Answers on "uterine isolation" (sterilisation)

Foundation: Congregation for the Doctrine of the Faith.
sourceHoly See.
language Original: Latin.
Copyright the Latin original: No.
English translation: Holy See.
Copyright of the Spanish translation: No.
Date: 31 July 1993.
Checked on 7 April 2003.

Answers to questions submitted on "uterine isolation" and other issues

The Cardinal members of the Congregation for the Doctrine of the Faith, to the questions presented at the Ordinary Session and listed below, have answered as follows:

1st. When the uterus (for example, during childbirth or cesarean section) is so seriously damaged that its removal (hysterectomy), even total, is medically indicated in order to avoid a serious current danger to the life or health of the mother, is it permissible to follow such a procedure, even if it results in permanent sterility for the woman?

Answer: Yes.

2ª. Where the uterus (for example, as a result of previous caesarean sections) is in such a state that, although it does not in itself constitute a present risk to the life or health of the woman, it is no longer foreseeably capable of carrying a future pregnancy to term without danger to the mother (a danger which in some cases may even be serious), is it permissible to remove it (hysterectomy) in order to prevent any such future danger arising from the pregnancy?

Answer: No.

3ª. In the same status described in question 2, is it permissible to replace hysterectomy with tubal ligation (procedure also called "uterine isolation"), bearing in mind that the same aim of preventing the risks of a possible pregnancy is achieved with a procedure much simpler for the doctor and less burdensome for the woman and that, furthermore, in some cases, the sterility caused in this way may be reversible?

Answer: No.

Explanation

In the first case, hysterectomy is lawful insofar as it is of a directly therapeutic nature, even if it is expected to result in permanent sterility. In fact, it is the pathological condition of the uterus (for example, due to haemorrhage which cannot be stopped by other means) which makes its removal medically indicated. The latter, therefore, has as its own purpose to avoid a serious present danger for the woman, independently of a possible future pregnancy.

From the moral point of view, the case of the procedures of hysterectomy and "uterine isolation" in the circumstances described in questions 2 and 3 is different; here we find ourselves in the moral supposition of direct sterilisation, which, in the document Quaecumque sterilizatio (AAS LXVIII 1976, 738-740, n. 1), is defined as an action which "has the sole immediate effect of rendering the generative School incapable of procreation". "Therefore (the document continues), despite any subjective good intentions of those whose interventions are inspired by the cure or prevention of a physical or mental illness, foreseen or feared as result of a pregnancy, such sterilisation is absolutely forbidden according to the doctrine of the Church".

In reality, the uterus, as described in question 2, does not constitute in se and per se any current danger for the woman. Indeed, the proposal to replace hysterectomy by "uterine isolation", under the same conditions, sample precisely because the uterus is not in itself a pathological problem for the woman. Therefore, the procedures described above do not have a therapeutic character as such, but are placed on internship in order to make future sexual acts, in themselves fertile, freely performed, sterile. The aim of avoiding the risks for the mother resulting from a possible pregnancy is therefore pursued by means of direct sterilisation, which in itself is always morally illicit, while other morally licit ways remain open to free choice.

The contrary view, which considers the aforementioned practices referred to in questions 2 and 3 as indirect sterilisation (licit under certain conditions), cannot therefore be considered valid and cannot be followed on the internship of Catholic hospitals.

The Supreme Pontiff John Paul II, in the audience granted to the undersigned Prefect of the Congregation for the Doctrine of the Faith, has C the above-mentioned answers and has ordered their publication.

Rome, at the headquarters of the Congregation for the Doctrine of the Faith, 31 July 1993

+ Joseph Card. Ratzinger, Prefect
+ Alberto Bovone, Tit. Archbishop of Caesarea in Numidia, Secretary