Should Catholic hospitals distribute needles and condoms?

A clean needle exchange program that distributes condoms is hosted in the parking lot of an Ohio Catholic hospital, and one Catholic bioethicist thinks the system can do better.

Cincinnati, Ohio (CNA) - "I would say Catholics are called to more. At a minimum, Christ articulated a higher standard for moral life than what other people are doing," Catholic bioethicist John Brehany told CNA April 4, addressing the needle exchange aspect in particular. 
The hospital statement justifying the practice stressed harm reduction.

 "It seems to me that they have a good motive," Brehany said. "They want to help people, they want to help people avoid harm. That's understandable, is that good enough? Is that what Christians are called to do?"
 Brehany is director of institutional relations at the National Catholic Bioethics Center, which handles inquiries on Catholic bioethics issues. He has a doctorate in healthcare ethics, a licentiate in sacred theology and is past executive director of the Catholic Medical Association.
 The Mercy Health Clermont Hospital in Batavia, Ohio is hosting in its parking lot an Exchange Project program that offers condoms as well as injection equipment and other health services, the Cincinnati Enquirer reports.
 "First and foremost, the needle exchange services program is a harm reduction program aimed at reducing the spread of sexually transmitted diseases, including HIV and Hepatitis C," Mercy Health spokesperson Nanette Bentley told CNA April 3. "The program includes needle exchange, access to testing and condoms as a holistic approach to harm reduction."
 "When clients enter the van, they enter the property of Hamilton County Public Health," Bentley said. "The van is staffed solely by employees of Hamilton County Public Health and all services are provided by those employees."
 "Mercy Health â€" Clermont Hospital provides a central location for the van to offer its harm reduction program but does not provide any services on the van," she added, saying that Mercy Health provides "many other medical and preventive services for patients with substance abuse issues."
 In Kentucky, the St. Elizabeth Healthcare system hosts the needle exchange program in parking lots at its Covington hospital and at St. Elizabeth Urgent Care in Newport. However, these programs will not distribute condoms. 
"St. Elizabeth Healthcare is dedicated to caring for our patients' medical needs without compromise of the Catholic Church's teachings concerning birth control," Guy Karrick, a spokesman for St. Elizabeth, told The Cincinnati Enquirer. "We are going above and beyond for our community to get a program in place as quickly as possible."
 St. Elizabeth considers hospital property to be bound by Catholic teaching, such as the U.S. bishops' Ethical and Religious Directives for Catholic Health Care Services.
 "Catholic health institutions may not promote or condone contraceptive practices," one directive reads.
 Karrick did suggest the program might be best off on health department grounds.
 Brehany said he couldn't adequately assess the entire program since he did not have all the details. He also stressed that issues of cooperation in evil are among the most complex in moral theology. While some Church teachings are clear and settled, others are not. For instance, the use of contraception in marriage is clearly forbidden, but Church teaching on the ethics of using condoms to reduce the transmission of disease outside of marriage is less developed.

In 2010, Pope Benedict XVI told journalist Peter Seewald that while condoms could not be considered "a real or moral solution," their use by homosexual prostitutes might be considered "a first step in the direction of a moralization, a first assumption of responsibility."

Benedict later clarified that "naturally the church does not consider condoms as the authentic and moral solution" to the spread of AIDs or other other sexually-transmitted diseases.
 "At the National Catholic Bioethics Center, when it comes to the question of justifying the use of condoms to prevent disease transmission, we've always argued against that," Brehany told CNA. "One reason is that Pope Paul VI's 1968 encyclical Humanae Vitae teaches that every sexual act must retain its essential openness to procreation."
 In addition, he said, "If someone has a dangerous disease, really, the better ethical action is not to expose someone else to it at all."
 Dr. Lynne Saddler, district director of the Northern Kentucky Health Department, voiced gratitude for the partnership with St. Elizabeth's, the Catholic system that barred condom distribution.
 Although the National Harm Reduction Coalition of New York City praised St. Elizabeth's participation in the program, it advocated that the system add condom distribution "as part of a comprehensive HIV prevention strategy for a particularly vulnerable population."
 Dr. Judith Feinberg, who ran the first needle exchange program in the Greater Cincinnati area in 2014, said the program was about doing anything possible to keep people safe.
 "The whole point is to prevent disease, and the condoms are part of preventing disease," she said.
 According to Brehany, the issue of cooperation in evil is "complex" and must be evaluated on several factors including intent and the nature of one's involvement with another person's unethical action. Catholic teaching, especially as taught in St. John Paul II's 1993 encyclical "Veritatis Splendor," rejects both a utilitarian mode of thinking and an ethical approach based only on good intentions or good consequences. 
Further, those cooperating in moral evil must always be aware of whether their cooperation might cause others to believe that a practice is morally allowed.
 "Adequately discerning the effect of our actions on other people's faith is always a consideration in issues of cooperation," said Brehany.
 As for needle distribution, while Church teaching is less developed, he suggested that a clean needle distribution would be more justifiable if the goal included weaning someone off drugs, rather than intending to help them maintain their drug use in a manner that merely reduced the risk of spreading disease.
 CNA sought comment from the Cincinnati archdiocese, but was referred to Mercy Health.

The Mercy Health system has hospitals in Ohio and Kentucky. Its sponsors include the Sisters of Mercy, the Sisters of the Humility of Mary, and the Franciscan Sisters of the Poor. 
The St. Elizabeth Healthcare system is sponsored by the Diocese of Covington. It operates six facilities in northern Kentucky.