Narcotics and Anaesthetics

344. On the use of morphine.¹ For lessening pains and for putting the senses to sleep, physicians now frequently use diverse means; and indeed morphine is ordinarily applied for lessening pains, but other "narcotics" also serve for putting the senses to sleep. The question is asked concerning their effects and concerning their liceity.

1. The effects which the use of morphine produces are diverse according to the diverse quantity which is taken. What is said here concerning morphine is also valid concerning opium, cocaine, and other remedies of this kind.

a. Drunk in a great quantity, in the same way as poison, it induces death; taken in a lesser quantity it causes stupor of the senses and privation of the use of reason, which effect indeed differs in nothing from drunkenness; finally, if a very moderate quantity is taken, it serves for quieting the nerves and restoring strength.

b. Injections of morphine, which are made under the skin in small quantity, serve for lessening pains and produce a certain pleasure that is by no means slight. But if those subcutaneous injections are repeated in greater quantity for a notable time, they gravely harm the health of the body, notably shorten life, and moreover provoke a vehement craving for morphine, which can be overcome with greater difficulty than drunkenness itself and can scarcely be cured except in hospitals erected for this end. Nevertheless these malignant effects are not caused except from the use of a greater quantity repeated rather often; a few injections, and those moderate, scarcely harm the body or the soul in any way.

¹ Cf. Olfers, l. c., p. 103 f. Capellmann, l. c., p. 41 ff.

345. 2. From these things, as regards the liceity of this use, the following are now gathered.

a. A use of morphine so slight that it produces no other effect except restoration of strength and quieting of the nerves is manifestly licit.

b. A moderate use of morphine, even without a just cause, applied only for calming the craving for it, does not exceed venial sin, since it does not gravely harm health nor cause a notable shortening of life; but to use morphine in that quantity and frequency such that notable detriment to health and life follows from it is a grave sin.

c. The use of morphine applied in such a quantity that the senses are put to sleep and privation of the use of reason follows:

a. without a just cause is a grave sin, equally as drunkenness arising from the drinking of wine;

b. from a proportionately grave cause of necessity or utility is licit, e.g. that the sick man in a surgical operation may permit himself without resistance to the hands of the surgeon, or that the sick man may not feel sharp pains;

c. in the article of death is illicit not only if the dying man is not yet disposed for dying well, but even if he has been duly disposed for death, because there is not a sufficient reason for depriving a dying man of the use of reason, unless a fall into sin is to be feared; since indeed at that time the use of reason is of such great utility that it cannot be compensated by any temporal advantage. For the dying man would lack the merits which he could gain both from pains patiently tolerated and from acts of perfect conformity with the divine will and of other virtues.

I. The use of chloroform, ether, and other things by which the use of reason is removed, is of itself illicit, but lawful on account of a proportionate cause. It is said:

1. It is of itself illicit, because it not only deprives one of the actual use of reason without any utility that will follow of itself, but also of the proximate faculty of using it for a sudden necessity, as was said about drunkenness (n. 320; St. Alphonsus, V, 73).

2. It is lawful on account of a proportionate cause; this follows from what has been said about an act with a double effect. But the avoiding of pains in a surgical operation constitutes a proportionate cause; likewise the forestalling of extraordinary pains of childbirth;¹ but the avoiding of ordinary pains does not seem to suffice.

Corollary. More probably, it is lawful for a dying person, by means for example of chloroform, to deprive himself of the use of reason, so that he may die without very acute pain. The things opposed by authors to this doctrine prove at most that a graver reason is required in the article of death than in the course of life. But the relief of very acute pains seems to involve a sufficient reason, although it is better to endure them patiently; indeed, the spread of a practice of this sort would give occasion to consequences to be disapproved. Yet it is supposed that the dying person is sufficiently prepared for death; nor is it lawful for another to deprive a dying person of the use of reason without his consent.

Objection 1. If ever, at such a time it is necessary that the faculty of meriting be preserved for man.

Response. Why would it not be lawful, on account of a graver cause, to deprive oneself of the faculty of meriting in the article of death, just as the same thing is permitted on account of a lesser cause in the course of life?

Objection 2. Privation of the use of reason would then be entirely equivalent to abbreviation of life.

Response. It would be equivalent to abbreviation of moral life, I concede; but that seems lawful on account of a graver cause, just as outside the article of death it is lawful, on account of a lesser cause, to take away something from moral life.

II. The infrequent use of morphine, opium, and cocaine in small quantity is not harmful, and therefore is lawfully employed for alleviating pains or driving away sleeplessness. But there is easily danger lest use pass over into abuse and habit (morphinomania), which produces the worst consequences and therefore must be put away with all one's strength. These things noted generally, receive these special points, especially from Antonelli.²

1. The external causes which induce morphinomania can be: 1. physicians who abuse morphine, either by administering too great a quantity or by too frequently prescribing injections for the calming of pains; 2. the sick themselves, who, after they have once known this solace of pains, ask the physician that they may be able to use morphine more often; and he, either because the disease is chronic, or to avoid troublesome complaints, or because the sick person is poor and is no longer able to pay for medical visits, not only permits it, but hands over the prescription into his hands, to be renewed at his discretion; 3. directors and attendants in hospitals, who, for procuring the quiet of the sick who are too talkative or too affected by pains, admit too many injections; 4. pharmacists who, either from excessive love of profit, or from fear lest those clients desert them, or for shamefully capturing the pleasures of women, sell morphinic solutions without caution; 5. writings which treat of the morphinic matter, examples, and persuasions of others. But once the passion has been contracted, it is altogether incredible how many means, how many pretexts, and how much cunning morphine addicts employ in practice for making injections as often as they wish, wherever they stay.

2. The consequences that will follow from a habit contracted and continued are: memory is weakened; the will grows sluggish and gradually lacks every force; whence it happens that the morphine addict is incapable of correcting himself and very quickly rushes into his own ruin; the individual character is changed; instability of spirit, irascibility, and impotence occur; the moral sense is diminished and can even be wholly lost; then the way is opened to crimes of every kind, for thefts and carnal crimes occur very frequently; women often forget modesty; like those affected by hysteria, morphine addicts continually lie so that their habit may remain hidden; they frequently suffer hallucinations and illusions in the same way as those who are affected by alcoholism; sexual excitations at first are increased, but generally for a short time; in those who labor under chronic morphinomania, they are absent; infants who are born from a morphinomanic mother sometimes die immediately because of the lack of morphine which they were drawing in the womb through the maternal placenta. Nor is this enough; since the nervous system is especially badly affected, sleeplessness occurs with headaches, tremors of the hands and tongue, and disturbances in the pronunciation of words. The heat of the body also is increased, about 38 degrees C., bringing on fever, which presents the same characters as malarial and typhoid fever.

3. The sole and necessary remedy is placed in this, that they be deprived of the faculty of procuring new morphine for themselves, and be subjected to diligent custody. It is better to send them to hospices established for this purpose. But if this can be obtained, within a few weeks they obtain restoration of health; nevertheless after the cure it must greatly be guarded against and feared lest they fall again into abuse, which indeed certainly occurs unless they are most vigilantly guarded in all things.

¹ For the infant - thus Aertnys-Damen, relying on the testimony of a specialist concerned only with giving narcosis - harmful consequences from the mother's narcosis are not to be feared, provided that the narcosis is not too deep and does not last too long; this also holds concerning the narcotic which is called chloroforme a la reine (Theologia Moralis, I, 259).

² Medicina Pastoralis, I, n. 354 sq.

Is drunkenness licit for undergoing a surgical operation? - The first opinion, which St. Alphonsus, 76, and others hold, denies it, because in this case drunkenness would be directly intended, or the privation of reason, which is intrinsically evil, as a means of removing the pain of the senses. But the second opinion affirms it. 1. Because privation of the use of reason at least for a brief time, and from a grave cause, does not seem intrinsically evil. 2. Because drink is not directly given for causing the privation of reason, but for the sleep of the senses; and therefore drunkenness follows indirectly per accidens. For neither does the sleep of the senses proceed from privation of reason, but from relaxation and dulling of the nerves; and from the sleep of the senses proceeds privation of the use of reason. Gur. Baller. 182.

Therefore in no way is to be condemned the use of other medicines whose primary power is to bring on sleep, or to make the nerves numb, such as opium and the inhalation of ether. Antonelli, vol. 1, p. 2, de 5 Praec., c. 6; La-Croix, l. 5, n. 314. Chloroform: Its use is licit for lessening or preventing pains in a surgical operation, in difficult childbirth, and even in ordinary childbirth, since the danger which some affirm would arise to mother and child does not in reality exist. Morphine: Taken in great quantity it causes death; in small quantity, it produces sleep of the senses and privation of the use of reason; in smallest quantity, it is useful for calming the nerves and for restoring strength. Injections, for lessening pains, if they are done sometimes and in small quantity, are not illicit. In great pains they provide true relief. But if they are used repeatedly, and in greater quantity, they gravely harm bodily health, and consequently are illicit. Cocaine: Insofar as it is used for lessening pains, if it is done with due moderation, and no grave danger afterward is present either to health or even to life, it is licit per se.

5. There are various kinds of medical treatment to which we can scarcely have recourse without exposing ourselves to serious evil consequences. Such is the use of cocaine, morphine, and even in special cases of alcohol. The drugs in themselves are useful, but they often lead to evil results. Now in the use of all such drugs as are apt to be beneficial in one way and injurious in another, we must ever be guided by the rules formerly explained concerning evil indirectly willed, or rather permitted to result, while good results are directly willed or intended. If the Doctor is satisfied that a dose of morphine or an application of cocaine will do more good than harm, he can, of course, prescribe or apply it. Still in such matters he must remember that the good effect is but temporary, while its pernicious consequences, especially when habits are thus contracted, are likely to be permanent and cumulative. Besides, the good results affect the body only, the evil often affect body and soul. Many a wreck in health and morals has been caused by imprudent recourse to dangerous treatment, where a little more patience and wisdom would have been equally efficient in curing the bodily ailment, without any deleterious consequences. If once a patient becomes a slave to the morphine or cocaine habit, the only cure is to cut off all the supply of the drug either at once or, at any rate, by daily diminution. To leave him free control of the poison is to co-operate in his self-destruction.

(b) For the same reason, the physician should not prescribe such doses of morphine or other anæsthetics as will render the patient unconscious at a time when he ought to be preparing to meet his Judge. This would be not kindness but cruelty. A little suffering more in this life may save much suffering in the next. If a Catholic priest, on being called to a patient’s bedside, finds that the family’s physician has been so inconsiderate, he cannot help protesting against employing such a man in Catholic families.

IV. Concerning the use of morphine and other narcotic medicines. - The matter concerns not only physicians but also nurses, indeed patients who can administer medicines to themselves, for example as a remedy for sleeplessness or against the pains of rheumatism.

For in modern times narcotics (νάρκωσις, i.e., sleep, stupor) are often employed, whether for soothing pains or for provoking pleasure, as opium, morphine, cocaine, or for putting the senses to sleep, as ether and chloroform; their effects can be harmful or even intercept the use of reason for a time, and therefore their use can be illicit.

Soothing or stupefying means (calmants, stupefiants; verzachtende, verdoovende, bedwelmende middelen), concerning which we are here treating exclusively, are medicines which cause a temporary suppression or diminution of the activity of the nerve centers, from which there arises a certain state of physical and moral inertia. They are opium, morphine, cocaine, and other derivatives or mixtures of this sort.⁴ These are taken not only by way of absorption or chewing, by smoking or inhalation, but also by subcutaneous injection, and they are very efficacious for soothing pains; indeed they provoke a certain sense of cheerfulness and pleasure, but at the same time they weaken the nerves.

⁴ The International Geneva Conference, 17 Nov. 1924 - 19 Feb. 1925, reserved exclusively the name stupefiants to certain things. They are: opium, or the latex collected from the immature fruits of the white sleep-bearing poppy, which is cultivated in Asia Minor, India, China, Egypt, Persia; morphine, which is a certain principal alkaloid extracted from opium, and heroin obtained from it by chemical operation; coca naturalis, or erythroxylon coca, which is a certain plant from the Peruvian region; cocaine, or a certain alkaloid derived from coca; hashish, or cannabis from India, which secretes a toxic resin or oil enjoying excitatory properties. Very recently also peyotl is denounced, a certain Mexican cactus plant, of which a certain extract comes into use in the United States of America and is called "mescal buttons." This first effects alacrity and vigor, but then nervous languor and depression, with illusions and disturbances, yet without loss of consciousness, so that the man knows his state to be fictitious. Nor does the use of this remedy render a man dull as the others are apt to do. Concerning these see Dupre and Logre, Intoxications par l'opium, l'ether, la cocaine, in Nouveau Traite de Medecine, fasc. VI, Paris 1922; Dr. De Block, Toximanies, Liege 1927; Dr. Lewin, Paradis artificiels, Paris 1928; Mgr. Beaupin, Le Probleme des Stupefiants, in Vie intell., 1930; Brouillard, Stupefiants et Anesthesiques, in Etudes, 1929; Dr. Vervaeck, Le Peril des Toximanies, in Dossiers de l'A. C., 1930. Likewise the periodical La Cite Chretienne, 1928; S. Luc medical, 1934; Kothen, Les Toximanes, in Coll. Mechl., 1931-32; St. Willems, in Coll. Brug., 1932; Meunier, Les stupefiants et la morale, in Rev. Eccl. de Liege, 1934.

If they are taken in great quantity, they are deadly by acute intoxication in the same way as poison; in lesser quantity they cause a sleep of the senses and privation of the use of reason, which effect differs in nothing from drunkenness; in moderate quantity but taken repeatedly for a long time they gravely harm health by slow and progressive intoxication, notably shorten life, and provoke a most vehement desire, for example for repeated use (morphomania), which can be overcome much more difficultly than even the habit of long-standing drunkenness, and scarcely can be cured except in hospitals erected for this end;⁵ indeed they cause abulia, or paralysis and as it were atrophy of the will, indolence, indifference toward the duties of state and negligence, dulling of the mind, irritability of spirit, perversion of the moral sense, and diminution of responsibility.

⁵ A moderate quantity of morphine is judged permitted at 0.1 gr., but not for a long time. One who uses 0.2 gr. or 0.5 soon comes to 1.0 and 3.0, which quantity equals 20 or 50 small bottles in a day. Thus Capellmann, o. c.

From all these things it is evident that the use of remedies of this kind is dangerous, and is to be avoided unless necessity requires otherwise; and therefore a physician cannot supply or leave with a sick person an injection syringe or morphine.

Certainly it is lawful to diminish pains, provided that by the remedies employed the healing of the disease is not delayed, or damage or danger is not directly brought to health or life. Hence in employing remedies someone can sin either from the fact that he takes too great a portion, harmful to health, or from the fact that he employs remedies too frequently.

In particular:

1. Transitory use, and so slight that it produces no other effect except restoration of strength and calming of the nerves, is lawful.

2. Use in greater quantity or frequency, employed without just cause, or for pleasure alone, or for quieting the desire for narcotics, is a grave sin if notable detriment of health and life can or probably will follow from it; venial if the detriment of health or abbreviation of life certainly is not notable; but it is lawful in decreasing quantity for him who has contracted so long-standing a custom of use, for example of opium, that he cannot abstain from it without grave detriment to health.

3. Use in such quantity that the senses are put to sleep and temporary privation of the use of reason follows: employed without just cause, it is a grave sin just as drunkenness is; but from a proportionately grave cause of necessity or utility it is lawful with the consent of the sick person, as if it is done so that he may not feel bitter pains, or in a major surgical operation so that the sick person may permit himself without resistance.

4. Especially in the article of death: a) to provide a remedy so that the sick person may be deprived of reason and depart without the sense of pain is gravely illicit, especially if he is not yet prepared for death, because he would be deprived of the opportunity of doing penance and would incur the danger of eternal damnation; also generally if he is duly disposed, because thus he would lack the opportunity of meriting and of immediately preparing himself for death and notably increasing heavenly glory. Hence a proportionately grave reason for permitting this is lacking; indeed, if there is danger that he will not return to the use of reason, this is equivalent to an abbreviation of life.

b) According to some, however, this could be tolerated, presupposing the consent and good faith of the sick person, who is already well prepared for death, namely on account of bitter pains,⁶ especially if he is very liable to movements of impatience, so that it can probably be feared that he may fall into grave sin; indeed, as has sometimes been said, even if at the same time an indirect abbreviation of life would follow in a sick person certainly soon to die. But this is more doubtful and rather to be omitted.

⁶ Not on account of agony alone, says Noldin, Th. M., I, n. 349.

c) Certainly, however, euthanasia properly so called, namely directly and in itself intended, or directly procured, is gravely illicit, namely a direct acceleration of death, so that insensibility and privation of the use of reason is only the effect of induced weakness and of abbreviation of life. For evils are not to be done so that goods may come. In the case there is rather intoxication than anesthesia.

Hence the Holy Office, 11 May 1852, declared the trade and use of opium, as they are exercised in the Chinese empire, to be illicit; and the S. C. P. F., 29 Dec. 1891, declared that in that region the cultivation and commerce of opium, likewise regular use, are to be prohibited to Christians, except in the case of avoiding graver harm.⁷

⁷ Consequently the Synod of Peking of the year 1880 commanded: 1. that absolution is to be denied to those who have not yet contracted the custom of smoking opium, if they are unwilling to renounce this; 2. that the customary users can be absolved if they promise to diminish the quantity; 3. that to those who do not keep the promise, absolution is to be deferred until they have fulfilled it; 4. that from those who exercise the cultivation and commerce of opium, it is to be required that they entirely leave it.

S. Th. I-II, q. 88, a. 5, ad 1; II-II, q. 150, a. 1, 2, 3.

985. Drunkenness (dronkenschap) is taken: a) for the state, namely the defect of reason which happens from much wine having been drunk, and thus it is not sin, but can be the effect of sin; b) for the act by which someone falls into this defect, whether it happens contrary to the opinion of the drinker, and then it can be without sin, especially if it does not happen from man's negligence; or whether it happens from inordinate concupiscence and use of wine, and thus it is sin, and can be defined: a voluntary excess in intoxicating drink, for the sake of pleasure. This indicates:

1. The genus: excess, for it pertains to intemperance, and thus it is distinguished from the opposite insensibility.

2. The material object: in intoxicating drink, that is, drink violently inducing privation of the use of reason. Thus it is distinguished from gluttony strictly so called, which is excess in non-intoxicating drink.

Hence if someone exceeds in non-intoxicating drink, for example in milk, chocolate, coffee, or in an intoxicating drink which in fact is not intoxicating, that is, does not reach defect of reason, as happens in those who by nature, custom, or means of pharmaceutical science are powerful, it is not the sin of drunkenness but of crapula. On the contrary, if someone were deprived of the use of reason by something other than drink, for example, by the odor of hops, or the smoke of tobacco, or by the use of morphine, chloroform, or opium, this is not properly drunkenness, although he can sin if it is done voluntarily and without proportionate cause.

3. The formal object: for the sake of pleasure; for the proper object of every temperance and intemperance is the delightful according to the sense of touch. For if someone drank even to alienation of mind, not for the sake of delight, but for some honorable cause, there is the state, but not the sin, of drunkenness. But if sufficient reason is absent, the privation of the use of reason is sought from such drink for its own sake, and therefore for one's own pleasure.

Namely, privation of the use of reason seems not to be in itself and essentially evil, but something indifferent. It is evil if it is done without a just and grave cause, only for pleasure or gluttonous excess, not through rest and in the natural mode, namely sleep instituted by God, but violently and in an unnatural mode, by disturbing the organs: for thus a lower good is preferred to a higher good. But it can be good if it is necessary in order to health of body, for example, for curing or driving off a disease such as typhus, for checking the force of poison from a serpent's bite, for performing a surgical incision more safely, etc.: not only if the good effect follows from the cause, namely from drink by which the senses are dulled, as immediately as the privation of reason does, but also if privation of the use of reason is a means for obtaining an intrinsic good, because for the good of the whole it is licit to deprive oneself of the good of a part, namely the use of reason for a time; indeed, according to some, even for avoiding harm or danger from outside, for example, for avoiding death which another threatens to someone unless he becomes drunk. This, however, cannot be admitted if it is formally requested, or requested from contempt.

4. The condition: voluntary, either in itself or intended, when someone expressly wills to be deprived of the use of reason, for example, to forget pains; or only in the cause, when someone foresees that he will be deprived of the use of reason from it and nevertheless prefers to incur drunkenness rather than abstain from drink.

986. Fully voluntary drunkenness is of itself a mortal sin from its kind, even if admitted only once. - It is proved:

1. From the Scriptures: Gal. 5:21; 1 Cor. 6:10; Rom. 13:13; Luke 21:34; Is. 5:11; Prov. 23:20, 21, 29... And "although it can seem that only the habit of drunkenness is in question, it does not appear how this very habit could per se arrive at grave malice, if its individual acts contained only light malice" (Genicot).

2. From reason: It gravely repugns right reason that a man, knowingly and willingly, for the mere pleasure of wine, without necessity, should deprive himself of the use of reason, and of the proximate power of recovering it and using reason for every sudden necessity: namely, of the most excellent good by which he is distinguished from brutes and operates in a human mode according to reason and avoids sins. From this inordination another follows, that he exposes himself to the danger of perpetrating many and grave evils which are apt to follow from drunkenness, and of omitting goods which he ought to perform.

Yet it can be venial: a) from imperfection of the act, through some inadvertence of the act or ignorance of the drink, which nevertheless is not to be admitted in habitual drunkards; b) from lightness of matter, namely from a slight excess, when drunkenness is imperfect, lightly disturbing reason, or also from shortness of time, if perfect drunkenness does not last long, for example, only some moments. Yet in practice this hardly applies, because no one can know how long it will last.

987. Drunkenness is not the gravest of sins: for other sins either directly deprive one of a divine good, if they are directly against God, or directly deprive one of the good of reason or virtue, which is always a good; but drunkenness itself only deprives one of the use of reason, which can be good or evil. Therefore it is among the lesser complete mortal sins.

Yet it is especially to be fled, because by depriving one of the use of reason, it can be the source of all sins accidentally, insofar as these are impeded by the use of reason.

988. The signs of drunkenness are: a) the certain sign of perfect drunkenness: 1) if someone by reason no longer discerns between moral good and evil. Conjectural signs are: 2) if he does those things which, in possession of himself, he would never do; for example, if he swears, speaks shameful things, starts quarrels, breaks vessels, strikes his wife; 3) if on the following day he does not remember notable words or deeds, for example, what quarrels he stirred up, how he returned home, by what way, with what companion; 4) if he scarcely, or not even scarcely, suffices for directing his common or easy actions; 5) if he has lost the use of the senses and members, for example, of sight, walking, speech.

On the contrary, b) probable signs of imperfect drunkenness or ambiguous signs are: some staggering of gait, stammering of the tongue, an apparent turning of things, seeing things doubled, forgetfulness of small matters, difficulty in carrying out due offices, a certain disturbance of the head or imagination, vomiting: for these also occur while sufficient presence of reason remains.

989. On the use of narcotics (morphine, opium, cocaine, chloroform, ether, etc.), whether for soothing pains or for dulling the senses, since from them can follow privation of the use of reason and great detriment to health, it is useful to say briefly:¹

¹ The question rather belongs to pastoral theology, where it is usually developed more fully. Cf. our little work De Variis Peccatis in sacramentali confessione medendis, c. 2, § B, IV and VI.

1. A transitory use, and so slight that it produces no other effect than restoration of strength and calming of the nerves, is licit.

2. Use in greater quantity or frequency, employed for pleasure alone, or for quieting the craving for narcotics which is generated most vehemently from repeated use of them, is gravely illicit if notable detriment to health and life can follow from it; lightly illicit if the detriment to health or shortening of life certainly is not notable.

3. Use employed in such quantity that the senses are dulled and temporary privation of the use of reason follows, if employed without a just cause, is a grave sin, just as drunkenness is; but from a proportionately grave cause of necessity or utility it is licit, as if it is done so as not to feel sharp pains, or in a major surgical operation, so that the sick person permits himself to be treated without resistance.

4. Use employed at the point of death so that the sick person is deprived of reason and dies without sense of pain is gravely illicit, not only if he is not yet prepared for death, so that he would be deprived of the opportunity of doing penance and would incur the danger of eternal damnation; but also if he is rightly disposed, because thus he would lack the opportunity of meriting and of immediately preparing himself for death and notably increasing heavenly glory. Hence there is lacking a proportionately grave reason for permitting this; indeed, if there is danger that he will not return to the use of reason, it is an equivalent shortening of life.

According to some, however, this could be tolerated, with the consent of the sick person, who is already well prepared for death, namely on account of sharp pains, especially if he is very liable to impatience, so that it can probably be feared that he will fall into grave sin; indeed, as has sometimes been said, even if at the same time an indirect shortening of life would follow in a sick person certainly about to die. But this is more doubtful and rather to be omitted. Without doubt, however, direct acceleration of death would be gravely illicit, so that insensibility and privation of the use of reason would be only effects of the very shortening of life: for evils are not to be done that good things may come.

990. Remarks. - 1. As St. Alphonsus notes, l. V, n. 78, he is not excused from mortal sin who takes a quantity of drink apt of itself to induce perfect drunkenness, even though, before he is deprived of his senses, he gives himself to sleep, by which he escapes the effect of the wine; because that drinking is already of itself intrinsically evil, since of itself it is already apt to deprive that man of the use of reason, and it is accidental whether he is deprived of his senses through sleep or through intoxication. He placed the whole cause of the evil, and there will remain an incapacity of recovering the use of reason which would not have arisen from natural sleep.

2. The confessor can rightly presume that drunkenness was voluntary in him who is accustomed to become drunk frequently, for example, ten times in individual months. But if a fairly intelligent man confesses that within a month he was drunk once or twice, he should be asked whether he foresaw the drunkenness. He who was drunk once or twice, without any habit, is to be presumed not to have foreseen the drunkenness.

3. To drive away sadness or melancholy it would be licit to drink only up to cheerfulness: for such a reason would not have proportion with the evil of perfect drunkenness. But clerics, fathers of families, and persons established in dignity ought also to avoid cheerfulness.