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YAMOUSSOUKRO, Ivory Coast (LifeSiteNews) — The following is the third open letter from a Catholic priest from the Ivory Coast to Pope Francis, the cardinals, and bishops regarding a decision made by the Congregation of the Doctrine of the Faith (CDF) in 2018 regarding hysterectomies. The priest, who writes under the name Father Jesusmary Missigbètò, holds that the 2018 decision contradicts a judgement made by the CDF in 1993. The first open letter can be read here, and the second here.


‘Third call for Pope Francis’ rectification’

Yamoussoukro (City of Peace); Ivory Coast; March 25, 2022

Solemnity of the Annunciation to Mary and of the Conception of Jesus

(This text has been read, approved and recommended by three eminent Catholic doctors)

Dear Father,

Dear Elders in the Catholic faith,

Why a third open letter?

 Two priests were on a trip for a conference on Moral Theology. At the entrance to a church they were visiting, the younger one pointed out to the older one a collection of 5 panels. The first one showed a chubby little boy who resembled those advertising baby food. Underneath it was written: “Too young to love God.” On the second panel were two newlyweds kissing and a text that read: “Too happy to love God.” Next was a businessman surrounded by several telephones and looking like he was working intensely: “Too busy to love God.” Then there was a fat rich man with fingers full of gold rings and precious stones, a cigar in his mouth, getting out of a luxury car: “Too sure of himself to love God.” The fifth and last panel showed a grave and read: “Too late to love God.” The old priest then said to the younger one: “There is a panel missing. We should put it before the first one by drawing a baby still in its mother’s womb, and underneath it we will write the following text: ‘Too useless to love God.’” The young priest was puzzled, but the old man replied, “This is the conclusion reached by the Congregation for the Doctrine of the Faith on December 10, 2018!” This last statement is surprising, but this open letter will help the reader to understand the problem. Always in the spirit of charity and truth of St. Paul at Antioch (cf. Galatians 2:11), we will see how the current pontificate contradicts the traditional moral teaching of the Catholic Church by accepting direct sterilization through hysterectomy, thus opening the door to situation ethics.

What did Archbishop Alberto Bovone, Pope Emeritus Benedict XVI, and Pope St. John Paul II say about hysterectomy?

Hysterectomy is the surgical act by which a woman’s uterus is removed. Archbishop Alberto Bovone (Secretary of the Congregation for the Doctrine of the Faith), Pope Emeritus Benedict XVI (then Cardinal Joseph Ratzinger, Prefect of the Congregation for the Doctrine of the Faith) and Pope St. John Paul II answered three questions about the morality of this preventive medical practice. This was on July 31, 1993, in the document “Responses to questions proposed concerning uterine isolation and related matters,” which I will call CDF1993. The two questions and answers relevant to this open letter are reported here. Let us pay attention to three adjectives: immediate, present, and future…

1) First case

Question 1: “When the uterus becomes so seriously injured (e.g., during a delivery or a Caesarian section) so as to render medically indicated even its total removal (hysterectomy) in order to counter an immediate serious threat to the life or health of the mother, is it licit to perform such a procedure notwithstanding the permanent sterility which will result for the woman?” Response: “Affirmative.” In this first case, “the hysterectomy is licit because it has a directly therapeutic character, even though it may be foreseen that permanent sterility will result. In fact, it is the pathological condition of the uterus (e.g., a hemorrhage which cannot be stopped by other means), which makes its removal medically indicated. The removal of the organ has as its aim, therefore, the curtailing of a serious present danger to the woman independent of a possible future pregnancy.” This hysterectomy is an indirect sterilization and is morally good because the health of the mother is an important good, superior to the removal of a currently injured and health-threatening uterus. It is better for the mother to live with her uterus gone than to die with her injured and dangerous uterus. Moreover, the mother’s intention is good because she does not desire permanent sterility but good health. In fact, she tolerates permanent sterility reluctantly.

2) Second case

Question 2: “When the uterus (e.g., as a result of previous Caesarian sections) is in a state such that while not constituting in itself a present risk to the life or health of the woman, nevertheless is foreseeably incapable of carrying a future pregnancy to term without danger to the mother, danger which in some cases could be serious, is it licit to remove the uterus (hysterectomy) in order to prevent a possible future danger deriving from conception?” Response: “Negative.” In this second case, the woman’s intention is also good: to avoid a serious danger to her health or death that could result from a future pregnancy. And “to prevent a possible future danger deriving from conception,” the means used is a hysterectomy. However, is this means lawful even if the intention is good? CDF1993 answers ‘no’ because the end does not justify the means. A good intention does not necessarily make good an action that is bad in itself. It is “an error to judge the morality of human acts by considering only the intention that inspires them” and “one may not do evil so that good may result from it” (Catechism of the Catholic Church 1756). Pope St. John Paul II, citing St. Paul, St. Augustine, St. Thomas Aquinas, St. Alphonsus Maria de Liguori, and the encyclical Humanae vitae of St. Paul VI, recalled these ideas at length in the encyclical Veritatis splendor (71-83).

Despite the good intention of avoiding a possible death of the woman in a future pregnancy, the present hysterectomy is morally unacceptable because the woman’s health is not presently threatened: “the uterus in and of itself does not pose a pathological problem for the woman”; “not constituting in itself a present risk to the life or health of the woman”. Performing a hysterectomy under these conditions falls into “the moral category of direct sterilization”. Indeed, according to the “document Quaecumque Sterilizatio (AAS LXVIII 1976, 738-740, no. 1),” it is an action “whose sole, immediate effect is to render the generative faculty incapable of procreation,” i.e., incapable of conceiving children.

What did Archbishop Giacomo Morandi, Cardinal Luis Francisco Ladaria Ferrer, and Pope Francis say about hysterectomy?

Archbishop Giacomo Morandi (Secretary of the Congregation for the Doctrine of the Faith), Cardinal Luis Francisco Ladaria Ferrer S.J. (Prefect of the Congregation for the Doctrine of the Faith), and Pope Francis answered a “new” question on hysterectomy. This was on December 10, 2018, in the document “Response to a question on the liceity of a hysterectomy in certain cases”, which I will call CDF2018. Here is the wording and the answer: “Question: When the uterus is found to be irreversibly in such a state that it is no longer suitable for procreation and medical experts have reached the certainty that an eventual pregnancy will bring about a spontaneous abortion before the fetus is able to arrive at a viable state, is it licit to remove it (hysterectomy)? Response: Yes, because it does not regard sterilization.”

Before a thorough critique of this answer, let us read the following parable told by a woman. The explanation corresponding to the moral cases of CDF1993 and CDF2018 is put in brackets: “My Father (God) has entrusted me with a valuable house (uterus). Let us suppose that one day the building materials of this house become a danger to the point of threatening my life (injured uterus and threat to the health or life of the woman). Do I have the right to destroy this house if there is no other solution to save my life? Yes, because my life is more valuable than this house. (This is the answer given by CDF1993 to the first hysterectomy studied.) Now let us suppose that this valuable house does not pose any danger to my life and my husband’s life. However, several construction experts (medical experts) tell me that they are absolutely certain that if one day I go to this house with my husband (marital relationship) and we have a child there (conception and pregnancy), this child will necessarily die there (spontaneous abortion). What will I do then? Will I destroy the valuable house for a child who does not exist and who will necessarily die even if he does exist? Obviously not! (This is the answer given by CDF1993 to the second hysterectomy studied.) So, what will I do? I am left with two reasonable solutions: absolutely avoid going into the house with my husband (sexual abstinence) or go in when we are sure we will not have a child there (infertile periods).” And yet CDF2018 answered, ‘Yes’ [to destroying the “house”].

How does CDF2018 contradict CDF1993, Catholic morality, semantics, fundamental moral theology, common sense, and eschatological theology?

1) CDF1993 rejects CDF2018’s hysterectomy

Indeed, CDF1993 condemned CDF2018, 25 years before the latter’s appearance, by prohibiting hysterectomy when the uterus does not constitute a present health danger for the woman (cf. Second case). Now, CDF2018 confirms this in its Illustrative Note: it is “not a question of difficulty, or of risks of greater or lesser importance” and we are “not dealing with a defective, or risky, functioning of the reproductive organs”. The error of CDF2018 is that it did not pay attention to the words “in and of itself… to the woman” contained in the explanation of CDF1993: “the uterus… does not constitute in and of itself any present danger to the woman”. Moreover, if we know that the uterus has a much stronger bodily link with the mother than with the future child, and if we remember that in 1993 the Congregation for the Doctrine of the Faith answered ‘no’ to hysterectomy when the future pregnancy would involve a mortal danger for the mother, why, 25 years later, should this same Congregation answer ‘yes’ when this mortal danger concerns a future child? This has moral implications.

2) Catholic morality rejects CDF2018’s hysterectomy

From the point of view of the connection of the uterus to the woman, we see that the hysterectomy of CDF2018 is not a new hysterectomy. It is rather similar to the one prohibited by CDF1993 in its Question 2, since “the end of avoiding risks to” the future fetus, “deriving from a possible pregnancy, is… pursued by means of a direct sterilization, in itself always morally illicit,” and which is for “rendering sterile future sexual acts freely chosen”. And from the point of view of the connection of the uterus with the future fetus? The same conclusion, since CDF1993 insinuates the possibility of spontaneous abortion of the future fetus through the following expression: “[the uterus] is foreseeably incapable of carrying a future pregnancy to term”. In short, “the contrary opinion which considers” the hysterectomy of Question 2 as indirect sterilization,“licit under certain conditions, cannot be regarded as valid and may not be followed in Catholic hospitals,” because one would fall into situation ethics. But what else could be the cause of CDF2018’s error? Semantics.

3) Semantics rejects CDF2018’s hysterectomy

 The following statements by CDF2018 are false: “the uterus is found to be irreversibly in such a state that it is no longer suitable for procreation”; “procreation is no longer possible”; it is “a couple for which it is not possible to procreate”; “the medical procedure should not be judged as being against procreation, because we find ourselves within an objective context in which neither procreation, nor as a consequence, an anti-procreative action, are possible”. In reality, the word ‘procreate’ means ‘to conceive’, ‘to give life’, ‘to engender’, ‘to bring forth’. And whatever the usage it always implies conception. CDF1993 uses it well, from conception to birth. On the contrary, CDF2018 uses it badly because it understands it in a sense that excludes de facto conception and retains only viability and birth. Evidence of the latter is found in the following expressions of CDF2018: “the reproductive organs are not capable of protecting a conceived child up to viability”; “in the case of a pregnancy, it would be spontaneously interrupted before the fetus arrives at a state of viability”; “the birth of a living fetus is not biologically possible”.

CDF2018 therefore recognises that conception is still possible in woman, which means that the woman’s fertility remains intact. If conception is still possible, then CDF2018’s hysterectomy comes under the prohibition of CDF1993 and effectively falls into “the moral category of direct sterilization” preventing conception. Moreover, if in the past the Church has not considered hysterectomy to be morally licit for objectively infertile couples (male and/or female infertility), why should it now accept CDF2018’s hysterectomy for fertile couples? CDF2018 insists: “an eventual pregnancy will bring about a spontaneous abortion before the fetus is able to arrive at a viable state”. What does Fundamental Moral Theology think about this?

4) Fundamental Moral Theology rejects CDF2018’s hysterectomy

To prove this, we will use a conceptual tool well known to specialists in Thomistic moral theology and allowing a scientific study of the present case: the principle of double effect. This tool is derived from Aristotle (cf. Nicomachean Ethics III, 1, 1110a, 4-29, Christopher Rowe, 2002, p. 123)and from St. Thomas Aquinas (cf. Summa Theologica II-II, Q.64, A.7). From a moral point of view, the goodness of an action usually implies that the effects of this action are good. However, here we have a case where an action produces both a good and an evil effect. The action consists of the removal of a uterus which does not pose a present threat of death to the woman but could pose a threat of death to a future fetus if the woman becomes pregnant. The good effect of this action is to avoid spontaneous abortion of a future fetus. The bad effect is the permanent sterility of the woman. For a double effect action to be morally good, 4 affirmative answers to 4 test questions are needed.

First question: Is the action to be taken good in itself or at least indifferent, regardless of its effects? The answer here is ‘no’ because it is a direct sterilization, as we have seen in points 1), 2) and 3). Second question: Is the good effect a direct consequence of the action and not of the bad effect? The answer here is ‘no’ because the good effect is a direct consequence of the bad effect: it is the permanent sterility that prevents the meeting of the gametes (male – female), and the conception of a new human being, and the possibility of spontaneous abortion. Third question: Does the will of the subject reject the bad effect? The answer here is ‘yes’ since the woman does not desire permanent sterility but rather to avoid spontaneous abortion of a future fetus. She reluctantly tolerates the bad effect of permanent sterility. The woman’s intention is therefore good. Fourth question: Does the action to be taken serve to safeguard a good greater than the evil that is tolerated? The answer here is ‘no’, for it is rather the failure to perform the action of hysterectomy that serves to safeguard several greater goods.

Let us not confuse spontaneous abortion with induced abortion: the former is a natural death and is absolutely not the fault of the woman but of nature; the woman is not responsible for it. Induced abortion, by contrast, is murder, that is, an unnatural action of human will that unjustly destroys the life of a fetus (cf. St. John Paul II, Evangelium vitae 58-63). Having said this, what are the greater goods that the woman saves for herself if she does not perform the CDF2018 hysterectomy? She retains her bodily integrity and the possibility of having children with another husband, in case, for example, her husband dies. (Doctors can prove that the resistance of a fetus to unfavourable conditions of survival in the uterus can also be related to the quality of the man’s biological material.) And the conceived child, what greater good is safeguarded for him, even if he should die a natural death and not be born? The great good of existence: existing gives us a panoply of possibilities that nihilism cannot offer. Life (existence) is superior to the natural death constituted by spontaneous abortion. This is confirmed by Aristotelian-Thomistic metaphysics: it is more perfect to exist than not to exist. In the famous words of William Shakespeare in Hamlet, we would say: “To be or not to be: that is the question”.

On the other hand, CDF2018’s hysterectomy is not a proportionate response to the purpose of avoiding spontaneous abortion. As St. Thomas Aquinas reminds us: “though proceeding from a good intention, an act may be rendered unlawful, if it be out of proportion to the end. Wherefore if a man, in self-defense, uses more than necessary violence, it will be unlawful: whereas if he repel force with moderation his defense will be lawful” (Summa Theologica II-II, Q.64, A.7, R.). Now, in this case, as CDF1993 had already pointed out, “other ways, which are morally licit, remain open to free choice” in order to achieve the same end, while allowing the woman to retain the higher goods mentioned above. CDF2018 itself quotes them: “for example, recourse to infertile periods or total abstinence”. But the same conclusion could have been reached with common sense.

5) Common sense rejects CDF2018’s hysterectomy

CDF2018 states that: “medical experts have reached the certainty that an eventual pregnancy will bring about a spontaneous abortion before the fetus is able to arrive at a viable state”; “the element that renders the present question essentially different is the certainty reached by medical experts that in the case of a pregnancy, it would be spontaneously interrupted before the fetus arrives at a state of viability”; “the problem of the criteria to evaluate if the pregnancy could, or could not, continue on to the state of viability is a medical question”; “from the moral point of view, one must ask if the highest degree of certainty that medicine can reach has been reached”. This argument might seem decisive. However, it is not valid at all because of a very simple reason, if we remember that spontaneous abortion is a natural death…

With or without medical experts, common sense allows us to affirm with absolute certainty the truth evoked each year on Ash Wednesday: “Remember you are dust and to dust you shall return” (cf. Genesis 3:19). Indeed, all human beings, from the moment of conception, are naturally mortal; no human being has an eternal life on earth. Do we really need medical experts to affirm such a certainty? Besides, is there any more absolute certainty among humans than that they will die? And this applies both inside and outside the womb. In fact, the absolute certainty that medical experts have that a future child conceived will necessarily die in the womb is the same as that affecting children suffering from genetic or hereditary diseases and whose life expectancy (outside the womb) is limited. This is the example of sickle cell disease. Therefore, uterine viability or the place of death of a future child cannot constitute a sufficient reason to justify direct sterilisation; otherwise one falls into situation ethics.

On the other hand, there is nothing to prevent the woman’s medical condition from improving naturally in the future. Let us not forget that medical certainty has sometimes been contradicted by objective facts. There are many testimonies of women who, despite a negative and unfavourable medical prognosis, have had not one but several children. For example, the Argentinean and soon to be Blessed Cardinal Eduardo Francisco Pironio told the story of his family. After the marriage of his mother (18) and father (20), there were complications with the first pregnancy: “The doctor told her that she could not have any more childrenbecause she would certainly die.” However, “my mother lived to be 82 and had 22 children. I am the last of them.”

Finally, if only one woman is given the right to have her uterus removed because she is absolutely certain that her future child will die a natural death in her womb, then logically all women should be given the same right, without exception, because all of them are absolutely certain that all of their future children, without exception, are called upon, sooner or later, to die a natural death, whether in the womb or outside it. It is therefore easy to understand that the mentality that resorts to the hysterectomy of CDF2018 can only be a contraceptive and anti-natalist mentality, and which, at bottom, contradicts the will of the Creator God on conjugal sexuality: “Be fertile and multiply; fill the earth” (Genesis 1:28). But why does God want so many children? It is not for the earth but for Heaven.

6) Eschatological theology rejects CDF2018’s hysterectomy

CDF2018 justifies its hysterectomy with another argument: “the objective of the procreative process is to bring a baby into the world, but here the birth of a living fetus is not biologically possible”;“we are not dealing with a defective, or risky, functioning of the reproductive organs, but we are faced here with a situation in which the natural end of bringing a living child into the world is not attainable.” This argument is not at all valid. From a philosophical and Christian perspective, “the objective of the procreative process” is not “to bring a baby into the world” to live only on earth (marxism) but, first and foremost, to enable a spiritual soul to go and live with God in Heaven (supernatural end).

This prime end remains entirely valid even for conceived children who die before their earthly birth (cf. Catechism of the Catholic Church 1261; Document “The hope of salvation for infants who die without being baptised”, International Theological Commission, 2007). Can we really, in all sincerity and truth before God, apply to these children the label “Too useless to love God”? Let us remember, for example, the Holy Innocents, Martyrs. Are they not in Heaven now living eternally and interceding for us, even though they lived a short time on earth? Is what they are doing now really useless for them and for us?

In conclusion, the woman does no harm by calling a child into existence, even if that child dies of natural causes shortly afterwards. On the contrary, she is doing him an inestimable and infinite good, that of offering him the possibility of living eternally with God. Thanks to the supernatural end, the mother who miscarries is not useless, and neither is her lost child. Despite the pain and suffering of the loss of a child, this woman plays an important role in the economy of the salvation of souls.

What should be the Christian reaction to the first historic error of the CDF?

 The first and most important reaction is to pray the Mass and the Rosary. Next: fidelity to Jesus Christ in the Catholic Church. Third: unity around Pope Francis in truth despite the serious rupture between him and his 265 predecessors (cf. my 1st open letter and my 2nd open letter). Only in this way will our Church beneficially overcome its present crisis of truth which God himself already knew from all eternity. CDF2018 had surprised several journalists and intellectuals who quickly sounded the alarm: Jeanne Smits (leblogdejeannesmits.blogspot.com, lifesitenews.com); Bruno Moreno (infocatolica.com); Carl Bunderson (catholicnewsagency.com); Joshua Schulz, PhD and William Hamant, PhD (DeSales University); et alia. The consequences of CDF2018’s error on a theoretical (Catholic teaching) and practical (Catholic hospitals) level are grave: having pushed, since 2018, Catholic and non-Catholic women and doctors to practice direct sterilization prohibited by divine law. Today, our honesty as Catholic Christians is put to the test: obedience has a limit, sin, because the law of God is above all laws.

May God grant that Catholic cardinals, bishops and intellectuals remember the following words of Christ and agree to stand up for the truth so that the Catholic Church may regain its walk in the furrow of moral and doctrinal truth lost from 2016! This does not mean being against someone but being with Jesus, the Eternal Truth of God: “Everyone who acknowledges me before others I will acknowledge before my Heavenly Father. But whoever denies me before others, I will deny before my Heavenly Father” (Matthew 10:32-33). May Jesus Christ, the Holy Embryo conceived in Mary on this day, open the gates of Heaven to all unborn children and give to his Church, through their intercession, the grace of authentic peace in unity, truth and love! Pax Christi Ecclesia.

Your son, Father Jesusmary Missigbètò

Gmail: [email protected] / Facebook: @fatherjesusmary / Twitter: @fatherjesusmary