DeCosse on Models of Conscience
David DeCosse in NCR offers this deft analysis of the reasoning underlying recent episcopal (and other) cries about infringements on religious liberty.
Money quote:
At present, the model of conscience used by most bishops is problematic in two ways. First, it emphasizes obedience, law, and hierarchical authority and thus departs from the Catholic tradition’s close linkage of conscience, practical reason, and freedom. Second, on account of this departure, these bishops needlessly lapse into using a sectarian model of the Catholic conscience ill-suited to the Church’s mission in a democratic pluralist society like the United States.
—
[T]he bishops have raised a hue and cry because they are defending the rights of conscience. But, for them, the conscience should be free to adhere to the truth of the universal moral law articulated by the hierarchical teaching office of the Church….But what about the freedom of conscience to adhere to a truth not identical with the moral law defined by the hierarchical authority of the Church? And what about the freedom to allow one’s practical reason to consult empirical data and a wide range of values in determining what conscience should do in a complex matter? Especially if that determination differs from one put forward by the bishops? The model of conscience favored by the bishops in the current disputes has little room for such obvious and significant scenarios.
And there’s lots more about a Thomistic understanding of conscience and the role of prudential reasoning. Too often these days Catholics are urged by Church leadership to ignore the breadth of our own tradition in favor of a narrower view. David reminds us otherwise.
Amen!
How can the new fed regulation be said to be forcing people to act against their consciences when almost 100% of Catholic women have used their consciences to decide *for* contraception? To define conscience as “thinking with the church” is to rob it of its true meaning, but I think the bishops know this – I think they’re disingenuously using the issue to further their goals.
I agree that David DeCosse’s NCR essay provides a fine critique of the Catholic bishops’ model of conscience, to use DeCosse’s way of putting the situation.
However, once we understand the kinds of considerations that are involved in prudential reasoning, according to DeCosse, we might want to revisit the admittedly low-keyed message that Bernard Dauenhauer posted in the thread that Grant Gallicho started on January 21, 2012, titled “An illiberal mandate.” Dauenhauer’s message was actually the first message posted in response to Grant Gallicho’s lengthy piece.
This response seems to confuse the Bishops’ (among others) concerns with the recent attempts by the Administration to frame a more restricted legal view of the role of government vis-a-vis distinctive ecclesial bodies with an intra-ecclesial dispute. The issue of the Bishops’ understanding of conscience, however narrow or broad one understands it to be, is unrelated to the debate about the appropriate limits on governmental coercion placed by the free exercise clause of the First Amendment. We are talking, in the first instance, about a constitutional, and hence legal, matter, however one views the role of individual conscience to dissent from Catholic moral teaching. We are talking, in the first instance, about the power of secular government over-against explicit religious belief; not about the relation between individual conscience and the magisterium.
These points were aptly summarized by Rick Garnett of Notre Dame and Thomas Berg recently:
http://www.usatoday.com/news/opinion/forum/story/2011-11-27/hhs-contraception-mandate/51424562/1
http://christiancentury.org/blogs/archive/2011-12/other-peoples-freedom
Mr. Landry: You have named one way to look at the situation regarding the regulations.
However, Archbishop Timothy Dolan has been widely quoted in the media as saying that the new time-line gives him a year to figure out how to violate his conscience. So Dolan has explicitly named conscience as the central issue. That’s why David DeCosse’s analysis of the bishops’ model of conscience is relevant to the discussion.
Needless to say, neither DeCosse nor Fullam mention that St. Thomas Aquinas taught that contraception was intrinsically immoral.
The issue of conscience is profoundly important, and cuts many ways, which we often forget about — what about the conscience of those who are “forced” to subsidize Catholic Church operations with their taxpayer dollars, for example?
But I’m not sure what that topic — and Decosse’s interesting essay — has to do with the HHS regs, which seem a straightforward violation of conscience protections and Obama’s pledge to uphold conscience protections across the board.
St. Thomas Aquinas taught that contraception was intrinsically immoral
If he did, he was wrong.
The Catholic Church explicitly allows contraception after rape, giving effect to her belief that contraception is not intrinsically immoral. The mandates to Catholic hospitals list this and the Vatican approved nuns at risk of rape in the Congo to take the pill. The papal teachings on contraception only apply to conjugal acts – acts of genuine love in marriage.
The complexities of the human condition provide ample cases where contraceptive use is within Catholic teaching.
Think for example of the unmarried, those subject to abuse, those coerced in marriage, those at risk of rape, those not wishing to transmit AIDS etc.
That’s one huge hole in the argument that mandating insurance policies to provide contraception violates Catholic teaching.
God Bless
It seems to me – an impression, no more – that Commonweal Catholics are increasingly determined to part company with the institutional Church. But without the institutional Church, what is Catholicism? What we’re looking at, I think, is a breakaway movement that has already taken concrete form in at least one place I’m aware of.
I very much appreciate the felt need to think for oneself, the innate inability to accept an order to think as directed, but the desire, the need for this freedom seems starkly at odds with two thousand years – or fifteen hundred years, or whatever very long, continuous period – of history and thought. Yet there seems to be no talk here of breaking away formally. You seem to want to have your cake and eat it, too – to both stay uneasily and leave definitively.
Thorin says: “Needless to say, neither DeCosse nor Fullam mention that St. Thomas Aquinas taught that contraception was intrinsically immoral.”
But the requirement is not that a Catholic hospital (for instance) provide contraceptives – only that the health insurance it provides to employees covers the cost of contraceptives if the employee chooses to use them and buys them somewhere else.
So far, the only USCCB statements i have seen don’t acknowledge that there is a moral difference between performing the act and cooperating in it.
My own opinion is that providing the insurance is certainly not formal cooperation and is at most remote material operation – but if the bishops have arrived at a different conclusion this would be the time to exercise their teaching office to explain how they arrived at that conclusion.
It seems to me that the likelihood of scandal is non-existent. Everyone knows that the Church opposes contraception – and any Catholic instiution will be free to make clear that it is only doing this because he law requires it and it is the lesser evil.
I think the bishops will do more harm if they give the impression that it is morally impossible for them to do his and then, when their efforts fail, suddenly announce that they can live with the problem and will continue to provide health insurance and keep their institutions open.
Operation = cooperation
Note that Fordham University does what I described – provide the insurance but not the services.
David S. –
If you look at the whole Church you will see that the only group that has broken away formally from the Church recently is a group of conservatives. No, there is no movement among us liberals to leave as a group. Has it occurred to you that perhaps it is the super-conservative Catholics who are the pseudo-orthodox these days?
David S, I think you are mistaken. They do not want to part company. If only that were the case.
“St. Thomas Aquinas taught that contraception was intrinsically immoral.”
So?
In 1866 Pope Pius IX declared, “It is not contrary to the natural and divine law for a slave to be sold, bought, exchanged or given.”
The 1864 encyclical “Quanta Cura” by Pius IX explicitly condemned freedom of religion.
The church condemned usury at the Second Lateran Council in 1139, the Third Lateran Council in 1179, and the Council of Vienne in 1311.
So, as this man is reputed to have said:
“Any man can make mistakes, but only an idiot persists in his error.” Marcus Tullius Cicero
This church can never aver with a straight face that it does not change. It does. I has done so and often.
David S: Commonweal Catholics have been associated with, and part of the reason for success of, this US church for about 88 years (http://commonwealmagazine.org/brief-history-commonweal). I suspect that most of the people who post here have absolutely no intention of departing for greener pastures, either as a group or as individuals.
As Ann pointed out, only the ultra conservative groups are the ones who leave or wrap themselves in a huff and effectively start their own retrograde rites.
Individuals are a different matter altogether, Orneryariate (oops, I had better dial that back a bit – Ordinariate) to the contrary.
David Smith: It seems to me that Commonweal Catholics are increasingly determined to part company with the institutional Church.
On the contrary, many of us are determined not to part company with the institutional church.
Adeodatus: They do not want to part company. If only that were the case.
Funny reading that wish right on the Sunday of the readings and homilies about the call to make each of us “fishers of men”. It’s like replacing “Come and follow me” by “Go away and do not bother me”!
David Gibson, What about the conscience of religiously-motivated citizens who are forced to subsidize war with tax payer dollars? What if the Bishops decided that it was “right and just” for women employed by Catholic Schools and Hospitals not to speak unless it was essential for carrying out their duties?
As many have already said, what other basic healthcare services should we simply let religious leaders not provide to their non-religious employees? Should we just give the Bishops the list and a red pen and let them go to town? If the healthcare legislation had to be sent around to every priest, imam, rabbi, and shinto monk who runs a business, no employee would have any idea what “right to healthcare” he or she might expect. And what about non-clerical administrators and owners of businesses… a Catholic who owns a hair salon? Is he or she allowed to just slash the provisions of the medical plan? So, after we allow for everyone’s conscience, who can be sure of what when one is told by his or her employer, “You will have full medical benefits as part of your compensation?” Now the phrase “full medical benefits” has lost all uniformity of meaning, which is what healthcare legislation is meant to ensure. We might as well not have any healthcare legislation at all, if we’re going to leave it open to revision by any religiously-informed employer. We’d be left exactly where we are now – people making decisions about what is an isn’t covered based on actuarial vagaries, but instead of money-grubbing insurance agents making life or death decisions for people, it’s the average, business owning, armchair theologian deciding about the life and death of their employees based on controversial interpretations of whatever scripture and tradition he or she recognizes (whether its the Bible and the Magisterium or something the Pastor said in yesterday’s homily).
Since the bishops are making a fuss about freedom of conscience, it might be good to question whether in fact the bishops’ consciences themselves are well-formed. To me, they suffer from what Aquinas calls ignorantia affectata, a willed ignorance, “so useful that one protects it, keeps it from the light, in order to continue using it (ST 1-2, q6, 8r).”
For example, the 2009 U.S. Bishops’ Pastoral Letter on Marriage repeats the Church position against artificial contraception, using as its sources papal encyclicals, allocutions, books and speeches. It’s a pastoral letter on a topic that by definition the bishops do not have first-hand knowledge. Yet the citations in its over one hundred footnotes reference only Church documents. There are no references to anything that would represent the insights of those who minister to married couples or the lived experience of the couples themselves whom the bishops are supposed to be guiding; there are no references whatsoever to any scholarly sociological or psychological material. Papal utterances and Church documents have thus taken the place of reality. In a Church that preaches the coherence of faith and reason, one would hope that positions would be taken based on reason and using the wealth of varied, concrete and detailed evidence available that shows us what God’s creation is like in all its messy complexity. Instead, they seem mostly based on a thin trail of papal documents.
I just want to say that the derogatory comments about Commonweal Catholics are becoming tedious at best.
I think Commonweal in general stands both for moderation and for intellectually grappling with issues(something Mr. Smith sometimes seems to think is bad.)
NCR is the voice of the Ctaholic left today and often deals with issues not covered here.
Voices on the right(e.g.Adeodatus) are voices of reactionarism in a Church already too far titlted one way and in deep division.comments
I fear with this kind of thinking matters will only get worse!
“As many have already said, what other basic healthcare services should we simply let religious leaders not provide to their non-religious employees? Should we just give the Bishops the list and a red pen and let them go to town? If the healthcare legislation had to be sent around to every priest, imam, rabbi, and shinto monk who runs a business, no employee would have any idea what “right to healthcare” he or she might expect. And what about non-clerical administrators and owners of businesses… a Catholic who owns a hair salon? Is he or she allowed to just slash the provisions of the medical plan? So, after we allow for everyone’s conscience, who can be sure of what when one is told by his or her employer, “You will have full medical benefits as part of your compensation?” Now the phrase “full medical benefits” has lost all uniformity of meaning, which is what healthcare legislation is meant to ensure”
I find this to be a red herring, Mr. Bugyis, as it is the HHS mandates that are CHANGING the status quo. It is not as if the mandates are removing a benefit that these persons have enjoyed heretofore. Furthermore, I can assure you that American society is not suffering from a lack of access to artificial birth control. But again, the issue, in the first instance, is not about the intra-ecclesial relationship between co-religionists, but rather the power of the federal government vis-a-vis its citizens.
By the way, since very little attention has been paid to what the USCCB actually argued, I thought this might be helpful. If you notice, the argument is not premised on the Church’s teaching with respect to birth control, but rather as a matter of federal law.
http://www.usccb.org/about/pro-life-activities/preventive-services-backgrounder.cfm
Lisa,
Could you speak briefly as to what role hierarchical authority has in helping Catholics to form their conscience? It seems that from what you excerpted above there is no much role for it? I ask this with no ax grind but really in order to learn more.
Thanks,
AA
(Looking to see what Lisa said, I find nothing.)
Surely no adults allow/expect other adults to form their consciences. (Is that even possible?)
Should lay Catholics pretend to believe what ordained Catholic pretend to believe?
Should we ignore our life experience, our education, our common sense, and the Gifts that the Holy Spirit bestowed on us at Confirmation?
Eric, I find it difficult to follow your arguments, but I guess my problem is that it sounds like a “two wrongs make a right” argument.
In other words, yes, many others have good claims to conscience protections. But should the government ignore them or try to take them into consideration and try to accomodate them?
I think freedom of conscience is a very important principle, critically important, and that it should not be dismissed so easily.
There seems to be a fundamental assumption at work in some objections that the the federal government is somehow not representing the will of its citizens in changing the status quo, as if it is doing so by fiat. This suggests a certain skepticism with regard to the legitimacy of the democratic process. If this is the case, I think we have an election coming up. Beyond this, the HHS seems to have received the dissenting opinions of Catholics, etc and has made some concession. Just because you weren’t successful in completely stopping the reform, there’s no reason to assume you weren’t heard.
It should be pointed out, as Eric Bugyis has admitted, that the logic of his argument (and the similar argument raised by Lisa Fullam) requires Catholic employers to pay for their employees’ abortions. (Indeed, the HHS regulations that are under discussion require Catholic employers to pay for abortifacient contraceptives). The bishops are right to object.
Eric –
The solution is not to ignore the consciences of the employers. The solution is a single payer system.
Further, just following the will of the people is not an ultimate value. Hitler followed the will of the majority, and look what the world got. He was vastly popular in Germany.
Eric, I think you make fundamental assumptions that no one else does.
Thorin,
I think there has to be a balancing of the rights to conscience of the various parties: employers, employees, and state.
By this conscience argument, funding abortion is clearly out because :
1. Abortion tramples all over the rights of the child whose conscience also needs to be respected.
2. Abortion is not the same kind of thing as contraception. In Catholic teaching abortion is always wrong but contraception can be accepted in some cases.
God Bless
Some recent pertinent words from the Holy Father on this issue:
In the light of these considerations, it is imperative that the entire Catholic community in the United States come to realize the grave threats to the Church’s public moral witness presented by a radical secularism which finds increasing expression in the political and cultural spheres. The seriousness of these threats needs to be clearly appreciated at every level of ecclesial life. Of particular concern are certain attempts being made to limit that most cherished of American freedoms, the freedom of religion. Many of you have pointed out that concerted efforts have been made to deny the right of conscientious objection on the part of Catholic individuals and institutions with regard to cooperation in intrinsically evil practices. Others have spoken to me of a worrying tendency to reduce religious freedom to mere freedom of worship without guarantees of respect for freedom of conscience
Ann, I agree that a single-payer system would side-step some of these issues. I am not advocating a tyranny of the majority. We have the representative democratic process, and we have the Constitution. If the Bishops think that their “freedom of religion” is being infringed upon, then, having lost in the political process, they can take their case to court.
David, I’m not sure what assumptions you are refering to. As for your “two wrongs” issue, it seems to me that the question is whether conscience protections trump the rights of citizens. Since the specific moral dictates of one’s conscience are outside the purview of the government, its only obligation is to protect the rights of citizens from being subject to the vageries of another’s conscience. So, as with any freedom, one’s freedom of conscience stops at the point where it appears to be denying someone else’s rights. For instance, my freedom of speech might be curtailed in the event that I commit slander or liable. As I’ve also argued, however, I think that, in addition to an employees right to healthcare, their own conscience might also need to be protected from religious imposition in this case. So, the government might be doublely obligated to protect non-believing citizens from the imposition of religious employer’s consciences.
If a Catholic (or any other) employer does not provide health insurance at all and simply pays employees a salary, some of that salary will go to pay for abortions, contraception, IVF, viagra, etc.
Is that OK? The employer is directy paying for those actions/activities just the same as they are via a health plan, particularly if it is self-funded, as so many are anymore.
” As I’ve also argued, however, I think that, in addition to an employees right to healthcare, their own conscience might also need to be protected from religious imposition in this case.”
You provide no coherent theory for why employees’ “conscience” has anything to do with the issue here. On the one hand, we have a few employers saying, “By our conscience, it is wrong to subsidize the purchase of contraceptives.” (Some people don’t want to subsidize carcinogens, go figure.)
On the other hand, we have a few employees saying, “But contraceptives would be cheaper for me if someone would subsidize it, and I like cheaper stuff.” What the employees are saying is NOT, for them, a matter of conscience in any way whatsoever.
Similarly, if I go to work for a Mormon restaurant that happens not to serve alcohol as a matter of conscience, then even if I think there’s nothing wrong with serving alcohol, my conscience rights have NOT been violated in any way. The only way MY conscience could be involved would be if I literally thought it a moral obligation that alcohol must always be served at restaurants, which would be quite an odd moral obligation to believe in. And even if I had such an odd belief, the easy solution for me would be to work at any of the thousands of restaurants whose conscience does not differ from mine.
Thorin –
What you quote from Pope Benedict is from his speech to American bishops who had just had their ad limina meeting with him. It is not surprising, therefore, that he ommented on what they — the bishops of the eastern U. S. including Archb. Dolan, the head of the NCCB, had said to him. And no surprise that he agreed with them.
But I have problems with this speech in response to only a few American bishops. Does the Pope actually have access at these ad limina meetings to what *all* the bishops are actually thinking — or even most of them. The reason I ask is that I notice in my diocesan newspaper this week that my archbishop and other bishops of this southwest region have their ad limina meeting this week. From advance notices about these meetings we were led to think that all of the bishops would have the opportunity to actually talk with the Pope. Unfortunately, this does not seems to be the case. According to my paper, our bishops will meet with members of Vatican commissions, councils, etc. HOwever, their announced schedule includes only a “possible audience with Pope Benedict”, and that on the very last day. So it seems that not all of the bishops get to talk with the Pope. Where is collegiality in all this?
(And who sets the agendas for the bishops’? meetings with the commissions, etc.?)
Thorin, the communication to which you refer demonstrates a certain circularity. Pope Benedict appears to be reflecting back the picture of the situation as presented to him by the American Bishops. His use of the phrases “many of you have pointed out” and “others have pointed out to me” clearly signal this. Married Catholics in the U.S. may disagree with them, but our Bishops seem to have an audience in Rome ready to find contraception “intrinsically evil,” and pleased to attribute that judgment to our Bishops as well.
Eric, yes, I agree you are always going to have competing rights, but it seems conscience protections have a prior claim here, and a greater one. At best it seems you can argue that it would violate one person’s conscience to have to subsidize birth control for others and it would violate another’s conscience not to have free birth control provided for them. Again, at best, you could say that is a toss up and so opting for either one would be neither wrong nor right.
Ann,
I do not know how ad limina visits work, but I find the Pope’s comments very pertinent, which is why I posted them.
Ann, I think that every bishop used to have an individual private audience with the pope, but it was recently decided to have them have visits that would be longer but in small groups instead of individual. I saw a photo of the audience with the bishop of my area: he and another three or four bishops saw Pope Benedict together. I believe that every bishop gets to meet with the pope in this manner.
The official reason is that he is getting old and his schedule needs to be made lighter. The other reason that I thought of is that it is a way to make sure that an individual bishop doesn’t say things to the pope that do not correspond to the official line: the small group can watch one another and mutually reinforce conformity. Of course, I have not a shred of a reason to think that. I imagine the Vatican as a big house of political machinations, where nothing is at it first seems and everything has an ulterior motive.
“If the Bishops think that their “freedom of religion” is being infringed upon, then, having lost in the political process, they can take their case to court.
David, I’m not sure what assumptions you are refering to. As for your “two wrongs” issue, it seems to me that the question is whether conscience protections trump the rights of citizens. Since the specific moral dictates of one’s conscience are outside the purview of the government, its only obligation is to protect the rights of citizens from being subject to the vageries of another’s conscience.”
Sounds like someone needs to read Hosanna-Tabor (as the Bishops have gone to Court); there the Court explicitly stated (9-0 it bears repeating) that the firm, textual commitment in the First Amendment that the government “make no law” abridging the free exercise of religion trumps various other societal rights. I suspect these mandates are heading toward the same fate.
Jeff, I suppose we’ll see, but reasonable people can still publically debate the decision of judges. So, the conversation will continue…
Thorin =-
I don’t object to what the Pope has said. This time I think the bishops are right. I don’t think there is an concerted, systematic push to deny religious liberty, but, yes, there are some who are pushing for the elimination of religion (see Dawkins). And there is the continuing social assumption of many people that religion and politics are not to be discussed in polite society. Ugh! What nonsense/
My point about the ad limina meetings, however, was simply that so far the Pope has listened to only some of the bishops and it looks like he’s planned it that way. I think that is bad business. It shows a lack of appreciation of input from all sources.
There might be practical reasons for listening to only some bishops, for instance, the pope is very old and there is just so much time. But it seems to me that the bishops as a group should decide who their spokesmen are to be. But deciding that might require giving the national organizations of bishops the power to decide who their spokesmen will be. However, for the Vatican bishops’ organizations with teeth are to be avoided.
There are several issues at play here, ISTM. A few words about a few of them:
1. What Catholics owe non-infallible magisterial teaching is “obsequium religiosum,” a phrase whose meaning has been debated. Generally, it is interpreted to mean “serious attention,” that is, a presumption in favor of the teaching and serious engagement with the arguments that underlie it. Those underlying arguments are very much in play on this issue. Here, the bishops have said “we refuse to pay for health insurance that covers contraceptive coverage because we believe that using contraception is wrong.” The magisterial argument against contraception is not convincing to most Catholics nor to the vast majority of Americans, based as it is on a reading of natural law that is questionable. The more interesting question here, though, isn’t whether Catholics can disagree with the magisterium–Catholics can and do. Nor is it about the rightness of their moral position on contraception. Rather, it’s about whether the bishops may claim that since they view contraception as wrong, they may refuse to fund insurance plans that cover it.
2. There are two traditional ways to engage matters of disagreement on serious moral matters. Let’s grant for now that the bishops will not change their mind on the “evil” of contraception. Even so, they might choose to tolerate that practice, on grounds that greater harm might ensue if they effectively forbid it. Aquinas went to bat for allowing non-believers (Jews, pagans,) to worship, even though allowing this jeopardized (he thought) the immortal souls of anyone who participated. In support of his argument, he cites Augustine, who argued that prostitutes have a place in society, and must be allowed to ply their trade, since suppressing them would do greater harm. Aquinas was not a new-age interreligious dude–he was advocating in civil society a practice he KNEW to be evil. As was Augustine. Sometimes we allow what we don’t view as right, because civil law plays by limited rules in Catholic tradition. The other concept is cooperation, which David discusses in his piece. Cooperation says that when we cannot effectively stop the evil practice, sometimes we go along with it, in order to prevent a greater harm.
3. If we argue this way. what’s the greater harm? Certainly children are not a medical problem, and pregnancy is not a disease. However, the effective regulation of births IS a matter of public health. Access to contraception has demonstrable public health benefits. More to the direct matter here–the bishops’ consciences. If we allow Catholics to decline coverage for birth control on religious grounds, even though there are public health benefits, we open the door for anyone claiming religious grounds to deny coverage for this or that to their employees. Chaos results, universal coverage is a joke. Some employers might even profess beliefs that “forbid” them in conscience from paying for health care at all–Christian Science, anyone? People may be denied life-saving treatments on the grounds of their employers’ religious beliefs. This also is a matter of public health. No one should die–or be denied standard medical care–because of the religious beliefs of their employers. If those beliefs are reconcilable with good medical practice, no problem. But that’s not the case here.
4. Religious freedom is a big deal. The Church (now) affirms it as central to human dignity, (even though it was condemned in the 19th century.) I think the exception as written respects religious liberty well–Catholics working for Catholic institutions that serve Catholics need not offer coverage for what Catholic leadership finds wrong. (This is an interesting echo of the mandatum requirement–Catholics teaching Catholic subjects in a Catholic institution are bound to seek the mandatum. If it works for academic institutions…) Same rules apply for JW’s, etc. To truly respect religious freedom means we respect everyone’s freedom–here, we establish baseline medical care based on solid medical evidence, and encourage religious leaders: 1. to make clear that while their health plans might fund this or that, they have objections to the practice, on these grounds…2. seek to convince at least their co-religionists that rejecting the practice is better than taking advantage of it. 3. seek to convince others that the practice is wrong. Let the JW’s reject most surgery, but let their employees seek it if they wish. Let the Christian Scientists reject medical care as wrong-headed–but health plans of their employees should provide it.
5. Labelling something “intrinsically evil” doesn’t say how bad it is, nor that it might not be tolerated or cooperated with. Masturbation, e.g., is labelled intrinsically evil in the Catechism, but I hear no outcry that it be criminalized–greater harm to society would ensue, even IF (that’s a big IF,) masturbation is correctly labelled intrinsically evil. “Intrinsically evil”only means that it can never be morally intended as an end in itself. Using such language for contraception, however, convinces only Catholics, if anyone, and only a tiny minority of Catholics. It won’t settle a debate of civil law.
6. So my question remains: if Catholics get to not pay for contraceptive coverage because the bishops don’t believe in it, do the same exceptions apply for other religious views which, while sincerely held, cannot be supported either by arguments from public health, common good, or accepted standards of medical care? And why doesn’t that violate Catholic tradition on the distinction of civil from natural law?
What’s startling is that any liberal Catholics here (except for David Gibson, thank you for your sane view sir!), who claim there is a freedom of conscience to disagree from the Church without suffering a religious penalty, would actually defend the government’s actions taking away freedom of conscience of religious groups (who are conservative) on pain of suffering fines and public penalties. Religious dissent from humanae vitae went from “we should be respected in our freedom to disagree on the church’s view that contraception is evil” to , now, “our party is defensible in denying the practice of anyone else’s view that contraception is evil.” I am thankful that not all liberals are cheering for totalitarian tactics just because those tactics agree with their view, but it is no less disturbing to see some of them send up those cheers. Giving the government power to coerce is not a great idea in today’s wildly changing world, whether it be terrorist detainment or forcing people to violate their moral beliefs by mandating that employers either pay for health insurance that covers contraception or pay a fine. The story quotes Bolt’s Thomas More, but that More had his own lesson to teach his future son-in-law about what happens when you tear down barriers to chase down the devil you disagree with, only to have him turn around when there’s nothing left standing for you to hide behind yourself. How can Ms. Fullam or Mr. Gallico ever again consistently defend a dissenting theologian from Church discipline, when they have said that since the Church doesn’t hold their view on moral cooperation it is unjustified in its complaint against government discipline? The NC Reporter article and Ms. Fullam’s comments, if honestly liberal, should have at least said that the Church and the government should respect conscientious freedom, not that the Church is wrong on suppressing contraception dissenters AND it is wrong to object to covering contraception since after all the Church doesn’t agree with the true liberal view that there’s hardly any evil involved and contraception is a wonderful, healthy, abortion-reducing thing. Is it a good idea to give the government power to take sides in that debate? Not from a truly liberal perspective, I say, and I am not alone. I would have hoped there would be agreement with Mr. Gibson by the bloggers here, too, if for no other reason than internal consistency and long-term self-preservation.
Lisa: The Catholic bishops as American citizens are free to work within the American political system to overturn or modify the Obama administration’s regulations.
For the sake of discussion, let’s say that the bishops somehow succeed politically to get the Obama administration’s regulations modified so that the modified regulations grant the kind of exemption that the bishops would prefer to have for Catholic employers of non-Catholic employees.
But such modified regulations would probably NOT be Catholic-specific. On the contrary, such modified regulations would almost certainly set up an exemption that also covered non-Catholic religious organizations as well as Catholic organizations.
Ms. Williams,
You are right. Sadly, “Roma locuta est, causa finita est” has been replaced by “Obama locuta est, causa finita est.”
@ Thomas; indeed–I can’t see how the Gov’t would exempt Catholic employers and not exempt non-Catholic employers. How would the gov’t be expected to adjudicate between legitimate and illegitimate claims of refusal to fund coverage on religious grounds? More troubling to me is that we’d WANT the feds to do so. They aren’t competent in that realm, for starters. Better to establish solid basic coverage expectations on medical grounds, establish a narrow religious exemption, and leave religious leaders free to encourage, exhort, or even censure their members (as Catholics who practice contraception are told they are committing mortal sin,) regarding procedures they find objectionable.
To say that Catholic objections to (funding) birth control are OK and JW objections to (funding) blood transfusions are not should not be the subject of government review. It would seem to violate the establishment clause, yes? The gov’t would be declaring RC theology as sound grounds for public policy, (what’s covered in insurance plans) while rejecting JW theology, even though both stances rest on religious arguments.
Lisa —
– Your point 2 rests on a very elementary confusion between the issue of legally forbidding a practice with the issue of being allowed not to subsidize the practice. These are two totally different things. The fact that Catholic bishops might prudently decide not to lobby for a society-wide ban on contraception tells us nothing whatsoever about whether they should be allowed not to subsidize contraception.
– Your point 3 claims, “Access to contraception has demonstrable public health benefits.” You might want to reconsider such fulsome praise of contraceptives; I refer you to birth control’s classification by the World Health Organization as a top carcinogen, along with asbestos and radium.
– Your point 3 also rests on the slippery slope argument that if Catholics are allowed not to pay for contraception, everyone else will be free not to pay for vital life-saving treatments. Well, we as a society are perfectly capable of drawing a line that would broadly allow conscience claims without going as far as the (wholly imaginary) specter that you present here.
– Your point 5 again confuses the issue of criminalization with the issue of not wanting to subsidize. This is quite a simple distinction to keep missing so often.
@ STudebaker,
Thank you for your thoughtful reply. However, I’d say the question of toleration and cooperation are applicable both in cases of forbidding contraception (not, as far as I know, the bishops’ intention here,) and providing coverage that would allow (not coerce!) employees to receive contraception. It’s hard to say that providing coverage for contraception is subsidizing contraception any more than providing coverage for cardiovascular disease is subsidizing unhealthy living, yes?
And on the notion that society can draw a line–OK, on what grounds? My problem is that it seems that to simply say “religious liberty trumps” in no way allows the gov’t to draw such a line without adjudicating between competing religious claims.
The JW’s don’t want to make blood transfusions illegal. They find them morally objectionable on religious grounds. Why would a JW employer want to pay for health insurance coverage that would pay for morally objectionable things like blood transfusions?
WHO on family planning: “Quality family planning services bring a wide range of benefits to women, their families and society.” This includes various forms of chemical contraception. See details at: http://www.who.int/mediacentre/factsheets/fs351/en/index.html
Ms. Fullam,
No, it shouldn’t be the task of government to decide that there is an intellectual difference between the Catholic teaching on contraception and the teaching of Jehovah’s Witnesses on blood transfusion.
However, those poor Catholics who scrimped and saved to endow Catholic universities to pass on the Faith surely had the right to expect that theologians employed at those universities would teach that there is an intellectual difference between the Catholic teaching on contraception (rooted in the thought of St. Thomas Aquinas, among others) and the teaching of Jehovah’s Witnesses on blood transfusions. Indeed, one can argue that they had the right to expect that the theologians employed at those universities would actually teach their students that what the Church teaches is true.
Anitra: Why don’t you read what I’ve written about this before ascribing to me positions I don’t hold.
INcluding what the Church teaches about the difference between civil and natural law, and the grand moral traditions like toleration and cooperation, yes? The breadth and depth of the tradition, yes? In fact, to teach students that Catholic tradition is one of deep thought, engaged with the best information available to us?
This question isn’t really about the liceity of contraception–it’s about how to adjudicate religious claims in making public policy in a pluralistic democracy. Protecting religious freedom by not asking the government to figure out which religious claims are acceptable and which are not.
BTW, my understanding is that the JW rule is based on a strict interpretation of scripture. We can disagree with their interpretation, (as I do,) and I don’t want that reading of scripture to dictate public policy, but they are free to read the scriptures as they see fit, unless there is demonstrable harm to the common good. This fits, I think, with what the Church teaches is true on matters of civil law and public policy.
Re: the World Health Organization’s classification of birth control pills as a carcinogen, see this. http://en.wikipedia.org/wiki/List_of_IARC_Group_1_carcinogens
Such a nice list of items that we should all be putting in our medicine cabinets: arsenic, benzene, formaldehyde, hepatitis, HPV, mustard gas, neutron radiation, plutonium, radium. Oh, and these: “Contraceptives, hormonal, combined forms (those containing both estrogen and a progestogen). Contraceptives, oral, sequential forms of hormonal contraception (a period of estrogen-only followed by a period of both estrogen and a progestogen).”
This makes no sense:
Your statement isn’t parallel: What you might have said is, “It’s hard to say that providing coverage for contraception is subsidizing contraception any more than providing coverage for heart operations is subsidizing heart operations.” But that looks wrong, because it is wrong. Of course providing coverage for contraception subsidizes contraception, otherwise no one would be complaining about it, would they? They’d pony up for the $9 a month at Wal-Mart all by themselves.
Thorin, You obviously have not done much teaching. Especially at a university, you can’t “teach” that something is true, that would be indoctrination. You teach students to think critically through argument, learn to examine and verify the premises under consideration, learn what kinds of criteria “verify” what kinds of premises, and learn how to move validly from one premise to the next. It’s a dialogical process. It’s about identifying deep and important questions and problems, and gaining the tools you need to begin to answer or solve them. Some of the answers will come by the end of class, but some will only be the fruit of a lifetime. Others will only find an end to their striving in the Beatific Vision. In the end, though, you don’t ask the students to passively sit there and receive the “truth” that you are giving them. If that’s what your good Catholic parents want to happen, they should save their money.
How is it possible for anyone even to have this discussion without breaking down in laughter over the claim that people need to have health insurance for oral contraceptives? It’s a complaint that isn’t much more serious than this guy: http://www.youtube.com/watch?v=D2p5svFJ9cQ
“I couldn’t reach my Wii game on the top shelf, and I had to pay for contraceptives all by myself.
More seriously, I have little doubt that were it not for the unspoken feeling that any price is worth paying to be able to have sex without having children, oral contraception would be not only not be subsidized, most forms of it would be banned outright except in the narrowest of circumstances. How many of the Group 1 carcinogens, after all, are allowed for daily household use?
How come? If I were you, rather that keep hitting my head against a wall that won’t move, I might find a much more congenial place to pray. Take the theology and whatever of the liturgy you like, keep developing them, and throw away the rest. Surely you don’t expect it to become a better place in your lifetimes? Staying seems masochistic.
http://www.accus.us/
http://en.wikipedia.org/wiki/American_Catholic_Church_in_the_United_States
http://americannationalcatholicchurch.org/
http://www.romancatholicwomenpriests.org/
Eric, democratic governments cannot possibly give “the people” what they want. There are far too many people with far too many conflicting desires. What happens when governments try to please people is that you end up with rule by majority, which you seem to think is a good thing. Rule by any group is tyranny. Government should provide those services that only a government is capable of providing well and, as for the rest, stay out of the way.
Whenever one group gets to define words like “fair” and “just” and “humane” and “decent”, bad stuff happens to good people.
If I were you, rather that keep hitting my head against a wall that won’t move, I might find a much more congenial place to pray.
David Smith,
If you are a Catholic, or even if you are not, do you really think it’s right to encourage others to leave the Catholic Church? Who exactly do you think you are?
David Smith: First, it seems like it might bear repeating that the U.S. government is neither a dictatorship (e.g. North Korea) or a tyranny of the majority (e.g. Socrates’ Athens). Obama did not speak the Affordable Care Act into law ex cathedra, as might happen in certain other fascist regimes, nor is it the result of a straight up and down vote of the people. We do have a representative democratic process and a Constitutional separation of power and protection of individual rights, whereby congress represents various constituencies (“many people with conflicting desires”) in making law, various levels of non-elected judges decide on the Constitutionality of that law, and a democratically elected President who tries to represent the majority in international affairs of State and influencing domestic policy. Now, it’s not a perfect system, but it’s neither rule by fiat nor rabble. You might say that at any one time and on any one issue, there is some “group” that seems to be “winning,” but if there were never any rough consensus about what to do within the bounds of the Constitution, we would have anarchy. So, the “rule by any group is tyranny” principle would lead to anarchy.
Second, do you really think that “The Government,” as you understand it, is competent to judge whether a particular law involves the possibility of a remote participation in Evil that might violate the religious conscience of a few citizens in some relevant way that trumps the rights of certain other citizens, but that this same “Government” has absolutely no competence in determining a “fair,” “just,” “humane,” and “decent” procedure for the distribution of healthcare resources? Now, we might disagree as to whether a particular procedure is necessary or the most just, but it’s a strange day when deciding what is “Evil” is thought to be easier than merely determining what is “decent” and practical rationality requires more competence than metaphysics.
David Smith: splitting up won’t help our divisions. We have to find a way to get along together as a community. Your suggestion is much like advising a spouse in a troubled marriage to leave and get divorced.
In fact, when voices on the right suggest that those who are unhappy with this or that ought to just leave, that’s when I know with certainty that they’re wrong; they’re pushing the Church into a sectarian corner. The exclusive aspect is a sure sign that that trend has an evil dimension. I have to stay to try to protect my Church from that sectarian drift.
As a followup, I suppose that for people who worry about population control, the fact that oral contraception not only prevents children but causes breast cancer must be a two-fer.
Studebaker, if you read the footnote of the page you linked to and are citing from, it says that the same oral contraceptives also have a preventive role for other forms of cancer.
David Smith: You’re out of line for suggesting that your interlocutors should leave the church. Do it again and you’ll find yourself blocked.
Lisa: In my most recent comment above, I was responding to your point 6, because your point 6 seemed to me to be garbled. In your response to my comment, you have agreed in principle that the hypothetical modification of the Obama administration’s regulations would NOT be Catholic-specific.
Now, you have the foresight to figure out just how complicated the hypothetical modification would probably have to be. Good for you. However, I suspect that the Catholic bishops have not thought through the implications of a broader exemption as carefully as you have.
I myself am not in favor of the broader kind of exemption that the Catholic bishops seem to want. At this time I see no problem with the Obama administration’s regulations.
Claire — if you look up the number of women who die from ovarian or endometrial cancer (as to which oral contraception has a protective effect), the number is considerably smaller than the number who die from breast cancer. On net, the effect of birth control is to give women cancer.
It’s never easy to decide which generally applicable laws should not apply to religious groups. But it seems to me that Eric and Lisa are making it harder than it needs to be. The state has an obvious compelling interest in barring a religious group from denying blood transfusions to patients who need them. Live citizens are better than dead ones. In such an extreme case, the state’s interests trump the religious group’s. But does free, rather than relatively cheap, for many (I don’t think we should pretend that everyone can get to a Walmart or a similar store), contraceptive services present such a compelling state interest? The answer is not so clear. That’s one reason I favor erring on the side of protecting religious freedom.
But does free, rather than relatively cheap, for many (I don’t think we should pretend that everyone can get to a Walmart or a similar store), contraceptive services present such a compelling state interest?
Your argument isn’t as strong as it could be: when insurance pays for contraceptives, it is not “free” — people are still paying through the higher cost of insurance and through co-pays. Moreover, it’s not just Wal-Mart (4,000+ U.S. stores): Target, Kroger, K-Mart, and Sam’s Club also make some contraceptives available for $9 a month. See http://www.reproductiveaccess.org/contraception/downloads/lowcost_pills.pdf The number of people in America who can’t get to one of these stores is vanishingly small.
Maybe after we’re done discussing a federal mandate to cover contraceptives, we can discuss whether the federal government should require home insurance to cover the purchase of every single package of screws or nails used for household projects, or perhaps the cost of getting a key duplicated (I’m trying, but it’s hard to think of any analogous item that is as frivolous a subject for federal intervention.)
As a followup, I suppose that for people who worry about population control, the fact that oral contraception not only prevents children but causes breast cancer must be a two-fer.
Studebaker,
That is one of the ugliest remarks I have ever seen on dotCommonweal.
David — why? The alternative is that people who push oral contraception on developing countries do care that women die of breast cancer, but cancer deaths take second place to the desire to limit the number of brown and black children in the world. Either way, population control zealots don’t look so good.
“It’s never easy to decide which generally applicable laws should not apply to religious groups. But it seems to me that Eric and Lisa are making it harder than it needs to be.”
I agree with Grant on this point. I think it should be kept in mind that it is the HHS mandates that are upsetting the apple cart in ways, if the Bishops’ legal analysis is accepted, that deviate from settled federal and state law. I’ve known many married (and single) women who work in our diocese, many of whom are on artificatial birth control. I’m sure some would be happy to have such benefits paid for; but as they are generally well-informed and serious Catholics, they aren’t taking to the barricades to demand change, as they understand the Church’s position, whatever they do with it in their own lives.
Studebaker,
Your implication is that those promoting population control want women to suffer the alleged negative side effects of oral contraceptives (and possibly die of breast cancer), or they are at least indifferent to the possible side effects, otherwise they would not promote oral contraceptives. (You also imply that they are racists.) You might equally argue that any doctor who prescribes drugs for his patients with possible side effects either wants a certain percentage of his patients to suffer those side effects, or is at least indifferent. You are ignoring the fact that side effects are always unwanted, and that a certain percentage of side effects are tolerated because of the overall good done by the drug being used. Your implicit assumption is that where family planning is promoted, it does no good at all, or at least not enough good to justify the risks of breast cancer. The US Government does not agree here:
Grant, You are right that there is always the weighing of competing interests going on in considering the point at which the freedom of one individual or person infringes on the rights of another. I think our discussion has, in part, helped to clarify some of the relevant (and irrelevant) issues involved.
I think at least one of the problems exercising Lisa and myself, though, is a result of the way the Bishops have framed the issue. Rather than a confrontation between the competing rights of various constituencies, they have presented the HHS mandate as a direct affront to moral conscience, which they have suggested should always be protected against the morally blind tyranny of the State. Now, this, as many have argued, is to stretch conscience protection and so priviledge it over all other rights that one could claim exemption from almost ANY state law requiring citizens to do something for the common good that they may find morally offensive – from subsidizing life-saving blood transfusions, to paying taxes that subsidize war, to the federal regulation of the meat industry, etc. What all of this moral outrage obscures, however, is precisely what you point to is the operative question that the State is actually competent to answer: What is the minimum “medically necessary” set of services that should be considered as part of the right to healthcare to which all citizens are entitled?
As Matt and I discussed on my post, the appropriate criteria for “medical necessity” is debatable, but what is clear is that questions of a moral and/or religious nature are not applicable. In your rejection of the rights of JWs to refrain from providing blood transfusions, you didn’t need to engage any of the moral/religious arguments for why a JW’s conscience might be so vexed by the mandate. You simply said that based on a particular definition of “medical necessity” (i.e. the immediate preservation of life), it is in the interest of the State (which is the same as the interest of the representative democratic polity) that religious exemption not be claimed.
The same is true in considering the Catholic case. The State has no competence in determining whether and why Catholics might have moral qualms with contraception. This is precisely what the “wall of separation” that preserves religious freedom entails. The government is not interested in determining the relative significance of challenges to conscience. The question is simply whether there is a “right” that trumps conscience. In your JW example the right to “medically necessary” service trumps conscience. The same principle applies to Catholics who might conscientiously object to birth control. If we want to debate “medically necessary,” then that is a discussion in which anyone, irrespective of his or her religious or moral view might participate, and I imagine such a debate occured at HHS among the relevant authorities. But it has nothing to do with appeals to conscience. This is why the Bishops are wrong.
As a postscript, it should be pointed out again, that no one is being forced, under penalty of death, to do anything. However, it is also not the case that conscientious objection comes without consequences. So, if a soldier conscientiously objects to a particular order of his or her superior, this is “allowed,” but not without the potential of discharge from the armed forces and possible imprisonment. So, it is not completely outrageous that religious people would be asked to refrain from participating in certain public positions, if they foresee an overwhelming challenge to their conscience in discharging their duties. So, conscientious objection for JWs might entail their not becoming doctors or running hospitals, but that does not mean they are being consigned to a hermetic existence.
Cupcake writes: “One important consideration with respect to contraceptives is that covering them may have a net negative cost due to preventing pregnancies which are expensive.”
This is the exact “secular reasoning” that the Church rightly opposes – it is this mechanistic and utilitarian view of human sexuality and human life that the Church stands against.
While there are plenty of sophists and pontificating would-be “professors” (dime-a-dozen on any campus) on here trying to explain away this totalitarian action by the state, the fact remains that it is not the Catholic leaders forcing views on society or wider health policy, but the state forcing its pseudo-morality and reductive view of human sexuality/life on Catholic communities and institutions.
It shouldn’t be necessary to point this out, but the Catholic Church teaches that contraception is evil, not good. According to Catholic moral theology, drugs dispensed for purposes of contraception are evil, not good. It is not possible to construct an argument in accord with Catholic moral theology that it is good to provide access to drugs used for contraceptive purposes, much less that this is so great a good as to outweigh the Church’s right not to subsidize contraception. It is possible to argue, for the Thomistic reasons cited by Ms. Fullam, that the state need not prohibit access to drugs used for contraceptive purposes. But there is no moral argument to be made in accord with Catholic teaching that the state may force the Church to pay for what it teaches is evil, though I can imagine arguments for the Church tolerating such an evil. But that state action would remain evil, not good.
a certain percentage of side effects are tolerated because of the overall good done by the drug being used.
That’s my point, David: the side effect of causing cancer (on net) is tolerated because of the perceived overall good of limiting population. I’m not sure that’s such a good tradeoff, particularly if you’re one of the women who got cancer.
But in any event, my original comment was targeted more at the zealots who actually admit that they wish the earth’s population of humans would drop to 10-15% of what it is now. If the shoe doesn’t fit, don’t be offended on behalf of those whom it does fit.
trying to explain away this totalitarian action by the state
Brett,
I am of two minds and might actually be arguing for a broader religious exemption if those so opposed to what HHS is doing were not making such bad arguments. There is just no way to rationally call the contraception mandate a “totalitarian action.”
I wonder how long Mr. Bugyis and Ms. Fullam can continue to discuss this pressing issue while remaining unwilling to admit 1) the prevalence (indeed, the unavoidability) of contraception so cheap (30 cents a day) that it’s hard to identify any item in all of society that is cheaper (gumball machines, maybe); and 2) the classification of oral contraception as a carcinogen (I haven’t even mentioned the fact that contraception doubles the risk of stroke).
Studebaker,
Sorry, but it is just outrageous to imply that anyone promoting or providing contraceptives for population control secretly hopes they will be getting more bang for their bucks by having breast cancer kill off women. There’s no way in the world you can justify the implication.
Studebaker,
You don’t need to go to the doctor and get a prescription to buy gumballs.
Any women who uses oral contraceptives is presumably aware of whatever risks there may be and is giving informed consent to take the medication. By the way, you are overblowing the risks. The conclusion of the study you link to reads: “Summary results indicate that risk of ischemic stroke is increased in current OC users, even with newer low-estrogen preparations. However, the absolute increase in stroke risk is expected to be small since incidence is very low in this population.” You want the headline to that to be CONTRACEPTION CAUSES STROKES!
You could make this kind of (bogus) case against almost any prescription drug. If you listen to the television ads for drugs for asthma, fibromyalgia, or any other number of conditions (including drugs to help people stop smoking), they all have potentially fatal side effects.
Sigh…first, there are a number of medical indications for which estrogens and progestins are prescribed. Drugs are non-rational substances, and as such are not “evil.” Their prudent use requires a balanced assessment of risks and benefits reasonably hoped for, in light of the particular patient’s overall health and situation. (That’s why this is a medical issue at all.) The magisterium does not object to the use of the same medications for non-contraceptive purposes. What the Church declares evil is the intention of blocking conception in sex, believing that this violates God’s purpose for sex. So enough on the drugs themselves–this started as a thread on models of conscience, not on OB-Gyn best practices.
In moral tradition, what may be tolerated or cooperated with, in certain circumstances, are evils. The full name of the concept is “cooperation with evil.” There are no moral qualms about tolerating or cooperating with good acts, after all! Not every evil should be tolerated or cooperated with–that’s what the teachings deal with–the kinds of situations in which the morally better, or (per Haring,) even morally imperative course might be to cooperate with another’s evil act. Augustine, Aquinas, Suarez, and Liguori talk about these. We can disagree as to whether this is a situation in which toleration or cooperation is the right course, but it’s stipulated in framing the question this way that the issue in question is an evil. Whether contraception is evil is also an arguable point, but is not the issue here–for the sake of the discussion, it’s granted.
Grant–your question of whether contraception is a compelling state interest is a good one. I don’t think this issue is the best place to settle questions of religious freedom and a health care mandate, either. If i had to pick between wider health care without contraceptive coverage and no coverage for the millions of Americans without it, well, that’s an easy choice. I do hope it doesn’t come down to that–and I don’t see how the argument from religious liberty serves this issue without opening up many, many new cans of worms.
But we’ll see. For myself, I think we’ve beaten this issue to death for now, and I’m stepping out of this one. New information? Then a new thread, doubtless–it’s the Way of the Blog.
You could also make this kind of (bogus) case against pregnancy itself with its 1 in 11,000 fatality rate.
http://en.wikipedia.org/wiki/Maternal_death
We keep coming back to the morality of contraception and the subsequent behavior conscience prompts. Thorin wants us to recognize that the Catholic Church teaches that contraception is evil. I agree that it does today but would like it acknowledged that the Church has made some pretty outrageous doctrinal mistakes in the past. It has taught that slavery is good. It has taught that democracy, free speech, biblical scholarship and freedom of conscience (!) are evil (“The shameful font of indifferentism gives rise to the absurd and erroneous proposition that claims freedom of conscience must be maintained for everyone.” – Gregory XVI in the encyclical Mirari Vos). I think the intra-ecclesial relationship between co-religionists (as Jeff Landry says) is best resolved *before* the dispute about the power of the federal government vis-a-vis its citizens is taken on. I don’t think this question can be avoided. The faithful have spoken by their actions and they do not agree with the bishops on the immorality of contraception.
Speaking in terms of responsibilities rather than rights (which I think is a more fruitful point of view), HHS has the responsibility to define an adequate standard of preventative care, in which they have chosen for the first time to include contraception, seeing it as a public health good.
If the bishops disagree with this for reasons of conscience, what is their responsibility? First of all I think it is their responsibility to ensure that their own consciences are well formed. Given the lack of support from the faithful in this stand, and given the lack of a response to the arguments raised in the Pontifical Commission on Birth Control Majority Report (which preceded Humanae Vitae) that artificial contraception is not intrinsically evil, the bishops have some work to do in forming their own consciences before they start tangling with the feds. They can start by having an actual conversation with the faithful on this topic. As Ladislas Orsy says in his book Receiving the Council, “All who are people of God are called to build the church and sanctify the world. Not one of the letters from St. Paul (who was much concerned about ‘building the church’) is addressed to the heads of the churches. Instead, they are addressed to the people. In his letters, we have an authentic source for the correct theology ‘of the people.’”
Eric and Grant – found this very interesting historical article by Avery Dulles in America, dated 1968. It has some points that are applicable and support Eric’s above comments:
http://www.americamagazine.org/content/article.cfm?article_id=10722
Highlights:
- “In view of the American tradition of freedom and pluralism, it would be a serious mistake to use the encyclical as a kind of Catholic loyalty test. Nothing could so quickly snuff out the spirit of personal responsibility, which has done so much to invigorate American Catholicism in the past few years. Nothing could be more discouraging to young people and intellectuals, upon. whom the future of our Church so greatly depends.”
(suggest that the same could apply to the episcopal hierarchy’s claim that religious liberty is being restricted by this decision – they effectively make it to sound like a litmus test and, in their passion, miss nuances, etc.)
- “If the present crisis is prudently handled, it can become an occasion of growth. The American church stands only to gain from a fuller discussion of the issues raised by Rahner’s article and by other similar statements. It will take time before the desired consensus is achieved. And by what means is this to be fostered? There is every reason to think that freedom and moderation, rather than force and intimidation, will eventually prevail. But meanwhile much unnecessary suffering could be caused by undisciplined protest on the one hand and by bureaucratic overkill on the other.”
(again, would suggest that some bishops’ overkill or undisciplined protests are not prudential; making this federal decision out as an attack upon conscience sounds more like a threat i.e. force and intimidation)
Some key parts of Rahner’s approach in this article:
- “In conclusion, Rahner points out that the church, as a society involved in the total history of mankind, moves forward slowly in working toward a definitive position. The ecclesiastical magisterium is an indispensable element, but still only one element, in the total interplay of forces that work together to achieve a clarity of doctrine. Many other factors, such as the “sense” of the faithful, new acquisitions of knowledge by individual Christians and theologians, and the “signs of the times,” which present ever new and varying questions, all have a contribution to make. It would therefore be unrealistic to demand total clarity from the outset. The individual Christian, relying on principles such as those outlined in the preceding paragraphs, must seek to reach a conscientious personal decision that does justice to all the factors. He must assume responsibility for his own decision before God.”
David — I appreciate your outrage, but it is misplaced. Consider what Stanford’s Paul Ehrlich said in The Population Bomb, p. 152:
Ted Turner once said, “A total population of 250-300 million people, a 95% decline from present levels, would be ideal.” Earth First people have made such charming statements as, “I suspect that eradicating small pox was wrong. It played an important part in balancing ecosystems,” or “The extinction of the human species may not only be inevitable but a good thing.”
“Rather than a confrontation between the competing rights of various constituencies, they have presented the HHS mandate as a direct affront to moral conscience, which they have suggested should always be protected against the morally blind tyranny of the State.” Forget the bishops for a moment, Eric. Forget that some of them have called the HHS ruling an affront to conscience. Forget the problem of ascribing conscience to a group of people. The nature of the dispute is the problem raised by the government’s decision to force religious institutions to act in a way that violates their moral teaching. You don’t need to agree or disagree with the way Catholic bishops have presented the conflict to understand that dilemma.
I’m not sure why you keep returning to the question of the state determining the religious value of a given religious tenet. Obviously in the case of blood transfusions — a hard case that should not be used as a test case — the state is saying, “We think your religious belief, if used to determine medical care, is harmful to the common good, because hospitals you run would end up letting people die with some frequency.” (Of course Jehovah’s Witnesses won’t agree. But they would have to comply.) You apparently believe a similar compelling interest pertains to the contraception-coverage mandate. I’m not persuaded — although I don’t think it’s an easy conflict to resolve, mostly because contraception is no longer a contested moral issue. But also because — as I’ve written elsewhere — it’s not difficult to construct a Catholic moral theological argument that would justify compliance with the HHS ruling. But it would be under duress.
As for your postscript, you can conscientiously object to going to war without doing time (it’s not easy, but it’s possible).
Stuart: Your point that contraception is not difficult to obtain is a good one. But you must know that not everyone lives near a Walmart. I wish you’d stop pretending otherwise.
David: And that’s not even mentioning the cancer treatments that could cause other cancers.
David S. quotes and then asks: “On the contrary, many of us are determined not to part company with the institutional church.
How come?”
Well, David, maybe some of us see an opportunity to join the PITA Rite. You know, the Pain In The A** Rite. The tighty-righties have taught the rest of us so very well how successful the PITA can be. Why, it even gets like-minded clerics advanced to the Next Higher Rank!
Why should insurance pay for the creation of children but not the prevention thereof? A lot of people do want children. A lot of people do not want children. Why does one take precedence over the other WHEN DEALING WITH INSURANCE PAYMENTS?
Don’t give me the “go forth and multiply” argument. This is about insurance, not a scriptural interpretation.
“The nature of the dispute is the problem raised by the government’s decision to force religious institutions to act in a way that violates their moral teaching.”
Grant, It’s hard for me to forget the rhetoric of the Bishops, because within the frame they have constructed, “problem” becomes “human rights violation,” “government’s decision” becomes “tyrannical fiat,” “force” becomes “unprecidented assault,” “religious institution” becomes “any institution run and sponsored by a religious person or group,” “act” becomes a “cooperation with evil,” “violates” becomes “directly contradicts,” and “moral teaching” becomes the “conscience of the administering group (as it supervenes on the consciences of the individuals employed).” And all of these substitutions are philosophically/theologically controversial and rhetorically manipulative.
But, I think we agree that if there is a compelling interest, the State can legislate that religious groups must comply with mandates regulating particular practices or opt out of direct participation in the particular profession to which such mandates apply. And, yes, I do think the provision of contraception in the basic healthcare rights of individuals is such an interest. But, it doesn’t do to argue against this interest by appealing to theology, conscience, or religious freedom. One would need to show that contraception is detrimental or completely neutral (and, thus, unnecessary) vis-a-vis the common good that healthcare legislation is intended to promote.
Studebaker,
I once had an extended argument with a woman who claimed the earth would be a better place if there were no people. However, she was unable to answer for whom the earth would be a better place. I really don’t think the crackpots you quote bolster your case any. I am happy to join you in condemning anyone who wants to control population, in part, by giving women birth control pills and hoping they die of cancer as a result. I just don’t think there are any such people.
If contraception is considered a medical necessity and if it should be “free,” why doesn’t the government simply hand out contraception stamps to one and all? If nothing else, useless insurance paperwork could be avoided.
Obviously legislation for a program of this type would never pass. But HHS achieves the same result through regulation under the cover of “expertise.” And in the process HHS bestows a lucrative benefit on insurance carriers.
The fact that the contraceptives are “free” to recipients is bound to encourage drug makers to develop newer more expensive versions, the tab for which will be picked up by employers rather than any individual recipients who select more expensive options.
Presto… the best of all possible worlds appears, payoffs for all the players in Washington’s game of interest-group liberalism (except for selected religious bystanders).
And lest we forget, there’s one more benefit for new voters: Young adults remain covered under their parents health insurance policies up to age 26.
Carpe diem.
Claire, this seems to me very well put:
“In fact, when voices on the right suggest that those who are unhappy with this or that ought to just leave, that’s when I know with certainty that they’re wrong; they’re pushing the Church into a sectarian corner. The exclusive aspect is a sure sign that that trend has an evil dimension. I have to stay to try to protect my Church from that sectarian drift.”
But I would add that it also implies an obligation not merely to stay, but to work hard and very actively in order to figure out why so many are walking away and have walked away in recent years.
And how to hear their testimony and invite them back into the dialogue.
The dialogue need not be only with those on the right who want to shove others out–as if their voice is more compelling than anyone else’s.
It can–and should–also be with the large numbers of Catholics who have been shoved to the margins, pushed out the door, or have walked away. And who may feel that the conversations of centrist Catholics who seem mesmerized by the voice of the right but who ignore the voice of those who have been alienated by the right do not welcome them.
The fact that the contraceptives are “free” to recipients is bound to encourage drug makers to develop newer more expensive versions, the tab for which will be picked up by employers rather than any individual recipients who select more expensive options.
Patrick Molloy,
Sorry, but the HHS guidelines allow insurers latitude in controlling costs. For example, they may charge a copay if a brand name drug is prescribed and there is an inexpensive equivalent generic.
If contraception is considered a medical necessity and if it should be “free,” why doesn’t the government simply hand out contraception stamps to one and all? If nothing else, useless insurance paperwork could be avoided.
Yes, I am sure you are always an advocate of having government do something instead of private enterprise.
And lest we forget, there’s one more benefit for new voters: Young adults remain covered under their parents health insurance policies up to age 26.
Benefit for new voters? I see it as a benefit for people who might otherwise go uninsured.
Medical Necessity is not used in the way many of you are ascribing to it. Realize that currently 66% of all US citizens receive medical coverage through a government program i.e. Medicare, Medicaid, etc. These government programs include contraception as an agreed upon treatment that most insurance plans cover. This does not mean that it is “medically necessary”. Just because a plan lists myriad treatment options and benefits, insurance and self-insured plans often manage their plans so that potential “high dollar” treatments (hospital stays, surgeries, expensive medications) must meet and be approved as medically necessary. (This is necessary because the medical/hospital industries are unable to self monitor and use best practice medicine or they overtreat to legally protect themselves or plan members will demand treatments that are not necessary (per studies and best practice national norms).
Given this, the HHS decision is consistent. You can disagree that contraception should not be part of a government plan but 95% of all insurance plans and self-insured (ERISA) plans include contraception. Hospitals accept federal funding and thus, a consistent decision is that they offer what almost every standard benefit plan offers.
If anything, the HHS decision could be argued as following the typical catholics’ behaviors (as tracked and reported by surveys, prescription data, etc.) in terms of contraception rather than the much narrower argument laid out by the episcopal hierarchy which seems to be more about their power/control than the common good in a diverse, pluralistic society. Really, the bishops insist upon renewing their exemption/exception because they are religious institutions even tho the actual means is providing contraceptive treatment which 95% of all catholics avail themselves of and reflects the actual vote of the Humanae Vitae committee (and recent historical releases from committee participants) that Paul VI made this decision based not on its merits but out of fear for setting a precendent or seeming to support earlier 1930′s Protestant decisions.
Would much rather see the bishops support religious liberty and exceptions based upon a real catholic need that actually impacts our religious liberty. If a Catholic hospital had to offer contraceptives via their benefit plans, does that catholic hospital become any less catholic in its mission, service, etc.?
Stuart: Your point that contraception is not difficult to obtain is a good one. But you must know that not everyone lives near a Walmart. I wish you’d stop pretending otherwise.
Grant, do you have statistics on the number of people who live more than 20 miles from a Wal-Mart, K-Mart, Target, Sam’s, or Kroger?
David — you talk of side effects. Hmm. Itchiness is a side effect. Dry mouth is a side effect. Drowsiness. But breast cancer is the most common cancer among women (1 in 8 will get it at some point), and a 44% increase in the risk of getting that cancer and dying isn’t just a f***ing side effect.
Sorry, but I’m a little touchy about that. I don’t usually like to get into personal details, but I’ll make an exception: my wife got breast cancer last year. She suspects (although of course one can never prove) that it’s at least partly because of the time she took oral contraception years ago. Her breast cancer cells are the type that grow in the presence of both estrogen and progesterone, so birth control pills are the most obvious factor (she has no genetic history). She would never have taken the pill if we had known, at the time, about the ominous evidence of how dangerous it is.
A broader observation: the pill is like Tylenol, in that given all that we now know about how lethal it is, the only reason it’s not banned is because enough people still want it anyway.
Anyway, I yield to no one in my contempt for people who so blithely talk about subsidizing contraceptive use while slighting or refusing to address the dangers that arise from messing with the body’s hormones that way.
William, it’s a good point. I am aware at all times of the presence, close to me, of individual people who have walked away. But I don’t see how to dialogue at the level of a group. They are not organized like those on the right… are they?
Studebaker, I’m sorry to hear that.
I note that in France many doctors recommend IUDs rather than oral contraceptives for women who have already had children (but not before they’ve had at least one child, because IUDs carry a small risk of causing infertility). Different countries, different evaluations of risk.
Studebaker,
Your wife is in my prayers. And I admire your willingness to criticize the sacred cow of contraception.
Claire, thank you for your gracious (and understanding) reply.
You ask, “They [i.e., those of us alienated by the the church] are not organized like those on the right… are they?”
No, and that’s a good point.
What I’m saying is that conversation spaces such as that created by Commonweal could/should effect such organization–could/should work to become spaces inviting such conversation with the many, many Catholics who are alienated.
The conversation between the center and the right seems altogether too narrow and parochial, if we consider all those large numbers of Catholics shoved entirely by the conversation–often, quite deliberately by the right.
As those in the center say and do little to nothing to challenge the alienating tactics of those on the right.
Sorry for the mistake in what I just posted: “large numbers of Catholics shoved entirely by the conversation” should read “large numbers of Catholics shoved entirely out of the conversation.”
For God’s sake, David, why can’t you just take something the way it’s written? I’m not encouraging anything – just saying that if I were in that situation …. It’s English. No need to reinterpret it into English.
Please see my reply to David N, above.
Eric:
Eric, the simple secret, the easy trick, is to govern minimally, in as small a way as possible. The wider a government spreads its net, the greater the number of possibilities for offending people in their deepest sensibilities. Unfortunately, governments are power machines, and power constantly seeks greater power.
Points taken, Claire. Thanks.
David Smith: That’s insufficient. Please refrain from making such suggestions here.
Stuart: You are the one making the claim that Walmart is so convenient. Prove it. If, for example, you live in Valentine, Nebraska, the closest Walmart is 130 miles away, in North Platte. If you live in Big Sur, CA, good luck finding a big-box store. If you live in Brooklyn, NY, and don’t own a car, good luck. There is no universe in which Walmart is as convenient for everyone as going to the local pharmacy.
I, too, am sorry to hear about your wife. And I also know the instinct to find causes for that disease. But we are subsidizing all kinds of risky drugs every time we (help to) pay our insurance premiums.
I realize there are already a large number of comments to this thread, but if I may, I’d like to go back to DeCosse’s article. If I understand it correctly, his main critique is as follows:
* A traditional Thomistic understanding of conscience combines several different elements: authority; personal freedom; and practical reason
* Recent popes, in teaching documents, have tended to increasingly emphasize authority’s role, thus ‘crowding out’ the traditional role that personal freedom and practical reason could play.
* In the case under discussion (the new HHS regulation’s extremely narrow definition of a religious institution for religious-exception purposes), the bishops, by adhering to this new understanding of conscience, have staked out a position that doesn’t permit Catholic institutions adequate ‘moral space’ to use practical reason to determine how to accommodate the new regulatory environment.
I wish De Cosse had provided more examples to illustrate how he thinks authority and practical reason could co-exist more fruitfully, because I’m struggling a bit to understand his ideal interplay. I would have thought that the two elements come into play in different ways:
* Authority’s role is to help *form* consciences; authoritative teaching constitutes, in a sense, a school for conscience
* Practical reason’s role is to help *apply* the (hopefully well-formed) conscience to concrete situations.
It seems that what has been happening recently is that authority is exerting itself more robustly into areas that it hadn’t before, and thereby “raising the bar” for conscience formation. E.g. prior to Humanae Vitae, the church hadn’t taught authoritatively on the then-new technology of the Pill, and so individuals, and their spiritual advisers, had a certain amount of freedom to apply practical reason, as best they could, to the complex decisions about whether and how contraception could rightly be used. But then Humanae Vitae, in staking out new ground for church teaching, had, in a sense, taken pure practical reason out of play in that decision-making.
I believe authority would say that it has ventured into hitherto-uncharted territory in HV because practical reason, by itself, was reaching morally dangerous answers, and so the church issued the encyclical in order to help married couples discern the correct way to live a married life. That doesn’t (the church authorities would say) constitute a desire to disenfranchise the faithful’s freedom to apply practical reason; it’s really intended to be quite the opposite, a support to practical reason by protecting it from the risk of inadequate reasoning.
Another example would be the pronouncement that nutrition and hydration always constitute ordinary care for terminal patients. Prior to this teaching, this was one of the innumerable areas in which practical reason had to be employed in weighing the human costs and benefits.
The applicability of De Cosse’s critique to the bishops’ response to HHS regulations isn’t clear-cut. I don’t see the bishops’ (and other Catholic leaders’, from the president of Notre Dame’s to the president of the Catholic Health Association’s) opposition to the new regulations as a binding exercise in teaching authority. (Am I wrong about that?)
I too was sorry to hear about Studebaker’s wife, and my first instinct was to drop the discussion. But the point he is making is that it is a very serious issue, so I think it would be a mistake to just drop it.
I did a fair amount of reading on the topic of breast cancer and oral contraceptives, and I found nothing really conclusive at the sites of the Mayo Clinic, WebMD, the National Cancer Institute, and other such reliable sources. It does seem reasonable to conclude, form all sources combined, that there is some elevated risk of breast cancer for women using oral contraceptives that continues for no more than ten years after they stop using them.
Calculating the risk is very tricky, however, and therefore weighing the risk versus the benefits is tricky. It is true that between 1 in 8 and 1 in 9 women will get breast cancer at some point in their lives. Studebaker uses a figure of a 44% increased risk with oral contraceptives. That appears to have been the conclusion of one study, and of course there have been studies that show some risk of breast cancer from oral contraceptives, and studies that show no risk. Here is an brief excerpt from an interesting Slate article:
So it’s difficult to know the risk for sure, and even more difficult to quantify it. Then there is the matter of interpreting the statistics. As I understand the studies, they do not attempt to find the lifetime risk of breast cancer among women who use oral contraceptives. They attempt to find the increased risk for women who are actually taking oral contraceptives. As I said earlier, there seems to be an agreement that if there is an increased risk of breast cancer associated with contraceptives, no more than 10 years after a woman stops taking them, her risk returns to that of women who are not using contraceptives and never have. So even accepting a 44% increased risk, that is a risk limited to a certain period, not a lifetime risk. So if the lifetime risk of getting cancer is 1 in 8, spread over, say, 60 years, the risk of getting cancer in a given year is 1 in 8 divided by 60, or 1 in 480. So a 44% increase would be 1.44 in 480. So the risk without contraceptives would be 0.208%, and the risks with contraceptives would be 0.3%. The overall risk would depend on how long the woman used contraceptives plus all the other factors that enter into breast cancer risk (heredity, smoking, diet, exercise, etc.)
It seems extraordinarily difficult to calculate the risks and even more difficult to calculate the risks versus the benefits.
One more point to remember is that the “contraceptive mandate” does not mandate prescribing the pill. There are many different kinds of contraceptives (plus sterilization), and while the pill is the most-used method of contraception, 28% of women use it, meaning 72% do not.
Warning: It would be wise to verify my calculations before accepting them!
I guess I don’ t agree that authority’s role is to be “a school for conscience” .
Much like the overplay of magisterium today, there is a string effort to bolster the declining role of “authority” in the Church today as it bangs up against moderniry.
The interplay and tension about this today is clear in the breach in the Church between two views.
As in a newer thread, how much value will be placed say on Abp. Dolan’s notions about the administration’s position wil be placed on the credibility of what is put forward.
Grant — thanks for the kind wishes.
I’m sure there are a small number of people who live in rural places so deserted (Valentine, NE: population, 2,820) that not even Walmart, despite its rural preference, will open up one of its 4,000+ stores nearby. As for Brooklyn, Google Maps says that there are 3 Target stores, and given the size of Brooklyn, it’s mathematically impossible for anyone to be more than a few miles away from one of those stores.
Yes, other drugs are risky too. But presumably there’s some corresponding medical benefit that outweighs the risk. Some people are so allergic to antibiotics that they go into shock and die, but antibiotics have saved so many other lives that they’re still a good thing to have.
But oral contraception, in the overwhelming majority of cases, isn’t being used for any health or medical reason at all: it’s being used to prevent having children. But even that isn’t the benefit of oral contraception, as there are other and safer ways to prevent having children (condoms don’t mess with the body’s hormones). So the real benefit of oral contraception for the vast majority of people is the ability to have sex without condoms.
Is that really a benefit akin to the lives saved by antibiotics, such that we should tolerate a substantial increase in the risk of cancer? Folks like Mr. Bugyis should try to come up with an argument that there is, in fact, some medical benefit that outweighs the increase in cancer risk. Good luck with that.
* * *
David, here’s a meta-analysis of 34 studies. http://www.ncbi.nlm.nih.gov/pubmed/17036554
A regular commenter emailed me to suggest that I say how my wife is doing currently. I’m happy to say that after surgery, chemo, and radiation, she is doing fine.
So, as you consider more data and numbers:
- in my work annual self-insured plans’ perscription data is available. For a typical employer who is self-insured (Fortune 1000), the top ten annual perscriptions in use and cost never include contraceptives. What does that say about how few actually avail themselves of this benefit?
- one in seven contraceptive users obtains and accesses these medications for medical conditions that have nothing to do with contraception Again, what does that say about the numbers who use this service?
- why hasn’t the USCCB made the same religious liberty arguments around perscriptions for ED (Cialis, Viagra)? Do we just assume that their use is totally moral?
Interesting point of view expressed: http://ncronline.org/blogs/grace-margins/unconscionable-consequences-conscience-exemptions
Highlights:
The hierarchy claims that this decision will force Catholics to either obey the law or violate their consciences. But whose consciences will be violated? According to the Guttmacher Institute, 98 percent of sexually active Catholic women (and, by association, their male partners) have used some form of contraception. (I know – if you get away from the “conscience” label, does this HHS decision create a “slippery slope”?)
Perhaps the most important accomplishment achieved through this decision is the government’s refusal to create a precedent for religious organizations to get a pass from obeying civil rights laws. A few decades ago, individuals and organizations whose religious beliefs opposed desegregation wanted to be exempt from the Civil Rights Act. We can all look back in gratitude that the government refused their request.
If the bishops had gotten their way, it would have opened up a Pandora’s box in which any religious group could claim exemptions from obeying a multitude of laws on religious grounds. I have little doubt that part of what propelled this fight was the bishops’ desire to set a precedent on which they could base their refusal to provide benefits to employees in same-sex marriages and civil unions.
(Appears that the “slippery slope” can go both ways)
After I wrote my message of 01/26/2012 – 11:07 am (in which I warned you to beware of my calculations), I looked at the meta-analysis Studebaker linked to and did some additional reading. As a partial correction to that message, I want to point out that in assessing the risk of contraceptives, I was incorrect to take the lifetime risk of breast cancer (1 in 8, or 1 in 9). The heightened risk of breast cancer from contraceptives (if any) is a heightened risk of premenopausal breast cancer. By far the majority of cases of breast cancer are in women over 50. The risk of breast cancer is consequently much lower for premenopausal women, and therefore the disturbingly high lifetime risk of breast cancer is not relevant to assessing the alleged increased risk of using oral contraceptives.
I think most people are aware that assessing risk is difficult and often done irrationally. For example, the odds of dying in a motor vehicle accident are 1 in 100 and of dying in an airplane crash are 1 in 20,000. But how many people are more worried about their drive to the airport than their flight?
These women do not use contraceptives: http://www.ncbi.nlm.nih.gov/pubmed/5777491
Studebaker: thanks for sharing your good news. God bless you and your wife.
The baseline risk of getting breast cancer is lower for premenopausal women, but being premenopausal at diagnosis is a risk factor that significantly reduces the chance of survival. There are various theories as to why this is: for one thing, when breast cancer shows up in relatively young women, it is probably a much more aggressive case than when it takes till age 60 or 70 to show up. But even accounting for all the signs of aggressiveness, breast cancer is still more dangerous for younger women. See, e.g., http://www.thelancet.com/journals/lancet/article/PII0140-6736(93)92407-K/abstract
So there’s still a question that no one seems to be able to address: how many young women’s lives are worth sacrificing so that men can have better orgasms by not having to use condoms?
If Google is to be believed, there is a Pamida Pharmacy and a Valentine Pharmacy in Valentine, NE. (Whew!)
So there’s still a question that no one seems to be able to address: how many young women’s lives are worth sacrificing so that men can have better orgasms by not having to use condoms?
Studebaker,
Even if that weren’t a preposterous question, it would still be irrelevant. You have argued that contraceptives are as cheap as gum balls and women who want them can and should buy them with their own money. Nobody is forcing women to use oral contraceptives. There are alternatives even if husbands and boyfriends insist their women folk take total responsibility for not getting pregnant. I don’t doubt your sincerity in earnestly wishing that women didn’t use contraceptives, but that is not the issue here. The issue is whether insurance ought to pay for contraceptives, and of course most insurance already does.
It would be an issue for the FDA to determine if the risks of oral contraceptives outweigh the benefits. Obviously, every oral contraceptive on the market has been approved by the FDA. Women who want to use contraceptives should talk to their doctors, do their own research, and decide for themselves what method or drug they want to use.