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Dear Catholic Exchange,
Could you help me with a question about endometriosis? I have a 30-year-old friend whose doctor has prescribed the Pill for her because of her severe endometriosis. Are there alternatives to this treatment? Might the side effects she’s now experiencing as a result of the Pill be enough to offset her taking it? She is not married, but is going to become engaged to our son.
Thank you very much. God bless.
In Christ,
Connie
Dear Connie,
Peace in Christ! Number 15 of the encyclical letter of Pope Paul VI, Humanae Vitae (HV) refers to the question of “therapeutic means.” The Holy Father wrote:
But the Church in no way regards as unlawful therapeutic means considered necessary to cure organic diseases, even though they also have a contraceptive effect, and this is foreseen—provided that this contraceptive effect is not directly intended for any motive whatsoever.
The pope is using a principle of moral reasoning called the “principle of double effect.” The principle of double effect applies when one performs an act intending to bring about a good end but a foreseen, unintended evil side effect will result. Further the good end intended must be proportionately equal or greater than the unintended evil side effect. So you have a “double effect” resulting from an act — one good and one evil. The act that is the means to achieve the good end must not be, in itself, evil. One cannot do an intrinsically evil act under any circumstances and justify it on the basis that it has a good result. One may not do evil that good may come.
Endometriosis is a condition in which tissue from the uterine lining (endometrium) is found elsewhere in a woman’s body such as the ovaries, fallopian tubes, or abdomen. The effects can range from internal bleeding, to permanent scarring, which can cause infertility. Though there are a few different ways to treat endometriosis, hormonal treatments (the Pill or Depo Provera) seem to be the most common. Because of the effect of hormonal contraceptives on endometrial cells, endometriosis is kept in check.
With the treatment of endometriosis, in light of the directive of HV, the end intended is the relief of a condition. An unintended, but foreseen, consequence is the contraceptive effect, i.e., a potential conception is prevented. In light of the principle of double effect and applying the teaching of HV, it would seem licit to use a contraceptive to treat endometriosis. The treatment of the illness is proportionate to the unintended contraceptive side effect.
There is one very important aspect to consider. If the woman is not married, and presumably chaste, there is no question. However, if she is married and presumably engaging in the marital act, one must ask if the contraceptive is also an abortifacient. If a conception is possible, the potential abortion of a human embryo is an evil side effect that, many Catholic moralists hold, is not rightly proportionate to the good end intended. The Pill in its common form is known to be abortifacient, so one must consider it, not merely a contraceptive, but also an abortifacient. There are other Catholic moralists who hold that because a resulting abortion is only potential and indirect (direct abortions are never morally permissible), using contraceptives with abortifacient properties legitimately falls under double effect and would, hence, be permissible.
There are a couple of institutions that specialize in just these sort of issues and exercise complete fidelity to the Magisterium in their work and research: The Pope Paul VI Institute, 6901 Mercy Road, Omaha, NE 68106-2604; Ph: 402-390-6600, Fax: 402-390-9851. The Couple to Couple League, P.O. Box 111184, Cincinnati, OH 45211-1184; Ph: 513-471-2000, Fax: 513-557-2449.
Both of these fine organizations have years of experience. The Pope Paul VI Institute was founded by Thomas Hilgers, M.D., and The Couple to Couple League was founded by John and Sheila Kippley. Each work closely with numerous medical professionals. That is to say, both of these organizations are sound on both moral and medical grounds. It could be that they are aware of medically sound alternatives to treat endometriosis. In addition to the contraceptive/abortifacient properties, the Pill has potentially adverse side effects that might be avoided by other means. It is often the case that other possible treatments are not offered, either because the doctor is not aware of them (they don’t teach everything in medical school) or because it is simply easier to distribute the Pill.
If you have further questions on this or would like more information about Catholics United for the Faith, please contact us at 1-800-MY-FAITH (693-2484). Please keep us in your prayers as we endeavor to “support, defend, and advance the efforts of the teaching Church.”
United in the Faith,
David E. Utsler
Information Specialist
Catholics United for the Faith
827 North Fourth Street
Steubenville, OH 43952
800-MY-FAITH (800-693-2484)
