The Lancet Strikes a Major Blow to the Pope's Flawed Argument Against Condom Use for prevention of HIV transmission

The Lancet, one of the most respected medical journals in the world joins the many public health professionals to call the Pope out for his irresponsible statement on condom use with regard to the HIV epidemic.

The Lancet states in an editorial, "When any influential person, be it a religious or political figure, makes a false scientific statement that could be devastating to the health of millions of people, they should retract or correct the public record."


AFP "Pope 'publicly distorted' condom science: Lancet"

See my previous posts on the Pope's comments here and here .

The Lancet

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Contraceptives and Catholics: "Sex and Drugs" goes to Divinity School for a Day

To understand some of the Catholic Church's recent stances on condoms (See my previous post )and abortion of a nine-year old incest survivor in Brazil (Source: Huffingtonpost), I thought it would be useful to review a key document that informs some of the Pope's recent decisions and statements. I'm no expert in religion and it shows- I just have more questions!

Documentation that Guides Catholic Church

Decisions

While the Old and New Testament address adultery and divorce, there is no Bible-based guidance to Christians on use of contraceptives, which came later. The reference most commonly used in Catholicism is the Humanae Vitae- a document attributed to Pope Paul VI in 1968. (Source: Wikipedia)

The Humane Vitae was written in response to the oral contraception becoming available in 1960 and a Catholic Church Commission Report in 1966 which proposed that, "that artificial birth control was not intrinsically evil and that Catholic couples should be allowed to decide for themselves about the methods to be employed", and a minority report which held that contraception was instrisically evil. (Source: Wikipedia)

The Humanae Vitae prohibits use of artificial contraception, but does not label it as evil and overall is a complicated document which is supposed to reaffirm previous Church positions and embody some of the conflict within the church on contraceptives. (Source: Wikipedia)

Three Catholic Cheers for Sex!

The Humanae Vitae does take a tremendous step and call, "sexual activity, in which husband and wife are intimately and chastely united with one another, through which human life is transmitted, is...noble and worthy.''

Hurrah for the Catholic Church's appreciation of sex!

Asserting an Inseparable Connection and then Severing it?

The Vatican's Humanae Vitae "is based on the inseparable connection, established by God, which man on his own initiative may not break, between the unitive significance and the procreative significance which are both inherent to the marriage act" yet "the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles."

Now this point confuses me. The overall point of this document is to say that the benefit the couples gets from sex relating to couple unity and intimacy should never be separate from the other benefit of sex- procreation. Yet then the document goes on to say that it is allowable for couples to time when they have sex to reduce the potential that the sex act will result in a pregnancy.

All is supposed to be "cleared up" when the documents says that "neither the Church nor her doctrine is inconsistent when she considers it lawful for married people to take advantage of the infertile period but condemns as always unlawful the use of means which directly prevent conception".

Oh thanks- all clear now.

My biggest issue with the Humane Vitae is that it states "an act of mutual love which impairs the capacity to transmit life which God the Creator, through specific laws, has built into it, frustrates His design which constitutes the norm of marriage, and contradicts the will of the Author of life. "

This is in conflict with my limited understanding of the Catholic interpretation of the power of God. As I understand, God is all powerful and miracles are possible. Couples who were previously thought to be infertile have been able to conceive and this miracle is attributed to God's will. How can we be so arrogant to belive that these small steps could override God's will?

As the religious right has brought up many times, there is no contraception that is 100%- not condoms, oral contraceptives, even sterilization. "In the United States, most studies of breakage caused by fault in the condom itself have shown breakage rate is less than 2 condoms out of every 100 condoms. Studies also indicate that condoms slip off the penis in about 1-5% of acts of vaginal intercourse and slip down (but not off) about 3-13% of the time." Avert.Org Condom Effectiveness If condoms work only 87-97% of the time, there is room for divine action.

The % chance for divine intervention for condoms is not too far off with perfect practice of contraception by following natural cycles. Chances of pregnancy in a typical ovulation calendar varies by day from 0-20%.

Why must a fertile 20-something be held to a higher standard of self-discipline than an infertile peer or the post menopausal generation? Chances of conceiving post menopause are extremely low per "Ask Our Expert" at drspock.com. Why do the baby boomers get to have all of the fun?

Limiting contraception to "infertile methods" puts the moral burden unevenly on the most fertile part of the population. If we were to truly hold ourselves to not separating the procreative and couple-intimacy benefits, wouldn't those populations who were less fertile be expected to abstain from sex full stop?

Understanding Why the Church Accepts Natural Cycle Contraception, but Not Artificial Contraception- Unpacking the Concept

Why is natural cycle contraception considered ok while artificial contraception (oral contraception, injectables, condoms, etc.) is not? I'll paraphrase the HV's section on this using two couple examples- Couple A live within the church rules of maintaining intimacy while avoiding a pregnancy while Couple B are avoiding a pregnancy using artificial birth control.

There seem to be two major arguments:

(1) Couple A's abstinence during the most fertile times of the ovulation cycle is self control that demonstrates their true love for each other, so they may have sex during infertile times with the intention of avoiding pregnancy within the rules of the church. Couple B is not practicing a method that is time-restrictive and are therefore not sacrificing anything to demonstrate their true love.

(2) Couple A is taking advantage, "of the natural cycles immanent in the reproductive system and engage in marital intercourse only during those times that are infertile, thus controlling birth in a way which does not in the least offend the moral principles", while Couple B obstructs, "the natural development of the generative process".

Is this the Catholic Church's Feminist Manifesto? If So Can I Get an Upgrade?

This document also asserts that that "a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires, no longer considering her as his partner whom he should surround with care and affection."

It is odd to me that the same document which praises self-discipline could expect such a severe swing to depravity with the simple use of contraceptives. Cases of men's lack of reverence of women, unfortunately, predates contraceptive devices. Regulating use of contraceptives will not change this- though perhaps if men were able to become pregnant this would change. The HV is supposed to be a statement with the Church's, "new understanding of the dignity of woman and her place in society"- but to me, limiting a woman's access to birth control seems to impair her ability to have her dignity.

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Pope Benedict dicts around with human lives in the face of the HIV epidemic, 359 years until the apology comes?

As a child of a lapsed Catholic, I do care about what the Pope says. As an epidemiologist, I am disappointed with the Pope's recent statements in Africa against the utility of condom use in reducing the spread of HIV. "You can't resolve with the distribution of condoms,"... "On the contrary, it increases the problem." Source: Yahoo News article on the Pope's stance.

In doing so, he ignores the immense body of evidence that condoms used effectively and consistently are very effective in preventing the sexual transmission of HIV and other sexually transmitted infections and that promoting condom use and increasing access to condom do not increase frequency of sex or number of sex partners. (Smoak et al, Sexual Risk Reduction Interventions Do Not Inadvertently Increase the Overall Frequency of Sexual Behavior: A Meta-analysis of 174 Studies With 116,735 Participants J Acquir Immune Defic Syndr 2006;41:374Y384).

He also sets back the progress that has been made to increase condom use in Africa and countries with large Catholic populations.

This is especially sad because in 2006, the current Pope was considering softening the Catholic Church's stance on condoms. Cardinal Carlo Maria Martini, a moderate in the Vatican said in April 2006, "We need to do everything possible to combat AIDS. Under certain conditions, the use of condoms is necessary. Those who are afflicted have an obligation to protect the other partner," and the Vatican's equivalent of health minister, Cardinal Javier Lozano Barragan, said that the Pope had taken the initiative on taking another look at the condom issue. Source: Deutsche Welle.

It does seem that the Catholic Church does have people who are a bit more sensible on life in the times of HIV. Cardinal Godfried Daneels of Belgium, who was once considered a candidate to suceed John Paul II, had a more sensible position to condom use. In 2004, he stated that someone had HIV could use a condom to protect life. Source: WorldNet Daily.

It took more than 300 years for the Catholic Church to apologize for persecuting Galileo and 60 years to apologize for its inactivity against the Holocaust. Perhaps with another 2 million deaths from AIDS-related complications (annual mortality rate is just over 2 million- source UNAIDS), including sero-negative spouses of people living with HIV, the apology and change from the Catholic Church will come sooner?