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Sterilization

Why not? In these days of fully informed consent and of reduced trust in healthcare professionals’ advice, there is an ever-growing awareness that no method of family planning is either 100% effective against pregnancy or - with the exception of modern natural methods - without potentially significant side-effects. The holy grail for many couples eventually is a normal sex-life without the worry of pregnancy and children ever again.

Amongst healthcare professionals, sterilization appears attractive to those who like effective, surgical solutions to “problems” with – they hope – very little possibility that the patient will come back complaining about a series of family planning options, all found ‘ wanting’ sooner or later. The holy grail for such professionals is a one-off method of family planning, which involves patients having a normal sex-life without the clinician having the worry of seeing them ever again!

Seriously, there have been many learned articles about Catholic Church teaching and sterilization. Some are profound, but impenetrable for those of us without moral theology training. Put a lot more simply, humans come with Maker’s instructions. It is a peculiar type of compartmentalising of our sexuality, which ignores human anatomy and physiology and assumes that we can get away with sterilization, physically, psychologically or spiritually. Our society may be over-sexualised and unbalanced but perhaps, in a perverse way, it is acknowledging that our sexuality is part of all of what makes us human, even if society is mistaken in the ways in which this is expressed. We can build on this.

Perhaps, with the vast number of male and female sterilizations around the world, as Catholic healthcare professionals in the 21st century, we have another perspective and this leads us where we may feel a little threatened. The proportion of men and women who suffer long-term adverse physical effects as a result of surgical sterilization may be difficult to quantify and, as with any iatrogenic injury when healthcare professionals cannot always put the clock back or reverse side-effects easily, there is little incentive or funding to carry out large scale, high quality prospective longitudinal studies. However, there are some studies comparing adverse outcomes post sterilization in Britain and the USA. Finding any which follow patients up long-term for regret, change in life-circumstances (not a minor consideration with current divorce rates) and physical sequelae which have not been reported previously seems to be more challenging.

As happens so often, it is not until we really listen to our patients, that we recognise meddlesome medicine for what it is, an attempt to play God in ways which demonstrate our arrogance in thinking we can alter the human body to the design God would have chosen if He had only had the benefit of our knowledge over the time He took to create the human race!

Perhaps, it would be a good start to considering the lifelong responsibility we bear those who listen to our clinical advice if we were to use data from the USA, where, despite a very different healthcare system and vested interests in avoiding yet more medical negligence, there is much food for thought in what does reach both healthcare professionals and the public. The United States Catholic bishops conference web site www.usccb.org has an extensive list of medical references and contributions, mainly by doctors. It is worth browsing a number of related topics as the filing of material on such an extensive site inevitably leads to ‘finds’ in unexpected places, which don’t always show on using the ‘search’ facility.

For all the debate about the true adverse sequelae-rate, it must be remembered that the patients, who post their experiences on the net both in Britain and elsewhere, were mainly fit people who have to live with chronic symptoms - possibly including pain - for the rest of their fertile lives, for a family planning decision they now regret. Faced with healthcare professionals, whom they say are not listening to them, they list their symptoms on patient discussion forums to try to dissuade others from undergoing sterilization procedures. A little intellectual integrity combined with compassion would not go amiss on all sides!