US bishops' contraception conundrum


The PillTo Australians it may seem strange that one of the most passionately fought issues in current United States politics has to do with contraception. It has divided Republicans from Democrats and set the Catholic Church against the Government. The issues raised in the debate are central to the relations between church and state, and also to the ways in which Christians deal with a less than perfect world.

The health department believes contraception is a health issue, and that its costs should be met through insurance. The majority of American women agree. But in a nation where medical insurance is private, the United States bishops were concerned that the Catholic Church and its agencies should not be forced to provide or pay for services that it believes to be unethical. It saw this as a breach of religious freedom.

In January the health department issued a draft mandate that to its mind resolved the tension between its responsibility for health and the demands of religious freedom. It ruled that all insurance policies should include access to contraception. It exempted church agencies that served the religious needs of their co-religionists from this obligation. But church agencies that provided public services, such as education or medical care, would be obliged to include contraception in their employees' insurance cover.

To Catholics with any sense of history the guiding principles behind this directive were unacceptable. It imposed a definition of church in which the outreach of charity was quarantined from the so-called core aspects of faith as prayer and worship. Furthermore, it made the state the judge of what is religious. Finally, it asked church agencies to pay for services that the Catholic Church regarded as morally unacceptable.

The Catholic bishops won considerable support in opposing the mandate.

In February the health department proposed a compromise which did not touch on principle, but meant Catholic agencies would not pay directly for contraceptive services. It proposed that insurance companies should provide contraceptive cover gratis to those who wanted it. How this was to be done was not specified. Nor was it clear how the many Catholic agencies that had established their own insurance funds could avoid direct involvement.

Although some Catholic organisations welcomed this compromise, the bishops remained implacable, unhappy both about the principles that remained unchanged and the lack of detail as to how the scheme might work.

This issue exposed the tensions involved in living in an imperfect world. In Catholic tradition these tensions are covered under the heading of cooperation with wrongdoing. Given the Catholic judgment that contraception is wrong (a judgment with which many Catholics disagree) people must then decide what forms of cooperation with it are permissible and which excluded. Possible forms of cooperation range from manufacturing contraceptives or holding shares in companies to selling, advertising, insuring, and paying taxes out of which they are subsidised.

In discussing these questions moralists usually distinguish between formal and material cooperation. We cooperate formally if we approve what is done. If the action with which we cooperate is wrong, this kind of cooperation is never right. Cases of material cooperation, where we have a part in something of which we do not approve, are more perplexing.

The moral judgment of material cooperation depends on how immediate or remote our cooperation is, and on what good end it might serve. To appear on stage to spruik contraceptives would be pretty immediate. To pay taxes to a government that subsidised their distribution would be a very remote form of cooperation. The more remote the cooperation is, the more it can be justified by countervailing values.

The effect of the February compromise was to make the cooperation required of church organisations more remote. They would no longer have to provide insurance themselves, but only work with insurance companies that covered it among their other provisions. So in continuing to oppose this compromise the bishops risked demanding a level of moral purity that they would not expect in other areas of life, notably in the making of war.

In March the Health Department offered another compromise. It involved extending to all Catholic organisations the exemption offered previously to those serving the internal needs of the Catholic community. It also established a period of consultation to look at all aspects of the issue before coming to a final resolution. The bishops' response was sceptical but muted, reiterating their concern for religious freedom.

I have looked at the issue from the perspective of the United States bishops. There are other perspectives. This is an election year, and the production of the mandate and the variations rapidly rung on it surely have much to do with the President's conflicting political pressures. Much of his core support comes from groups for whom easy access to contraception and abortion are a central issue.

Equally, he does not wish to incur the hostility of the Catholic Church. The bishops therefore have a stronger negotiating position than at other times, and that is perhaps why they carried their opposition to the early amendments further than they might have at other times.

But ultimately political influence depends on moral influence. When you are defending a position as counter-cultural as is opposition to contraception, moral influence depends on radical integrity.

The bishops are certainly counter-cultural in the United States in calling for a public national health insurance scheme. But their fastidiousness about indirect cooperation with government in contraception would also need to be matched by an equal fastidiousness in cooperating indirectly with government in the abuses associated with military, penal and immigration policy. That is a hard ask. 

Andrew HamiltonAndrew Hamilton is consulting editor of Eureka Street


Topic tags: Andrew Hamilton, US Catholic Bishops, Contraception



submit a comment

Existing comments

That's a very good piece, Andrew -- the first carefully reasoned and unshrieking piece I have read about this in a while, and here in the States there have been many on both sides. While it is tempting to wonder aloud what American Catholicism would look like if the bishops also extended this admirable insistence on life to other areas -- would Catholic hospitals not serve U.S. lawmakers who voted to go to war? Would the same few bishops who made such public relations hay from denying the Eucharist to come Catholics make the same stand against, say, states with death penalties, like Texas? -- I cannot see how the bishops, trying to simply stay consistent, can say anything else than what they do say about, for example, abortions at Catholic hospitals. In the larger sense this is a tempest in a teapot, for the vast majority of Catholics do not adhere to the Church's ban on contraception; but what we do and what we say we should do are of course often things divided by oceanic spaces.

brian doyle | 29 March 2012  

You are right in saying this is a "less than perfect world" Andrew. I would venture to say that many Catholics disregard the Catholic Church's teaching on contraception. And the Catholic bishops are a group who no doubt love and care for their flock, which includes women in the childbearing age group. However, the "less than perfect world" that many women live in means they are the ones who are most affected when things "go wrong". The relationship between over-population and the environment is not often discussed in this context but is relevant. And it is the poor countries who are contributing to this population explosion. Contraception is a global issue.

Pam | 29 March 2012  

Remember many of these bishops are second raters foist on the people by JP II because they would toe the line. Look at the mess they made about sexual misconduct

Brian Costar | 29 March 2012  

"by an equal fastidiousness in cooperating indirectly with government in the abuses associated with military, penal and immigration policy." Why? Because the Church has ruled, with equally clear and binding force as she has with contraception, exactly what constitutes grave sin in the areas of U.S. military, penal and immigration policy, and what might be legitimate differences of opinion about concrete policy options? I don't think so. I love the word play. Liberals are always "consistent" where their foes are "fastidious", if not "obsessively compulsive".

HH | 29 March 2012  

I couldn't really follow the moral theology arguments - mathematics is much easier - but I got the gist of the final paragraph. I heard recently that Rick Santorum is a member of Opus Dei. Can it be that the Americans do not realise who they are thinking of electing and the alternative of an evangelical Catholic convert or a Mormon is scarcely much better, unless you are among those convinced that Obama is a Muslim. My brother is retired after a lifetime as a teacher in a public school in the Bronx. Among his many Irish friends, he is the only one who stands up for Obama and the Democrats and is regarded in a kind of patronising way by retired builders and firemen and blue collar workers. (I suspect that some of the attraction the Republicans have for the Irish is merely the word itself). The choice between Obama and one of the three alternatives, four if you include another Bush, is surely a no-brainer. Brian, could we have a few words from you on the "Christian" right in the US.

Frank | 29 March 2012  

Andrew indirectly highlights a threat to truly democratic government. Namely, the excessive influence of 'single-issue' groups who can threaten to swing an election when opposing parties have near-equal support. Such groups are certainly less than fair and democratic, and in danger of self-defeat in the long run, by trying to force their views on others. They are more likely to achieve lasting success by explanation and persuasion of others to accept their principles and beliefs rather than using short-term tactics to manipulate votes.

Bob Corcoran | 29 March 2012  

You are so right, Andrew. I have tried to have this issued raised in the catholic media in Australia. Admittedly I have criticised the US bishops for their using a dubious philosophical concept - the conscience of companies. Your distinction between remote (very remote) cooperation and proximate cooperation seems to have been lost on them. As for their selectivity on picking a fight with the US government on this issue rather than more pressing proximate issues like the control the military-industrial complex has on American life and government policy, the wasteful expenditure of time, money and energy on Presidential campaigns, the drift away from the catholic faith because the laity is not being listened to, etc. I have a Freudian explanation for the Bishops pre-occupation with sexual matters but this is not the place to psycho-analyse their behaviour. But calm rational discussion when discussing matters where sexual and social behaviours intersect seems to be beyond them. It's good to read what Brian Doyle, as the man on the sport, has to say on the matter. I don't feel so out of kilter.

Uncle Pat | 29 March 2012  

unlike for modern means of contraception, isn`t paying tax (ie compulsory health insurance in this instance) something we have direct guidance on from Our Lord? He would have known quite well and accepted, that the coins returned to Caesar would be used (among other more enlightened things) for services highly unpleasant and frequently unethical to Jews and Christians (including the costs of His own execution!).

Eugene | 29 March 2012  

I was saddened but not shocked to hear an American woman commenting on TV news about Santorum's stance on contraception, she said, "If you know someone's stand on contraception, you pretty well know everything else they stand for." ALso fitting neatly into this evil bipartisanship is the notion that if you're pro-gay it means you support abortions but don't support war. Weird reasoning.

AURELIUS | 29 March 2012  

The U.S. government mandate makes compulsory the provision of cover for sterilization and contraceptives including abortion-inducing drugs like Plan B and Ella. Why only refer to contraception Andrew?

Ross Howard | 29 March 2012  

As a doctor for over 40 years I know from a daily review of prescriptions that the vast majority of Australian Catholic women have a different view about contraception from that of the Vatican. Why does the average Catholic family now have about the same number of children as non-Catholic families? Truly it is not due to abstinence or natural family planning. Getting our church tied in knots here or in the US because of opposition to contraception is really daft. Why is the hierarchy sticking to a policy that the great majority of its adherents have, after examining their consciences, decisively rejected? And if the ultra-pure would rather eject from the church those who practice contraception, they might as well plan to hold mass in a telephone box.

A Physician | 29 March 2012  

"The choice between Obama and one of the three alternatives, four if you include another Bush, is surely a no-brainer."

Sure is a no-brainer, Frank, I would have thought, to Catholics and others who believe in the right to life, especially if it's between Rick Santorum (or Ron Paul) and one who, as a state senator for Illinois voted against requiring abortionists to keep failed abortion newborns alive (HSB 1082 on 3/12/2003) and then brazenly lied about it.

HH | 29 March 2012  

I've been following this issue on the US web since it first appeared in November,2011, and apart from the core issue, there are some strange patterns to be discerned.

Firstly, the bishops are not attracting much support from Catholics, apart from a few hardline organisations like the Cardinal Newman Society. Most of the support is coming from the far right of the Evangelical Christian movement, which has bought the "religious freedom" line.

Even stranger, they are not conducting their campaign on the public web. Instead of commenting directly below articles, they are cutting and pasting - or linking to - opposing articles on their own websites, and proceeding to be vitriolic there. I have tried posting mild criticism of the bishops stance, and even this is not approved for publication.

This effectively insulates their position from any criticism it might receive in a public forum, while fuelling the internal rage.

Andrew has set out the reasoned position, which is amenable to reasoned opposition on a fine theological point. From my reading of the online debate over the last four months, the finer points of theology have been swept away, and opposition of any kind is not tolerated.

Alex Prior | 29 March 2012  

Eugene, that was brilliant!

Gavan Breen | 29 March 2012  

The "majority of women" agree contraception should be paid for through insurance?

Not according to the New York Times, whose poll found that when asked, “Should health insurance plans for all employees have to cover the full cost of birth control for female employees or should employers be able to opt out for moral or religious reasons?” women favored opting out by a 46-44 margin.

The margin increased to a decisive 53-38 for “religiously affiliated employers, such as a hospital or university.”

And we can't exactly call the NYT a friend of the Catholic Church.

It's hard to stand against a culture that thinks anyone opposing contraception must be either nuts or brainwashed.

But the pill is not some benign medication - it's a carcinogenic that treats a woman's fertility like some defect. I can't really see how making it even more freely available than it already is will really advance women's health.

But then, this is not really a health issue is it, or blood pressure medication would also be free under the HHS Mandate. It's about ideology and forcing those who disagree with the prevailing culture into submission.

Meg | 29 March 2012  

I agree with Pam's comment! I do not believe that contraception is a religious issue. It is a social, health and feminist issue. Women in poor third world countries are especially disadvantaged because of their lack of access to artificial contraception and women's health services.

Mark Doyle | 29 March 2012  

Thank you MEG. You speak on behalf of many loyal Catholics. God bless.

Ron Cini | 29 March 2012  

The bishops in USA, and here in Australia, have taken a moral position on contraception which is open to argument both against and for. Selfishness of spouses in a marriage in avoiding children can be seen as morally undesireable. Reponsible family planning is acceptable. Therefore using artificial contraception, if appropriate in the particular circumstances,by spouses in marriage for family planning should be morally acceptable but the bishops say that only 'natural' methods are morally permissable. It is the motive that matters not the method! Medical intervention procedures to save life, whether natural or artificial, are permissible. The bishops and Rome need to listen to the arguments of the laity.

Gerard Tonks | 29 March 2012  

Thank you, Alex Prior. I too have followed the debate on the web. Great articles/comment have appeared in Commonweal and America. The Bishops seem to me to be politicking rather than preaching the Good News of Jesus Christ - point well made by Eugene. The Bishops' politicking smacks of totalitarianism.

Uncle Pat | 29 March 2012  

If only the Bishops had been so forthcoming in relation to clerical sexual abuse and other scandals in our Church. This Health Bill will for the first time give some dignity and Health care to the poor and marginalised of the USA. Many lives are lost there because of an inability to access adequate health care. Ask any nurse or doctor who has worked there. This Bill will address some of these injustices. And as others have observed the Bishops have not raised the issue of the Death Penalty, or the wars that are killing millions around the world. Margaret M.Coffey

margaret M.Coffey | 30 March 2012  

Contraception is wrong no matter how you look at it. If a majority of Catholics use contraception that does not make it right. It is a mortal sin and offends Our Lord greatly. I can see no need for any type of family planning. To have a large family and to educate them in the one true Faith is a most satisfying good and pleasing to God. No true Catholic can pick and choose what Church teachings they want to follow and not follow, otherwise they have placed themselves outside of the Faith and place their eternal salvation in great danger. Also as Ross Howard said "The U.S. government mandate makes compulsory the provision of cover for sterilization and contraceptives including abortion-inducing drugs like Plan B and Ella." which is utterly evil.

Trent | 30 March 2012  

Trent, "No true Catholic can pick and choose what Church teachings they want to follow and not follow, otherwise they have placed themselves outside of the Faith." That is not quite true. The recently beatified Cardinal Newman in his famous Letter to the Duke of Norfolk ( argued that an individual Catholic's conscience has a vital role to play. He was very careful to define conscience as informed by scripture, rather than merely being informed by human whim, but came to a conclusion which he expressed as a mock toast: "I will drink to the Pope if you please; but to conscience first, and the Pope afterwards". Further, he says: "conscience being a practical dictate, a collision is possible between it and the Pope's authority only when the Pope legislates, or gives particular orders, and the like. But a Pope is not infallible in his laws, nor in his commands, nor in his acts of state, nor in his administration, nor in his public policy."

Alex Prior | 30 March 2012  

Alex Prior,

The conscience you must have is a well-formed Catholic conscience instructed by the Teaching of the Church. When one fails to comply with the Catholic Faith and follow the worldly opinions of men and not God, they are being prideful and their conscience is no longer Catholic.

Trent | 30 March 2012  

I don't think celibate elderly men in frocks in Rome should be telling woman that contraception would offend God.

AURELIUS | 31 March 2012  

what hypocrisy!

George Northerton | 31 March 2012  


Hypocrisy? Have you considered: pathetic hoax?

Why would Cardinal Levada be addressing someone as
"Eminence" who is not a Cardinal?

HH | 31 March 2012  

Trent, stating that the Blessed John Henry Newman did not have a fully informed Catholic conscience is a little strange. He is often known as the father of Vatican II (1962-65) an event at which his views were championed by a Cardinal called Ratzinger. Pope Paul VI went so far as to say Vatican II was “Newman’s council.” And Newman's views included what he called "consensus fidelium", in which the laity had a firm role in developing doctrine, and opposing doctrine when it conflicted with their conscience.

A good example is the Church's teaching the Jews bore collective responsibility for the death of Christ. It taught that for 1,000 years. But in 1965, the Church admitted that it was wrong, and reversed the doctrine. On your view, a Catholic who in 1964 disagreed with the Church would have gone straight to hell, but one who held the identical view in 1966 would not.

The way this doctrinal change came about was through Newman's consensus fidelium. Following the Holocaust, Catholic's of good conscience looked at the doctrine of deicide and said "look at the great evil that this doctrine has wrought." And the Church changed its mind. As many Catholics of good conscience believe that it will on contraception.

Alex Prior | 31 March 2012  

The Catechism also proclaims that "There are no limits to the mercy of God...." and that "...although we can judge that an act is in itself a grave offence, we must entrust judgment of persons to the justice and mercy of God." We cannot see into their mind to know if it was deliberate or committed in full knowledge that it was a grave matter.

AURELIUS | 31 March 2012  

Not a bad piece, but I think making the analogy of remote cooperation with aspects to do with war is misplaced. In the current system, employers are still required to *provide* the health insurance with contraception included. A more direct analogy might be if employers were required to provide shares in a weapons manufacturer. There would be some outcry about this, I'm sure.

Deeper than the problem of the Government deciding who is and is not a religious organisation (though an excellent point!), is the fact that the issue here is one of conscience that applies to individuals. Whether or not the employer is an official religious organisation, the issue of conscience remains. Lay business owners also must not be required to act against their conscience. Whether Catholic or not.

And it's unnecessary. If contraception is such an essential health-care measure - and that's debatable - then the government can provide it themselves. Or people can have their own recourse to health funds that do provide it, and receive the appropriate payout from their employers. There is no reason to require employers to be involved in this, when there are clearly issues of conscience and freedom at stake.

Mike | 02 April 2012  

Great article Andrew. I think you have demonstrated the hole in the US Bishops' argument about some of the doctrinally objectionable inclusions in National Health Insurance plan and that is, they seem incabable of making the clear standard Catholic distinction between formal and material cooperation cheers to Eugene!
And yes, Hugh Henry (HH) you do qualify for the term 'obsessive compulsive' when it comes to discussing moral issued. You cannot make the above distinction because your moral theology is done out of the Code of Canon Law, not out of Thomas Aquinas and certainly not out of the Gospel. For you education, you might look up the article by Dr Brian Lewis linked in today's (02/04) Cathnews by Michael Mullins in Blogwatcher.

David Timbs | 02 April 2012  

Liberal subterfuge Andrew. What you fail to do is declare your own assent to the Church teaching on contraception (i.e. artificial contraception is sinful and a grave matter). Those of us who can read between the lines see covert criticism of Humane Vitae in your little essay.

Marcel | 02 April 2012  

the sting is in the tail if this piece - basically insinuating that the US bishops really shouldn't be so philosophically picky. Kind of like saying - "just ignore it, it's only a little bit mortally sinful". Like many other pieces out of the modern Jesuit stable, after reading this I am left asking "just what do Jesuits stand for?".

Peter in Canberra | 02 April 2012  

Movie tip: Maafa 21 - Planned Parenthood history: 13 episodes. Demographic winter - the decline of the human family 2 Episodes Barack Obama and The Negro Project. Abortion and Black Genocide. Human rights for the unborn.

SML | 02 April 2012  

A few more notes after a highly...colorful comment pile. One: You have to admire, gently, bishops who insist on the sanctity of the possibility of life; I only wish they were as stalwart against wars and letting kids starve and killing prisoners. Two: It's interesting to consider that the bishops here stand firm against something the vast majority of Catholics long ago accepted. Whose Church is it, exactly? Can we even say "The Church" is against contraception when it so manifestly is not? Three: Imagine, however, that the vast majority of Catholics suddenly decided that abortion is actually fine. Should the bishops then acquiesce? Four: It seems to me that perhaps this debate here is more about money, as usual, than it is about principle.

brian doyle | 03 April 2012  

I am always bemused that people who oppose artificial contraception and abortion are generally irrational and hysterical men. These issues are not religious; they are social. I also find it interesting that Catholic countries such as Spain, Portugal and Argentina are more liberal and rational than conservative countries such as America and Australia.

Mark Doyle | 03 April 2012  

'Physician' must understand that Catholic doctrine is not traced from head counts or surgery anecdotes let alone polling booth surveys. Jesus's message in Jerusalem and beyond in 1 CE was a Gallup poll disaster! [POLLS SCREAMED 'CRUCIFY HIM'] Magisterium is based on undying revealed principles not phone in popularity polls. The Decalogue has repeatedly been a demographic no-no in brain washed human history[eg re holocaust, gulags, secular dictatorship of relativism], Furthermore, for BISHOPS on other social issues than sexual, a check of uscbc website manifests US bishops have spoken out on other issues than contraception, but media reaps readership on sexual issues.

Father John Michael George | 07 April 2012  

Would any of your correspondents have knowledge re the Vatican having shares or investing in companies manufacturing contraceptive chemicals or condoms?

nellmay | 16 April 2012  

In reply to Nellmay re Vatican investments many media allegations have been made re the IOR[of varying confirmation vis a vis 'VATICANLEAKS':[themselves not infallible dogma-nb elsewhere eg wikileaks, on other vat issues, use mere subjective impressions by eg diplomats, hardly documentary hermeneutic substance re spate of growing cyber leaks. 1'The Holy Father cannot have his finger on the pulse on every fiscal activity of I.O.R[IN FACT NOT A BANK-cf John Allen's NCR article on same] 2 The Pope, in fact, has issued a motu proprio to secure IOR activities. moyu proprio below: It is noted that German bishops apologised for German church bank that unknown to bishops invested in pharmaceutical company producing condoms

Father John Michael George | 18 April 2012  

Mark Doyle argues: "I am always bemused that people who oppose artificial contraception and abortion are generally irrational and hysterical men" Could Mr Doyle supply link to global scientific research to substantiate his claim or is it wishful thinking??

Father John Michael George | 20 April 2012  

Similar Articles

Easter manifesto

  • John Falzon
  • 06 April 2012

The Easter motif of suffering and resurrection comes alive in movements of social change, when people who have been treated as nothing proclaim by their collective dreaming we are everything. For those who hunger for justice it is a sin to be disorganised, when the misery we confront is well organised.


Easter in detention

  • Andrew Hamilton
  • 06 April 2012

Over many years I have celebrated Christmas and Easter in places where people are locked up — in refugee camps, prisons and detention centres. To be in these places at such times is hard. It is also a privilege.



Subscribe for more stories like this.

Free sign-up