Adjusting Doctrines as the Church Ministers to the Modern World:
Part III—Rethinking Contraception
by James Magner, MD

This is the third in a multipart series of essays on the process of updating church doctrine. The first, on the concept of the magisterium and women’s ordination, is available here; the second, on the example of evolution, is available here—Ed.

Let me start by making clear that I am not in this article advocating in favor of or against contraception. Instead, I just want briefly to recapitulate relevant events that resulted in certain church policies being established, and near the end I want to raise a medical and technical comment.

An article at the website Catholic Answers by Monica Miller caught my eye in August. She discusses “reformable doctrine” while walking though the events that led to current church thinking about contraception. Apparently, barrier contraception was a hot topic among the general public in Europe and North America during the swinging 1920s. In 1930, at the Lambeth Conference, the Anglican Church decided that married couples could make use of artificial contraceptives if there were serious reasons to do so. Within a year or two all of the other major Protestant denominations also approved use of contraception. In contrast, the Catholic Church insisted that artificial contraception was intrinsically immoral. The term intrinsic meant that under no circumstances could artificial birth control be justified. The Catholic Church also stated that this position was rooted in a long tradition about the value of human life, and that this teaching could never be altered. Pope Pius XI released his encyclical on marriage, Casti connubii—“On Chaste Married Love” —on December 31, 1930. Of note, the church approved of the rhythm method of timing conjugal acts to minimize the chance of conception, a method that the church believed was not artificial and actually made use of natural law. Of course, the rhythm method was not very reliable.

Let me insert a side comment at this point about whether or not papal encyclicals define dogma as divinely revealed and infallible. There have been about 275 papal encyclicals published since 1740. Of note, Pope Leo XIII, who reigned from 1878 to 1903, wrote 85, but these generally were very brief as each dealt with some specific church issue. The prolific Pope Pius XII wrote 41 of them. My current understanding after review of several church sources is that papal encyclicals express extremely important views that should guide and even constrain church teaching in parishes, seminaries, and schools, but encyclicals do not actually carry the weight of ex cathedra dogma. Apparently, guidance expressed by a pope in one encyclical might later induce a nuanced view that might be a little different in a later encyclical. It is to be expected, though, that there likely would not be a complete reversal of opinion. One historical example of doctrine near-reversal that is relevant to me comes to mind, however. I married a Protestant girl in 1977, and we are still quite happily married. For decades after the time of Martin Luther, the church believed that Protestants would be condemned to eternal hellfire. But clearly this view has moderated considerably over the centuries. Protestants are now our respected brothers and sisters in Christ—even if they are still a bit misguided!

In the 1960s a new challenge arose. Barrier contraceptives were commonly supplanted by birth control pills that were, for most women, very safe and highly effective. In response, Pope Paul VI issued Humanae vitae, “Of Human Life.” I just finished rereading this eloquent and carefully written document, and I was truly impressed by the well-structured arguments that artificial birth control is a violation both of natural law and of God’s law that gives ultimate meaning to human life. (Note that modern science struggles mightily about what might be the ultimate meaning of tiny humans in this vast universe— some scientists claim that there actually is no ultimate meaning of anything. A sad philosophy.) But I should add that the encyclical Humanae vitae was a huge disappointment to progressive elements in the church. The progressives wanted impoverished women to have an inexpensive and reliable way to space out children that clearly would benefit the quality of the lives of their family members by being both a social and financial blessing. This also would strengthen marriages. Even women of means would benefit by better planning within their families. But the encyclical emphasized the possible increase in sexual promiscuity. The document even mentioned government officials who might force the use of birth control to improve the economics of their countries.

There the issue has stood for more than 50 years. Polls show that many married Catholic women have used birth control during part of their lives, and presently little is said about this from the pulpit. In my view, this pastoral silence is appropriate and wise, though my reasoning is a topic for another article. It actually would be better, though, if the church could find its way to come to terms with responsible use of birth control so that an undercurrent of guilt or worry by members of the congregation could be alleviated.

A surprise has arisen in 2022. The Vatican’s publishing arm, Libreria Editrice Vaticana, has released an official document that has had substantial input from Pope Francis. This is a new 528-page book on bioethics titled Theological Ethics of Life: Scripture, Tradition, and Practical Challenges. The book summarizes discussions held in 2021 at a meeting of the Pontifical Academy for Life. Though the book is said not to offer changes to church teaching, in the introduction by Archbishop Vincenzo Paglia, the president of the academy, he states that what now must be clear regarding church teaching on sexual ethics is that personal life circumstances must be considered. One must allow for the conditions in which human beings actually find themselves.

Fr. Jorge Jose Ferrer, S.J., wrote an important chapter about artificial contraception. He points out that in article 302 of Pope Francis’s document Amoris laetitia (2016), it is noted that our personal culpability for an action can be diminished or even nullified by fear, habit, social circumstances, psychological duress, and other factors. This stresses the primacy of conscience. I here paraphrase the article by Monica Miller to explain that, in other words, in some circumstances God approves of the commission of objective sin—or at least forgives it as it is being committed. For Pope Francis, the doctrines of the church are subordinated to the primary value of mercy. Francis places emphasis on mercy first, whereas the ethical requirements of natural law are second.

A key quote from the bioethics book states: “Since there are conditions and practical circumstances that would make the choice to generate irresponsible . . . a married couple may decide to resort, with a wise choice, to contraceptive techniques, obviously excluding the abortive ones.” The book text also reinforces longstanding church teaching restating that the conjugal act during marriage must not be a selfish act. This act expresses love between the persons, oftentimes with the possibility of giving rise to new life. It would not be correct to deny this meaning of the conjugal act, even when for various reasons it may not always in fact beget a new life.

As a physician, I wanted briefly to raise a point that has bothered me for some time. Many Catholic documents state, perhaps somewhat unthinkingly, that the human fetus is a person “from the moment of conception.” That moment is when the sperm penetrates the egg, though the DNA of the sperm may not enter the cell nucleus of the egg and thereby join with the mother’s set of chromosomes located there for several hours. This “at the moment of conception” formulation has major implications, but loose use of language can be misleading. What supports theologically this precise timing of ensoulment? That timing may well be correct, but how do we know? Birth control pills have their anti-pregnancy effect by preventing the fertilized egg from implanting in the wall of the uterus, so the fertilized egg then dies and is eliminated from the womb a few days after fertilization. Has an ensouled human person thereby been lost? If in vitro fertilized eggs are stored frozen but then discarded, have ensouled humans been destroyed? One possible alternative opinion is that ensoulment does not occur that early, but instead is delayed a week or two after fertilization. What evidence could rationally support that later timing of this miraculous act of the Almighty? The answer: evidence from monozygotic (identical) twins.

As the fertilized egg starts early development, a sphere of a few human cells forms called a blastocyst. During the first two weeks after fertilization, this blastocyst splits into two independent blastocysts in 0.42 percent of normal pregnancies, creating identical twins. Just under one third of such splitting occurs within 72 hours of fertilization, about two thirds of the splits occur 4 to 8 days after fertilization, and about 5 percent of the splits occur 8 to 13 days after fertilization. (Those very uncommon cases result in monochorionic-monoamniotic twins, meaning one placenta and one amniotic sac.) Even more rarely, splitting occurs after 13 days, resulting in conjoined twins that will require surgery after birth to separate them. (Technical data gleaned from the Virginia Center for Reproductive Medicine.)

The point of this line of argument is that as identical twins live out their adult lives, there is no question in anyone’s mind that though they share identical DNA and arose from a single fertilized egg, the twins clearly are two different people; they presumably each have their own God-given soul. The simplest explanation (via Occam’s razor, though who knows if it is the correct explanation?) is that the ensoulment of the twins did not occur at the moment of conception. By the principle of parsimony (the idea that the simplest solution to a given problem is most likely the correct one), the ensoulment more reasonably occurred up to two weeks later. Of course, one also could argue that God knew that the blastocyst was going to split in a few days, so at conception he added two souls at the start. Or he may have put in one soul at the start, then added a second soul days later. Clearly, no human really knows what is correct, but the unthinking proposition that a new ensouled human being is created “at the moment of conception” is a theological construct that is not the simplest answer to this question.

As a physician and scientist, perhaps I should just leave doctrinal questions alone and get back to my proper role in the hospital and biochemistry laboratory. But I believe that in the modern era all Catholic laypersons should be able to state what is on their minds. That is what is occurring around the globe as comments are being collected at synodal sessions. Let’s pray that our church may continue to find proper ways to adapt to and thereby give relevant and vital Christian counsel to the modern world. ♦

James Magner, MD, is an endocrinologist and scientist who spent years studying the biochemistry and physiology of the pituitary hormone, TSH, and providing medical supervision for several projects within the pharmaceutical industry. He is an avid chess player and expert poker player who placed 27th in the world in 2015. Dr. Magner is married and has two adult daughters. Seeking Hidden Treasures, his third book and debut collection of fiction, was published in 2019 by Archway Publishing. He is a member of the board of directors of Today’s American Catholic.

Image: The arrival of Pope Saint Paul VI to the Shrine of Fatima to celebrate the 50th Anniversary of the First Apparition of Our Lady, May 13, 1967