There is a pedagogical method of bringing undergraduate students to conceive the body–soul question. Similarly, there is a simple philosophical argument in defense of the existence of the soul via contemporary autobiographical stories, recent neuroscientific literature, and Socrates’s distinction between condition and cause in Plato’s Phaedo. This method has proved helpful in enabling students to gain access to the mystery and grandeur of the body–soul question and its foundational importance with respect to ethics and, indeed, to the meaning of life. (...) There must be a revival of collaboration between neuroscientists and philosophers to coauthor papers that explicitly challenge the materialist assumptions in the fields of neuroscience and psychology. (shrink)

In a short section of his 2015 book Beyond the Abortion Wars, Charles Camosy claims that direct abortion to save the life of the mother is consistent with Catholic principles. Joshua Evans published an essay critical of this view in the Summer 2017 issue of the National Catholic Bioethics Quarterly, to which Camosy responded in the Summer 2018 issue. In the current essay, Evans replies to Camosy’s recent response by offering a further examination of three central issues in dispute: how (...) the history of moral theology bears on public debates, how past authoritative Church teaching applies when the method of moral theology apparently has shifted, and how the analysis of vital conflicts is affected when examined in relation to more fundamental theological considerations. (shrink)

Some defenders of legal abortion claim that even if the human fetus is a human being with the same right to life as an adult, abortion is not necessarily morally impermissible. They argue that abortion can be considered a form of indirect killing that results from the refusal to provide life support through one’s own body, which another person has no right to receive. While Catholic moral theology does not require people to donate organs against their will, this principle does (...) not justify direct abortion. (shrink)

Our moral compass is not the only thing that compels us to provide compassionate health care, which also improves patient outcomes and patient and provider satisfaction. In the current era of increasing medical complexity, provider burnout, and value-based reimbursement, health care systems struggle to durably improve their providers’ compassion in the provision of care. A religious retreat curriculum for leaders at OSF HealthCare, in Illinois and Michigan, has led to a significant, long-term increase among employees in their compassion toward patients, (...) colleagues, and self. (shrink)

Although body alterations, including body art, sexual alteration, technological enhancements, and cosmetic surgery, usually are evaluated separately, they also can be approached by identifying common cultural trends. Because a person’s conception of identity lies at the core of many body alterations, any change to the body must pursue sincere authenticity, the virtue that fulfills one’s true identity.

Teenagers enjoy better physical and mental health when they avoid early sexual debut and reserve the sexual act for marriage. Teens who initiate sexual relations outside of marriage risk contracting sexually transmitted diseases, and those who also use hormonal contraception to avoid pregnancy often suffer unwanted physical and emotional side effects. Teens who have multiple partners may have later attachment or bonding difficulties. The consequences of an unintended pregnancy after a casual sexual relationship are often abortion or single motherhood and (...) an increased likelihood of poverty. Teenagers who save sexual relations for marriage experience freedom from these negative consequences and are more likely, in marriage, to experience the beauty of self-giving love. (shrink)

Medical literature on the protective effects of salpingectomy against ovarian cancer has challenged Catholic health care institutions to reexamine policies that prohibit tubal sterilization at the time of cesarean section. Salpingectomy performed for a woman whose fallopian tubes are known or suspected to have a serious and present pathology—risk-reducing salpingectomy—is morally justifiable as a therapeutic intervention. However, salpingectomy performed at the time of another medically indicated procedure, such as cesarean section, on an otherwise fertile woman whose fallopian tubes are presumed (...) to be healthy—opportunistic salpingectomy—constitutes direct sterilization and fails to meet the conditions of double effect. Moreover, until magisterial guidance clarifies the right application of Catholic teaching to the specific question of opportunistic salpingectomy, Catholic health care institutions should, out of prudential judgment and to avoid scandal, avoid establishing institution policies that permit the practice. (shrink)

Neuroethics is a new and rapidly expanding field in the academy and clinical practice. However, there is no comprehensive treatment of it from a specifically Catholic perspective. Nevertheless, the Catholic tradition contains possible criteria for a systematic approach to neuroethics. The personalist philosophical tradition, specifically modern ontological personalism, provides a framework for organizing and articulating those aspects of personhood that are most relevant to neuroscience and neuroethics.

In the Summer 2017 NCBQ, Joshua Evans strongly criticized arguments made by Charles Camosy about the possibility of a prenatal child being a material mortal threat to her mother. Here Camosy demonstrates that the formal/material debate remains open for non-dissenting Catholic moral theologians. He also shows that his reference to just-war theory is used to discuss innocence; it is not evidence of a particular methodology. Despite Evans’s claim to the contrary, Camosy notes multiple examples where he affirms the uniqueness of (...) pregnancy and the special duty of parents to children. He argues for full deference to the magisterium in matters where doctrine has been defined and urges solid theological grounding for teachings on abortion when the mother’s life is at risk, especially given the profound personal and political issues at stake. (shrink)

In 2015, the Supreme Court of Canada decriminalized euthanasia. Soon after, the College of Physicians and Surgeons of Ontario enacted the Professional Obligations and Human Rights policy and the Medical Assistance in Dying policy. Neither these policies nor the Medical Assistance in Dying Act, the Ontario law permitting euthanasia, contains a conscientious objection clause. Instead, the policies require objecting doctors to provide an effective referral to a doctor who will euthanize the patient. Objecting physicians brought suit against the college. In (...) a recent decision, the Ontario Superior Court of Justice held against the plaintiffs, finding the infringement of the effective referral policy on physicians’ rights to conscience and religious freedom to be appropriate when balanced against a patient’s right to equitable access to health care. Therefore, Catholic physicians in Ontario now must choose to violate either their religious beliefs or their professional obligations. It is imperative that these policies be struck down on appeal, superseded by an amendment, or revised by the college through the addition of a conscience clause. (shrink)

Eugenic thinking divides people into groups according to real or perceived genetic traits, identifies some groups as unwanted, and then promotes the elimination of the unwanted groups. Some American medical professionals are pursuing a eugenic agenda that pressures and misleads parents to abort unborn children with Down syndrome. These counselors have a strong, unwar­ranted bias that influences parents’ decisions significantly. The use of prenatal genetic testing and in vitro fertilization increases the number of deaths of unborn children with Down syndrome. (...) The widespread practice of identifying and aborting children with Down syndrome is properly called eugenics. (shrink)

Pope St. John Paul II’s work on the Theology of the Body is well known among his many followers. Less well known is his conception of the human soul. Karol Wojtyla’s intricate philosophy of the soul fully endorses Aristotelian Thomistic psychology. Wojtyla’s main contribution is a phenomenological description of human action, which provides a credible basis for inferring the soul’s necessity. In the papal writings, John Paul II develops other resourceful doctrines, especially about the timing of ensoulment. His unelaborated notion (...) of the genealogy of the person has implications for ethics. Following in the tradition of St. Thomas Aquinas, John Paul II presents an integrated wisdom about the soul that weaves together Christian revelation, modern science, and different modes of philosophical reflection. (shrink)

The financial toxicity of biotherapeutic treatments is examined. Kymriah, a new gene therapy, has a list price of $475,000 per treatment; Yescarta, from Kite Pharma, costs $373,000 per treatment. Such costs are a significant burden on patients, patients’ families, payers, health care systems, and communities. Studies have shown that financial toxicity—the effect of excessive treatment cost—diminishes patients’ quality of life, compliance, and survival. Some pharmaceutical companies promote outcomes-based pricing and other strategies to offset financial toxicity, but these approaches have not (...) been shown to reduce burdens. Catholic teaching holds that the benefits of treatment should outweigh its burdens, and that burdensome treatments are not obligatory. The financial toxicity of treatments should be included in the ethical assessment of burdens on the patient. (shrink)

The authors work in a variety of clinical ethics consultation services that employ a range of methods and approaches. This article discusses the approach to ethics consultation at the Center for Medical Ethics and Health Policy at Baylor College of Medicine and describes the development and transformation of the authors’ CECSs. It discusses how one CECS shifted from a nascent program with only fifty consultations a year to a vibrant, heavily staffed service with five hundred ethics consultations a year.

Little is known about how certain patient characteristics can affect the timing of an ethics consultation, which has been hypothesized to affect patient length of stay. This study assessed how specific patient characteristics affect the timing of an ethics consultation, namely, age, race, Medicaid status, the presence of a living will, the presence of a health care proxy, and the absence of decisional capacity. Moving beyond the typical case-series evaluation of an ethics consultation service, this study used an innovative approach (...) to model how predisposing, enabling, and need factors affect health behavior and subsequently affect health outcomes for patients who received an ethics consultation at a Catholic health care system in Oklahoma. (shrink)

Although ethics consultation services often engage in some of the most complex and delicate clinical situations, little is known about the qual­ity of these services or their effect on patient care and patient and provider satisfaction. There is still significant work to be done in the areas of training, credentialing, and standardization. This article articulates the essential “build­ing blocks” of the Proactive Ethics Integration model developed at Ascension as well as the lessons we have learned along the way.

At Providence St. Joseph Health in Oregon, many factors contribute to the integration and success of the ethics services. There are three principal lenses through which one can understand the distinct way in which the ethics services are operationalized and integrated: the theological foundations of ethics as a service, the institutional ecology, and the professionalization of the field of health care ethics. The authors review key realities that have shaped their work through these three lenses and then describe the activities (...) of the Providence Center for Health Care Ethics regarding its strategic objectives and clinical and administrative integration. (shrink)

The field of health care ethics continues to grow as the ethics structures in health care organizations become well established. While the literature is saturated with reports on clinical ethics consultation services, very little is known about the development and success of ethics programs. The following describes the development and growth of an ethics program at the largest health care provider in Georgia. With a focus on nine key components of an ethics program, the paper reviews what one system did (...) on its path to a flourishing program and what others can learn from it. (shrink)

Ethics committees in Catholic health care are responsible for con­sultation, education, and policy development and review. Historically, ethics committees were reactive and had no articulated goals. This article argues that the essential goals of Catholic ethics committees are to promote the human dignity of patients and staff; to promote the common good; to promote institutional identity, integrity, and ethical climate; and to improve quality of care. These goals are most effectively met when ethics committees are proactive and integrated in the (...) institution, embrace systems thinking, and utilize professional ethicists locally or regionally. (shrink)

The American Society for Bioethics and Humanities poses a chal­lenge in Core Competencies for Healthcare Ethics Consultation: health care ethics consultation services “should be able to demonstrate their value to those who pay for the service, as well as to those whom the service is intended to serve.” To respond to this challenge, this article provides a brief review of the literature on evaluating ethics consultation in its traditional frameworks of quality outcomes. The author follows this discussion with a new (...) methodology to evaluate ethics consultation on the basis of the intrinsic good of the service. He ends with a novel risk-based assessment to complement the evaluation of clinical ethics services grounded in the Ethical and Religious Directives for Catholic Health Care Services. (shrink)