Vasectomy: what the Church says about permanent male contraception

Vasectomy: what the Church says about permanent male contraception

In the Bible, God said to Adam and Eve: “Be fruitful and multiply.” Should we understand this sentence as a recommendation to have as many children as possible?

Father Bruno Saintôt: This quote from Genesis has been interpreted differently depending on the context. The world described in the first mythical account of the beginning of the world (Gen 1) is intended to be in development, in orderly growth, whereas it was initially “formless and empty” (Gen 1:2). To grow is the opposite of to decline. The second story describes a “garden” that man must “work and keep” (Gen 2:15), that is to say, he must “take care of” it. Taking care is opposed to predation and exploitation of the world and other living things considered as an inexhaustible resource. It is certain that fears of overpopulation, which emerged in the 1960s, played a role in the interpretation of these stories.

Over the centuries, the relationship with the child has changed depending on the economic context (depending on whether we lived in an agricultural or industrial world, whether or not we had the resources to feed children), medical ( high or low infant mortality), political ideals and pressures (having children for social prosperity and to wage war), religious ideals (giving “new children” to the Church so that it develops), housing (possibility of living or not with parents and grandparents), etc.

In these different contexts, the Church has never said that we should “have as many children as possible”, but the overall guideline is indeed that of generosity in welcoming children. The Second Vatican Council took note of the new context of life in the 1960s and insisted on the “responsible transmission of life” (Gaudium et spes1965, § 51, 3).

In 2015, Pope Francis defended “responsible fatherhood”, indicating that to be good Catholics “it is not necessary to procreate “like rabbits”. What was he talking about?

The humorous expression of Pope Francis is not very happy, because it was perceived as a criticism of large families. She wanted to point out the erroneous understanding that one should have “as many children as possible.” Pope Francis only recalls the central affirmation of the Council that it is up to spouses to discern in responsibility the number of children they wish to educate by taking into account multiple parameters and by forming, “by mutual agreement and with a common effort”, a “right judgment”: “They will take into consideration both their own good and that of children already born or to be born; they will discern the material as well as spiritual conditions of their time and their situation; they will finally take into account the good of the family community, the needs of temporal society and the Church itself. (Gaudium et spes1965, § 50, 2)

The notion of “responsible fatherhood” was first developed by Paul VI in the 1968 text, Humanae vitae (§10), and in the context of the long debates on the moral legitimacy of contraception. He insists on the fact that the notion of “responsible paternity” must “be exactly understood”, that is to say not become a reason to admit contraception but only the so-called regulation natural births. Then John Paul II recalled that “responsible fatherhood” is not a question of unlimited procreation or of a lack of awareness of what is involved in the education of children, “(…) but rather the possibility given couples to use their inviolable freedom wisely and responsibly, taking into account social and demographic realities as well as their own situation and legitimate desires, in the light of objective moral criteria” (Letter to the Secretary-General of the United Nations International Conference on Population and Development of March 18, 1994).

We should of course talk today about “responsible fatherhood and motherhood” or the “responsible choice to become parents” (Amoris Laetitia, 222). More than his predecessors, Pope Francis insists on the discernment that belongs to couples, particularly in Amoris Laetitia from March 19, 2016.

Should we see this as an open door to Catholics for vasectomy?

Not at all, in the sense that vasectomy is a method that permanently prevents conception while contraception prevents it temporarily. Since Pius XII, all successive popes have kept the same doctrine: sterilization is decreed more serious than contraception, except for serious medical reasons where sterilization is not directly desired. As early as 1951, Pius XII affirmed: “direct sterilization – that is to say, which aims, as a means and as a goal to make procreation impossible – is a serious violation of the moral law and is, therefore, illicit .” (Speech to participants of the congress of the Italian Catholic Union of MidwivesOctober 29, 1951).

Three texts from the Congregation for the Doctrine of the Faith take up this general principle of the ban in different contexts, notably illness, in 1975, 1993, 2018. They give rules for applying this principle without calling it into question and deal more precisely with different reasons for hysterectomy at the point from a medical and moral point of view. The texts do not in fact speak of vasectomy, but of tubal ligation (an operation formerly called “isolation of the uterus”) or hysterectomy. It is therefore, as with contraception, the woman who is concerned. Current perspectives of male contraception and vasectomy seek to “balance” responsibilities within the framework of social developments in male-female relationships.

Undoubtedly due to Catholic influence, the opposition of many doctors to voluntary sterilization led French law to formulate a specific conscience clause relating to “ligation of the tubes or vas deferens for contraceptive purposes”: “A The doctor is never required to perform this act for contraceptive purposes but must inform the person concerned of his refusal from the first consultation.” (Public health code, art. L2123-1).

Should we make a difference between a man who is already a father and chooses a vasectomy because he no longer wants children and a young man who uses it because he does not want one at all?

All Catholic moralists will obviously make this distinction from the point of view of the analysis of ethical gravity. But the principle laid down has been very firm since Pius XII. The text of the Congregation for the Doctrine of the Faith of 1975 speaks of the refusal “of an approval of direct sterilization… which, in the objective order, is by nature (or intrinsically) evil” (Congregation for the Doctrine of the Faith, Response to questions from the North American Bishops’ Conference regarding sterilization in Catholic hospitals (Quaecumque sterilizatio. Responsa ad quaesita conferentiae episcopalis Americae Septentrionalis circa sterilizationem in nosocomiis catholicis) March 13, 1975, AAS 68, 1976).

The question of vasectomy revives the challenge to the doctrine of the Catholic Church relating to contraception. For a majority of Catholics, contraception is no longer an ethical question, except for those who consider, particularly out of ecological concern and health concerns, the physiological and psychological consequences of hormonal contraception on women. The moral argument is therefore very different from that adopted until Benedict XVI.

The new thing is that the younger generations, especially in wealthy circles and including in the Catholic Church, are showing themselves to be more and more sensitive to questions of overpopulation (“no kids” movement), to the human impact on the environment. , to equality between men and women, particularly with regard to birth control. These factors combined could lead to greater acceptance of vasectomy, including among some Catholics.

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