Contraception medical dilemna


So on a pediatric rotation, I had the pleasure of meeting a product of a brother-sister relationship. The brother-sister parents in question from an intellectual point of view are not completely there and receive government support to function on a daily basis. Needless to say, the poor child of the relationship has all sorts of problems with intellect, health and pain. On my current rotation there is another lady who takes her mentally challenged daughter to get a depo shot on a regular basis. Her intent is to prevent anyone who might take advantage of her daughter to impregnate her with a child destined to be mentally incapacitated and unable to be cared for by the mother.

I know there has been a history of forced contraception of the mentally challenged under eugenics and nazi germany, but it seems that a mother’s concern is not even in the same category of intent as the previous two forces. I feel it would a be grave insult to the mother in question if we even began to compare the three. If the parents of the of the brother and sisters had anticipated what was going on behind their backs, would it have been alright for them to institute some form of birth control on their children?
thanks and peace!



Contraception and sterilization are intrinsic evils, whether done to oneself or to others. Good intentions cannot make a bad act into a good one. We may never do evil even in pursuit of a good.


Is that really applicable to someone who cannot actually consent to sex? The whole point about contraception being evil is that it is a rejection of cooperating with God’s design. It’s selfishness. If someone cannot comprehend how to cooperate with God’s design… why is there evil there?

Forced sterilization by the state or something is one thing, but what about sterilization or prescribing shots/pills by a caretaker for someone with the intellectual capacity of a child? I mean, someone who couldn’t deal with menstruation, much less raising a child. Such a person would never be consenting to sexual activity anyway, not really, so why would pills or shots be immoral?


This is one thing I don’t know whether morally I will be able to critique the mother for her action. I can understand her concern and I find it very hard to say that what she is doing is morally reprehensible.Truly the girl cannot consent,the mother works hard all day long and leaves the girl more or less at home alone. The studies shown that the mentally handicapped have a higher rate of physical and sexual abuse compared to the general population. Plus the neck of the woods where I am stationed at now isn’t particularly known for good natured men of virtue. Surely there is such a thing as an exception to the rule?


“To subject such persons - who are often unable to give truly informed consent - to contraception, sterilization or, worse, abortion as a matter of official policy is a practice that is not only unethical, but can also jeopardize their psychological development.”


I am not sure why you think you need to critique her.

All sad, but irrelevant to the morality of sterilization or contraception.


Nor can YOU participate in any contraception or sterilization.


How is sterilization by the state, which often describes itself as a caretaker, different than sterilization by a personal or individual caretaker? Both are committing a moral evil.


Well so could having a baby when they don’t even understand what’s happening to them.

I think you have to look at the intentions behind the action - is sterilisation in such cases a way of defending the disabled person against grave physical/mental harm? Or is it because you find the disabled person distasteful and don’t want them to reproduce? One of these motives shows concern for the patient, the other is similar to what the Nazis thought.


Those are the words of the Church. The Church is the authority in the matter.

No. A good intention cannot make a bad act into a good one.

1755 A morally good act requires the goodness of the object, of the end, and of the circumstances together. An evil end corrupts the action, even if the object is good in itself (such as praying and fasting “in order to be seen by men”).
The object of the choice can by itself vitiate an act in its entirety. There are some concrete acts - such as fornication - that it is always wrong to choose, because choosing them entails a disorder of the will, that is, a moral evil.

1756 It is therefore an error to judge the morality of human acts by considering only the intention that inspires them or the circumstances (environment, social pressure, duress or emergency, etc.) which supply their context. There are acts which, in and of themselves, independently of circumstances and intentions, are always gravely illicit by reason of their object; such as blasphemy and perjury, murder and adultery. One may not do evil so that good may result from it.


Any sexual intercourse that that girl could partake in, because of her mental state, would be considered rape. If the church is in favor of rape victims being able to take reasonable measures to prevent conception, I fail to see how this is any different morally.

We are called to make sex open to life. Sexual assault is not “love-making” and therefore not tied to the same standards as intercourse between consenting persons.


Read what the Church has written. It can’t be any more plain that that.

We are NOT to sterilize (permanently or temporarily) other people, regardless of their mental handicap. It is a violation of their human dignity and bodily integrity.

Rape is also a violation of dignity and bodily integrity.

But once again we CANNOT do evil in pursuit of a good. So, sterilizing the mentally handicapped is NOT something we can ever do.


I would also like to point out that the so-called rape protocols are NOT Church teaching. These are writings by the USCCB, not the Magisterium. The Vatican has not issued any such director or interpretation nor has it approved the USCCB document.

I no longer reference this document, as it does not have magisterial weight.


Not so much her, but the actions as we need to be able to discern and recognize evil and ills in society.

I believe it to be completely relevant. In medicine there is a time and a place for everything. There is a saying in the field that all antidotes can be poison and poisons can be antidotes. The thing which makes a particular medicine a poison arises from the situation. Since psychiatry and care of a mentally disabled person is very much a social form of medicine, her situation is very much relevant to the realm of medicine we venture. The question is does the realm include contraception as a prophylactic against the consequences of rape? I honestly don’t know the answer to this.

I haven’t yet, but one of these days I will have to make a call on a situation very similar to this one.


From a legal perspective, a minor cannot actually consent to sex. Are you suggesting that it’s morally licit for minor children to use contraception? :wink:


The episcopal members of the USCCB are members of the magisterium. Neither the pope nor the complete college of bishops have weighed in on this particular assertion, to the best of my knowledge, so we cannot say that this teaching is in opposition to the magisterium. In the absence of a contrary teaching of the magisterium, the teaching of a bishop – within his diocese – is authoritative.

A particular bishop can, referencing this document, assert “not in my diocese!” and it would be an authoritative statement. Similarly, if the local bishop assented to this teaching, it would be licit (unless and until it were contradicted by higher authority)… wouldn’t it? :wink:


This question would be irrelevant, because biologically children cannot conceive until they hit puberty and the type of contraception we’re discussing does nothing to reduce risk of STDs. If a pubescent minor was at high risk of victimization, that would be a different story.


A conference of bishops are *members *of the magisterium but are **NOT **the magisterium.

Yes, doctrine of the Church does have more weight than a document produced by a committee within a bishops’ conference.

Waiting for the magisterium as a whole to speak on this topic. Takes a long time sometimes. Donum Vitae was many years after successful in vitro.


These situations you mention are very sad. I am not sure that the baby in this case would necessarily have to have been born with these birth defects, unless the related siblings were suffering from genetic problems; however, the solution would be to *care for *the sibling-parents, one aspect of which would be teaching and supervision. In these types of cases, adoption of the baby might be the best solution.

On my current rotation there is another lady who takes her mentally challenged daughter to get a depo shot on a regular basis. Her intent is to prevent anyone who might take advantage of her daughter to impregnate her with a child destined to be mentally incapacitated and unable to be cared for by the mother.

Again, teaching, supervision, and adoption if the worst happens… I mean, think about this. The mother seems to be more concerned about her daughter’s becoming pregnant as the result of rape than she is about the daughter’s being infected with an STD or being raped or sexually abused?


I don’t think there is ever such a thing as a favorable product of such a narrow genetic bottle neck. Almost invariably, bad things happens when you dip twice from the same gene pool, there’s a reason why he bible forbids such unions.

I think she was weighing the options that were within her control. She loves her daughter, but cannot afford or arrange constant supervision. Also most STD’s are treatable with antibiotics or can be managed pretty effectively with antiretrovirals, but an unplanned pregnancy really has no solution, particular those with mental disabilities. If adoption was an effective solution for mentally disabled children, we wouldn’t have so many in institutions. I’m afraid this problem is something that has no easy answer, particular for those of us working on the ground.


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God bless,

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