Contraception / ivf

CONTRACEPTION & NON-THERAPEUTIC STERILIZATION

• HUMAN SEXUAL INTERCOURSE

• 2 DIMENSIONS OF SEXUAL INTIMACY

• CONTRACEPTION / DIRECT STERILIZATION

• BIOETHICAL ANALYSIS

• PRINCIPLE OF DOUBLE EFFECT

• ECTOPIC PREGNANCY / CANCEROUS UTERUS

• BRIEF HISTORY OF THE PILL

HUMAN SEXUAL INTERCOURSE, UNIQUE:

• PHYSICAL LEVEL

• PSYCHOLOGICAL LEVEL

• SPIRITUAL LEVEL

Mammals: intercourse (mounting) -> naturally essential for achieving fertilization

In animals, strictly for reproduction (not face-to-face)

Unitive and Procreative Dimensions of Married Love

unitive: bonding, the blending, the intertwining that occurs between spouses
in the mutual expression of their love

The human call to love is universal

unique to marital love is the physical sexual intimacy,
which has radical implications

first implication: married couple, unlike any other familial or friendship love,
share their naked bodies

Human nature: nakedness does not belong between people who have not made
a mutual life-long commitment

Ex: when a spouse shares that nakedness with someone other than his or her spouse,
and the other spouse finds out, a deep sense of betrayal sets in

Human nature: sexual intimacy be exclusive because,
alongside with the physical intimacy there comes also a spiritual intimacy
that “seals” those two souls in a very unique and abiding way

Ex: sharing daily experiences,
which molds the couple into a new reality that was not there before,
and could not be there even if each individual went through the same experience alone

second implication: spiritual intimacy,
the spiritual intercourse that also happens when the physical intercourse
is honestly lived and properly understood

Unitive significance of marriage = new reality, double bonding
―physical & spiritual―

mutual surrender: 2 naked bodies + 2 naked hearts (Gn 2,24-25)

flows natural desire to make that bond fruitful,
with nothing less than creating a new human life = procreative significance

Mammals: intercourse -> naturally essential for achieving fertilization

However, humans don’t reproduce; we procreate

Human intercourse: 2 dimensions are inseparable (complex unity) ex, coin

Regarding the procreative dimension, however,
what is inseparable from the unitive dimension is not so much
the actual begetting of a child,
but rather the desire for doing so

Whether the children actually happen or not,
that’s up to the Author of life, the Creator of life

CONTRACEPTION & STERILIZATION

Definition

sexual intercourse only within valid marriage

intentional avoidance of having children without serious reason

“default” position in human sexual intercourse is the desire for having children

For grave reasons, it is justified to try to avoid conceiving:

• finances
• relocation
• emotional instability
• medical
• many other children
• etc.

mature and honest conscience is required for determining what serious reasons are

Various Methods of Artificial Contraception

3 categories: mechanical, chemical and surgical (or combo)

Mechanical:
• male and female condom
• cervical sponges and caps
• Diaphragms
• intrauterine devices (IUD)

Chemical:
• synthetic estrogens and progestins (oral Pill, “minipill”)
• injectable doses
• subdermal patches

Surgical:
• vasectomy (men)
• tubal ligation (women)
• hysterectomy (women)

In theory, some surgical sterilizations are reversible;
in practice much depends on what type of surgery was done,
how long ago, and even fiscal considerations

Some contraceptives are also abortifacient,
such as the IUD and possibly the Pill

POSSIBLE ABORTIFACIENTS:

“MORNING AFTER” PILL (PLAN B)

CONTRACEPTIVE PILLS

IUD

Effectiveness, Risks and Side Effects

Most claim success rates 97% ~ 99%

assumes perfect and consistent use, which seldom is the case with humans

risks:
• blood clots
• Cancer
• high blood pressure
• Depression
• etc

side effects:
• Nausea
• Vomiting
• Dizziness
• Headaches
• vaginal infections
• abdominal pain
• irregular bleeding or “spotting”

The Catholic bioethical analysis of contraception is not based on its risks or side effects

• diminished desire for sexual activity
• weight gain
• increase or decrease in acne
• appetite changes
• tender breasts
• increase or decrease in body hair
• vaginal discharge
• bone density loss
• ectopic pregnancy

Moral Evaluation: Means and Ends

2 dimensions to marriage: unitive and procreative

• The unitive dimension involves the generous mutual love expression
of the spouses

• The procreative dimension involves their openness to having children
in each act of sexual intercourse

• If either one of these two dimensions is truncated,
the marital act is not truly and fully human

Intrinsic Evil

Contraception: introduces a radical separation ÷ unitive <-> procreative

Unitive love w/o procreative love

• even unitive: truncated, defective, pseudo-unit

• act of selfishness and/or of fear (conscious or subconscious)

• betrays a lack of trust in God’s Providence for that couple

Today’s lifestyles = much control over our daily decisions;
the more control we have, the further control we want to have

engendering a new human being = God is in control

The role of the couple is to cooperate with God in creating that new life

The couple is given the gift and privilege of being co-creators with God

God decides

God intends: intimate sexual act of husband and wife

love-giving
simultaneously

life-giving

Contraception frustrates all this

UNFAIR DYNAMICS OF ARTIFICIAL CONTRACEPTION:

• LIBIDO DIFFERENTIAL

• TURNS SEXUAL INTERCOURSE INTO ENTERTAINMENT

• BURDEN ON THE WOMAN

• PROMOTES CONTRACEPTIVE MENTALITY IN SOCIETY

• SEXUALLY TRANSMITTED DISEASE (STD) EXPOSURE

2,334,382 TOTAL CASES IN 2017 ALONE

TOTAL US POPULATION 2017 = 325,700,000

~ 1 IN EVERY 14 AMERICANS HAS AN STD

US STD EPIDEMIC:

STDs in U.S. 2017 Reach Record Highs (CDC website)

• Chlamydia = 1,708,569
• Gonorrhea = 555,608
• HIV = 38,643
• Syphilis = 31,562

Bad Medical Practice

contraception and sterilization seek to render a healthy organ inoperative

Thus contraception, honestly speaking, goes against sound medical practice: mutilation

contraception = act of arrogance against God’s created plan

Alternative: develop a deep trust in God’s Plan and Providence

The Church calls God’s Plan and Providence for a married couple a VOCATION

Therapeutic sterilization justified for serious medical reasons

PRINCIPLE OF DOUBLE EFFECT

good
act -> 2 simult effects

bad

conditions:

1. the act to be done must be good in itself or at least morally indifferent
(independently of its consequences)

2. the good effect must not be obtained by means of the evil effect
(evil an incidental by-product, not an actual factor in the accomplishment of the good)

3. the evil effect must not be intended for itself but only permitted
(evil desire not permitted)

4. there must be a proportionately grave reason for permitting the evil effect

5. Last resort (no other action w/o evil effect available)

All five conditions must be fulfilled. If any one of them is not satisfied, the act is morally wrong.

ECTOPIC PREGNANCY:

REMOVAL OF TUBE W LIVE UNBORN OK (SALPINGECTOMY)

REMOVAL ONLY OF LIVE UNBORN NOT OK (SALPINGOSTOMY)

CANCEROUS REPRODUCTIVE SYSTEM w PREGNANCY:

THERAPY AND/OR HYSTERECTOMY OK (DOUBLE EFFECT)

BRIEF HISTORY OF THE CONTRACEPTIVE PILL:

MARGARET SANGER (1879-1966):
6th of 11 siblings (18 pgs), nurse @ 20, suffragist, eugenicist, absol control over repr, utilitarian

GREGORY PINCUS (1903-1967): Biologist, Harvard, Hormones; progestins

JOHN ROCK (1890-1984): OB/GYN, Harvard, Catholic, Clinical Trials

CLINICAL TRIALS: Enovid; Puerto Rico, Haiti, Mexico, Los Angeles

FDA APPROVAL: 1957 menstrual regulator, 1960 contraception

PAPAL COMMISSION:
Pope John XXIII 1963 (6 members), Pope Paul VI (72 members) report 1966

HUMANAE VITAE (POPE PAUL VI, 1968): 2 dimensions, intrinsic evil, serious reasons, NFP

http://w2.vatican.va/content/paul-vi/en/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae.html

IVF, Assisted Reproductive Technologies and Human Embryos

The short answer is: no.

Expensive and burdensome:

physically
psychologically
socially
spiritually

To what purpose? “To have a child”

“To have a child”

@ 2 levels:

• superficial

• deeper

No child may be “had,” possessed; an object, a thing

Rather, a gift from God

Catholic teaching: having a child is only ethical
within the context of a valid marriage.

Automatically excludes all other possibilities:

• non-married couples
• married woman becoming pregnant by sperm from a donor
• single woman becoming pregnant by sperm of a donor
• woman carrying a pregnancy for another woman

Within a valid marriage:

2 central issues: 1. unitive / procreative dimensions together

2. responsible parenthood

Unitive / procreative: like 2 sides of a same coin

Does not mean that each time a couple has intercourse…

“…for grave motives…” (Humanae vitae 10)

In a sense, IVF is the converse of contraception:

contraception is unitive without procreative

IVF is procreative without unitive

In other words, in IVF, the unitive is
radically separated from the procreative
such that “procreation” occurs in the lab (manufacture).

Now, 2 aspects of human procreation:

• a natural act

• a vital act

We just don’t have a right to change natural, vital acts
that involve the species as a whole (natural selection).

Specifically, in order for human procreation to be ethical,
the sperm must fertilize the egg in the proper place,
that is, in the ampulla of the Fallopian tube (in vivo).

Ampulla

Endometrium

DAY 1

DAY 7

In other words, we have no right to take out a human egg,
collect sperm, and mix them in a lab (in vitro).

We can do it (technologically)

We may not do it (ethically)

Aside from this consideration of principle,
which makes IVF intrinsically evil,
there are a number of considerations of practice.

Considerations of practice:

• Risk to women due to ovarian hyperstimulation and egg extraction

• Typical sperm collection by masturbation

• Abortions due to failed implantations

• Abortions due to freezing and thawing of embryos

• Creating and feeding the problem of ~ 1 million frozen human embryos

• What to do with frozen embryos when parents divorce

• Denying the child and the species natural selection

•Selective reduction

Spontaneous abortions and miscarriages:

• 25-50% of all human pregnancies

• Most within the first couple of weeks of pregnancy

• Most due to genetic defects

We just do not have a right to negate natural selection to a child
at such an early stage that it is not even painful
either to himself or his mother

Double right to natural selection:

• at the individual & family level

• at the social level

Bottom line: human procreation is extremely complex:

Physically: as banal as tight shorts
as complicated as one or both spouses having Down syndrome

Psychologically: low % of pregnancy resulting from rape vs general rate
“infertile” couple getting pregnant shortly after having first child

Socially: blanket acceptance of IVF
one million “spare” embryos

Spiritually: “having a child” for the right reasons: gift from God

No one has a “right” to a child;

yes, a right to desire children,
but not at all costs ($ 20 ~ 30 thousand)

So, for infertile couples: perhaps assist, but ultimately:

Reflect on the apparent silence of God
in this aspect of their marriage
at this particular time.

God can speak volumes in His silence…

Therefore, pray, with an open heart, with humility, accepting Divine Will

In view of the Incarnation, all human life is an act of Divine Will:

Therefore, surrendering to Divine Will, in the married couple,

is especially redemptive and sanctifying, for all society.

Divine Will in the married couple: an extension of their wedding vows:

“to be true to you in good times and in bad,
in sickness and in health;
to love and honor you
all the days of my life.”

Nowhere does it say there: we have to have a child at any cost.