A Frank Ob/Gyn's Message

An honest assessment of all things medical and ethical.

In my last column, I wrote about the uniquely human capacity to choose when and if to act on our natural sexual instincts. This should be sufficient grounds to accept that we should be held accountable and responsible for all of our actions in this regard. This applies not only to the most serious issue of consent but also other issues such as the proper context in a minimum of a natural marriage which doesn’t require religious belief or ceremony. As we come to appreciate that every act of marital intercourse is a conscious decision of the free will, we can better understand how the practice of periodic continence or “natural family planning” (NFP) is an entirely reasonable approach to postponement of child bearing that fully respects the man and woman’s human dignity.

We acknowledge that there do exist legitimate situations where it may be advisable for serious reasons (medical or others) to avoid pregnancy for a time or indefinitely. Accordingly, there is nothing intrinsically evil about delaying pregnancy. However, as with any noble goals (ends), there are morally licit (good) ways of seeking ends, and there are illicit (evil) manners of attaining the same end. A commonly used analogy is one where a father seeks to provide for his family. He could do so by performing honest work or he could do so by stealing or other criminal activity. Similarly, with regard to human fertility and marital intercourse, we know that those actions which intentionally cause the man or woman to be infertile at a time when conception might otherwise occur are contrary to human nature and also violate God’s law.

A frequent objection to the seemingly subtle distinction between contraception and “NFP” is that they are ethically equal since they have the same goal of avoiding pregnancy. In other words, why isn’t NFP just a Catholic version of contraception? The answer can best be understood in the context of the need to exercise self-control in a way that contraception actions do not require. The previous discussion on how animal behavior are not subject to free will explains why the Catholic Church does not condemn contraceptives and sterilization when applied to animals. Those familiar with animal population control programs are quite familiar with various types of contraceptives (even in vaccine form) that are routinely used among animal populations. Sadly, I think it needs to be stated hear clearly that those practices which are entirely legitimate for us to apply to animals are frequently in no way acceptable for human beings.

A more specific analogy that illustrates how NFP differs fundamentally from contraception can be seen in the comparison of dieting and fasting versus binging and purging with regard to weight loss strategies. Maintaining a healthy weight with occasional fasting and exercising self-restraint with regard to portions and food choices follows natural law and therefore promotes good health. Attempting to maintain a normal weight with the practice of induced vomiting and diarrhea (purging) after gorging on unhealthy quantities and types of food is contrary to natural law and is accordingly harmful to one’s health. Sexual love, like eating, were designed to be enjoyable as they are also required for maintaining and creating new life. Likewise, when these natural functions are abused (as only humans can do), profound spiritual as well as physical harm results.

On the most pragmatic level, as a physician, I must appreciate that the only 100% effective methods of avoiding pregnancy are either complete abstinence or complete castration. Many people should practice complete abstinence for at least some time for various reasons. One such example would be during the 6-8 weeks of healing after a vaginal surgery. Complete castration should only be performed when such is required to treat serious disease such as malignant cancer of the reproductive organs. Fertility awareness methods (my preferred term for what is often described as natural family planning) are equally or more effective than any of the various forms of contraception. Further development and defense of this point will follow in my next article.


Dr. Frank



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