Re: Scrupulosity or doing what's right?

[Guest guest]

With the availability of the vaginal contraceptiveRing which is inserted a left for three weeks, the Depoprovera shot which is given every 3 months the contraceptive rods inserted subQ every few years I don't think daily versus weekly Versus monthly versus yearly " decision" making would Modify culpabilityLes RuppersbergerSent from my iPhoneOn 2012-06-07, at 11:04 AM, " E. " <k.e.miller@...> wrote:

,

Interesting thought. It seems reasonable – I think I need to kick it around in my mind for a while.

I would want to interpret ‘non-negligible’ in a moral as distinguished from scientific sense – i.e. I would go back to the point that moral (morally adequate) certainty isn’t necessarily identical to scientific certainty (again – whatever one ends up concluding about the merits of Austriaco’s scientific argument – I’m quite convinced he’s right about that philosophical/theological point).

In any case – and here I’m thinking (doing the “kicking it around in my mindâ€) out loud – I think that one needs to remember that even when something is a “side effect†– in Aquinas’ Latin, praeter intentionem – “beside the intention†– not intended as end or means (the “or means†is important and plays a key role in distinguishing this from, say, proportionalism) – this does not mean that the effect is not in any sense ‘willed.’ At minimum – in doing X which will have (praeter intentionem) effect Y – one is not willing to prevent Y – one is perhaps even willing to ‘allow’ Y.

Thus – on the one hand – a praeter intentionem effect doesn’t have (nearly) the same moral relevance as does an intended (end or means) effect. Under the right conditions, we may (permissibly) allow something as a side-effect that it would be morally unacceptable to intend (as end or means).

On the other hand – there do need to be the right conditions – having to do with things like the degree of goodness/importance of the intended (as end) effect relative to the degree of badness/importance (as I’ve suggested before, I think “importance†would include probability of actual occurrence) of the praeter intentionem effect. If the praeter intentionem effect weren’t in any sense willed, then I don’t think that there would be this moral need for “right conditions.â€

So getting back to your suggestion – consider two cases. (1) A woman has a medical treatment for some condition (whatever it might be) that needs to be performed only once – and thereafter will result (praeter intentionem) in some morally significant chance that any given act of sexual intercourse by her could lead to fertilization followed by (elevated) failure to implant. (2) A woman is given a drug for some medical condition that needs to be taken daily – and if and only if she continues to take it, any given act of intercourse by her could (praeter intentionem) lead to fertilization followed by (elevated) failure to implant.

On the one hand – in case (2) there is, daily, a chosen (external) action in which there is a renewal of the will to “allow†the possible abortifacient effect – whereas in case (1) there isn’t.

On the other ... if someone wills to receive/use a one-time treatment for some condition (as in case 1), there is a sense in which the patient (generally, anyhow) would likely continue to will that use/acceptance thereafter – as opposed to (say) concluding that doing so was a mistake. E.g. – I had shoulder surgery last January. Obviously in one sense the choice to have that surgery is now over and done with – it was a choice that I made (past tense) in the several weeks leading up to the operation. But now, I still regard (which is itself a kind of choice) that earlier choice as the right one – I don’t regret it or anything like that – if I could go back in time knowing what I know now (that the surgery would be as successful as possible given my injury but that, given the injury as it was seen more clearly through the arthroscope than it had been seen on X-ray and CT and MRI, this success would nevertheless be only partial and that I’ll need to have a shoulder replacement in possibly just a few years), I would still “do it again.â€

This continuing willing of the surgery may not be the kind of continuing willing that is involved in – say – my willing each night before bed to take an Aleve (for the pain that remains due to essentially advanced arthritis in the joint).

So – if the surgery had brought with it any permanent (and undesired/unintended) “side effects†(it didn’t – my shoulder is better now than it was post-injury and pre-op, though not as it was pre-injury, and nothing about me is in any way worse), my continuing willing to do the thing that caused those side effects – not to prevent them – to “allow†them – might be somewhat different than is, say, my continuing willing to take nightly a drug that has the side effect of some irritation of my stomach.

But how psychologically/morally significant is this difference? I’m not sure one way or the other.

BUT – now consider a couple more cases – different from the ones you suggest, if I’m understanding correctly. (3) A woman undergoes – with a contraceptive intention – some one-time “treatment†(procedure, injection, whatever) that results in permanent “sterility†but that might (i.e. the chance is morally significant) sometimes actually allow fertilization but then prevent implantation. (This might be purely hypothetical – I don’t know of any such treatment but I also don’t know that there is no such treatment.) She then genuinely repents of this decision. She then continues to have marital intercourse with her husband (taking such steps as are possible – if any are – to abstain from intercourse during what might still be the fertile time). (4) A woman takes – with a contraceptive intention – daily OC – knowing (assuming for the sake of argument that this is true) that there is a morally significant risk that this will (following intercourse) sometimes allow fertilization and then cause early abortion. She continues to do this (there is no repentance – which in this case would obviously entail stopping the drug). And she continues to have intercourse.

Would there be a moral difference here? I think so. Even if in case (3) the woman and her husband would not be doing moral evil by continuing to engage in intercourse (I’d need to think still more about that but I also need to do other things right now ... I would say that offhand it seems more likely that this would be sinful vs. the case of the couple who’ve repented of standard surgical sterilization, which doesn’t that I know of have any abortifacient effect), I think it would still be different from (4).

That may or may not be helpful.

From: Bouchard

Sent: Wednesday, June 06, 2012 10:29 PM

Subject: Re: Scrupulosity or doing what's right?

Thank you for a very thorough and thoughtful analysis.

One argument I would make is that unlike sterilization, those using a pill have an ongoing involvement in the process (taking a pill every day) that is rendering them partially-sterile. (It could be argued the IUD is more like sterilization in that it is a single event causing the partial sterility, but unlike it in that it can be easily removed at any time). Even though the contraceptive effect is secondary and in our argument an "unintended" consequence (although some may desire it), I wonder whether the daily involvement (and therefore affirmation of) the process could make someone more culpable IF we were to say that there is a non-negligible abortifacient effect.

Any extra thoughts ?

Thanks,

Bouchard, MD

Family Medicine Resident

University of Calgary

On 2012-06-06, at 10:53 AM, E. wrote:

After thinking about this for a while last night and early this morning, a few tentative (and somewhat verbose) thoughts ...

- When I teach the senior-level Sexual & Medical Morality course, this question sometimes comes up – i.e. what a couple should be advised to do if they’ve been sterilized and have then repented. I answer that (among other things) it seems like a good idea to suggest practicing periodic continence – assuming that getting the sterilization reversed would not be practical (for medical, economic, or any other reasons) – as a way of abstaining from the fruits of one’s past sin, so to speak. I don’t intend to alter this answer in the future.

- I also don’t think I’d want to suggest to a couple or to a priest that this should be regarded as absolutely essential for forgiveness. I agree with that repentance generally involves both a change of heart and a change of actions (and that being genuinely ‘pastoral’ doesn’t entail – is in fact contradicted by – “holding back†regarding the genuine requirements of repentance and virtue). But let’s ask the question – if a couple (either man or woman) undergoes contraceptive sterilization, and doesn’t repent, then what exactly is the nature of their continuing sinful action? Is it something like ‘having marital intercourse during what would otherwise be the fertile time’? Or is it something more like ‘intending the continuing infertility of their acts of marital intercourse during what would otherwise be the fertile time’? In other words – is the sinful ‘action’ more like an external one (the sort of thing we most often have in mind when we speak of ‘action’), or an internal one – a sin of ‘thought’? Obviously the latter kind of sin is possible – some sins are internal sins of thought only – and in the case of such a sin, the change in ‘action’ that’s required when one repents is a change in that internal action of thought.

- Suppose, then, that a couple genuinely regrets that they have done something that results in their acts of intercourse during what would otherwise be the fertile time, being instead infertile. They have been converted in ‘thought.’ They have perhaps even looked into sterilization reversal – or into adoption – though have ascertained (either quickly or after some investigation) that neither of these is likely to work for them (sterilization reversal would not succeed or would not be affordable or whatever – and they would not be regarded by adoption agencies as good candidates for adoptive parenthood). Again – I think that it would still be a good thing for such a couple to practice periodic continence as a manifestation of their repentance – as an act of penance – and also as something that can be good in itself for one’s growth in virtue and in the spouses’ relationship with each other and with God (e.g. – because it involves self-control – a good thing). But I think I’d be somewhat reluctant to conclude that such a couple is simply not repentant in any real/significant sense – and is unable to be forgiven – if they didn’t practice periodic continence. (This point is, I think, basically the same as Steve Koob’s.)

- A “thought experiment†involving a possible analogy: Consider a couple who are of normal reproductive age but who are permanently infertile due to natural causes – not causes that they have in any way brought about (not, e.g., surgical sterilization). Suppose that such a couple are actually happy about their infertility. Perhaps they do not have adequate reason to want to avoid children, but they want to avoid children anyway. Or, perhaps they do have adequate reason, but don’t want to have to bother practicing periodic continence as the means toward avoiding procreation. (Perhaps in the absence of natural infertility, they’d even be contracepting rather than using NFP.) Is there a sin here? I suspect so. Is it a sin primarily of ‘thought’? It seems so to me. What would repentance have to look like? I would say – conversion of their thoughts (the details would depend on the details of the sinful thoughts from which they were converting). Would repentance necessarily have to involve practicing periodic continence? I doubt it. (Would we tell an infertile couple who are from the beginning unhappy about their infertility that they need to practice periodic continence in order to avoid sinning? Again, I doubt it.)

- And getting back to the issue that I think provoked this discussion – i.e., the case of a couple who’re rendered infertile by treatment for a gynecological condition – this seems more like the case of natural infertility than like the case of infertility due to intentional sterilization. I.e. – if a couple are infertile due to hysterectomy to treat uterine cancer – or due to hormonal treatment for something like endometriosis – or whatever similar kind of treatment one might think of (in many such cases, we seem to be dealing with treatments for conditions that would themselves compromise fertility “anyway,†i.e., even if not treated) – then, even to the extent that one would want to counsel periodic continence for a couple who have repented (or whom one is trying to convince to repent) of intentional sterilization – I don’t think it would follow that one would need similarly to counsel periodic continence for the couple infertile as a “side effect†of medical treatment.

- Of course, even if periodic continence wouldn’t be required of such a couple in order to avoid the sin of contraception, there remains the distinct question of whether it should be counseled due to concern that intercourse during part of the woman’s cycle might sometimes lead to fertilization followed by early abortion. I don’t think I have anything to add to what I and others have already said about that – i.e. – I think it depends on factors like a careful analysis of the likelihood of this abortifacient effect (which, again, others need to work out).

From: Kathy Schmugge

Sent: Tuesday, June 05, 2012 3:57 PM

Subject: Re: Scrupulosity or doing what's right?

Perfect ! It is not our job to give the penance or the absolution. If we are asked what we would do in the circumstance we can offer our advice. Letting priests know about the option of periodic abstinence is a great ideas for couples who have beensterilized because it might help the couple heal as suggests. Our diocese is looking at starting a foundation for couples who want to have reversals and can't avoid them as yet another way to respond to the heroic efforts of the couples who regret their sterilization decision. Remember that many couples do these things out of ignorance not defiance or evil intent. Also we should never put the marital act between a repentant married couple in the same boat with sodomy and fornication.

Re: Scrupulosity or doing what's right?

Dominic, I don't know how you or anyone else can say that what I have posited in that chapter goes "beyond what the Church would say pastorally." The ecclesiastical censor rated my opinions as at least "probable" and perhaps "probabilior," i.e., "more probable." There is nothing un-pastoral about telling a couple that if they are repentant and wish they had never had themselves sterilized they should now act as if they had not been sterilized. That is, consider themselves of normal fertility and abstain accordingly.

We are all dealing with the huge problem of what has passed for pastoral theology during the last 43 years -- benign neglect of Humanae Vitae and doing almost nothing to teach it. The Obama birth control mandate simply would not have happened if even 25% to 40% of fertile-age Catholics were not contracepting. And of course, there are some pastors who are already saying and/or will be soon saying that as a matter of pastoral concern we should go along with the mandate.

What was pastorally correct? St. Fisher or his fellow pastors?

Sincerely,

F KippleyNFP Internationalwww.NFPandmore.org"Sex and the Marriage Covenant: A Basis for Morality" (Ignatius)

Re: Medical indications for OCP

"Scrupulosity" begs the question. We first need to assess the presence or absence of true moral responsibility, something quite apart from the question of scruples.Sent from my iPhone

On Jun 3, 2012, at 1:47 PM, rbamer2@... wrote:

You know I understand where you all are coming from and don't disagree but how is this different from say a couple who have obtained sterilization for one of them and then after having a conversion of heart, decides to practice nfp during their "fertile period"? Do we tell them they are overscrupulous?And just a slight clarification with richards correction noted the couple would only have to use a clearblue digital OPK kit which runs less than $20 for box of 20 and she would probably only need a couple of tests per month. No monitor is needed. It would cost $5 per month that way. Still I agree that it may be overscrupulous to recommend this but what an act of obedience by the couple! Blessings

Sent via BlackBerry by AT & T

[Guest guest]

,

I take it that you’d agree that analogies can potentially be helpful – e.g. – you use the adultery analogy below. I think that the question is – what is the best analogy for the case that we’re really trying to think through? I think that the answer to this depends in turn on an analysis of the precise nature of the sin being committed by the unrepentant sterilized couple.

I don’t think that, from the (quite true) statement that repentance entails “I would not do it over again†– or in the specific case of the repentant sterilized couple, that it entails “I wish I were still fertile†– it follows that repentance would entail always practicing periodic abstinence. Plenty of fertile and non-contracepting couples don’t do this – i.e. those who have not discerned that they have a serious reason for avoiding procreation.

I mentioned the possibility that a repentant sterilized couple would look into reversal and/or adoption. Clearly, a couple who sincerely (which doesn’t automatically mean successfully) pursues these options at least might – in the case of adoption, certainly would – be willing to accept children. For such a couple genuinely to wish they were still fertile, would not have to entail then trying to avoid procreation.

I don’t think that “(absolute) moral norm†and “optional pious practice†are necessarily the only options. I think that there is some middle ground. As I said, when I’m asked about this kind of situation, I suggest periodic abstinence (assuming reversal or adoption aren’t practical/successful options), and indeed I suggest it as an especially fitting manifestation of repentance, and I intend to continue making this suggestion to future students and others. But I don’t think I could honestly say that it’s the only possible manifestation of authentic repentance (especially if the couple have sincerely looked into reversal or adoption).

Finally – I fully appreciate (I hope) your concern about the ways in which HV has been undermined – often by silence, even more often by flat-out contradiction. But I just don’t agree that what I and some others here are saying about sterilization/repentance is in any way a downplaying or contradiction of what HV teaches.

From: Kippley

Sent: Thursday, June 07, 2012 12:00 PM

Subject: Re: Scrupulosity or doing what's right?

 The issue of what is required of the repentant sterilized couple can be clouded by all sorts of analogies, but the question remains. Is abstinence during the fertile-time a moral "ought" or simply a suggested pious practice? If we want analogies, consider the couple in an invalid marriage. By the teaching of the Lord Jesus, they are living in adultery. Imagine that the man sincerely regrets leaving his true wife for his current legal spouse. Without getting into all sorts of additional details, the question before him is whether he is morally obliged to live as brother and sister or if such abstinence would just be a pious suggestion.

With regard to contraceptive sterilization, does repentance involve saying to oneself, "If I had it to do over again, I would not do it." To put it the other way, if a person says, "I regret what I did but I would do it over again," is such a person repentant? Regretful is not the same as repentant.

If a person/couple is truly repentant and would not do it over again, then the repentant sterilized person or couple is saying that they wish they were still fertile, and that means that they would be practicing periodic abstinence. That is the moral norm. I'm not saying it is easy to live out the moral norm. It is frequently a daily cross, but that's simply the price of Christian discipleship. Periodic abstinence is no different for the sterilized couple than it is for the couple of normal fertility who think they have a sufficiently serious reason to seek to avoid pregnancy.

The widespread no-abstinence-required "pastoral approach" has reduced the moral norm to an optional pious practice, and the entire teaching of Humanae Vitae has been undermined.

Sincerely,

Kippley

Re: Scrupulosity or doing what's right?

After thinking about this for a while last night and early this morning, a few tentative (and somewhat verbose) thoughts ...

- When I teach the senior-level Sexual & Medical Morality course, this question sometimes comes up – i.e. what a couple should be advised to do if they’ve been sterilized and have then repented. I answer that (among other things) it seems like a good idea to suggest practicing periodic continence – assuming that getting the sterilization reversed would not be practical (for medical, economic, or any other reasons) – as a way of abstaining from the fruits of one’s past sin, so to speak. I don’t intend to alter this answer in the future.

- I also don’t think I’d want to suggest to a couple or to a priest that this should be regarded as absolutely essential for forgiveness. I agree with that repentance generally involves both a change of heart and a change of actions (and that being genuinely ‘pastoral’ doesn’t entail – is in fact contradicted by – “holding back†regarding the genuine requirements of repentance and virtue). But let’s ask the question – if a couple (either man or woman) undergoes contraceptive sterilization, and doesn’t repent, then what exactly is the nature of their continuing sinful action? Is it something like ‘having marital intercourse during what would otherwise be the fertile time’? Or is it something more like ‘intending the continuing infertility of their acts of marital intercourse during what would otherwise be the fertile time’? In other words – is the sinful ‘action’ more like an external one (the sort of thing we most often have in mind when we speak of ‘action’), or an internal one – a sin of ‘thought’? Obviously the latter kind of sin is possible – some sins are internal sins of thought only – and in the case of such a sin, the change in ‘action’ that’s required when one repents is a change in that internal action of thought.

- Suppose, then, that a couple genuinely regrets that they have done something that results in their acts of intercourse during what would otherwise be the fertile time, being instead infertile. They have been converted in ‘thought.’ They have perhaps even looked into sterilization reversal – or into adoption – though have ascertained (either quickly or after some investigation) that neither of these is likely to work for them (sterilization reversal would not succeed or would not be affordable or whatever – and they would not be regarded by adoption agencies as good candidates for adoptive parenthood). Again – I think that it would still be a good thing for such a couple to practice periodic continence as a manifestation of their repentance – as an act of penance – and also as something that can be good in itself for one’s growth in virtue and in the spouses’ relationship with each other and with God (e.g. – because it involves self-control – a good thing). But I think I’d be somewhat reluctant to conclude that such a couple is simply not repentant in any real/significant sense – and is unable to be forgiven – if they didn’t practice periodic continence. (This point is, I think, basically the same as Steve Koob’s.)

- A “thought experiment†involving a possible analogy: Consider a couple who are of normal reproductive age but who are permanently infertile due to natural causes – not causes that they have in any way brought about (not, e.g., surgical sterilization). Suppose that such a couple are actually happy about their infertility. Perhaps they do not have adequate reason to want to avoid children, but they want to avoid children anyway. Or, perhaps they do have adequate reason, but don’t want to have to bother practicing periodic continence as the means toward avoiding procreation. (Perhaps in the absence of natural infertility, they’d even be contracepting rather than using NFP.) Is there a sin here? I suspect so. Is it a sin primarily of ‘thought’? It seems so to me. What would repentance have to look like? I would say – conversion of their thoughts (the details would depend on the details of the sinful thoughts from which they were converting). Would repentance necessarily have to involve practicing periodic continence? I doubt it. (Would we tell an infertile couple who are from the beginning unhappy about their infertility that they need to practice periodic continence in order to avoid sinning? Again, I doubt it.)

- And getting back to the issue that I think provoked this discussion – i.e., the case of a couple who’re rendered infertile by treatment for a gynecological condition – this seems more like the case of natural infertility than like the case of infertility due to intentional sterilization. I.e. – if a couple are infertile due to hysterectomy to treat uterine cancer – or due to hormonal treatment for something like endometriosis – or whatever similar kind of treatment one might think of (in many such cases, we seem to be dealing with treatments for conditions that would themselves compromise fertility “anyway,†i.e., even if not treated) – then, even to the extent that one would want to counsel periodic continence for a couple who have repented (or whom one is trying to convince to repent) of intentional sterilization – I don’t think it would follow that one would need similarly to counsel periodic continence for the couple infertile as a “side effect†of medical treatment.

- Of course, even if periodic continence wouldn’t be required of such a couple in order to avoid the sin of contraception, there remains the distinct question of whether it should be counseled due to concern that intercourse during part of the woman’s cycle might sometimes lead to fertilization followed by early abortion. I don’t think I have anything to add to what I and others have already said about that – i.e. – I think it depends on factors like a careful analysis of the likelihood of this abortifacient effect (which, again, others need to work out).

From: Kathy Schmugge

[Guest guest]

My thoughts go toward women who have Had hysterectomies for valid diseaseOr post menopausal couples - ridiculous I know- But they would not " ought" to abstain at ant timeIt seems more a matter of intent and what is in The heart- if the intent or heart desire is to Not be open to life then there is ongoing Culpability; if not and there is repentance, remorseAnd regret then none. I am a simple Gyn not a theologianBut we all sin. Les RuppersbergerSent from my iPhoneOn 2012-06-07, at 12:00 PM, " Kippley" <jfkippley@...> wrote:



The issue of what is required of the repentant sterilized couple can be clouded by all sorts of analogies, but the question remains. Is abstinence during the fertile-time a moral "ought" or simply a suggested pious practice? If we want analogies, consider the couple in an invalid marriage. By the teaching of the Lord Jesus, they are living in adultery. Imagine that the man sincerely regrets leaving his true wife for his current legal spouse. Without getting into all sorts of additional details, the question before him is whether he is morally obliged to live as brother and sister or if such abstinence would just be a pious suggestion.

With regard to contraceptive sterilization, does repentance involve saying to oneself, "If I had it to do over again, I would not do it." To put it the other way, if a person says, "I regret what I did but I would do it over again," is such a person repentant? Regretful is not the same as repentant.

If a person/couple is truly repentant and would not do it over again, then the repentant sterilized person or couple is saying that they wish they were still fertile, and that means that they would be practicing periodic abstinence. That is the moral norm. I'm not saying it is easy to live out the moral norm. It is frequently a daily cross, but that's simply the price of Christian discipleship. Periodic abstinence is no different for the sterilized couple than it is for the couple of normal fertility who think they have a sufficiently serious reason to seek to avoid pregnancy.

The widespread no-abstinence-required "pastoral approach" has reduced the moral norm to an optional pious practice, and the entire teaching of Humanae Vitae has been undermined.

Sincerely,

Kippley

Re: Scrupulosity or doing what's right?

After thinking about this for a while last night and early this morning, a few tentative (and somewhat verbose) thoughts ...

- When I teach the senior-level Sexual & Medical Morality course, this question sometimes comes up – i.e. what a couple should be advised to do if they’ve been sterilized and have then repented. I answer that (among other things) it seems like a good idea to suggest practicing periodic continence – assuming that getting the sterilization reversed would not be practical (for medical, economic, or any other reasons) – as a way of abstaining from the fruits of one’s past sin, so to speak. I don’t intend to alter this answer in the future.

- I also don’t think I’d want to suggest to a couple or to a priest that this should be regarded as absolutely essential for forgiveness. I agree with that repentance generally involves both a change of heart and a change of actions (and that being genuinely ‘pastoral’ doesn’t entail – is in fact contradicted by – “holding back†regarding the genuine requirements of repentance and virtue). But let’s ask the question – if a couple (either man or woman) undergoes contraceptive sterilization, and doesn’t repent, then what exactly is the nature of their continuing sinful action? Is it something like ‘having marital intercourse during what would otherwise be the fertile time’? Or is it something more like ‘intending the continuing infertility of their acts of marital intercourse during what would otherwise be the fertile time’? In other words – is the sinful ‘action’ more like an external one (the sort of thing we most often have in mind when we speak of ‘action’), or an internal one – a sin of ‘thought’? Obviously the latter kind of sin is possible – some sins are internal sins of thought only – and in the case of such a sin, the change in ‘action’ that’s required when one repents is a change in that internal action of thought.

- Suppose, then, that a couple genuinely regrets that they have done something that results in their acts of intercourse during what would otherwise be the fertile time, being instead infertile. They have been converted in ‘thought.’ They have perhaps even looked into sterilization reversal – or into adoption – though have ascertained (either quickly or after some investigation) that neither of these is likely to work for them (sterilization reversal would not succeed or would not be affordable or whatever – and they would not be regarded by adoption agencies as good candidates for adoptive parenthood). Again – I think that it would still be a good thing for such a couple to practice periodic continence as a manifestation of their repentance – as an act of penance – and also as something that can be good in itself for one’s growth in virtue and in the spouses’ relationship with each other and with God (e.g. – because it involves self-control – a good thing). But I think I’d be somewhat reluctant to conclude that such a couple is simply not repentant in any real/significant sense – and is unable to be forgiven – if they didn’t practice periodic continence. (This point is, I think, basically the same as Steve Koob’s.)

- A “thought experiment†involving a possible analogy: Consider a couple who are of normal reproductive age but who are permanently infertile due to natural causes – not causes that they have in any way brought about (not, e.g., surgical sterilization). Suppose that such a couple are actually happy about their infertility. Perhaps they do not have adequate reason to want to avoid children, but they want to avoid children anyway. Or, perhaps they do have adequate reason, but don’t want to have to bother practicing periodic continence as the means toward avoiding procreation. (Perhaps in the absence of natural infertility, they’d even be contracepting rather than using NFP.) Is there a sin here? I suspect so. Is it a sin primarily of ‘thought’? It seems so to me. What would repentance have to look like? I would say – conversion of their thoughts (the details would depend on the details of the sinful thoughts from which they were converting). Would repentance necessarily have to involve practicing periodic continence? I doubt it. (Would we tell an infertile couple who are from the beginning unhappy about their infertility that they need to practice periodic continence in order to avoid sinning? Again, I doubt it.)

- And getting back to the issue that I think provoked this discussion – i.e., the case of a couple who’re rendered infertile by treatment for a gynecological condition – this seems more like the case of natural infertility than like the case of infertility due to intentional sterilization. I.e. – if a couple are infertile due to hysterectomy to treat uterine cancer – or due to hormonal treatment for something like endometriosis – or whatever similar kind of treatment one might think of (in many such cases, we seem to be dealing with treatments for conditions that would themselves compromise fertility “anyway,†i.e., even if not treated) – then, even to the extent that one would want to counsel periodic continence for a couple who have repented (or whom one is trying to convince to repent) of intentional sterilization – I don’t think it would follow that one would need similarly to counsel periodic continence for the couple infertile as a “side effect†of medical treatment.

- Of course, even if periodic continence wouldn’t be required of such a couple in order to avoid the sin of contraception, there remains the distinct question of whether it should be counseled due to concern that intercourse during part of the woman’s cycle might sometimes lead to fertilization followed by early abortion. I don’t think I have anything to add to what I and others have already said about that – i.e. – I think it depends on factors like a careful analysis of the likelihood of this abortifacient effect (which, again, others need to work out).

From: Kathy Schmugge

[Guest guest]



Les,

The subject of my opinions are people who have had themselves contraceptively sterilized, not those you mention.

K.

Re: Scrupulosity or doing what's right?

After thinking about this for a while last night and early this morning, a few tentative (and somewhat verbose) thoughts ...

- When I teach the senior-level Sexual & Medical Morality course, this question sometimes comes up – i.e. what a couple should be advised to do if they’ve been sterilized and have then repented. I answer that (among other things) it seems like a good idea to suggest practicing periodic continence – assuming that getting the sterilization reversed would not be practical (for medical, economic, or any other reasons) – as a way of abstaining from the fruits of one’s past sin, so to speak. I don’t intend to alter this answer in the future.

- I also don’t think I’d want to suggest to a couple or to a priest that this should be regarded as absolutely essential for forgiveness. I agree with that repentance generally involves both a change of heart and a change of actions (and that being genuinely ‘pastoral’ doesn’t entail – is in fact contradicted by – “holding back†regarding the genuine requirements of repentance and virtue). But let’s ask the question – if a couple (either man or woman) undergoes contraceptive sterilization, and doesn’t repent, then what exactly is the nature of their continuing sinful action? Is it something like ‘having marital intercourse during what would otherwise be the fertile time’? Or is it something more like ‘intending the continuing infertility of their acts of marital intercourse during what would otherwise be the fertile time’? In other words – is the sinful ‘action’ more like an external one (the sort of thing we most often have in mind when we speak of ‘action’), or an internal one – a sin of ‘thought’? Obviously the latter kind of sin is possible – some sins are internal sins of thought only – and in the case of such a sin, the change in ‘action’ that’s required when one repents is a change in that internal action of thought.

- Suppose, then, that a couple genuinely regrets that they have done something that results in their acts of intercourse during what would otherwise be the fertile time, being instead infertile. They have been converted in ‘thought.’ They have perhaps even looked into sterilization reversal – or into adoption – though have ascertained (either quickly or after some investigation) that neither of these is likely to work for them (sterilization reversal would not succeed or would not be affordable or whatever – and they would not be regarded by adoption agencies as good candidates for adoptive parenthood). Again – I think that it would still be a good thing for such a couple to practice periodic continence as a manifestation of their repentance – as an act of penance – and also as something that can be good in itself for one’s growth in virtue and in the spouses’ relationship with each other and with God (e.g. – because it involves self-control – a good thing). But I think I’d be somewhat reluctant to conclude that such a couple is simply not repentant in any real/significant sense – and is unable to be forgiven – if they didn’t practice periodic continence. (This point is, I think, basically the same as Steve Koob’s.)

- A “thought experiment†involving a possible analogy: Consider a couple who are of normal reproductive age but who are permanently infertile due to natural causes – not causes that they have in any way brought about (not, e.g., surgical sterilization). Suppose that such a couple are actually happy about their infertility. Perhaps they do not have adequate reason to want to avoid children, but they want to avoid children anyway. Or, perhaps they do have adequate reason, but don’t want to have to bother practicing periodic continence as the means toward avoiding procreation. (Perhaps in the absence of natural infertility, they’d even be contracepting rather than using NFP.) Is there a sin here? I suspect so. Is it a sin primarily of ‘thought’? It seems so to me. What would repentance have to look like? I would say – conversion of their thoughts (the details would depend on the details of the sinful thoughts from which they were converting). Would repentance necessarily have to involve practicing periodic continence? I doubt it. (Would we tell an infertile couple who are from the beginning unhappy about their infertility that they need to practice periodic continence in order to avoid sinning? Again, I doubt it.)

- And getting back to the issue that I think provoked this discussion – i.e., the case of a couple who’re rendered infertile by treatment for a gynecological condition – this seems more like the case of natural infertility than like the case of infertility due to intentional sterilization. I.e. – if a couple are infertile due to hysterectomy to treat uterine cancer – or due to hormonal treatment for something like endometriosis – or whatever similar kind of treatment one might think of (in many such cases, we seem to be dealing with treatments for conditions that would themselves compromise fertility “anyway,†i.e., even if not treated) – then, even to the extent that one would want to counsel periodic continence for a couple who have repented (or whom one is trying to convince to repent) of intentional sterilization – I don’t think it would follow that one would need similarly to counsel periodic continence for the couple infertile as a “side effect†of medical treatment.

- Of course, even if periodic continence wouldn’t be required of such a couple in order to avoid the sin of contraception, there remains the distinct question of whether it should be counseled due to concern that intercourse during part of the woman’s cycle might sometimes lead to fertilization followed by early abortion. I don’t think I have anything to add to what I and others have already said about that – i.e. – I think it depends on factors like a careful analysis of the likelihood of this abortifacient effect (which, again, others need to work out).

From: Kathy Schmugge

[Guest guest]

I am currently in a session about infertility treatment given by an infertility physician. Any guess what the primary " treatments" being discussed are??? IVF. IUI, ovulation inductionEmbryo growing, "selecting out" those who are not "genetically affected" transfer of appropriate embryos, male or female...So yes, appropriate treatment of all fertility and reproductive system disorders is certainly needed. We on this list though are a very small minority. Like you, I and most of us on this list do not Rx OCP's like water for so called treatments. Many providers ARE NOT AWARE of the testing and evaluation, or the treatment needed for "XYZ", and many do RX OCP'S out of that ignorance. I like the suggestion of a ( referenced!) "cheat sheet" for at least a starting point - if nothing else- for the women to use and take to their physician! Sent from my Verizon Wireless 4G LTE DROID Re: Scrupulosity or doing what's right?

Sorry ..I am at a midwives conference... I was responding to Dr. 's question when I replied about double effect.

While pregnancy/conception is a possibility with OCP use, it does not always or even often happen to the best of our knowledge. When a woman is 100% suffering with a problem and she is unable to obtain an alternative treatment, doesn't the current, real and existing problem outweigh the "possible" conception? And couldn't that be mitigated as well by instructing in the use of fertile signs to avoid conception?

Sandrock CNM

Sent from my Verizon Wireless 4G LTE DROID