Sterilization

STERILIZATION. - It is a surgical intervention on the reproductive apparatus, both male and female, aimed at preventing the formation or the natural utilization of the sexual elements. Sterilization does not aim at the total destruction of the sexual glands, and is therefore distinguished from castration which, by also affecting the portions with the value of endocrine glands, leads not only to the loss of the faculty of procreation but also to that of the secondary sexual characteristics and to serious general alterations of the entire organism.

Sterilization, particularly if brought about by surgical means, can, in general terms, be considered reparable, albeit with difficulty and uncertain outcome, for which reason it cannot be considered in an absolute sense a definitive impediment to procreation.

The intervention can be of two kinds: 1st, elective action on the germinal epithelia, so as to destroy the spermatogenetic and ovogenetic activity of the respective sexual glands; 2nd, destruction of the patency of the ducts carrying the reproductive elements, in order to prevent their meeting. To the first kind belong the well-dosed irradiations of the specific sexual glands with X-rays; in women another method is that (experimented with particularly in America on animals and in Russia also on women) of obtaining a sort of immunizing vaccination against the male seed by repeated intramuscular injections of it; thus up to 8-10 months of sterility are obtained after each treatment. Of the second kind are vasectomy or deferentectomy in man and oophorectomy (fallectomy, tubectomy, salpingectomy) in woman, which consists in the cutting and extirpation of a stretch of the ducts along which the sexual elements are conveyed. In man these are operations of modest extent, for which, however, complications, at times even of notable gravity, are not excluded. In woman, in whom a laparotomic intervention is necessary, the extent and gravity are greater.

Sterilization is imposed by law in various countries, as a eugenic means or as a judicial penalty. In particular, in America it existed as a legal measure as early as 1907 in the State of Indiana; about twenty States of the Confederation have since then successively adopted legal and eugenic sterilization. The conditions vary; thus, for example, in California (where sterilization has been imposed since 1912) anyone who has committed at least twice the crime of violation or seduction of a person, or three times other classes of crimes, or who has been condemned to perpetual penalty if a sexual and moral depraved person, or the violator of a minor under 10 years of age, may be subjected to legal sterilization; to these categories are added idiots and certain other mentally infirm persons on the proposal of the director of the institution in which they are interned. States in the forefront for the application of the law, besides California, are Kansas and Oregon. Laughlin, of the Eugenics Record Office, would want the sterilization of no fewer than 100,000 defectives a year until reaching 15 million individuals; only thus, according to him, could one hope for a satisfactory purification of the American people. In the 28 North American States in which sterilization is admitted by law, in 1950 alone more than 1500 were performed, while since the beginning of the promulgation of the law more than 21 thousand men and about 31 thousand women (altogether 52,233 individuals) underwent it (data of the «Human Betterment Foundation of California»).

Legal sterilization was imposed in Germany, with the law of 14 July 1933, for all individuals affected by a hereditary ailment (congenital intellectual debility, schizophrenia, manic-depressive psychosis, hereditary epilepsy, hereditary chorea, hereditary blindness, hereditary deafness, serious hereditary physical malformations) or by grave alcoholism, with a request made by the interested party or coercively or upon denunciation by the official physician or the director of the hospital, nursing home, hospice or penitentiary. By 1935, 16,000 sterilizations had already been carried out. The events of the war have in fact put an end to the aforesaid law. Switzerland has already practiced coercive sterilization by law for many years in certain Cantons: thus in that of Zurich and of Vaud (law of 3 Sept. 1928). In Finland, where as early as June 1929 there existed a law authorizing the sterilization of the mentally abnormal at the expense of the State, a set of three laws has recently been promulgated legalizing respectively abortion, sterilization and castration, indeed imposing these last two interventions in determined circumstances (transmitters of physical and psychic defects, sexual abnormals). In Denmark, since 1929 there has existed a law that permits voluntary sterilization for those who might give origin to defective offspring; for the mentally infirm the decision is taken by the legal guardian. Sterilization is legalized also in Japan (in 1950 about 11,500 were performed) and is in the process of being legalized in other countries.

THE MORAL PROBLEM

From the moral standpoint, sterilization is gravely unlawful because it is a grave mutilation (v.) that deprives the individual of the natural right to procreation and renders him doubtfully capable of contracting a valid marriage. Nor can it be imposed by law by the State, since the State cannot have over the person of the citizen powers superior to those the citizen possesses over himself (cf. the encyclical Casti connubii: AAS, 22 [1930], p. 565). Man, in fact, "may dispose of individual parts so as to destroy or mutilate them, when and to the extent required for the good of the being as a whole, to ensure its existence, or to avoid, and naturally to repair, grave and lasting harms, which otherwise could not be removed or repaired"; on the other hand, "man in his personal being is not ordered ultimately to the utility of society, but rather, on the contrary, the community is made for man": address of Pius XII to the participants in the First International Congress of Histopathology of the Nervous System of 14 Sept. 1952 (AAS, 44 [1952], p. 786); cf. also the address, The apostolate of midwives, of 29 Sept. 1951 (ibid., 43 [1951], pp. 843-44).

It is irrelevant that sterilization touches only a minimal material part of the organ; the criterion for judging the gravity of the mutilation is in fact the importance of the vital function impaired, which in this case is most grave. Likewise, the fact that one has bound oneself to perpetual chastity does not remove the malice of sterilization, which is given by man's usurpation of a right of ownership over the members of his own or another's body; a right that belongs only to God. For the same reason, sterilization performed for the purpose of preventing harmful effects for the offspring (eugenic purposes) is not lawful. Even if the eugenic motives recommending it were most well-founded and scientifically certain, there would always remain the intrinsic unlawfulness of the act, because of the violation of a natural right of man, the right of disposal of one's own genetic capacity. The harmful effects of hereditary diseases are to be diminished only by lawful means. Sterilization is lawful only within the limits of the lawfulness of mutilation, that is, if it is necessary for the health of the body (the part, in fact, may be sacrificed for the whole) and the consent of the patient is had. However, pure criminality cannot be placed on the same level as disease, regarding it as a form of malady. Disease is a physical phenomenon, whereby the organism is not as it ought to be; pure criminality is the action or series of actions of one who does not act as he ought to act; it is therefore an evil that depends on a vicious orientation of the will and cannot be corrected by violence (compulsory sterilization).

The question presents itself under another aspect if one asks whether it is lawful to apply sterilization as a punishment. Here the answer may be affirmative, if two conditions are met: a) that the punishment be applied to a man truly guilty of a grave crime. But physical or mental illness (dementia, idiocy, etc.) is not a crime and therefore is not liable to punishment, which in this case would be sterilization; b) that the punishment be good from the standpoint of criminal law, that is, serve to attain the ends proposed by criminal law (restoration of public order, emendation of the delinquent). Now from this standpoint sterilization does not present itself as an effective means to the ends indicated, inasmuch as it does not entail the deprivation of a good that is esteemed; indeed, for many who are set on vice, it can constitute a liberation from eventual burdens of offspring.

Two decrees of the Holy Office (21 March 1931 and 21 Feb. 1940: AAS, 23 [1931], pp. 118-121; 32 [1940], p. 73), to the question whether sterilization, perpetual or temporary, in man or in woman, is lawful, answer in the negative, declaring it, even on eugenic grounds, forbidden by the natural law.

With regard to the question whether the sterilized are to be considered as affected by impotence and therefore excluded from marriage (v.), the majority of theologians (among them also Card. P. Gasparri in Tract. can. de Matrimonio, I, Appendix, Vatican City 1932, pp. 467-71) consider them as such; since, however, the question is disputed by others (v. A. Vermeersch, Theologia moralis, t. IV, Rome 1933, p. 45), in the possibility that the harm suffered may be repaired by a subsequent operation (provided, however, that this does not expose one to danger of life or to grave harm to health), marriage can be granted to the sterilized. The S. Rota, however, in one of its sentences (25 Oct. 1945) declared invalid the marriage of a sterilized person. Sterilization undergone after marriage does not forbid its use.

Giuseppe de Ninno-Pietro Palazzini