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81. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Marissa L. Mullins When Cardiopulmonary Resuscitation Becomes Harmful
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Cardiopulmonary resuscitation is a standard emergency medical procedure. Since its inception in the late 1960s, CPR has been performed on patients unless they or their proxies refuse it. However, like all medical inter­ventions, CPR has its benefits, risks, and consequences. Although the expected benefits of the procedure often outweigh its potential harm, CPR is not always clinically appropriate, especially for the dying, who have a very small statistical chance of surviving the intervention. Just as antibiotics are not prescribed for viruses and surgeries and treatments are withheld when clinically inappropri­ate, CPR should not be offered as a clinical treatment when it has a very low probability of success and is thought to be futile. Health care providers have an ethical and moral responsibility to withhold clinically inappropriate CPR, even when patients or their proxies request the procedure.
82. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Frederick J. White III, MD Lessons from Recent Polls on Physician-Assisted Suicide
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Physician-assisted suicide is an active political issue, and recent polls have indicated shifts in public opinion in favor of its permissibility and moral acceptability. However, structural errors and biasing effects exist in these polls, including several subtle logical fallacies as well as cognitive and reporting biases. Analysis of the polls suggests that public support for physician-assisted suicide is more conditional and much softer than the popular news headlines indicate. An understanding of how these factors function beneath the headlines provides important lessons for the discussion of physician-assisted suicide.
83. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Francisco Javier Insa Gómez, Pablo Requena Meana Is Medical Futility an Ethical or Clinical Concept?
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The concept of medical futility first appeared at the end of the 1980s, was developed throughout the 1990s, and now is widely cited in medical literature and clinical practice to justify refraining from or limiting the use of life-sustaining therapies. The definition of medical futility, however, is not very clear or universally accepted. In this article, we examine the strengths and limitations of a particular concept of medical futility, based exclusively on clinical considerations, that enables the physician to make unilateral decisions about whether to withhold, withdraw, or continue treatment without being required to consult the patient or his family. To respect the patient’s spiritual, philosophical, and ethical values, several significant ethical issues need to be narrowly defined, and the concept of medical futility must be rarely invoked to justify such unilateral decisions.
84. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Joshua Evans The Catholic Tradition on Vital Conflicts: A Critique of Charles Camosy and James Mumford
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In two important books on the ethics of abortion, Charles Camosy and James Mumford appeal to the concept of “material aggression” to justify direct abortion in cases of vital conflict. Both authors argue that just-war theory justifies the direct killing of merely material aggressors by private citizens and suggest that papal condemnations of unjust-aggressor arguments fail to consider the distinction between formal and material aggression. However, both authors omit any reference to the historical context of the papal condemnations, do not recognize that the justification for killing in just-war theory is fundamentally political, and do not consider how the special relationship between mother and baby might affect the ethics of vital conflicts.
85. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
John M. Haas Incentivizing Cost Reduction through POLST: NCBC Letter to the Secretaries of HHS and the VA
86. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Jacob Harrison Karol Wojtyla, Sex Reassignment Surgery, and the Body–Soul Union
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Dialogue about the moral permissibility of sex reassignment surgery (SRS) in Catholic health care has recently received considerable attention. In an effort to further this discussion and bring clarity to the debate, the author uses Pope St. John Paul II’s robust theological and philosophical anthropology to evaluate the morality of SRS and enter dialogue with current arguments that suggest SRS is morally licit. The author argues that John Paul II’s anthropology renders SRS morally illicit. Moreover, current arguments supporting SRS rely on an anthropology of body–soul dualism. This conclusion suggests that future arguments for the permissibility of SRS in Catholic health care will always be invalid if they fail to uphold the body–soul unity of the person.
87. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
David J. Ramsey, MD Medicine
88. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Christopher Kaczor Philosophy and Theology
89. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
David A. Prentice Science
90. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Katherine Feiler Replacement Parts: The Ethics of Procuring and Replacing Organs in Humans
91. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Mary Shivanandan Relational Sociology: A New Paradigm for the Social Sciences
92. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Christopher J. Wolfe The Future of Assisted Suicide and Euthanasia
93. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Brian Welter Science Was Born of Christianity: The Teaching of Fr. Stanley L. Jaki
94. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Thomas P. Sheahen Dreamland: The True Tale of America’s Opiate Epidemic
95. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 2
Christopher Kaczor The Ethics of Pregnancy, Abortion, and Childbirth: Exploring Moral Choices in Childbearing
96. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 3
Greg Schleppenbach Washington Insider
97. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 3
Katarina Lee, Charles Robertson, Elizabeth Bothamley Rex Colloquy
98. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 3
Edward J. Furton In This Issue
99. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 3
John F. Roth Opiates and the Removal of Life Support: A Moral Obligation of Health Care Providers
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Medical and nursing personnel have an obligation to provide the medication necessary for every patient’s pain relief. This includes patients whose life-supporting mechanical ventilation is being removed, who may not exhibit traditional signs of pain or dyspnea. The purpose of this paper is not to argue a position on withdrawing life support. Rather, it argues that nurses and physicians have an obligation to provide pain-relieving medication, such as opiates, when life support is removed, to ensure that those entrusted to their care do not experience pain or significant distress. This is based on the principle of double effect, by which two actions, one intended and one unintended, may be permissible if there is a proportionate reason. The goal in these situations is never to hasten death intentionally but to make patients’ pain and suffering tolerable as a matter of compassionate and loving care.
100. The National Catholic Bioethics Quarterly: Volume > 17 > Issue: 3
Irene Alexander The Error of Intentionalism
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Some Catholic theologians are redefining the meaning of “direct” and “indirect” by including only the agent’s intention in defining the moral object, while simultaneously excluding the physical actions that the agent consciously and deliberately chooses. The net effect is that these theologians now approve of many kinds of abortions traditionally understood to be morally evil in situations of maternal–fetal vital conflict. Such an error has grave implications for Catholic bioethics and health care. When the intentionalist method is applied to other disputed questions in bioethics, however, it becomes clear that its ideology is fundamentally erroneous.