Nutrition and hydration—including artificially delivered, or assisted, nutrition and hydration (ANH)—are typically considered ordinary or proportionate care in the Roman Catholic moral tradition. They are thus morally obligatory, except when the benefit to the patient does not justify the burden their administration places on the patient or when they no longer prolong life (e.g., in end-stage disease when death is imminent). A review of Church documents and the medical literature provides convincing evidence that there are cases in which ANH provides little hope of benefit and may impose an excessive burden on the patient. This paper closely examines advanced dementia of the Alzheimer’s (DAT) type and shows how ANH can be properly considered extraordinary care and hence is not obligatory in patients with advanced DAT. National Catholic Bioethics Quarterly 8.2 (Summer 2008): 291–305.

The Hippocratic oath and ethic have guided medicine for twenty-five hundred years. In the past thirty years there has been an effort to discredit the Hippocratic tradition. The mantra has been “the Hippocratic ethic is dead.” An article by Robert Veatch and Carol Mason, “Hippocratic vs. Judeo-Christian Medical Ethics,” epitomizes the anti-Hippocratic crusade. Veatch and Mason make three points: (1) there is no continuity between the oath and Judeo-Christian ethics; (2) the oath is flawed; and, more important, (3) the Hippocratic tradition is at variance with modern social contract ethics. This essay rebuts each of these contentions. National Catholic Bioethics Quarterly 7.4 (Winter 2007): 245–254.

The author reviews one of the more intriguing articles in the stem cell research issue of the journal Metaphilosophy (April 2007), “Killing Embryos for Stem Cell Research,” by Jeff McMahan. He begins by recapitulating McMahan’s argument against the proposition that we are essentially individual human organisms. He then turns to two main critiques of the argument. First, he shows that the term “essentially” is insufficiently defined by McMahan and, more important, if we take the typical explication of the concept by modal metaphysicians, then the claim “we are essentially human beings” is true—contrary to McMahan’s argument. Second, the author offers a counterexample to McMahan’s implicit acceptance of the principle that only beings who have developed the capacity for self-consciousness are the proper subjects of moral worth. The author presents a regenerative therapy example to show that McMahan’s commitment on this point is counterintuitive. National Catholic Bioethics Quarterly 8.2 (Summer 2008): 255–264.

The recent conversion of adult cells into so-called induced pluripotent stem (iPS) cells through direct reprogramming opens a new chapter in the study of disease and the development of regenerative medicine. It also provides a historic opportunity to turn away from the ethically problematic use of embryonic stem cells isolated through the destruction of human embryos. Moreover, because iPS cells are patient specific, they render therapeutic cloning unnecessary. To maximize therapeutic benefit, adult stem cell research will need to be pursued in parallel with studies using iPS cells. Among the four alternative methods presented by the President’s Council on Bioethics, direct reprogram­ming is the most ethically acceptable. Nonetheless, iPS cells are tainted by their association with the human embryonic stem cell lines, derived in the past, which will be required for their validation. This concern is one that can be resolved. Human iPS cells will serve to stem the tide of human embryonic stem cell research, changing it and diverting stem cell research in a more ethical direction. The National Catholic Bioethics Quarterly 8.2 (Summer 2008): 277–290.