for a non contracepting spouse to engage in marital relations with a contracepting spouse and not be culpable for sin?

 

[mosher]

What is the principle of agency and is this why it is licit for a non contracepting spouse to engage in marital relations with a contracepting spouse and not be culpable for sin?

No this is not the reason for that. The principle of agency simply put is that a subordinate has an obligation to act in accord with both the explicit and implicit directives of their superior. This is a moral obligation unless the superior is requiring something immoral.

The reason why I mention this in this circumstance is because the principle of agency forms a bond between superior and subordinate that can, when faced with the duty to go against an immoral directive, a level of fear that can mitigate culpability if the subordinate is complicit in the immoral directive.

A good example is the Nuremberg trials. In this the architects of the Holocaust received a much graver punishment than the subordinates because of the limited culpability. However, even thought culpability is limited does not mean that it will completely exonerate the subordinate because they also had an obligation to proper moral behavior. Thus, punishment is just but it cannot be applied as sternly as it should be given the superior.

What you are thinking of is what we are talking about specifically in this thread at the moment. In your scenario the non-contracepting spouse is not formally participating in the sin of the contracepting spouse and it is not even proximate especially if the non-contracepting spouse has raised objection to the actions of the other spouse.

 

[fix]

No this is not the reason for that. The principle of agency simply put is that a subordinate has an obligation to act in accord with both the explicit and implicit directives of their superior. This is a moral obligation unless the superior is requiring something immoral.

The reason why I mention this in this circumstance is because the principle of agency forms a bond between superior and subordinate that can, when faced with the duty to go against an immoral directive, a level of fear that can mitigate culpability if the subordinate is complicit in the immoral directive.

A good example is the Nuremberg trials. In this the architects of the Holocaust received a much graver punishment than the subordinates because of the limited culpability. However, even thought culpability is limited does not mean that it will completely exonerate the subordinate because they also had an obligation to proper moral behavior. Thus, punishment is just but it cannot be applied as sternly as it should be given the superior.

What you are thinking of is what we are talking about specifically in this thread at the moment. In your scenario the non-contracepting spouse is not formally participating in the sin of the contracepting spouse and it is not even proximate especially if the non-contracepting spouse has raised objection to the actions of the other spouse.

So, the case of the OP may be remote mediate material cooperation?

 

[mosher]

So, the case of the OP may be remote mediate material cooperation?

Yes, that is what it sounds like. As I said earlier it does not seem that it is a matter for the confessional but it was a missed opportunity to practice virtue.