«THE CATHOLIC CHURCH’S MISSED OPPORTUNITY Gabriel Moran During recent centuries there has been a struggle to put in place humane controls of the ...»
THE CATHOLIC CHURCH’S MISSED OPPORTUNITY
During recent centuries there has been a struggle to put in place humane controls of
the power unleashed by modern knowledge and its artifices which the nineteenth century
named technology. From the beginning of modernity the Catholic Church has been
skeptical of claims to progress in politics and ethics. Given the violent wars of the
nineteenth and twentieth centuries a skeptical outlook on human progress is understandable. Reserve and skepticism concerning claims of progress can slip into stubborn opposition to humans reshaping the gifts that the species has to work with.
My interest here is not condemning the Catholic Church for being on the wrong side of history but in tracing the Catholic Church’s involvement in two areas of life and death during the last half century. If the church had seen these two areas as parallel it might have gone a different route in its decisions about the beginnings of life. In this second area, however, the question was not only about “life” but about sex, an area in which Catholic Church leaders badly misunderstood the question.
The year 1958 was the crucial moment. On questions about the end of life, 1958 was the beginning of a positive role that Catholic tradition has played in the complicated world of contemporary medicine. At the same time, on questions about the beginning of life there was an opening which was not pursued. Attention to what science and medicine were doing might have led to thinking anew about conception and birth. In both areas there was a question about the relation between the “natural” and the “artificial.” Neither word has a simple definition. There is room for endless debate about their relation in particular cases. The starting point, however, is that the two are not inherently opposed. It is obvious that some artifice has been an improvement in human life; it is just as obvious that some artifice has proved to have had deleterious effects. Most inventions have been ethically neutral; much of ethics pertains to human actions in which artifice is a means to either good or bad ends.
Few people would be aware of two documents published in 1958 by Pope Pius XII.
One document spoke about legitimate reasons for removing a respirator from a dying patient, the other about the legitimate use of the pill that came to be called the birth control pill. In both cases, this very conservative pope was ahead of the curve. The era of contemporary medicine was only at its beginning; most people had no idea of technology’s ability to prolong a person’s dying almost indefinitely. As for the pill, the pope was two years ahead of the FDA approval of enovid as a pill that allowed women to control pregnancy. The pope was not endorsing the use of the pill to control conception;
it would have taken a leap of imagination to integrate that use of the pill into existing church teaching. Nonetheless, Pope Pius XII had taken a first step in rethinking the place of artifice in the control of life’s functions.
On the use of artifice at the end of life, Catholic tradition asserted that a person has a duty and a right to ordinary means in the service of life. A distinction between ordinary and extraordinary things can be misleading today. Instead of some objects being ordinary and others extraordinary, the important distinction is between actions that humanly make sense and actions that no longer make sense in particular situations. The Vatican Declaration on Euthanasia in 1980 helpfully used a distinction between proportionate and disproportionate means. Human beings have a right to care from the human community;
that includes provision of air to breathe, food to eat, water to drink, basic medical care and physical security. A modern hospital can routinely provide services that have helped to extend the average life span by several decades. Which treatments make sense for a particular patient at a particular time have to be decided by informed patients (or their proxies) and competent health care professionals.
It has become a cliché that “death is natural.” Death is natural but human death is not; it is more than natural; it is historical, social, artistic, religious and artificial. We prolong our lives every day by “artificial means.” But at some point what is being prolonged is the act of dying. In a hospice, where the ideal is not “natural death,” a liberal drug policy is often helpful for a person moving toward death but some technology is judged to interfere with a humane death. A person’s inability to eat can be a sign that the body is shutting down in preparation for death. If the artificial substitute for eating no longer makes sense and is discontinued, the patient has not been starved to death; the body’s dying has run its course.
Pope Pius XII addressed the question of removing a respirator from a dying person.
The decision involves reflecting on the relation between the person’s “nature” and the artifacts of modern medicine The main reasons for removing a respirator are medical, the lack of any hope that a person can recover a place in the human community. Surprisingly, the pope included an economic reason. Continuing to pour tens of thousands of dollars into treatment which is not working can ruin a family’s chance for a decent life. The pope surely knew the danger of appearing to say that people should be allowed to die if it is too expensive to keep them alive. But the pope was acknowledging that economics is unavoidably involved in whatever decisions affect living and dying.
Many secular writers today bundle together euthanasia and abortion and pronounce the Catholic Church to be the main obstacle to humane policies in both areas. The critics are often unaware of church doctrine and actual practice in the care of the dying. In many of the famous cases in the U.S. the Catholic Church has been a participant on the side of humane treatment allowing a person to die. In nearly all cases the Church’s language has helped to shape the discussion. The Catholic Church does have some legitimate concerns about the treatment of dying people. The Church continues to resist the idea of giving over the power to kill to a physician or anyone else. The line between killing and allowing death to occur is sometimes blurred but in most cases it is clear. When the ethical difference between killing and letting die is dismissed, people are sometimes accused of being murderers after they have tearfully accepted the death of their loved one.
On the issue of the birth control pill, Pope Pius XII approved its use in 1958 to treat hormonal disorders. He was aware that “indirectly” it would prevent conception. On the issue of controlling births the Catholic Church had begun to recognize the need when it approved what was called the rhythm method in 1936. Before the twentieth century, the need was for large families; children could be an economic blessing; almost half of children did not make it beyond infancy. Starting near the year 1900 world population began growing exponentially. There is a desperate need to control the number of children; the need is greatest in the poorer parts of the world, most dramatically in Africa.
The big questions are how is population to be controlled and by whom.
In the twenty-first century it would be irresponsible not to exercise a control of the number of pregnancies a woman has. In the distant past, women had very little control over this aspect of their bodies. Women today wish to assert that control; one would hope that women would attempt to reach mutual consent with the prospective father. One would also hope that the artifice used would be consistent with a humanizing expression of sexual love.
Similar to death, sex is natural but human sexuality is not; it is an historical, imaginative, artistic, ethical, religious and artificial transformation of animal biology. The human race will be the poorer if a connection between sexual activity and the beginning of human life is ever entirely severed. But the human race discovered at an early stage what every teenager discovers, namely, that sexual activity is a pleasure, an important part of life that needs integration with the rest of life.
When the Catholic Church recognized the need for the control of birth it looked for a way to protect the integrity of sexual activity. If it had been more imaginative it might have joined the call for better artifice to regulate pregnancy. Condoms do not do violence to the body but they are a primitive technology that does not aid the expression of love and they have a significant rate of failure. The human race had made little progress in the method of birth control since Roman times.
Having quietly admitted that birth control is indispensable, the Catholic Church came up with a principle that every act of intercourse had to be open to conception. The principle makes no sense. It is based on a remnant of medieval biology together with an unwillingness to accept sexual activity as a good, even it is a good that requires discipline in one’s life. The principle of open to conception when applied to a married couple in their sixties is an obvious fiction. If sixty-year olds can choose to express their love sexually without any reference to pregnancy, why cannot thirty-year olds?
The church could have lent its voice to protesting against sexual violence. For example, the U.S. Supreme Court in 1927 made one of its most disgraceful decisions in Buck v. Bell. The Court upheld a state’s right to sterilize anyone that it deemed “unfit.” Justice Oliver Wendell Holmes, Jr. illogically pronounced that “the principle that sustains compulsory vaccinations is broad enough to cover cutting the Fallopian tubes.” The lone dissenting vote was that of Pierce Butler, the one Catholic on the Court. Although liberal critics of Butler’s dissent thought he was opposing progress, he understood that this particular form of artificial birth control deserved condemnation. Justice Butler gave the Catholic Church an opening for distinguishing among forms of birth control and condemning those that violently intrude on natural processes.
On May 11, 1960, the FDA announced approval of the birth control pill. The person most associated with the project was Dr. John Rock, a devout and conservative Roman Catholic. He was determined to convince Catholic leaders that this pill was their way out of an increasingly indefensible position. Rock insisted that the pill was “an adjunct to nature,” that it worked by extending the “safe period,” a method recognized by the church. He was wrong about exactly how the pill worked but he had the right principle that the Catholic Church could have worked with. His book, The Time Has Come, was a plea to Church leaders to come over to his side but there was no give.
The Catholic Church missed the opportunity to rethink its past teaching. Since the Church had accepted the need for birth control and the Pope had said that the pill did not violate nature, the pill would seem to be acceptable. Of course it is “artificial” but that is irrelevant. If the Church’s main concern had been violence to the reproductive system of women, it might have listened to medical research and supported women’s demands for a safer pill for women (or men), that is, a pill clearly in nonviolent accord with the human body’s nature. The Catholic Church could have staked a claim that it was defending life, including the integrity of sexual relations. Instead, the Church removed itself from any debate about improving the means of contraception. There was an explosive reaction against the pill in 1970 by women who were angry that its side effects had been hidden from them. Fifty percent of women stopped taking the pill in the 1970s.
Within the Catholic Church, a hopeful sign in the summer of 1964 was Pope Paul VI’s appointment of a committee to advise him on the issue of birth control. The Pope did stack the deck with conservative Cardinals who seemed safely on the side of digging in their heels. There were only two women in the nineteen person committee. As the committee continued its discussions there were leaks to the public that it was moving toward advising the pope to revise church teaching. And in fact, the committee did move from being almost unanimously against admitting change to almost unanimously acknowledging the need for change.