Why I'm Pro-Life, Anti-Artificial Contraception and Think That Reproductive Health Bill is Totally Unecessary 9/01/2008 07:06:00 PM

I'm already bracing myself for a lot of violent reactions to this post... I know I'm not the only pro-life physician in this country (I know several others just like me, a few, but I would like our tribe to definitely increse), yet perhaps I will be the lone voice of dissent in this edition of the blog rounds. Do allow me to explain myself though.
Since I was in high school, the issue of contraception has been my pet peeve. I had to write an assigned article, elaborating on the artificial methods of contraception as well as the reason why it was immoral. Pretty hard to digest for a teenager then. But I did get the point of the Church's teaching on it: Separating the procreative and unitive aspect of sex from each other was what made it against the natural law and therefore immoral in itself (the same principle applies to the immorality of doing an in-vitro fertilization procedure, but that's a whole other story).
In college, I once mentioned to a friend (who happenened to be a physician as well) that I had to write a paper on a topic for my ethics class. She suggested that I take it up artificial contraception as using abortion as my topic would be too easy (the act is already banned by our constitution). Thus I found myself reading books that explained why this was so not in terms of the teachings of the Catholic Church but in terms of the nature of the sexual act. Unfortunately, I have lost my original soft copy of the paper I made, but I shall reiterate here the little that I remember in my own words.
The sexual act is a means of a very intimate form of communication between the man and the woman, essentially indicating that they are giving their whole selves to each other. Artificial contraception in whatever form it comes is tantamount to saying "I give you my whole being, except that I hold my fertility back." Thus in this most intimate form of communication, the man and woman are lying to each other (the same principle applies to the immorality of pre-marital sexual relations, but again, that's a whole other story).
When I finally went to medical school and did my senior clerkship, I found out that a lot of times, patients were not actually giving informed choices as they were not in the first place fully informed either. A lot of physicians seemed to not take the time to explain to patients the real pros and cons of one family planning method and the other. For instance, how often does a woman hear that an IUD and oral contraceptive pills can cause induced abortions as one of their mechanisms of actions as sited in even the latest OB-GYNE textbooks. Do people ever hear that the natural family planning methods are the only ones without any side-effects and are upto 99% effective if they are employed to the letter? I have also witness illeterate mothers berated into signing the consent form for Caesarean sections plus bilateral tubal ligation once it has been noted in their history that it is their third C/S? Is this even mandatory? I have heard of at least 1 woman who has had 5 C/S (In one ethics book, it states that there are cases of 9 or more C/S without maternal or fetal complication). I heard some of my then OB-Gyne residents say that the uterus gets too scarred the third time around. Well, if the uterus gets too scarred, they should remove it as a diseased organ and not tie the perfectly healthy fallopian tubes. This violates the ethical principle of totality and bodily integrity. I also find it apalling that it seems people think that people are incapable of periodic abstinence thus sterilization is the easy way out. It seems to close to saying that we are like, let's say those dogs who have to be spayed or neutered as they cannot control themselves either. I think there is also a tendency for many to selfishly see child as a burden, not as a real gift from above.
Unfortunately, there are so many Caholic physicians who have as little knowledge of some basic teachings of their faith as they are well-versed of their subspecialty. In one online article, I read about this Catholic doctor who didn't know that it was a mortal sin to consel a woman to use artificial contraceptive methods. I also remember the shock of one of my doctor-friends when I told her that even assisting in a bilateral tubal ligation is a mortal sin as it publicly signifies that you are approving of the act (I have at least once refused to assist my resident in a C/S + BTL while she was doing the BTL part). If the reader has had no previous knowledge of the above facts, at least I have now stated the obvious for your benefit.
Pope Paul VI was quite prophetic when he wrote these words in point 17 of the landmark encyclical HUMANAE VITAE in 1968, and I quote:
Consequences of Artificial Methods
Responsible men can become more deeply convinced of the truth of the doctrine laid down by the Church on this issue if they reflect on the consequences of methods and plans for artificial birth control. Let them first consider how easily this course of action could open wide the way for marital infidelity and a general lowering of moral standards. Not much experience is needed to be fully aware of human weakness and to understand that human beings—and especially the young, who are so exposed to temptation—need incentives to keep the moral law, and it is an evil thing to make it easy for them to break that law. Another effect that gives cause for alarm is that a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires, no longer considering her as his partner whom he should surround with care and affection.
Finally, careful consideration should be given to the danger of this power passing into the hands of those public authorities who care little for the precepts of the moral law. Who will blame a government which in its attempt to resolve the problems affecting an entire country resorts to the same measures as are regarded as lawful by married people in the solution of a particular family difficulty? Who will prevent public authorities from favoring those contraceptive methods which they consider more effective? Should they regard this as necessary, they may even impose their use on everyone. It could well happen, therefore, that when people, either individually or in family or social life, experience the inherent difficulties of the divine law and are determined to avoid them, they may give into the hands of public authorities the power to intervene in the most personal and intimate responsibility of husband and wife.
I would like to end this post by stating his particular appeal to those of us in the health care sector in point 27 of the same encyclical:
To Doctors and Nurses
Likewise we hold in the highest esteem those doctors and members of the nursing profession who, in the exercise of their calling, endeavor to fulfill the demands of their Christian vocation before any merely human interest. Let them therefore continue constant in their resolution always to support those lines of action which accord with faith and with right reason. And let them strive to win agreement and support for these policies among their professional colleagues. Moreover, they should regard it as an essential part of their skill to make themselves fully proficient in this difficult field of medical knowledge. For then, when married couples ask for their advice, they may be in a position to give them right counsel and to point them in the proper direction. Married couples have a right to expect this much from them.

8 other thoughts:

MerryCherry, MD said...

"When I finally went to medical school and did my senior clerkship, I found out that a lot of times, patients were not actually giving informed choices... "

I am glad I ran into your post.

As was written in my post, I only want artificial methods to be included (as in the Bill) for the very same reason you mentioned -- informed choice.

What choice would there be if we only included natural methods in the Bill? And it's not all the time that physicians fail to explain ALL forms of contraception.

But I commend you Dr. J.A. for a well researched post. I have to giv e it to you because you certainly know what you are talking about here. Well done. Especially that time when you had to bail our of an OR to fight for what you believe in.

LOREN said...

Nice blog you have here. Can I add you in my blogroll? Thanks.

J.A. said...

Merrycherry, I don't think there is any more reason for the artificial methods to be further advocated by a bill since they are already so publicly available to everyone in any pharmacy and even advertisements for condoms are heard and seen in the different forms of mass media. I really personally advocate the use of the natural methods for those who are poor as they do not need to spend for this method. They only need to be properly trained.

J.A. said...

I have an unmarried (by choice also, I guess) aunt who teaches the Billing method or a modification of it to members of the basic ecclesiastical community of a parish here in our city. Aside form that, they have a livelihood project (the best catering service in town, I can attest to that!) and regular feeding programs and livelihood programs for the less fortunate parishoners. I remember on one occasion hearing the testimony of a mother who felt grateful for how this method of family planning has helped her have a closer relationship with her husband and understand the language of her body.

J.A. said...

Loren, thanks for showing interest. I would be honored to be added to your blogroll.

Gaya said...

Don't worry, Dr. JA, I'm behind you! Hehe. My only concern is the children. Whatever happens between a man and a woman, whatever choices they make, that's between them and God. That's free will, di ba? But the sad reality is that their children do suffer, and I don't think it would be just to punish children for the sins of their parents.

Congressman Beltran says that when Humanae Vitae was being formulated, there was a committee that actually sat down and discussed the issue of contraception, and majority actually agreed to its use. Maybe something we should consider? The Pope stuck lang with the minority, but I don't think he invoked infallibity on this one?

All the same, I admire your bravery for taking such a strong stand, and for sticking by our Catholic faith. Pag me umaway sa 'yo dahil sa paninindigan mo, I got your back, gurl.

J.A. said...

You are right, Gaya. There was a committee that sat down and decided as a majority that it was permissible to allow the use of contraceptive. They presented this to the Holy Father then, who after careful study and a lot of prayer decided to do the opposite and reject the commitee's recommendations. It led to a lot of upheaval in the Church then with even some priests and religious taking the opposite stance. It was a difficult thing for the Holy Father to do, yet majority does not make a something intrinsically wrong right, does it?

MerryCherry, MD said...

You certainly added flavor to this edition of the blog rounds.

But I don't think artificial family planning methods are marketed more. It's just, they are commodities, that's why you see them in drugstores. As compared to NFP, which are theories. I mean, you can't sell these, literally, in drugstores right?

In terms of marketing, I belive that NFP have the advantage. I mean, considering this is a catholic country and these are the concepts that have been discussed more in the past years. Way more than AFP.

Kudos to your aunt. We need more of her in the rurals. :)