Monday, May 01, 2006

The news of an official intra-Vatican debate on whether condoms might be permissible within marriage to prevent the spread of HIV is simultaneously very welcome and very strange. For one thing, it is strange that even the most wholehearted natural lawyer could think that married couples with, say, medically-documented infertility, or married couples in which the woman is post-menopausal, would be acting sinfully by using condoms within marriage to prevent HIV transmission. There is an odd elevation of the condom as symbol of contraception into an absolute moral rule-- a rule that is by then utterly untethered from its supposed underlying moral justification. Intercourse with condoms is "disordered," according to Catholic doctrine, because it intereferes with reproduction; but if it does not do so, if the condom use has both only the intent and only the effect of reducing the likelihood of HIV transmission, what could the moral problem possibly be, even in doctrinal terms? Of course, the debate isn't restricted to infertile couples. But infertile couples are the limiting case to show how strange a position is being articulated by those who elevate "no condoms" into an absolute moral and doctrinal prohibition.

But that's not what struck me the most. Quoth the Times, unsupported by quotes or evidence:
A change would address a relatively small part of the problem since most transmission of AIDS is not between married couples.

Well, a change might have only a very small effect in the world, because the reluctance of married couples to use condoms in high-HIV settings has a lot more to do with their desire to have children than it does with a desire to follow church doctrine. But that doesn't mean that intra-marital transmission is a "relatively small part of the problem." Indeed, it appears to be a major problem in much of Africa-- men who acquire HIV prior to marriage transmit it to their wives (and thence to their children) after marriage, when sexual frequency goes up and condom use goes down compared to premarital relations. (See: Bruce and Clark, 2004, Clark 2004.) The change in doctrine might not make much of a change in infection rates, but that's because married couples refrain from condom use for other reasons than Catholic doctrine.

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