 he recent UN conference on HIV
and Aids ended with disagreements over prevention
strategies and language. Such an outcome is no
longer a surprise, even if it is a disappointment.
Given the fact that HIV is largely (though not
exclusively) transmitted through sex, it is no
surprise that for many cultures and religions,
it’s difficult to go beyond
the taboos. I know from the work my organisation,
Progressio, has done with Islamic religious leaders
in Somaliland, how hard and painstaking it is even
to discuss the issues involved. But as the scale
of the pandemic grows ever larger, addressing the
issues continues to be vital. Religious groups
and leaders have a very important role in tackling
HIV – it is well documented that the leadership
from religious groups is a force for change – both
positively and negatively.
Nowhere is this more evident than with regard
to the Catholic church. The church has come under
intense criticism for its implacable objection
to condom use. The rigidity of its position on
this matter becomes, I believe, a diversion, and
actually undermines the excellent work the church
(through many agencies) does on front line health
and care services. The church has vital messages
- on respect and fidelity in relationships - that
are so important in the context of HIV, that never
get the attention or respect they deserve because
of this apparent intransigence that seems obsessed
with the condom.
Despite the arguments and the fears, deaths and
rate of infections continue to rise. In many parts
of the world it is the church projects and agencies
that provide the health care and other support
services. The workers (often religious sisters)
face a very difficult moral decision about the
kind of advice and support they offer. These HIV
and health care workers continue to struggle with
the complex personal and moral dilemmas that individuals
face – that can often seem a world away from
the simple ideal that church teaching can espouse.
In practice, these moral challenges are far from
simple. Who would condemn the woman who faces being
infected by a partner even though she has remained
faithful? Or the woman forced by poverty to sell
her body for food? I remember talking to a religious
woman at an HIV project who struggled to broach
the gap between her church’s ideal and the
mess of everyday life. “If, whatever I say,
the man is going to have sex and we all know he
is HIV+, then I have to tell him to use a condom.
He is killing people otherwise.” This surely
is a sensible, and pro-life position, arising out
of deep and considered thought, even if it seems
to go against the official teaching.
Behind the media hype, the Catholic church has
a good record with regard to pastoral care for
people with HIV and has issued strong statements
about the evils of stigma. Although the media has
failed to appreciate it, there has been a debate
and a plurality of opinions for some time on this
issue and a growing call for change.
So, I was pleased to hear that the Vatican is
considering a statement on HIV and condom use in
particular. Pope Benedict has apparently asked
the Vatican's council for health care to study
the issue of prevention and it is expected that
the Vatican will soon issue a document about the
use of condoms ‘by persons who have grave
diseases, starting with Aids’.
Part of the reason for the plurality of opinion
within the church is that there isn’t a clear
framework of teaching around HIV prevention. Official
church teaching simply hasn’t kept up with
the reality of HIV and Aids. The ban on condom
use is based on preventing artificial methods of
contraception hailing back to a document from 1968 – well
before HIV was recognised. Whilst it is a relevant
teaching on contraception (though in practice largely
ignored by the catholic community), it simply doesn’t
stack up when it comes to HIV. It is widely accepted
that using a condom to prevent HIV transmission
is not preventing life, rather it is preventing
the transmission of death. The church leadership
has, for too long, failed to understand the essential
complexity and difference that the HIV/Aids pandemic
represents. Whilst there has been a lot of thinking
and writing on the issue from many experts, there
is a lack of teaching explicitly on HIV from the
hierarchy.
A new document is potentially historic. There
is a growing voice calling for change, but there
are also those who would be dismayed by any such
change, seeing it as a weakness in the church’s
moral stance. The battle between these factions
is about the very nature of church – is it
an institution that dictates and tells people what
to do, or is it one that supports, encourages and
empowers people in their daily and complex struggles.
Cardinal Carlo Martini, has recently added to
the debate saying that with married couples, where
one partner had HIV/Aids, the use of condoms was ‘a
lesser evil’. Although retired, he is the
most senior church leader to join the many people
from all levels in the church seeking a change
in the teaching on HIV prevention. His comments
have increased expectation that this forthcoming
document may be more liberal, or at least more
understanding of complexities. Three principles
are at play in the question of future teaching
on the issue: that of lesser evil (the least damaging
between two choices), that of double effect (where
the purpose of preventing transmission of death
also has the side effect of preventing conception)
and the primacy of conscience (where individuals
ultimately have to make considered and thoughtful
choices). It is this final category that is most
contentious for those people who see the authority
of the church as the important thing!
The addition of Cardinal Martini to the voices – and
the fact that he has not faced any public rebuke,
adds to the expectation of a more liberal position – or
at least some recognition of the coherence and
strength to the argument that condoms have a role.
Pope Benedict is a man of great intellect and strong
theological prowess. I have no doubt that he sees
the contradictions and inherent flaws in the vacuum
that is current teaching. Although many liberals
greeted his election to Pope with trepidation,
perhaps it is only a conservative who could make
this most liberal of changes.
No one should expect the church to say ‘condoms
for all’! The insistence that abstinence
is the only 100% effective prevention is right
- but in such a matter people need support to make
choices, not just instruction. HIV raises real
questions about powerlessness, violence, vulnerability
and poverty. For so many who are the poorest and
the most vulnerable in the world, the issues of
sexual violence, exploitation, stigma and the lack
of access for treatment need addressing and fast.
I hope that this document will have the courage
to go beyond the totem of the condom and recognise
that a diversity of methods of prevention are needed
to respond effectively in what are complex situations.
It is also time for the church to speak out about
these structural injustices without its position
on condoms acting as a deflection. It is time for
the teaching to come up to date with the reality.
A change is long overdue.
For those front-line workers on HIV, having some
up to date, explicit teaching on HIV will provide
a clearer framework in which they can support people
in making complex and difficult moral choices.
In so many respects the church encourages people
to think for themselves in their life choices.
Greater understanding and compassion will strengthen
the church in this work. Closing up the condom
cul-de–sac will enable a more realistic debate
of the issues and will also mean that the fundamental
message of the church – that of respecting
human life and human dignity especially for the
poor and powerless – can be shouted from
the roof tops.
Christine Allen is the Director of Progressio,
an independent Catholic organisation working
for sustainable development. She is writing in
a personal capacity. Go to www.progressio.org.uk for more information. |
This
month
Archive
of past articles