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.

Comments

Anonymous | 6/13/2009 - 3:26am
Fr. Coleman's article was successful in eliciting thoughtful responses. As a lawyer, however, and not a theologian, I question Fr. Coleman's concluding remarks, particularly as to ''intent'' and as to distinguishing the use of condoms in as opposed to outside marriage. As to both issues, I wonder (without knowing) whether Paul VI or John Paul II made such distinctions. If not, then I submit both issues are irrelevant. If the Church's Magisterium holds that the use of contraceptives in or outside marriage is prohibited, the discussion is over, and anyone (bishop, priest or layman) is free to disagree, so long as he/she complies with the Church's teaching.
Anonymous | 6/11/2009 - 11:13pm
To Carolyn (and others), I want to apologize for my awkward use of language as I would never ever say that the women were encouraging the sexually abusive men to have sex with them.  On the contrary, I was trying to say it is those who distribute condoms who are enabling the men to have exploitative sex with these women who are desperate and are victimized time and time again.  I am obviously not a moral theologian and have to speak from my life experiences: many years as a social worker in Child Protective Services, advoacacy for persons with disabilities and  single motherhood of my mentally disabled children.  I do know what sufferering is and i have learned that to change behaviors of individuals and societies, you do not enable bad behavior.  The long term solution is education and jobs for the women to be self-supporting.  In the meantime, there is absolutely no reason why American Catholics cannot financially support these women so they do not have to prostitute themselves.  There is a great amount of wealth in this country and what better way to show our love for Christ's children than to give from our abundance to these suffering women.  The Jesuits with their great organizing skills and resources could have a fund perhaps  tailored on the one of Bishop Gassis of the Sudan which has American support.  Money can be distributed as quickly and as easily as a carton on condoms and the result would be lives of women lived in dignity.
Anonymous | 6/10/2009 - 1:45pm
Is not the sexual exploitation of women a grievous moral issue and is not the abetting/enabling of the perpetrators of the acts also a grievous moral issue?  What is the message you give these perpetrators when you give them condoms to use during these exploitive acts?  The solution for women is not encouraging men to abuse them, but to give women the means to say, NO!!  Education and jobs are the means to womens' freedom.  This is what the church needs to work on (and I believe that Catholic Relief Services is instrumental in that regard),  If there aren't enough jobs for women to survive then, there is ample money in America among wealthy Catholics to provide for them.  Distributing condoms is the easy, cheap way and seems to ease the consciences of all of us.  Please note the op-ed essay by Edward C. Green, senior research scientist of the Harvard School of Public Health, in the Washington Post.  Studies, such as one done by Norman Hearst and Sanny Chen of the University of California for the UN AIDS program (and several others) found that condoms have not worked as a primary intervention in the HIV epidemic in Africa.  In one study, 10 AIDS experts conclulded that:  "consistent condom use has not reached a sufficiently high level, even after many years of widespread and often aggressive promotion, to produce a measureable slowing of new infections in the generalized epidemiscs of Sub-Saharan Africa."    Pope Benedict is right when he talks about humanizing the relationships of men and women as the way to prevent HIV.  THis is a pro-woman stance in a heavily patriarchal society. Another woman-related exploitation hits closer to home.  This is the "hooking-up culture" which is prevalant on Catholic college campuses.  Please note the study done by Donna Freitas.  This behavior is very damaging to the growth and well-being of women.  The Jesuits should take a good look at their colleges including the University of San Francisco.  Maybe it takes a John Henry Newman Society to wake people up to what is happening in so-called Catholic education.  It is unfortunate that their views and others identified as "traditional" are summarily dismissed as partisan.  It is heartbreaking when, in the American Catholic church, a person is termed "orthodox" and that is an insult!!
Anonymous | 6/11/2009 - 8:03pm
Magdalena’s charge that Bishop Dowling or someone like him is only supporting abuse by allowing condom use to prevent infection, or is not working to help women escape exploitation, is truly beyond bizarre. No wonder dialogue is foreshortened in our church. Bless the Dowlings and Romeros of this world.
Anonymous | 6/11/2009 - 9:27am
[size= 14pt] Sorry I directed a comment to the wrong person on the last transmission.  [/size]Below is the revised comment. [size= 14pt]Though bringing life into the world by the conjugal act is the primary reason, certainly strengthening the bond between married couples is still very much apart of having relations and God’s plan.  [/size]I did NOT say anywhere in my comment that bringing life into the world is the ONLY reason.  I would hope people will not read more into comments than what is written.  The comment about HPV is a straw man argument.  Condoms do very little to prevent this unfortunate disease.  Unlike HIV, HPV is transmitted by skin to skin contact.  And yes jurisdiction does have a role in some matters, but Bishop Dowling being a bishop must answer to a higher power, just the same as any other Catholic, when it involves situations of faith and morals.  Michael substitute condoms with facilitating abortions and see if you can still make your argument with a straight face.  Finally, Dave for those married couples who naturally pass the age of bearing life and completed their vocation by bringing children of God into the world, as I mentioned above, can continue to strengthen their bond with their spouse.   I have nothing against this.  
Anonymous | 6/11/2009 - 9:09am
[size= 14pt]Though bringing life into the world by the conjugal act is the primary reason, certainly strengthening the bond between married couples is still very much apart of having relations and God’s plan.  [/size]I did NOT say anywhere in my comment that bringing life into the world is the ONLY reason.  I would hope people will not read more into comments than what is written.  The comment about HPV is a straw man argument.  Condoms do very little to prevent this unfortunate disease.  Unlike HIV, HPV is transmitted by skin to skin contact.  And yes jurisdiction does have a role in some matters, but Bishop Dowling being a bishop must answer to a higher power, just the same as any other Catholic, when it involves situations of faith and morals.  Dave substitute condoms with facilitating abortions and see if you can still make your argument with a straight face.  Finally, Dave for those married couples who naturally pass the age of bearing life and completed this part of thier vocation by bringing children of God into the world, as I mentioned above, can continue to strengthen their bond with their spouse.   I have nothing against this.
Anonymous | 6/10/2009 - 7:55pm
Re: the effectiveness of abstinence programs in fighting AIDS, the experience of Uganda is instructive. Contrary to earlier reports that such programs were successful, it turns out the reason for the lower infection percentage of the population was due to a high fatality rate in the period covered, not a lower incidence. And the ABC slogan used stood for: Abstinence, Be faithful, and if A & B fail, always use condoms. According to the Kaiser Family Foundation study, “The researchers found that the ''single greatest factor'' in Uganda's declining HIV prevalence rate is premature death among HIV-positive people who died of AIDS-related causes during the study … The number of HIV-positive people who died each year of the study was about 70% more than the number of people newly infected with HIV annually…The study's findings suggest that Uganda's ''much-lauded success'' in reducing its HIV prevalence has ''little to do with'' the abstinence and monogamy programs… the study's findings emphasize that ''condoms are the main preventive tool against HIV'' First, let’s keep women alive, pending education and jobs that can improve their circumstances. We all want an end to exploitation. Despite Janice Johnson’s idea that women are encouraging men to abuse them because of condoms, or that the lack of a condom gives women a means to say no (anyone think that would stop men in a “heavily patriarchal society”?), I find no validity in either assertion. The research Johnson quotes indicates that ''consistent condom use has not reached a sufficiently high level” to make a difference, not that condoms don’t prevent infection among those who use them. Use all options, foreclosing none that actually work. Congratulations to Bishop Dowling.
Anonymous | 6/10/2009 - 4:47pm
''We need to remember what the primary reason for having relations is not to have good feelings for one another it is to bring life into the world.''  I am continually dumbfounded by how narrow minded, wrong headed and unrealistic our discussions about our faith can be.  I am 57 years old; my wife is long past her child-bearing years.  We have raised two wonderful children.  We are no longer able (nor wish to) bring life into the world via intercourse.  But we still very much wish to continue with this expression of our love.  I'm not sure how you reconcile the above-mentioned comment with our own situation.  And that's the point; we Catholics are arguing ourselves out of existence by keeping our heads in the sand.  I do very much agree with the eariler post that we should not allow our fellow human beings to die while our man-made theology catches up.
Anonymous | 6/10/2009 - 2:02pm
Mr. Thomas, substitute HPV for HIV in your argument and see if you can still make it with a straight face (given the prevelance of HPV). The argument is as much about jurisdiction as it is theology.  As the local Ordinary, Bishop Dowling has a right to care for his flock in the way he sees fit.  If Rome or it psychophants have a problem with that, it is too bad for them. USF is operated by the Society of Jesus, not the local bishop or the USCCB.  It is up to the Society to decide the appopriateness of their graduation invitations and honors and no one else's, certainly not the Cardinal Newman Society's. As to sex on campus, perhaps the problem is that adequate provision has not been made for students to become married while in school without loss of future employability or financial hardship.  Frankly, the early Church would be scandalized at the way that we don't take care of eachother.  The idea that marriage and childbearing are something that should wait until later is counter-life, counter-evolutionary and counter-survival of the species.
Anonymous | 6/10/2009 - 8:28am
I think two married persons, where one has HIV, who sacrifice by abstaining is the best demonstration of Love.  Bishop Dowling seems confused as to what authentic love and sacrifice means.  Loving someone does not always have to include intercourse, there are other ways to bond with your spouse.  We need to remember what the primary reason for having relations is not to have good feelings for one another it is to bring life into the world.  I think Pope Benedict said it best when he mentioned that we need a "humanization of sexuality" and this what are bishops should working at, not promoting condoms.
Anonymous | 6/10/2009 - 2:12am
Thank you to Fr. John Coleman for his nuanced and wonderful post on Bishop Kevin Dowling. It is a resounding breath of fresh air.  Kudos as well to the University of San Francisco. God bless Dowling for focusing on the reality on the ground; the concrete, as opposed to abstract theological positions that can end up killing people. Vulnerable women caught in “survival sex” with tragic consequences be damned, apparently. Count me and perhaps other millions as champions of dissent if that is what it takes to bring some sanity to pastoral practice. No wonder popes and bishops have lost moral authority, deservedly so.  They are well on their way to irrelevancy, having become obstacles to faith, more than shepherds. Pharisees laying burdens indeed, in areas in which they are particularly ignorant. When a teaching is so stunningly not received, one might hope some light would dawn. Anyway, Paul6’s decision was all about authority issues (about THEM), not the merits. Daneels, Martini, and some African bishops are the real voices of hope.
Anonymous | 6/9/2009 - 2:23pm
Father Coleman, your profile of Bishop Dowling and his views is intriguing and carefully written.  But I think you make a poor choice of ''critic'' to rebut, if that is your intention.  The Cardinal Newman Society has never engaged in any critique of Bishop Dowling's theology, but instead has noted the fact of his dissent from the Vatican's teaching against the use of condoms even for the purpose of avoiding AIDS (as you confirm in your report) and the condemnation of those views by the South African bishops conference (which you do not mention).  We note these facts not to engage Bishop Dowling in theological debate or even for the primary purpose of criticizing him, but to question the University of San Francisco's choice of commencement speaker and honorary degree recipient, especially given ongoing concerns about USF's commitment to Catholic teachings on sexual morality.  Your article would have been strengthened by citing a substantial critic of Bishop Dowling's views - perhaps the Holy Father and his statements in Africa, or the South African bishops conference - rather than batting around a straw man.  Now if you want to tackle the question of USF honoring a bishop who repeatedly and vocally challenges the Vatican on the use of condoms, bat away and we can have a meaningful exchange.
Anonymous | 6/12/2009 - 12:18am
One disturbing thing about this debate is the way in which it is framed: do people who oppose condom use in marriage in cases of disease transmission truly believe that every time someone raises a question they are ''dissenting''? While Rome expects its teaching to be held by the faithful that does not mean it cannot be questioned, elaborated upon and even developed to the point where new possibilities are seen which before were invisible. If such thing were impossible then St. Thomas could have never written his Summa, democracy would still be considered dangerous by Rome and Jesuits would still be slave owners. Another disturbing aspect of this debate is the presumption that marital chastity can become celibate chastity by a simple act of the will. I thought married people were called to marriage; not celibacy. Married people involved in this debate above all should recognize what an impossibility that is - and also how over time it would thwart the very meaning of marriage. A relaxation of the rule concerning condom use within marriage to stop the spread of diseases is therefore not a permission to sin; it is an act of charity. It opens the possibility for a couple to reconcile in the face of whatever act brought HIV into their relationship, to live a somewhat normal married life, and to raise their children rather than have them become orphans.  Bishop Dowling doesn't dissent from Church teaching; only the way that teaching has been applied. And if we can't even do that - well then, we can't even ask, ''what would Jesus do?'' - because questioning the application of teaching was exactly what he did. And if we can't even do as Catholics what Jesus himself did, well then I would say that the Church has far more serious issues to face than condom use.
Anonymous | 6/11/2009 - 12:54pm
I really don't think there are too many women who actually want to have sex with their HIV-infected husbands. In patriarchal societies like these, however, women can be coerced. In the US when a man rapes a woman while knowing he is HIV positive, he is often charged with attempted murder. The solution is not to hand out condoms to the men who abuse their wives this way, the solution is to END THE ABUSE. Similarly there aren't too many women who would be prostitutes if they could obtain work that respected their human dignity. "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." Why is the local Church allowing the children of the poor to be fed through exploitation and assault, albeit assault to which these women submit out of desperation? And the head of the local Church, the Bishop, his proposed solution is to hand out condoms to their "customers"! So that Mother doesn't get sick and can live another day to be abused and degraded, I assume. Frankly I am glad to be on the side of the bishop of Rome, who is "on his way to irrelevancy" and has all these "unrealistic" ideas about human dignity and the meaning of eros and agape in Christian love.
Anonymous | 6/11/2009 - 11:17am

I write from El Salvador, where for years I have heard people speak about Archbishop Romero, and about why they loved him.  I was reminded of this when, in this post, I read the following: “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 could imagine Archbishop Romero saying those very words – except that he would have added, “and have heard them speak of how death squads burst into their homes and dragged away their spouses and children.”  On one occasion, he said that their suffering “touches the very heart of God.”  Most certainly he, like Bishop Dowling, would have said, “Their hopelessness has seared my heart and spirit.”  As a result, he changed – a change that included becoming a different kind of bishop.

Anonymous | 6/10/2009 - 12:47am
This article is a futher example of how the call for dialogue on moral issues is really just an attempt to confuse the faithful and attempt to undermine morals. After spending years as a priest, it is astounding that Father Coleman still doesn't seem to understand why using a condom during a sinful sexual encounter is wrong. It is because the act necessitates a certain form of its own, because regardless of the participants, it is an action that involves the creation of human life. All simply moral manuals explain that the act needs to be open to human life, or it is sinful. Using a condom in a sinful relationship increases the sinfullness, even if using a condom to prevent a birth seems like the most expedient thing to do to avoid the consequences of one's actions. A more interesting point would be regarding the use of condoms during homosexual sex. Obviously here, it is morally irrelevant, and perhaps even morally positive if one is preventing aids infection.
Anonymous | 6/9/2009 - 11:03pm
What would be the effect of supporting the affected women directly before they get infected; that is, using the money used for retroviral treatment (isn't this terribly expensive- gotta love the big pharma) to help them get housing and food and other needs like some sort of job before they get infected? Another question - doesn't just having a condom insinuate a sort of intention to possibly commit a sexual act? Or, does it point towards the intention of avoiding infecting/getting infected? While not having a condom leaves one vulnerable to hiv infection were one to fall into a sexual situation (or, get infected/transmit infection). What is you take on the morality /ethics of this sort of delimna?
Anonymous | 6/10/2009 - 12:40pm
In case - to clarify who ''THEM'' is in my post above: Pope Paul VI's decision to promulgate HV had more to do with the reputation of the hierarchy's exercise of authority than the merits or not of birth control. JPII hardly attended the Birth Control Commission's meetings, out of which came careful study and recommendations for a change in the church's stance. Chris makes the case succinctly: watching people die while waiting for theology to catch up. Jim Thomas indicates the primary reason for relations is the transmission of life, narrowly defined as conception. I do not understand then how couples can be allowed relations outside the fertile period, when the primary reason is frustrated. That must be a lesser act, having to make do with perhaps some good feelings for one another. Those feelings come off as a deficient reason somehow. These differences are well covered in endless discussion elsewhere, but it is interesting to see their expression here. From a ''champion of dissent'' on this one.
Anonymous | 6/9/2009 - 4:14pm
This is what we in the secular world call a no-brainer.  There must be a sin for watching people die while waiting for theology to catch up.  Fortunately, Bishop Dowling is too sensible for that.