Janet Smith’s grave errors on Contraception and Sterilization

In a new article, Did Paul VI approve of Congo nuns using the Pill? Does it matter if he didn’t?, Catholic theologian Janet E. Smith continues to assert certain grave errors on contraception and abortion. See my previous post: Janet E. Smith’s grave errors on Abortifacient Contraception.

In her new article, Smith clarifies her previously stated position (seeming to give obtuse reply to my criticism) by specifying her approval for “anovulant or non-abortifacient contraceptives” in cases of rape. Then she again states approval for this type of chemical contraceptive, on a continuous basis, for a “nuns in the Congo” situation (i.e. women in danger of future rape). She notes that the Church permits chemical contraceptives in cases of rape, in a Catholic hospital emergency room, if it is first determined that the woman has not yet conceived — in other words, if it is first determined that the chemical contraceptive will only act as a contraceptive, and not as an abortifacient, in the case at hand.

My position is that mere contraception, used in cases of rape, is indirect, as it is morally an interruption of the rape. The deprivation of the procreative meaning is indirect. A Catholic hospital emergency room may even use abortifacient contraception, in cases of rape, if the physician is morally certain that the chemical will not act as an abortifacient in that particular case.

The problem with Smith’s position, though, is her approval for chemical contraceptives, on a continuing basis, to defend against rape in advance. In such a case, there can be no determination as to whether the chemical will act as an abortifacient. Contraception is moral in cases of rape, but abortion is not. How does Smith address this difficulty in her ethical position? By a common modern-day technique in ethics: disingenuous labeling. She states that the chemical contraceptives are “anovulant or non-abortifacient contraceptives,” when in fact they are abortifacient contraceptives. In the hospital ER, as a one-time use intervention, it might be determined with moral certitude that the particular use is not abortifacient, but only contraceptive. But as an intervention in a “nuns in the Congo” situation — constant use of abortifacient contraception pills in anticipation of possible future rape — no such determination is possible. Therefore, if a woman is raped in such a situation, the abortifacient contraception might cause an abortion, rather than acting as a contraceptive.

So by her disingenuous labeling of chemical contraceptives as “non-abortifacient”, she is giving implicit approval for the use of abortifacient contraception, on a continuing basis, in anticipation of possible rape. Does Smith know of a chemical contraceptive that never acts as an abortifacient? If so, she should state which chemical contraceptives fit that description. I know of no such birth control pill which is only contraceptive, and never abortifacient.

Pregnancy rates for actual use of oral contraceptive pills (OCP) are about 5%, and breakthrough ovulation rates can go as high as 20% [Gardner, Ph.D. and Miller, M.D., Journal of Women’s Health, Vol. 14, n. 1, 2005]. Many factors affect whether breakthrough ovulation occurs, including stress, disturbances in sleep schedule, skipping doses or not taking the pill at the same time every day, other medications taken at the same time, and other factors. Morally, we cannot assume that every woman using abortifacient contraception will have “perfect use” and therefore obtain the lowest possible rate of breakthrough ovulation (which is never zero).

Direct abortion is not justified, even for the high medical purpose of saving the life of the mother. Similarly, abortifacient contraception is not justified for the lesser medical purpose of interrupting the progress of the rape toward conception. Abortifacient contraception is intrinsically evil and always gravely immoral, even in cases of rape. For the abortive death of an innocent human person in no way defends against rape.

In addition to having a gravely immoral object, abortifacient contraception is gravely immoral due to the circumstances. The reasonably anticipated bad consequence of the death of an innocent human person greatly outweighs any good consequences. And what is the good consequence of killing an innocent prenatal conceived by rape? Is it that the mother has less of a psychological burden? But abortion has proven to be a weighty psychological burden for many women. Is it that the woman is relieved of the burden of having to raise an unplanned child? Children can be difficult and troublesome, but they are also a great joy. So in the circumstances of the use of abortifacient contraception in cases of rape (when the medication acts as an abortifacient), the act is gravely immoral under both the font of object and the font of circumstances.

Abortifacients for a Medical Purpose

In her previous article, which she has not yet retracted or corrected, Janet Smith approves of “therapeutic use of hormones”, which she also terms the use of “the contraceptive pill”, for the treatment of medical conditions. Again, she ignores the abortifacient action of this medication. She also errs by assuming that the couple will continue having sexual relations. She treats this decision, to have sex while using an abortifacient, as if it were not even subject to the moral law.

She justifies all this by saying: “In the terminology of the principle of double effect, they are using hormones in pursuit of the good effect of reducing pain and, as a secondary effect, they are tolerating the infertility caused by the hormones they are taking.”

To the contrary, the principle of double effect NEVER justifies an intrinsically evil act. And these euphemistically termed “hormones” are an abortifacient, the effects of which include the deaths of innocent prenatals — the longer the medication is taken, the high the risk and the higher the number of deaths. Yet Smith does not weigh this effect in the consequences at all. She justifies the use of abortifacient contraception by pretending that it is mere contraception.

In the consequences of the act, certainly the good of treating a medical disorder is outweighed by the deaths of innocent prenatals. And this is particularly true because the good effects of the treatment can be obtained without any deaths, by simply refraining from sex while taking the medication. But sex has been exalted, in the minds and hearts of many Catholics, almost as if it were a god to be worshiped. Even the suggestion that a married couple refrain from sex for a period of time is treated with contempt and ridicule. It is unthinkable for many Catholic theologians to even consider the possibility of suggesting that some married couples refrain from sex. The influence of sinful secular society on present-day moral theology is doing great harm to souls.

As for the moral object of the act, Smith ignores this font entirely. I’ve read tracts by her which evaluate proposed acts based on a lengthy analysis of the moral object. But in her most recent two articles, there is no mention of object. She justifies abortifacient contraception by reference to the “new font” discovered recently by ethical researchers: appeal to obscure, possibly non-existent documents, private conversations, and claimed unwritten approvals. If someone at the Vatican approved of abortifacient contraception in cases of a possible future rape, or approved of direct sterilization for the same reason, that has no effect on the eternal moral law. Smith has fallen into the modern-day ethical practice of ignoring the definitive teaching of the Magisterium on the three fonts of morality and on specific acts, and substituting the prevailing opinion among Catholic theologians and authors.

If a married woman can use abortifacient contraception for a medical purpose, and continue to have marital relations, how many women qualify for such use? I’ve read many articles and posts, each proposing that this use is moral, and NONE of them consider that the medical disorder must be of grave weight. They propose abortifacient contraception for use if a woman’s cycle is irregular, or is more painful than usual, or for a wide range of other reasons. They even propose abortifacient contraception for the purpose of preventing pregnancy in women who are undergoing cancer treatment.

Begin Sarcasm. Why of course a husband can’t be expected to stop having sex with his wife just because she is going through chemotherapy. We must not anger the sex gods by abstaining from marital relations just to keep innocent prenatals from being killed. What devout Catholic married couple would not be willing to kill their own children in the womb so that they can keep having sex? And what faithful Catholic theologian would refuse to provide that couple with clever theological rationalizations, to justify abortion in the service of sex? Don’t worry, you theologians who publicly approve of killing innocent prenatals with abortifacient contraception. God will certainly REPAY you when you go to your reward. End Sarcasm.

Did you know that the use of chemical contraceptives can decrease a woman’s risk of ovarian cancer? The risk reduction for women who have ever used the oral contraceptive pill (OCP) versus never-users is 27%. And the risk reduction for women who have used OCPs for 10 years or more is greater than 50%. Both those figures have high statistical significance. [Havrilesky et al., Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis; Obstetrics and Gynecology, Vol. 122, n. 1, July 2013.]

If a woman is justified in using abortifacient contraception for any substantial medical purpose — while remaining sexually active — then all women would be justified in taking abortifacient contraception, despite the deaths of innocent prenatals. For the reduction in risk of ovarian cancer is a substantial medical purpose. How many prenatals are killed by abortifacient contraception in present-day society? Certainly millions are killed, given the high rate of use of the OCP and the rate of breakthrough ovulation with actual use (as opposed to perfect use). The death toll could conceivably be in the tens of millions or hundreds of millions.

And yet the justification of abortifacient contraception, while sexually active, is joyfully proclaimed, very loudly, by many Catholic theologians, authors, and commentators. They do not weigh the deaths of the innocent in the consequences of the act, and they do not consider the grave immorality of the object of the act. Some pretend that abortifacient contraception is mere contraception. Others openly admit that the deaths of innocent prenatals will result, and yet they justify those deaths in various ways.

Germain Grisez

Janet Smith cites Germain Grisez as an example of a “faithful theologian”, and she links to his online book “The Way of the Lord Jesus”, specifically to the section on contraception here. In that section, Grisez errs gravely by claiming that the intrinsically evil act of contraception is based on the end willed by the person. Grisez does not mention the moral object in this section of his book.

But the Magisterium teaches (Veritatis Splendor, CCC) that intrinsically evil acts are wrong due to an evil moral object, regardless of intention or circumstances. Any intrinsically evil act is always knowingly intentionally chosen. But what makes the act inherently wrong is the ordering of the chosen concrete act toward its object, independent of the intention of the subject. The intentional choice of certain kinds of behavior is always wrong. By choosing any concrete act (the act in a particular case), you are also always choosing, at least implicitly, its moral nature and its moral object. You cannot choose any “end” (object) you wish, and then associate that willed end with any concrete behavior. Every knowingly chosen act has a moral nature, good or evil, determined by the end toward which the act itself is inherently directed, regardless of intention or circumstances.

Grisez claims that contraception is not “a pattern of outward behavior”, but is based on intention. And this incorrect definition of contraception allows him to claim that “some outward performances which usually are ways of contracepting can be chosen for other reasons”. In other words, an intrinsically evil act of contraception is transformed, by a change of intention (the reason for choosing the act), into “not contraception” — despite having the same evil moral object.

By taking this position, Grisez clearly rejects the teaching of Veritatis Splendor that the intentional (willful, deliberate, knowing) choice of certain kinds of behavior is what constitutes an intrinsically evil act:

“49. A doctrine which dissociates the moral act from the bodily dimensions of its exercise is contrary to the teaching of Scripture and Tradition. Such a doctrine revives, in new forms, certain ancient errors which have always been opposed by the Church, inasmuch as they reduce the human person to a ‘spiritual’ and purely formal freedom. This reduction misunderstands the moral meaning of the body and of kinds of behaviour involving it (cf. 1 Cor 6:19). Saint Paul declares that ‘the immoral, idolaters, adulterers, sexual perverts, thieves, the greedy, drunkards, revilers, robbers’ are excluded from the Kingdom of God (cf. 1 Cor 6:9). This condemnation — repeated by the Council of Trent — lists as ‘mortal sins’ or ‘immoral practices’ certain specific kinds of behaviour the wilful acceptance of which prevents believers from sharing in the inheritance promised to them. In fact, body and soul are inseparable: in the person, in the willing agent and in the deliberate act, they stand or fall together.”

If you willfully (knowingly, intentionally, deliberately) choose an intrinsically evil type of act, then no intention or purpose or circumstance or effects can make that choice moral. You have chosen to do what is evil before the eyes of God.

Now in the same book cited by Smith, Germain Grisez openly rejects magisterial teaching against direct abortion to save the life of the mother. And he approves of partial birth abortions. Grisez claims that it is moral for a physician, when a child’s head is too large to allow for birth, to perform “an operation in which instruments are used to empty and crush the head of the child so that it can be removed from the birth canal….” [section 3. d.] Grisez admits that this and other types of actions to save the life of the mother are considered direct abortion. But he approves of these abortions nonetheless.

Janet Smith thinks that Germain Grisez is a faithful Catholic theologian. I think that he is guilty of formal cooperation with direct abortion, and that his teachings on ethics are gravely harmful to body and soul. And Smith herself is guilty of formal cooperation with abortifacient contraception, as well as direct sterilization (see below).

Contraception and Rape

No one seems to notice that both rape and contraception are intrinsically evil acts. All intrinsically evil acts have a common structure: the knowingly chosen concrete act is ordered toward an evil moral object. This ordering toward evil makes the concrete act evil by its very nature. Therefore, the knowing (intentional, deliberate, voluntary) choice of that disordered act is always a sin.

No one seems to notice that if contraception is justified on the basis of intention or circumstances or anything else, then every other intrinsically evil act, including rape, adultery, other sexual sins, abortion, murder, theft, and genocide would all be justifiable on the same basis. Every intrinsically evil act works the same way. The act is always wrong to knowingly choose because the act is wrong by the very nature of the concrete act, regardless of the intention (or purpose), circumstances, or consequences of the act.

If any intrinsically evil act, even a single venial lie, is justified by reference to intention or circumstances, then every other intrinsically evil act would also be justifiable in the same way: rape, adultery, other sexual sins, murder, abortion, euthanasia, and genocide. No matter how clever and socially-acceptable a justification for lying or contraception or abortifacients may be, it necessarily implies that all other intrinsically evil acts can be justified in the same way.

For example, if you claim that an act which deprives sex of its procreative meaning is only the sin of contraception when accompanied by a contraceptive intention, then you imply that every other intrinsically evil act is only that type of act when accompanied by the matching intention. But is it really true that genocide is only genocide if you have a genocidal intention? Of course not. The objection to this argument is “no one is claiming that genocide is ever justifiable”. Sure, but under Catholic moral teaching EVERY intrinsically evil act is never justifiable. And when you contradict that teaching by finding a way to justify ANY intrinsically evil act, you implicitly imply that EVERY intrinsically evil act is also justifiable in the same way, including: genocide, murder, abortion, and many other intrinsically evil sins.

This argument is not merely theoretical. Notice the example above from the writings of Germain Grisez. He defines the intrinsically evil act of contraception based on intention, dissociating the bodily act from its inherent moral meaning. And what does he say about abortion? He justifies partial birth abortions in which the physician directly crushes the skull of little innocent children. Such an act is certainly the direct killing of an innocent. But having severely perverted the basic principles of ethics on intrinsic evil, Grisez has no trouble offering a justification for this crime against humanity. Once you start down the road of cleverly rearranging the teaching of the Church on intrinsic evil and the moral object, exceedingly grave sins become justifiable.

But moral theologians today have quietly divided intrinsically evil acts into two types: popular and unpopular. For the popular sins, they have devised all manner of clever rationalizations, rearranging the terminology and meaning of magisterial teaching, so as to justify those sins as much as possible. And then for the unpopular sins, these are condemned as they should be: intrinsically evil and always gravely immoral.

Direct Sterilization

In this new article, Smith adds yet another grave moral error: the approval of surgical sterilization as a defense against possible future rape. The basis for this approval is a “response of the CDF in 1975 to a query of the US bishops about surgical sterilizations” and a claimed private conversation with a Vatican official in 1980, all of which is taken from a book by Fr. Bayer called “Rape Within Marriage” (1987). Smith’s position is morally problematic for several reasons.

First, it ignores the definitive magisterial teachings against direct sterilization. This is the new trend in moral theology. Ignore Veritatis Splendor, Evangelium Vitae, Familiaris Consortio, and the Catechism of the Catholic Church. Cite a claimed private conversation, or a supposed (possibly non-existent) non-magisterial approval by a Pope or some Vatican official — and then conclude the act is justified. The hypocrisy is that none of the theologians, apologists, and authors who use this approach would accept, on the same basis, any teaching or decision with which they disagree. It is only treated as definitive if they like the outcome of the decision.

Direct sterilization is intrinsically evil and always gravely immoral. Contraception in cases of actual rape is indirect. But Smith presents no theological argument that sterilization, used in advance of rape, is indirect. The obscure reference that she gives does not offer us a single paragraph nor even one whole sentence from the claimed document.

A hysterectomy to treat a serious medical disorder is indirect sterilization, and therefore not intrinsically evil. But when has the Magisterium ever approved of a hysterectomy to treat a serious medical disorder that has not yet occurred, but may occur in the future? The chosen act, to remove the uterus of a woman who has no medical problem does not directly treat any disorder. The act sterilizes the woman as the sole proximate end of the chosen action. The possible future aversion of a medical disorder of the uterus is only in the circumstances. In other words, the end of preventing a medical disorder occurs only subsequent to, and as a result of, the sterilizing act. Therefore, it is direct sterilization, which is intrinsically evil.

Moreover, sterilization is not in any sense a defense against rape, let alone a defense against the mere possibility of a future rape. When a woman seeks treatment at a Catholic hospital for rape, does any medical professional consider permanently sterilizing the patient, to prevent conception? Mere contraception is moral, as a post-rape intervention, since prevention of conception is morally an interruption of the rape. But sterilization, in advance, is not a moral interruption of the rape. The chosen act is ordered toward depriving the human body of its natural fecundity. The intention to prevent pregnancy, if rape occurs in the future, is an intended end and is in the circumstances. The moral object is neither the intended end, nor a circumstance; it is the end toward which the chosen act is ordered, by its very nature. Sterilization for the purpose of preventing conception, in case a rape occurs in the future, is direct and therefore intrinsically evil.

Smith’s approval for sterilization in cases of rape is disturbing. She does not give sufficient explanation to show that the act is indirect and moral. She concludes that the act is moral based on a claim, in a book from 1987, that the CDF, in 1975, and a Vatican official in 1980, approved of surgical sterilization for cases of rape. She ignores the question of the moral object. She does not weigh the possible good and bad consequences of the act. She does not weigh the loss, temporary or permanent, of the procreative meaning.

Edited to add: The 1975 Document

Here is a link to the 1975 document cited by Bayer and Smith:
Responses To Questions Concerning Sterilization In Catholic Hospitals, and it’s Latin text.

That document expressly calls the use of sterilization with “the sole immediate effect of rendering the generative faculty incapable of procreation” as “absolutely forbidden”, despite “any subjectively right intention of those whose actions are prompted by the care or prevention of physical or mental illness which is foreseen or feared as a result of pregnancy”. This magisterial document stands in clear opposition to Smith’s claim that sterilization can be used in order to prevent conception due to a possible future rape.

It also stands in opposition to her claim that the Magisterium has never condemned contraception outside of marriage. The English translation and the Latin text have no mention of marriage or any form of the word “conjugal” (in Latin or English). For this magisterial document concerns Catholic hospitals, who might be treating persons who are sexually active outside of marriage. The text condemns contraception and sterilization of “freely chosen sexual activity” (libereque electam activitatem sexualem), also phrased as: “sexual actions deliberately performed” (actuum sexualium … deliberate admissorum).

Rape is not freely chosen by the victim; it is not a deliberate act of the victim. Nevertheless, the document does condemn sterilization with “the sole immediate effect of rendering the generative faculty incapable of procreation”. The intention of averting a future possible bad consequence (conception from rape) is not accepted by the Magisterium as a justification for sterilization.

So the magisterial document cited by Smith contradicts her position on two important points.

Summary

The procreative faculty is integral to human nature, and is of high value. It should not be lightly cast aside, temporarily or permanently. Rape only justifies a one-time (or short-term) intervention, to prevent conception as a moral interruption of the rape. The mere possibility of a future rape does not justify sterilization, nor the constant use of abortifacient contraception.

Mere contraception is justifiable in cases of rape only because it is indirect. It is not justified because the sexual act was non-marital, or because the woman lacks a contraceptive intention, or because the circumstance is dire. Is contraception moral in cases of rape because it is a type of self-defense? That claim is only true if self-defense is explained in terms of the moral object, and not exclusively in terms of intention and/or circumstances.

Abortion is not justified in cases of rape. Abortifacient contraception is a type of abortion, as well as a type of contraception, so it is not justified in cases of rape — unless the physician can be morally certain that, in the particular one-time use, it will only act as a contraceptive.

If any unborn children are killed by abortion or abortifacients because of Germain Grisez’s words, then he is morally responsible for those deaths. If any unborn children are killed because of Janet Smith’s approval for abortifacient contraception, which she disingenuously calls “non-abortifacient contraceptives”, then she is morally responsible for those deaths. This issue is not merely theoretical: innocent vulnerable lives are at stake.

Rape is a terrible crime which causes lasting harm to the victim psychologically, in addition to any physical harm. Rape is intrinsically evil and always gravely immoral. But intrinsically evil acts are never justified by intention or circumstances.

How many innocent unborn human persons have been killed by surgical abortions? The number certainly exceeds one billion. And how many more have been killed by the hidden type of abortion called abortifacient contraception? The number is certainly in the millions, and may be in the hundreds of millions. Abortion is a type of genocide, and abortifacients are a method of abortion. Whosoever approves or justifies any form of direct abortion or abortifacients is guilty of formal cooperation with that type of genocide called abortion.

The current trend in moral theology is to seek every possible rationalization and excuse to distort, ignore, or radically reinterpret the definitive teaching of the Magisterium on intrinsically evil acts, especially acts pertaining to sexuality. As a result, many false ideas are being spread among the faithful. How much harm will be done to the unborn and to the souls of misinformed Catholics, before the Magisterium reaffirms its teaching on intrinsically evil acts?

by
Ronald L. Conte Jr.
Roman Catholic theologian and translator of the Catholic Public Domain Version of the Bible.

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