The National Catholic Bioethics Center’s commentary on the Congregation for the Doctrine of the Faith’s 2018 responsum concerning hysterectomy fails to address the explicit reasoning that the CDF offers to justify its response. The CDF does not condone the hysterectomies in question as indirect sterilizations, justified by double effect. Rather, it defines procreation—and consequently sterilization—such that the moral categories of direct and indirect sterilization are not applicable in such cases. The CDF responsum is far more radical (...) and consequential than the NCBC commentary acknowledges. The responsum provides Catholic ethicists with an occasion for a necessary conversation that can be had only once the reasoning of the 2018 responsum is taken seriously in its own right. (shrink)

Since the introduction of the concept of brain death by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death in 1968, the validity of this concept has been challenged by medical scientists, as well as by legal, philosophical, and religious scholars. In light of increased criticism of the concept of brain death, Stephen Napier, a staff ethicist at the National Catholic Bioethics Center, set out to prove that the whole-brain (...) death criterion serves as good evidence for death in the Catholic bioethical framework, on the grounds that when whole-brain death has occurred the soul has already departed from the body. Opponents have argued that (1) brain death does not disrupt the somatic integrative unity and coordinated biological functioning of a living organism and (2) clinical tests outlined in the practice guidelines for determining brain death lack sufficient power to exclude persisting function and fail to detect elements of the brain that, although currently functionless, may retain potential for recovery under conditions of optimal medical care. It is therefore possible that heart-beating organ procurement from patients with impaired consciousness is de facto a concealed practice of active euthanasia and physician-assisted death, both of which, either concealed or overt, the Catholic Church opposes. (shrink)

In 1996 the Pope John Center (now the National Catholic Bioethics Center) offered a workshop for bishops to examine Pope John Paul II's landmark encyclical Evangelium vitae (The Gospel of Life). This collection of essays represents the proceedings of that workshop for scholars and students.

In response to national trends calling for increasing accountability and an emerging dialogue within bioethics, we describe an effort to credential clinical ethicists at a major academic medical center. This effort is placed within the historical context of prior calls for credentialing and certification and efforts currently underway within organized bioethics to engage this issue. The specific details, and conceptual rationale, behind the New York-Presbyterian Hospital’s graduated credentialing plan are shared as is their evolution and (...) ratification within the context of institutional policy. While other programs will design their credentialing schema consistent with their local context and demographics, the description of one such effort is offered to be instructive to others who want to bring additional standardization to the assessment of the readiness and credentials of those who will engage in the practice of clinical ethics case consultation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.2 (2000) 175-188 [Access article in PDF] Scope Note 38 Bioethics Resources on the Web * Once described as an "enormous used book store with volumes stacked on shelves and tables and overflowing onto the floor" (Pool, Robert. 1994. Turning an Info-Glut into a Library. Science 266 (7 October): 20-22, p. 20), Internet resources now receive numerous levels of organization, from basic directory (...) listings to elaborate "links" (cross-references to other Internet documents) that flash and glow in the dark. In many ways, the Internet functions as a direct extension of the traditional library. Following linked references across various sites is an electronic version of browsing library stacks, and the serendipitous discoveries made while "surfing the Net" recall the wonders of physically going "book-to-book." Although many of the Internet's best aspects augment library strengths by eliminating physical distance from sources, Net resources pose unique problems for researchers. It is not always clear who is responsible for the content of Web documents, when the document was produced, or how often (if ever) it is updated. Internet resource tools, then, must enable researchers to identify appropriate resources and to evaluate what they find when they get there. Web Research as Taking "Snapshots" Given the Internet's visual nature and fluid content, the process of conducting research on the Web has been likened to taking an informal picture of information on a specific date at a particular time. This metaphor also conveys the "zoom-in" aspect of searching through Web pages by going from general to specific categories. In the first section of this Scope Note, National Reference Center for Bioethics Literature (NRCBL) staff present a snapshot of bioethics resources taken during the spring months of 2000. Entries are divided into the categories of directories, electronic journals, full-text documents, news/current awareness, and teaching resources. In the two subsequent sections, this series of categories is repeated for entries on a specific topic within bioethics-genetics-and again for general search and evaluation tools. Where a Web site may contain pages applicable [End Page 175] to more than one category, multiple entries are made for that site with appropriate information for each category.Much as telecommunication advances have strengthened the relationship of patients and providers as partners, the dynamic nature of the Internet acknowledges that the researcher functions as a librarian whenever accessing the Web. It is our hope that BIOETHICSLINE and the other NRCBL databases not only will enable researchers to search the Web more efficiently, but also will help them to evaluate what they find when they get there. Bioethicsline on the Web: An International Plan in Progress Once only available through libraries, the U.S. National Library of Medicine (NLM), the funding agency for the ongoing development of the BIOETHICS LINE® database from the Kennedy Institute, has provided free Web access to that database of 63,000 citations since September 1998 through Internet Grateful Med. Plans are now underway to eliminate such specialty databases and incorporate all citations into PubMed (for journal articles) or LOCATORplus (for book-like materials and chapters in books). Both of these databases are likewise available at no cost on the Web. In the transition to PubMed and LOCATORplus some features of BIOETHICSLINE that presently are available may be lost. Researchers are encouraged to contact the National Reference Center for Bioethics Literature with search requests or for search strategy assistance with either the current or the future system ([email protected]).The inclusion of bioethics citations in PubMed and LOCATORplus will have several advantages. First, unique keywords from the Bioethics Thesaurus will be considered for inclusion in Medical Subject Headings (MeSH), the indexing vocabulary for PubMed and LOCATORplus, thereby enhancing retrieval of relevant clinical literature by offering more precise terminology covering ethical issues. Second, it will be easier to identify foreign-language materials, which are not currently included in the scope of BIOETHICSLINE. Third, the updating schedule will become more frequent. On the other hand, there may be some loss of searching precision because certain specialized features... (shrink)

This research examines the most important historical, political, economic, social, cultural, and religious factors before, during, and after the reign of Communism in Czechoslovakia from 1918 to 2021 and their effect on the extreme increase in atheism and decrease in Christianity, particularly Roman Catholicism, in the present-day Czech Republic. It devotes special attention to the role of the Clandestine Catholic Church (Ecclesia Silentii) and the changing policies of the Holy See vis-à-vis this Church, examining these policies' impact on the (...) continuing decline of Roman Catholicism in the Czech Republic after the collapse of Communism. The article also deals with Pope Pius XII's Secret Mandates of 1948-1950, the Second Vatican Council, and the Holy See's Ostpolitik. Scholars, who previously relied only on the views of the Czechs, blame the unprecedented drop in Christianity, the near-total destruction of the Catholic Church, and the rise in atheism on the Czechoslovak communist government's four decades of totalitarianism. Although the increase in atheism and decrease in Christianity were substantial during the era of Communism from 1948 to 1989, our data indicate that the decline in Christianity, particularly the historically predominating Roman Catholicism, did not commence with the 1948 communist coup d’état but traces its origins to the breakdown of the Austro-Hungarian Empire after the conclusion of WWI and the establishment of Czechoslovakia on October 28, 1918. What's more, this research shows that the most significant and unprecedented steep deterioration of the Christian Faith, namely Roman Catholicism, did not occur during the era of Communism but only after the Czechoslovak communist government collapsed in 1989. This massive decay did not happen even during the most extraordinary communist persecution of the Catholic Church during the era of Stalinism in Czechoslovakia. This research further finds that the Holy See's ill-advised policies and systematic, sustained, and prevalent failures in leadership, guidance, and teachings are responsible for the near destruction of the Roman Catholic Church and especially the end destruction of the Clandestine Catholic Church (Ecclesia Silentii), in the Czech and Slovak Republics after the fall of Communism. These failures furthermore contributed to the Czech Republic, the historical lands of Bohemia and Moravia that once were in the center of Christendom, degenerating into the most atheist country in Europe and the world today. (shrink)

By its central terms, the language of the culture of death sends signals that produce life-accepting associations and at the same time mask its intentions against life. On the one hand, the culture of death includes certain behaviors. On the other hand, it includes those social and legal structures that strive to make killing socially acceptable by camouflaging it as a medical service or a social assistance. The culture of death wants to remove killing from condemnation, so that it is (...) no longer cursed as a crime. In the center of the culture of death is the battle for the legalization of abortion, euthanasia, and embryonic stem cell research. National Catholic Bioethics Quarterly 14.4 : 647–657. (shrink)

The nature of the Catholic faith often places practitioners at odds with established order and the specificity of our values may cause us to run afoul of secular sensibilities. What follows is a collection of writings by National Catholic Bioethics Center President, Dr. Joseph Meaney, exploring our place in the public square, the proper way to respond to government driven injustice, and some specific instances in which the current administration has infringed or threatened to infringe (...) upon the conscience and religious rights of not just faithful Catholics, but faithful members of many other religions as well. (shrink)

Catholic ethicists faithful to the magisterium of the Church are currently divided on the permissibility of using methotrexate to treat ectopic pregnancies. This paper examines the defenses of Rev. Albert Moraczewski, OP, and Christopher Kaczor, who argue that its use is morally permissible, in an attempt to demonstrate that methotrexate constitutes a direct abortion by virtue of its object. Specifically, the paper challenges the claims that methotrexate is aimed at inhibiting pathological tissues, that the trophoblast is not an (...) organ of the embryo, and that direct removal of a nonviable fetus is not a direct abortion. National Catholic Bioethics Quarterly 14.4 : 625–635. (shrink)

This manuscript consists of two parts, Part I. and Part II. Part I., written by the same author and titled "THE PERSECUTED CHURCH: THE CLANDESTINE CATHOLIC CHURCH (ECCLESIA SILENTII) IN CZECHOSLOVAKIA DURING COMMUNISM 1948 – 1991," was published in the January issue of the Occasional Papers on Religion in Eastern Europe (OPREE), ISSN: 2693-2148.2 It includes a brief historical overview and introduces the Clandestine Catholic Church (Ecclesia Silentii) in Czechoslovakia during Communism from 1948 to 1991. Part II. directly (...) follows Part I. and continues with the following sections: Results, Discussion, Conclusion, and References. Part II considers the collapse of the Czech Roman Catholic Church and the end destruction of the Clandestine Catholic Church by the Holy See, along with the process of secularization after the fall of communism in Czechoslovakia from 1991 to 2021. (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 (1) to promote the human dignity of patients and staff; (2) to promote the common good; (3) to promote institutional identity, integrity, and ethical climate; and (4) 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)

American health care is in the process of a significant social, institutional, and economic restructuring of the manner in which health services are provided in local communities. The Catholic health care ministry is undergoing the same sort of restructuring. The history of American health care demonstrates that the ministry has experienced at least two similar major restructurings of its institutional framework. The principle of cooperation has been the customary tool to assess the moral propriety of evolving social structures in (...) which the health care ministry has been housed. A process of discernment can lead to the conclusion that the central issue is not moral agency but rather how the ministry engages the secular culture of American society and American medicine. National Catholic Bioethics Quarterly 13.2 (Summer 2013): 263–274. (shrink)

How could it happen that the very processes intended to assure ethical research in Australia might, themselves, undermine good research practice?This paper describes one PhD candidate’s recent experiences of multicentre review for a Human Research Ethics Committee approved, low/negligible risk, qualitative study, at the crossroad of health services research and organisational research.A retrospective review of international literature about multi-centre review processes revealed that many of these experiences were not unique and might have been expected, notwithstanding Australian efforts at harmonisation of (...) multi-centre review. This paper examines not only the burden of red-tape that was applied to a small doctoral study, but also the way in which the red-tape threatened the anonymity of potential study participants and risked exposing them to undue pressure and distress.These experiences support the view that harmonisation initiatives have not yet developed as the Australian National Health and Medical Research Council may have hoped and that further attention is needed to harmonise research governance processes. (shrink)

The main trends of the bioethics development in Belarus have been analyzed on the basis of the materials collected by the Ethics Documentation Center (ISEU, Minsk, Belarus). A critical review of the most important publications in the field since 2000 suggests that development of bioethics in Belarus has occurred in two parallel directions distantly connected to each other: a theoretical direction and a practical one. Despite there are objective and subjective reasons for introducing bioethics in Belarus (...) as an institutionally-organized system based on liberal values such as individual rights and freedom, a range of essential problems could be identified. Non-equivalent regulation of ethical issues in health care and other fields of biomedical research has been emphasized, as well as the problem of unclear hierarchical relationships among institutions dealing with various aspects of bioethics in the country and low ethical and educational level of the social and professional groups involved in further expansion of bioethical knowledge. The contextual aspects of the development of bioethics in the country such as the consequences of the Chernobyl disaster, the prevalence of the authoritarian social morality and traditionally paternalistic nature of the relations between physicians and their patients are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Adjusting Laboratory Practices to the Challenges of WartimeOksana Sulaieva, Anna Shcherbakova, and Oleksandr DudinFunding. Oksana Sulaieva, MD, PhD is supported by the Loyola University Chicago–Ukrainian Catholic University Bioethics Fellowship Program, funded by the National Institutes of Health Fogarty International Center (D43TW011506).After 500 days of the unjust war initiated by the Russians, we look back to reflect on the challenges our medical laboratory faced during these (...) early days. On the morning of February 24th, we were awakened by the dreadful roar of sirens, the sound of which filled us with adrenaline and anxiety. Although our team had considered the risks of Russian military aggression and thus updated our emergency plan at the beginning of 2022, the first day of the war revealed that nobody was truly ready for the bombing, air alarms, tanks on the streets of towns and cities, violence and murders of civilians. That morning the city’s transportation system collapsed, and the flow of cars cluttered all the roads as people were trying to leave the city and escape the upcoming atrocities and death. Serious and disquieted people hurried along the streets—some people rushed to shelters, and others went to the military registration and enlistment offices to fight against Russian aggressors for the life, independence, and sovereignty of Ukraine.We hurried to work, committed to performing our duties. Our medical laboratory serves more than 750 hospitals in Ukraine. Despite fear and uncertainty, we walked to the lab, taking our children and alarm case1 with documents and essential things. Months later, people asked us why we went to the laboratory instead of leaving the city or even the country. At that moment, our [End Page 155] professional duties were an anchor linking us to each other against fear and panic. Our responsibility to provide patients and physicians with the results of blood testing, pathology, and molecular reports outweighed our fears of the war. We had to complete the testing of all the samples delivered to the laboratory to provide our customers—who include children, pregnant women, diabetic and cancer patients—with data essential for identifying accurate diagnoses and effective treatments. So we spent the first days of the war in the laboratory. At the same time, we had obligations and responsibilities to our staff as well. We had to consider how to manage our employees’ protection along with continuous laboratory services provided under endless air alarms and bombings. Many healthcare facilities in eastern regions and around Kyiv were affected by missiles or completely destroyed. Of our sixty laboratory offices around Ukraine, ten were damaged or abandoned due to occupation. Several of our fleet cars were also damaged and riddled with bullets. Many employees in the regional offices in Melitopol, Kherson, Mariupol, Chernihiv, and in suburbs of Kyiv such as Bucha and Irpin lost their homes as a result of massive military operations or occupation. Dozens of our employees joined the Ukrainian armed forces to defend civilians and fight against aggressors. Many others became volunteers, involved in blood donation, medical care for the wounded, cooking, and serving the troops. And still, we had to continue our work and protect our staff at the same time. We also helped each other by sharing our goods, medication, homes, cars, warmth, and support. Some pathologists stayed at the workplace for several days moving between pathology stations, microscopes and shelters, and sleeping on the floor but continuing to work.Our main challenge was the regular terroristic attacks on healthcare facilities situated far away from the front line, which in fact, violated international humanitarian law regarding respect for human rights during armed conflicts. During the first weeks of the war, the magnitude of military aggression, massive bombing, and air attacks undermined the healthcare system and endangered laboratory staff and patients. We prioritized protective measures. Some of our laboratory staff and facilities were evacuated from Kyiv to Lviv in western Ukraine. The partial relocation of our laboratory to Lviv was also driven by the displacement of several million Ukrainians to the western part of the country.We were able to arrange relatively safe accommodations for our laboratory employees and their families in Lviv. Under strikes and alarms, our... (shrink)

The past five years have brought important and rapid developments for the scientific bioethics community in Germany. Bioethics was institutionalized as an obligatory part of the undergraduate and graduate schedule in medical schools. Clinical ethics committees are spreading all over the country, and research on ethical issues of biomedicine is sponsored on a large scale, for example, by the German Ministry of Education and Research. Two main institutions, dealing with bioethics and biopolicies, were established and have worked (...) on central bioethical issues, mostly ending up with diametrically opposed recommendations: the Enquetekommission Recht und Ethik der Modernen Medizin, composed of parliamentarians of all political parties and appointed external experts, and the National Ethics Council, composed of experts, politicians, several stakeholders, and representatives of the Catholic and Protestant churches. (shrink)

Respected Catholic ethicists have recently defended the use of salpingostomy and methotrexate in the management of ectopic pregnancies.This article examines the arguments for the revised assessments to determine whether there are sound reasons to believe that these two methods do not constitute the direct and immediate killing of innocent human beings. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 65–82.

In this essay, I offer some reflections on how the topics were identified and approached by the Presidential Commission for the Study of Bioethical Issues, on which I had the honor to serve, in the hope that the reflections may be useful to future national bioethics commissions. In the executive order that established the bioethics commission, President Obama explicitly recognized the ethical imperative to responsibly pursue science, innovation, and advances in biomedical research and health care, and the (...) importance of national attention to these issues. The bioethics commission prioritized practicable, actionable, targeted recommendations. Like most earlier U.S. national bioethics commissions, President Obama's commission did not undertake projects on significant and troublesome issues related to health and health care that were not associated with new science or technology. Issues such as health care access, health care delivery, opioid addiction, end‐of‐life care, and physician‐aid‐in‐dying are topical and ethically complex areas of significance to bioethics, and they are also being discussed and debated by the public, the media, and policy‐makers. In my view, there are good reasons to select and prioritize projects as well as a justification for confining commission efforts to issues related to novel science and emerging technologies, when there is only one national‐level bioethics commission that has been established by the Office of the President. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Revisiting the Launching of the Kennedy Institute: Re-visioning the Origins of BioethicsWarren Thomas Reich (bio)Twenty-five years ago, on October 1, 1971, at a press conference held at Georgetown University, the Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics, later called the Kennedy Institute of Ethics, was officially inaugurated. To revisit that event—and the Institute’s five founding collaborators who spoke at it—provides an opportunity (...) to re-vision some of the most significant intellectual, moral, cultural, and political factors that shaped both this Institute and the then-nascent field of bioethics.Eunice Kennedy Shriver, who spoke at the press conference, was intensely committed to a new sort of philanthropy that would effect socio-political change in favor the dignity and well-being of the mentally disadvantaged. As executive vice-president of the Joseph P. Kennedy, Jr. Foundation, she had already applied the Foundation’s vision and resources to the task of harnessing the best of the “biological revolution” of the 1960s to prevent developmental disorders. Prompted by the values at stake in the care of the disadvantaged, she turned the Foundation toward the creation of the Institute in 1971.Just prior to the opening of the Institute, Mrs. Shriver had produced and appeared as introducer in a highly influential film, “Who Shall Survive?”, which dealt with a “mongoloid baby” who was allowed to die in the newborn clinic because of its condition. Showcased at a highly publicized symposium involving 2000 people (Editorial 1971) and widely discussed in the press, the film helped to establish neonatal ethics as paradigmatic for the emerging field of bioethics (Bedeviling Question 1971; Rothman 1991, pp. 190–221). Undoubtedly under the influence of her involvement in the publicizing of those issues, Mrs. Shriver commented at the press conference that she hoped the Institute would re-emphasize the value of children in face of the widespread feeling that children are a burden (Kennedys 1971, p. 19).At the press conference, then president of Georgetown University, Robert J. Henle, S.J., announced the Kennedy Foundation’s grant of $1.35 million to establish the Institute. Henle was undoubtedly alert to the fact that certain issues, such as abortion and terminating the lives of infants, would be perceived [End Page 323] as highly controversial when raised at a Catholic university. Not surprisingly, reporters at the press conference raised provocative questions about how Georgetown University would reconcile Catholic moral doctrine with the Institute’s broadly-based inquiries. Henle replied tersely that the Institute “will be a ‘truly ecumenical and catholic effort,’ defining catholic in its classical meaning of universal” (Helping 1971). The reporters might have found it quite ironic that within a few years Georgetown’s ecumenical vision had provided the intellectual environment that permitted the Institute to become famous for development of the first systematic, secular (principle-based) approach to bioethics (Reich 1995).Father Henle was probably also aware that by launching the Kennedy Institute he was creating the first institute principally devoted to ethics research ever established at a university. It took a special sort of university to take this first step into bioethics research and policymaking. In 1971, ethics was regarded as belonging to religion, and religion was generally regarded as suspect academically. While it was difficult, in that atmosphere, for a nonreligious university to take such a bold step, Henle’s Georgetown University offered a promising setting that could scarcely have been found in any other university. It departed from the common mold of Catholic-college-as-indoctrination-center, yet it had an explicit and unashamed commitment to the investigation of religious and secular values in an environment of academic freedom. It was an increasingly cosmopolitan university, committed to developing the best of secular scholarship. Furthermore, Henle was willing to experiment with as-yet unproven interdisciplinary studies.Sargent Shriver—god-father of the Kennedy Institute, chairman of its first Advisory Board, and a constant dialogue partner of his friend and the Institute’s founding director, Dr. André Hellegers—was intensely interested in linking scientific progress with religious belief, unfettered moral debate, and commitment to disadvantaged humans.At the inaugural event, the new Institute was described as... (shrink)

The first meeting of the Global Forum for Bioethics in Research was initiated by the Fogarty International Centre of the National Institutes of Health and sponsored by the World Health Organisation, the Pan American Health Organisation and the NIH. Held in Bethesda on November 7-10,1999, the intent was to bring together individuals involved in medical research in low- and middle-income nations to share views with each other and with organisations that support clinical research. Approximately 120 persons from 34 (...) countries participated, including individuals from developing countries, pharmaceutical organisations, and communities where medical research is under way.The participants addressed the partnerships required between research sponsors and investigators involved in clinical trials in developing countries and the long-term needs for international multicentred training programs. (shrink)

The first meeting of the Global Forum for Bioethics in Research was initiated by the Fogarty International Centre of the National Institutes of Health and sponsored by the World Health Organisation, the Pan American Health Organisation and the NIH. Held in Bethesda on November 7-10,1999, the intent was to bring together individuals involved in medical research in low- and middle-income nations to share views with each other and with organisations that support clinical research. Approximately 120 persons from 34 (...) countries participated, including individuals from developing countries, pharmaceutical organisations, and communities where medical research is under way.The participants addressed the partnerships required between research sponsors and investigators involved in clinical trials in developing countries and the long-term needs for international multicentred training programs. (shrink)

The sequencing of the entire human genome has opened up unprecedented possibilities for healthcare, but also ethical and social dilemmas about how these can be achieved, particularly in developing countries. UNESCO's Bioethics Programme was established to address such issues in 1993. Since then, it has adopted three declarations on human genetics and bioethics (1997, 2003 and 2005), set up numerous training programmes around the world and debated the need for an international convention on human reproductive cloning. Negotiating (...) class='Hi'>Bioethics presents Langlois' research on the negotiation and implementation of the three declarations and the human cloning debate, based on fieldwork carried out in Kenya, South Africa, France and the UK, among policy-makers, geneticists, ethicists, civil society representatives and industry professionals. The book examines whether the UNESCO Bioethics Programme is an effective forum for (a) decision-making on bioethics issues and (b) ensuring ethical practice. Considering two different aspects of the UNESCO Bioethics Programme - deliberation and implementation - at international and national levels, Langlois explores: - how relations between developed and developing countries can be made more equal - who should be involved in global level decision-making and how this should proceed - how overlap between initiatives can be avoided - what can be done to improve the implementation of international norms by sovereign states - how far universal norms can be contextualized - what impact the efficacy of national level governance has at international level Drawing on extensive empirical research, Negotiating Bioethics presents a truly global perspective on bioethics. (shrink)

This paper examines contemporary Catholic higher education and its unique role in preparing graduates, who have been grounded in natural moral law, to respond to the bioethical questions of the day. The importance of the commitment by both administration and faculty to articulating and embracing the mission of Catholic higher education as they prepare graduates for a culture of relativism is presented. Curricular objectives, content, and teaching strategies are provided which address the most relevant bioethical dilemmas of the (...) day. The importance of an integrated approach to examining these dilemmas, as well as a grounding in core content in philosophy and theology for all graduates, regardless of discipline of concentration, are presented. The interjection of government mandates into the void of bioethical resolutions is examined in relationship to the rights of conscience. The paper concludes with examples of best practices, showing the role of Catholic higher education as uniquely suited to advance the common good. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 705–734. (shrink)

The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group (...) of bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics ConsultationPat Milmoe McCarrick (bio)(John La Puma, M.D., from the Department of Medicine at Lutheran General Hospital in Chicago, contacted the National Reference Center for Bioethics Literature and suggested bioethics consultation as a topic for the Scope Note Series. He provided an extensive list of citations about ethics consultations collected by him and by David Schiedermayer, M.D., for their new book Ethics Consultation: A (...) Practical Guide.)In Ethics Consultation in Health Care, editors John Fletcher, Norman Quist, and Albert R. Jonsen (I, 1989) define ethics consultation as "the provision of specialized help in identifying, analyzing, and resolving ethical problems that arise in clinical care. In medical ethics the area of consultation has grown rapidly since 1978 when Edmund D. Pellegrino (II, 1978) noted, "we cannot separate technical-moral decisions from the philosophic principles we use to justify them. Medicine and ethics must be engaged with each other at every level."In 1980 Albert Jonsen raised the question of whether an ethicist could be a consultant and said that the ethicist as consultant is a casuist, one whose moral reasoning is based on a system of reasoning that is applied to particular cases. He describes historical casuistry in Western culture, comparing it to modern moral philosophy, and suggests that a "new casuistry seems timely" for ethics consultation (II, Jonsen 1980). By 1984 ethicist Ruth Purtilo recorded her thoughts following an ethics consultation. She raised questions about the ethicist's place on a hospital staff and how to make that role appropriate and beneficial to all concerned, saying that "the ethicist retreats after the consultation; under no circumstances would the outcome of an ethics consultation be that the ethicist became the primary care giver or assumed ongoing responsibility for the clinical management of a case" (II, Purtilo 1984). Nevertheless, in 1992 two physician-ethicists who had been called as ethics consultants for a patient who had requested that he be removed from his ventilator reported that they became the persons who turned off the ventilator and administered the drugs that eased his dying (II, Edwards and Tolle 1992).In recognition of the growing number of persons identifying themselves as [End Page 433] consultants, the Society for Bioethics Consultation was founded in October 1985 as a professional society of persons engaged in bioethics consultation. It encourages and supports consultation, assists in establishing clinical education programs, and raises funds for consultation education. Although the Society has no permanent office, the president (currently, George Kanoti in the Cleveland Clinic Foundation's Bioethics Department) conducts its work and plans an annual meeting.The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) established new criteria concerning ethics in its 1992 Manual (III, JCAHO 1992) and in a special issue of QRB devoted to ethics consultation (I, Defining Quality 1992). These publications undoubtedly have contributed to the increased use of experts in medical ethics. The Manual notes that all organizations seeking accreditation should have some sort of "mechanism for the consideration of ethical issues arising in the care of patients and to provide education to care givers and patients on ethical issues in health care." A health care institution's eligibility for JCAHO accreditation, which is required for federal reimbursement, requires adherence to this specification (III, JCAHO 1992).The new International Directory of Bioethics Organizations provides an index of 129 different groups that indicated to the authors that they offer bioethics consultations. Of these, 83 are in the United States and 46 are in other countries. The ethics consultants included in the directory encompass a broad group of professionals who will assist patients, families, and primary care medical staff in finding solutions to ethical dilemmas resulting from use of new technologies or new treatments in health care. Consultants often come from the health fields: physicians, nurses, and other health personnel, but other professionals are also active as ethics consultants. Lawyers, pastoral counselors, philosophers, and social workers also offer bioethics consultation services (III, Nolen and Coutts 1993).Drs. Siegler, Pellegrino, and Singer wrote in 1990 that "Physician-ethicists and professional ethicists will continue to work side by side in the future. One is not likely to replace the other, nor is this desirable, because... (shrink)

The obvious appeal and growing momentum of clinical ethics in academic medical centers should not blind us to a potential danger: the collapse of critical distance. The very integration into the clinical milieu and the processes of clinical decision making, that clinical ethics claims as its greatest success, carries the seeds of a dilution of ethics' critical stance toward medicine and medical education. The purpose of this paper is to suggest how this might occur, and what potential contributions of ethics (...) to medicine might be sacrificed as a result. Medical sociology will be used for comparison. Sociologists have found that they may function either as students and critics of established medical practices and educational philosophies, or as collaborative participants in them — but rarely both. It may be that professional ethics is most effective when it plays the role of stranger rather than insider, and is continually able to question the most basic assumptions and values of the enterprise with which it is associated. As with medical sociology, ethics and humanities must ask to what extent their desire for acceptance in the clinic requires their acceptance of the clinic: specifically, acceptance of basic assumptions about optimal ways of organizing medical education, socializing physicians-in-training, providing care, and even of defining medical ethics itself. The paper concludes by recommending that ethics reassert its strangeness in the medical milieu even as it assumes a more prominent role within the medical center. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Blossoming of Bioethics at NIHEzekiel J. Emanuel (bio)The establishment of the Department of Clinical Bioethics at the Warren G. Magnuson Clinical Center of the National Institutes of Health (NIH) has coincided with a burgeoning of interest and activity related to bioethical issues at NIH. The department has precipitated a reexamination and revitalization of existing bioethics activities in the Clinical Center and has (...) launched new programs especially in the areas of education and research. In addition, the department contributes to the work of others throughout NIH who address bioethical issues.The Organizational Location of the Department of Clinical BioethicsBefore describing the history and current activities of the Department of Clinical Bioethics, I will say something about it administrative location. Comprehension of the department’s organizational location is essential to understanding its history, role, and function. Prior to interviewing for the position of chair of the department, I did not—and, if truth be told, still do not fully—understand the details of the organizational structure of NIH. I therefore assume that many other bioethicists outside of the Institutes, especially those who do not regularly receive NIH funding, may not fully grasp its organizational intricacies.The Department of Clinical Bioethics is a department within the Warren G. Magnuson Clinical Center, which is NIH’s “hospital.” Hospital is in quotes because all of the patients at the Clinical Center must be enrolled in a research protocol and, therefore, are research subjects. The Clinical Center is where NIH’s clinical researchers admit their research subjects or see them in the out-patient setting. The Department of Clinical Bioethics reports directly to the Director of the Clinical Center, John I. Gallin, M.D., and receives its finances, space, and other resources from the Clinical Center.In this way, the department is part of NIH’s intramural (“inside”) program. People employed by NIH conduct intramural research, training, and other initiatives. The extramural program, which receives approximately 87 percent of NIH’s budget, funds research at institutions outside NIH. The extramural program awards grants and contracts for research, training, and conferences conducted [End Page 455] by investigators who are not affiliated with NIH. The National Human Genome Research Institute’s ELSI (Ethical, Legal, and Social Implications) program, for example, is part of NIH’s extramural program. As part of the NIH intramural program, the Department of Clinical Bioethics is not empowered to fund independent initiatives of people outside of NIH through grants and contracts. However, the department can collaborate with bioethicists and others on research, educational, and other programs outside of NIH and has some funds to support these collaborations.In addition, it is important for bioethicists to understand that NIH is a collection of 24 institutes and centers. Although there is coordination and collaboration between the institutes and centers, each is funded separately, and each has its own scope, programs, administrative structures, research agendas, training priorities, boards of advisors, and so forth. In this sense, NIH is more like a university that has many distinct schools, each with its own dean, faculty, budget, and fund raising office, than one that is tightly integrated and centrally-administered. Within NIH’s diffuse administrative structure, the Department of Clinical Bioethics is located within one of the centers (the Clinical Center) and has defined authority and responsibility only for bioethics within that center; in addition, because the Clinical Center’s mission is to support clinical research at other institutes, the department’ mission includes supporting the work of those institutes as well. Intellectual exchanges and relationships with other institutes and centers are neither pre-ordained nor administratively established; such relationships must be developed case-by-case, topic-by-topic, and initiative-by-initiative.The History and the Development of the Department of Clinical BioethicsThe Department of Clinical Bioethics was launched in late 1996. Although the department’s creation marked a major commitment to bioethics by the Clinical Center, and especially by its director, Dr. Gallin, it was formed on a pre-existing foundation of bioethics activities at NIH. 1In 1977, John Fletcher, Ph.D., was appointed by then Director Mortimer Lipsett as the bioethicist at the Clinical Center; his official title was Assistant for Bioethics... (shrink)

This paper explores the concept of ectogenesis in both the partial and the complete forms and argues for the moral permissibility of artificial womb technology in some restricted contexts. The author proposes that artificial wombs could licitly be employed for the purpose of saving the lives of infants born at very young gestational ages either by miscarriage or by delivery induced for very serious medical reasons. The author also proposes that artificial womb technology may be licitly used for the rescue (...) of embryos created through in vitro fertilization and subsequently abandoned by their parents, but the technology would have no ethical application when used electively. National Catholic Bioethics Quarterly 10.3 (Autumn 2010): 515–528. (shrink)

This article explores the way the distinction between enhancement and therapy has been used in Catholic bioethics to assess the moral character of technologies that developments in genetics and neuroscience have made possible. The purpose of drawing lines between therapy and enhancement is typically to claim that the former is always ethically justified and the latter is morally suspect, if not altogether impermissible. The author connects the enhancement versus therapy distinction to concepts of human nature that ground it (...) and examines the function of the distinction in these theological anthropologies. She argues that the distinction is insufficient for making decisions regarding use of neurotechnologies. Catholic ethicists thus need to explore alternative methods to begin the essential project of developing neuroethics. National Catholic Bioethics Quarterly 15.1 : 63–72. (shrink)

The National Bioethics Advisory Commission, of which I was a member, was established by a 1995 executive order that identified its “first priority” as “the protection of the rights and welfare of human research subjects.” Not surprisingly, then, most of NBAC's work focused on research involving human subjects or participants. A second priority concerned “issues in the management and use of genetics information, including but not limited to, human gene patenting.” NBAC's charter (in contrast to the executive order) (...) listed this charge as “part B” of the “first priority.” Nonetheless, NBAC never fully developed it. In addition to responding to requests and recommendations from the National Science and Technology Council, NBAC could accept suggestions from Congress and the public for bioethical issues it should consider, and it could also identify other issues to consider and set priorities among them. From its first meeting on October 4, 1996, until its charter expired on October 3, 2001, NBAC produced six reports, with 120 recommendations. In this essay, I make a few observations about principles and moral reasoning in NBAC's deliberations and about NBAC's attention to religious beliefs in the context of two bioethical controversies, provide a rough evaluation of NBAC's impact, and consider three possible models for future public bioethics directed at federal public policy. (shrink)

The Catholic moral tradition has a rich foundation that applies broadly to encompass all areas of human experience. Yet, there is comparatively little in Catholic thought on the ethics of the collection and use of data, especially in healthcare. We provide here a brief overview of terminology, concepts, and applications of data in the context of healthcare, summarize relevant theological principles and themes (including the Vatican’s Rome Call for AI Ethics), and offer key questions for ethicists and (...) data managers to consider as they analyze ethical implications pertinent to data governance and data management. (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)

In The Gospel of Life, Pope John Paul II encouraged organ donation as a genuine act of charity. Some Catholics reject the notion of vital organ transplantation and the use of neurological criteria to determine a donor’s death before organs are extracted. This article reviews Church teaching on the use of neurological criteria for determining death—including statements by three popes, a number of pontifical academies and councils, and the U.S. bishops—to show that Catholics may in good conscience offer the gift (...) of life through the donation of their organs after death as determined by those criteria, and may in good conscience receive such organs. This article is not a defense of the legitimacy of neurological criteria for determining death but rather a presentation of the moral guidance currently offered by the Church on the legitimacy of organ donation after death has been determined by their use. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 279–299. (shrink)

Comparative assessments of national bioethics commissions in the United States commonly look at the differences among these groups over their forty‐year history. A particular focus has been differences in the membership, mission, methods, and reports of the President's Council on Bioethics, which was active from 2001 until 2009, compared to those of its predecessors and the recent Presidential Commission for the Study of Bioethical Issues, active from 2009 until 2016. The differences are real, but disproportionate attention to (...) them can obscure the substantial similarities in commissions’ structure and function throughout the history of expert bioethics advice to government. As the Trump administration considers what role, if any, a bioethics commission will play in its work, it would be well served to consider how choices regarding the design of such a group and the topics it examines can best facilitate the unique contributions it can make to the government and to the country. (shrink)

The last several years have been marked by a seemingly increasing numbers of individuals with homosexual inclinations. There are consequences to society-wide increases in disordered dispositions, and this paper presents one such consequence. Patients often enter the physician–patient relationship basedon the physician’s “sexual preference.” In order to avoid sexual misconduct from a physician, patients often choose physicians that are not inclined to be sexually attracted to the patient. It is often assumed that a patient can infer a physician’s sexual inclinations (...) by his or her gender, but this is not the case. Due to the inability to determine a health care professional’s “sexual preference” by their gender, a physician has a duty to disclose this information prior to care. National Catholic Bioethics Quarterly 13.3 (Autumn 2013): 445–450. (shrink)

United States ethicist Ronald M Green approaches the issue of embryo research (ER) in the very accessible form of a “philosophical memoir” (xv). Reporting in detail from his experience of serving on several high level ethics advisory boards, focusing mostly on his membership of the National Institutes of Health’s (NIH) 1994 human embryo research panel, Green portrays both the functioning of this increasingly more influential form of institutionalised ethics, as well as the social and political dynamics governing its (in)effectiveness. (...) The author also covers extensive ground regarding the subject matter of ER itself and familiarises the reader with the technical issues and conceptual conundrums (potentiality, moral status, harming future persons) involved. Green states in the title of The Human Embryo Research Debates: Bioethics in the Vortex of Controversy, that he is concerned with a plurality of debates. Examining the discourse in the US, he first deals with the different areas in which ER is debated: of the book’s eight chapters, chapters one and four stress the relevance of ER for the fields of in vitro fertilisation (IVF) research, the study of birth defects, and the development of contraceptive methods. Chapter 6 deals with the relation of ER to reproductive cloning; Green formulates a comprehensive …. (shrink)

In The Future of Human Nature, Jürgen Habermas raises the question of whether the embryonic genetic diagnosis and genetic modification threatens the foundations of the species ethics that underlies current understandings of morality. While morality, in the normative sense, is based on moral interactions enabling communicative action, justification, and reciprocal respect, the reification involved in the new technologies may preclude individuals to uphold a sense of the undisposability of human life and the inviolability of human beings that is necessary for (...) their own identity as well as for reciprocal relations. Engaging with liberal bioethics and Catholic approaches to bioethics, the article clarifies how Habermas’ position offers a radical critique of liberal autonomy while maintaining its postmetaphysical stance. The essay argues that Habermas’ approach may guide the question of rights of future generations regarding germline gene editing. But it calls for a different turn in the conversation between philosophy and theology, namely one that emphasizes the necessary attention to rights violations and injustices as a common, postmetaphysical starting point for critical theory and critical theology alike. In 2001, Jürgen Habermas published a short book on questions of biomedicine that took many by surprise.[1] To some of his students, the turn to a substantive position invoking the need to comment on a species ethics rather than outlining a public moral framework was seen as the departure from the “path of deontological virtue,”[2] and at the same time a departure from postmetaphysical reason. Habermas’ motivation to address the developments in biomedicine had certainly been sparked by the intense debate in Germany, the European Union, and internationally on human cloning, pre-implantation genetic diagnosis, embryonic stem cell research, and human enhancement. He turned to a strand of critical theory that had been pushed to the background by the younger Frankfurt School in favor of cultural theory and social critique, even though it had been an important element of its initial working programs. The relationship of instrumental reason and critical theory, examined, among others, by Max Horkheimer, Theodor W. Adorno, and Herbert Marcuse and taken up in Habermas’ own Knowledge and Interest and Theory of Communicative Action became ever-more actual with the development of the life sciences, human genome analysis, and genetic engineering of human offspring. Today, some of the fictional scenarios discussed at the end of the last century as “science fiction” have become reality: in 2018, the first “germline gene-edited” children were born in China.[3] Furthermore, the UK’s permission to create so-called “three-parent” children may create a legal and political pathway to hereditary germline interventions summarized under the name of “gene editing.”In this article, I want to explore Habermas’ “substantial” argument in the hope that philosophy and theology become allies in their struggle against an ever-more reifying lifeworld, which may create a “moral void” that would, at least from today’s perspective, be “unbearable”, and for upholding the conditions of human dignity, freedom, and justice. I will contextualize Habermas’ concerns in the broader discourse of bioethics, because only by doing this, his concerns are rescued from some misinterpretations.[1] Jürgen Habermas, The Future of Human Nature.[2] Ibid., 125, fn. 58. 8[3] Up to the present, no scientific publication of the exact procedure exists, but it is known that the scientist, Jiankui He, circumvented the existing national regulatory framework and may have misled the prospective parents about existing alternatives and the unprecedented nature of his conduct. Yuanwu Ma, Lianfeng Zhang, and Chuan Qin, "The First Genetically Gene‐Edited Babies: It's “Irresponsible and Too Early”," Animal Models and Experimental Medicine ; Matthias Braun, Meacham, Darian, "The Trust Game: Crispr for Human Germline Editing Unsettles Scientists and Society," EMBO reports 20, no. 2. (shrink)

The article aims to articulate and defend St. Thomas Aquinas’s understanding of the transcendence of the political common good and argues against the new natural law theory’s view of the common good as limited, instrumental, and ordered toward the private good of families and individuals. After a summary of John Finnis’s explanation of the common good in Aquinas: Moral, Political, and Legal Theory, the article presents an analysis of the political common good in Aquinas’s Summa theologiae and De regno. This (...) analysis shows, contrary to Finnis, that for Aquinas the political common good transcends the private good of individuals and families, that it consists in the virtuous life of the political multitude, and that the family is insufficient to lead men to virtue apart from the civitas. National Catholic Bioethics Quarterly 13.1 (Spring 2013): 133–155. (shrink)

The United Kingdom has many bodies that play their part in carrying out the work of national ethics committees, but its nearest equivalent of a U.S. presidential bioethics commission is the Nuffield Council on Bioethics, established in 1991. The Council is charged with examining ethical questions raised by developments in biological and medical research, publishing reports, and making representations to appropriate bodies in order to respond to or anticipate public concern. It is a nongovernment organization with no (...) defined or guaranteed channels of influence. It has no authority merely by virtue of the position it holds. Rather, it has established relational authority based on its reputation. Unlike the U.S. bioethics commission, it is not part of executive government, nor is it constituted to contribute to the legislative branch, as does the French Comité Consultatif National d'Ethique. Its nongovernmental status notwithstanding, the Nuffield Council's work affects the U.K. government and the British public, and the Council has achieved international recognition for its reports. I was the chairperson from 2012 to 2017 and draw on my experience in this piece to consider three key audiences: governments, publics, and the international community. (shrink)