A reader writes:
My wife is pregnant with our eighth child.
Pregnancy has been and is increasingly getting quite complicated and painful.
When not pregnant, my wife has a uterine condition that is very painful.What does the church teach about a hysterectomy in this situation?
Are there documents that the church has in this regard?Perhaps you can understand the moral and ethical questions that we as faithful Catholics are facing. We are not in a huge hurry to make a decision on this. We are simply trying to talk to the right people and read the correct recourses / documents about this matter. We are not sure where to start. Can you help us with some direction and point us in a direction that will lead us toward Gods will?
I’ll do what I can.
First, let’s look at the potential motives for getting a hysterectomy. One possible motive is to avoid the increasingly difficult pregnancies that you wife has been experiencing. This is not a permissible motive for a hysterectomy because it relies on the contraceptive effect of the hysterectomy as a means to the end of avoiding a difficult pregnancy. While it is licit to wish to avoid difficult pregnancies, doing so in a contraceptive manner (a manner that relies on the contraceptive effect of a thing or procedure) is not licit. So you could not get a hysterectomy for that reason. You could, however, use Natural Family Planning for that reason.
But that’s not the only reason that there seems to be in this case. Your wife also has a painful uterine condition when she is not pregnant. That can be a valid motive for a hysterectomy.
The U.S. bishops’ document Ethical And Religious Directives For Catholic Health Care Services (which is approved by the full body of bishops, not just a committee) states:
53. Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.
Whether your wife’s condition constitutes a valid reason in your particular case depends on how painful the condition is and whether there are better ways of treating it.
To explore that subject, you’ll need to talk both to doctors and–preferably–Catholic medical-moral experts.
In talking to doctors, be on your guard against possible contraceptive motives on the part of your doctor. Also, as with any major surgery, seek at least a second opinion, and be sure to ask about the downside of having the surgery as well as the downside of not having it.
If your doctor is older, try to find out if there are newer ways of treating the condition that he may not be aware of. (Also be aware that in former days doctors prescribed hysterectomies for all kinds of reasons that today would not be regarded as sufficient. This could also be a factor if your doctor is older.)
In talking to Catholic medical-moral experts, I would recommend the National Catholic Bioethics Center.
Ultimately, these things are judgment calls, and your wife will be the one who needs to make the call. It is only she who knows what she is really experiencing as a result of her condition, and after she has all the relevant facts, her judgment in the matter should not be second guessed by others.
The thing to do in a situation like this is pray, research, make the best choice you can, and then leave it in God’s hands. God knows that we’re dealing with limited knowledge and must make the best decisions we can. Wrestling with that fact is part of the human condition, and the fact we wrestle with it brings glory to God.
God bless, and I hope this helps!
20
Jimmy, I never cease to be amazed at the clarity, completeness, and charity of your responses to these types of questions. You sure are good at what you do.
Perhaps this is answered in your entry and I simply missed the point but…
Assuming that ones condition is severe enough ( and otherwise untreatable ) so as to warrant a hysterectomy, does the contraceptive effect of the procedure place a barrier on further marital relations?
No. Because the sterilizing effect of the surgery is merely an unintended and unwilled byproduct of a morally legitimate procedure, morally speaking the couple is in precisely the same situation as a couple in which one or both parties happen to be sterile through no choice of their own at all.
What is morally wrong is deliberately contraceptive acts, not contraceptive effects. Even having recourse to times of infertility (using NFP to avoid pregnancy) relies on the “contraceptive effects” of a certain stage in a woman’s cycle.
I will be conducting an interview tomorrow o be posted 03/10/06:
Dr Paddy Baggot, OB/GYN on Human Reproductive issues in light of Catholic theology. Dr. Baggot is a practicing OB/GYN who ensures that all of his medical advice conforms to Catholic teaching on “Sanctity of Life” issues, including abortion, ‘in vitro’ fertilization, NaProTechnology, Natural Family Planning, etc…
I will be sure to ask him about this issue…
Jim
“What is morally wrong is deliberately contraceptive acts, not contraceptive effects. Even having recourse to times of infertility (using NFP to avoid pregnancy) relies on the ‘contraceptive effects’ of a certain stage in a woman’s cycle.”
So. . .wouldn’t that make NFP to avoid pregnancy always morally wrong? So, despite the fact that the Humane Vitae says I can use this method to avoid pregnancy for things such as emotional health and financial health, in your view, I’m sinning?
Never mind, I just reread your post, and I see what your saying. I’m a little touchy on the subject because I just got in an argument about NFP the other day. The person told me it was “always a grave sin” to use the method.
So, I’m ready to jump down throats now.
Don’t jump down the person’s throat, CMick. Just ask him to read 1Corinthians 7:5.
Okay, as a non-Roman Catholic, I completely fail to understand how NFP gets around the whole “acts which are contraceptive in nature” thing. You’re having sex at that time precisely because you know that a pregnancy won’t result. How is that different from wearing a condom or using an IUD?
Incidentally, I don’t think that I Cor. 7:5 has anything to do with reproduction. It’s more like “fasting from sex” so as to be able to concentrate more fully on spiritual things for a while.
Hi Hokie, the mistake in your thinking is, you assume since the ends seem the same, then the means don’t make any difference.
Artificial contraception changes the very act of sex and demotes it to something that isn’t completely giving. It is positively not open to life. Each act of the marital embrace is a lie, since the act is supposed to be a completely giving act, including the giving of potential fertility. NFP does nothing to change each act; in fact, it remains open to the possibility of life, however remote, when NFP is practiced. Nothing artificial is in the way, and the door to life is not completely closed to God’s intervention. Nothing illicit is going on within each act. Don’t confuse the similar ends with meaning that the means are similar and that it doesn’t matter.
There are actually some good posts here that might help answer your question better. I was reading it the other day. You have to scroll down to (do a Ctrl F) where they start talking about NFP.
http://forums.catholic.com/printthread.php?t=97266
And yes, it’s possible to abuse NFP with a contraceptive mentality overall, so we’re warned against that. But for people with a grave reason who need to try to plan their families without trashing what sex is supposed to be, NFP is a licit and very good option. I hope that, or the link above, helps!
Hokie,
I agree that when you consider NFP in an abstract sense it’s hard to see the difference between it and artificial contraception.
Pope John Paul II reminded spouses that they are called to speak the “language of the body” to each other– that in the marital bed the spouses say, “my lover is mine and I am his.” He also affirmed that the capacity to give life is an essential part of this mutual self-donation.
In other words– within the context of an entire marriage, spouses are free to decide when to engage is sexual relations. But within the context of each such act, they must respect the nature of the act (total, free self-giving) and of each other (human beings with a capacity for life-giving love).
It should be added that, as one of the purposes of marriage is the creation of new life, even within the context of the entire marriage a couple is called to be generous. A couple that used NFP the way many people use contraception– as a kind of “default mode” until they decide to have children– would be missing the point of it. Rather, the Catholic “default mode” would be NOT to try to avoid conception.
“Humane Vitae says I can use this method to avoid pregnancy for things such as emotional health and financial health”
Honest question here: If God is going to provide for the family having children and the children themselves, hence the need to skip contraception, can’t God be counted on to provide for emotional and financial health? Honestly, I’m just asking, not trolling.
Hi Protestant Visitor.
No, you’re not a troll. Many Catholics ask themselves the same things as they work these teachings out.
We don’t do whatever we like because God will save us. We don’t ignore the helicopter coming to save us during a flood, because “God Himself will save us”.
God let the natural science behind reproduction become known to us, in quite some depth, in recent years. It is not wrong to use this knowledge when we are in a grave situation, as long as we are not impeding the natural order of things.
In a grave situation, there is a licit way and an illicit way to postpone pregnancy indefinitely. If we are in a grave situation, we have two choices: Use NFP and trust in God, or mock sex by using artificial contraception.
Merely doing what you want and trusting in God is presumptuous. On the surface, it seems like the honorable, faithful thing to do, but it’s debatable how far you can “test the Lord” and whether you even can, when He already gives you exactly what you need–a helicopter.
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Hello Dr.
I have a question that I have never heard but I’m sure it is revelant. How many hysterectomies are caused by sexual abuse or self-abuse/mutilation by having excessive and multiple partners
thanks,
Back to the original question, about hysterecomies: If the reason for the procedure is valid (i.e., health of the woman) and the decision is to leave the ovaries, is there an issue with the fact that eggs are still produced? Is there any chance of fertilization of the egg, and subsequent death of the embryo due to the fact that there is no uterus? Or is this possibility eliminated in some way during the procedure? And if so, does Church teaching allow a hysterectomy of this nature?
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