Orders, decorations, and medals of the Holy See of the Catholic Church by his authority as head of the Holy See and sovereign of the Vatican City State. Historically, membership in these orders was either conferred by Papal bulls not signed by the Pope or by apostolic letters signed by the Pope himself. Since the reforms of these orders in the beginning of the 20th century, the diplomas have been signed by the Cardinal Secretary of State. In general, "Papal orders of knighthood" refers to the five equestrian orders of the Holy See awarded directly by the Supreme Pontiff as head of the Catholic Church, Holy See and
Multilateral foreign policy of the Holy See and secondly, true friendship offered above all to those who are suffering, a willingness to make sacrifices and to practise self-denial, to be alongside the suffering." The Holy See underlined that responsible parenthood entails responsibility and demands discipline and self-restrain, particularly in the area of sexual behavior. The Holy See opposed efforts to endorse Family planning methods which separate what, in its view, are the two essential dimensions of human sexuality: the transmission of life and the loving care of parents. At the Cairo Conference, the Holy See opposed the term "family planning services" which encompass sterilization, since it was