Second Sight

Much time and media space has been devoted to the Pope’s remarks on HIV prevention in sub-Saharan countries. I wrote about the factual background in my column of March 27.

But the topic is coming closer to home, as proposals for advertising condoms on television are in the news. It has indeed been smouldering away in discussions about the sexual education of children in schools for some time.

I bear in mind that those who are preparing educational programmes, perhaps for the summer term, need a substratum of impartial fact. And those of us who can influence opinion in other forums need this too.

So I have looked at twinned articles in the British Medical Journal from the issue of January 2008. They take opposing points of view and I will leave you to draw your own conclusions. You will find a link to the full articles below. And your library may have a copy.

The first article, by Markus Steiner and Willard Cates, argues that condoms are the answer to rising rates of non-HIV sexually transmitted diseases (STDs). It points out that good laboratory studies have shown that condoms offer a very high level of protection against a whole range of such infections. And that, where these studies have not been able to provide full empirical evidence, this has been owing to the technical difficulties of designing experiments.

Having read the major study in this area, I would certainly confirm that this conclusion is correct. The article goes on to say that the incidence of infections caused by skin contact alone is also reduced. 

It quotes studies showing that condom promotion does promote sexual activity, but also quotes a meta analysis (an overall assessment of a number of studies) which concludes that such promotions do not increase unsafe sexual behaviour.

It concludes that condoms should be promoted within the context of other risk-prevention strategies but that condom use should have a “pivotal role” in this. Those who choose to be sexually active should be reassured that condoms reduce the risk of most infections provided that they are correctly and consistently used.

In the twin BMJ article Stephen Genuis takes a different view. The first point he makes is that skin-to-skin contact, outside the specific area protected by the condom, allows infection by a whole range of STDs, including the most common pathogens. His description is a trifle graphic for this newspaper, but the article itself gives full details.

He tells us that average people, particularly aroused young people, do not use condoms consistently - whether they have the appropriate knowledge or not. In one study only 19 per cent of students used condoms consistently and nearly half never did. Only eight per cent of those with herpes use condoms, despite ongoing counselling, and just less than half of stable adult couples, one of whom is infected with HIV, do not consistently use condoms - again, notwithstanding counselling.

He points out that the unprecedented increase in education and promotion of condoms has been accompanied by a “relentless” rise in STDs - even in First World countries with advanced sexual relationship programmes. And he quotes Einstein: “The definition of insanity is doing the same thing over and over again and expecting different results.”

He writes about the reduction in STDs in Thailand and Cambodia, where condom use is the major thrust of strategy. But he tells us that careful analysis of the data suggests that the beneficial changes in sexual behaviour (fewer partners, less casual sex, less use of sex workers) have played a larger part than widespread condom use.

Quoting the World Health Organisation’s worldwide estimates that two thirds of STDs occur in teenagers and young adults, he speaks of extensive studies which show that risky sexual activity is “often the expression of non-sexual need and associated with fundamental problems and difficulties”. To promote the use of condoms as the answer is to fail to tackle the real problems. He concludes by exhorting us to abandon ideological positions and to develop our remedial strategies according to the actual evidence.

An interesting study from America, published in the April Issue of the Journal of School Health, tells us that some 12 per cent of children have indulged in sexual intercourse by the age of 12. It comments: “These findings are alarming because youth who start having sex before age 14 are much more likely to have multiple lifetime sexual partners, use alcohol or drugs before sex and have unprotected sex, all of which puts them at greater risk for getting a sexually transmitted disease (STD) or becoming pregnant.” And Centers for Disease Control and Prevention reports that 80 per cent of the births to mothers aged 15 to 19 were the result of unintended pregnancies. We cannot directly transfer American experience to Britain, but I would be surprised if our statistics differed greatly.

It is not my province to tell you how to translate your own conclusions into an educational programme, because most of my experience has been with adult education. 

But I recall, from some years back, asking engaged couples how they had received their first sexual education. About one in 10 had done so from their parents, and the largest single source reported by the others was from the playground. If that situation still pertains then it is folly to rely on the ideal of good parental education. The emphasis has to fall on the schools. The schools had better get it right although they start with the odds stacked against them.

So tell us what you think about these opposing points of view. And you may like to share your thoughts on how this topic might be handled in school or in the family. If at all

Those may seem fighting words given that the world’s population has doubled since the 1950s, and is expected to reach 9.2 billion by 2050. By this time the population will be peaking, and the slope likely to turn downwards. This issue certainly exercises the minds of some blog contributors, who see this as one of the greatest threats we face – and one that will contribute mightily to global warming.

But, by and large, it is over. The rate of world population increase has fallen by about a half since the 1960s. More and more people in poor countries are now using contraception, although Africa remains a problem for a variety of reasons (economics and high infant mortality among them). In fact people take to contraception like ducks to water wherever free facilities are readily available.

I make no claim to expertise here, and I have no doubt that those who have studied the question in depth will have some comments to make. I look at the UN projections, and I see estimates which vary between 8 billion and 10 billion by 2050. The major growth will take place in the less developed countries, while the developed countries continue to decline. Current world population is nearing 7 billion of which 60% is in Asia and 14% in Africa. Europe accounts for 11%.

The major factors in the assumptions are the control of disease. (Aids is important here) and the rate of fertility (changes in half a child per woman, up or down, make a substantial difference). These in turn depend on prosperity.

We are exhorted not to look at contraception as the solution to problems in Africa, but rather to put our energies into lifting Africa out of poverty by promoting sustainable development through different and positive means. But of course if that should be achieved it will certainly be accompanied by widespread use of contraception. That’s an interesting dilemma. 

But lowered fertility rates are a mixed blessing. As they drop so the proportion of the elderly tends to increase, and this is accelerated by prosperity extending life expectancy. Were the overall fertility rate to drop below replacement level (as is already the case in Europe) the world would eventually decrease, and continue to decrease, in population. One would expect this to have a deflationary effect as consumers become fewer and the efficiency of production grows. And I take no account here of the demographic effects of global warming.

Population projections since the days of Malthus have tended to be over pessimistic, and the ingenuity of mankind to increase our ability to support population has proved remarkable. But there seems to be no doubt that there will continue to be many problems between now at 2050. And these will steadily grow. By that time I shall be aged 116, But many of you will be younger. Good luck!

In my occasional columns examining ways in which we discern right and wrong I have looked at deontology, which sets out by “rule” that certain actions are permitted, and others forbidden, and utilitarianism, which is judged on the consequences of an action. Here I want to look at an approach which I find most attractive: virtue ethics.

The focus of deontology and utilitarianism is on acts - are they right or wrong? The focus of virtue ethics is on the actor: what sort of person is he and what sort of person should he strive to become? Most of the discussion and argument about moral matters centres on specific decisions: we can easily forget that our first duty is to be moral people. In fact the whole emphasis of Jesus’ message is that we focus on our faith in him, and work to become as perfect as his father. We not only have to be virtuous, we are required, as our constant vocation, to develop virtue.

St Thomas said that all moral issues can be reduced to the consideration of virtues. If we are virtuous, we do virtuous things, and doing virtuous things strengthens our state of virtue. Virtues might be described as deep habitual dispositions which are expressed in how we lead our lives. As the Catechism puts it: “The virtuous man is he who freely practises the good.” (See 1803 ff. for a description of the virtues.) This approach is natural and acceptable to us, because good parents use it to bring up their children well. We are less concerned with children’s immediate actions in themselves but rather because they enable us to watch and guide what sort of people they are growing up to be.

A virtue of particular interest is practical moral judgment. We sometimes call it prudence (a somewhat misleading word). It is known as the “charioteer” of the virtues because it addresses our judgment in the practice of virtue in general and particular circumstances. It enables us to recognise the salient moral aspects of a situation, and to achieve the best balance in both the short and long term. Aristotle (whose writings on the virtues have been, and remain, highly influential) tells us that it can only be fully developed through experience. So we do not expect it to be well-developed in children or even in adolescents. And, interestingly, we now know that, irrespective of levels of IQ, the adolescent brain has not yet developed its full capacity for emotional control, mature judgment and sensitivity to the long term consequences of actions.

The outcome of the development of virtue was known to Aristotle as eudaimonia, best translated as “flourishing”. It cannot properly be described as happiness because happiness is ephemeral or may result from unworthy causes - giving rise to unworthy actions. Rather it means living up to the full nature of a human being, as a human being. Similarly an elephant has its own eudaimonia when it is fulfilling itself according to its elephant nature.

In our terms eudaimonia is achieved through living our lives according to human nature as God created and redeemed it, body and soul. And our flourishing grows as we grow in virtue.

While virtue ethics has recently grown in importance in the eyes of both Christian and agnostic philosophers, it also has opponents. Some suggest that it is selfish because it concentrates on the self. But this has little merit because it is clear that the practice of virtue leads to a spread of benefits. A basic aspect of human nature is that we are social people, and so our virtues lead us to respect others through such qualities as care, or truthfulness or keeping promises. This is of course explicit in the concept of loving our neighbour as ourselves.

A more substantial objection is that it does not deal with moral decisions or address the dilemmas in which we have to deal with conflicting courses of action. It may prepare us for this, but it offers no solutions.

I leave aside the thought that, in general, neither deontology nor utilitarianism have been notably successful here either. Instead I would refer to my column of 29 August 2008 in which I summarised the Pope’s view (as cardinal in 1991) on true conscience. He tells us that the starting point is our recollection of the moral truth inside all of us - but which we often stifle so that we can cling to the opinions which happen to suit us - and then claim conscience as our defence. He presents the moral law as taught by the Church not as a command but as an invitation. We are not being required to do things because the Church says so, but because, after listening to the Church, we may be ready to say so. (See Holding out for a hero, 28 August 08)

The connection with virtue ethics is clear. Our development in virtue prepares us to respond freely to this invitation. It enables us to see more deeply and clearly how the moral law relates to us as, we may hope, virtuous people. And the growth in our practical and moral judgment (prudence) not only guides us towards respecting the wisdom of the Church in its moral authority, but also to see how it may apply to the decisions we have to make. It is only the imprudent person who neglects to consider what the Church invites. And our autonomy remains unimpugned because, to repeat myself, all moral issues can be reduced to the consideration of virtues. Thus: “The virtuous man is he who freely practises the good.”

In your comments on this you might like to think whether virtue ethics really works as a guide to the moral life. Is it enough, as Juliana suggested in one comment, to ask ourselves: what would Jesus have done? How would it solve the exchange Malteser and I have had on the question of condoms and HIV? (The Pope was right, 26 March 09) Does it throw too much weight on our fallible consciences and not enough on the Church’s authority with regard to moral law? Can obedience ever cease to be a virtue and become a vice? Plenty of meat here.

Two young boys allegedly being viciously beaten by two other young boys is just a single, shocking incident. Yet it may strike us as a symbol for a society which has gone seriously wrong.

At one end of the scale we have bankers who have thrown us into a fearful economic mess while emerging wealthy with bonuses and pensions, and politicians who, quite legally, milk the allowances paid for by us for every penny they can get – while claiming that their sole interest is the good of society.

At the other end we have overcrowded prisons, a high rate of teenage pregnancy, cohabitation swiftly replacing marriage, and fearful difficulties in many schools with undisciplined pupils. Killing the young before they are born is considered acceptable – even admirable, by people who are horrified by the memory of the Holocaust. You can make your own list.

Yet we have a legal structure which appears to cover every human activity, and a surveillance system through camera and database to ensure that Big Brother is always watching you. (After all why should you worry if you’re not doing anything wrong?) Even many local councils use terrorism laws, which were designed for tracking terrorism and serious crime, for the spying out of petty offences.

The old saying “If you’re in a hole, stop digging” seems to apply. We all have some general ideas of how society ought to be, but it’s harder to discern practical ways through which that could be achieved. It certainly doesn’t seem to be the way we’re travelling now.

So what do you see as the major problems, and ways in which they could be put right or at least alleviated? And what can we do personally to contribute?

I should really like to know.

Do human beings have a true moral sense or is their altruism merely the outcome of natural selection through the genes? This is a key question because we hold that a true moral sense is a faculty unique to human beings, a characteristic of the soul directly created by God.

First, some definitions. Altruism is our tendency to do good to each other, even when this is at a cost to ourselves. True moral sense is a recognition that the good ought to be done and that evil ought to be avoided, and, since we exercise true morality through free will, we may hold ourselves or others responsible for moral or immoral behaviour.

In practice articulate sceptics demonstrate a full-blown true moral sense because they expend a great deal of energy in condemning the Church, in its current or historical actions, for immoral behaviour. But in their theory they hold that altruism is simply an outcome of natural selection and therefore has no true moral content. This is of course a major inconsistency. While I have asked in many forums for an explanation of this inconsistency I find that the usual defence employed is to change the subject.

 Perhaps this was most frankly epitomised by Bertrand Russell: “I find myself in a dilemma. On the one hand I certainly want to condemn the Nazis’ behaviour towards the Jews as wrong in itself. On the other hand, my ethical theory does not allow me to say this.”

 There are a number of natural reasons for altruism. First is the “selfish gene” theory which argues that in many groupings from the primitive up to the human animal altruistic behaviour is beneficial to the welfare and continued success of the group. Thus the inheritance of genes for altruism is evolutionarily adaptive. Some theorists relate this to closeness of kin. Thus we care more for those who are closer to us genetically, and less for those who are more remote. So we are acting to preserve our genes. And a “halo” effect may include those with whom we have enough in common.

A second is self-protection: if I am altruistic towards you, you are likely to be altruistic towards me. Related to this is the fear that we may be punished by society for breaching its own code of altruism. Third, we get scientifically measurable pleasure from altruistic behaviour. When I had a full leg plaster cast I was aware of the sense of self satisfaction and the boost to self-image I was giving to people who helped me at very little cost to themselves; I was a walking (limping?) social service.

None of these causes for altruism produce true morality because they are all ultimately founded on self-preservation or personal benefit. We should of course be glad that altruism is well rooted in our evolved human nature, because it’s is hard to imagine living in a society without it. On the other hand it has a disadvantage: the more closely we are bonded to our own group, the more we are susceptible to opposing other groups whose interest differs from ours. Altruism and xenophobia are two sides of the same coin. Machiavelli recommended in The Prince that a powerful way of unifying your subjects was to create an external enemy. We have seen this at work in the Middle East and Northern Ireland in our own time, and in countless historical examples. Loving your enemies and doing good to those who hate you has no currency here.

 So what constitutes true morality? The first requirement is a rational intelligence capable of dealing with abstract thought. We do not require morality from those without this capacity either through youth or mental disability. We also need free will: we cannot be held responsible if we cannot make choices.

 These requirements are outside the sphere of science. It is impossible to demonstrate abstract thought scientifically without the use of abstract thought thus obliging us to assume what we are setting out to prove. Second, free will is by definition uncaused, and science is only equipped to deal with causes. Of course many factors, such as evolved altruism, innate characteristics and experience will play a part in choices and can be examined scientifically, but, unless we are ultimately free to make a choice for the good or the evil, true morality is not involved.

Since recognition that the good should be done and the evil avoided is innate in anyone who has the use of reason, it would be an error to suggest that an atheistic scientist, for instance, has no such sense. As St Paul puts it, those who do not have the law of God have what the law requires written in their hearts, to which their consciences bear witness. But they, and we, have a regrettable capacity to blunt our innate moral sense through bad habits, intellectual arrogance and self-indulgence. And often, ironically, we use conscience as our justification while forgetting the fundamental basis on which conscience rests.

The application of law in the detailed circumstances of our choices is a subject which I have often addressed in this column, and will do so again. But for now I will merely summarise, as Jesus did, with the love of God, and the love of neighbour. “On these two commandments hang all the law and the prophets.” 

So if you hear, read or see on television, in this Year of Darwin, the claim that our moral sense is no more than an altruism which has developed through genetic natural selection, just bear in mind that the author, however virtuous he may be, is talking bunkum.

But you may want to disagree, or add some extra points. Open for comment!