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Compassion, not Capitulation, on AIDS

The University of San Francisco (USF) recently awarded Bishop Kevin Dowling of South Africa an honorary degree. Dowling – alone among his fellow South African bishops – is known for his “courageous stance” (as USF described it) against the Vatican on condom use. But his comments on AIDS deserve careful scrutiny – and not only on the moral front.

Let’s start with epidemiology. The bishop’s descriptions of his personal encounters with the AIDS-afflicted show deep concern for the poor, the vulnerable, the sick. He seems to regard poverty, prostitution, and similar scourges, however, as the driving forces behind the spread of AIDS and the rationale for accepting condom promotion: “Unfortunately, extreme poverty is driving particularly vulnerable young women to extreme positions. They are forced into transactional sex.” Given these desperate circumstances, he says, “the only solution we have at the moment is condoms.”

But unlike many other infectious diseases, HIV is associated not with poverty, but with higher economic status across Africa. The United States has funded Demographic and Health Surveys that have found in country after country that HIV rates are higher among the better off and even the better educated. Furthermore, prostitution simply does not account for a large share of HIV transmission in southern Africa.

AIDS is primarily driven by multiple sex partners among both men and women in southern Africa. A handful of African countries have managed to alter this pattern of behavior, and have seen a subsequent decline in AIDS. Not so for South Africa, where multiple partners and high rates of AIDS persist. Condoms, which have been widely promoted, simply do not account for the few cases of declining AIDS rates in Africa. Pope Benedict XVI has a better grasp of these realities than do his vocal detractors in the media and in several European governments.

As to Dowling’s support for condom use because of men who disregard moral norms and recklessly impose themselves on women, Fr. Michael Czerny of the African Jesuit AIDS Network provides a clearheaded response: “It is obviously a total illusion to imagine that a sexual aggressor could ever be persuaded to use a condom by the Pope, the State, an NGO or anyone else.”

South African anthropologist Suzanne Leclerc-Madlala acknowledges that “our hip-hyped AIDS prevention campaign and its condom promoting ‘have fun but play safely’ message has thus far failed us as a people.” The painful evidence, not religious faith, led her to challenge her peers, and to promote abstinence and fidelity “unapologetically as a modern and relevant public health message.”

That’s also probably where a bishop should come down too.

We cannot expect a prelate to have a command of HIV epidemiology – particularly because in some respects it may be counterintuitive. But we can expect him to have a command of moral theology – and a certain measure of hope that people can respond to the Good News.

By advocating condom use, Dowling appears to endorse a kind of consequentialism, by which a given course of action can be justified by its outcome, and no action is categorically ruled out. This mode of ethical reasoning is explicitly rejected by the Catholic Church, most recently in Veritatis Splendor. Sadly, he is not alone. Even some official statements by national Church bodies such as “AIDS: Society in Question” in France and “The Many Faces of AIDS” in the United States have taken similar approaches.

“Abstinence before marriage and faithfulness in a marriage is beyond the realm of possibility here,” Dowling insists, to the delight of overtly dissenting groups such as Catholics for Choice, sponsors of a campaign called “Good Catholics Use Condoms.” But that statement also reveals a surprisingly pessimistic – even condescending – view of Africans and other Catholics.

Capitulation, in other words, rather than compassion. It manifests too little faith in human beings and their capacity for moral behavior, even as it puts too much faith in technology – if that is what we can call a condom. After all, is the law not stamped on every human heart – including those of young males in South African dioceses?

No doubt those exposed to degrading circumstances and the threat of AIDS require a liberating alternative, pastoral sensitivity, and mercy. Bishop Dowling works tirelessly at many works of mercy. But as Cardinal Biffi of Bologna cautions in his memoirs, embedded within the legitimate desire to be pastoral is a “danger of forgetting that the first and irreplaceable form of “mercy” for wayward humanity is the “mercy of truth.” Without this truth, without a standard of behavior to which all persons are called, mercy has no point of reference, and can only approximate the real thing.

The behaviors that drive HIV transmission need to be challenged, not accommodated. This will require a bold evangelization of culture – something the United States needs as well. After all, a full quarter of American teenage girls are burdened by sexually transmitted infection.

Bishop Hugh Slattery has taken up that very challenge in the nearby diocese of Tzaneen, which is now home to one of the most dynamic responses to AIDS on the African continent. (See for yourself.)

Maybe, in the interest of “dialogue”, the University of San Francisco will invite Bishop Slattery next year.

Matthew Hanley

Matthew Hanley’s new book, Determining Death by Neurological Criteria: Current Practice and Ethics, is a joint publication of the National Catholic Bioethics Center and Catholic University of America Press.