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African bishops reject condoms to counter AIDS

NCR Staff

The Southern African Bishops’ Conference released a statement in late July saying the promotion of condom use to combat HIV/AIDS was an “immoral and misguided weapon against the disease.” However, the bishops left open the option for married couples to decide for themselves how to defend against the disease when one of them is already infected.

“Condoms may even be one of the main reasons for the spread of HIV/AIDS,” the bishops said in a statement issued July 10 following their seven-day plenary meeting in Pretoria, capital of South Africa. “Apart from the possibility of condoms being faulty or wrongly used, they contribute to the breaking down of self-control and mutual trust.”

The statement from the more than 30 bishops from South Africa, Botswana and Swaziland is only the latest in an often contradictory range of opinions from Catholic officials in response to the AIDS pandemic, as some have attempted to reconcile the church’s bans on extramarital sex and contraception with the need to stem the spread of the disease. Dealing with condoms in particular, opinions have ranged from the condemnation of their use in any case, to permitting the use of condoms when an infected person does not choose chastity.

The Southern African bishops’ discussion followed widely reported remarks by South African Bishop Kevin Dowling of Rustenburg, who said that in a narrow set of circumstances the use of condoms would be acceptable as “the lesser of two evils,” according to Catholic moral teaching.

Dowling, the South African bishops’ liaison for AIDS programs, said the only complete safeguard against HIV infection is abstinence from sexual relations before marriage and faithfulness in marriage. But he said the process of moral education would be slow. “We must promote a prevention strategy where people will be challenged if they are not going to follow essential values for prevention, then at least they must take account of their responsibility as a human being in sexual activity not to transmit death and use a condom to prevent it,” he said. Dowling said June 28 that he planned to present to his fellow bishops a “reflection document” dealing with condoms from that perspective.

More than 4.5 million South Africans are HIV positive or have AIDS. The nation has the highest prevalence of HIV infection among adults in the world.

The South African Catholic newspaper Southern Cross voiced its support for Dowling in an editorial published the week before the bishops’ meeting. “Condoms, when used to save a life, provide one way, albeit an imperfect one, of stemming the AIDS pandemic,” the editorial said. “In that light, the church is called to reconcile its total ban on prophylactics with the philosophy of the sanctity of life.”

In the end, Dowling’s proposal was rejected by the bishops’ conference after a discussion described in news reports as lengthy and sharply divided.

The debate among the Southern African bishops is representative of the ongoing attempt by bishops, theologians and other church leaders to wrestle with the use of condoms to prevent the spread of AIDS. Last year, Pope John Paul II’s own in-house theologian, Dominican Fr. Georges Cottier, described the question as “an ongoing debate.”

Some theologians maintain it is immoral to use condoms under any circumstance. At a 2000 Vatican conference on AIDS, Camillian Fr. Felice Ruffini, undersecretary to the Pontifical Council for Health Care Workers, said that even in marriage in which one partner is infected with HIV, condom use is always prohibited. “Certainly, it’s difficult, it’s tough to be able to maintain matrimonial chastity in this case,” Ruffini said, but moralists cannot make “an exception to Christ’s law.”

Other church officials have, like the Southern African bishops, cited exceptions for married couples, as long as the principle intent of condom use is to defend the healthy partner from infection rather than to prevent pregnancy. Franciscan Fr. Maurizio Faggioni, professor of moral theology at Alphonsianum university and a consultant to the Congregation for the Doctrine of the Faith, has described this as an application of the Catholic moral principle of “double effect.”

The principle of the lesser evil cited by Dowling -- that violation of an obligation of chastity should not be compounded by a violation of justice in the threat to another person’s life -- has been invoked by other church officials to defend condom use.

In 1996, a report from the Social Commission of the French hierarchy said, “condom use is understandable in the case where a pattern of sexual activity is already established and in the interest of avoiding a grave risk.” In the 1990s, appeals to the principle of lesser evil have been put forth by other bishops around the world, including Cardinal Christoph Schönborn of Vienna, accompanied by cautions that teaching about condoms should not overshadow leading people to practice chastity and sexual fidelity within marriage.

The same reasoning was implicitly sanctioned in a 1987 document, called “Many Faces of AIDS,” prepared by the administrative committee of the U.S. bishops. However, after Cardinals Bernard Law of Boston and John O’Connor of New York objected to Rome, a second document was published in 1989. That document, “Called to Compassion and Responsibility,” did not rescind the first, but condemned educational programs promoting the use of condoms to counter AIDS.

Cottier has declined to say whether he thought the principle of lesser evil applied to condoms and AIDS, but said, “I personally think that one must take into account the fact that the sexual act in these circumstances leads to death. The principle fully holds: Do not kill.”

The final statement from the Southern African Bishops’ Conference, released July 30, stepped back from Dowling’s appeal to the lesser evil principle. It said that the promotion of condoms for AIDS prevention, especially by governments, “is a matter of deep concern for us in the church.” The statement emphasized that condoms do not guarantee protection against AIDS and that they “change the beautiful act of love into a selfish search for pleasure, while rejecting responsibility.”

“Abstain and be faithful is the human and Christian way of overcoming HIV/AIDS,” the statement said.

Addressing married couples with one of the partners living with HIV or AIDS, the bishops did not directly refer to condom use, but said that the spouses “must listen to their consciences. They are the only ones who can choose the appropriate means, in order to defend themselves against the infection. Decisions of such an intimate nature should be made by both husband and wife as equal and loving partners.”

In their statement, the bishops also called on all South Africans to “break the silence” surrounding AIDS and to accept those who are diagnosed with the disease.

In a news conference to announce the statement, Cardinal Wilfrid Napier of Durban, South Africa, acknowledged such means of prevention for married couples could include condom use, if the couple abstained from sex while the woman was ovulating, the Associated Press reported. “This is one possibility during which the condom could be used in a morally responsible situation,” said Napier, president of the bishops’ conference.

Napier also told reporters that Dowling’s position had not changed. “It would be fair to say that his position is a different one” from the one expressed in the final statement, the cardinal said.

Dowling, who left the bishops’ meeting early, was traveling and unavailable for comment.

Jesuit Fr. Jon Fuller, a medical doctor with the Clinical AIDS Program in Boston, called the Southern African bishops’ statement “confusing.”

“The bishops seem to be setting up a false dichotomy, that any use of condoms creates a climate of promiscuity,” said Fuller, who is an associate professor of medicine at the Boston University School of Medicine.

“The bishops recognize the legitimate use of condoms in marriage -- but if they say condoms are not effective, then why recommend them? Why is it OK to use them to protect married couples, but not other lives -- the lives of sex workers and their partners, and people who choose not to be abstinent or in marriage?”

Noting the other bishops who have made statements similar to Dowling’s proposal, Fuller said, “Their point is not to change sexual ethics, but also to pay attention to the command not to kill. If you are violating chastity, don’t also violate the fifth commandment. The preservation of human life is the highest priority.”

Jesuit Fr. James Keenan, professor of moral theology at Weston Jesuit School of Theology and editor of Catholic Ethicists on HIV/AIDS Prevention, said of the recent debate among the Southern African bishops, “What we are witnessing is the painful process of an eventual recognition of the moral licitness and the medical significance of condoms in a time of HIV/AIDS. For the past 15 years many moral theologians have written about the application of traditional moral principles that on the one hand protects church teaching on Humanae Vitae and on the other hand permits the use of condoms as a preventative strategy against HIV transmission. Clearly, we need to keep talking about the need for people to reform their lives, but that call must be with and not opposed to other prevention strategies.”

The statement from the Southern African bishops “certainly does not end the conversation,” Fuller said. “It should further stimulate dialogue on this question. What are our priorities here -- defending an ethic of sexuality, or protecting lives?”

Catholic News Service contributed some information used in this report.

The e-mail address for Teresa Malcolm is tmalcolm@natcath.org

National Catholic Reporter, August 10, 2001