Medical use BCP with marital relations

I am starting this thread as a continuation of a post which fits much better in Moral Theology forum than Family Life forum, and will hopefully garner more posters to help this topic come to an understandable conclusion.

Here is a brief summary of the prior thread. Aaron, feel free to write your own summary or add parts if you feel mine is imbalanced or lacking in some way:

OP is on BCP for medical reasons and is having sex, and asks if this is within the realm of Catholic morality. Aaronlgates responds stating

[quote=aaronlgates] because it acts as an abortifacient hormonal ‘contraception’ is not a viable treatment if there is a possibility of intercourse during this treatment.

This is responded to, with information that BCP is not considered contraception when used for medical purposes and therefore not considered sinful; also, due to double effect, the pill can be used while having sex and that since abortion is considered a willful act, it is not an accurate term for unintended acts. References:

aaronlgates disagrees and responds

[quote=aaronlgates] this whole thread is focused on legitimizing the use of abortifacient contraceptives which is what I am opposed to altogether. Killing is wrong, especially when the ‘treatment’ causing the ‘inadvertent killing’ is out of proportion to the end as Aquinas observes in the principle of double effect.

as well, he brings up an analogy asking if Thalidomide (drug which helped pregnant women with morning sickness which spawned a terrible amount of surprise birth deformities in the mid 20th century) could fall under the double effect principal today, likely feeling that the bad far outweighs the good in both circumstances of this and medical-use BCP, and relates this to Aquinas’ lesser evil.

Aaron and I both feel that we are stating what the Catholic position is when it comes to medical use BCP and sex. Please chime in. I feel wary about contributing much to the Thalidomide discussion as it seems it would be more of a subjective realm, and my original purpose was simply to point to what Catholic teaching was, but I’d be interested in others’ views. (Pope Paul VI Institute has already been discussed as being a good resource in the prior thread)

(Prior post is here )
Thanks in advance for your contributions! The more heads, the better! :slight_smile:

If a medication was prescribed by a physician as a therapy for a medical condition (such as endometriosis) and it has the side effect that is contraceptive (with a very, very slight possibility of being an abortifacient – particularly if it is taken precisely according to manufacturer’s instructions), that side effect is tolerable according to the principle of double effect.

If a medication was prescribed as a contraceptive because it also has the effect of lessening the effects of another medical condition, such as endometriosis, the principle of double effect would not apply…as the root reason for the prescription was to prevent childbirth.

As stated in this articleThis Rock from 2006,
*The principle of double effect means that sometimes one must perform an action that is in itself morally good but may also have an unintended ill effect for which the person is not morally culpable.
The bottom line is that the root motivation for the prescription needs to be carefully examined. If the root motivation is appropriate, then there is no real moral issue.

The root motivation is definitely to be examined, but this is not what really matters in this scenario. Because it acts as an abortifacient, hormonal ‘contraception’ is not a viable treatment if there is a possibility of intercourse during this treatment. Be careful about saying what itching ears want to hear in the interest of expressing what you think may be love for your neighbor. This sort of ‘support’ could be mortally wounding that person’s soul. Jesus had a few things to say about this… false prophets were those who gave the comforting words instead of the harsh realities… and millstones around the neck of those who lead others astray is not a pleasant thought.

Just because someone with a doctorate states something or prescribes something, however, does not give you a ‘get out of jail free card’ when you follow the physician’s advice against the clear teachings of the Church.

Because it acts as an abortifacient, hormonal ‘contraception’ is not a viable treatment if there is a possibility of intercourse during this treatment.

The church at large is not so strict as this. For instance a woman with cancer who is pregnant may take chemotherapy treatments with abortafacient side effects. For that matter a woman who is pregnant and is discovered to have uterine cancer could morally choose hysterectomy. The intent being to remove the cancer and not to kill a child. Most woman would be encourage to and most likely would wait long enough for the baby to be old enough to live with care but she is not required to do that. She may take live saving treatments immediately.

The truth is the Vatican has not definitively ruled on what should married couples do in the case of the woman being told she should take hormonal contraception to alleviate symptoms. Humana Vitae speaks about a cure not alleviating symptoms. I’ve seen some moralists use that as a standing point to say that it is not allowed. The pill was not being used as a treatment for anything at the time HV was written.The pill does not cure anything only alleviates some symptoms. Some moralists say use the pill but abstain until treatment is finished. Some moralists say use the pill and don’t be concerned because of the prinicipal of double effect. Others say use the pill and do your best to ascertain ovulation and abstain on the likely occurence or evidence of occurence.

You should research this principle a bit more. Be careful about making such confident statements that the killing of the unborn is ok as long as you didn’t expressly purpose to kill.

Let’s see how two common alternative treatment scenarios(acne, and ovarian cysts) available with hormonal birth control hold up as we examine them under the conditions of the principle of double effect.

The New Catholic Encyclopedia provides four conditions for the application of the principle of double effect:

  1. The act itself must be morally good or at least indifferent.

Treating acne or lessening pain due to ovarian cysts is certainly a morally good aim.

  1. The agent may not positively will the bad effect but may permit it. If he could attain the good effect without the bad effect he should do so. The bad effect is sometimes said to be indirectly voluntary.

Ahhhhhh… here is where this scenario sheds light on our situation… there are alternative therapies that could be used to treat the woman’s acne or ovarian cysts/pain. Here, we cannot choose hormonal birth control when we can avoid the possibility of killing the unborn by choosing another treatment modality. It seems that the bad effect of this abortifacient ‘is said to be indirectly voluntary.’

  1. The good effect must flow from the action at least as immediately (in the order of causality, though not necessarily in the order of time) as the bad effect. In other words the good effect must be produced directly by the action, not by the bad effect. Otherwise the agent would be using a bad means to a good end, which is never allowed.

We’re ok here.

  1. The good effect must be sufficiently desirable to compensate for the allowing of the bad effect” (p. 1021).

Ahhhhh… again we see the light! Killing or maiming the child so that the mother can live with less acne, or lessen pain associated with ovarian cysts? Obviously the bad effect of killing the unborn outweighs the good that comes from the therapy. In fact, it is hard to try and construct a scenario where killing an innocent image of God is justified.

And that’s up to your conscience, properly formed according to the Magesterium.

Father Serpa of Catholic Answers does not agree with you though. See here.

Neither does Pope Paul VI (Humanae Vitae 15)

  1. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever.

But if your conscience compels you to be stricter than what the Pope says, by all means, do so.

If there is one thing the human race should not have messed with, it is our procreative nature. Abortion, contraception, and cloning all seem to me to be those sins that cry out to Heaven.

I understand that giving up the marital embrace is a VERY difficult thing to do. Living with constant pain is difficult as well. If someone hadn’t spent the time to create a drug specifically for the morally unacceptable purpose of contraception, would there be a drug that dealt specifically with these medical conditions? I think there might be one. I also think time would be spent on attempting to create a drug that treats these conditions without such a negative effect on our procreative nature.

If anyone knows of a medical research lab that is trying to create such a drug, please let me know. They could probably use the support of Catholics.

HV 15 merely states that therapy resulting in a “foreseeable impediment to procreation” is ok… The “forseeable impediment to procreation” does not include the sacrificing of newly created and genetically whole human beings for therapeutic means. HV 15 is more appropriately applied to hysterectomies, etc.

While I believe that ‘being strict’ in areas dealing with the sanctity of life is the wise thing to do, the Church’s positions on abortion and sanctity of life is more than enough to support my position.

I really am saddened at the impact of the culture of death upon the minds of this generation. Perhaps we don’t quite understand or are blinded to the fact that these are individual human beings with their traits already determined. Blond hair, brown eyes, 5’10", good athletic skills, potential for the priesthood… all of these things are genetically determined in these lives created in the image of God… these lives we are so determined to sacrifice to ensure a possibility of a bit more comfort for the woman… and this tx is even questionable in its efficacy for the alternate indications it is used for.

We are indeed in the end times and the innocent are being killed by the millions. May God have mercy on us.

Here we may find more support for the position that killing is ok with pharmaceutical treatment… It is scenarios like this that we should look into to help shape the discussion. Any sources out there?

Yes, I do believe that this is the case. It is the same with respect to the abortifacient nature of combination hormonal birth control(I don’t like the term ‘contraceptive’ because it can be deceiving). The Church hasn’t taken the official position that birth control is evil because it kills… it takes the stance that ALL contraceptive measures are evil because they are ‘anti-life’. Still, I believe that this is perhaps the single most telling thing about the Church. While the protestants are aborting children by the millions, the Catholic Church is steadfast in its condemnation of it.

Once upon a time I asked someone about why “the pill” wasn’t ok for Catholics. I know some of you would never believe this, but the Pope actually had people look into the Church saying it was ok. What I was told is that the Pope said no to “the pill” because it was not the natural order of things. As far as I can see he made perfect sense.

Gotta love the natural order of things. Seems like that is the way God made things.

So, lets continue on down that thread. The natural order of things would have me having sex with my spouse instead of masturbation. Hard to argue with that. The natural order of things would be that you have sex whenever you want to. This is consistent with the idea that we are not supposed to deny sex to our spouses.

The idea that children come from sex, while true, is not always true. There is an element of God’s work in getting the baby made into a baby. Some couples simply don’t have kids and I’ll assume they have sex all the time because they want to have kids.

So I guess you could say that Catholics should be happy folks. Lots of sex, no masturbation, no adultery. You get the idea? Why not? What paragraph in the Catechism says I am wrong here?

Understandably some people don’t want to have 12 kids. Others that want kids are not happy about not having any. How can you say that this isn’t God’s will? Again, Scripture or the Catechism please. I have a hunch I know where personal opinion resides on this issue.

Wouldn’t the standard of “natural order” and all the Scriptural and Church teachings on having sex and babies support leaving the connection between sex and babies entirely up to God?

Then, by that standard, anything we do based on our understanding of biology, that is not somehow supported in Scripture, that takes God’s place in procreation would be wrong. Please don’t yell at me here, it was the Pope’s idea, not mine.

Consider this.

A couple wants to have kids. Much sex, no kids. Not-daddy in an ***. Is it possible God doesn’t want him to have kids?


Couple goes on a date, not married, have sex. That would be a sin. Baby comes. Baby isn’t loved the way babies are supposed to be loved. Baby has bad life. Not God’s plan. This be the wages of sin.


Man meets woman. Get married. Baby comes. Baby comes … Baby comes. Big family. Happy family. Maybe God saw that this couple were going to be good parents and gave them lots of babies. Just maybe they are very happy.

If you think having lots of kids is bad, which most people do, then I submit you are ever bit as much a sinner as a those people who actively prevent having babies according to the idea of “natural order”.

So, to get to the point. Medicine could be viewed as against the natural order of things. The Church does not view medicine in this way. I agree with the Church, no problem. There are difficulties associated with medicine and morality, big problems. Medicine’s impact on having babies is just one of many moral issues with medicine. I do not believe there will ever be a statement that the Church issues on what is not ok and what is ok. For one thing, the issues change too fast. What happens to a morally acceptable procedure, lets say in 2008, that becomes unacceptable in 2009 because there is a medically better procedure? The Church would get dizzy keeping up with all the changes.

How many of you want your parish priest to be your doctor? If my doctor tells me this pill will save the life of my wife, even if he is wrong, and my wife dies, it is not the place of the Church to argue with my doctor. Maybe I need another doctor. Do you see the really big hole that sits here?

Medicine needs to be amoral. Yes people use medicine to do immoral acts, but the norm should be that medicine is amoral. I believe that is the position of the Church and it is the correct one.

So, to put it short, as long as a person is not using medicine for a deliberately immoral act (i.e. abortion, cosmetic surgery?) whatever happens as a by-product of medical treatment is not sinful. The Church, and these forums, should assume a hands off policy. Just as your salvation is something between you and God and your priest, your medical care should be between you and the doctors you choose.

I most definitely agree that medical treatment that inadvertently frustrates the procreative aspects of marital relations is not sinful as long as there are no other valid medical treatments and the reason for treatment is sufficiently grave.

What I don’t agree with is the use of ‘therapies’ which are abortifacient in nature when there is the possibility of intercourse during said treatment. I have yet to see an official Church statement that allows the killing of the unborn for treatment of ovarian cysts, acne, menstrual irregularity, etc. In fact, I have yet to see ANY Church statement granting the faithful permission to use abortifacient chemicals for the treatment of ANY medical condition when there is the possibility of intercourse during said treatment.

We could go even further into this debate and it could get really sticky… what about the use of cancer medication such as methotrexate or radiation… both of which are contraindicated in the pregnant patient. Do we deny this person marital relations during the period of treatment? The answer is YES. In fact, several drugs(ex. accutane) absolutely require repeated pregnancy tests and two forms of birth control(ex condom and ocp’s) to minimize the chance of extreme harm/death to the unborn fetus. Accutane, an acne medication, is a pregnancy category X for good reason… can the Christian take birth control while on this medication to ensure that you flush the embryo before accutane can cause irrepairable mutations to the poor child? Only if you do not have any marital relations during treatment.

So the question is this:

Which is more important… the protection of the unborn, or the medical treatment of the one we truly worship(ourselves). We as a society have so many needs/wants/must-have’s… we are a society of rights… you have a RIGHT to whatever medical care you or your physician deems appropriate… this is a fallacy.

You were bought at a price. Honor God with your body and make the sacrifice to ensure you are not killing the precious lives that He is creating in His image. If you want the therapy, don’t have sex. If you want to have sex, don’t have the therapy. It’s as simple as that.

I don’t really see how this is a valid argument as several different synthetic hormones exist, along with many other treatments, dietary changes and surgeries or therapies.

Perhaps if the only choice was an abortifacent birth control pill, then it would make sense to argue that it is okay to use it for a medical reason.

With over what? 30? 40? different types of marketed BCPs, along with synthetic hormones (such as progestigin) available, why would anyone choose a COC? The difference between COC and regular contraceptives is often only efficacy in preventing conception, and we know why…:shrug:

Also, there is the question of how medically required the BCP is for many situations.

For example, functional cysts are oftentime treated with BCPs and respond well to treatment. Yet, many women are using BCPs to treat cysts without any true healing, as cysts are caused for a variety of reasons and only a particular kind responds to this HRT.

I see this with my coworker, who has suffered from cysts since highschool. She has used ABC for almost 5 years with no relief. She is suffering from another condition that is causing her multiple health issues and lots of painful symptoms, but her doctors just keep passing the BCP over to her. Instead of getting a PAP, laparoscopy, pelvic exam, etc, she is going to pop the pill for the next 10, 20 years. Then she can find out about her endometriosis, ovarian cancer, infertility and who knows what.

Furthermore, the example of treating cancer and using COCs is comparing apples to oranges. If someone suffering from cancer is past a stage or other preventative therapies (and even alternative therapies) then chemotherapy is the only option for them.

Ok, when I think of medical treatment I think of treating a condition that is potentially life threatening. I must admit that fixing acne at the risk of having a baby with a birth defect would be a problem for me. But, on the other hand, there are plenty of medical treatments that remove the ability of one or the other parents to procreate. Removing a uterus is a big one. If you remove a uterus are you saying the couple cannot have sex, because the act is not open to life? I hope not. How about the “one-shot” wonders? You know, drugs that taken once, may cause birth defects for the life of the woman. There might be a few of those. I am curious about this.

Yes, there are drugs that cause birth defects and if you are taking them you should not get pregnant. Some of the drugs are taken for years. aaronlgates, you seem to be saying that if you need the treatment, or the drug, you shouldn’t have sex. I am sure that is your personal opinion. But it is not the opinion of the Catholic Church. Curiously, this is an area where the Church is very understanding. If you discount the wacko priests, and there are always some of them out there, the priests I’ve talked to are aware of the fear that people have to deal with in confronting a life threatening condition. To take away sex at a time when the person is thinking about dieing is cruel. I hate to break it to you, but sex is a gift from God to strengthen a marriage and makes the couple feel closer. Hard as it is to believe, the Church recognizes that. Making love is the focal point of the Sacrament of Marriage. It is not expected that every time you make love you are going to have a baby.

I have yet to see ANY Church statement granting the faithful permission to use abortifacient chemicals for the treatment of ANY medical condition when there is the possibility of intercourse during said treatment.

You will never see a statement from the Church saying it is ok to go to the bathroom during Mass if you really got to urinate, either. Some things are best left to the imagination, or one on one talks with a priest.

can the Christian take birth control while on this medication to ensure that you flush the embryo before accutane can cause irrepairable mutations to the poor child? Only if you do not have any marital relations during treatment.

Well where did the embryo come from then? Boy am I missing something. Are you implying you are killing Jesus, or some other embryo that somehow gets there without marital relations?

you have a RIGHT to whatever medical care you or your physician deems appropriate… this is a fallacy.

Ok, pick a medical treatment you do not have a right to. Maybe for you that is easy. But you are never going to convince 3 other people on this web site, or 3 other people in the Catholic Church, that they are not entitled to that medical treatment. Usually Catholics on this web site, and pretty much in general, get all huffy if every possible medical treatment is not done to save a life. I think that is what we Catholics call “Respect for Life”. But, you know, I agree with you. Seriously. Doctors are doctors because they don’t want to fail. A young person shows up with a terminal illness and they bust their but to save them. They will sometimes do things that are experimental to save the life. I have my doubts about that being respectful.

Now, just because I don’t want to be stupid, BCP means birth control pill, right? Some of them kill the fetus, if one exists. Most do not. Right? I would hope that the doctor, if it were medically acceptable, would use a BCP that does not kill the fetus, or embryo.

I guess this can be a very passionate subject. Just be aware that taking sex away from a married couple is like going to Mass and not receiving the Eucharist. Generally speaking you shouldn’t do it and there is a whole bunch of Scripture and Church teaching to support that.

Dude…this is NOT what the Pope said. What you just said goes against what the Pope has clearly laid out for us.

Look, we are free as catholics to take advantage of medical advancements to make our quality of life, and health, better. Some women have crippling pain. You can’t know until you’ve spent a week with your head in a bucket vomiting from the pain, laying in a bed, white as a sheet and shivering violently, and threatened job loss from taking too much time off work (a week a month). Now granted, I didn’t help anything by starving myself for 2 years, but still. Medical treatment allows me to lead a normal life.

Now, ALL medicines have side effects. Look at your bottle of over-the-counter pain killers. Those can cause organ damage and even death. Does this mean we should boycott it as a death pill? Some people abuse them to kill themselves. Should they be outlawed as poison? Or can people take them for the use for which they are intended?

What is a side effect of hormonal “birth control”? Infertility. That is how anyone taking it for medical reasons sees it as. It’s a side effect. A rather sucky one at that. I can’t have kids until I’m 24-25 because going off it and having a natural period will be…well, hell. It’s better for me to wait until my doctor assures me that it would be so bad.

About the abortion thing. The point of the drug is to thin your endometrium. This is how it works to treat endometriosis. However, the birth control effect PROTECTS women on it from unintended abortion. To just thin the endometrium without preventing ovulation guarantees an abortion. If you take your pill at the same time EVERY DAY your chances of ovulation are lower than .01% (this is on the box and from my doc.) So women in my postion set alarms and take it at the same time every day to do all we can to avoid anything like that from happening.

Lastly, “abortion” happens on NFP too. Even with couples TRYING to conceive. Not every fertilized egg implants. MOST do, but not all. This is unintended by the couple. Same with ABC I dearly pray that if any life is created by my husband and I, s/he survives. I would love nothing more than to discover i was pregnant. It wouldn’t be the first time someone got preggers on the pill. I know at least 5 kids born despite BCP, and I know there are more. Bascially, if you want to call a woman on BCP for medical reasons causing “abortions” you have to call any woman who has had a miscarriage or non-implantation case, abortive. IT. IS. UNINTENTIONAL.

So before you write inflammatory statements accusing women with DEBILITATING MEDICAL PROBLEMS of being killers, really think about what you are saying. I am sick of myself and others feeling like second rate citizens because we were born with a medical problem. It’s no different that getting in the face of a woman being treated for cancer and therefore infertile (or deadly to any fertilized egg) because she is “killing her children”. :banghead:

So you have the case of a woman who deals with irregular/infrequent menses, and the pro-death physician orders hormonal ‘contraception’ to regulate the cycle… knowing full well that the woman is having intercourse during this period of time… you have the case of a woman who is taking oral contraceptives because ‘the doctor ordered it’ for whatever reason they may deem medically legitimate… cramping, acne, mood swings… you are told by the physician that you are not psychologically ready for the child in your womb and the child is pulled out of your body in pieces… is this legitmate medical advice? Sure! Legitimate in this culture of death, but NOT legitimate in the eyes of God. What level of discomfort rationalizes murder of the unborn? What degree of acne makes killing babies OK? What level of cramping pain calls for the killing of humans created in the image of God?

Since when has the physician ever taken the place of God? Since when is their judgement NOT subject to scrutiny? Is the ‘doctors note’ a ‘get out of jail free card’ regardless of their rationale for treatment?

I am here to tell you that neither the physician NOR the patient are immune to the judgement that comes from the murder of human life. And neither are WE immune from the judgement of CONTRIBUTING to the murder of the innocent through words of ‘support’ of the patient who CHOOSES to listen to the advice of an abortionist.

The idea that we are ENTITLED anything as servants is a completely western idea that has no basis in historic Christianity. As a servant of God, we are entitled nothing… our Lord grants us certain blessings according to His will, but we are entitled to nothing but death and punishment. He, in His grace, grants his servants eternal life and forgiveness at His discretion… we are entitled to nothing. If we were to defiantly demand what we are due, we would get what ‘is coming to us’… death and damnation.

Upon accepting Christ as Lord and Savior, we give up all ‘rights’. We were bought at a price and we are to honor God with our bodies. Be careful. Jesus said: “Enter through the NARROW gate; for the gate is WIDE and road broad that leads to destruction, and those who enter though it are MANY. How NARROW the gate and constricted the road that leads to life. And those who find it are FEW.” (Matthew 7:13-14) (NAB) (1071)

The development of combination hormonal ‘contraceptives’ was indeed with abortifacient mechanisms in mind. The original name for these compounds were ‘implantation inhibitors’(abortifacients), and they were studied in rats to see if artificially introduced fertilized eggs would implant and thrive in the womb of rats treated with such chemicals. When it was observed that the embryo/zygote was consistently flushed in rats treated with these ‘implantation inhibitors’ some scientists saw this as having potential use in humans… and we all know ‘the rest of the story’…

Also, in terms of other treatments available for these indications, there are a host of other treatments available to treat things such as acne, irregular menses, ovarian cysts, etc. that do not have abortifacient mechanisms.


I am working on a different time zone as I am stationed in Germany, so I apologize for back to back posts by just me…

Anyway, I think that the thalidomide analogy is a good one for us to consider because it forces us to come face to face with that child that God created in the womb. Let’s examine this a bit more closely:

50 years ago, the thalidomide scare came about. This drug which helped pregnant mothers sleep and combated morning sickness, was the cause of very dramatic harm to the unborn. “From 1956 to 1962, approximately 10,000 children were born with severe malformities, including phocomelia(no limbs), because their mothers had taken thalidomide during pregnancy.[1] In 1962, in reaction to the tragedy, the United States Congress enacted laws requiring tests for safety during pregnancy before a drug can receive approval for sale in the U.S.[2] Other countries enacted similar legislation, and thalidomide was not prescribed or sold for decades.”

WHY ON EARTH would we stop the use of thalidomide in women who are of childbearing age? Just because their children would be born without limbs is not a sufficient reason. It’s not like we are killing them or anything… Of course I am mad to talk like this.

The reason we would stop the use of this drug in women of childbearing age, is because it is a whole lot more personal when you actually have to FACE THE PERSON(baby) and ask their forgiveness for taking a drug that rendered them mutilated.

NOW, if a woman took this drug to help with sleep, with the physician and patient knowing full well the risks to mutilating an unborn child, would you say that this was sin? My answer would be that there would be no sin AS LONG AS THE WOMAN ABSTAINED FROM MARITAL RELATIONS DURING TREATMENT. BUT, if the mother who was fully aware of the effects of this drug on the unborn continued to take this medication AND continued to have marital relations AND conceived a child that ended up being born without limbs… would this be sinful?

If we answer the above question, I believe all other questions will be answered for us concerning this debate.

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