Can I take birth control pills for a medical need?

Over at the Ask an Apologist section of Catholic Answers Forums, a poster asks: “Can I take birth control pills for a medical need?” She then says that she needs to be put on “retinol” for an “incurable autoimmune disorder”, and that her doctor has prescribed birth control pills to prevent pregnancy, because of the side effects to the baby. She also says that she gets “horrible cramps” monthly and that being on the pill will help her cramps.

Now before I discuss the answer given by apologist Michelle Arnold, I need to point out a few things about the stated claims. First, “retinol” is nothing other than vitamin A. But perhaps she has the name of the medication wrong, or perhaps vitamin A supplements are part of the therapy.

Second, an autoimmune disorder, by itself, can complicate pregnancy and cause problems for the baby. So the reason for the birth control pill (BCP) may be the disorder itself, not the treatment.

Third, sometimes BCP is prescribed to treat irregular or painful menstruation, which seems to be what she is describing in the last part of her post.

Fourth, the poster is a married woman (as she states in other posts). So she is proposing the use of abortifacient contraception, while sexually active with her husband. This use over time would result in the deaths of one or more prenatals. And since she says her autoimmune disorder is incurable, she is proposing to use abortifacient contraception continuously for a long time, resulting in perhaps multiple prenatal deaths.

What answer does Michelle Arnold give? She claims that it is moral to use abortifacient contraception (BCP), despite its contraceptive and abortive effects, “to treat your cramps”. She acknowledges that this decision, to use abortifacient contraception while sexually active, will have “both contraceptive and abortifacient” effects. But she claims that these “risks” are acceptable as long as they are “not sought as either an end or a means.” She opines that the use of abortifacient contraception is only immoral with a bad intention, if you “deliberately will to prevent the conception of a child”.

Her answer is gravely contrary to magisterial teaching and the eternal moral law. If this woman follows her advice, and uses abortifacient contraception while sexually active, then Michelle Arnold will be morally responsible for the deaths of innocent prenatals that result. Her advice, justifying the use abortifacient contraception while sexually active, is formal cooperation with the mortal sins of contraception and abortion.

Why is this so? The Catechism of the Catholic Church and the encyclical of Pope Saint John Paul II, Veritatis Splendor, clearly and definitively teach that morality is based on three sources or “fonts”, which are intention, moral object, circumstances. To be moral, an act must have three good fonts. If one or more fonts are bad, the act is a sin.

(1) The font called intention is your intended end or goal; it is the reason or purpose for choosing the act. It is always a sin to act with a bad intention.

(2) The font called moral object (or simply “object”) is the chosen concrete act, with its moral nature (or “moral species”), as determined by the end toward which that act is inherently ordered. This end is the object of the act. Every act with an evil moral object is intrinsically evil and always a sin to knowingly choose.

But while the intended end is freely chosen by the subject (the person who acts), the moral object is inherent to the act itself. Every concrete act has a moral nature and a moral object. If you choose that concrete act, then you have chosen its nature and its object.

(3) The font called circumstances is the totality of the foreseeable consequences of that act for all persons concerned. In this font, the good and bad effects of the act are compared, according to their moral weight. If the act is reasonably anticipated to do more harm than good, then the act is a sin.

The Roman Catholic Magisterium teaches that both abortion and contraception are intrinsically evil and always gravely immoral. Each is immoral due the object of the act, regardless of intention or circumstances. Furthermore, abortion is a type of murder, and it carries the penalty of automatic excommunication. This sentence of automatic excommunication is not limited only to surgical abortions.

Arnold proposes that abortifacient contraception is only immoral if one intends a contraceptive or abortive end. She thinks that the intention or purpose for which the act is chosen determines whether it is intrinsically evil or not. But the Magisterium clearly teaches that intrinsically evil acts are immoral regardless of the intention or purpose of the act.

Arnold claims that the use of abortifacient contraception, while sexually active, is moral for a good intention, such as to treat a medical disorder. She fails to understand that intrinsically evil acts, including abortion and contraception, are always immoral, due to an evil object, regardless of the purpose (or intention) of the act, and regardless of the circumstances.

The Catechism of the Catholic Church: “2399 Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception).”

The CCC explicitly clearly states that a legitimate intention does not justify the use of contraception. Even if abortion and contraception are not your intended end, you still cannot choose that type of act, and act that is inherently abortive or contraceptive.

Arnold fails to understand that the purpose for which the act is chosen is the same as the intention (the reason for choosing the act). But the CCC clearly identifies the intention or intended end with “the purpose pursued in the action.”

The Catechism of the Catholic Church: “1753 A good intention (for example, that of helping one’s neighbor) does not make behavior that is intrinsically disordered, such as lying and calumny, good or just. The end does not justify the means.”

Therefore, a good intention, to treat a medical disorder, does not justify the choice of an intrinsically evil act, to use abortifacient contraception while sexually active.

What Arnold is proposing is that the choice of an intrinsically evil act (the use of abortifacient contraception while sexually active) could be justified by the purpose or reason for choosing the act (to treat a medical disorder). And that claim is contrary to Catholic moral teaching. Nothing justifies the choice of any intrinsically evil act.

Pope Saint John Paul II: “No circumstance, no purpose, no law whatsoever can ever make licit an act which is intrinsically illicit, since it is contrary to the Law of God which is written in every human heart, knowable by reason itself, and proclaimed by the Church.” [Evangelium Vitae 62]

The intention (purpose) to treat a medical disorder is good, but the chosen act is intrinsically evil.

Pope John Paul II: “If acts are intrinsically evil, a good intention or particular circumstances can diminish their evil, but they cannot remove it. They remain ‘irremediably’ evil acts; per se and in themselves they are not capable of being ordered to God and to the good of the person…. Consequently, circumstances or intentions can never transform an act intrinsically evil by virtue of its object into an act ‘subjectively’ good or defensible as a choice.” (Veritatis Splendor, n. 81).

Pope John Paul II: “The reason why a good intention is not itself sufficient, but a correct choice of actions is also needed, is that the human act depends on its object, whether that object is capable or not of being ordered to God, to the One who ‘alone is good’, and thus brings about the perfection of the person. An act is therefore good if its object is in conformity with the good of the person with respect for the goods morally relevant for him.” (Veritatis Splendor, n. 78.)

A good intention does not justify the choice of an intrinsically evil act, such as abortion, contraception, or abortifacient contraception.

Moreover, we must also consider the consequences of the act. The use of abortifacient contraception while sexually active is intrinsically evil and always gravely immoral. But this choice also has bad consequences of grave moral weight: the death of one or more innocent prenatals. Even if this bad effect is not intended, it still weighs in the third font.

Arnold proposes that the deaths of multiple innocent prenatals is justified by the good effect of treating a medical disorder. We can add to this good effect, the good of being able to continue having marital relations. Even so, the deaths of one’s own children in the womb is of great moral weight, and the treatment of a medical disorder and the ability to have marital relations is of lesser weight.

It is also morally relevant to point out that the good effect of the use of abortifacient contraception as a medical treatment can be obtained without any intrinsically evil sin and without the grave bad consequence of the deaths of prenatals, by refraining from marital relations while using the medication. So no one can claim that the deaths of the prenatals was an unavoidable bad effect. It is entirely avoidable by refraining from relations while taking the abortifacient contraception.

Michelle Arnold has written on this subject before, with the same general answer. But is it really moral for married Catholic couples to kill their own unborn children, repeatedly, merely to be able to continue having marital relations? What a perverse and wicked claim! Anyone who advises married couples that they can remain sexually active, while using abortifacient contraception, is guilty of formal cooperation with abortion, and is automatically excommunicated. Instead, couples should be advised to refrain from marital relations while taking abortifacient contraception, if that medication is in fact medically necessary.

Pope Saint John Paul II: “Christians, like all people of good will, are called upon under grave obligation of conscience not to cooperate formally in practices which, even if permitted by civil legislation, are contrary to God’s law. Indeed, from the moral standpoint, it is never licit to cooperate formally in evil.” [Evangelium Vitae 74]

Ronald L. Conte Jr.
Roman Catholic theologian and translator of the Catholic Public Domain Version of the Bible.

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