Hellegers, Andre E.

English

epublications@Marquette

The Linacre QuarterlyVolume 40 | Number 2 Article 5May 1973Population, Rhythm, Contraception and AbortionPolicy QuestionsAndre E. HellegersFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationHellegers, Andre E. (1973) "Population, Rhythm, Contraception and Abortion Policy Questions," The Linacre Quarterly: Vol. 40 : No.2 , Article 5.Available at: http://epublications.marquette.edu/lnq/vol40/iss2/5,. A third area that is sure to cause increasing concern in Catholic hos-pitals in the light of the recent Su-preme Court decision is that of abortive procedures. Many Catholic hospitals have formally reaffi rmed as hospital policy the position on abortion stated in the Directives, but it is feared that attempts may be made to force Catholic hospitals by court order, especially in those areas where they are the only health faci lities serving the community and where they have received commu-nity funds, to permit abortive pro-cedures within the guidelines al-lowed by law. Other Factors Other issues which have been raised concern questio ns regarding the moment of death, euthanasia, organ transplantation, genetic counseling, experimentation guide-lines, medical fees and expenses, and the delivery of health care for the poor and needy. From these indications it is quite clear that the present Ethical and Religious Di-rectives for Catholic Health Facil-ities promulgated by the American Bishops are far from being regarded as a finished product, but rather mark the beginning of what will hopefully be a ·continuing and co-operative effort among all involved in the health care apostolate to work towards a more adequate and com-prehensive summary of guidelines for medical care in Catholic health facilities. In light of the available evi-dence, the followin g recommenda-tions seem to suggest themselves as appropriate regarding the present Directives: ( I ) that loc.al Bishops 90 promulgate and individual hosp· tals formally adopt the Directive as official policy even while rec ognizing the limitations of the doct ment and thereby acknowledgin their responsibility to be part of continuing process of updating an renewal, (2) that serious and co1 tinuing education programs be a· ranged on the hospital, diocesa , and state-wide levels for all men bers invol'Ved in the health ca1 · apostolate in order that the Chri tian moral values and theologic I principles that underlie the E>ire -tives and that are crucial to the r proper understanding and imp! mentation might be better graspe (3) that medico-moral committe s be established on the hospital, c -ocesan or state levels comprisi1 g representation from all areas f the health care apostolate to cre2 e the necessary bridge that w II translate the abstract Direc~i\ s into responsible, concrete det t -sions, sensitive and responsive o the particular circumstances of t e individual case, and (4) finally, tl tt clear channels of communicati •n be established to forward local c '(-perience, questions and difficult .!S to the Bishops' Committee >n Health Affairs whose responsibi l ty it is to make the Directives e· er more responsive to the realities of the Christian experience. 0 . ly when the above elements are m• •re widely and effectively realized at all levels can we expect the Eth-ical and Religious Directives for Catholic Health Facilities to be re-vised and to reflect more clearl v a Christ-like concern for the sick and suffering. ®. Linacre Quarterly Population,_ Rhythm, Contraception and Abortion Policy Questions Andre E. Hellegers, M.D. The recent Supreme Court abor-tion decision . has caused a great deal of anguish in Catholic circles as well as in some others. It is too soon to judge the effects, but it may be confidently predicted that attempts to amend the Constitu-. tion will be made. Since that is a . long process, and since it is likely to be tried again and again if it does not succeed at first, it is clear that for several years there will be much public bitterness in the en-tire area of human reproduction. Yet while the abortion debate will rage in all its bitterness, we cannot avoid other issues in human repro-duction. In fact this may be the very best of times to reflect on what should be done and to recog-nize that many things should have been done long ago. Our past neg-ligence comes out all the more clearly and our future needs seem all the more obvious. We must recognize first of all that the world is presently under-going an unprecedented rate of population growth. In a sense it is a gigantic medical success story, overwhelmingly due to a massive international reduction in infant death rates. We used to bury the problem by burying our children. Now we save them and they be-come the parents of further chil-~ren. The very rate of the success •s the problem. Death rates of I 0 per I 000 and less are now wide-ly if birth rates continue at levels of 40 per I 000, typica l of coun-tries where family planning is not yet in vogue, growth rates of 30 per I 000 or three percent will, and do, occur. This yields a dou-bling of populations in less than 25 years. Common sense tells us that this cannot long continue. It may be argued that this is of no concern to the United States -that recent figures clearly show we have our reproduction under control. Two points are to be stressed in this regard. The first is that av-erage family size in the late 1920's and 30's was no greater than today, yet it was followed by the baby boom of the 1950's. What we are seeing today may simply be a de-lay in the having of a first child Dr. Hellegers is the Director of The Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics. He suggests positive steps that the Catholic Church can take in deal-spread in the developing countries, ing with the problem of overpop-excluding parts of Africa. Obvious- ulation and reproduction. May, 1973 91 and a delay in marriage, just as in the 1950's we suddenly decided to marry and reproduce earlier. The devastating population ex-panding effect of early marriage, or rather childbearing, is schemati-cally presented in Table I. Here in both families A and B, a boy and girl are aged 20 in the year 1900. They are to have four children each, as do all of their descendants. All die at age 70. The only differ-ence between them is that family A has its children at age 20 (quad-ruplets in the first year for mathe-matical simplicity's sake! In family B they have the quadruplets at age 30). Nothing more devastat-ingly shows the dire effects of early reproduction with close pack-ing of generations. Any tendency to delay childbearing, if it occurs fairly suddenly, will yield data on average family size for a given year which are deceptively low until the children are ultimately had . One present possibility is that we are turning from Type A into Type B families, without it nec-essarily meaning that we will only have the mythical 2.1 I children suggested by advocates . of zero population growth. First then, we s hould not be blinded to the real possibility of marked growth in U.S. population on the basis of the trend during this decade . We did grow from the 1920's to the 1950's and surely it was not because we knew less about fam-ily planning in the 1950's than in the 1920's that · we had more chil-dren in the 1950's. The second point is that there is no reason for complacency among 92 Catho lics when family sizes of tw are reached. We know fro m man surveys that this is produced ove1 whelmingly by methods other tha rhythm. We must therefore acknowledg that four facts are to be of concer to the Catholic community: I . There is, on a world-wide br sis, an unprecedented rate of popu lation growth ; 2. The United States may w.e go back to the growth rates of th 1950's; 3 . If the United States or th rest of the world were present! to reach a fami ly size of two chi dren , it would be in spite of th teachings of Hu manae Vitae; 4 . Early marriage . and reprodut tion have a devasta ting effect o 1 population growth, as they a1 · a lso shown to be associated wi t 1 markedly higher divorce rates. It would be my suggestion · th: t in the middle of the abortion acr -mo ny we try to do what we shoul ! have done long ago, cooperate wi t 1 all others of goodwill to dimini s 1 the magnitude of the abortion an 1 other problems. T his is all th; more important since 1974 h; s been proclaimed " Population Yea1'' to dramatize the world populatic n problem. It could easily degenera c into an abort ion d ebate and ma~k very positive steps that could 1:-e taken by the Cathol ic community and its leaders. Action Needed We should constantly keep 10 mind some simple biological facts. Conception occurs fro m bringing sperm and ovum together. Rhythm a ims at keeping s perm and ovum Linacrt: Qua rterly May, 1973 8 .0 N 0 N <:>< v -o "'"' -o ~. "' -N + N v ~. + "' "' + ..... ~ I ~ I + "' ..... ~I ... 0 z 93 . ' apart wi thout drugs or appliances while maximizing the possibilities of intercourse. "Artificial" contra-ceptives a re a imed at interposing a barrier between sperm and ovum or destroying ei ther. In orde r to bring any of these processes fully under human con-trol, we need basic research in re-productive bio logy. Put mo re clear-ly: Those interested in curing ste-rili ty, in enhancing fertility, in per-fecting rhythm or in producing contraceptives or abortifacients require the selfsame fundamental knowledge of sperm, ovum an menstrual physiology. I inclu< the cure of sterility since the steri invariably will pay the price f( perfect fertility control whetht by perfect rhythm, perfect contn ceptio n or perfect abortion, sine there will be no children to adop This research in reproducti' · biology is immensely expensiv No private or religious found; tion can support such work by_ i self. It requires major feder funding. Table I I shows na tiona l · ex-TABLE II FEDERAL SU I' PORT OF FAMILY PLA~NI~G SERVICES AND POI•ULA TION RESEARC H (U. S. in Millions of Dollars) (est.) Family Planning Services 1967 1968 1969 1970 197 1 1972 1973 I . OEO Famil y Planni ng Project Grants 4. 1 8.5 13.8 22.0 23.2 24.0 15.0 2. DH EW Family Planning Project G rants 12.0 2208 33 .6 98.9 14000 3 . D H EW Comprehe nsive ~laternity a nd Infa nt C are Projects 2 .5 4 0 D H EW ;\ la ternal a nd C h ild 2.5 2.5 3.0 Health Program 2.5 3.5 3.5 3.5 17.0 17.0 17.0 50 O ther _::.:.20~2 __ 1:..:·::..5 _ _:2::·::...5 __ 4_:.0:.._........::.6.:.:.5 __ 8::...0_:7 __ 1 0_.6 TOTAL 11.3 16.0 34.3 55 .3 80.3 148 .6 182.6 Research I . Reproduc tive Bio logy and C o nt raceptive Development U Basic Re•earc h . 0 .... 0 .. 4 .7 5°6 4°8 7.3 7.8 12.5 N Directed Research . . . . . 1.4 3.9 3.8 4 .2 S Product Development 2.2 3.5 P 2 . Testing i\ledical Effects of E Available M ethod~ 1.2 0.7 U 1.6 3.2 4.4 C 3. Behavioral Science• 002 1.0 2.1 6°1 7 . 1 I 4 . ;\lanpower Development r (trai ning) 2.0 2 . 1 2.4 207 3.0 2°9 I 5. Po pulation Research Centers 0 .3 1.5 E 6. Federal Agency Staffing ~0::.:. 2 _~0:..:. 3 _~0-:..:3 .__0:::0:....7 _ _:0:.::. 8::.... _ __::.0.:.:. 7:..___-=.D TOTAL 8. 1 8.9 11.2 18.3 27.2 36.8 36.8 94 Linacre Quarterly penditures for family _planning services and research by the U.S. government (exc luding foreign aid programs). It will be immedi-ately apparent tha t the famil y plan-ning services · have markedly in-creased . In other countries these services would never have been listed in a budget related to the population proble m. They would be included under health insur-0 ance schemes. It needs little imag-. ination to add U .S. abortion costs to these figures and see that we annually spend very la rge and in-creasing sums o n the rendering of services of which official Catholic teach ing hardly approves. Compare these costs with the expenditures in reproductive bio l-ogy, here called "contracepti ve de-velopment." These are the funds used to · study sperm, ovum and menstrual physiology. It is fro m these funds that the solution to rhythm must come. Compare these figures also with the items listed as behavioral sci-ence. III-named, these funds a re supposed to finance the study of the entire nature of the popula-tion problem - its sociological, demographic, psychologica l and economic antecedents, processes and consequences. The population research centers, and the training of experts in the area, obvious ly show in their funding that we a re more inte rested in doing things than in ana lyzing whether we a re doing the right things or whether we ought to be doing additiona l ~r different things. Moreover train-Ing progra ms have recently been ended, aond the s tudy centers wi ll May. 1973 be phased out. In brief, it is clear that if the Catholic community means what it says in opposing abortio n and arti ficial contraception, and if it is at a ll honest m its interest in perfecting the rhythm system, it has been de re lict in its duty. An-nually appropriat io n heari ngs are held in the Congress. Innumerable lobbies plead their respective causes. Representatives of the Catholic hierarchy have pled their many causes without hesitation. Yet to the best of my knowl edge there has never been a move o n the part of the official Catholic Church to demand an increase in expenditure of funds in reproduc-tive biology until the problem of rhythm is solved. No Catholic bi sh-op, to my knowledge, has asked for the funds to study the demo-graphic factors and non-biological solutions to perceived populatio n problems. If today suction bottles, curettes and saline are decried in Catholic circles, we must accept our share of the blame for not having lob-bied for the a lternatives. We shall a lso have to recognize that we have done very little to counter the trend to early marri age and reproduction with its high attendant popul ation growth and di vorce rates. We have done little to spearhead the admissio n of wom-en to colleges and jobs which can be effecti ve in delaying childbear-ing. Indeed we have tended to op-pose those trends which could have helped to alleviate the prob-lems we now face. It may be argued that support-95 ... ~. ; ,. . :-... ing research in reproductive biol-ogy may lead to birth control meth-ods the Church opposes, including early aborti facients. But ultimately . we shall have to show that respon-sible pa renthood as we under-stand it is a viable alternative to what presently reigns. Whether the knowledge required can a lso be used in ways of which we do not approve should not, under the principle of the double effect, re-strain us from pushing for the knowledge which can be used properly. We do not oppose atomic research because it may produce better bombs when we know it may solve the energy crisis. Recommendations would make several recom-mendations which I believe long overdue: I. That the offici al Catholic Church strongly lobby for in-creased expenditures in reproduc-tive biology research . Presently the administration spends less than one-th ird of the funds recommend-ed by one study committee after the o ther. The President's personal-ly stated repugnance of abortion should be an indicator of his will -ingness to concur in such expendi-tures. Certainly more human li ves will annually be lost through abor-tion tha n through cancer and heart disease combined, yet these are the maj or areas of researc h expan-s ion tod ay. 2. That demographic research which is a t the heart of the na-ture of population and reproduc-tion problems be strongly support-ed by the official Church . 96 3. That the Vatican re presen tives at the official internatio d conferences of the United Natic ;, during the 1974 Population Ye ", take the lead in advocating p )-grams to delay age at marriage. n so doing, a ll those interested n lowering popula tion growth ra >, divorce rates and in improving e opportunities for the education ;1 d development of women's tale ts could make common front. . 4. That Catholic leaders, hier r" chical and private, encourage Ca 1-olic foundations to foster ' the s-tablish ment at Catho lic univet i-ties of major research centers tn problems of population, reprod -:-tion and the fami ly. Major Cath< ic lay organizations like the Kni g ts of Columbus and the Natio al Catholic Council of Women < 1d Men should have taken the h td in this years ago instead of .1 st opposing abortion retrospectivl y. 5 . That while Catholics n JY have serious differences with n n-Catho l ics on other issues, they r c-ognize, as has been shown y polls and referenda , th at there re many other sectors of the Am, ri-can public who cons ider abort on a less than desirable, if no t re-pugnant, procedure, and that t 1cy should make common front v. tth these sectors without recri mi w-tion about lesser issues. 6. That the Supreme Court's de-cision should be viewed not _, u t as a disaster, but as an opportunity to reflect upon our own deficiencies in the solution of problems which we have for too long avoided ,JOd must now take the lead in correct-ing. Linacre Quart.:rly Sterilization: Roman Catholic Theory and Practice Father Charles E. Curran The question of the morality of sterilization in the teaching of the Roman Catholic Churcl) has recent-ly been raised in a number of dif-ferent contexts. Vasectomy, si nce it is efficient and a comparatively simple procedure, has become very popular with many people in ou r society. 1 In a specifically Catholic context, a recent cour:t decision in Billings, Montana, ordered a Cath-olic hospital to perform a steri li za-tion in the specific case of a woman who was going to de liver a baby with Caesarean section. 2 There is a third context within which questions of sterilizations arise - problems connected with the retarded.3 Sterilization is o ften recommended as a form of protec-tion for a retarded girl who through force or her own ignorance may be induced into having sexual inter-course. Also it often happens that a retarded girl is not able to care for her own feminine hygiene, thus placing a very great burden on her Father Curran is a professor of moral theology at the Catholic Uni-versity of America and a member of the Linacre Editorial Advisory Board. He is the author of several books, among them the often quoted Contemporary Problems in Moral Theology. Father Curran approach-es the topic of sterilization by con-sidering "the stewardship which man has over his sexuality and gen-erative.fimctions." May. 1973 family and those caring for her. Sterilization is recommended as a means of preventing the menstrual bleeding which becomes so burden-some in this case. In 197 1, the American Bishops promulgated a new set of "Ethical a nd Religious Directives for Cath-olic Health Faci lities," which in-clude the following directives con-cerning sterilization : 18. "Sterilization, whether per-manent or temporary, for men or women. may not be used as a means of contraception. 20. "Procedures that induce ste-rilit y, whether permanent or tem-porary, are permitted w hen: (a) they are immed iately directed to the cure, diminution or prevention of a serious pathological cond itio n and are not directly contraceptive (that is, con-traception is not the purpose), and !b) a simpler trea tment is not rea-sonably available . Hence, for ex-a mple, oophorectomy or irradiation of the ovaries may be a llowed in treati ng carcinoma of the breast and metastasis therefrom; and o r-97 

Population, Rhythm, Contraception and Abortion Policy Questions

https://epublications.marquette.edu/cgi/viewcontent.cgi?article=3203&amp;context=lnq

Population, Rhythm, Contraception and Abortion Policy Questions

Abstract

Similar works

Full text

Available Versions

epublications@Marquette