In a responsum from 2018, the Congregation for the Doctrine of the Faith (CDF) judged hysterectomy as permissible when a uterus is unable to bring any pregnancy to term, raising the question of why such hysterectomy does not constitute direct sterilization forbidden by previous responsa from 1975 and 1993. This paper outlines these theological views, both supportive and against, concerning the consistency of the CDF’s 2018 decision with both its 1993 responsa and the Principle of Double Effect (PDE). It argues that the Principle of Double Effect (PDE) can be applied to explain the CDF’s judgement, provided that the hysterectomy is regarded as concerning infecundity, the inability to have a live birth. In cases of hysterectomy concerning sterilization, the preservation of the woman’s life (the good effect) is evaluated against her sterilization (the bad effect). In cases of hysterectomy concerning infecundity, sexual intercourse without miscarriages (the good effect) is evaluated against the removal of the uterus (the bad effect). This paper argues that, when the hysterectomy described by the CDF in its 2018 re sponsum is evaluated in terms of the PDE as concerning infecundity, such hysterectomy is found to meet all four conditions and is therefore permissible.