A Question of Conscience

Dr. John J. Billings
Reprint with permission

Some years ago, in the course of my neurological practice, I was consulted by a woman who had developed recurrent, severe attacks of migraine after commencing contraceptive medication, not at all an uncommon sequence. When I explained to her that she had little prospect of improvement unless she stopped the medication, she explained, "But I wasn't taking it for contraception". She may have thought any complication of medication would result from feelings of guilt, or the intervention of an avenging God, or perhaps some other reasons which do not concern us here. The important point is that she was wrong, wrong in the belief that the personal consequences produced by our actions are determined only by our intentions. On the contrary, they depend primarily upon the nature of the action itself.

Fifty years of medical practice as a consultant physician has provided many insights into human behavior. It has demonstrated the extraordinary goodness which is readily evident in so many human beings, and helps to develop an understanding that similar goodness exists in the others in whom it is not immediately so evident. Concurrently there have been forty-two years in natural family planning, since what began as a hobby prospered unexpectedly. Teaching natural family planning and counselling couples with various problems, including the need to regulate their fertility, has meant the privilege of admission for the time being into what is an intimate, exclusive relationship. This has provided the opportunity to observe the status of family life amongst people of different cultures, people of different religions or no religion at all and illiterate groups living in very deprived economic conditions, remembering all the time that their actions are known to the same loving Father in Heaven. There were many opportunities to study the operation of birth-control practices everywhere, especially the operation of the programs funded and controlled in the so-called Third World by the affluent countries, specifically the "birth-control package", as it is called, of contraception, sterilization and abortion.

In the earliest years natural family planning meant the Calendar Rhythm Method and its limitations were quickly recognized. At the same time a minority of the couples seeking help declined to use the Rhythm Method, turning instead to contraception or sterilization. A substantial proportion of these couples returned some time later because one or both of them had been unfaithful, within a few months of the introduction of contraception or sterilization to the marriage; this was the beginning of insight into the fact that there is a fundamental difference, especially in its influence upon the marriage, between the use of a natural method and those methods which distort the sexual act, suppress or destroy fertility and especially abortion. As Pope John Paul II has written in Familiaris Consortio: "In the light of experience of many couples and of the data provided by the different human sciences, theological reflection is able to perceive and is called to study further the difference, both anthropological and moral, between contraception and recourse to the rhythm of the cycle; it is a difference which is much wider and deeper than is usually thought, one which involves in the final analysis two irreconcilable concepts of the human person and of human sexuality". (Familiaris Consortio 32).

The Conjugal Relationship

As one's knowledge increased during those early years it became unmistakable that whereas the use of a natural method tends strongly to strengthen the love between the husband and wife, all the techniques of the birth-control package tend to create disharmony and separation, in many cases leading to the breakdown of the marriage. It is not difficult to perceive why this should be so, seeing that the totality of the gift the husband and wife make to each other is very seriously diminished when the gift of their fertility, such a vital and invaluable part of the whole human organism, is withdrawn or rejected from the gift, or both withdrawn and rejected.

So it was that, long before the encyclical Humanae Vitae was published, it already seemed inconceivable that the Catholic Church will ever change its traditional teaching regarding contraception, sterilization or abortion. It was still prudent to recognize that one's theological perceptions are limited to those of the ordinary individual, who must of course in the future give an account of his stewardship. One also remembered Christ's promise to Peter at Caesarea Philippi (Matt.16:18-19), and was ready to accept the teaching of the Magisterium of the Church.

When Pope Paul VI released his decision there was no surprise to read his injunction to upright men to reflect upon the consequences of methods of artificial birth control. "Let them consider, first of all, how wide and easy a road will thus be opened towards conjugal infidelity, and the general lowering of morality. Not much experience is needed in order to know human weakness, and to understand that men -- especially the young, who are so vulnerable on this point -- have need of encouragement to be faithful to the moral law, so that they must not be offered some easy means of eluding its observance." (Humanae Vitae 17.) In a prophetic statement he wrote: "Let it be considered also that a dangerous weapon will thus be placed in the hands of those public authorities who take no heed of moral exigencies. Who could blame a government for applying to the solution of the problems of the community those means acknowledged to be licit for married couples in the solution of the family problem? Who will stop rulers from favoring, from even imposing upon their people, if they were to consider it necessary, the method of contraception which they judge to be most efficacious?" (Humanae Vitae 17).

The contraceptive pill was introduced early in the 1960's and was promoted by intensive sales propaganda which deceived many doctors and sadly also a number of theologians. The doctors failed to recognize that it is against sound medical principles to administer to a healthy person any drug which depends for the production of the desired effect on the suppression of the activity of a normally functioning biological system, forgetting also the pharmacological axiom that no drug acts in isolation within the human body. Some of the theologians who came to dissent from the teaching of the Magisterium of the Church were deceived by the blandishments of those in the contraceptive industry, persuaded to an unrealistic assessment of their scientific insights and to accept the myth that contraceptive medication imitates nature. The widespread acceptance of contraception which followed led to a sexual revolution characterized by gross immorality, marital infidelity, divorce, one-parent families, an increase to epidemic proportions of sexually-transmitted diseases, and the promotion of sexual perversions, demonstrating that contraception is of its nature intrinsically evil, therefore damaging to the individual and to society, and objectively an offence against God.

The link between contraception and the tolerance of sexual deviations becomes clear when we remember that if it is legitimate to sterilize sexual genital relationships, it becomes difficult to stigmatize homosexual acts, which are of their nature sterile.

If not immediately perceived, the fact that contraception is a primary and major cause of these disorders should be evident on reflection. The word contraception itself means "against conception", that is against the child. It eliminates the idea and therefore the acceptance of the child, and when the contraceptive technique fails it is common for the child to be eliminated by induced abortion. It did not take long after introduction of the contraceptive pills for many governments to enact legislation to provide "abortion for failed contraception". By contrast, couples using a natural method take responsibility for their own actions and do not transfer the responsibility to a technique. The refusal to accept truth, such as the truth that contraception is objectively evil, leads to more untruths, including the dental that from the moment of conception a new human life has come into existence, a new human person; this untruth is expedient in diminishing the guilt involved in the procurement of abortion and this quietening of conscience flows into other areas of human behavior. The selfishness engendered by sexual gratification, along with the idea that the possibility of conception has been totally eliminated, creates an illusory concept of freedom: there is a turning away from truth, weakening of the will, damage to the unitive element of the sexual relationship in marriage and love itself becomes a casualty. As Pope John Paul II pointed out in his encyclical letter Evangelium Vitae: "When freedom, out of a desire to emancipate itself from all forms of tradition and authority, shuts out even the most obvious evidence of an objective and universal truth, which is the foundation of personal and social life, then the person ends up by no longer taking as a sole and indisputable point of reference for his own choices the truth about good and evil, but only his subjective and changeable opinion or, indeed his selfish interest and whim" (Evangelium Vitae 19).

Speaking about an earlier encyclical Veritatis Splendor he said: "for man, to live at peace with his conscience means living at peace with the law of his own nature, and, vice versa, living in accord with this law means living in accord with his conscience; obviously, with a true and upright conscience, that is, with a conscience that correctly interprets the contents of the law written in human nature by the Creator." (Angelus reflection, 12 June 1994).

The present "culture of death" in human society is perhaps an intimation of the final trials to which humanity will be subject, referred to in the "Catechism of the Catholic Church" as the "final trials that will shake the faith of many believers" (CCC 675) and in the Gospel as a time when "love in most men will grow cold" (Matt. 24: 12). There is need also to emphasize the influence of disordered patterns of behavior leading others into error, that is to say, to be a cause of scandal, "an attitude or behavior which leads another to do evil" (CCC 2284)

Pastoral Care

It is unfortunate that some bishops and many priests are reluctant to promote the teaching of natural family planning, often as a result of misguided compassion. Some of them have the idea that even modern, scientific natural family planning is unreliable in its application for the postponement of pregnancy, an opinion which demonstrates a lack of correct information. Others fear that the natural methods are too difficult, which is an error of judgement, possibly indicating that they are faking advice from the wrong people.

Sometimes the idea exists that the presence of some disturbance of the conjugal relationship excludes the prospect of success with the natural method, which is actually the reverse of the truth. If there is a problem of marital disharmony, that is a specific indication for the introduction of the natural method into the marriage. Problems such as selfishness and alcoholism joined to the need for the spacing of children create a complex which will cause great unhappiness and perhaps destroy the family: it is a complex which will yield in all its elements to the therapy of natural family planning, but will not be at all likely to yield to contraception or direct sterilization. Surgical sterilization performed to prevent further pregnancy is a degradation for the individual, man or woman: it is a veterinary operation, appropriate for domestic or farm animals, but not for human beings. Every human person who has been surgically sterilized in order to destroy fertility has been thereby reduced and may become the victim of sexual abuse, or of even greater sexual abuse than had previously been inflicted. It is a serious mistake to believe that the major problem is the need to avoid pregnancy, which in any case can be solved by natural family planning. The tragedy which threatens is disintegration of this family, with immeasurable suffering for both parents and most of all for the children. The danger can be overcome by the healing influence of natural family planning assisted by the gentle, compassionate advice of its teacher. Introducing contraception or surgical sterilization may very well make separation and divorce inevitable, as the result of the harmful effects of all such techniques on both husband and wife and the marital relationship. Each of these sequences mentioned has been observed in personal experiences in differing societies in different countries of the world.

It is very unwise for a celibate religious ever to state, or even to think, that the gentle discipline of modern natural family planning is too difficult for some people. Sometimes it may be difficult, rarely it may be very difficult, but never impossible. Catholics especially can be encouraged by the words of Pope Paul VI, "Let married couples, then, face up to the efforts needed, supported by the faith and hope which 'do not disappoint... because God's love has been poured into our hearts through the Holy Spirit, who has been given to us'. Let them implore divine assistance by persevering prayer; above all let them draw from the source of grace and charity in the Eucharist. And if sin should still keep its hold over them, let them not be discouraged, but rather have recourse with humble perseverance to the mercy of God, which is poured forth in the sacrament of Penance" (Humanae Vitae 25).

It may be proposed that it is legitimate to "choose the lesser of two evils" in order to justify the supply of contraceptives to adolescents in the belief that this will reduce the incidence of pregnancy and therefore the demands for abortion. It is of course never lawful to choose evil of any kind, although it could sometimes be necessary to tolerate a lesser evil in order to prevent a greater evil. However, it is a myth that distributing contraceptives to young people will reduce the incidence of abortion. The contrary is true, as was admitted by the delegates to the United Nations' Conference on Population in Mexico City in 1984; they agreed that all over the world the supply of contraceptives had actually increased the number of abortions, for the reason that they had promoted promiscuity and other irresponsible sexual behavior. It is also foolish to be beguiled by the extravagant propaganda regarding population growth, which is often another example of the anti-child mentality. Whatever restriction of demographic population growth may be indicated in certain regions these results can certainly be obtained by appropriate programs of natural family planning. Natural family planning teachers are not afraid of babies.


The primacy of conscience is not a teaching of the Catholic Church. What is the teaching of the Church is the primacy of truth. It is true that an individual can without guilt accept the direction of his/her properly formed conscience, and is even obliged to do so when it is in error, as St. Thomas Aquinas taught us. The conscience will be properly formed by a Catholic when there has been careful, prayerful study of the official teaching of the Church. If then he feels directed by his conscience against this teaching he can be in "good conscience" but is certainly not in "correct conscience"; his erroneous conscience has led him into the performance of one or more evil actions from which he and perhaps others may suffer harmful consequences.

As Pope Paul VI stated: " The defence of human life must start from the very source of human existence". This statement was made soon after the issue of the encyclical Populorum Progressio in 1967, before the publication of Humanae Vitae in 1968.

Conscience is not the master, it is the pupil that needs to be trained. The people who argue for the inviolability of human rights, cannot at the same time argue for the primacy of conscience. The primacy of conscience would really mean that each individual person is entitled to trust his own judgement as to whether every action is either right or wrong. The desire to make such judgments takes us back to the Garden of Eden, when Adam and Eve were tempted to "be like gods, knowing good and evil" (Gen. 3:5). As Pope John Paul II wrote in Veritatis Splendor: "What is unacceptable is the attitude of one who makes his own weaknesses the criteria of truth about the good, so that he can feel self justified, without even the need to have recourse to God and His mercy. An attitude of this sort corrupts the morality of society as a whole, since it encourages doubt about the objectivity of the moral law in general and a rejection of the absoluteness of moral prohibitions regarding specific human acts, and it ends up by confusing all judgments about values" (Veritatis Splendor 104). St Augustine taught us that "God does not command the impossible, but in commanding He admonishes you to do what you can and to pray for what you cannot, and He gives His aid to enable you (De Nature et Gratia, 43:50).

Remembering that for a married person it is the spouse to whom the second great commandment to love our neighbor as ourself primarily directs us, Pope John Paul has written: "At the root of every act of violence against one's neighbor there is a concession to the 'thinking' of the evil one, the one who was 'a murderer from the beginning' (Jn 8:44). As the Apostle John reminds us: 'For this is the message which you have heard from the beginning, that we should love one another, not be like Cain who was of the evil one and murdered his brother' (1Jn 3:11-12). Cain's killing of his brother at the very dawn of history is thus a sad witness as to how evil spreads with amazing speed: man's revolt against God in the earthly paradise is followed by the deadly combat of man against man".

It is unfortunately true that many married couples have had the very sad experience, after being advised by their doctor that one or other should submit to surgical sterilization or to use contraceptives, that the priest to whom they have turned for advice has only replied, "Follow your conscience". What the couple has been wanting to know is what their consciences should be telling them, in other words, what is the teaching of the Church? Instead of that information, the message has been, "Do what you think is best in your own circumstances". Many of these couples feel deserted, feel that at this regional level the Shepherd has deserted his flock, that their Spiritual Father has abandoned his children. Under pressure from the world around them and even at times directly from dissenting clerics they have been persuaded to seek a solution in contraception or direct sterilization. There is no need to look further for explanations as to why so many nominal Catholics do not follow the teaching of the Church regarding the regulation of births, why so many Catholic marriages have ended in divorce and remarriage and why so many Catholics have even submitted to induced abortion. In many countries the advice to "follow your conscience", given in isolation from an exposition of Catholic moral teaching, has emptied the churches and the seminaries. This loss of faith is of critical importance in modern society where respect for human life is lost in the culture of death; throughout the two millennia of Christianity it was the people with loyalty to their strong religious faith who were supreme in providing education and health care to the poor, the sick and their other disadvantaged brethren.