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.

The mystery of embodiment is ubiquitous in medical settings. Even so, health care professionals may find themselves driven by daily clinical tasks that prevent this mystery from coming to focal awareness. The author explores embodiment from five approaches, (1) offering a simple account of developing a skill that proceeds in several stages from novice to expert, (2) examining critically the “capabilities approach” of Amartya Sen and Martha Nussbaum and what it says and does not say about embodiment, (3) developing a brief description of the human body as vulnerable, (4) exploring the long-term trend in clinical contexts sometimes described as the “commodification of the body,” and (5) highlighting connections between Christian faith and embodiment. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 239–248.

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.

This essay argues that marriage is to be defined as an exclusive, indissoluble union of one man and one woman with openness to children. The nature of marriage is approached through an exploration of the nature of love, understood as willing the good of the other. From this study, marriage’s essential characteristics of exclusivity, indissolubility, heterosexuality, and fruitfulness emerge. A brief consideration of the role of the state and its interest in marriage shows that the legal definition of marriage should not deviate from this reality. National Catholic Bioethics Quarterly 11.2 (Summer 2012): 267–275.

Some difficulties arise when considering the 1930 encyclical letter of Pope Pius XI, Casti connubii, and the 1997 Vademecum for Confessors in light of the consistent teaching of the magisterium on the intrinsic evil of every contraceptive act. One difficulty is how to reconcile certain teachings of these two documents, which clearly allow for some sort of cooperation with a spouse who voluntarily renders the marital act infecund, with the absolute prohibition against formally acting in a contraceptive manner. The author provides a care­ful reading of the documents that takes into account related magisterial and curial decisions, and shows that the documents reveal a consistent teaching. The teaching permits a certain limited cooperation with a spouse who renders the marital act infecund in a so-called natural way (e.g., natural onanism, or withdrawal) but excludes active material cooperation in sexual acts with a spouse who employs a condom or its equivalent. This teaching has relevance to recent debates about the prophylactic use of condoms among spouses. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 301–328.

This article reports the case of prenatally diagnosed twins who were conjoined at the umbilical cord and treated before birth. Fetoscopic cord abla­tion of the twin with a severe anomaly was chosen by the parents to reduce the risk of death for the co-twin, although the procedure meant the certain death of the disabled twin. The author discusses different ethical perspectives on the case and on preventive fetal therapy in general. He concludes that care should be taken to help parents find and articulate their ethical position in complicated clinical settings in which life-or-death decisions must be made. Catholic physicians in particular have a duty to participate in such cases and to develop alternatives to a utilitarian medicine. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 329–344.

The author applies the definitions of surrogacy offered by Donum vitae to the question of embryo adoption and shows that embryo adoption does not in fact constitute an act of surrogacy. The author shows that neither Donum vitae nor Dignitas personae condemns heterologous embryo transfer or embryo adoption per se but only when these acts also involve illicit forms of artificial fertilization or surrogacy. The author suggests that the apparent reason for a lack of endorsement of embryo adoption by Donum vitae and Dignitas personae is pastoral caution, concern for scandal, and the connection between embryo adoption and IVF; it is not because embryo adoption is intrinsically illicit. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 249–256.

This paper addresses a certain lacuna in moral theological reflec­tion. An institutional review board (IRB) reviews research on human subjects and so represents the institution’s ethical review mechanism for research. The author argues that if an IRB approves a research project that is immoral, it thereby implicates the institution in formal cooperation. The author also argues that numerous ethical concerns are created by current research enterprises—concerns that extend beyond the “usual suspects” of embryonic stem cell research and research using cell lines of illicit origin. The author describes these more subtle issues and shows how IRBs at Catholic hospitals can navigate them. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 257–266.

Responding to criticism of my Vital Conflicts in Medical Ethics, this article corrects misrepresentations and answers objections. The core of the debate is the moral category of “direct killing” as opposed to “indirect.” The article argues that critics beg the question by simply presupposing, instead of argumentatively defending, the very physicalist understanding of “directness” which the book has shown to be untenable. This article clarifies the intentional meaning of “direct” and what it means to choose something as a means; it also argues that this does not imply a subjectivist conception of morality, and refutes objections to the view that the moral evil of killing is constituted by its opposition to justice. It finally shows why this is essentially an argument against proportionalism and in defense of the core teaching of Veritatis splendor. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 519–540.

There are two competing accounts for a theory for human action proposed by Catholic theologians working within the received moral tradition today: a hylomorphic account and an intentional account. In this article, the author compares each of the rival theories for its ability to explain both the structure and morality of the human acts surrounding the elective termina­tion of the pregnancy of a woman with pulmonary arterial hypertension. This scenario of PAH is a superb test case to compare the explanatory power of the two rival action theories. The author’s analysis reveals that the hylomorphic account is the superior account, which can explain better not only the norma­tive conclusions of the Catholic moral tradition but also our lived experience as acting persons in a world governed by cause-and-effect relationships. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 503–518.

What insights into Church teaching can be drawn from the biblical account of Abraham and Sarah’s experience with surrogate pregnancy? When Sarah’s maid, Hagar, conceives Abraham’s son Ishmael, negative conse­quences ensue. Hagar’s contempt for Sarah incites Sarah’s jealousy. Sarah’s abuse of Hagar leads Hagar to run away. Abraham is forced to banish Hagar and his son Ismael. These unhappy repercussions arise from the fact that surrogacy violates God’s plan for marriage and for the dignity of the human person. Although reproductive technologies continue to advance, human nature remains the same. The lessons learned from Abraham, Sarah, Isaac, Hagar, and Ishmael’s experience with surrogacy can be profitably applied to Church teaching on marriage and reproductive technologies. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 443–451.

By analogy to justifications offered for craniotomy by Catholic moralists (e.g., Germain Grisez and Rev. Martin Rhonheimer), a recent instance of casuistry (by the moral theologian M. Therese Lysaught) attempts to apply double-effect reasoning and, separately, the concept of a vital conflict to justify dilation and curettage in order to preserve the life of a pregnant woman. This paper examines and rejects these bases for justifying craniotomy and D&C. It concludes with a consideration of Pope John Paul II’s discussion of moral martyrdom in Veritatis splendor. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 453–463.

Many churches are being asked to support new environmental initiatives, including those of the new food movement. In today’s cultural environment, it requires courage even to raise a question about programs to save the planet, protect helpless animals, or feed developing nations. Yet it is important for Christians to be aware of the agenda behind these initiatives, which looks to creation not for visible signs of God’s power and divinity but with a view to immortalizing the earth itself as the source of life. It sees man not as uniquely made in the image and likeness of God, with the responsibility for stewardship over His creation, but as an animal himself, co-equal with other animals. Environmentalism has become in effect a new religion, with the food movement its frontier mission. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 465–475.