Monday, June 09, 2003

More on hormone treatments

My last posts have generated lots and lots of comments, which is good. Most of them have to do with details of medical conditions, which is bad; as I said, I am a doctor, but not a medical doctor. However, I want to clear up some things.

Is it permissible to treat diseases with The Pill? Of course it is. But, and this is a big "but", it is to be avoided if possible, since it causes infertility, which is an objective evil. (I am using evil in a technical way, meaning a lack of a good that ought to be there.) As Aquinas says, the first principle of the moral law is "Good is to be done, evil is to be avoided." So we should avoid it, if we can.

Now, an action (the hormonal treatments) which has a bad effect can be done, but only if 1) the bad effect is not the intended goal of the action, and 2) the good to be achieved outweighs the bad effect. So, prescribing the pill to a fifteen year-old girl who is having difficulty coping with her period would be impermissible, since 2) the good of eliminating the pain is not proportionate to the bad effect of making her infertile. In addition, it is likely that such treatment may be chosen because the contraceptive effects are in fact desired: don't you want your kid to be on the pill so she's "safe?" A facile diagnosis of severe cramps and treatment with contraceptives would be a bad thing.

What of more severe cases? Clearly, there are occasions where the treatment is warranted due to the severity of the disease. Then criterion 2 would be satisfied. But, due to the abortifacient nature of birth control pills, sexual intercourse would not be permissible at the time of the treatment. We just can't take the chance, since sex while on the pill could kill a child. This bad effect, though unintended, surely outweighs any good that can be gained by the treatment. We don't trade pain for death. (We rarely trade death for death, and then only when both lives already exist.)

I hope this gives some clarity to my thinking on this issue, which I believe to be in line with the Church.

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