So, Let’s Talk About – Condoms and AIDS Prevention

Is it really true that Pope Benedict’s approval of condoms to prevent the transmission of HIV/AIDS is backed by very traditional teaching of Augustine and Aquinas? James Heffernan, writing at Huffington Post, seems to think so. First, he refers to Aquinas on the validity of self-defence, and  asks, does this imply that condoms are justifiable in AIDS prevention, as self-defence against infection?

In the 13th-century Summa Theologica, perhaps the greatest of all treatises on Roman Catholic doctrine, Saint Thomas Aquinas says that one may lawfully kill an assailant in self-defense. In such cases, says Aquinas, one’s action has a double effect: killing another and saving one’s own life. “Therefore, this act” he says, “since one’s intention is to save one’s own life, is not unlawful, seeing that it is natural to everything to keep itself in being as far as possible” (ST II-II, Qu. 64, Art 7).

If Aquinas says it is “NOT unlawful” to kill in self-defense, could he possibly say it IS unlawful to use a condom in self-defense, as a means of protecting oneself against fatal infection, or one’s partner from such infection?

St. Thomas Aquinas (c. 1225-1274), the eponym ...

St Thomas Aquinas (Fra Angelico)

Heffernan recognizes that the answer is no. This is not what the pope said, or implied – he was referring to the moral value of a decision to reduce the danger of passing on infection to others, not to self-interested reducing danger for oneself. However, there are important issues that this question raises. Heffernan’s purpose here is to highlight the consternation and alarm among some conservative bishops and commentators following the publication of the interview extracts, who have been emphasising just how limited the Pope’s remarks were, and how they do not point to any kind of moral relativism on Benedict’s part – although they fear that we may be now headed in that direction:

… the eyes of Catholic conservatives, Benedict has just put us on the slippery slope to moral relativism and secular values or, according to one Catholic blogger, opened a Pandora’s box of new evils. Oh my. Even when the pope himself is at the wheel, Catholic conservatives cannot bear the slightest detour from what they take to be the high road of absolute truth.

The point is that those who are so agitated about the dangers of “relativism” are themselves guilty of it. Claiming that the Church demands we be “pro-life” in all circumstances, without exception, they denounce all forms of contraception and abortion whatever the circumstances, and demand excommunication for politicians and others who condone, permit or practice abortion.  Yet these same fierce advocates for life do not make the same argument in denouncing war (or, for that matter, the death penalty).

If you deplore the Pope’s tolerance for contraception, and if you also think the church should excommunicate all Catholic politicians who oppose re-criminalizing abortion, why do you not also think the church should excommunicate any Catholic politician who tolerates the killing of civilians in Afghanistan, who isn’t out there on the hustings demanding that such killings be criminalized?

The second theological principle quoted by Heffernan in support of the use of condoms as an AIDS preventive, is that of “the lesser evil”, first enunciated by Augustine,  and later quoted by Aquinas to promote the legalization of prostitution. This, says Aquinas, is clearly a moral evil – but laws to permit it can be supported as preventing a greater evil:

But guess what? He (Aquinas) also thought civil authorities should tolerate it. And for backup on this point, he quoted Augustine. “In human government,” Aquinas wrote, “those who are in authority rightly tolerate certain evils, lest certain goods be lost, or certain evils be incurred: thus Augustine says [De Ordine 2:4]: ‘If you do away with harlots, the world will be convulsed with lust.'” (Summa Theologica 2-2.10.11).

Let’s be very clear: Pope Benedict did not “approve” the use of condoms for anyone, prostitutes or anyone else, not even to prevent the transmission of HIV/AIDS. All that he did concede, in his extremely cautious and limited observation, was that for a prostitute, the use of a condom could represent the awakening of some moral awareness – and so could be the lesser of two evils. The fascination of this for me,  has been not in the words or their meaning directly, but in the widespread and confused reaction over their implications.

The conservatives have been alarmed, and quick to stress (as I do) that there was no “approval” of condoms. They are undoubtedly right. They are also right to be alarmed. The importance of the words that have been so widely quoted lies not in their direct meaning, but on the impact they will have, which will be profound.  Words have a power that goes way beyond their immediate and direct sense. These words of Benedict will have an impact and a heritage that goes way beyond their basic meaning. Most people do not pay close attention to the precise nuances of theological discourse, nor do they read every word of papal pronouncements for a full understanding of detail and context. Rather, they remember what they have read and what they have heard, not what was said. What they will remember, is that Pope Benedict has approved the use of condoms to prevent HIV/AIDS.

Beyond the public understanding, there will also be an impact in more formal Church discourse. The simple consideration of the circumstances of the hypothetical prostitute raises the importance of considering the context in which moral decisions are made. For far too long, “moral relativism” has been a term of theological abuse. It is not. As Heffernan’s observations have shown, it is unavoidable. Killing another human being is agreed to be an absolute evil, which is abhorrent in all cases – except in self-defence. War is another unmitigated evil, always to be deplored – unless it is a “just” war, to avoid even greater destruction.

Abortion is an absolute evil, unless…. unless what? And even if we agree that it is wrong in all circumstances, does this mean that secular law must prohibit it in all cases, or should legislators allow safe clinical procedures to avoid dangerous back street abortions as the lesser of two evils, just as Augustine and Aquinas opposed prostitution, but argued in favour of its acceptance in civil law?

Contraception, says the Church, is likewise an absolute evil as it prevents life, unless…… unless what?

The great thing about Pope Benedict’s non-approval of condoms is that it is opening up for discussion a widely known and widely discredited part of orthodox Catholic teaching that has been largely ignored in public discourse.  On the more progressive side of the ideological divide of the Church, some other commentators have also been quick to claim that the Pope’s thinking is not new, but for quite different reasons – that the more nuanced view has been widely promoted for years by some theologians, and that gradualism is an essential component of the development of Catholic theology. This may be so, but the theologians who have been saying so have hardly been allowed any public exposure for their thinking: Bishop Kevin Dowling of Rustenburg (South Africa) was quickly shot down when he argued publicly for a more thoughtful Church response to condoms as part of the fight against AIDS. When Fr Thomas Reese, as editor of America magazine,  published a piece arguing this case, he was forced to relinquish his post.

A chief reason for the conservative distress — and the extended media coverage of the pope’s comments — is that Benedict himself, when he was Cardinal Joseph Ratzinger and the longtime guardian of doctrine for the Vatican, had fought hard against any invoking of casuistical reasoning in dealing with the AIDS epidemic.

For instance, Cardinal Ratzinger strongly disapproved of a 2000 article published in America magazine, a Jesuit weekly, that argued that there was a “moral consensus” among Catholic theologians that condoms could be used to fight the spread of H.I.V.

When Cardinal Ratzinger was elected pope in April 2005, the editor of America, Father Thomas Reese, was forced to resign in part for publishing that piece. And just last year the Vatican acknowledged it had shelved a formal study on the morality of condom use to fight AIDS out of concern that issuing a pronouncement would cause more confusion than clarity.

New York Times


What will change now, is the greater visibility of the more nuanced view – and greater public discourse.

So, let’s engage in this public discussion. Let’s talk about condoms, and about contraception – in Catholic orthodoxy, and in reality.

In the Seewald interview,  Benedict protests than on HIV/AIDS, his in-flight remarks on his way to Africa were “provoked” by a particular journalist, and overshadowed the rest of his observations. But here is the crux of the matter: he insists, now as then, that condoms “alone” have done nothing to combat the spread of AIDS. There are three major problems with this:

  • It is factually incorrect. Globally, the rate of new infections has fallen dramatically. This is directly attributed by the professionals of the AIDS agencies to the take-up of condoms. The one region where there has not yet been a conspicuous fall, is sub-Saharan Africa. This is also the one region where there is widespread popular resistance to the use of condoms. It is true that condoms have not slowed the spread of AIDS in Africa as a whole – because they have not been used. In the handful of African countries where they have been more widely adopted, as in Uganda, the rate of new infections has indeed dropped, just as in the rest of the world.
  • His reference to condoms “alone” is ingenuous. No credible agency anywhere is arguing that condoms alone are a solution to anything. Rather, the argument is that condoms are one component in a multi-pronged strategy, also including abstinence and monogamy. They are also the only viable strategy for “sero-discordant” married couples, where one partner is infected and the other is not.
  • Benedict’s argument against condoms, that they have not stopped the spread of infection in Africa, can be more validly applied to the Church’s own reliance on Church teaching. There is no evidence from anywhere that church teaching, “alone”, has done anything at all to prevent the spread of HIV. For sero-discordant” married couples, the orthodox teaching of complete abstinence is particularly harsh.
  • Benedict insists that the Catholic church has done more than any other organisation in the fields of AIDS prevention and treatment. On treatment, he is undoubtedly correct. The work of the Church in dealing with people with AIDS, their families and their communities is impressive and fully deserves widespread acknowledgement and praise. His claim on prevention is decidedly shaky. The Church’s strategy for prevention is based on little more than teaching abstinence. Is there any evidence whatever that the teaching is being followed in numbers sufficient to counter the negative impact of the parallel opposition to condoms?

Now I want to turn my attention away from abstract principles, to a very specific context. Pope Benedict spoke of one very precise scenario, that of a prostitute who uses a condom to avoid transmitting a virus. This is one of very limited relevance to most ordinary Catholics, and concerns a person who is already operating well outside the bounds of Catholic sexual orthodoxy. I want to set against this a very different scenario, one which is directly relevant to many millions of people, attempting to live within Catholic teaching.

In many regions of Africa, as many as a quarter to a third of all adults are infected with HIV.  Many of these people are married. Some of the spouses have been likewise infected, but some have not. Unlike the rich Western countries, affordable management and treatment is not yet widely available, and infection continues to result in high mortality rates. What are the as yet uninfected spouses to do?

Fully orthodox Catholic doctrine recognizes the importance of the unitive value in marriage of sexual love, alongside the procreative value. Should the HIV negative spouse deny any possibility of this unitive benefit in a relationship that will already be under strain as a result of the disease? If this is the decision taken, I must also ask a further question. If the supposed evil of contraception lies in its preventing the possibility of the male sperm being united with a female egg in conception, in what sense is a couple more open to procreation by preventing this union even more absolutely, by not releasing the male sperm in the first place? Is total abstinence truly “pro-life”?

Or should the HIV negative spouse accept the benefits of conjugal love, bravely accepting the very real risk of infection and probable ensuing death, all in the name of being open to life? In what way is exposing oneself to the risk of death, “pro-life”?

Forced to choose between two undesirable alternatives, which really is the lesser of two evils?

In the real world, many millions of Catholic married couples who have to face these issues as life or death decisions, and not as idle questions of abstract sexual ethics, know the answers. So do their wise and compassionate pastors. It is high time that the theologians who have been saying so, we are now told, “for years”, should now be given greater encouragement and a stronger public voice – and fears of the “slippery slope to moral relativism” be swept aside.

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