Both the mainstream media and the blogosphere have been abuzz lately with the rumoured possibility that the Vatican will make a declaration stating that it would be possible for married couples to use condoms in the case where one of the partners was infected with HIV, so as to prevent transmission of the virus.
For myself, I simply can't see such a declaration being made. My reasons are both dogmatic and pragmatic.
The issue at stake is called the principle of double effect. According to Catholic teaching the use of condoms is not permissible in general because the use of artificial contraception is contrary to the natural law. But the issue at stake in this particular case is that the condom prevents not just conception but infection. Given this double effect, can the use of the condom be moral?
The dogmatic issue
The principle of double effect needs to be properly understood if we are to apply it. As some initial background, the Catholic Church teaches that for a choice to be morally good neither the intention behind the act *nor the act itself* can be oriented towards evil. The first principle is more obvious: most people easily see that it is possible to do something for someone that appears good, when in fact it is tainted by a negative intent (a common term for this is "having a hidden agenda"). The second principle, on the other hand, is widely contested today: the idea that some actions are simply evil in themselves, without regards to the circumstances or consequences of the action. Nevertheless, this is a cornerstone of Church teaching, in part because without it the idea that there are values worth dying for risks becoming meaningless (with the sacrifice of the martyrs becoming meaningless as well). As an example, consider the case of adultery: it is to be avoided, pure and simple, and there is no dispensation a person can receive from the Church permitting him/her to commit adultery in particular circumstances.
For the principle of double effect to apply, then, several conditions need to be met: (1) the act being contemplated cannot be immoral in itself, (2) it must be contemplated with a morally good intent, (3) both the negative and positive consequences must flow directly from the single action, and (4) there must a proportionality between the positive and negative consequences such that the positives outweigh the negatives. A good example is going in the room of a sick patient. There is nothing immoral in itself with visiting the sick, and certainly it can be contemplated with a morally good intent (in fact, the Church teaches it is an act of charity). If the sick person, however, has a disease that is highly contagious, the risk of infection means that the good consequence of performing an act of charity is accompanied with the negative consequence of being exposed to the risk of catching the disease. Both consequences flow directly from the action, so for the visit to the sick person to be morally good the proportionality criterion must be met. Consider these two possible "visitors": a nurse coming to administer medicine, and a small child who just really wants to see his sick family member. The proportionality criterion weighs in favour of the nurse being morally allowed to take the risk regarding infection, but I think most people would agree that keeping the child out of the room is probably a wiser course of action no matter how much he might emphasize his desire to see the sick person.
So what about condoms used in marriage to prevent HIV transmission?
Regarding criterion #2, if the intention really is to avoid infection and not to prevent conception I would say it is met. Criterion #1 is trickier: is the use of a condom something which is *intrinsically* morally disordered? If so, then the principle of double effect cannot apply, and this option is not open to married couples. If not, then we need to continue our analysis further.
My understanding is that the Church *does* hold the use of the condom to be intrinsically morally disordered, because the use of contraceptive methods is something which the Church teaches is contrary to the natural law (and not simply contrary to a regulation implemented by society). The debate therefore ends here. But for the sake of completeness, let us take a look at the positive and negative consequences of the use of the condom in this specific case, and examine the proportionality involved.
The issue, as I have often seen it constructed, goes as follows: the negative consequence of the use of the condom is the direct prevention of conception, while the positive consequence is the prevention of infection by a deadly disease. Put in these terms, the proportionality between the two is clearly in favour of the use of the condom. But this, unfortunately, is a false comparison.
First of all, condoms are not a 100% guarantee of prevention of disease transmission. They do break from time to time, and are also often used improperly. Simply put, accidents happen! So rather than being an exercise in shooting oneself with a loaded revolver, the use of the condom simply turns the case in question into a game of Russian roulette. It is better, yes, but not by much!
There are also all the negative consequences of the use of contraceptive methods that Pope Paul VI listed in Humanae Vitae, such as the increased risk of objectification of one spouse by another. Even if the intent is to prevent disease, the use of a condom is still a contraceptive act contrary to the natural law, and so it carries with it the "natural consequences" listed by Paul VI.
The list of negative consequences now weighs quite heavily. What about the positive consequences?
Chief among the positive consequences of the use of the condom within marriage is the possibility of the couple to enjoy a sex life that is at least partially renewed. Because the conjugal union in itself is normally a good thing, as it promotes the communion of life of the couple, this is a genuine good worth considering. Indeed, it is really the only positive good that is put forward by the proponents of the idea of using condoms within marriage where HIV infection is involved.
Now lets try looking at this from the opposite angle. As everybody knows, there is at least one sure-fire way to avoid infecting someone with HIV: don't have sex! The proponents of the use of condoms in this case need to demonstrate that not having sex is so negative a consequence to marriage that this negative outweighs the positive of a zero-infection risk, as well as the positive of avoiding the possible detrimental effects to marital love of the use of contraceptive methods. And I don't think they can, in part because of the example of two great saints: the Blessed Virgin Mary, and St. Joseph.
According to Catholic tradition, Mary and Joseph had a "virginal" marriage, in which they never had sexual relations. Ever. And yet, the Catholic teaching is that this was not an insult to the nature of marriage. According to Catholic teaching, marriage *does* open up the possibility for sexual relations to be a holy act. As well, according to the Bible, the exchange of consent in marriage means that each member of the couple is given certain rights over the body of the other, such that if one member requests sexual relations the other cannot refuse without reasonable cause. But there is no direct obligation to actually have sexual relations. If Joseph *had the right* to ask Mary for sex but he never exercised that right (and vice versa), it was not detrimental to the dignity of their marriage or to their personal holiness (and vice versa). Indeed, it may have actually increased it. The desire for physical union with one's spouse if perfectly natural, and to deny oneself that union is definitely a form of sacrifice; and in the case of Mary and Joseph's marriage this sacrifice had definitely spiritual overtones, as the conception of the Son of God in her womb effectively transformed Mary into a living Ark of the Covenant.
So I have to ask myself this question: what HIV+ husband in his right mind would insist that he have sex with his wife, knowing that he risked infecting her with a deadly disease? What HIV+ wife in her right mind would insist that she have sex with her husband, knowing the same? And even if it was the other partner who asked for sexual relations, what HIV+ individual *who truly loved his/her spouse* would accede to the request? The simple fact that the uninfected spouse is willing to take the risk does not take away from that fact that it *IS STILL* a terrible risk, and Catholic teaching DOES NOT allow for positive consent to transform evil actions into good ones.
Let me put this another way. If I was married, and then I became HIV+ because of some innocent circumstance (such as a tainted blood transfusion), I would cease having sex with my wife. It is a reasonable guess that I probably would not cease desiring such relations, but if I truly loved her I would never want to expose her to such a terrible disease. And if she were to approach me with a box of condoms and say "With these it'll be ok" I would have to reply, "My dear, I appreciate the gesture, and I know that our not being close in this way anymore is hard for you as well. But I love you too much to expose you to this disease, and I could not live with myself if you became HIV+ as well, knowing that you got it from me. Let's focus instead on how we *can* show affection to each other. Let me bring you a flower on my way home from work each day. Let me hold you when you are sad, and hug you when you are happy. Let's go for walks together, and I'll rub your feet when we get home after making you a mug of hot chocolate. Let's pray together, and volunteer our time together, taking our "sexual energy" and re-focussing it on love of God of neighbour. Even if we can't have a union of bodies anymore, let's work on having a union of hearts."
(Good grief, I really am a hopeless romantic. :-) )
My bottom line is this: knowingly having sex when one spouse is HIV+ and one is not is always a defect of charity, condoms or no condoms.
The pragmatic issue
Any declaration by the Vatican that the use of condoms in marriage in the case of an HIV+ partner would be a disaster, and not just because of the dogmatic issue. Such a declaration would risk being terribly misunderstood, and would confirm the idea in the minds of many that Church teaching is arbitrary and can be changed thanks to public pressure or some crazy idea of the Pope. It would risk increasing contempt for the magisterium of the Church itself, and would precipitate a much greater crisis of authority than what we have currently. All of this is bad.
Worse, however, is the message that it would communicate to HIV- spouses who are married to an HIV+ spouse. In essence, it would say "If your spouse proposes using the condom, despite his/her being HIV+ you do not have a reasonable basis to refuse sexual relations." In effect, it would turn the refusal of sexual relations with an HIV+ partner into a sin. I know, I know, the proponents of the condom idea are only considering the case where both partners desire the sexual act, but the bottom line is that the Bible itself says that the general consent given to be married includes in it an obligation to give specific consent to sexual relations when they are requested. As I've already mentioned, the Church does mitigate this when it teaches that sex can be refused in reasonable circumstances — but a positive decision in favour of condoms in this case would basically say that having an HIV+ partner is not a reasonable circumstance to refuse sexual relations. Does that make sense? And I have a sneaking suspicion that, all other things being equal, it would more likely be the HIV+ husbands making this request of their wives than the reverse. In effect, then, a Vatican decision in favour of the use of condoms in marriage for HIV+ cases would, simultaneously, be a message to women to quietly accept being used as sexual objects by husbands whose desire for sex overrides their concern for the health of their wives, to such a degree that they would, in effect, be disobeying the Bible itself even if the risk they are running is that of contracting a deadly disease.
So no, I don't think the Vatican should make any such decision or declaration. Not only would it be misogynistic, not only would it contradict long-standing Catholic principles, but it would also suffer from what can only be described as "mega-boneheadedness". And no quantity of applause from the world and its pundits can justify such stupidity.