The principle of the "double effect" also applies to sexual sterilization. If a woman must have a hysterectomy to remove a dangerously cancerous uterus, this will result in her sterilization, but is not a sinful act. However, if the purpose of the operation is not to heal or safeguard health, but to directly sterilize, then that act is intrinsically evil and is always a mortal sin.

— Donovan

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