Reply to the Usual Claims on Birth Control for Medical Reasons

Those who claim that the intrinsically evil acts of using abortifacient contraception while sexually active is moral for a medical reason usually make the same set of grave moral errors. A list of those errors, with the correct understanding, follow.

1. They ignore the fact that the type of birth control pill being discussed is an abortifacient, and that the Catholic spouses own prenatal children can be reasonably anticipated to die as a result of using this pill while remaining sexually active.

2. They ignore the fact that the medical effects can be obtained without the deaths of the innocent prenatals by refraining from sex while using the birth control pill (BCP).

3. They incorrectly cite the principle of double effect (PDE). This principle never justifies intrinsically evil acts. The first step, in determining if the PDE applies is to determine if the act is intrinsically evil. It is a foolish error in ethics to claim that an act can’t be intrinsically evil because the PDE applies. That is backwards.

Use of abortifacient contraception while sexually active deprives the marital act of its procreative finality, and, when the pill fails to prevent ovulation (~20% of the time, per cycle), it deprives an innocent prenatal of life by causing an early abortion. The contraceptive and abortive ends of the act make this choice intrinsically evil and always gravely immoral.

4. They claim that the deaths of the Catholic spouses’ own unborn children is justified as an unintended side effect. That is false for a few reasons.

First, these deaths are entirely avoidable, while still obtaining the medical benefit, by refraining from marital relations. Grave harm to innocent life is never justified as if it were an unavoidable bad consequence, when it is in fact easily avoidable.

Second, the good and bad consequences in the third font of morality (circumstances) have moral weight regardless of whether or not they are intended. A bad intention weighs in the first font (intention). A bad consequence weights in the third font, even if it is not intended.

Third, the spouses are deliberately choosing to engage in marital relations and deliberately using an abortifacient pill, so the deaths of their own unborn children are a result of these intentional choices. You cannot use abortifacient contraception and justify the intentional choice of that intrinsically evil act by reference to a good intention (or the lack of a bad intention). Intrinsically evil acts are immoral regardless of intention or circumstances.

5. When a person intentionally chooses to commit an intrinsically evil act, such as abortion or contraception, the choice is termed “directly willed” because the deliberately chosen act is directly ordered toward its evil end, in this case, contraceptive and abortive ends. The intentional choice of the disordered act makes the act intrinsically evil, regardless of the intended end (the purpose for which the act was chosen).

For example, when an act of direct abortion (directly killing the prenatal) is chosen for the medical reason of saving the life of the mother, it is an intrinsically evil act, despite having a good medical purpose (the intended end, to save the mother’s life). In another example, the medical purpose of relieving severe suffering in a dying patient does not justify the intrinsically evil act of euthanasia.

The intention to use an abortifacient contraceptive pill for a medical purpose does not change the act from intrinsically evil to morally defensible. The use of abortifacient contraception while sexually active is always wrong.

6. The PDE never justifies an intrinsically evil act, so the use of abortifacient contraception while sexually active cannot be justified by that principle. But, in addition, the PDE never justifies an act where the reasonably anticipated bad consequences morally outweigh the reasonably anticipated good consequences. In this case, the reasonably anticipated bad consequences are the deaths of innocent prenatals, as the couple continue to use abortifacient contraception and have marital relations. The good consequence is merely the treatment of a medical disorder, one that is not even life-threatening. And, those good consequences can be obtained without the bad consequence (of killing one’s own unborn children) by refraining from sex. So in no way is the PDE a justification for this choice.

7. Humanae Vitae 15 does not justify this use of abortifacient contraception.

“15. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from — provided such impediment is not directly intended for any motive whatsoever.”

The deliberate choice of any intrinsically evil act is always considered to be “directly intended”. This expression does not refer to the intended end, but to the intentional choice of an intrinsically evil act, since all intrinsically evil acts are directly related to their evil moral object.

Humanae Vitae makes this quite clear in other places. Contraception is condemned “whether as an end or as a means.” Contraception is a means to a good end, when the intention is not to contracept, but to obtain some medical benefit. But a good intended end does not justify the means. The CCC teaches this same point: “Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception).” (CCC 2399).

Humanae Vitae also condemns “all direct abortion, even for therapeutic reasons,” thereby excluding the use of abortifacients for a medical purpose.

Humanae Vitae 15 only applies when the intentionally chosen act is not intrinsically evil, for example when a hysterectomy treats a severe medical disorder and then results indirectly in sterilization.

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

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