Choice and Compliance:
The Unavoidably Human Aspect of Human Sexuality
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By Rebecca Oas, PhD
WASHINGTON, D.C., JUNE 13, 2012 (Zenit.org).- It could be said that the common enemy of the diet industry and the junk food industry is self-control.
Information from the World Health Organization indicates that global obesity has doubled since 1980, which suggests that self-control is not winning the fight. Many tactics have been attempted to curb this trend, due to the heavy cost of obesity, both to the individual’s health and the society’s health care system. Educational programs have been implemented to teach children good habits early in life, taxes have been levied against foods deemed to be nutritionally lacking, and restrictions have been placed on where and how such foods can be accessed. A recent attempt to ban the sale of soft drinks larger than 16 ounces in New York City drew intense scrutiny, although it ultimately failed to pass into law. Meanwhile, popular diets lure people to join programs promising quick results “without dieting or exercise,” to quote a common slogan.
While psychologists tout the benefits of self-control and suggest that it can be increased through practice, it’s easy to see why campaigns to improve societal health don’t focus on this angle, and not only because impulsive consumption provides economic stimulus. Self-control, self-denial, and a willingness to forego immediate gratification are fundamentally moral concepts. A recent column in Time Magazine presented the notion that self-control, as highlighted during Lent, has benefits beyond the spiritual, referring to this as “the open secret of all religions”. Nonetheless, even if you manage to convince people that self-control has its advantages, developing it in a society that emphasizes convenience, sensory pleasure, and material acquisition is an uphill battle.
One of the central difficulties in the field of public health is the fact that influencing large populations of people to make healthier choices is extremely difficult. This struggle is echoed in the realm of morality as well – both priests and medical doctors know that the advice they give in a confessional or examination room may fail to be effective when met with a lack of compliance on the part of the penitent or patient.
Nowhere is the uneasy association of public health and public morality more fraught with controversy than in the area of sexual behavior. While religious teachings, such as those of the Catholic faith, focus on self-control and a view of human sexuality in the context of the divine plan, public health officials focus on pragmatism, arguing that people will engage in potentially risky behavior regardless of the consequences, particularly when the behavior presents immediate sensory rewards. Public health advocates pay nominal tribute to the fact that reserving sexuality for a faithful and committed marriage affords the optimal outcomes both for the sexual health of the individual and the long-term well-being of the resulting children, but are then quick to point out that many people do not live according to this standard, even among those who claim to uphold it, and cite studies linking increased emphasis on abstinence-only education with increased rates of unintended pregnancy among teenagers.
The gap between “ideal” and “typical” behavior exists among users of contraceptives as well as those who aspire to be abstinent. A recent survey of women who identify themselves as being sexually active and desiring reversible contraception measures revealed that the women overestimated the effectiveness of the contraceptives, especially those which rely more heavily on human compliance, such as condoms, pills, injections, patches, and rings. In fact, nearly 60% of participants overestimated the ability of these measures to prevent an unintended pregnancy, a fact which the study’s authors attributed in part to the information contained in the manufacturer’s packaging of these products, which report failure rates with the assumption of perfect use.
It is worth pointing out that this survey was conducted as part of a program designed to promote the use of long-acting reversible contraception (LARC), including intrauterine devices and implants. Another study published in The New England Journal of Medicine reported that approximately half of unintended pregnancies are attributable to contraceptive failure, emphasizing human error as the primary cause, again proposing LARC methods as the best solution. However, the effort to promote the use of LARC methods may come at a cost: a recent report in the British Medical Journal indicates that non-oral contraceptives, including LARC methods, as well as contraceptive rings, carry a higher risk of serious blood clots than the pill, and the accompanying press release urged women to consider switching to oral contraceptives.
The idea that humans are not perfectly consistent or reliable is certainly no new revelation: the fallen nature of man is a central teaching of Christianity, and our capacity for error is unavoidably evident to religious and non-religious people alike. So it should come as no surprise that people often fail at both abstinence and contraception, in much the same way as we often fail to exercise moderation when we eat. But where the religious and the secular world diverge is in the response after a failure occurs. Within the Catholic Church can be found methods to grow in virtues like self-control, the Sacrament of Confession for when we fall, and a spirit of gratitude and welcome for new life, even when its arrival is unintended. In contrast, the secular world, having long-since abandoned sexual self-control, can only view unintended pregnancy as a tragedy, and one to be avoided by adopting forms of contraception that place a woman at increased risk of life-threatening blood clots, for the sake of avoiding maternity.
In the United States, there has been widespread controversy regarding the sex education curricula presented in public schools, with some favoring “abstinence-only” education and others touting a more comprehensive approach. Critics of “abstinence-only” education object to its moralistic tone, exemplified by the language in its definition that condemns all extramarital sexual activity. While some might argue that this standard, which derives from Judeo-Christian morality, should not be part of a curriculum presented to students who may or may not embrace that worldview, the separation of public health and public morality into discrete boxes is apparently only desirable when it curtails the establishment of moral standards. When Pope Benedict XIV reiterated the Church’s stance against barrier methods of contraception in 2009, it ignited a huge controversy, partly due to the tendency of many news outlets to take his words out of context, but also because he challenged the notion that condoms are the best solution to the worldwide AIDS epidemic. In fact, he went further; lost in the media tempest regarding condoms was his plea for the “humanization of sexuality”.
The Holy Father’s words call us back to the recognition that humans are endowed with intelligence and free will, and while this means we are capable of falling, it also means we are able to succeed and improve ourselves through the development of virtue. However, the harmony that exists within the Church’s teachings on human sexuality cannot be replicated outside of a framework that acknowledges the importance of self-control, the procreative aspect of human sexuality, and the value of human life at all stages. Only when we acknowledge the harms caused by lust and gluttony can we fully appreciate the benefits of chastity and temperance, and only when we embrace self-mastery can we know both its difficulty and its desserts.
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Rebecca Oas, Ph.D., is a Fellow of HLI America, an educational initiative of Human Life International. Dr. Oas is a postdoctoral fellow in genetics and molecular biology at Emory University. She writes for HLI America's Truth and Charity Forum.
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4) Eisenberg DL, Secura GM, Madden TE, Allsworth JE, Zhao Q, Peipert JF. Knowledge of contraceptive effectiveness. American Journal of Obstetrics and Gynecology. 2012 Jun;206(6):479
5) Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, Secura GM. Effectiveness of long-acting reversible contraception. The New England Journal of Medicine. 2012 May 24;366(21):1998-2007.