I heard South African Bishop Kevin Dowling speak to our Saint Ignatius Parish’s adult formation session a week ago Sunday. The parish piggy-backed off his presence at the adjacent University of San Francisco, where Dowling was the recipient of an honorary doctorate and served as the commencement speaker at the undergraduate graduation ceremonies.
For two decades, Dowling has served as bishop of the diocese of Rustenberg, about 65 miles northwest of Johannesburg. In the midst of his diocese is a large plutonium mine. The mines draw highly paid young male workers for long periods living far away from their families. The surrounding shanty-towns include a bevy of vulnerable women—many of them economic refugees (many of them, also, undocumented from other African countries) drawn into what the Bishop calls "survival sex.” The case is both tragic and stark.. The single miners (in a heavily patriarchal society) are committed to be sexually active and have money and the single mothers who can not get jobs need money to feed their children.
The bulk of Bishop Dowling’s presentation was about his diocese’s impressive work to stem and respond to AIDS. South Africa has more than 6 million people who are HIV positive. In Dowling’s diocese, in 2004, 49% of all the pregnancies involved mothers who were HIV positive. Since 1996, the diocese has built up a very impressive array of services for people who are HIV positive or already in the stage of full-blown AIDS. It runs several hospices for those dying of AIDS. It sponsors orphanages or foster family services for children whose mothers died of AIDS. It maintains nine anti-retroviral clinics which provide anti-retroviral drugs for HIV positive mothers and children. It supports thirteen counseling teams who educate on the causes and prevention of AIDS. Moreover, in recent years, through an aggressive dosage of retroviral drugs for HIV positive mothers, the diocese has achieved a 100 percent success rate in being able to deliver babies who remain HIV negative.
Bishop Dowling has become a lightening rod for some of the more conservative factions in the church, because of his stand on the use of condoms to prevent the spread of AIDS. I had been alerted to several Catholic blogs attacking the bishop and the Jesuit university for offering him an honorary degree and a platform to speak to students. Patrick Reilly, President of the Cardinal Newman Society, called Dowling 'a champion of dissent’: “Our Holy Father was viciously attacked during his recent visit to Africa for teaching that condom use is gravely immoral”, Reilly said. "Bishop Dowling’s concern for the plight of AIDS victims is admirable but he has become a champion of dissent against the Vatican’s clear teaching on condoms and USF’s decision to honor him will be seen as approval for his dissent and encourage dissent in the Church”. Catholic Answers and A Shepherd’s Voice, two other traditionalist Catholic groups, chimed in with this motif of branding Dowling a dissident.
I asked Dowling, pointedly (he had not broached the topic in his presentation), during the session, to explain to us his position on the use of condoms to prevent AIDS. He straightforwardly and fully endorsed the twin Catholic values of abstinence before marriage and sexual fidelity in marriage. But, in the style of earlier Catholic casuists, he asked whether, in the context of AIDS, condoms need to viewed always and only as a sexual morality issue in the Catholic Church. He argued that condom use to prevent the spread of AIDS could also be seen as a justice and ethical issue—the right to life and the protection from serious harm. Dowling said: what is at stake is both the sixth and the fifth commandment. Yes, he insisted, I fully endorse Catholic teaching on sexual fidelity. But in situations where the wide populace is not going to abide by that teaching, at least their sinful fornication or adultery should not also include ‘a second sin’ of harm or potential taking of another human life as its result—the fifth commandment.
I was reminded, listening to him, of a confession case I heard about when I was a student in theology. A young man confesses fornication and, as if it were a second and separate sin, the use of a condom in the act. I remember puzzling over that case years ago and wondering why Catholics came to think that the use of a contraceptive (forbidden, in church teaching, within marriage, because of its blocking of the appropriate procreative union of marriage) had the same meaning in sinful, non-marital intercourse, which is not, per se, ordered , as marital sexuality is, to procreation as such. Not only was the use of a contraceptive in a sinful sexual act not some ‘second' separate sin but irresponsible sexuality outside marriage might be doubly irresponsible, if one did not protect against its further, perhaps tragic, consequences.
A raft of Catholic voices have been calling for the licit use of condoms, in cases where one of the marital partners is HIV negative on the assumption that: (1) pure life-long abstinence in marriage might be virtually impossible or negate the unitive purposes of marital sexuality; ( 2) unprotected sex would have life-threatening potential consequences.. So, Cardinal Daneels of Brussells and Cardinal Martini, retired Archbishop of Milan, and a host of African bishops have been calling for a sensible rule to allow married couples, where one partner has AIDS or is HIV positive, to use condoms. The argument is that this involves the famous principle of double effect. The intention is not contraceptive, as such, but the prevention of bodily harm to a marital partner. The indirect, but not intended, effect is contraceptive in effect.
Deep pastoral experience has clearly touched Dowling. As he has said, “ I’ve sat with vulnerable women for years in their shacks, have seen them and their babies in the arms dying of AIDS. Their hopelessness has seared my heart and spirit. I believe Jesus’ injunction against the Pharisees applies to me. He said that they are the ones who put impossible burdens on the shoulders of their people but will they lift a finger to help them carry them ? I want to be the one who lifts a finger.”
Dowling—the supposed ‘ dissident’—also has said: “I am not saying my position is the right one, but I do think there needs to be a more formal dialogue within the church”. Cardinal Barragan, the head of the Pontifical Council on Health Pastoral Care, remarked about this issue:” This is a very difficult and delicate subject that requires prudence”. I loved that final word of Barragan, because it reminded me of what was at the heart of the moral theology I learned, over forty years ago, from a saintly and learned Jesuit, Robert Dailey S.J.. Dailey stood in the line of the great Jesuit casuists and knew that a moral theology based simply on categorical universals tends to fail us pastorally and eludes the real world we live in. Of course, there are some deontological (always and everywhere) duties but, as I recall, Thomas Aquinas thought these deontological first principles of the Natural Law were rather few and fairly general. Nor does casuistry mean that we end up with a purely ‘situational’ ethics.
What the case that Dowling raises forces us to ask is: is condom use only always and everywhere primarily contraceptive in intention? Does condom use in sex outside marriage (such sex, admittedly, sinful in church teaching) have the same meaning as condom use within marriage? Bluntly, does the use of a condom in sinful extra-marital sex involve a ‘second’ serious sin ? Or, conversely, in sinful situations can condom use minimally represent a modest element of responsibility in the illicit sex ?
To be sure, as Barrigan notes, there is a delicacy involved. Will permitting condom use in some special circumstances (to avoid infection with AIDS) encourage greater promiscuity ? But that is, at best, a consequential argument (arguing from possible effects). The argument, however, to allow condoms to prevent AIDS transmission involves an intrinsic evil: Always avoid intentionally inflicting bodily harm and possible loss of life to an innocent other. I am inclined to assume that this second argument trumps. But what is clear to me, as Dowling seems to claim, is that the debate is about casuistry. One has to look carefully at the case. It clearly is not—as Patrick Reilly seems to suggest—something which calls for a ukase!
John Coleman, S.J.