This article appears in the February 2003 edition of the Catholic Medical Quarterly
CAFOD and Condoms
One of the questions most frequently asked of CAFOD, in its own words, is how it deals with the matter of condoms as a prevention strategy for HIV in the context of the sexual transmission of the virus. This is important as it is the official agency of the Catholic Bishops Conference of England and Wales and claims to be respectful of Catholic teaching and beliefs.
CAFOD is adamant that it does not fund the supply, distribution or promotion of condoms. But it then proclaims it actively supports 'on-going theological reflection on the implications of prevention for HIV and asks what should be our response as Catholics in 'This Time of Aids . In support of this stance, CAFOD then asks all partners working in the area of HIV prevention to give individuals full information about all means of HIV prevention and whether this advice is scientifically correct. It states that a person must be able to make decisions about preventing HIV transmission that are consistent with their religious convictions and based on their knowledge and understanding of their individual situation. Programmes are listed which CAFOD maintains gives false or misleading information, such as that HIV will inevitably pass through holes in latex. This is scientifically incorrect. Evidence from WHO was included in The Quarterly The findings of the National Institute of Health Report in America (20.7.01) noted that consistent condom use reduces the yearly risk of contacting HIV from an infected sexual partner via vaginal sex by approximately 87%. This is hardly a reassuring prophylaxis for what is likely to be a lethal condition.
The theological reflection, to which reference is made, comes from a paper by Rev. Enda McDonagh, Emeritus Professor of Moral Theology, Maynooth College, University of Ireland. It points out that to care effectively for drug-users, already infected with HIV or exposed to infection, takes time. Drug addiction is not cured instantly and by a simple decision of the will. In the impoverished conditions in which they live it may be necessary, among other measures, to provide clean needles free of charge, without endorsing in any way drug-addiction or the drug culture. This could be regarded as a morally acceptable interim measure to save life and offer some hope of tackling and eventually overcoming the problem.
Sufferers from AIDS/HIV transmitted by sexual intercourse with prostitutes and their clients in sex-tourism and the sex industry, may be no more capable of instant conversion than drug addicts. Interim measures may be also necessary here also; and it may be socially necessary and morally legitimate to accept the use of condoms. However it must be made clear that this is in no way regarded as a good in itself. It is tolerated as an interim measure to protect life and allow time for personal and social conversion. The theology goes on to discuss the lesser evil. It is morally right to seek to persuade somebody intent on evil to do a lesser evil: to wound rather than to kill where somebody is intent on shooting his neighbour to death. But can evil, however lesser, be properly intended and approved at all? The suggestion is that in a more dynamic view of the situation the Christian intent is to accompany and care for people beyond their present enslavement. The concern over condoms, which it states can become a fixation for some people, must be put in context. The use of condoms, when introduced as a cover for endorsing promiscuity or exploiting the sex trade, should be exposed and opposed. It admits that risks of this kind can never be entirely excluded and have to be balanced against the open and serious intention of liberating people into some hope of a humane and Christian style of living. It even goes on to state that, in this kind of situation, the prohibition of Humanae Vitae on the use of artificial contraceptives as disrupting the intrinsic connection between the unitive and procreative dimensions of the marriage act, does not seem to apply.
As a final throw, the theology takes the view that, where a married partner is infected, the pressures created by AIDS/HIV would more readily persuade the �compassionate casuist� that the use of condoms could be acceptable to prevent an act of marital life-giving from becoming death dealing.
There are two counter positions against this reasoning: first the recent admission by UNFPA that the widespread use of condoms to prevent HIV/AIDS has failed; secondly, that a married partner who knowingly persists in the use of condoms with a 17% chance of transmitting the infection can hardly be described as a �compassionate casuist�.
When CAFOD claims that it is respectful of Catholic teaching and beliefs, it is using a weasel word. As the official agency of the Catholic Hierarchy, it should state that it recognises the authority of Catholic teaching and beliefs. Equally when it refers to prevention it should remember that Archbishop Javier Lozano Barragan, President of the Pontifical Council for Health Care Workers, said recently �We say prevention entails chastity, although chastity sounds ridiculous in the society in which we are living�.