Because most philosophies that frown on reproduction don't survive.

Thursday, February 09, 2012

"Material Cooperation" and the HHS Contraception Mandate

There's nothing like a public policy debate on a sex-related issue to get a lot of people doing amateur moral reasoning, and I can't help getting into the action a bit. One of the questions I've heard a lot about Catholic institutions' reluctance to cover contraception as part of their health care plans is: "They're already paying their employees, and a lot of their employees are probably going out and buying birth control with that money. How is it any different to make them pay for health coverage that covers all birth control 'free' than it is to simply give them a money and let them buy birth control if they want to?"

The moral concept at play here is one of degree of moral cooperation. The old Catholic Encyclopedia provides a nice summary under it's entry for "Accomplice":
A term generally employed to designate a partner in some form of evildoing. An accomplice is one who cooperates in some way in the wrongful activity of another who is accounted the principal. From the viewpoint of the moral theologian not every such species of association is straightway to be adjudged unlawful. It is necessary to distinguish first of all between formal and material cooperation. To formally cooperate in the sin of another is to be associated with him in the performance of a bad deed in so far forth as it is bad, that is, to share in the perverse frame of mind of that other. On the contrary, to materially cooperate in another's crime is to participate in the action so far as its physical entity is concerned, but not in so far as it is motived by the malice of the principal in the case. For example, to persuade another to absent himself without reason from Mass on Sunday would be an instance of formal cooperation. To sell a person in an ordinary business transaction a revolver which he presently uses to kill himself is a case of material cooperation. Then it must be borne in mind that the cooperation may be described as proximate or remote in proportion to the closeness of relation between the action of the principal and that of his helper. The teaching with regard to this subject-matter is very plain, and may be stated in this wise: Formal cooperation is never lawful, since it presupposes a manifestly sinful attitude on the part of the will of the accomplice. Material complicity is held to be justified when it is brought about by an action which is in itself either morally good or at any rate indifferent, and when there is a sufficient reason for permitting on the part of another the sin which is a consequence of the action.
With this in mind, I think it should be clear there is a big difference for an organization which considers contraception to be immoral between providing employees with health care coverage specifically for buying contraception and providing them with money which they can choose to use for anything they want. The former clearly restricts their actions only to getting something which, according to a Catholic view, is immoral anyway. The latter is simply the just act of paying a worker for his labor, and leaves the worker in charge of deciding how to spend that money. Even if in both cases the worker ends up getting birth control, the proximity of the employer to the buying of birth control is clearly much greater with the contraception mandate than with simply providing his workers with money.

I'd argue that this distinction is actually really clear to us even on subjects which don't involve any clearly immoral action if we start applying it to things that we think of as strictly option. Suppose, for example, an employer provided bicycle coverage to all his employees. Any employee could get a free bicycle. Of course, if you don't want a bicycle, you don't have to get one. People strongly in favor of bicycles might think this was just awesome, but a lot of employees might see this as interfering and overly benefiting the people who are bicycle fanatics. However, a lot of people might see this as a inconsequential "perk" that the company offers and not worry about it too much, though they would certainly see the company as encouraging cycling.

Now let's apply the same model to something that is legal but a little more controversial. An employer announces that they will provide "2nd Amendment Coverage" to all their employees. Any employee who wants can get a "free" Glock 9mm pistol as part of this coverage. He or she can also get unlimited ammunition. Of course, no one is required to get a gun, and the company is not encouraging anyone to do anything illegal or dangerous with these guns. Guns are perfectly legal, and any employee who wanted to could obviously go out and buy a Glock and ammunition for it with his salary if he wanted. However, I think basically everyone would agree that this "2nd Amendment Coverage" would represent the company far more directly being involved in gun ownership and gun promotion than a company which simply payed its workers and didn't prevent them from buying guns with their salaries. This employer would be engaged in "material cooperation" with gun ownership and gun culture in a way that other employers were not.

14 comments:

Anonymous said...

Nice example, Darwin. What if the company paid everyone an extra $500 a year in order that (purpose, not result clause!) employees could buy a handgun? Does the fact that the money could be used for something else matter?

Rob Alspaugh

Mary said...

Excellent, clear reasoning.

Anonymous said...

But 99% of sexually active American women either have used or will use contraception at some point in their lives (Vital and Health Statistics, 2010).

Virtually all women - including all Catholic women! - are voting with their feet on this issue. Have you even considered the possibility that the Magisterium is just dead wrong about this?

Forgive me, but as a non-Catholic, what I see going on here is a cloistered group of middle-aged celibate men telling everyone else that *their* sex lives are screwed up. The jokes that could be made about this situation from a Freudian perspective are just too easy to bother with.

Joel

JoAnna said...

Joel - actually, that statistic is specious. Please see here for an explanation of why it is so inaccurate: http://a-star-of-hope.blogspot.com/2012/02/i-am-98-percent.html

If the Magisterium is "dead wrong" about this, why have all the predictions in Humane Vitae come true? Seems to me they've been proved right.

Regardless, your point is irrelevant. 100% of Catholics sin, we already know this. That doesn't make it okay for the Obama administration to demand that a church then subsidize sin.

If 98% of people thought it was okay to cheat on their income taxes, would that mean that the IRS should be abolished?

MrsDarwin said...

I doubt that 99% of sexually active women in America are Catholic, so already that statistic has less significance. Also,note that the question as stated says "has used". That means ever. I'm one of the Catholic women who can answer that I've never used contraception, but there are also many Catholic women who are either converts or who have used contraception in the past but who don't anymore. These kinds of survey questions are almost meaningless without more clarification.

And even if the statistic is correct that 99% of sexually active American women use or have used contraception, why should that have any effect on what the Church teaches? If something is true, it is true no matter whether it is popular or not.

Darwin said...

Taking a quick look at the study:

http://www.guttmacher.org/pubs/Religion-and-Contraceptive-Use.pdf

The way the study results are put together and presented is kind of weird. They're going by religious identificiation, which they then break down according to how often the woman attends services. Thus, they have a sample of Catholics, of which 30% actually attend mass weekly and another 30% do so monthly. However, they don't break down their other measures according to these, although this would be very helpful. They also don't split married and unmarried sexually active women in any of their tables.

They do state that 89% of unmarried Catholic women are sexually experienced by the time they are 24. They also show 2% of Catholic woman using NFP, 4% using "other" methods of birth control, and 11% using "no method" (although they say that they are trying to avoid pregnancy). They don't provide breakdowns of these percentages by actual religious practice, nor do they provide breakdowns of the percentage who are currently pregnant, trying to become pregnant or post-partum, though they vaguely state "Similarly, proportions of married women who are pregnant or desiring pregnancy do not differ by religious affiliation."

Without seeing those numbers broken down by practice, it's really hard to say what the level of agreement with Church teaching really is. Roughly estimating by their numbers, it looks like at least 10% of Catholic women who actually attend mass weekly are probably following Catholic teaching on birth control, but because of the way they organize data it's honestly very hard to tell. It could be much higher without contradicting the figures they choose to show.

However, as both MrsDarwin and Joanna point out: Neither the rate of compliance nor the fact that Catholic clergy are celibate has any relevance to whether Church teaching is actually right on this issue. (And come to that, if compliance determines morality, it would seem based on this survey that neither going to church nor only having sex with one's spouse is actually a moral requirement.)

Jen R said...

"With this in mind, I think it should be clear there is a big difference for an organization which considers contraception to be immoral between providing employees with health care coverage specifically for buying contraception and providing them with money which they can choose to use for anything they want. "

I would argue, though, that they are not providing employees with health care coverage specifically for buying contraception. If they were, I would agree with you. But they are actually providing employees with general health care coverage, and one of the many things it could be used for is contraception.

With your bicycle example, it would be more like if the company provided a transportation allowance for all employees to get to work. Some employees might use it to take cabs or buses, some might use it for gas for their cars, and some might buy bikes. I don't think that can be considered to be specifically encouraging bike usage.

Darwin said...

But they are actually providing employees with general health care coverage, and one of the many things it could be used for is contraception.

But here's the thing: the coverage mandate does not treat contraception the same as any other kind of health coverage. If you have to get penicillin or insulin or an asthma inhaler, you have to pay a copay and your deductible. Contraception, however, is set aside as a special category to be "free" with no co-pay and no deductible. (Which, incidentally, is downright silly as "insurance". The whole idea of insurance is that it covers unexpected expenditures beyond a specific amount.)

Jen R said...

"Contraception, however, is set aside as a special category to be "free" with no co-pay and no deductible."

There are a lot of other things in that category, not just contraception. There's a list here: http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

Darwin said...

Jen,

Yes, and? The result is still much more like my example than yours. The function is not that people are given coverage which they can then use to pick any one of a number of services, in the way that someone given money can decide what to buy it on. Rather, the Obama administration (doubtless with the help of a few friendly lobbyists) has put together a grab bag of goodies and said, "Employers are required to buy coverage which provides all of the following free of charge."

To go back to my example: If a company announced, "We will provide any of our employees who wants a Glock, a whoopee cushion, or a rubber chicken. You can get any one of these, or all three, or any combination of them, free of charge." surely you would not accept the argument, "This is not remotely promoting gun ownership. After all, someone who wants a whoopee cushion can take advantage of this program as well!"

Not only is the Obama administration trying to force everyone to actively subsidize contraction use (regardless of religious objections) but this is, as I pointed out, an incredibly bad use of the "insurance" mechanism. As Finance Professor John Cochrane wrote in the Wall Street Journal the other day:

http://online.wsj.com/article/SB10001424052970204136404577210730406555906.html

It's not just an attack on religious freedom, it's also a terrible economic incentive which will end up costing everyone more money. He compared it to the idea of requiring car insurance policies to provide "free" oil changes.

Darwin said...

Rob,

Sorry to be slow in answering: That's an interesting question. Giving people cash for such a purpose is such a poor way of achieving such a stated object, I'm not sure that someone would try it. That said, it seems to me that if the moral purpose of the employer was to achieve a certain end, they would be culpable for that end, however incompetent their means.

Jen R said...

I'll be honest. I don't realy know how to respond to a comparison of prescription contraception and other preventive services to "a Glock, a whoopee cushion, and a rubber chicken." For several reasons. I may have to just bow out.

Anonymous said...

http://www.slate.com/blogs/xx_factor/2012/02/10/obama_riled_up_republicans_on_contraception_and_then_delivers_a_knock_out_punch_.html?lucy

Yup.

Joel

Darwin said...

Jen,

If an employer announced it was providing a benefit wherein any employee could get a free gun, no one would accept the claim that they weren't pushing gun ownership just because they would allow you to get any number of other free things as well. Similarly, the fact that the regulation requires other types of care to be given away as well does not mean that the administration is not trying to force religious employers to give away free contraception as an employment benefit.

Joel,

Yes, well, Amanda Marcotte brings her typical intelligence and objectivity to that analysis -- which is to say, not much. Whatever one thinks of the "compromise" that Obama rolled out, the idea that this was all a clever ploy on his part to make Republicans look bad is silly. You can bet that he did not roll out this policy (reportedly against the advice of a number of members of the administration -- even the usually dim vice president -- who pointed out the likely firestorm to come) and allow himself to be bounded for two weeks simply in order to slink out with an empty "compromise". He's the tail, not the dog, that much is clear -- and a tail hoping to end the barking.

Whether this works in putting things to bed is less clear. The "compromise" itself is downright laughable. Religious employers will not be required to "pay for" the contraception coverage, but insurers they pay to cover their employees will be required to provide the coverage. What a joke. (The claim that the insurers want to do this because it will save them money is likewise laughable. The record for free preventative care actually reducing care costs is not actually very good. People who don't care enough to shell out a few bucks for a really cheap preventative service usually end up being bad about using the service even when it's free.)

The bishops have already clearly stated they'll keep pushing. They're not fooled, and even as reformulated the regulation would make illegal the self-insurance plans some Catholic health care providers offer their employees, and the student health plans which some Catholic universities provide. Instead, the bishops are putting their weight behind the legislative efforts to put in a real religious liberty exemption which Republicans in congress are are already pushing.

Whose narrative ends up winning on this remains to be seen, but Obama's attempt to generate a reality distortion field has not been working nearly as well since he actually took office, so the chances are probably at least even.