The Linacre Quarterly

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HIV / AIDS

Richard White

To cite this article: Richard White (2009) HIV / AIDS, The Linacre Quarterly, 76:1, 89-91

To link to this article: http://dx.doi.org/10.1179/002436309803889340

Published online: 18 Jul 2013.

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 Case Studies

HIV / AIDS

by
Richard J. White

In the summer of 2008, the author interned at the National Catholic Bioeth-
ics Center in Philadelphia, Pennsylvania, where he compiled the following
case studies from their files.
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1. HIV and Condom Use

Case
A married, Catholic man becomes HIV infected. In order to avoid in-
fecting his wife with HIV, the man is considering using a condom during
sexual relations. Would the use of a condom be morally licit?
Response
There is an inseparable connection between the unitive and procreative
meanings of the conjugal act that is willed by God and unable to be broken
by man on his own initiative. In this case, the use of a condom would alter
the very nature of the marital act, rendering it directly closed to the trans-
mission of life. Pope Paul VI’s encyclical Humanae Vitae states: “It is never
lawful, even for the gravest reasons, … to intend directly something which
of its very nature contradicts the moral order, and which must therefore be
judged unworthy of man, even [if] the intention is to protect or promote the
welfare of an individual.”1 The most secure way to protect and promote the
welfare of the man’s wife would be through abstinence.
Condoms are not 100 percent effective. By using a condom during
the marital act, the husband would subject his wife to the risk of becoming
infected with HIV. Tragedy could be compounded by the conception of an

The Linacre Quarterly 76(1) (Feb. 2009): 89–91.

© 2009 by the Catholic Medical Association. All rights reserved.
0024-3639/2009/7601-0007 $.30/page.

February 2009 89
 HIV-positive child. The use of a condom would not truly protect the man’s
wife; it would subject both his wife and any children conceived to the risk of
contracting the deadly human immunodeficiency virus. Marital sexuality is
meant to be the expression of the deepest love of spouses, but freely and in-
tentionally choosing an act that could cause the death of one’s spouse would
indicate that the act was not an expression of the deepest love of a husband
for his wife. Instead, the decision to remain abstinent would properly and
authentically express that love.
The need for abstinence, however, is not the only concern raised by a
case like this. Feelings of guilt, anger, injustice, victimization, and power-
lessness may also need to be dealt with. The husband and wife should seek
out psychological and pastoral counseling so that they might cope with the
situation in a responsible manner.
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2. HIV Testing and Partner Notification

Case
A couple hoping to be married in the Catholic Church are both free of
AIDS, but the man suspects that he may have been exposed to HIV during
a blood transfusion. The man is reluctant to be tested, as he fears a positive
result may end the couple’s marriage plans. Is the man obligated to submit to
an AIDS blood test? If the results are positive, is the man required to inform
his fiancée?
Response
The 34th directive of the Ethical and Religious Directives for Catho-
lic Health Care Services states: “Health-care providers are to respect each
person’s privacy and confidentiality regarding information related to the
person’s diagnosis, treatment, and care.”2 While Catholic health-care fa-
cilities are generally obligated to respect the privacy and confidentiality of
all patients, it seems that, in this case, if there were a positive result, the
man’s physician should strongly encourage him to share the information
with his fiancée. If the man were to refuse to submit to testing or were
to refuse to inform his fiancée of the results, he would subject his future
wife to life-threatening circumstances. The seriousness of the AIDS virus
calls for the man to be tested and to inform his fiancée of the results. To do
otherwise on a serious suspicion of being infected would not be morally
permissible.
The situation should be handled with care, sensitivity, and openness.
The process of testing and notification will be difficult for both the man and
the woman. Both should seek out psychological and pastoral counseling to
help cope with the trials of testing and notification. Upon learning of the

90 Linacre Quarterly
 results, the couple is free to marry, but may not neglect risks of which they
are aware.3
3. Needle Exchange Programs
Case
A Catholic health-care provider is considering establishing a needle
exchange program. The program would provide clean needles to intravenous
drug users in exchange for used needles. The goal of the program is to limit
the spread of HIV. Is the program morally permissible?
Response
Intravenous drug users inject harmful drugs that lead to addiction and
serious health consequences. The act, in itself, can be considered self-harm.
The Catechism of the Catholic Church states, “The use of drugs inflicts very
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grave damage on human health and life. Their use, except on strictly thera-
peutic grounds, is a grave offense” (n. 2291). The injection of illegal drugs
by the intravenous drug user is, thus, morally illicit.
In this case, by establishing the needle exchange program, the Catholic
health-care provider would implicitly approve of the immoral act. While
the needle exchange program would provide clean needles with good inten-
tions (to prevent the spread of HIV), the program would, nevertheless, be
reasonably anticipated to encourage the evil act. If the Catholic health-care
provider were to establish a needle exchange program, the provider would,
thus, offer implicit formal cooperation in the evil of intravenous drug use.
Despite the good intentions of the Catholic health-care provider, for-
mal cooperation in evil, even when implicit, is never morally permissible.
Instead of implementing a needle exchange program, the health-care pro-
vider might offer counseling and HIV education programs to those at risk.

References
1
Pope Paul VI, Humanae Vitae, July 25, 1968, n. 14, http://www.vatican.va/holy_
father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_
en.html.
2
United States Conference of Catholic Bishops, Ethical and Religious Directives
for Catholic Health Care Services, 4th ed. (Washington, D.C.: United States Confer-
ence of Catholic Bishops, 2001).
3
Pope Pius XII, “Address to Hematologists,” September 1958.

February 2009 91