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Moral Responsibility Sexual Violence, Contraceptives Use, and the Principle of Self-Defense in Marriage Daniel Ude Asue* Abstract: With the assumption that women should have rights over their bod-
ies this essay argues that women who are sexually assaulted should recourse to emergency contraception as a form of self-defense. Sexual assault can result from domestic violence or during large scale conflicts (wars). This essay focuses in most part on domestic sexual violence which often occurs within the home among family members resulting into rape and at times incest. The most traumatizing cases are in-cidences of spousal rape that occur between HIV/AIDS discordant couples. The women who are usually the victims in African set-up can request their husband to use a con-dom as a form of self-defense. Introduction: Sexual violence refers to unconsented sex, that is, sex against some-
one's will. Sexual violence is usually divided into two: domestic sexual violence and conflict-related sexual violence. Domestic sexual violence occurs within the home among family members resulting into rape and at times incest.1 On the other hand, conflict-related sexual violence occurs often during warfare which gives room to rampant rape of women and children without impunity. This study focuses on an aspect of domestic sexual violence, which is sexual vio- lence between spouses. Married people who often force their spouses into sexual acts believe their actions are legitimate because they are married to each other. In reality this may be classified as spousal rape. In light of this, the overall scholarly agenda of this study discusses the meeting point between practical theology and, Catholic sexual ethics, and the intersection of pastoral life and patriarchal culture in Africa, specifically as relates to women. Specifically, this study focuses on the conflicts that exist between Catholic sexual ethics and women's reproductive health, and even further their right to 1 For more on sexual violence and domestic sexual violence, see Patricia Mahoney and Linda M. Williams, "Sexual Assault in Marriage: Prevalence, Consequences, and Treatment of Wife Rape," eds. J. L. Jasinski and L. M. Williams, Partner Violence: A Comprehensive Review of 20 Years of Research (Thousand Oaks, CA: Sage, 1998), Daniel Ude Asue (M.Sc. in Gender Studies, MA[Theology] in Church History and Polity, Ph.D. in
Practical Theology) is a priest of the Catholic Diocese of Gboko in central Nigeria.
Hekima Review, No. 50, May 2014 Sexual Violence, Contraceptives Use, and the Principle of Self-Defense in Marriage life, as seen in the context of African Catholic women's sexual decision-making when confronted with HIV/AIDS. Starting with the assumption that women should have rights over their bodies2 and all aspects of reproductive health, especially in defense of their lives, the study explores women's sexual narratives in a culture of patriarchal dominance from a theo-logical perspective. This study acknowledges the general treatment of women as non-persons in African cultures and their vulnerability as members of patriarchal societies. It also examines how women are excluded from sexual decision-making in the time of HIV/AIDS pandemic. It further engages Catholic moral tradition and the principle of self-defense on how the conflict between Catholic sexual ethics and reproductive health among African women can be resolved. It begins with the understanding of sex and rape within marriage.
Rape within Marriage
This study defines marital rape as any unwanted sexual penetration or genital con- tact that results from actual or threatened physical force; or whenever a woman is unable to freely give an affirmative consent.3 At times, there may be social coercion arising from cultural inhibitions that may pressure a wife into unwanted sex.4 There are many cultural beliefs that may provide fertile ground for this: a) the idea that a woman's sexuality is a commodity under her father and husband, b) belief that what happens between a husband and wife in the bedroom is totally their private affairs, c) a husband is entitled to sexual relations with his wife at any time, and d) that out of a sense of duty a wife is obliged to consensually engage in sex with her husband thereby making rape a non-issue in marriage. These are some of the stereotypes and misun-derstandings that appear to influence societal attitude to women that may become overwhelming for them to give in to unwanted sex in order to "conform to the norms." Under such circumstances women are not anything close to equality with men. It is against this background that a woman may either use a female condom for protection or request her HIV positive husband to use a condom for her protection. While this is not an ideal, the woman is obliged to use whatever is best possible for her self-defense for bodily health, in this case the condom.5 Women's experiences are often tragic.
A Tragic Pastoral Experience
In 2003, there was an incident at St. Gregory's Catholic Parish, Ikpayongo, Benue State in central Nigeria that demonstrates the effects of patriarchy and women's lack of rights on sexual decision-making.6 A family doctor tested a man for HIV; he tested 2 This right however, does not include the right to suicide or abortion. Further, the right over the body is a God-given right and needs to be exercised according to moral law. That right also includes the right to defend one's own life against unjust threats to one's life 3 Mahoney and Williams, Sexual Assault in Marriage, 113-118.
4 See Daniel Ude Asue, "Catholic Sexual Ethics and Tiv Women: A Case-Study of Pastoral Practice in Re- gards to HIV/AIDS" (Ph.D. diss., St. Thomas University, Miami, Florida, USA, 2012).
5 Asue, "Catholic Sexual Ethics and Tiv Women."6 This is a personal experience as the author of this work, while I was serving as the parish priest of St. Greg- ory's Catholic Parish, Ikpayongo, Benue State in central Nigeria when this incident occurred in 2003. The incident Hekima Review, No. 50, May 2014 positive, his wife was tested in turn and tested negative. The doctor counseled them on the necessity of practicing safe sex. As Catholics, the couple knew that the condom7 was unacceptable to the Church. As a result, the wife insisted on abstinence, and her husband initially complied. Influenced by cultural beliefs, the husband attributed his illness to "terrible bodily cold" (wuhe iyolugh in the Tiv language), ascribing its cause to his enemies. The man claimed that HIV is only a form of this "terrible bodily cold" and is non-transmittable. He even said that AIDS stands for "American Idea of Discour-aging Sex" in the interest of world population politics, suggesting the idea that HIV/AIDS is propaganda, part of a grand scheme to slow the growth of the African popula-tion. Supporting his stance with these dismissive comments, the man mounted intense pressure to have sex with his wife. The wife's initial resistance was overwhelmed, however, after her parents joined in the effort to remind her of her subordinate position and duty to her husband. She was told that it is not right for a wife to refuse having sexual intercourse with her husband. In addition, she was accused of having extramarital affairs that provided her sexual satisfaction and so made her despise her husband. Her family threatened to disown her, and reminded her that she belonged to her husband since a bride price had been paid for her. At last, she succumbed to the pressure. Today, both are deceased. The couple's six orphaned children were raised by an uncle who died five years later of the same disease.8 This story reveals the vulnerability of victims in a patriarchal society. Such realities raise practical pastoral questions in the midst of the immense cultural and social power of patriarchy. Should wives who have reason to suspect that their husbands are HIV positive be allowed to use condoms for protection? Should women have unprotected sex with their husbands and risk exposure to sexually transmitted diseases, especially in situations where producing children is no longer a key issue in the marriage? This study applies feminist ethics9 to argue that if an infected husband wants to have sex with an uninfected wife; the principle of self-defense10 allows the wife to defend her-self by any means necessary, including the use of condoms for protection. This would still be within the wider framework of catholic sexual ethics. This work argues that though Catholic sexual ethics is not a problem in Africa its application often leads to pastoral conflicts resulting to miseries in the lives of women. There is often the strug-gle between contemplative ethics and practical theological ethics in the face of African ethical dilemmas. left an indelible mark on me and has inspired me to do this work.
7 Though a condom does not absolutely guarantee protection, it is still effective at reducing the risk of sexu- ally transmitted diseases, including HIV. See American Foundation for AIDS Research, "Assessing the Effectiveness of Abstinence-Only Programs for HIV Prevention among Young People," Issue Brief 2 (Revised October 2007). 8 Personal communication with a member of the family who wants to remain anonymous, July 14, 2011.
9 Feminist ethics is a way of looking at how actions directed toward women could be considered right or wrong. Feminist ethics has emerged to address women's vulnerability in the face of patriarchy. 10 Catechism of the Catholic Church, 2nd ed., 2263-2264. CCC, 2264 explicitly teaches that, "Love toward oneself remains a fundamental principle of morality. Therefore it is legitimate to insist on respect for one's own right Hekima Review, No. 50, May 2014 Sexual Violence, Contraceptives Use, and the Principle of Self-Defense in Marriage Contemplative Ethics vs. Practical Theological Ethics
Contemplative ethics11 draws upon philosophical construction of morality that leads us to the ultimate truth of our lives. On the other hand, practical theological eth-ics12 incorporates the methodology of contemplative ethics but calls us not to disregard or be blind to the overriding evidence of ethical concern in the daily lives of Christian communities. While accepting that contemplative ethical approach has speculative in-cisiveness this paper argues that Africans are crying for a theology with eyes to see and eyes to hear. Most of the current ethical discourses in Africa stem from contemplative approach (deductive reasoning) and fail to take into cognizance the existing practices (inductive reasoning). In reality, most African Women lack the cultural resources to resist unprotected sex and the economic resources to obtain treatment. This gravely harms women's dignity as human beings, which is at the very core of Catholic social doctrine.13 Significant to this study is the fact that wives are commonly infected with HIV/AIDS when their husbands do not use adequate protection. Wives infection with HIV/AIDS is aggravated by cultural norms that allow men to have more than one wife. When in-fected women get pregnant, the unborn child is typically infected as well. Both women and unborn children are condemned to long lingering deaths for lack of protection. Catholic teaching respects the ABC (Abstinence, be Faithful, use a Condom) ap- proach to HIV/AIDS prevention and control, but with reservation. In the words of Archbishop Gabriel Charles Palmer-Buckle of Accra, Ghana, "the Catholic Church …offer[s] three methods to help solve this problem of AIDS in Africa: ‘A,' abstain; ‘B,' be faithful; ‘C,' chastity, which is in consonance with traditional African values."14 The Church's approach emphasizes control and fidelity to one partner, but not the use of the condom. The church's position, "From the public health point of view, it would represent a common sense return to the discipline's bedrock disease control principle: primary prevention."15 This study argues that wives requesting that their husbands use condoms may not be the best approach; however, in a culture where men dominate women, excluding the use of condoms for HIV/AIDS prevention is also not helpful. In such situations where women are coerced into having sex with HIV-positive husbands, condom use may be considered a legitimate form of self-defense. While this suggests that women requesting their HIV-positive husbands use condoms can be considered part of an HIV/AIDS prevention strategy in specific contexts, it clearly requires research work that brings these specific contexts in dialogue with various, sometimes conflicting moral principles. 11 Dennis J. Billy, CSSR, Contemplative Ethics: An Introduction (New York: Paulist Press, 2011), 1-8. Billy highlights the interrelationship between contemplation and action, draws out its importance to Catholic moral theol- 12 Daniel Westberg, Right Practical Reason: Aristotle, Action, and Prudence in Aquinas (New York: Oxford University Press, 2002), 1-6. On page 4, the work distinguishes between theoretic reasoning which aims at knowing something and practical reasoning which gears towards doing something. 13 Thomas D. Williams, The World As it Could Be (New York: Crossroad, 2011), 19.
14 John L. Allen, "Ghanaian Archbishop Says Church has Failed Africa," National Catholic Reporter, October 15 Matthew Hanley and Jokin de Irala, Affirming Love, Avoiding AIDS (Philadelphia: National Catholic Bioeth- ics Center, 2010), 3.
Hekima Review, No. 50, May 2014 Pius XI in Casti Connubi recognizes the importance of authentic reproductive health in sexual ethics, specifically noting the health of the mother.16 However, women's re-productive health can only be fully addressed when Catholic moral theology engages the narratives of people's sexual lives. Here, theologians and pastoral agents ought to strike a balance between contemplative ethics and pastoral theological understandings that deal with the concrete lived experiences of real African women as they struggle to make authentically Catholic sexual decisions in their daily lives.
Following the Catholic tradition, ethical, sexual decision-making should not be based solely on the object of the action without considering the intent and circum-stances behind the action. Deriving morality solely from the object of an act is a static way of reasoning, which belies the active stewardship of God and is ill-equipped to handle the process of human evolution.17 In morality, the problem is often not in the facts, but in their interpretation. The problem of interpretation lies between two moral theological methodologies, both of which flow from natural law reasoning: the physi-calist paradigm and the personalist paradigm. "In the physicalist paradigm the moral-ity and moral norms for human behavior are grounded in what is perceived as the structure of nature," whereas the personalist paradigm looks at the "concrete human person, in his or her matrix of relations, with his or her talents, concrete circumstances, personal history. To ignore any of these fundamental aspects of the human person would lead to a mistaken and misleading view of human nature."18 When making a Catholic moral judgment on sexual issues, this study argues that one ought to rely on the "three font" principle to determine the morality of human actions: (i) the object, (ii) intention, (iii) circumstances (and consequences) of the action.19 Thus, ethical truth is practical truth. So, this forms the basis for the church's response when it comes to rape even when it is spousal rape. The rules of emergency contraception may apply. The Church teaches that "marriage and married love are by their character ordained to the procreation and the bringing up of children."20 Therefore, "Each and every mar-riage act must remain open to the transmission of life."21 At the same time the church affirms that marital sexual act must be a free-mutual self-giving of couples to them-selves. When one partner uses marriage as a pretext to force "one's partner without regard to his or her condition or personal and reasonable wishes in that matter, is no true act of love, and therefore offends the moral order."22 This could be considered spousal rape. The Catechism of the Catholic Church describing rape as an offence against the sixth commandment says: Pius XI, Casti Connubi, sec. 58.
Charles E. Curran and R. A. McCormick, SJ, eds., Readings in Moral Theology No.8: Dialogue about Catholic Social Teaching (New York: Paulist, 1993), 256.
James T. Bretzke, SJ, A Morally Complex World (Collegeville: Liturgical, 2004), 37-38.
The object is an action rationally chosen by the will, the intention is the choice of the will to carry out an act (also known as the proximate end), and the circumstance is what is involved when all is considered. See Josef D. Zalof and Benedict Guevin, OSB, Catholic Ethics in Today's World (Winona: Saint Mary's, 2008), p.34.
20 Paul VI, Humanae Vitae, sec. 9.
21 Paul VI, Humanae Vitae, sec. 11.
22 Paul VI, Humanae Vitae, sec. 13.
Hekima Review, No. 50, May 2014 Sexual Violence, Contraceptives Use, and the Principle of Self-Defense in Marriage Rape is the forcible violation of the sexual intimacy of another person. It does injury to justice and charity. Rape deeply wounds the respect, freedom, and physical and moral integrity to which every person has a right. It causes grave damage that can mark the victim for life. It is always an intrinsically evil act. Graver still is the rape of children committed by parents (incest) or those responsible for the education of the children entrusted to them.23 The catechism is very clear that rape is "an intrinsically evil act." This means that it is evil by its very nature, and cannot be justified under any circumstance, and as such is objectively a mortal sin. Since rape is sexual violence, it lacks the properties of a hu-man act to be considered ordered to the unitive and procreative goals of marriage. That is why the U.S. Catholic Bishops' Ethical and Religious Directives for Catholic Health Care Services for instance states that, A woman who has been raped may defend herself against a conception resulting from sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medication that would prevent ovulation, sperm capacita-tion, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.24 A woman is not obliged when raped to allow the natural potential for conception to take its course as would be the case in consensual sexual relations. "The forced introduction of sperm is an act of aggression she may resist even through means that prevent the creation of new life."25 Though most rape treatment protocols recommend anti-fertility drugs to be administered within seventy two hours and over a period of several days, Catholics are particularly encouraged to seek for help within twenty four hours to prevent pregnancy. The emphasis is on stopping ovulation. Therefore, care should be taken to avoid abortion in the process of preventing pregnancy during rape. Even though drugs like Ovral may inhibit ovulation there are many contraceptives that affect the endometrium of the uterus resulting into an expulsion of an already conceived ovum. This then becomes abortion which is unacceptable in Catholic moral teaching.26 Here, there should be reasonable certainty that ovulation has not taken place and is not about to occur. It is within such a context the Catholic understanding of the principle of self-defense applies.
Catholic Tradition and Self-Defense
According to Thomas Aquinas, the first precept of the moral law is that "good should be done and pursued, and evil is to be avoided." All other precepts of the natural law are based upon this basic precept.27 The good in this case is the protection of human life. Thomas Aquinas further clearly states that when one is confronted with a threat to his or her life, one is obliged to use proportionate means of self-defense to 23 Catechism of the Catholic Church, 2nd ed., 2356. 24 United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care 25 Massachutts Catholic Conference, "Emergency Contraception," cycontraception, accessed on February 27, 2014, 26 Vatican II, Gaudium et Spes, sec. 51.
27 See Thomas Aquinas, Summa Theologica, I-II, q. 94, a. 2.
Hekima Review, No. 50, May 2014 protect his or her life.28 As shown in the incident at the beginning of this study, African women are commonly forced by their HIV-positive husbands to have life-threatening sexual intercourse with them. These women are obliged to defend themselves with the best possible means at their disposal, which may well be to request their HIV-positive husbands to use condoms in this case. Some moral theologians argue that condoms will increase promiscuity and encourage licentious lifestyles. Others who argue for the use of condoms note that condom use helps a husband avoid endangering the life of the vulnerable wife who might be coerced to have sex with an infected husband.29 Consensual sex within marriage is licit, but Catholic teaching holds that artificial contraception is immoral. In a forced sexual act, which involves social and cultural coercion that may be considered rape, African Catholic women are right to request an HIV-positive husband to use a condom as self-defense against the unjust sexual attack that involves a lethal contagion. As observed by Martin Rhonheimer, in 1961, the case of contraceptives and forceful sex (rape) was assigned to three eminent theologians who accepted use of contraceptives as a legitimate act of self-defense against forceful sex.30 In the 1960s, "during a period of civil war in what was then the Belgian Congo, religious women [nuns] were targeted for rape by various paramilitary groups. Ac-cording to Redemptorist Fr. Brian Johnstone of the Catholic University of America, the Vatican's Holy Office (forerunner to today's Congregation for the Doctrine of the Faith) gave permission for the nuns to use contraceptives,"31 as defense against rapists.32 The argument supporting this was that it was legitimate for the nuns to use contraception because they did not will the sexual act. Since the sexual act was being imposed on them through force by the rapists, their lack of consent to the sexual act meant they did not consent either to its unitive or procreative aspects.33 Justice demanded that the nuns do whatever best possible to avoid the procreative aspects of the sexual act in the same way as it was just for them to do whatever they could to avoid the unitive aspect of the sexual act. Their use of contraception was a legitimate defense against the con-sequences of a forced sexual act imposed on them by rapists, and a planned frustration of the consequences of a sexual act in which they did not willingly and freely chose to participate.34 A similar argument was used in 1993 to allow contraceptives for victims of rape in Bosnia.35 Gonzalo Miranda, director of the Institute of Bioethics at the Regina Apostolorum Pontifical University in Rome, argues that this does not cover only cases 28 Thomas Aquinas, Summa Theologica, II-II, q. 64, a. 7.
29 Jude Uzochukwu Njoku, "The Controversy of Condoms in the Unfolding History of Moral Theology: Be- tween the Sixth and Fifth Commandments." Paper presented at the conference of Catholic Theological Ethics in the World Church, Trent, Italy, July 24-27, 2010.
30 Martin Rhonheimer, OD, Ethics of Procreation and the Defense of Human Life (Washington, DC: Catholic University of America, 2010), 134.
31 John L. Allen, "Sometimes Bishops Say Yes," National Catholic Reporter, November 16, 2007, http://www.
32 Benezet Bujo and Michael Czerny, eds., AIDS in Africa: Theological Reflections (Nairobi: Paulines, 2007), 63-77. See also Bruce Johnston, "Nuns at Risk of Rape Can Take the Pill, says Rome," The Telegraph, April 28, 1996, 33 Jimmy Akin, "Contraception and Extra-Marital Sex," May 8, 2006, contraception_e.html. 34 Akin, "Contraception and Extra-Marital Sex,35 Andrew Brown, "Vatican Acts over Bosnian Rapes: Birth Control Ban Eased for Women at Risk," July 20, Hekima Review, No. 50, May 2014 Sexual Violence, Contraceptives Use, and the Principle of Self-Defense in Marriage of rape, but mentally handicapped women who fall under a similar situation. They too could licitly use the contraceptive pill as a form of legitimate defense. "Contraception is morally illicit when it accompanies a desired sexual act, but when a sexual act is imposed, and not wanted, then contraception represents the only form of protection."36 The emphasis is on the right of self-defense. Catholic tradition has a high regard for the health of people and, in this case, wom- en's reproductive health. The Second Vatican Council, calling for respect of the human person, classifies all acts that violate the integrity of persons as criminal.37 According to the Catechism of the Catholic Church, "Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good."38 Every human being has a right to life, and when this life is violated, going by the principle of legitimate self-defense, an individual is bound to defend him or herself. In a 1996 interview, then Cardinal Joseph Ratzinger as Prefect of the Congregation of the Doctrine of Faith (CDF) situated the issue of contraception as a pastoral issue that is best handled by an individual with his or her pastor in spiritual direction.39 In his own words, Pope Benedict XVI asserted, "I would say that those are questions that ought to be discussed with one's spiritual director, with one's priest, because they can't be projected into the abstract."40 While being sympathetic to the difficulties many Catholics express in understanding contraception, Benedict XVI states that, "We ought to look less at the casuistry of individual cases."41 He noted three things that are im-portant in the contemporary debate on contraception. First, the value of the child is at stake because the child is a new human being with divine blessings, and should not be seen as a threat and burden to anyone‘s interest. Second, it is not right to separate sexu-ality from procreation because a child becomes a product, quite apart from men and women in relationships. Third, people should know that human moral problems can-not simply be resolved with techniques and chemistry without recourse to how people live.42 Here, Bendict XVI highlights the importance of context in dealing with human acts, so that they are not treated as abstractions. This is potentially very fruitful, suggest-ing the importance of practical theology, pastoral discernment, and spiritual direction for persons like African Catholic women in the context of HIV/AIDS and forced sex.
In 2010, Pope Benedict XVI stated that prostitutes could use condoms in certain circumstances to prevent the transmission of HIV. The pope said that this can be a first step in the right moral direction, by assuming responsibility and awareness of one‘s immoral action as well as not infecting another person. The pope noted that the most authentic way of dealing with the evil of HIV infection lies only in a humanization of 36 See also Bruce Johnston, "Nuns at Risk of Rape Can Take the Pill, says Rome," The Telegraph, April 28, 37 Vatican II Council, Gaudium et Spes, sec. 27.
38 Catechism of the Catholic Church, 2nd edition, 2288.
39 Cardinal Joseph Ratzinger [Pope Benedict XVI], Salt of the Earth: The Church at the End of the Millennium, trans. Adrian Walker (San Francisco: Ignatius Press, 1997), 200-203. See also Thomas P. Rausch, SJ, Pope Benedict XVI: An Introduction to his Theological Vision (New York: Paulist Press, 2009). Rausch argues that Benedict XVI as a theologian believes in naming conventions.
40 Peter Steinfels, "Benedict on Contraception, Circa 1996," Commonweal, November 23, 2010, http://www.
41 Steinfels, "Benedict on Contraception, Circa 1996,"42 Steinfels, "Benedict on Contraception, Circa 1996," Hekima Review, No. 50, May 2014 sexuality, whereby people change their behaviors.43 Amidst the controversy that arose regarding the weight of the pope's statement, the CDF issued a statement in support of the pope's statement.44 The CDF remarks acknowledged that some people, Sought to soften the Pope's remarks by referring to a "male prostitute," but the German origi-nal referred to both male and female, and Fr Lombardi, the Vatican spokesman, subsequently pointed out that this was the Pope's intention. The CDF clarification double-underlines this, when, immediately after a paragraph defending Humanae vitae, it says that the Pope in his interview "refers to the completely different case of prostitution." The HIV infected prostitute (or her client) who fails to use a condom is adding to the sin of fornication by the (even more serious) sin of murder.45 This suggests ongoing evolution in Catholic tradition. When sex takes place be- tween two male prostitutes, contraception is not involved, but when sex takes place involving a female prostitute and a man, she is not just using a condom to prevent disease; contraception is at stake. Here the pope expands the tradition to take into cog-nizance the health of the person without disregard to the ends of marriage. The context places the contraceptive act of a female prostitute in a different understanding.46 The contraceptive act is consequent upon the prevention of sickness, but not as a result of direct intent. The Vatican spokesman, Frederico Lombardi, SJ, restated the pope's position that using the condom is the first step to taking responsibility and considering the risk to the life of the other person with whom one has a relationship. According to Anthony Fisher, the auxiliary bishop of Sydney, Australia, "the lack of a contracep-tive will or intention means this is not an act of contraception."47 Benedict XVI invokes Paul VI's encyclical, Humanae Vitae, which acknowledges that contraceptives could be used for health reasons,48 and is in line with John Paul II's apostolic exhortation, Consortio Familiaris, which upholds the principle of gradualness. By gradualness, a person recognizes a sin, and works progressively towards total conversion away from sin.49 However, this study recognizes that certain couples may know that one of them is infected and may choose to exercise the conjugal act. These may be saintly married partners — for instance, one who contracted HIV through, a blood transfusion. If they choose to have sex without forcing the other, this is within the purview of Catholic teaching on marriage, whereby couples commit to love themselves both in health and sickness. These couples may follow the rules of natural family planning and use the condom during infertile periods that do tamper with the both the unitive and procrea-tive aspects of marriage thereby rendering the condom to serve as medical aid in their 43 See Edward Vacek, SJ, "What is new?" America, The Condom Question section, January 3, 2011, http:// 44 John L. Allen Jr, "On Condoms, Has the Vatican Rejected the Pharisees?" National Catholic Reporter, December 23, 2010, When Benedict XVI's remarks were first reported in a book long interview with Peter Seewald, some theologians dismissed them, saying that church pronouncements do not come through journalists. The Congregation for the Doctrine and Faith is- sued a follow up statement in support of the pope's declaration, noting that the declaration did not change the church's general teaching on contraceptives.
45 Austen Ivereigh, "AIDS and Condoms: What the Clarification Clarifies," America, December 22, 2010, 46 Ibid. Ivereigh gives a detailed presentation and analysis of the CDF's position. 47 Anthony Fisher, OP, "HIV and Condoms within Marriage," Communio no.2, 36 (2009): 346.
48 Paul VI, Humanae Vitae, sec. 15.
49 John Paul II, Familiaris Consortio, secs. 9 and 34.
Hekima Review, No. 50, May 2014 Sexual Violence, Contraceptives Use, and the Principle of Self-Defense in Marriage marriage.50 The goal is to let couples move away from a dangerous state that does not encourage condom use, but suggests that the woman request her husband to use a condom as self-defense in the midst of life-threatening circumstances, such as when an HIV-positive husband forces sex on an HIV-negative wife. Conclusion: This study focusing on sexual violence and the use of contraceptives in
a Catholic marriage as a way of self defense on the part of a violated partner ex-amined women's sexual decision-making and recognizes the role of patriarchy in African cultures in regards to HIV/AIDS. As noted in the tragic story of women's vulner-ability at the beginning of this work, Catholic African women are commonly coerced to have sex with HIV-positive husbands. Patriarchal culture has resulted in the loss of women's dignity, and made them subordinate to men. Women's subordination can be directly linked to the increasing number of women becoming infected with HIV/AIDS within the African cultural context. This work particularly notes that women who are sexually assaulted may use emergency contraception to prevent pregnancy, discordant couples following the rules of natural family planning may use a condom for protection during infertile periods, and women under HIV-infected husband's sexual coercion may request their husbands to use condoms in protective sex as a form of self defense. What is discussed in this paper hinges on the morality regarding emergency contra- ception in Catholic sexual ethics. This is not the general rule but exceptions to the rule. The church as a moral institution cannot teach, promote nor encourage people to do wrong things. Rather, as a carrier of the good news, it searches for ways of making the good news good in the lives of distraught people, in this case, the sexually assaulted women. Akin, Jimmy. (blog).
Allen, John L. "Sometimes Bishops Say Yes." National Catholic Reporter, November 16, 2007. _. "Ghanaian Archbishop Says Church has Failed Africa." National Catholic Reporter. October 14, 2009. _. "On Condoms, Has the Vatican Rejected the Pharisees?" National Catholic Reporter, De- American Foundation for AIDS Research. "Assessing the Effectiveness of Abstinence-Only Pro- grams for HIV Prevention among Young People." Issue Brief 2, October 2007. Asue, Daniel Ude. "Catholic Sexual Ethics and Tiv Women: A Case-Study of Pastoral Practice in Regards to HIV/AIDS." Ph.D. diss., St. Thomas University, Miami, Florida, USA, 2012.
Benedict XVI [Ratzinger Cardinal Joseph]. Salt of the Earth: The Church at the End of the Millen- nium. Translated by Adrian Walker. San Francisco: Ignatius, 1997.
Billy, Dennis J., CSSR. Contemplative Ethics: An Introduction. New York: Paulist Press, 2011.
Bretzke, James T., SJ. A Morally Complex World. Collegeville: Liturgical, 2004.
Brown, Andrew. "Vatican Acts over Bosnian Rapes: Birth Control Ban Eased for Women at Risk." 50 Fisher, "HIV and Condoms within Marriage," 345.
Hekima Review, No. 50, May 2014 The Independent, July 20, 1993.
Bujo, Benezet, and Michael Czerny, eds. AIDS in Africa. Theological Reflections Nairobi: Paul- Catechism of the Catholic Church. Second edition. Accessed June 16, 2012. http://www.vatican.
Curran, Charles E., and R. A. McCormick, SJ. Eds. Readings in Moral Theology No.8: Dialogue about Catholic Social Teaching. New York: Paulist Press, 1993.
Flannery, Austin, OP. Ed. Vatican Council II: Constitutions, Decrees, Declarations. New York: Costello, 1996.
Fisher, Anthony, OP. "HIV and Condoms within Marriage." Communio 36, no.2 (2009): 329-359.
Hanley, Matthew, and Jokin de Irala. Affirming Love, Avoiding AIDS. Philadelphia: The National Catholic Bioethics Center, 2010.
Ivereigh, Austen. "AIDS and Condoms: What the Clarification Clarifies." In All Things (blog), America, December 22, 2010. id=2&entry_id=3703. John Paul II. Familiaris Consortio [Apostolic Exhortation on the Role of the Christian Fam- ily in the Modern World]. Accessed July 28, 2012. Johnston, Bruce. "Nuns at Risk of Rape Can Take the Pill, says Rome." The Telegraph, April 28, Mahoney, Patricia, and Linda M. Williams. "Sexual Assault in Marriage: Prevalence, Consequenc- es, and Treatment of Wife Rape." In Partner Violence: A Comprehensive Review of 20 Years of Research. Edited by J. L. Jasinski and L. M. Williams, 113-167. Thousand Oaks, CA: Sage, 1998.
Massachusetts Catholic Conference. "Emergency Contraception." Accessed February 27, 2014. Njoku, Jude Uzochukwu. "The Controversy of Condoms in the Unfolding History of Moral Theol- ogy: Between the Sixth and Fifth Commandments." Paper Presented at the Conference of Catholic Theological Ethics in the World Church, Trent, Italy, July 2010.
Paul VI. Humane Vitae [Encyclical Letter on the Regulation of Birth]. Accessed July 28, 2012. http:// Pius XI. Casti Connubii. [Encyclical Letter on Christian Marriage]. Accessed July 28, 2012. http:// _. Ethics of Procreation and the Defense of Human Life. Washington, DC: Catholic University of America, 2010.
Steinfels, Peter. "Benedict on Contraception, circa 1996." dotCommonweal (blog), Commonweal, November 23, 2010.
Thomas Aquinas. The Summa Theologica. New York: Benziger Bros, 1948.
Vacek, Edward, SJ. "What is new?" America. The Condom Question section, January 3, 2011. Westberg, Daniel. Right Practical Reason: Aristotle, Action, and Prudence in Aquinas. New York: Oxford University Press, 2002.
Williams, Thomas D. The World As It Could Be. New York: Crossroad, 2011.
Zalot, Josef, and Benedict Guevin, OSB. Catholic Ethics in Today's World. Winona: Saint Mary's, Hekima Review, No. 50, May 2014


C2chi#080035 1.4

J_ID: CHI Customer A_ID: 08-0027 Cadmus Art: CHI20564 Date: 23-MAY-08 Stage: I CHIRALITY 00:000–000 (2008) Use of Large-Scale Chromatography in the Preparation of Armodafinil WILLY HAUCK,1 PHILIPPE ADAM,2 CHRISTELLE BOBIER,2* AND NELSON LANDMESSER3 1Novasep Inc., Boothwyn, Pennsylvania 2Novasep SAS, Pompey, France 3Cephalon Inc., West Chester, Pennsylvania Armodafinil, the (R)-enantiomer of modafinil, is a medication used to

Childrearing discipline and violence in developing countries

Child Development, January/February 2012, Volume 83, Number 1, Pages 62–75 Childrearing Discipline and Violence in Developing Countries Jennifer E. Lansford Kirby Deater-Deckard Virginia Polytechnic Institute and State University The present study examined the prevalence and country-level correlates of 11 responses to children's behav-ior, including nonviolent discipline, psychological aggression, and physical violence, as well as endorsementof the use of physical punishment, in 24 countries using data from 30,470 families with 2- to 4-year-old chil-dren that participated in UNICEF's Multiple Indicator Cluster Survey. The prevalence of each response variedwidely across countries, as did the amount of variance accounted for by country in relation to each response.Country-level indicators of life expectancy, educational attainment, and economic well-being were related toseveral responses to children's behavior. Country-level factors are widely related to parents' methods ofteaching children good behavior and responding to misbehavior.