The Pope, condoms, and the principle of double effect

While I was at ETS, some of our ThM students were discussing theological ethics and the principle of double effect (PDE), a way of thinking through complex moral situations in which a single act has both a negative and a positive consequence. (See Chris Smith’s post on Double Effect and the Ethical Dilemma.) Since I was not able to participate in the discussion, and since I don’t want to look stupid in front of my students, I thought it would be a good idea for me to work on my own understanding of this principle. So, it was with interest that I dug into a recent post by Katie over at the Women in Theology, arguing that the Pope’s recent statements about condom use can be analyzed using PDE.

By now, you’ve probably heard about the upcoming book in which Pope Benedict XVI apparently condones the use of condoms in certain situations, particularly when used to prevent the spread of HIV/AIDS among prostitutes. At first glance, this seems rather surprising given that for Catholic theologians, condom use necessarily results in the bad effect of separating the the sexual act from its unitive and procreative act. Although this is an unpopular position in modern culture, this view underlies the traditional Catholic rejection of contraception in general. But, as the Pope has pointed out, condom use also has the intrinsically good effect of preventing the spread of a deadly disease. Thus, we have a situation in which a single act (condom use) will result in both a good effect (preventing disease spread) and a bad effect (separating the sexual act from its divinely intended purposes).

To determine whether PDE applies to this scenario, we must see if the scenario meets the following conditions:

  1. The Nature of the Act: The act in question must be at least a morally neutral act (i.e. it cannot be an intrinsically bad act).
  2. Means-End: The bad effect  cannot be the means by which the good effect is accomplished.
  3. Right-Intention: The bad effect cannot be that which is intended by the actor.
  4. Proportionality: The good effect must be equivalent to or greater than the corresponding bad effect.

And, as I see it, the condom-use scenario meets all four conditions.

  1. The Nature of the Act: It seems to me that even for Catholic theologians, condom use is a morally neutral act. In and of itself, using a condom has no moral consequences (e.g. using it as a water balloon). It is one  particular result of using a condom (preventing conception and, consequently, separating the sexual act from its procreative function) that is instrinsically wrong.
  2. Means-End: As in most PDE scenarios the good effect and bad effect are inseparable. Wearing a condom during the sexual act (assuming that the condom does not malfunction) necessarily results in both consequences. But, it seems clear that the bad effect in this situation is not the means for accomplishing the good effect – i.e., a person does not seek to separate the sexual act from its intended purposes as a means to preventing the spread of a deadly disease. The two consequences are inseparable, but the one is not the means for accomplishing the other.
  3. Right-Intention: This is critical. For this situation to come under PDE, the actor must intend the good effect and not the bad one. So, in this scenario, the person using the condom must intend to stop the spread of a deadly disease and not to prevent procreation.
  4. Proportionality: The benefit of preventing the spread of a deadly disease must outweigh the drawback of separating the sexual act from its procreative function. As with most PDE scenarios, there is a strong element of subjectivity in this final step. But, it is certainly not obvious that this scenario violates this condition.

So, it would seem to me that this scenario is amenable to analysis using PDE. And, the Pope’s conclusion seems warranted, assuming that you agree with the application of condition 4 and the use of PDE in general.

That is my best attempt to explain how PDE works and how it applies to a situation that most Protestants would not necessarily see as involving a significant moral quandry. But, it demonstrates how PDE might be applied to other scenarios with more existential angst for us. And, it also highlights some of the weaknesses of the approach: the often opaque appeal to intentions, an ambiguous understanding of what qualifies as an “act”, and the necessarily subjective judgment required by the proportionality condition. At the same time, though, I like the way that PDE forces us to acknowledge how difficult it can be to make moral judgments in the midst of a broken world in which sometimes there are no “right” answers.

    About Marc Cortez

    Theology Prof and Dean at Western Seminary, husband, father, & blogger, who loves theology, church history, ministry, pop culture, books, and life in general.

    Posted on November 23, 2010, in Philosophical Theology, Th.M. Program and tagged , , , , , , . Bookmark the permalink. 9 Comments.

    1. Marc, I guess I would have to disagree with your assessment, in several ways.

      1. nature of the act: while you are considering the use of condoms morally neutral, you neglect to address the context in which the Pope is discussing this: prostitution. I think I can make a fairly conclusive argument scripturally that using a prostitute’s services constitutes an act that is not morally neutral, and is in fact intrinsically bad. (something which I would expect to remain uncontested, at least by visitors of this forum) Thus the nature of the act here isn’t using a condom, but rather using a prostitute’s services.
      2. Means-end: while the condom provides the means by which the spread of disease is prevented (good) it is in the pursuit of a bad end: using a prostitute’s services
      3. Right-intention: Even if you disagree with my redirection as seen in points 1 & 2, from the Roman Catholic view, the person using the prostitute’s services (assuming male “customer” female prostitute) is in fact the intent to prevent pregnancy as well as to prevent the spread of disease. Therefore, this fails the PDE conditions on this point.
      4. We have to ask the difficult question: does preventing the spread of disease outweigh the negative of facilitating and encouraging prostitution? (of course we could also bring this home to the American Church and simply modify the question and say teen pregnancy instead of prostitution)

      Here is where I would make a hard departure from the Pope’s view, and in doing so reveal my protestant affiliation. I would posit that the use of condom’s in a marriage relationship in Africa as acceptable. In this we have to acknowledge that there are many people suffering from HIV/AIDS through no moral failing of themselves in any way (rape victims, child abuse, children born with HIV, non-sexual transmission, etc).
      1. Nature of the act: marital relations are morally good and right.
      2. Using condoms as the means to prevent the spread of disease from one spouse to another is the good, with the bad being the prevention of conception.
      3. Right-intention: this scenario might fail here anyway, depending on how one views contraception for the purpose of prevention. Is it ok to prevent the conception of a child when there is guarantee they will be born with AIDS?
      4. Proportionality – same question here.

    2. Thanks for the response, Tim, but I’m going to have to disagree significantly. And, I think the fundamental disagreement is about the nature of the act in question. You suggest that this is really a discussion about visiting a prostitute. And, you rightly note, that such an act is inherently wrong and, consequently, not subject to PDE. Indeed, it would be absurd to try since it is the act of having sex with a prostitute that caused the occasion for spreading the disease in the first place. So, there’s no point in asking whether the good of preventing a disease offsets the bad of seeing a prostitute.

      So, I’d go back to arguing that the specific act in view is the use of a condom. The context for that act is one of prostitution, but prostitution is not the act in question. (I realize that may sound like a fine distinction, but being clear on the act in view is important in this kind of discussion.) If it were, we wouldn’t be having this discussion because no one involved in the conversation thinks that prostitution is a morally neutral act.

      I actually think you demonstrate some ambiguity in your own analysis when you suggest at the end that the choice is between preventing disease and “encouraging prostitution.” That last clause itself suggests that you have some other act in mind (using condoms) that is distinguishable from the act of prostitution itself.

      So, I do think that the act in question is the use of a condom and that the good and bad effects should be analyzed accordingly (preventing disease and separating sex from its divine purposes). Thus, the Pope’s argument is that using a condom in a situation in which disease could be spread is justified despite this negative consequence. He would, of course, argue that it is far preferable not to be having sex in a situation where disease could be spread. That is not debatable. But, it is also not a part of this particular discussion. That is a separate moral issue.

    3. Before I take up disagreement with Marc on the next post I wish to provide the except from the Papal interview which has triggered the discussion and also a website that gives official Vatican clarification so we can argue from the data.

      ROME, NOV. 22, 2010 (Zenit.org).- Here is an excerpt from German journalist Peter Seewald’s book-interview with Benedict XVI titled “Light of the World:”

      Seewald: On the occasion of your trip to Africa in March 2009, the Vatican’s policy on Aids once again became the target of media criticism. Twenty-five percent of all Aids victims around the world today are treated in Catholic facilities. In some countries, such as Lesotho, for example, the statistic is 40 percent. In Africa you stated that the Church’s traditional teaching has proven to be the only sure way to stop the spread of HIV. Critics, including critics from the Church’s own ranks, object that it is madness to forbid a high-risk population to use condoms.

      Benedict XVI: The media coverage completely ignored the rest of the trip to Africa on account of a single statement. Someone had asked me why the Catholic Church adopts an unrealistic and ineffective position on Aids. At that point, I really felt that I was being provoked, because the Church does more than anyone else. And I stand by that claim. Because she is the only institution that assists people up close and concretely, with prevention, education, help, counsel, and accompaniment. And because she is second to none in treating so many Aids victims, especially children with Aids. I had the chance to visit one of these wards and to speak with the patients. That was the real answer: The Church does more than anyone else, because she does not speak from the tribunal of the newspapers, but helps her brothers and sisters where they are actually suffering. In my remarks I was not making a general statement about the condom issue, but merely said, and this is what caused such great offense, that we cannot solve the problem by distributing condoms. Much more needs to be done. We must stand close to the people, we must guide and help them; and we must do this both before and after they contract the disease. As a matter of fact, you know, people can get condoms when they want them anyway. But this just goes to show that condoms alone do not resolve the question itself. More needs to happen.

      Meanwhile, the secular realm itself has developed the so-called ABC Theory: Abstinence-Be Faithful-Condom, where the condom is understood only as a last resort, when the other two points fail to work. This means that the sheer fixation on the condom implies a banalization of sexuality, which, after all, is precisely the dangerous source of the attitude of no longer seeing sexuality as the expression of love, but only a sort of drug that people administer to themselves. This is why the fight against the banalization of sexuality is also a part of the struggle to ensure that sexuality is treated as a positive value and to enable it to have a positive effect on the whole of man’s being.

      There may be a basis in the case of some individuals, as perhaps when a male prostitute uses a
      condom, where this can be a first step in the direction of a moralization, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants. But it is not really the way to deal with the evil of HIV infection. That can really lie only in a humanization of sexuality.

      Seewald: Are you saying, then, that the Catholic Church is actually not opposed in principle to the use of condoms?

      Benedict XVI: She of course does not regard it as a real or moral solution, but, in this or that case, there can be nonetheless, in the intention of reducing the risk of infection, a first step in a movement toward a different way, a more human way, of living sexuality.

      The Vatican’s Clarification can be found at:
      http://press.catholica.va/news_services/press/vis/dinamiche/a6_en.htm

    4. The ethical problem is not whether the use of a condom can be morally justified. The ethical problem of condoms in the Roman Catholic Church consists only in their contraceptive effect. Since there can be no contraception in anal intercourse, there can be no ethical problem with condoms in this case; the only problem is anal intercourse itself and the consequences of STI’s.

      The Pope uses “lawful therapeutic means” (H. Vitae) of condom use while moving toward the end of appropriate sexual expression, he call it humanization. That is the moral issue.

      So contrary to Marc’s position, there is no change in the Moral teaching of the Church in this case, just progressive Roman Catholic theologians who are looking for a flaw in Magisterial authority to argue for the broad use of contraception. From an accused crypto-catholic -small c-, “it ain’t gonna happen;-)

      • Jerome, thanks for the response. I probably should have been clearer in the post that my main purpose really wasn’t to engage the Pope’s comments themselves, but to use the situation as an opportunity to reflect on the principle of double effect. So, I didn’t take the time to lay out more specifically that I was only engaging on part of the situation. After the Pope made these comments, one Vatican official indicated that the comments were not intended to be limited just to situations involving male prostitutes, but would apply to those involving female prostitutes as well. That latter possibility is what raises the issue of contraception and seemed like such a radical departure from prior Catholic teachings. So, as you can see in my post, I chose to focus narrowly on the latter situation.

        Also, maybe I mis-spoke in my post, but I actually was not arguing that there was a change in Catholic moral policy. If my understanding of the argument is correct, it would only support the use of condoms in certainly narrowly, prescribed situations. And, more importantly, it’s not an argument in favor of contraception at all. It’s only an argument that the evil of contraception (in Catholic theology) can be counterbalanced by relevant goods in certain contexts. So, I don’t see how my argument involves a change in Catholic theology, even if it discusses an application of that theology in ways that surprised people at first. (More recent statements from the Vatican have tried to clarify that no fundamental change was intended.)

        I probably should have brought the idea of “humanization” into the post, since it was fundamental to the Pope’s comments. But, I don’t see how that affects my argument at all. If anything it strengthens it since it adds another good consequence of condom use into the scenario.

        Mostly, though, I was just looking for an excuse to engage the principle of double effect and this seemed like a good and relevant opportunity.

    5. Marc: Thanks for the clarification. Maybe I am just missing the point of your argument. I am suggesting that that the use of a condom with a male prostitute for the proportionately grave reason of avoiding HIV infection does not have a possible secondary effect of contraception nor does it fall within the contours of the other three rules for PDE. The PDE is not what is being argued in P. Benedict’s very carefully chosen example; rather, it is the issue of intention, a first step of being “morally responsible.”

      In the ethical discussion, Benedict emphasizes the immorality of “the sheer fixation on the condom” as “banalization of sexuality.” He statement removes confusion of equating an instrument of means of responsibility, the condom, with the good-responsible intention of sparing the male sex partner HIV infection in a context where pro-creation is impossible. Some like progressive Roman Catholic moral theologians in Association of Teachers of Moral Theology are trying to make this argument applicable to good-responsible intention of avoiding conception for proportionately grave reasons, like the financial constraints of the poor. My sense is that this is where your argument goes. I just don’t see the moral analogy or equivalence in contexts.

      May I add one of my favorite quotes from a RC moralist in in a global Roman Catholic moral theology discussion group that I am a part of? It really is my personal theological sentiment in this discussion? It is as follows:

      “A thought I had yesterday, after hearing and preaching upon the magnificent hymn about Christ in the reading from Colossians 1: How in the world did we ever get to the point that the headline-grabbing message from the Church that is the Body of Him Who brought reconciliation and peace through the blood of His Cross to a place where our message has to do with condoms?” Selah!

      • I don’t think that’s where my argument goes for two reasons. First, as I (unsuccessfully) tried to explain in my previous comment, I wasn’t addressing the use of a condom with a male prostitute at all. I realize that was the context of the Pope’s comments. But, a Vatican official indicated later that day that the Pope also said that his position could be extended to include situations with a female prostitute. That’s where the question of contraception comes up. Now, it’s entirely possible that this was never the Pope’s intent; I’m just going off of what the other Vatican official indicated. They’ve put out quite a number of comments and clarifications since then, and I haven’t tried to follow all of them. So, if they have since retracted that statement and are now saying that the Pope’s comments would not include situations where contraception might be an issue, that would certainly change things. But, when I wrote this, that’s not what they were saying. So, the situation I wanted to discuss was specifically the use of a condom where contraception would be involved.

        Second, although the shape of my argument would be applicable to other situations involving contraception, I disagree that the same conclusion applies. One would still have to argue that the good consequence in other situations (e.g. alleviating poverty) outweighs the bad consequences involved in contraception. The Catholic Church has consistently rejected such arguments and they could continue to do so consistently even if the argument above holds.

    6. Let’s look at your argument:

      “we have a situation in which a single act (condom use) will result in both a good effect (preventing disease spread) and a bad effect (separating the sexual act from its divinely intended purposes).”

      and let’s for example use the notion of an HIV infected male in a now monogamous Christian marriage relationship. If I were Roman Catholic, sexual relations has two points which I think ought to be biblically considered for validity by all Christians:

      (1) conjugal love (with)
      (2) an openness to pro-creation

      Are these moral norms biblical and binding for a sexual act to be moral? If not, PDE might apply and I concur with yhour reasoning. If so, then would abstinence be the norm in that marriage situation rather than exposing the woman to a deadly disease? PDE would not apply because the 1st criterion of PDE is not met. Perhaps the use of the HIV vaccine and then sex without contraceptives would be a better option.

      What is also raised in this question is your notion of just what the structure of the human act might be.

      Exactly,what entails the notion of the “structure of a human act” in particular is it merely the execution of the material act alone?

    7. Correction: Actually after rethinking the “If not,” there is no reason for using PDE, contraception (not abortafacients) can be used at will without moral culpability.

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