After all threads I have read here and consulting some people I still can’t understand this issue. When a pregnancy would put at risk the life of a person (woman A) the only way allowed by the Church to cope with this situation is to abstain from sex or the use of NFP. If NFP does not work for her the only moral solution for that woman is to abstain from sex.
We all know that contraception and sterilization are not allowed unless the contraception is not directly intended but results as a secondary effect. That is the case of sterilization for medical reasons to remove, for instance, a cancerous uterus. The same case applies to the use of hormones for therapy that as consequence render a woman sterile. This is call indirect sterilization (temporal or definitive).
Direct sterilization (sterilization to prevent a risky pregnancy) is not allowed because it is not necessary for the health of the woman. The woman could use NFP or just abstain from sex to prevent a risky pregnancy. The idea here is that one can not do evil that good might come from it. And one does evil when intentionally separates the two aspects of the sexual act. But I would like to think again if the use ABC in this case (serious risk for the woman) is really intrinsically evil. According to some theologians and Church’s officials it is not.
The Church allows (as already happened in the past) to a nun (our “woman B”) to use non-abortifacient contraception in case of possibility of rape. The idea is to defend her from an external attack that could lead to a pregnancy as a consequence of a non-free sexual intercourse. In this case this temporal direct sterilization is not seen as intrinsic evil because the woman is not engaged in a FREE sexual relation and the contraceptive act is seen as a self-defense act. She does not want any relationship an neither to contracept. This act of contraception is not considered evil because the circumstances and the **intention **of the person. There is not separation of the two aspects of the marital act because there is not marital act. But, still, she impairs her natural reproductive functions. The difference between the two women cases is about “the how” the pregnancy could take place and this defines the morality of the contraceptive act.
Impairing one’s reproductive functions by itself might be, therefore, not intrinsically evil. The problem, as we see here, is the reason, the circumstances and what the intentions to do it are. It is intrinsically evil ONLY when intended intentionally to separate the unitive and procreative aspects of the marital act or when it is seen as a simple act of mutilation.
But consider again “woman A”: she does not want to contracept, she does not want to separate the two aspects, she probably would even like to have more children. All what she wants is to avoid for once or temporally the possibility of a danger for her life that could come from a free or not so free relation ship (by the way, how free is one to get or not involved in a “medical safe” sexual relationship with his/her partner with whom one lives and sleeps every day?). In medicine the right term used is “prophylaxis”. But the Church only accepts the term “therapeutics” as a medical approach to the problem. “Woman A” would use temporal or definitive sterilization as an act of self-defense to prevent that her reproductive function would kill her. The primary intention would not be contraception by itself. Contraception could, therefore, be seen in this case as a secondary effect when prophylactically the woman’s health is protected. That is MEDICAL use of ABC.
Continue… in part 2