Untreated depression at the end of life may affect treatment and raise ethical concerns. Patients with a major depressive disorder may desire a hastened death, may refuse reasonable and beneficial medical care, or may present with cognitive distortions that hinder their ability to make decisions about care. Treating depression can avert or minimize these problems in many cases. For a patient who does not respond to antidepressant medications and other interventions, however, the unrelieved depression could tip the balance and make additional medical treatments burdensome. In such cases, a proposed medical treatment might be considered extraordinary. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 697–710.

Despite billions of dollars spent in risk-reduction measures, the HIV rate in men who have sex with men (MSM) continues to soar. Although MSM represent approximately 4 percent of the male population in the United States, in 2010 male-to-male sex accounted for 78 percent of new HIV infections among males. More emphasis needs to be given to risk-avoidance measures. The Catholic Church is both courageous and medically correct in stating that homosexual acts are harmful. The health risks of homosexual sex are scarcely mentioned in the public debate, as misguided political correctness seems increasingly to hold science and medical data hostage. Our brothers should be informed about the dangers of an active homosexual lifestyle and encouraged to live chastely. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 637–645.

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 (Winter 2014): 647–657.

Examination of the bioethical concept of futile-care theory reveals its deleterious effects on patients when put into practice. Futile-care policies and laws unilaterally locate health care decision making in persons and committees other than the patient and his surrogate(s). Although not voluntarily ceded by the patient, this authority is assumed by third parties whose interests and goals do not contribute to the material and spiritual flourishing of the individual patient. A prime example is the Texas medical futility law, which blatantly disregards the natural right of patients to decide the course of their own health care. Christians are called on to oppose this unprecedented assault on human dignity, freedom, and life itself. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 619–624.

In recent articles, Daniel Gannon argues that, according to Catholic morality, morally good decision making about life-sustaining treatment is intrinsically based on in-the-moment circumstances. Measured against this moral criterion, Gannon finds physician orders for life-sustaining treatment (POLST) to be morally unacceptable and proposes his own medical order form. The authors argue here that Catholic moral teaching and tradition do not reduce the role of circumstances to those in the present moment and that such a reductive criterion undermines many of the sources of morality, including conscience, prudence, and moral principles such as the principle of ethically proportionate and disproportionate means. The authors also show that Gannon’s criterion and form generate conceptual and practical contradictions, that POLST is not intrinsically evil, and that when properly implemented, POLST can be morally acceptable. National Catholic Bioethics Quarterly 15.1 (Spring 2015): 53–61.

The authors respond to a recent consensus statement on maternal–fetal vital conflicts. Sound ethical analysis must depend on accurate medical facts, but there appear to be inconsistencies in the medical analysis. The consensus statement says that the specific threat to the health of the mother immediately subsides following detachment of the placenta from the uterus. The authors refute this assertion, since death from peripartum cardiomyopathy may occur months to years following delivery of the neonate or following termination. The authors assert further that the placenta is an organ of the fetus and that any act on the placenta is a direct act on the fetus itself. National Catholic Bioethics Quarterly 15.1 (Spring 2015): 31–37.

The question of whether it is permissible to deactivate a pacemaker at the end of life has been addressed in medical journals but rarely in ethics journals. The ethics of pacemaker deactivation is especially challenging because of the disparate ways the devices are viewed by both medical professionals and patients. Some consider pacemakers replacement therapy, and some consider them substitutive therapy. If they are the former, then deactivation would not be permitted, since a replacement device is considered a part of the body, akin to a new heart. Some ask whether pacemakers are natural or artificial; if pacemakers are artificial, deactivation would be permissible. Another factor is whether a patient is pacemaker dependent. Some medical experts decide the issue of deactivation on the basis of patient autonomy. Others weigh in on whether pacemakers are ordinary or extraordinary means of care. This paper examines each proposal and concludes tentatively that pacemaker deactivation is not permissible at the end of life. National Catholic Bioethics Quarterly 15.1 (Spring 2015): 39–51.

Possession of a BRCA1 or BRCA2 gene mutation puts a woman at very high risk of developing breast and ovarian carcinoma at an early age. One treatment option is surgical removal of the target organs—breasts, ovaries, and fallopian tubes—before the malignancy develops. This risk-reduction surgery has been shown to significantly reduce the likelihood that a woman will develop one of these cancers. This paper argues that such surgeries do not violate Catholic moral principles, but can be justified using the principles of double effect and totality and integrity. The paper does not recommend or endorse any specific treatment option. National Catholic Bioethics Quarterly 15.1 (Spring 2015): 75–89.

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 (Spring 2015): 63–72.

Since the 1980s Catholic moralists have discussed whether the use of condoms to prevent the transmission of the virus that causes AIDS is morally permissible. In 2004 Rev. Martin Rhonheimer argued that the use of condoms by HIV-discordant married couples, although not prudent or advisable, was nevertheless not intrinsically wrong. Many other Catholic moralists strongly disagreed with him. This paper analyzes both sides of the argument and concludes that the practice is not morally permissible even for an infertile married couple because the use of a non-perforated condom, by preventing male ejaculation into the vagina, deprives the act of its essential ordination to procreation. National Catholic Bioethics Quarterly 15.1 (Spring 2015): 91–105.

The anatomist Nicolaus Steno (1638–1686), a key figure of the Scientific Revolution and founder of modern geology, engaged in research on human procreation and proved for the first time that women have ovaries and not so-called female testicles. Steno took the view of “simultaneous animation” of the embryo and demythologized malformations of the embryo by appealing to original sin. His sexual ethics presages the pastoral constitution Gaudium et spes (1965). Steno, who was later ordained a priest and consecrated a bishop, was a defender of human life and looked at the human body as an “interpreter” of divine love. He was beatified by Pope St. John Paul II in 1988; his tomb is in the Basilica San Lorenzo in Florence. National Catholic Bioethics Quarterly 15.1 (Spring 2015): 107–126.

The common belief regarding contraception is that it leads to reductions in abortion, and many in the pro-life movement hold this belief, some going so far as to support access to contraception as a means to reducing abortion. A review of the abortion industry’s own studies and statistics reveal, however, that the opposite is true—widespread access to contraceptives actually leads to increases in the abortion rate. To oppose abortion, the pro-life movement should speak with a unified voice in opposition to contraception as well. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 231–239.

The director of Courage International talks about the work of the apostolate in addressing homosexuality according to the mind and heart of the Church, which he calls “one of the most demanding aspects of education, formation, and pastoral care today.” But it is also an opportunity to attend to the often acute and persistent wounds of those who need healing within what Pope Francis calls the “field hospital” of the Church. The author points out that the work of Courage is not first about homosexuality but about what it means to be human. It is an invitation to consider the question of the fulfillment of the human heart according to God’s gracious plan. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 221–230.

In Evangelium vitae, Pope St. John Paul II recognized that scientific progress would bring about new attacks on the dignity of the human person. Since that time, remarkable expansion in our knowledge and understanding of the human genome has brought forth questions of ownership rights via patents on human genes and related technology. This article argues that patenting human genes is incompatible with human dignity as it commodifies that which is priceless. In contrast, granting patents to manipulations of human genes does not violate human dignity so long as it is utilized toward the common good. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 265–285.

A recent consensus statement claimed that double effect can justify induction of labor before viability when life-threatening pathological complications arise from the interaction of a normally functioning placenta with the diseased heart of the mother. The authors of this essay agree. They analyze two pieces published in response, using the framework of the first and fourth criteria of double effect; identify and attempt to clarify inaccuracies and other sources of ambiguity in the discussion; and acknowledge practical implications for other scenarios previously considered illicit. They conclude that more thorough medical and moral discussion is needed regarding the fourth criterion, even if the act itself is not intrinsically evil. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 251–261.

In this essay, some of the signatories to “Medical Intervention in Cases of Maternal–Fetal Vital Conflicts: A Statement of Consensus” respond to “The Placenta as an Organ of the Fetus: A Response to the Statement of Consensus on Maternal–Fetal Conflict,” both recently published in this journal. The response examines Bringman and Shabanowitz’s claims and assumptions about the morally relevant pathologic condition in some cases of peripartum cardiomyopathy complicated by a subsequent pregnancy, the moral status of a normally functioning placenta, and the use of the principle of double effect in these cases. The signatories’ response sets out to demonstrate how Bringman and Shabanowitz do not engage the essential points of the statement of consensus and how their argument is premised on false assumptions. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 241–250.