Previous studies have documented the fallibility of attempts by surrogates and physicians to act in a substituted judgment capacity and predict end-of-life treatment decisions on behalf of patients. We previously reported that physicians misperceive their patients' preferences and substitute their own preferences for those of their patients with respect to four treatments: cardiopulmonary resuscitation (CPR) in the event of cardiac arrest, ventilator for an indefinite period of time, medical nutrition and hydration for an indefinite period of time, and hospitalization in (...) the event of pneumonia. (shrink)

Previous studies have documented the fallibility of attempts by surrogates and physicians to act in a substituted judgment capacity and predict end-of-life treatment decisions on behalf of patients. We previously reported that physicians misperceive their patients' preferences and substitute their own preferences for those of their patients with respect to four treatments: cardiopulmonary resuscitation in the event of cardiac arrest, ventilator for an indefinite period of time, medical nutrition and hydration for an indefinite period of time, and hospitalization in the (...) event of pneumonia. (shrink)

Among the many criticisms advanced against the enlightenment is that its emphasis on rational reflection and commitment to universal moral truths serve as solvents of tradition and community. Here, I wish to show how the German Jewish enlightenment figure, Moses Mendelssohn in his classic work, Jerusalem succeeded in bringing together universal rational religious reflection and Halakhah, Jewish ceremonial law. Essentially, the ceremonial law for Mendelssohn, forms a traditional mimetic society, whose members absorb the Halakhah naturally and intuitively both from the (...) community at large and from its teachers through a process of total immersion. If we see religious practice as a language, then members of this halakhic mimetic community, for whom the Halakhah is a first language practiced fluently and intuitively, are able to use this language to intelligently discuss the great truths of religion. In this way, tradition and community and rational reflection turn out to be mutually supportive. (shrink)

This is a comprehensive study of the philosophy of Maimonides by the noted 20th-century rabbinic scholar and thinker, Rabbi Joseph B. Soloveitchik. Based on a complete set of notes on Rabbi Soloveitchik's lectures, it constitutes a major contribution to our knowledge of both Maimonides and Soloveitchik.

Rosemary Hennessy, Materialist Feminism and the Politics of DiscourseRichard J. Bernstein, Hannah Arendt and the Jewish QuestionDavid Ames Curtis, The Castoriadis ReaderDavid Ames Curtis, World in Fragments: Writings on Politics, Society, Psychoanalysis and the ImaginationMorris Kaplan, Sexual Justice: Democratic Citizenship and the Politics of Desire.

Howard Brody expresses concern that citing the “two cases that put futility on the map,” namely Helga Wanglie and Baby K, may be providing ammunition to the opponents of the concept of medical futility. He in fact joins well-known opponents of the concept of medical futility in arguing that it is one thing for the physician to say whether a particular intervention will promote an identified goal, quite another to say whether a goal is worth pursuing. In the latter instance, (...) physicians are laying themselves open “to the criticism of taking on basic value judgments that are more appropriately left to patients and their surrogates.” Brody states that in both the Wanglie and Baby K cases, the “basic value judgments” had to do with the worthiness of maintaining unconscious life via medical technology. He classifies this as “a question of professional integrity—but not a question of futility,” adding that “more than semantics hinges on this distinction.” The “more than semantics” factor is a pragmatic, even political one. Failure to make this distinction renders physicians “that much more suspect and less trustworthy in the public debate.”. (shrink)

It probably should not be surprising, in this time of soaring medical costs and proliferating technology, that an intense debate has arisen over the concept of medical futility. Should doctors be doing all the things they are doing? In particular, should they be attempting treatments that have little likelihood of achieving the goals of medicine? What are the goals of medicine? Can we agree when medical treatment fails to achieve such goals? What should the physician do and not do under (...) such circumstances? Exploring these issues has forced us to revisit the doctor-patient relationship and the relationship of the medical profession to society in a most fundamental way. Medical futility has both a quantitative and qualitative component. I maintain that medical futility is the unacceptable likelihood of achieving an effect that the patient has the capacity to appreciate as a benefit. Both emphasized terms are important. A patient is neither a collection of organs nor merely an individual with desires. Rather, a patient (from the word to suffer ) is a person who seeks the healing (meaning to make whole ) powers of the physician. The relationship between the two is central to the healing process and the goals of medicine. Medicine today has the capacity to achieve a multitude of effects, raising and lowering blood pressure, speeding, slowing, and even removing and replacing the heart, to name but a minuscule few. But none of these effects is a benefit unless the patient has at the very least the capacity to appreciate it. Sadly, in the futility debate wherein some critics have failed or refused to define medical futility an important area of medicine has in large part been neglected, not only in treatment decisions at the bedside, but in public discussions—comfort care—the physician’s obligation to alleviate suffering, enhance well being and support the dignity of the patient in the last few days of life. (shrink)

How is it that sounds from the mouth or marks on a page—which by themselves are nothing like things or events in the world—can be world-disclosive in an automatic manner? In this fascinating and important book, Lawrence J. Hatab presents a new vocabulary for Heidegger’s early phenomenology of being-in-the-world and applies it to the question of language. He takes language to be a mode of dwelling, in which there is an immediate, direct disclosure of meanings, and sketches an extensive (...) picture of proto-phenomenology, how it revises the posture of philosophy, and how this posture applies to the nature of language. Representational theories are not rejected but subordinated to a presentational account of immediate disclosure in concrete embodied life. The book critically addresses standard theories of language, such that typical questions in the philosophy of language are revised in a manner that avoids binary separations of language and world, speech and cognition, theory and practise, realism and idealism, internalism and externalism. (shrink)

Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled (...) to at least a decent minimum level of care — which might include access to scarce life-saving organs. However, if criminals forfeit their entitlement to the same level of medical care afforded to all members of society, they still would be entitled to a kind of rudimentary decent minimum granted to all persons on simple humanitarian grounds. Almost certainly this entitlement would not include access to organ transplants. (shrink)

Erich Fromm was a political activist, psychologist, psychoanalyst, philosopher, and one of the most important intellectuals of the twentieth century. Known for his theories of personality and political insight, Fromm dissected the sadomasochistic appeal of brutal dictators while also eloquently championing love--which, he insisted, was nothing if it did not involve joyful contact with others and humanity at large. Admired all over the world, Fromm continues to inspire with his message of universal brotherhood and quest for lasting peace. The first (...) systematic study of Fromm's influences and achievements, this biography revisits the thinker's most important works, especially _Escape from Freedom_ and _The Art of Loving_, which conveyed important and complex ideas to millions of readers. The volume recounts Fromm's political activism as a founder and major funder of Amnesty International, the National Committee for a Sane Nuclear Policy, and other peace groups. Consulting rare archival materials across the globe, Lawrence J. Friedman reveals Fromm's support for anti-Stalinist democratic movements in Central and Eastern Europe and his efforts to revitalize American democracy. For the first time, readers learn about Fromm's direct contact with high officials in the American government on matters of war and peace while accessing a deeper understanding of his conceptual differences with Freud, his rapport with Neo-Freudians like Karen Horney and Harry Stack Sullivan, and his association with innovative artists, public intellectuals, and world leaders. Friedman elucidates Fromm's key intellectual contributions, especially his innovative concept of "social character," in which social institutions and practices shape the inner psyche, and he clarifies Fromm's conception of love as an acquired skill. Taking full stock of the thinker's historical and global accomplishments, Friedman portrays a man of immense authenticity and spirituality who made life in the twentieth century more humane than it might have been. (shrink)

Nietzsche's On the Genealogy of Morality is a forceful, perplexing, important book, radical in its own time and profoundly influential ever since. This introductory textbook offers a comprehensive, close reading of the entire work, with a section-by-section analysis that also aims to show how the Genealogy holds together as an integrated whole. The Genealogy is helpfully situated within Nietzsche's wider philosophy, and occasional interludes examine supplementary topics that further enhance the reader's understanding of the text. Two chapters examine how the (...) Genealogy relates to standard questions in moral and political philosophy. Written in a clear, accessible style, this book will appeal to students at every level coming to read the Genealogy for the first time, and a wider range of readers will also benefit from nuanced interpretations of controversial elements in Nietzsche's work. (shrink)

Through his innovative study of language, noted Heidegger scholar Lawrence Hatab offers a proto-phenomenological account of the lived world, the “first” world of factical life, where pre-reflective, immediate disclosiveness precedes and makes possible representational models of language. Common distinctions between mind and world, fact and value, cognition and affect miss the meaning-laden dimension of embodied, practical existence, where language and life are a matter of “dwelling in speech.” In this second volume, Hatab supplements and fortifies his initial analysis by (...) offering a detailed treatment of child development and language acquisition, which exhibit a proto-phenomenological world in the making. He then takes up an in-depth study of the differences between oral and written language (particularly in the ancient Greek world) and how the history of alphabetic literacy shows why Western philosophy came to emphasize objective, representational models of cognition and language, which conceal and pass over the presentational domain of dwelling in speech. Such a study offers significant new angles on the nature of philosophy and language. (shrink)

This book is a comprehensive exposition of the Transcendental Deduction of the Categories in both editions of Kant’s Critique of Pure Reason.

The principle of double effect has a long history, from scholastic disputations about self-defense and scandal to current debates about terrorism, torture, euthanasia, and abortion. Despite being widely debated, the principle remains poorly understood. In Intention, Character, and Double Effect, Lawrence Masek combines theoretical and applied questions into a systematic defense of the principle that does not depend on appeals to authority or intuitions about cases. Masek argues that actions can be wrong because they corrupt the agent's character and (...) that one must consider the agent's perspective to determine which effects the agent intends. This defense of the principle clears up common confusions and overcomes critics' objections, including confusions about trolley and transplant cases and objections from neuroscience and moral psychology. This book will interest scholars and students in different fields of study, including moral philosophy, action theory, moral theology, and moral psychology. Its discussion of contemporary ethical issues and sparse use of technical jargon make it suitable for undergraduate and graduate courses in applied ethics. The appendix summarizes the main cases that have been used to illustrate or to criticize the principle of double effect. (shrink)

Vedānta Deśika produced his monumental poetic biography of Kṛṣṇa in a time when Kṛṣṇa-centered devotionalism was expanding to become perhaps the dominant mode of bhakti across South Asia. Central to this phenomenon is the growing popularity of the Bhāgavatapurāṇa, and especially of its exploration of Kṛṣṇa’s erotic play with the gopīs in his youth. Troubled by the unrestrained and seemingly adharmic sexuality of Kṛṣṇa, Deśika used the literary techniques and narrative paradigms of the mahākāvya to assimilate but also domesticate this (...) increasingly important Bhāgavata episode: Kṛṣṇa’s eroticism remains central but confined within more conventional marital norms and is thus made dharmically and theologically acceptable. Once he has resolved these dharmic problems, however, Deśika is happy to explore the soteriological, devotional, and paradoxical dimensions of erotic love with Kṛṣṇa. (shrink)

Jnanasrimitra (975-1025) was regarded by both Buddhists and non-Buddhists as the most important Indian philosopher of his generation. His theory of exclusion combined a philosophy of language with a theory of conceptual content to explore the nature of words and thought. Jnanasrimitra's theory informed much of the work accomplished at Vikramasila, a monastic and educational complex instrumental to the growth of Buddhism. His ideas were also passionately debated among successive Hindu and Jain philosophers. This volume marks the first English translation (...) of Jnanasrimitra's Monograph on Exclusion, a careful, critical investigation into language, perception, and conceptual awareness. Featuring the rival arguments of Buddhist and Hindu intellectuals, among other thinkers, the Monograph reflects more than half a millennium of competing claims while providing an invaluable introduction to a crucial philosopher. Lawrence J. McCrea and Parimal G. Patil familiarize the reader with the author, themes, and topics of the text and situate Jnanasrimitra's findings within his larger intellectual milieu. Their clear, accessible, and accurate translation proves the influence of Jnanasrimitra on the foundations of Buddhist and Indian philosophy. (shrink)

Hatab's work is more than an interpretative study, inspired by Neitzsche and Heidegger of the historical relationship between myth and philosophy in ancient Greece. Its conclusions go beyond the historical case study, and amount to a defence of the intelligibility of myth against an exclusively rational or objective view of the world.

Regina R. is a 12-year-old girl with recently diagnosed insulin-dependent diabetes. Before discharging her from the hospital, her family physician and consulting diabetes specialist try to instruct the girl and her parents in the appropriate program of treatment, including diet, insulin, and regular self-monitoring. However, the parents become upset when they learn what is involved in insulin treatment and inform the family physician they plan to employ the services of an alternative healing clinic that promises to cure their daughter with (...) a combination of herbal potions, macrobiotics, aroma therapy, therapeutic touch, Ayurveda, homeopathy, and guided imagery. (shrink)

For two and a half millennia readers of Aristotle have been struggling to understand just what sort of causation is being attributed to the Prime Unmoved Mover or PM, whether final or efficient, assuming that this supreme being could not be a material cause or even a formal cause of the entire cosmos. Fred Miller entered into this still ongoing debate with a fresh proposal, drawing on an almost incidental remark in GC 1.6.323a25-33 that was later picked up by Philoponus (...) in his commentary on Aristotle’s text. The fundamental question is whether the PM’s causal role is to be restricted to a case of final causation or is there evidence for efficient causation as well? Just how ancient this question of interpretation is can be clearly shown by the following remarks made by Simplicius in the first half of the sixth century in his Neo-Platonist commentary on Phys VIII.6.267b17-26:Simplicius goes on to argue in some detail for this dual picture, primarily because of his harmonizing approach to Plato and Aristotle, but also by referencing some very specific passages in other works—notably Cael, GC, DM—but also Met, albeit only from its first book (1361.11-1363.24). He starts out here by claiming that “[n]o one disputes that Aristotle calls god or the primary mover a final cause” but realizes that showing that the PM is an efficient cause as well needs some textual support, which he dutifully attempts to provide. We will be going over some of the same ground cited here in trying to articulate Aristotle’s conception of divine causation and in particular to decide if Fred Miller’s thoughts about the “untouched toucher” will help us in the overall endeavor to explore Λ.6-10. Since he points out (at p. 278) that the PM could hardly be a material cause or even a formal cause, his framing the issue as to whether the mode of causation here is exclusively efficient or exclusively final, or, on the other hand, both at once, seems very close to how Simplicius set up the problem. Indeed, he cites the same section of Simplicius’s commentary quoted above and finds this ancient perplexity a good jumping off point for his own attempt to shed light on a fundamental issue of interpretation, noting that if we balk at the Neo-Platonic suggestion that Aristotle’s PM “is on a par with Plato’s demiurge,” the question becomes: “in what way is the prime mover supposed to be an efficient cause?” (p. 279). Miller’s novel suggestion is that one way of dealing with this question is the thought that the PM is an “untouched toucher.” It is crucial to his picture that this suggestion is strongly tied to the prospect of finding “a way in which the unmoved mover of the cosmos could be a genuine efficient cause” (p. 287) and not I believe, as W.D. Ross may have held, an efficient cause only by being a final cause. This will become important when we explore what untouched touching would be quite generally, given the emphasis on the psychological dynamics of this sort of affective action as suggested by the everyday examples provided by both Aristotle and Philoponus. (shrink)

The report of the President's Council on Bioethics, Human Cloning and Human Dignity, addresses the central ethical, political, and policy issue in human embryonic stem cell research: the moral status of extracorporeal human embryos. The Council members were in sharp disagreement on this issue and essentially failed to adequately engage and respectfully acknowledge each others' deepest moral concerns, despite their stated commitment to do so. This essay provides a detailed critique of the two extreme views on the Council (i.e., embryos (...) have full moral status or they have none at all) and then gives theoretical grounding for our judgment about the intermediate moral status of embryos. It also supplies an account of how to address profound moral disagreements in the public arena, especially by way of constructing a middle ground that deliberately pays sincere respect to the views of those with whom it has deep disagreements. (shrink)

Professor Imwinkelried is surely right: the propriety of bioethicists serving as expert witnesses in litigation is problematic, and, I would add, it should remain problematic. Such testimony most certainly does not belong everywhere it will be offered by lawyers and litigants in an effort to advance their interests. Yet in contrast to some commentators, Imwinkelried and I both see a place for bioethicists serving as expert witnesses, although we differ significantly on how to understand and justify this place. In any (...) event, serious questions regarding the proper place for expert bioethicist testimony in the courtroom do exist, not only for law but also bioethics as well.The threshold question regarding the prospect of bioethicists serving as expert witnesses would seemingly have to be: “could a bioethicist qualify as an expert witness under the controlling rules of evidence?” Imwinkelried, however, does not perceive any need to even entertain this question as he claims that “technical evidentiary standards are inapplicable when information is presented to a judge to permit the judge to perform… a legislative or law-making function.”. (shrink)

I critically explore various forms of the language of thought (LOT) hypothesis. Many considerations, including the complexity of representational content and the systematicity of language understanding, support the view that some, but not all, of our mental representations occur in a language. I examine several arguments concerning sententialism and the propositional attitudes, Fodor's arguments concerning infant and animal thought, and Fodor's argument for radical concept nativism and show that none of these considerations require us to postulate a LOT that is (...) innate or otherwise distinct from spoken languages. Instead, I suggest that we maintain the more conservative hypothesis, supported by introspection, that some of our thoughts occur in the languages that we speak. (shrink)

In this essay I take up Plato’s critique of poetry, which has little to do with epistemology and representational imitation, but rather the powerful effects that poeticperformances can have on audiences, enthralling them with vivid image-worlds and blocking the powers of critical reflection. By focusing on the perceived psychological dangers of poetry in performance and reception, I want to suggest that Plato’s critique was caught up in the larger story of momentous shifts in the Greek world, turning on the rise (...) of literacy and its far-reaching effects in modifying the original and persisting oral character of Greek culture. The story of Plato’s Republic in certain ways suggests something essential for comprehending the development of philosophy in Greece (and in any culture, I would add): that philosophy, as we understand it, would not have been possible apart from the skills and mental transformations stemming from education in reading and writing; and that primary features of oral language and practice were a significant barrier to the development of philosophical rationality (and also a worthy competitor for cultural status and authority). Accordingly, I go on to argue that the critique of writing in the Phaedrus is neither a defense or orality per se, nor a dismissal of writing, but rather a defense of a literate soul over against orality and the indiscriminate exposure of written texts to unworthy readers. (shrink)

This paper reports data and scholarly opinion that support the perception of systemic flaws in the management of scientific professions and the research enterprise; explores the responsibility that professional status places on the scientific professions, and elaborates the concept of the responsible conduct of research (RCR). Data are presented on research misconduct, availability of research guidelines, and perceived research quality.

Like most philosophers, Heidegger gave little attention to childhood, but his philosophical emphasis on pre-reflective practice and understanding seems uniquely qualified to help make sense of a child’s experience and development. Moreover, it seems to me that many central Heideggerian concepts are best defended, exemplified, and articulated by bringing child development into the discussion. A Heideggerain emphasis on pre-theoretical world-involvement opens up a rich array of phenomena for studying child development, which can improve upon standard theories that have over-emphasized exclusive (...) conditions or criteria. I begin by laying out some basic features of Heidegger’s conception of being-in-the-world as a preparation for understanding the world of the child. Then I will briefly discuss some of Heidegger’s remarks on childhood, followed by some reflections on language acquisition and the correlation of anxiety and meaning. (shrink)

An anencephalic infant, who came to be known as Baby K, was born at Fairfax Hospial in Falls Church, Virginia, on October 13, 1992. From, the moment of birth and repeatedly thereafter, the baby's mother insisted that aggressive measures be pursued, including cardiopulmonary resuscitation and ventilator support, to keep the baby alive as long as possible. The physicians complied. However, following the baby's second admission for respiratory failure, the hospital sought declaratory relief from the court permitting it to forgo emergency (...) life support on the grounds that “a requirement to provide respiratory assistance would exceed the prevailing standard of medical care,” and that “because any treatment of their condition is futile, the prevailing standard of medical care for infants with anencephaly is to provide warmth, nutrition, and hydration.” The United States Court of Appeals for the Fourth Circuit ruled in favor of the baby's mother, citing the federal Emergency Medical Treatment and Active Labor Act , which contained no “standard of care” exception to the requirement to provide “treatment necessary to prevent the material deterioration of the individual's condition.” An appeal to the United States Supreme Court was rejected. The baby died some two and one-half years later of cardiac arrest during her sixth visit to the emergency department of Fairfax Hospital for respiratory failure. (shrink)

Abstract:Social contracting has a long and important place in the history of political philosophy (Hardin, 1991; Waldron, 1989) and as a theory of justice (Baynes, 1989; Rawls, 1971). More recently, it has been developed into an individual rights-based theory of organizations (Keeley, 1980, 1988), and as a way to integrate ethics and moral legitimacy into corporate strategy and action (Donaldson, 1982; Freeman&Gilbert, 1988). Currently, it is being proposed as an integrative theory of economic ethics (Donaldson&Dunfee, forthcoming). This paper will extend (...) the Donaldson and Dunfee approach by arguing thatsocial contracting can best be understood and applied in organizational settings if it is perceived and treated as a network governance process. This insight can benefit management scholars and practitioners alike, since it calls attention to the processes by which trust is created and sustained in on-going contractual relationships. It also strongly suggests that a new approach to applying managerial discretion, asmoral agency, is needed to realize the full competitive and ethical potential of emerging network forms. (shrink)

ABSTRACT By means of the high ratings that they awarded to subprime mortgage‐backed bonds, the three major rating agencies—Moody's, Standard & Poor's, and Fitch—played a central role in the current financial crisis. Without these ratings, it is doubtful that subprime mortgages would have been issued in such huge amounts, since a major reason for the subprime lending boom was investor demand for high‐rated bonds—much of it generated by regulations that made such bonds mandatory for large institutional investors. And it is (...) even less likely that such bonds would have become concentrated on the balance sheets of the banks, for which they were rewarded by capital regulations that tilted toward high‐rated securities. Why, then, were the agencies excessively optimistic in their ratings of subprime mortgage‐backed securities? A combination of their fee structure, the complexity of the bonds that they were rating, insufficient historical data, some carelessness, and market pressures proved to be a potent brew. This combination was enabled, however, by seven decades of financial regulation that, beginning in the 1930s, had conferred the force of law upon these agencies' judgments about the creditworthiness of bonds and that, since 1975, had protected the three agencies from competition. (shrink)

U.S. politicians and policymakers have been preoccupied with how to pay for health care. Hardly any thought has been given to what should be paid for—as though health care is a commodity that needs no examination—or what health outcomes should receive priority in a just society, i.e., rationing. I present a rationing proposal, consistent with U.S. culture and traditions, that deals not with “health care,” the terminology used in the current debate, but with the more modest and limited topic of (...) medical care. Integral to this rationing proposal—which allows scope to individual choice and at the same time recognizes the interdependence of the individual and society—is a definition of a “decent minimum,” the basic package of medical treatments everyone should have access to in a just society. I apply it to a specific example, diabetes mellitus, and track it through a person's life span. (shrink)

Both John Henry Newman and Vincent Gasser offered influential interpretations of the First Vatican Council’s teaching on infallibility. In contrast to many of theircontemporaries, Gasser and Newman placed papal infallibility alongside episcopal infallibility and the infallibility of the Catholic faithful. After exploring the views of Gasser and Newman, this essay compares their views to the Second Vatican Council’s teaching on infallibility in Lumen Gentium and concludes that even though Lumen Gentium cited Gasser, its theology is closer to Newman’s.

In lieu of an abstract, here is a brief excerpt of the content:The Call for New Theological Reflection on the Sacramental Character of Marriage and the Thought of St. ThomasLawrence J. WelchTheologians across the theological spectrum have called attention to the urgent need for a new reflection on the theological and sacramental character of marriage. Peter Hünermann, known for his strong criticism of magisterial teachings on marriage, and the late Cardinal Carlo Caffarra, known for his equally strong defense of them, (...) have both drawn attention to this need. At an international symposium in September 2015, held in Rome prior to the Ordinary Synod of Bishops on Marriage and the Family, Hünermann gave a presentation entitled "On the Specific Theological Character of the Sacrament of Matrimony."1 The symposium aimed at providing a critical and scholarly discussion of new and constructive perspectives for the Church doctrine on marriage and family life in time for the 2015 synod on the family.2 Some of Hünermann's work from this paper also came to be known from an interview in Commonweal magazine where he summarized some of the main points of his symposium presentation.3 In the interview, he also revealed that before the 2015 synod he [End Page 845] was invited to speak with Pope Francis about the theology of marriage. Understandably, this meeting heightened interest in the German theologian's thought.Hünermann argues that "the specific character of the sacrament of marriage, which is very closely connected to the dying of the marriage bond,... has scarcely been the object of theological reflection, [and] is almost unknown in the consciousness of the bishops." 4 Hünermann appeals to St. Thomas as a way forward for understanding the theological character of marriage. This appeal is situated within a wider examination5 that offers an elaboration and new interpretation of "the specific dogmatic characteristics of the sacrament of matrimony that emerge in today's situation from a critical comparison of the encyclical Casti connubii and the Catholic theological tradition, especially the theology of St. Thomas."6 Sharply critical of the encyclical, Hünermann sees it as having saddled the Church with a legalistic concept of marriage elevated above history that is too far removed from the Catholic theological tradition and St. Thomas's theology of marriage.The year before his death, Cardinal Caffarra gave the 2016 graduation address at the John Paul II Institute for Marriage and Family in Washington, DC.7 Among the challenges he identified for the institute to address was the [End Page 846] need for theological reflection on the sacramental character of marriage. Referring to his earlier work, he pointed out that theology after the Council of Trent "lost the awareness of sacramental ontology, of the real transformation produced by the sacrament in the persons of the spouses [res et sacramentum]."8 Furthermore, according to Caffarra, the "theology of the conjugal covenant was supplanted by the notion of a contract, as a human act by which two persons commit to one another." The sacramental character was thought of as consisting of the assurance of divine graces given to fulfill the contract. Caffarra claimed that, "consequently, the words of Jesus 'What God has joined together, let not man put asunder,' lost all their realistic force. Absolute indissolubility, once the sacrament was perfected [=a ratified, consummated marriage], became essentially indefensible."9The primary interest of this paper is to respond to the call for a renewed theological reflection on the specific character of the sacrament of marriage. I wish to take up Caffarra's suggestion to focus on the sacramental character (res et sacramentum) on the one hand, and on the other hand, Hünermann's suggestion that a kind of ressourcement from St. Thomas Aquinas's theology of marriage can be of great help for a fresh theological reflection on the specific character of the sacrament of marriage. Although I agree with Hünermann that a renewed consideration of the thought of St. Thomas can be a way forward, I differ from him on how it can be. Hünermann notices that St. Thomas speaks of the grace of the sacrament of marriage as a helping grace.10 St. Thomas does indeed speak this way of the... (shrink)

Book reviewed in this article: The Physician's Covenant: Images of the Healer in Medical Ethics. By William F. May.