"Safe sex" counseling as a Catholic physician

Hello all!

I tried asking this in the Ask An Apologist forum, but I’m thinking it might not be answered, so I decided to pose this question here.

I’m a med student, and in one of our classes this week they are talking about the barriers between the LGBTQ community and adequate healthcare, and one of those “barriers” is that physicians do not give “safe sex” counseling to these individuals. I got to thinking whether it would be possible for a responsible Catholic physician/PA/etc to give this sort of counseling to any patient, be they LGBTQ or an unmarried heterosexual patient.

Thanks all for your time.

I don’t see why it would be a problem. Say: now there only way way to avoid all risk of STDs – not to have sex. Second best is to have sex only with one partner, who is not promiscuous. If you do have sex, the following actions could decrease your risk: using condoms and the like.

You are not telling them, for example, to use condoms. You are telling them that condom use decreases the risk of certain diseases. That is true.

So I don’t see any problem. :shrug:

As a physician you are obligated to prevent disease.
As a Catholic you can not encourage sinful behavior.

So, simply tell your patient that you are Catholic and sexual relations outside of a marriage between one man and one woman is a sin.

Now the patient knows your moral standing.

Now explain as a physician you have an obligation to tell him how to prevent disease, even if it is within a sinful relationship.

You are not condoning their actions, just teaching how not to get sick.

I understand what you both are saying. I’m not condoning the action per se, instead I am just telling people how to best prevent disease as a health professional.

But let’s extend this same argument to say IV drug abuse. I would tell them that the best way to prevent disease would be to stop using heroine altogether, but if they do shoot up they should use a clean needle. I guess what I’m trying to say/ask is by giving a patient information about safe-sex am I really looking out for the best interest of the patient, his or her partner, and society at large? There are so many social problems and diseases that stem from extramarital sex, that I feel like it’s questionable to start condoning these actions by saying “wrap it up,” and throw on the fact that I’m a Catholic physician, and I feel like I’m treading on very thin moral ice.

You cannot counsel others to sin or this is actual personal sin for you. There is no way you can counsel patients to use artificial contraception without going against your faith. So don’t do it. Stand your ground and profess your beliefs.

Contact the National Catholic Bioethics Center or the Pope Paul VI Institute if you have more questions.

He’s not counseling anyone to sin. There’s a big difference between Prodigal Son laid out and a doctor literally writing a prescription for the Pill for contraceptive purposes or counseling an abortion or performing one.

Suggesting that someone can avoid disease by using a condom is a clear endorsement of this mortally sinful method and cannot be condoned in any way.

Stating the fact that condoms reduce the risk of contracting a disease while at the same time saying that you cannot condone such use is not “suggesting” that someone use condoms nor is it condoning the action. It is stating a true fact and advising against a sinful action.

Is saying that people are able to murder others using guns an endorsement of murder?

Is saying that people can treat their parents dishonorably an endorsement of such treatment.

Of course not.

Likewise stating facts about contraception use is not an endorsement of their use.

Just like a doctor might say to a cancer patient, “you can do radiation and chemo or you can do surgery and then chemo only, but I always recommend surgery and can’t recommend radiation”

So too can a physician state the options and their recommendation.

Career specific ethics questions are really better served talking to specific orthodox groups for this sort of things. If you talk to random people they’ll either tell you everything is okay or they’ll carelessly shatter your world by telling you to pick a different field.

Manningv, the question hinges on the way you asked it. Is it possible for a *RESPONSIBLE *Catholic medical professional to advise so-called “safe sex.”

You are in a process of forming your own conscience at this very moment. Questioning your personal level of responsibility with regard to your fellow man, children of God, and with respect to the Hippocratic Oath. Only input from experts in the field of question are qualified to assist you in forming your conscience. Experts in this field would be bioethics people with a commitment to the Catholic faith. Search the Vatican website for links in that direction.
www.vatican.va.
The advice from Elizium23 seemed reasonable, with links to experts in your field.

When it comes down to the moment, when one of your patients is asking you about this matter, pause for one deep breath, and then act in accordance with your informed conscience. You will recognize the voice of your conscience because it will be the one that gives you peace. 1Cor 14:33 “God is not a God of confusion, but of peace.” When you are torn about any issue, this is an attempt of the devil to complicate things and to deceive you.

Incidentally, the oath “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone” covers you either way. You are acting "for the good of my patients" and “according to my judgment.”**

If it is in your judgment that advising someone in safe sex would actually not be for their good, then you are acting with the highest medical integrity.

God Bless you,
Debbie

It’s an interesting analogy. I would originally have agreed that simply stating a fact about contraception (i.e., it can reduce the probability of STDS or unintended pregnancy) is not sinful. Yet in the context of a conversation with a medical provider about maintaining one’s reproductive health, I can easily see how saying something like, “condoms can help prevent the transmission of or reduce the risk of aquiring certain STDs” could be seen as an endorsement.

To extend your analogy:

Teenager: I hate my parents! I’d do anything to get them to stop nagging me about my boyfriend.
Teacher: Well, guns are able to murder people.

Could we really say in this situation that the teacher was just stating facts, or would it appear, in this context, that the teacher was suggesting the teen consider committing some kind of violence against her parents?

No, it would not be permissible. The only thing you could advise is for them to abstain. This may be a problem for you if you join a group of doctors who provide family services. Of course you could specialize in a branch a practice that would not be exposed to that kind of problem. And you would know more about that than I would.

Good Luck
Linus2nd

This. There are organizations that are qualified to help you navigate the moral quagmire that is healthcare. I’m sure either would bend over backwards to help a medical student learn and follow Catholic healthcare ethics guidelines.

I would suggest contacting your local Catholic Medical Society. Asking other Catholic medical professionals may give you a clearer perspective. Also ask your priest.

Interesting.

It’s obviously mortal sin to use contraceptives.

Further it would be grave matter to recommend someone use contraceptives.

However,

Someone coming into a doctor and asking questions of which you answer honestly is not sinful, it is spreading knowledge. Especially if coupled with a recommendation to just use abstainance.

In a similar manner,

A Catholic apologist knows a lot about witchcraft/paganism.

Someone discerning religion comes and asks an opinion of the apologist regarding religion.

Knowing the person is pagan the apologists, tells facts about paganism to the candidate and then tells his belief and why he rejects paganism.

This would be no more the apologist advocating paganism than the doctor advocating contraception.

Would the apologist be saying anything positive about witchcraft? Could it at all be perceived as a valid choice?

I think in a medical context if two choices are presented as options, it lends a certain air of validity to both options, even if the provider expresses an opinion about which one he prefers or recommends.

For example, the doctor might say, “You have cancer. You can choose surgery plus chemotherapy or just the surgery. If you do both, it increases your odds of survival, so that is what I recommend. But some people don’t like to do both because of the side effects associated with chemo.” Even though the doctor recommends doing both surgery and chemo, the second option (just surgery) is still presented as a valid option, even one with significant benefits. We could not fault the patient for choosing that course of action because it’s presented as a good choice.

Likewise, if a doctor says, “To prevent a sexually-transmitted disease, you should abstain from sexual intercourse unless you are married. Or you could choose to have sex and use condoms. I recommend abstaining because it is the most effective way to prevent the spread of disease, but if you use condoms, you would have to use them consistently for them to offer the most protection.” The patient may choose abstinence, but the doctor suggests through this conversation that the second option - condoms - while not ideal, is still a good option.

I see this being akin to the hypothetical gun violence conversation:

Teenager: I hate my parents! I wish they would stop nagging me.
Teacher: You could try talking to them. Maybe they would listen to your concerns. That is what I would recommend. If they don’t listen to you, most people are scared of guns and they would stop nagging you if you shot them. I don’t recommend that option because it’s against the law and it would hurt them.

Do you see what I’m saying? It becomes an affirmation of the extramarital sex (or gun violence) if it’s presented as a valid choices alongside other, perhaps better choices, during a discussion of options. It would be better if the teacher or doctor didn’t suggest the immoral course of action at all, and if it were suggested by the student or patient, the authority figure should explain why s/he does not recommend that course of action without making it appear to offer some benefit, since, in the doctor/teacher’s estimation, the harm is so damaging as to make it not worth considering.

I disagree with those who say it is simply a sharing of information, mostly because of the setting. I think it would be a sin of scandal because it would seem like an endorsement from a medical professional.

I used to be a health educator, and this is exactly the reason I chose not to teach health in the public schools when I became a teacher. While I love the health field, and wish I could teach things like healthy eating and fitness, there was no way for me to teach the curriculum without giving the appearance of endorsing the use of condoms and other contraceptives. I would say it would be easiest to just work in a specialty where that topic wouldn’t come up, or else talk to someone who specializes in Catholic ethics to make sure you don’t commit any sin.

Best of luck with your career! God bless…

Well using contraception is a valid choice.

It is a mortal sin but so is stealing and yet it’s a valid choice.

If the doctor both states his objection and refuses to prescribe contraception I see absolutely no culpability in his actions.

Lets face it a simple google search can answer this question for people so I’m sure it’s a relatively rare question for a doctor.

People can make their own decisions. Writing or describing information is not sinful.

Sounds strikingly like moral relativism to me…

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