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81. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Pope Francis The Limitations of Our Mortality: Message to the European Regional Meeting of the World Medical Association, November 7, 2017
82. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Charles C. Camosy Defending against Formally Innocent Material Mortal Threats: A Response to Joshua Evans
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In the Summer 2017 NCBQ, Joshua Evans strongly criticized arguments made by Charles Camosy about the possibility of a prenatal child being a material mortal threat to her mother. Here Camosy demonstrates that the formal/material debate remains open for non-dissenting Catholic moral theologians. He also shows that his reference to just-war theory is used to discuss innocence; it is not evidence of a particular methodology. Despite Evans’s claim to the contrary, Camosy notes multiple examples where he affirms the uniqueness of pregnancy and the special duty of parents to children. He argues for full deference to the magisterium in matters where doctrine has been defined and urges solid theological grounding for teachings on abortion when the mother’s life is at risk, especially given the profound personal and political issues at stake.
83. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Christopher M. Reilly Medical Professionals as Agents of Eugenics: Abortion Counseling for Down Syndrome
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Eugenic thinking divides people into groups according to real or perceived genetic traits, identifies some groups as unwanted, and then promotes the elimination of the unwanted groups. Some American medical professionals are pursuing a eugenic agenda that pressures and misleads parents to abort unborn children with Down syndrome. These counselors have a strong, unwar­ranted bias that influences parents’ decisions significantly. The use of prenatal genetic testing and in vitro fertilization increases the number of deaths of unborn children with Down syndrome. The widespread practice of identifying and aborting children with Down syndrome is properly called eugenics.
84. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Deacon Gregory Webster Financial Toxicity: Treatment Expense and Extraordinary Means
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The financial toxicity of biotherapeutic treatments is examined. Kymriah, a new gene therapy, has a list price of $475,000 per treatment; Yescarta, from Kite Pharma, costs $373,000 per treatment. Such costs are a significant burden on patients, patients’ families, payers, health care systems, and communities. Studies have shown that financial toxicity—the effect of excessive treatment cost—diminishes patients’ quality of life, compliance, and survival. Some pharmaceutical companies promote outcomes-based pricing and other strategies to offset financial toxicity, but these approaches have not been shown to reduce burdens. Catholic teaching holds that the benefits of treatment should outweigh its burdens, and that burdensome treatments are not obligatory. The financial toxicity of treatments should be included in the ethical assessment of burdens on the patient.
85. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
The National Catholic Bioethics Center Employed Health Care Providers and the Provision of Direct Contraception
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This March 2018 document replaces an earlier template policy, “Model Clinical Practice Ethics Guidelines for Affiliated Health Care Professionals with Respect to Prescription of Contraceptives,” drafted by The National Catholic Bioethics Center in the 1990s. Instead of a template policy, the new document provides definitions and principles to help health care institutions apply Catholic moral teachings if, for whatever reason, they happen to employ providers who prescribe contraception. The three basic principles are (1) distinguishing responsible agents and maintaining organizational integrity, (2) avoiding immoral cooperation, and (3) avoiding and resolving theological scandal.
86. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Carter Anne McGowan Conscience Rights and “Effective Referral” in Ontario
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In 2015, the Supreme Court of Canada decriminalized euthanasia. Soon after, the College of Physicians and Surgeons of Ontario enacted the Professional Obligations and Human Rights policy and the Medical Assistance in Dying policy. Neither these policies nor the Medical Assistance in Dying Act, the Ontario law permitting euthanasia, contains a conscientious objection clause. Instead, the policies require objecting doctors to provide an effective referral to a doctor who will euthanize the patient. Objecting physicians brought suit against the college. In a recent decision, the Ontario Superior Court of Justice held against the plaintiffs, finding the infringement of the effective referral policy on physicians’ rights to conscience and religious freedom to be appropriate when balanced against a patient’s right to equitable access to health care. Therefore, Catholic physicians in Ontario now must choose to violate either their religious beliefs or their professional obligations. It is imperative that these policies be struck down on appeal, superseded by an amendment, or revised by the college through the addition of a conscience clause.
87. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
James Beauregard Advancing a Personalist Neuroethics
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Neuroethics is a new and rapidly expanding field in the academy and clinical practice. However, there is no comprehensive treatment of it from a specifically Catholic perspective. Nevertheless, the Catholic tradition contains possible criteria for a systematic approach to neuroethics. The personalist philosophical tradition, specifically modern ontological personalism, provides a framework for organizing and articulating those aspects of personhood that are most relevant to neuroscience and neuroethics
88. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
William F. Sullivan, John Heng, Christopher De Bono, Gerry Gleeson, Gill Goulding Healing Relationships and Transformations in Health Care: IACB Consensus Statement on Ethical Discernment and Practical Recommendations
89. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Richard A. Spinello Bioethics and the Human Soul: Pope St. John Paul II’s Reflections on Ensoulment
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Pope St. John Paul II’s work on the Theology of the Body is well known among his many followers. Less well known is his conception of the human soul. Karol Wojtyla’s intricate philosophy of the soul fully endorses Aristotelian Thomistic psychology. Wojtyla’s main contribution is a phenomenological description of human action, which provides a credible basis for inferring the soul’s necessity. In the papal writings, John Paul II develops other resourceful doctrines, especially about the timing of ensoulment. His unelaborated notion of the genealogy of the person has implications for ethics. Following in the tradition of St. Thomas Aquinas, John Paul II presents an integrated wisdom about the soul that weaves together Christian revelation, modern science, and different modes of philosophical reflection.
90. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Peter J. Colosi Discussing the Spiritual Soul in the Classroom
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There is a pedagogical method of bringing undergraduate students to conceive the body–soul question. Similarly, there is a simple philosophical argument in defense of the existence of the soul via contemporary autobiographical stories, recent neuroscientific literature, and Socrates’s distinction between condition and cause in Plato’s Phaedo. This method has proved helpful in enabling students to gain access to the mystery and grandeur of the body–soul question and its foundational importance with respect to ethics and, indeed, to the meaning of life. There must be a revival of collaboration between neuroscientists and philosophers to coauthor papers that explicitly challenge the materialist assumptions in the fields of neuroscience and psychology.
91. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Joshua Evans The Mother’s Child as Aggressor: A Further Reply to Charles Camosy
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In a short section of his 2015 book Beyond the Abortion Wars, Charles Camosy claims that direct abortion to save the life of the mother is consistent with Catholic principles. Joshua Evans published an essay critical of this view in the Summer 2017 issue of the National Catholic Bioethics Quarterly, to which Camosy responded in the Summer 2018 issue. In the current essay, Evans replies to Camosy’s recent response by offering a further examination of three central issues in dispute: (1) how the history of moral theology bears on public debates, (2) how past authoritative Church teaching applies when the method of moral theology apparently has shifted, and (3) how the analysis of vital conflicts is affected when examined in relation to more fundamental theological considerations.
92. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Divya Joshi, Dwight Stapleton The Influence of Spiritual Retreats on Compassion in Health Care
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Our moral compass is not the only thing that compels us to provide compassionate health care, which also improves patient outcomes and patient and provider satisfaction. In the current era of increasing medical complexity, provider burnout, and value-based reimbursement, health care systems struggle to durably improve their providers’ compassion in the provision of care. A religious retreat curriculum for leaders at OSF HealthCare, in Illinois and Michigan, has led to a significant, long-term increase among employees in their compassion toward patients, colleagues, and self.
93. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Trent Horn Abortion and Good Samaritan Arguments
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Some defenders of legal abortion claim that even if the human fetus is a human being with the same right to life as an adult, abortion is not necessarily morally impermissible. They argue that abortion can be considered a form of indirect killing that results from the refusal to provide life support through one’s own body, which another person has no right to receive. While Catholic moral theology does not require people to donate organs against their will, this principle does not justify direct abortion.
94. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Mary Beth Phillips The False Freedom of Promiscuity: Consequences of Teenage Sexual Activity
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Teenagers enjoy better physical and mental health when they avoid early sexual debut and reserve the sexual act for marriage. Teens who initiate sexual relations outside of marriage risk contracting sexually transmitted diseases, and those who also use hormonal contraception to avoid pregnancy often suffer unwanted physical and emotional side effects. Teens who have multiple partners may have later attachment or bonding difficulties. The consequences of an unintended pregnancy after a casual sexual relationship are often abortion or single motherhood and an increased likelihood of poverty. Teenagers who save sexual relations for marriage experience freedom from these negative consequences and are more likely, in marriage, to experience the beauty of self-giving love.
95. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Cardinal Pietro Paolin The Wisdom of Finitude: Letter to Archbishop Vincenzo Paglia, February 28, 2018
96. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Archbishop Christophe Pierre Protecting the Vulnerable: Remarks on Palliative Care, April 12, 2018
97. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Sean O’Brien Pursuing Authenticity by Changing the Body
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Although body alterations, including body art, sexual alteration, technological enhancements, and cosmetic surgery, usually are evaluated separately, they also can be approached by identifying common cultural trends. Because a person’s conception of identity lies at the core of many body alterations, any change to the body must pursue sincere authenticity, the virtue that fulfills one’s true identity.
98. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Jonathan Scrafford, Lisa Gilbert Opportunistic Salpingectomy during Cesarean Section
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Medical literature on the protective effects of salpingectomy (surgical removal of the fallopian tubes) against ovarian cancer has challenged Catholic health care institutions to reexamine policies that prohibit tubal sterilization at the time of cesarean section. Salpingectomy performed for a woman whose fallopian tubes are known or suspected to have a serious and present pathology—risk-reducing salpingectomy—is morally justifiable as a therapeutic intervention. However, salpingectomy performed at the time of another medically indicated procedure, such as cesarean section, on an otherwise fertile woman whose fallopian tubes are presumed to be healthy—opportunistic salpingectomy—constitutes direct sterilization and fails to meet the conditions of double effect. Moreover, until magisterial guidance clarifies the right application of Catholic teaching to the specific question of opportunistic salpingectomy, Catholic health care institutions should, out of prudential judgment and to avoid scandal, avoid establishing institution policies that permit the practice.
99. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 3
Pope Francis Unite to Cure: Address to the International Conference on Regenerative Medicine, April 28, 2018
100. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 4
William Newton Adoption as an Analogy for Gender Transitioning: A Reply to David Albert Jones
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David Albert Jones recently proposed an analogy between adoption and gender transitioning. Jones notes that adoption grants a child a social identity that is distinct from the natal identity and suggests that a similar situation might obtain in the case of gender transitioning. According to this proposal, a biological male who wishes to be called a woman is not assuming a false identity. Adoption and gender transitioning are significantly different, however: adoptive sonship participates in natural sonship in a way that is not true of the relationship between a biological woman and a man who wishes to be called a woman. Attention is given to different forms of analogy, leading to the conclusion that the use of the word woman for a biological male would be either a metaphor or a very weak analogy. In contrast, the term son as applied to an adopted boy fulfills the fundamental signification of that word.