EM The_Rhythm_Method_an_Upbeat_Update The Rhythm Method An Upbeat Update
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A CATHOLIC PERSPECTIVE ON MORAL ISSUES IN THE HEALTH AND LIFE SCIENCES
The Rhythm Method: an Upbeat Update
()
A conviction common to some philosophers and scientists is that a right understanding of the human
person guarantees wisdom in every kind of intellectual pursuit, whether practical or theoretical. It is particularly fascinating to note how the perspectives and
conclusions of disciplines as divergent as science and
philosophy can complement one another in their
attempts .to understand the human person. Scientific
data challenges philosophers to expand and modify
their anthropological theories while holding fast to
principles; authentic philosophical principles provide
intelligent guides for scientific research and constitute the criteria against which its work can be adequately interpreted and evaluated.
Recent research and development in a method of
natural family planning is an example of how good
philosophy can supplement and critique a specific
contribution of science. In the space provided here,
we will first describe the research just mentioned and,
second, assess this work in light of the particular
philosophy of the human person that is presupposed
in the teaching of Humanae Vitae.
'Rhythm Without .Blues'
Dr. Carl Djerassi, internationally known chemist
and one of the original contributors to the chemical
development of. the oral contraceptive, has recently
turned his contraception research and development
efforts from artificial contraception to one of the natural family planning (NFP) methods (cf., "Fertility
Awareness: Jet-Age Rhythm?" Science, 1 June 1990,
pp. 1061-2).
Djerassi's goal was two-fold: first, to change the NFP
from an unreliable to a reliable means of regulating
births by making it an accurate ovulation indicator
and, second, to change it from a largely unpopular to
a more appealing method of birth regulation by
reducing by half the number of days of required abstinence (from 17 to 8 days) .
Formerly, couples using the rhythm method as a
means to avoid conception calculated the time of ovulation (the period of abstinence) by relying either on
the text book 28-day cycle with ovulation at day 14 or
L
JULY, 1991
VOL. 16, No. 7
on the rise of the woman's body temperature.
Presently, couples using the sympto-thermal method
of NFP rely on examination of cervical mucus and on
daily measurement of basal body temperature. The
difficulty of relying on these indicators is that not
every woman's cycle is regular and her body temperature may rise in the context of variables like tension,
sickness, physical exercise, or travel. Consequently,
Djerassi chose to analyze and chart a more stable
ovulation indicator, namely, the rise and fall of female
hormones. He concluded that if his hormonal
research were the basis for a hormonal dipstick testing system, a woman would be able to track the rise
of estradiol (estrogen) that occurs three days before
ovulation and the rise in progesterone that occurs in
the post-ovulation phase of her cycle (approximately
one day following ovulation). If she were trying to
avoid a conception, she would be able to identify the
two hormonal markers that outline the beginning and
end of the required period of abstinence.
Based on Djerassi's research, a diagnostic company
has already developed a home urine test that,
employing recombinant monoclonal antibodies, can
identify the "green light" rise of progesterone (the end
of the fertile period), and it is predicted that the availability of a test to measure the corresponding "red
light" rise of estrogen (the beginning of the fertile period) is just a matter of time. These home tests could be
used not only by couples who want to avoid a conception through a natural method but also by those who,
desiring a child, want to know the optimal time for
conceiving.
(continued on page 2)
IN THIS ISSUE
The Rhythm Method: an Upbeat Update
Improved method of determining ovulation
time
Futility and the PVS Patient
Medical futility as a non-moral assessment
(continued from page 1)
A Critique
The remainder of this article will attempt to show
how Djerassi's contribution could be appreciated
when judged in light of sound philosophical principles. Since Humanae Vitae teaches that there is an
anthropological and moral difference between regulating births by means of artificial contraception and
doing so by having recourse to infertile periods and
periodic abstinence, examining the philosophy of the
human person that leads to that conclusion would, at
the same time, demonstrate whether Djerassi's work
is good science in the sense defined at the outset.
Vision of the Human Person in Humanae Vitae
Body/Soul Unity: The human person is a body/soul
unity; the person is bodily and the body is personal.
Understanding this truth has profound implications
for the nature of human activity- everything one does
in the body has a personal dimension, and everything
one calls a personal act is accomplished in and
through the body.
In reference to our creation as male-persons and
female-persons, it also follows that sexuality is not
just a matter of biology or of the use of physical
organs. Human sexuality is not a thing outside of the
person or apart from the "I"; it is a biophysiological
capacity that is wedded to the person. The twodimensional unity of the human person and human
sexuality in general characterizes a fertile act of marital intercourse in particular. It is an act that, while
symbolizing the reciprocal gift of self (the personal,
spiritual meaning). at the same time capacitates the
husband and wife to share that love beyond themselves by creating, with God, a new life (the biological,
bodily meaning). The truth of the conjugal act is
upheld when those engaging in it respect its constitutive dimensions.
Vocation to love: Embedded in each human being is
his vocation to love like God loves. The human person, created in the Divine image, is called to be an
icon of God, to reenact the complete Divine self-gifting
that loved each created person into existence and rescued him from the forces that destroy love and life.
Although complete in Himself, God, in a perfect act of
gratuity, "stepped outside" the interpersonal lovecommunion of the Trinity and shared Himself. The
result; A Divine act of love spilled over into life: the
material created world with the human person as its
crowning glory. But Divine love did not stop there, for,
in order to restore life to a world fractured by man's
sin and selfishness, a second act of creative love,
equally gratuitous, became enfleshed in the person of
His Son. The human vocation to love, then, comes
with this imperative; Love in such a way that others
can learn how God's love brought life to His people
and how Jesus' love brought life to His Church. It is
to this Divine tradition of total, faithful, and fruitful
love that every husband and wife is heir.
Steward Over Creation: Genesis teaches that the
human person is entrusted with creation, invited to
bring the world and himself to fulfillment.
Stewardship implies a relationship of entrustment
between an owner who is also a master and a manager; being a faithful steward, therefore, involves first
and foremost identifying the master's plan so thoroughly that one's stewardship faithfully advances the
master's goals. In regard to the human person's stewardship over himself, God the master Creator has,
first. written that plan on the human heart by making
it the very law of human nature and, second, confirmed it by Divine Revelation. Whether from a perspective of reason or faith, human stewardship over
self (including sexuality) is never a question of arbitrarily compiling one's own agenda for human happiness; it must always be a matter of discovering,
respecting, and cooperating with the Divine agenda
whose outlines are indelibly inscribed within each
person's being.
Personally Related to God: The human person has
his beginning in God and his end or fulfillment in
Him. It is one's Divine origin and destiny, one's original and final relationship to God, that enlightens the
meaning and value of everything between birth and
death. At the final judgment, we will enjoy unending
life with God if God recognizes some measure of the
image of His Son in us. We will have grown into that
Image to the extent we have become good while on
earth.
Entrusted with Divine authority, the magisterium of
the Catholic Church is the guardian and defender of
the truth and is charged with teaching that truth in
the area of faith and morals. Through her moral
teachings, the Church explicates the Divine plan for
human fulfillment and guarantees that those who
obey it will be living in truth and embracing good.
Because the Church's teachings reveal the demands
of objective truth, each person can form his conscience in accord with it. Appeal to an upright conscience, then, will help a couple discover the personal
language that they speak in the intimacy of the conjugal act and their corresponding moral responsibility
to speak this language truthfully.
Cocreator of Human Life: Each of us comes into
being by a Divine act of creative love. One's ensoulment was not a result of chance or necessity but the
result of an act of Divine gratuity. It follows, then,
that when a husband and wife participate in a fertile
act of marital intercourse, they are involved in an
event which is primarily God's domain. In every such
act, ·the couple is faced with a correlative decision: To
admit that God is the author of every human life or to
insist that human life is only of human origin and
able to be blocked at will. The dynamics of the fertile
(continued on page 3)
Ethics and Medics is a publication of the Pope John Center and is sent to its Subscribing Members, at the annual subscription rate of $15. (12
issues). For subscription information, please write: The Pope John Center. 186 Forbes Road, Braintree. Mass. 02184: Telephone (617) .848-
6965/Editor: the Rev. AlbertS. Moraczewski, O.P.. Ph.D .. Publisher: the Rev. Msgr. Roy M. Kllster./Contents copyright© 1991 by the Pope John
XXIII Medical/Moral Research and Education Center. All rights reserved.
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('-·- )
· (continued from page 2)
act of marital intercourse, then, is momentous- serious matter- because it strikes at God's creation at
the level of the deepest interaction between Creator
and cocreator.
Conclusion
Prescinding from any subjective motives for which
Djerassi might have undertaken his work, the sound
anthropological principles of Humanae Vitae confirm
that work like his is, objectively speaking, good science. It respects the full truth of the human person. It
provides couples not only with a dependable method
of regulating births but also with a moral means of
fulfilling the mandate of-responsible parenthood. Any
couple using the rhythm method as a means to postpone a pregnancy for grave reasons utilizes the Godgiven natural rhythms of their fertility cycle. They
abstain from sex during their fertile period and avoid,
thereby, the deliberate destruction of the procreative
good of a fertile conjugal act, and they foster the unitive dimension of marriage by engaging in sex during
their infertile periods.
Ultimately, then , the value of scientific research
such as Djerassi's is determined by what it makes
possible. The moral use of a natural method of birth
regulation defends the ca use of God , affirming God's
glory manifested in the marital exchange between
husband and wife in their openness to life. and it
defends the cause of the human person promoting
the dignity of the spouses who are fulfilled in their
total reciprocal gift of self.
Sr. Renee Mirkes. OSF. MA
Pope John Center Consultant
Waukesha, WI
"Futility" and the PVS Patient
0
The use of futility as a criterion for deciding whether
to forgo or withdraw artificially provided nutrition and
hydration to patients in the persistent vegetative state
(PVS) has gained increasing attention by physicians
and ethicists, but not without some confusion. The
judgment that artificially provided nutrition and
hydration is futile treatment or care in the case of the
PVS patient is often regarded as a moral judgment
about the presence or absence of the moral obligation
to preserve life. This analysis attempts to show two
things: ( 1) that the judgment of futility in itself is not
a moral judgment, and (2) that only after the futility
(or usefulness) of artificially provided nutrition and
hydration to the PVS patient are determined should
those means be judged morally optional or obligatory.
Categories of Futility
0
Futility is recognized as a valid criterion for forgoing
or withdrawing the artificial provision of nutrition and
hydration in different ways by those holding different
positions on the issue. Three categories of futility are
identifiable in the recent literature on the subject.
One type of futility has been described as "futility in
the strict sense"- that which is completely ineffective
towards ameliorating the pathological condition of the
patient. It signifies the impossibility of achieving any
physiological benefit for the patient. A second type of
futility might be considered a corollary of the first. It
could be characterized as "medical futility." In this
category the treatment employed gives the patient
some amount of physiological benefit but still offers
no probability of amelioration or cure of the pathological condition. This category is derived specifically
from the claim that artificially provided nutrition and
hydration is a medical treatment. The argument is
made that if the provision is a medical treatment,
then the same criteria for withholding or withdra wing
of other futile medical treatment applies to it. A third
sort of futility is referred to as "futility in the broad
sense." It signifies a futility in which the patient
receives a physiological benefit which is insignificant
in comparison to the burdens resulting from the care
or treatment.
The Meaning of Futility
The judgment of futility is actually a judgment about
the suitability of means for the fulfillment of the end
originally intended. (S e e St. Thomas Aquinas.
Summa Theologica, HI, 11 , 2, c.; ibid., 1, ad 3m.) As
such, it is not a judgment about the moral suitability
of the means in relation to the end. The moral suitability of the means must b e judged by a separate a ct
and according to independent moral principles.
Given this distinction, it may be argued that the
concept of futility is not in and of itself a moral criterion. It is incorrect to treat futility as being in itself a
moral criterion for judging what ought to be done
when in fact it represents simply an intellectual
assessment about whether some means has or is fulfilling an end. Thus, for the PVS case, the futility of
life-sustaining measures ought not refer to a moral
judgment as such but to a morally neutral act where(continued on page 4)
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