The primary moral question involved is, Should Ann have a sterilization procedure? Ann’s decision to have her tubes tied is irresponsible, selfish, and a permanent mistake. It is an ethical issue because sterilization will prevent Ann to have future siblings for her only daughter Sally. Also sterilization will not solve her current marriage problems. Ann is looking for a solution to her marital problems and is wondering what to do. She has her best friend as a lifetime partner who has shared her life crucial moments for many years. Ann has made a decision that could affect her marriage, faith, family, health and friendship with her best friend Julie. In this case of Sterilization, Ann has made up her mind to share her decision with her best friend. This is how the story develops.Some of the ethical options in general for Ann are the practice, natural, safe method of Natural Family Planning (NFP), Marriage Counseling, therapist, Alcohol Counseling and even pastoral counseling. These are more options and the possibilities are to give Ann choices that will be in cooperation with these resources to make the best decision. This way Ann will have a clear conscience and will not be walking alone in this challenging decision.Some important Christian values regarding sterilization are what the church says about contraception or birth control. “Contraceptive lovemaking is always immoral and sinful.”1 This means that to have sex outside marriage is immoral since the couple is not marry but there is an additional moral evil if the unmarried couple engage in contraceptive lovemaking. The reason is that the couple is using contraceptives for a good sex experience without any responsibility whatsoever but only for pleasure. To counsel anybody to use contraceptives will be encouraging them to sin. Sterilization is a permanent form of birth control that prevents pregnancy. It is difficult to reverse the effects of sterilization if the woman changes her mind. At the same time sterilization does not protect anyone from STDs. Ann will be making a great, permanent mistake to get sterilized which it will not give her any peace of mind, security and stability in her life. The enemy of Christian marriage is not contraception but selfishness, indifference, arrogance and irresponsibility. In the Scripture we find St. Paul telling the Ephesians to discern for ourselves the will of the Lord. “Live as children of light, for light produces every kind of goodness and righteousness and truth. Try to learn what is pleasing to the Lord”2 One of the ways we can find the will of God is for the couple to seek advice from professionals and counsel from the church authorities such as bishops, priests or deacons. We are not alone in this world of challenges, ideas and life circumstances. There is always help, assistance available to find answers to difficult questions, and choices in our human experiences.Another Christian value affecting sterilization is found in Genesis, “Onan, however, knew that the offspring would not be his; so whenever he had intercourse with his brother’s wife, he wasted his seed on the ground, to avoid giving offspring to his brother.”3 God does not wants us to kill the person in the seed or destroy the sperm. This one was one of the position St. Augustine took in the thirteenth century. This behavior was seen unnatural. Pope Pious XI argued that “the procreation of children was the primary purpose of intercourse”.4 To procreate children was the only purpose for having sex. There has to be a cultivating, mutual love between the couple, it is a relationship of two persons. Ann has to get her husband involved in her decision about having the sterilization. She has to ask her husband how does he feels about sterilization? Does he even care? It is a decision that it will affect the two of them as a family since infertility can cause great suffering to couples who experience it. Sterilization is once and for all, and it is not the best solution to Ann’s marital problems. The only time the church allows contraceptive in the Catholic healthcare facilities is to treat victims of rape. “The unitive and procreative meanings of human sexuality is not the basis for the exclusion of every case of contraception by the church”. 5 There is always other issues regarding sexual and medical ethics. There will always be some implications and it is intrinsically evil to use contraception in a conjugal act. Any situations of rape are not conjugal acts. Ann is not experiencing rape in her matrimony but her determination to go for sterilization makes her feel matrimony things might get better in her relationship and she is wrong.My understanding of sterilization is a way to regulate births, to stop pro-creation is against God’s will. Since Sterilization is a contraception surgery that will permanent stop pregnancy and this procedure will not straightened Ann’s life. I do not agree that sterilization is the best option or only solution to Ann’s marriage problems. According to this case Ann is having marital problems. Her marriage cannot take the strain of a second child, the husband is already experiencing stress at the workplace. He has a drinking problem, to have another baby will make things worse, and Ann does not like taking birth control pills since her life is not well organized. Ann thinks that having her tubes tied will give her security, peace of mind and stability in her relationship. Ann is not thinking about the future of her relationship. So far, her husband is not cooperating at all with his own issues. He is not looking for solutions and even rejecting advice from his own Dad. Mitch has not done anything to change or even work in his own personal struggles. He is unwilling to see a therapist or go to an AA support group. The problem stated her is not Ann but the husband Mitch. One action that should take place is that Ann must encourage to bring her husband to a therapist to start coming out with a plan that will take time but can give peace of mind as it progresses to resolve the issues together as a couple. Ann is not single but married and her husband has to also participate to protect, defend the dignity and health of her wife. Married couple forms an intimate partnership of life and love and share together their relationship as a covenant. They have to work together to find solutions to their challenges, it is their obligation and expectation. Another action is to have a very serious talk with the husband about making the decision to go to an AA support group to treat and learn to control his alcohol addiction. Ann must also find out why the new job of her husband is so stressful. May be Ann should suggest her husband to find another job that will be stress free, and this way will alleviate family problems.A good ethical justification for my position is not to use sterilization as the ultimate solution to solve Ann’s marriage. She is twenty eight years of age and her future is still bright with her only child just in case her relationship does not work. The best ethical justification for Ann is to try the method of natural family planning. The saying goes, practice makes perfect, so it is with this method that in order to work and make a difference in Ann’s life the couple must really engage in it and follow all the rules and steps according to the plan. NFP will help the couple to become aware of fertility and learning and this process can assure great results. It is over 99% effective in preventing pregnancy. This is what we call responsible parenthood. This method is natural, there are no drugs, chemical or devices involved which this is a very positive way to keep away from contraceptive approaches. This approach will honor the dignity of the persons involved by respecting the natural and functions of the body. Our Lord command us to take care of our bodies since they belong to God. “Do you not know that your body is a temple of the Holy Spirit within you, whom you have from God, and that you are not your own? For you have been purchased at a price. Therefore glorify God in your body”.6 When we use an artificial method then the person is not accepted in its totality like saying I accept you without your fertility. The person is not complete. The method of Natural Family Planning is natural in its totality and from this way of taking care of our bodies, it derives and values life like a gift from God and not like a right. To have a son in the natural way with dignity and not the other way, which sterilization treats life like an object manipulated by man’s science. It is for all of the above that only the spouses can participate in theses natural methods. When we manipulate our body to make it obey by our standards, in our sexual relationships that go contrary to God’s will to procreate, to multiply then it is not done any more in true love. Sterilization will always be influencing my conveniences, private matters and it is seen as a great selfishness option. The person, and the family is affected, because this artificial contraception surgeries affect the wellbeing of the family, the natural law given by God our creator. One might feel used by the other and the person runs to fulfill its own matters.We all live in a utilitarian society and hedonistic where one’s ideas, opinions about what is better for me is on top of one’s life, true identity in this society. The statistical analysis that are done for natural family planning only measure the errors that the couples experience and the ones that get pregnant. Yet it would be even more interesting to find a way to measure the index of happiness, marriage fidelity, commitment and perseverance in its usage.Any method of natural family planning if is not done with motivation, discipline and cooperation then the user will not obtain the benefits in its totality. Family planning is the privilege and obligation of a married couple to decide with love the number and spacing of their children using an ethical means.When choosing a natural family planning method, the child is seen and received as a person, as a gift and not as a right or as an object that can be loved or not. It is an obligation of the couple since the natural methods depend exclusively on the spouses, on their intelligence and will, on knowing how to make a decision and sustain it; The responsibility for the transmission of life is really shared and I do not leave it in the hands of a third party that can fail like the pill or the condom. It is a decision based on love, since the spouses respect each other as people, they love each other as they exercise their self-control, they can sustain the decision to “want to love you” as well as to space their children; in themselves natural methods favor love and not selfishness.Ann and Mitch form a family of three. The decision of sterilization must take into consideration all the parties involved since each person will be affected in one way or the other. Mitch might find a better job with less stress and his drinking problem might be healed and put under control. Yet the decision to go for sterilization the end effects is lifetime, there is no fixing or going back, once the surgery takes place is done for good and there is no way to go back.An act is ethical if the means, purpose and circumstances are according to the natural law, that is, tend to the good and the truth.A means to achieve family planning, to be ethical, must respect the person and the human nature of the act. For example when the animals have sex, mate the animal responds to an instinct and has the sole purpose of reproduction (the animal itself is not able to recognize the relationship between mating and procreation). On the other hand, the conjugal sexual relation is not a response to an instinct but a free decision, therefore the intelligence and the will participate in it. Unlike the animals, which only mate during the heat (fertility), the conjugal sexual relationship, being an act of the will, is not exclusive of the woman’s fertility period, and has two purposes: union of the couple and procreation. “The inseparable connection between these two unitive and procreative go together”.7 Only natural family planning in which the two ends of the sexual relationship are respected is in accordance with the natural and therefore ethical law. The act will be ethical if the end is good and the circumstances are also good. On the contrary, if the medium is not ethical because it is contrary to the natural law: contraception where only one of the ends of the sexual relationship is sought (unitive), but that of procreation is erased. I would like to stress here the ethical seriousness of abortion and of contraceptives whose instrument of action is unsuccessful because they do not close the possibility of giving life unless it is against the life of the smallest and defenseless of our species call itself: pre-embryo and no end can justify this action. Through a right use of human sexuality, where people respect each other and do not consider, the natural law of the act is respected, is given within marriage where the donation is total because there is a commitment for life, it will be a source of happiness.I think it is up to us as teachers, parents, priests, people of authority to dignify human sexuality so that generations of the future will sow a culture of life.In my opinion sterilization that runs over the person’s will is totally contrary to morality, whatever the justification invoked to practice it. Neither state reasons, nor any other, can make it legal, legally or morally. When I say that the will of the person runs over me, I mean that if the person, being able to reflect, to discern, is sterilized against his desire, his right to autonomy is openly violated. However, there is a situation when sterilization could be practice without the direct consent of the person. For example people with mental disabilities. They might be capable to feel sexual attraction, and even participate in a heterosexual relationship but mentally they are incapable of supporting the physical and emotional changes during pregnancy and childbirth. At the same time of responding to raise the child up the society expectations. Also since these special woman are not able to use some of those contraceptive methods correctly, I think sterilization would be the best method for them. This procedure will have to be requested by the husband or partner or a relative, guardian, the person responsible. Therefore, it will be up to the society to make the decision for them.Therefore, Ann should not base her decision only based on her friend’s advice, nor wondering will help her see with clarity the consequences and right the choices about her life.Parents and teachers all of us play as role of responsibility to help each other make life decisions. In Mexico, the family doctor was the person in charge to answer such questions about our sexual life. Not anymore. Who then better than the medical professional to talk to about fertility, sterilization, contraception, the options, impacts, side effects and cost.For Ann there are out there more alternatives, but she has to reach out, to go look for, to ask, Jesus said it, “Ask and it will be given to you; seek and you will find; knock and the door will be opened to you.”8 Whoever asks, seeks, knocks shall find one way or another. God always provides and never hides from us, yet HE is always reminding us that we are never alone in this life nor the life to come, since we belong to him, we shall die with him and be resurrected with him, and in the second resurrection we will be with our Lord forever. There are many people out there who struggle in their relationships like Ann and Mitch. Struggles, challenges, stress, addictions etc, will be part of our daily life. Pope Francis said, “Avoiding pregnancy is not an absolute evil”. He wants us to use the right method which is referring to Natural Family Planning. The church encourages and teaches this is the best way to go to abstain from sexual activity during those fertile periods. In the other side contraception is always opening the doors to greater sexual freedom.