Martin Rhonheimer has written extensively on disputed issues in medical ethics: the use of condoms to prevent HIV, contraception, masturbation to provide semen for analysis, and at length on “vital conflicts” in medical ethics that arise in a pregnancy in which the lives of both the mother and the child are seriously threatened. If nothing is done, both will die, but if a medical intervention is performed, the child will die but the mother has a chance of living. After offering his interpretation of relevant magisterial documents on the difference between “direct” and “indirect” killing and of St. Thomas's teaching on the lawfulness of killing in self-defense and the principle of double effect, Rhonheimer proposes to solve conflicts of this kind by an ethical analysis based on what he calls a “virtue-based ethics” concerned with rendering justice to both mother and child. Using this approach he justifies craniotomy, salpingectomy, and salpingo(s)tomy as morally permissible ways of saving the mother's life without doing any injustice while rejecting use of the drug methotrexate to end a tubal pregnancy. His analysis can be seriously challenged as rooted in a misinterpretation of key magisterial documents and for failing to consider the principle of double effect revised to bring it into harmony with Aquinas's teaching on the distinction between killing as intended and as the unintended although foreseen effect of an act of legitimate self-defense.
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References
1.
Born in 1950, Rhonheimer studied philosophy, history, political science, and theology in Zurich, receiving his doctorate in philosophy from the University of Zurich. He also studied in Rome. In 1974 he joined Opus Dei and in 1983 was ordained to the priesthood. He is the author of more than twenty books, most originally written in German with many translated into Italian, English, and other languages, and over two hundred major essays in anthologies and journals, including essays published in some of the proceedings of the Pontifical Academy for Life. Major works translated into English include Natural Law and Practical Reason: A Thomist View of Human Autonomy (New York: Fordham University Press, 2000); and The Perspective of the Acting Person: Essays in the Renewal of Thomistic Moral Philosophy (Washington, D.C.: The Catholic University of America Press, 2008). Currently professor of ethics and political philosophy at the School of Philosophy of the Pontifical University of the Holy Cross in Rome, he is a member of the editorial boards of The American Journal of Jurisprudence (Notre Dame Law School) and member of the scientific board of Acta Philosophica (Pontifical University of the Holy Cross). In 2002 he was appointed as a corresponding academician to the Pontifical Academy of St. Thomas Aquinas.
2.
See The Linacre Quarterly56.2 (May 1989): 20–57. This essay appeared originally in English under the same title in “Humanae Vitae” 20 Anni Dopo: Atti di II Congresso Internazionale di Teologia Morale: Roma (November 8-12, 1988) (Milan: Ares, 1988), 73-113.
3.
Rhonheimer“‘Intrinsically Evil Acts’ and the Moral Viewpoint: Clarifying a Central Teaching of Veritatis splendor,” in Veritatis Splendor and the Renewal of Moral Theology, ed. di NoiaJ.A., and CessarioRomanus (Chicago: Midwest Theological Forum, 1999), 161–193; and “Intentional Actions and the Meaning of Object: A Reply to Richard McCormick,” in ibid., 241-268.
4.
Rhonheimer“Intentional Actions and the Meaning of Object: A Reply to Richard McCormick,” in Veritatis Splendor and the Renewal of Moral Theology, 254, emphasis added.
5.
See Pope Pius XII, Address to Delegates at the Twenty-Sixth Congress of Urology, October 8, 1953, AAS45 (1953), 673–679.
6.
See, for example, Benedict Guevin, O.S.B., “On the Use of Condoms to Prevent Acquired Immune Deficiency Syndrome,”National Catholic Bioethics Quarterly4 (Spring 2005): 37–38; David Crawford, “Conjugal Love, Condoms and HIV/AIDS,” Communio: International Catholic Review 33 (Fall 2006): 505-510; Luke Gormally, “Marriage and the Prophylactic Use of Condoms,” National Catholic Bioethics Quarterly 5 (Winter 2005): 735-750. See also my “Using Condoms to Prevent HIV,” in the “Colloquy” section of National Catholic Bioethics Quarterly 4 (Winter 2004): 667-668.
7.
Although many Catholic authors judge such use of condoms to be contraceptive, I (and several others) agree with Rhonheimer that such use need not be contraceptive or intended as a means to impede procreation, which is the way Pope Paul II's encyclical Humanae vitae describes contraception in section 14. The English translation provided by Editrice Vaticana, unfortunately, is not as accurate in describing contraception as the official Latin text. The English version reads as follows: “Excluded is any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent procreation—whether as an end or as a means” (emphasis added); whereas the Latin text reads: “Quivis respuendus est actus, qui, cum coniugale commercium vel praevidetur vel efficitur vel ad suos naturales exitus ducit, id tamquam finem obtinendum aut viam adhibendam intendat, ut procreatio impediatur“ (emphasis added). In other words one contracepts if one intends, either as end or as means, to impede procreation, i.e., the beginning of a new human life. I focus on the Latin text of this important passage to show that one does not contracept if one does not intend to impede the beginning of new human life either as end or as means. Thus my wife is now past menopause and is no longer able to conceive. It would be foolish and a waste of money to use condoms as a means of impeding procreation. However, it would not be foolish or a waste of money to use condoms to prevent transmission of HIV/AIDS if, for example, I contracted HIV when receiving a blood transfusion. However, with others I consider condomistic or condomized intercourse between spouses as intrinsically evil for other reasons. I note here that in the 1980s several theologians, among them Norman Ford of Australia, defended the use of condoms by married persons to prevent transmission of HIV/AIDS. At that time I published a brief essay in the Fellowship of Catholic Scholars Newsletter 11.3 (June 1988): 1-2, in which I argued that it would “be morally wrong to use condoms in this way.” I argued that condomistic sex is “an ‘unnatural’ or perverted sexual act, and cannot be regarded as a true act of marriage.” I discussed this matter with several married Catholic moral theologians and all immediately agreed that condomistic sex cannot be considered a true marital act, and their wives agreed with them.
8.
Rhonheimer“On the Use of Condoms to Prevent Acquired Immune Deficiency Syndrome,”National Catholic Bioethics Quarterly4 (2005): 41, emphasis added.
9.
National Catholic Bioethics Quarterly, Luke Gormally refers to this text of Rhonheimer in his article “Marriage and the Prophylactic Use of Condoms,” at page 736. There Gormally writes: “In Fr. Rhonheimer's recent response to criticism from Fr. Benedict Guevin, readers of this journal will have encountered the claim that ‘the act as such [i.e., condomistic intercourse] is of a generative kind, but it is modified by human intervention’ [Rhonheimer, “On the Use of Condoms,” 44]. And since the modification is prophylactic in intent, not contraceptive, he [Rhonheimer] reasserts his view that the choice of condomistic intercourse within marriage for prophylactic purposes cannot be excluded on the grounds that it is an intrinsically evil choice“ (emphasis added). As noted already, while I think that condomistic sex by married couples is intrinsically evil, I do not think, as Gormally does, that it is necessarily a contraceptive act. Other critics of Rhonheimer agree with Gormally, e.g., Benedict Guevin, O.S.B., “On the Use of Condoms”; David Crawford, “Conjugal Love”; Christopher Oleson, “Nature, ‘Naturalism’ and the Immorality of Contraception: A Critique of Fr. Rhonheimer on Condom Use and Contraceptive Intent,” National Catholic Bioethics Quarterly 6 (Winter 2006): 719-729; Janet Smith, “The Morality of Condom Use by HIV-Infected Spouses,” Thomist 70 (April, 2006): 27-69.
10.
Rhonheimer's critique of the earlier draft of this article did not mention the passages in his debate with Guevin just examined. But he asked that I inform readers of clarifications of his position that he made in The National Catholic Bioethics Quarterly in the Autumn 2009 issue. He summarized the clarification given there as follows: “In all my expositions of the subject I have always underlined, that even in such cases the use of condoms should never be recommended; and that personally I would never recommend somebody to use condoms even to prevent infection, but to abstain. I also wrote that, if someone did use them, this could not be called an act of contraception in the sense in which it is prohibited by Humanae vitae, and that this should be taken into account in the moral evaluation of such persons' way of behavior. However, when I wrote this I did not consider it correct to say that such an act of sexual intercourse could nevertheless lack the property of being a real marital act, as e.g., Luke Gormally has argued against me, and which is also John Finnis's view, expressed towards me in personal correspondence. Their solidly argued view receives strong support by the tradition of canon law. This is why I have written in this very quarterly [The National Catholic Bioethics Quarterly]: ‘I acknowledge the strength and coherence of the canonistic tradition and am aware of the difficulty of challenging it. I do not do this without taking into account the possibility that I might be wrong’…. I have publicly declared not to go on to defend this view any further but to wait for a decision from Rome.”
11.
Rhonheimer says that his book was “drafted for the Roman Congregation for the Doctrine of the Faith and completed and submitted to the congregation in 2000. After it was carefully studied in the Congregation and by its then prefect, Cardinal Joseph Ratzinger, the congregation in turn asked that it be published, so that the theses it contains could be discussed by specialists. Obviously, the observations made here are my personal opinions and not those of the Congregation for the Doctrine of the Faith (Rhonheimer, Vital Conflicts, xiii). Note that in 1990 the Congregation under Ratzinger and with the approval of Pope John Paul II had issued Donum veritatis or Instruction on the Ecclesial Vocation of the Theologian. In it the Congregation taught that “even if the doctrine of the faith is not in question, the theologian will not present his own opinions or divergent hypotheses as though they were non-arguable conclusions. Respect for the truth as well as for the People of God requires this discretion” (n. 27). But if a theologian “might have serious difficulties, for reasons which appear to him well-founded, in accepting a non-irreformable magisterial teaching,” and if, “despite a loyal effort on the theologian's part, the difficulties persist, the theologian has the duty to make known to the Magisterial authorities the problems raised by the teaching in itself, in the arguments proposed to justify it, or even in the manner in which it is presented. He should do this in an evangelical spirit and with a profound desire to resolve the difficulties. His objections could then contribute to real progress and provide a stimulus to the Magisterium to propose the teaching of the Church in greater depth and with a clearer presentation of the arguments” (Donum veritatis, nn. 26-30, emphasis added). Rhonheimer notes that the draft submitted to the Congregation was soon published in German, but that the German edition elicited meagre response. He attributed that result to the fact that in German-speaking areas “proportionalism” is the reigning ethical theory, which, as we have seen, is incompatible with Catholic faith.
12.
In the late nineteenth century the Sacred Congregation of the Holy Office (now called the Congregation for the Doctrine of the Faith) issued two brief documents regarding craniotomy, one in 1884 and the other in 1889. The second of these “decrees,” available in the Acta Sanctae SedisXXII (1889-1890), 748, declares: “It cannot be taught with certainty in Catholic schools that the surgical operation known as craniotomy is permitted.” Rhonheimer says that this appears to be a disciplinary and not a doctrinal statement (see Rhonheimer, Vital Conflicts, 28). Germain Grisez had commented on the same Holy Office decree in his 1970 work Abortion: The Myths, the Realities, and the Arguments, and also judged it a disciplinary and not doctrinal statement.
13.
RhonheimerVital Conflicts, 1–9.
14.
Vital Conflicts, 14–30. Proportionalism is repudiated by John Paul II in Veritatis splendor. Thus he wrote in number 79: “One must therefore reject the thesis, characteristic of teleological and proportionalist theories, which holds that it is impossible to qualify as morally evil according to its species—its object—the deliberate choice of certain kinds of behavior or specific acts, apart from a consideration of the intention for which the choice is made or the totality of the foreseeable consequences of that act for all persons concerned.”
15.
In page 5 note 10, Rhonheimer cites my article “The Management of Ectopic Pregnancies: A Moral Analysis” in The Fetal Tissue Issue: Ethical and Medical Aspects, eds. CataldoPeter J., and MoraczewskiA.S.O.P. (Braintree, MA: Pope John XXIII Medical Ethics and Research Center, 1994), 121–147. (The Pope John XXIII Medical-Moral Center was the predecessor of the National Catholic Bioethics Center.) I have since changed my mind on this matter, recognizing that I had erroneously identified the “moral object” with the “physical structure of the action” (see my Catholic Bioethics and the Gift of Human Life, 2nd ed. (Huntington, IN: Our Sunday Visitor, 2008), 197ff.
16.
Rhonheimer, Vital Conflicts, 49–57.
17.
Vital Conflicts, 49–50 notes 50-51.
18.
Vital Conflicts, 93–102 (sec. 2a of ch. 3).
19.
Note the new title of the more recent directives.
20.
Rhonheimer, Vital Conflicts, 9–10.
21.
Vital Conflicts, 40–42.
22.
Vital Conflicts, 41.
23.
Vital Conflicts, 41–42.
24.
See Vital Conflicts, 11–12 and 84 for these formulations of Rhonheimer's major claim and reference to Aquinas on killing in self-defense.
25.
Vital Conflicts, 61, quoting Aquinas, Summa theologiae II-II, q. 64, a. 7.
26.
Rhonheimer, Vital Conflicts, 62.
27.
Rhonheimer, Vital Conflicts, 62
28.
Vital Conflicts, 63–64.
29.
Vital Conflicts, 65.
30.
Vital Conflicts, 65 note 51.
31.
Vital Conflicts, 116.
32.
See note 24 above.
33.
Rhonheimer, Vital Conflicts, 123, emphasis added.
34.
Vital Conflicts, 138–150.
35.
Vital Conflicts, 141.
36.
PaulJohnII, Veritatis splendor, n. 71, quoting Gregory of Nyssa, De Vita Moysis II, 2, 3; PG 44, 327-328.
37.
Rhonheimer, Vital Conflicts, 142.
38.
See Vital Conflicts, 40–42.
39.
Vital Conflicts., 123, emphasis added.
40.
Vital Conflicts., 142.
41.
Vital Conflicts, 41–42.
42.
With a footnote reference to Vatican II, Lumen gentium, n. 12.
43.
With a footnote reference to Vatican II, Gaudium et spes, n. 27.
44.
With a footnote reference to Vatican II, Lumen gentium, n. 25. Lumen gentium, n. 25, sets out the conditions under which bishops in exercising their authority as God's appointed teachers of the Church when acting in union with the Holy Father can propose truths of faith and morals infallibly through the ordinary exercise of their magisterium. With other theologians I hold that in this text John Paul II is saying that the teaching that it is always intrinsically immoral intentionally to kill an innocent human being has been infallibly taught in this way.
45.
With a footnote reference to the Congregation for the Doctrine of the Faith's Declaration on Euthanasia.
46.
With a footnote reference to Veritatis splendor, n. 96.
47.
On this see the helpful distinction John Finnis makes between a “liberty” and a “right” in the strict sense in his Natural Law and Natural Rights (New York and Oxford: Oxford University Press, 1980), 199–204. He shows that to understand rights we need a three-term relationship between the person holding the right, other persons, and a specific action and that the action in question is not that of the person holding the right but of others. For example, an unborn baby (x) has a strict right to life, if and only if all human beings (y) have the obligation to forbear intentionally killing them (z). The three-term relationship for a “liberty” is the same but here the action in question is that of the one claiming the liberty. Thus, a woman (x) has the liberty to abort her unborn child (z, the specific action), if and only if the unborn child does not have a right not to be intentionally killed.
48.
GrisezGermainAbortion: The Myths, the Realities, and the Arguments, 329.
49.
GrisezGermainAbortion: The Myths, the Realities, and the Arguments, 329.
50.
GrisezGermainAbortion: The Myths, the Realities, and the Arguments, 329.
51.
See Abortion: The Myths, the Realities, and the Arguments, 331ff, where Grisez criticizes the “utilitarianism” (consequentialism) of Peter Knauer S.J., William van der Marck, O.P., and Cornelius Van der Poel, early champions of what later became known as proportionalism.
52.
See Abortion: The Myths, the Realities, and the Arguments, 331ff, where Grisez criticizes the “utilitarianism” (consequentialism) of Peter Knauer S.J., William van der Marck, O.P., and Cornelius Van der Poel, early champions of what later became known as proportionalism.
53.
Abortion: The Myths, the Realities, and the Arguments; in later writings Grisez speaks of adopting by choice the proposal to destroy human life rather than “turning directly against the basic good of human life.”
54.
Abortion: The Myths, the Realities, and the Arguments, 340ff.
55.
Abortion: The Myths, the Realities, and the Arguments, 340.
56.
Abortion: The Myths, the Realities, and the Arguments, 341.
57.
Abortion: The Myths, the Realities, and the Arguments, 341.
58.
Abortion: The Myths, the Realities, and the Arguments, emphasis added.
