The question of when human life begins is critical in debates related to life issues. While there are a variety of proposals as to how an organism should be defined, many biologists and ethicists, particularly Catholics, have approached this issue by arguing that fertilization defines the beginning of a new organism. Examining the processes of fission and fusion, which take place before gastrulation, provides strong evidence for when human life beings and therefore how it should be defined. Among the four (...) dominant theories, regulative fission and fusion are the best explanations in terms of being the most consistent with the biological data. This explanation of twinning provides compelling evidence that fertilization is not a necessary condition for human generation, although it may be a sufficient condition. While fertilization generates the vast majority of human beings, additional human beings may rarely be generated during fission events. (shrink)

Directive 36 of the Ethical and Religious Directives for Catholic Health Care Services gives guidance to health care professionals on the reactive administration of contraceptives to women in instances of isolated rape. This paper examines the moral permissibility of long-term proactive contraceptive use in instances of repeated marital rape by comparing it to the moral permissibility of reactive contraceptive use in cases of isolated rape found in directive 36.

When discussing the morality of gonad transplantation for procreative purposes, it can be tempting to examine the act solely qua reproductive technology. This paper, instead, compares the gonad to the kidney and evaluates the act qua organ transplantation. First, the author expounds a hierarchy of organs in relation to personal identity. Next, after considering an organ’s subjective effect on identity, the author elucidates an organ’s objective effect by ranking the powers of the soul and the goods of the human person. (...) The hierarchy of organs shows the gonad to be among the highest organs and most perfective of the human person. Because of the gonad’s highly personal nature, it cannot licitly be directed to another’s good. (shrink)

Persons who identity as LGBTQ+ should be treated with respect, compassion, and sensitivity. Under the guise of helping such persons, legislation is surreptitiously appearing in several countries seeking to ban so-called conversion therapy. While the definition of the term remains concerningly vague, the terms of enforcement for alleged offences tend to be precisely delineated, often including provisions that curtail Christian catechesis, teaching, and preaching in the areas of human dignity and sexuality. These problematic and repressive initiatives can prevent access to (...) any psychotherapy that is not strictly gender-affirming. This article reviews and assesses conversion therapy in support of a judicious approach to the practice, accurately understood. It reviews past abuses and misunderstandings while considering the merits of conversion therapy and related therapeutic and pastoral approaches. Concerns about gender-affirming interventions are considered, especially for youth and teenagers, and efficacy claims around conversion therapies and related psychotherapies are also discussed. (shrink)

Although there is discussion among ethicists about the permissibility of actions on the antenatal placenta, these discussions rarely take seriously the metaphysics involved. Rather, authors resort to opinion on how the placenta comes to be and for whose good it exists. This paper takes these metaphysical questions seriously. Through discussion of the biology of the placenta, I conclude that it is a shared organ of the mother and the fetus. In an analogy to the ethics of conjoined twinning, I conclude (...) that actions on the placenta must take the good of both the mother and the fetus into account. (shrink)

The preferential option for the poor is a concept and set of ideas in Catholic social teaching that is highly relevant to bioethics scholarship and practice. The option for the poor is mentioned frequently in the bioethics literature but with little specification of its history and implications for ethical and theological analysis. This article examines the origins and implications of the preferential option; compares it to critical race theory, which dominates current debates about discrimination and oppression; and proposes a set (...) of principles for further application in bioethical scholarship and discussion. (shrink)

Abortion jurisprudence in the United States has been criticized by many for allowing the destruction of millions of lives. What many may not know is that the Supreme Court decision which legalized abortion in all fifty states was very similar to another Supreme Court decision, namely, Dred Scott v. Sanford. The parallels between these two cases are astounding, revealing how dehumanization, while a very old idea, is almost always achieved through the same means. A legal analysis of Roe v. Wade, (...) and subsequently Planned Parenthood v. Casey, shows that these cases are both morally and legally unjustified. Just like Dred Scott, Roe, by dehumanizing a specific group of individuals, is a case which does not belong in the American legal system. (shrink)

Clinical decisions about medically assisted nutrition require practical wisdom: a goal-directed virtue that makes decision-making purpose-oriented rather than intervention-focused. This deliberative process includes seven basic dimensions: diagnosis, prognosis, test or treatment, burdens, probabilities, goals of care, and clarification of diagnosis or prognosis. These must be integrated within a larger framework of meaning constituted by foundational beliefs and values—for example, social, philosophical, or theological perspectives on human identity, dignity, and purpose—that are substantive enough to explain the clinical context and clear enough (...) to guide a reasoned response to it. This framework, which combines goal-oriented reasoning with empirical data, can clarify the assessment regarding the benefits of percutaneous endoscopic gastrostomy for persons with advanced dementia. (shrink)

This essay criticizes the subjective understanding of “best interests” adopted by the United Kingdom’s Mental Capacity Act 2005 and by the 2018 guidance of the British Medical Association and the Royal College of Physicians on the provision of clinically assisted nutrition and hydration to incapacitous adults. The key criticism is that such an understanding wrongly values people’s preferences above their lives.

This essay claims that one can consistently maintain a sanctity of human life principle that is explicitly grounded in theology, while making a kind of quality-of-life judgment regarding withholding or discontinuing life-sustaining treatments for those with advanced illnesses. For those who embrace them, resources that are specific to the Christian tradition delineate the parameters of responsibility for people dying with advanced illness and those who care for them. Those who embrace the sanctity of human life for the theological reasons provided (...) in this essay are under no moral obligation to continue merely to sustain life at the end of life—that is, when, in view of our best available judgment, the human being will not ever be able to exemplify other human values that contribute to human flourishing, theologically understood. (shrink)

New Natural Law Theory and the Catholic medico-moral tradition often lead to similar conclusions in hard cases regarding end-of-life care. Considering the provision of artificial nutrition and hydration to patients suffering from post-coma unresponsive wakefulness, however, brings to light subtle ways in which NNL differs from the centuries-old natural law tradition. In this essay, I formalize the methodology embedded within the casuistry of the medico-moral tradition and show how it differs from NNL with respect to the role played by double-effect (...) reasoning and the perspective for analyzing cases regarding care for those who cannot speak for themselves. Importantly, the ordinary/extraordinary means distinction has never historically been understood as an application of double effect and logically cannot be so understood. Given the outsized role that double effect plays in NNL, the theory leads to conclusions that deviate from the Catholic medico-moral tradition and creates additional burdens and duties for the sick. (shrink)

In this essay, I discuss the role that vocation plays in assessing the proportion of burdens to benefits in end-of-life options. I then look at the case of patients in a persistent vegetative state. What vocational considerations are relevant for persons considering what care to accept should they ever be in a PVS or for those caring for patients in such a state? Ultimately, I argue that the vocational shape of a patient’s life ought not to be a consideration for (...) a caregiver in favor of removing artificial nutrition and hydration. (shrink)

In this paper, the author takes the perspective of the patient who is very ill and facing death and examines the traditional ethical question of whether forgoing medical treatment, including artificial hydration and nutrition, is equivalent to suicide. She approaches this question by way of a discussion of St. Thomas Aquinas and Aristotle and via a critical look at David Hume. At the end, she turns to Elizabeth Anscombe for the light that this twentieth-century philosopher sheds on the question.

Pregnancy causes maternal pathology by combining maternal predispositions with healthy physiology. In maternal cardiovascular collapse, previable induction of labor is justifiable despite the definition of abortion in directive 45 of the Ethical and Religious Directives for Catholic Health Care Services. Central to this conclusion, the placenta is a fetal organ, and pregnancy is a cardiovascular condition placing new demands on the maternal cardiovascular system. Previable delivery, a morally neutral separation, addresses the cause of pathology even if fetal death is anticipated. (...) This is acceptable under double-effect reasoning. Directive 45 defines all previable deliveries as abortions, so this analysis proposes an alternative definition established by obstetrician/gynecologists. (shrink)

The essay begins with an explanation of St. Alphonsus Liguori’s understanding of the distinction between formal and material cooperation, identifying also some problems inherent in that understanding. The essay goes on to expound related ideas in the writings of St. Thomas Aquinas, ideas that are applicable to cases not easily analyzable by means of the distinction between formal and material cooperation. The essay then applies these ideas to two contemporary issues: the use of vaccines connected in some way with abortions (...) and the objection by the Little Sisters of the Poor to the contraceptive mandate issued by the US Department of Health and Human Services. (shrink)

When threatened with rape, is it permissible for a virgin to commit suicide so that she might preserve her virginity? Both St. John Chrysostom and St. Ambrose allowed for suicide in these situations because they considered it a martyrdom, but St. Augustine argued that such an act is always illicit unless commanded by God, a teaching later adopted by St. Thomas Aquinas. In this paper, these arguments will be presented and then applied to cases of vital conflict, which involve many (...) of the same principles disputed by these Doctors of the Church. This article contributes to the discussion of vital conflicts by reinforcing its patristic and Thomistic foundation. (shrink)

In this essay, we respond to Dustin Crummett’s argument that one cannot consistently appeal to body count reasoning to justify being a single-issue pro-life voter if one is also committed to the usual response to the embryo rescue case. Specifically, we argue that a modified version of BCR we call BCR* is consistent with the usual response. We then move to address concerns about the relevance of BCR* to Crummett’s original thesis.

Often-cited papal pronouncements regarding organ donation emphasize the importance of gift giving and the consent of the donor. However, a critical reading reveals an ill-defined separation of living organ donation and donation after death. Given that a corpse cannot engage in gift giving, nor can it give consent, the family, acting as good stewards, is the proper decision maker for organ donation after death. A historical examination of relics and human anatomical dissection reveals that the Catholic Church has primarily favored (...) the decisional authority of the family over the first-person consent of the dead. Given this history, family-based consent is the best model to ensure the dignity of the dead. (shrink)

Recent magisterial teaching suggests that Catholics should prefer COVID-19 vaccines in which immortalized cells derived from the remains of aborted fetuses did not play a role in production, even though all of them can be licitly used. Many scholars contest any distinction between the different vaccines, in part by arguing that these cell lines have become artifacts. This argument is inadequate on a number of levels. First, these scholars have not sufficiently proven the point that the cell lines become artifacts (...) through biotechnological manipulation. Second, considering cell lines as mere artifacts commodifies them in a way that is rejected even by secular authors. Third, this mode of commodification reinforces the technocratic paradigm. Finally, embracing this commodification of cell lines will prevent moral theology from properly judging other aspects of the growing bioeconomy. These arguments suggest that distinguishing between different vaccines remains the most appropriate course. (shrink)

Cooperation in wrongdoing is an everyday matter for all of us, though we need to discern when such cooperation is morally excluded as constituting formal cooperation, as opposed to material cooperation whether justified or otherwise. In this paper, I offer examples of formal cooperation such as referral of patients for certain procedures where the cooperating doctor intends an intrinsically wrongful plan of action on the part of the patient and a medical colleague. I also consider a case of formal cooperation (...) where the cooperator intends a choice on the part of another person that is not intrinsically wrong, but wrong in the circumstances because the person believes it will cause serious uncompensated harm. (shrink)

Cooperation in wrongdoing is an everyday matter for all of us, though we need to discern when such cooperation is morally excluded as constituting formal cooperation, as opposed to material (unintended) cooperation whether justified or otherwise. In this paper, I offer examples of formal cooperation such as referral of patients for certain procedures where the cooperating doctor intends an intrinsically wrongful plan of action on the part of the patient and a medical colleague. I also consider a case of formal (...) cooperation where the cooperator intends a choice on the part of another person that is not intrinsically wrong, but wrong in the circumstances because the person believes it will cause serious uncompensated harm. (shrink)

This article seeks to demonstrate that the perverted faculty argument is at the foundation of magisterial teaching in sexual ethics. Yet new natural law theorists have consistently condemned this argument for decades despite their claim that they support the moral teachings of the Catholic Church. This situation is incongruous. Current scholarship indicates that NNL theorists do not accept the rationale for magisterial teaching in sexual ethics because, despite their opposition to proportionalism, they still hold in common its most critical error—an (...) error that Pope St. John Paul II was at pains to condemn in Veritatis splendor. (shrink)

The Catholic debate over embryo adoption is at a genuine impasse awaiting resolution from the magisterium of the Catholic Church because both sides have reached a point where there is a fundamental disagreement. Several Catholic ethicists have argued that the ethical reasoning linking the acts of having sex and of making a baby, and therefore reserving both to the causality of a husband, should be extended to the act of becoming pregnant. This would rule out embryo transfer in all its (...) manifestations. However, this dispute cannot be resolved by further argumentation, but requires authoritative definition in response to the question, Should the principle of inseparability be extended to the act of becoming pregnant? (shrink)

On July 14, 2020, the Congregation for the Doctrine of the Faith issued Samaritanus bonus, beckoning the human family to take the Good Samaritan as the ideal in the care of all persons in critical and terminal phases of their lives. The import of this letter is understood best as seen through three prisms: Fratelli tutti, the encyclical of Pope Francis signed at Assisi on October 3, 2020; the Declaration on Euthanasia issued by the CDF in 1980; and “the remarkable (...) progressive development of biomedical technologies [which] has exponentially enlarged the clinical proficiency of diagnostic medicine in patient care and treatment [which] call for growth in moral discernment to avoid an unbalanced and dehumanizing use of the technologies especially in the critical or terminal stages of human life”. (shrink)

North America is facing an ongoing, persistent opioid epidemic, and Vancouver, British Columbia, continues to be one of its devastating epicenters, with record overdose deaths in 2020. Roman Catholic health care organizations in Vancouver are compelled to pioneer potential solutions to this public health crisis—in solidarity and employing necessary strategies to help the most vulnerable in the communities served. While controversial, harm reduction strategies for intravenous substance use keep people alive until they are able to receive the help that they (...) need to recover. An evaluation of the degree of cooperation involved in some harm reduction strategies indicates that they can be considered morally permissible and compatible with core tenets of Catholic bioethics. (shrink)

This essay argues against Charles Camosy’s proposal, found in his book Beyond the Abortion Wars, for premature induction of labor in a mother whose child is diagnosed with a life-limiting disease, such as Potter syndrome. This proposal is critiqued within the context of motherhood as sacrificial self-gift, which has been raised to new heights by the Incarnation and Resurrection of Christ, as witnessed by the motherhood of Mary.

Using cell lines like HEK 293 or their products—like many of the COVID-19 vaccines—involves no cooperation with evil strictly speaking, but it does involve appropriation of the benefits of past evil. Applying M. Cathleen Kaveny’s framework for assessing the permissibility of appropriating the benefits of evil, the duty to avoid using cell lines like HEK 293 or their products is weak and defeasible. Proper interpretation of Dignitas personae requires recognizing the crucial moral differences between the use of these cell lines—which (...) does not perpetuate the injustice of abortion, imply approval of abortion, or involve significant risks of corrupting moral character or provoking scandal—and the direct use of fetal tissue or human embryos in research. (shrink)

Gender ideology and medical interventions for so-called transitioning pose profound challenges for Catholic health care. Unfortunately, many institutions do not offer clear, specific policy guidance addressing these issues. This template policy is offered to Catholic health care institutions and systems to assist them in drafting such guidance. The template defines the mission of Catholic health care, summarizes Church teaching with regard to gender ideology, and identifies both licit and illicit clinical interventions for gender dysphoria. The template also offers guidance on (...) practical issues, including name and pronoun use, sex-specific facilities, employee training programs, and health benefits. An appendix offers model language that institutions can incorporate into employment documents to maintain Catholic identity and mission. (shrink)