God presented each of us with the gift of human life, for which we each have a duty of stewardship. The complementary principles of totality and integrity provide moral guidance for decisions on whether specific acts are consistent with this obligation. Totality directs that anatomical completeness must not be sacrificed without proportional justification. Integrity focuses on maintaining basic human capacities and provides a hierarchical ordering of higher functions over lower functions for use in decision making. The decisions of secular American courts rely heavily on statutory authority and case precedent. This essay explores whether the moral principle of totality and integrity is reflected in judicial opinions. The first part examines judicial decisions in cases in which the plaintiff’s desired outcome was consistent with the principle of totality and integrity. The second part analyzes judicial decisions in which the desired outcome was not consistent with this moral principle. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 43–54.

Organ transplantation offers many people who suffer from organ failure a chance to live longer. The Catholic Church, which has endorsed organ donation if it is practiced in an ethically acceptable manner, requires that unpaired vital organs be donated only after the donor is certainly dead. In an effort to increase the number of viable organs, a procedure called donation after cardiac death was introduced in the 1990s. This procedure violates the Roman Catholic moral teaching on the dignity of human life because it violates the dead donor rule and undermines the dignity of the dying person. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 55–65.

The author was consulted by two Catholic schools in separate cases of a student and a teacher preparing to undergo sex reassignment. Such cases give rise to special ethical and pastoral concerns. This article discusses the disorders that may lead to sex reassignment, distinguishing between con­genital disorders of sex development (intersex conditions) and gender identity disorder (gender dysphoria). It also notes the ethical differences between the correction of congenital anomalies and interventions to relieve dysphoria: in the former, treatment is meant to restore as much normal function as possible; in the latter, mutilating intervention destroys what were otherwise healthy bodily functions. In Catholic schools, concern for the well-being of an affected student or teacher is required, as is a clear understanding of the condition being treated, the ethical implications of treatment, the privacy issues, the effects on other students and staff, and the effects on a teacher’s ability to give faithful witness to Catholic teaching. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 85–97.

The permissibility of circulatory determination of death (CDD) preceding organ procurement remains controversial. This paper discusses the controversy and the liceity of irreversible circulatory cessation as a determinant of death. When specific protocols have been satisfied, including a waiting period of five minutes of asystole, CDD licitly signals the disintegration of the unitary and integrated whole that was the living human person. The author contends that after terminating disproportionate care, a surrogate may rely on irreversible circulatory cessation thus determined and may authorize organ donation, including limited pre-death procedures that are consonant with the dignity and well-being of the dying patient-donor. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 69–84.

The ethical propriety of routine male infant circumcision has been debated in journals of medicine and law for many years. This article explores the issue from historical, medical, and moral perspectives. Two essentially different forms of circumcision (one more drastic than the other) are distinguished. Discussion focuses on the effects of the more radical kind of nontherapeutic surgery on a normal healthy child’s body: whether it constitutes a mutilation, whether it is medically warranted, and whether it is ethically defensible in light of general philosophical principles and Catholic moral doctrine. The conclusion questions the social bias favoring parental choice to circumcise a non-consenting son. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 99–128.

Was there resistance in the Catholic Church during the Middle Ages to human dissection? Was autopsy thought to be a desecration of the body? The belief that the Church is opposed to dissection was due in part to the misinterpretation of a papal bull issued during the fourteenth century. Dissection of a corpse and autopsy were never in fact decreed by the Church. Rejection of these was based not on Church teaching but on a perceived violation of social honor because of the unappealing public nature of the practices. To this day, the Catholic Church does not view dissection and autopsy as desecration of the body; the practices remain theologically compatible with Catholic doctrine. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 37–42.

Catholics have been at the forefront of efforts over many years to secure universal access to health care in the United States. These efforts suf­fered a serious setback when the federal government enacted the Affordable Care Act and then quickly used it to assault rights of conscience. This assault has brought into serious question the once promising hope that a partnership might be forged between church and state to benefit those at the margins of society. Given recent events, Catholics and others are compelled to reassess their willingness to trust the power of government to carry out this aim in a manner that respects fundamental human rights, including the rights of religious believers. The words of our founders and framers, who warned against the dangers of an overbearing government, merit renewed attention. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 27–36.

Advocates of active euthanasia and physician-assisted suicide argue that a patient’s intractable pain and suffering are a sufficient justification for his life to end if he autonomously so chooses. Others hold that the non-utilization of life-sustaining treatment, the use of pain-relieving medication that may hasten a patient’s death, and palliative sedation may be morally acceptable means of alleviating pain and suffering. How a patient should be cared for when approaching the end of life involves one’s core religious and moral values, particularly concerning whether pain and suffering can have some sort of instrumental value. The author reasons why a patient who is terminally ill can find his suffering valuable for both religious and nonreligious goals. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 251–261.

The use of sedation at the end of life is proving a difficult topic of bioethical debate. In spite of efforts to reach agreement on definitions and guidelines, the practice most commonly known as palliative, or terminal, sedation remains a source of ambiguity and confusion. The goal of this article is to offer the reader a primer on the topic of palliative sedation. Two specific objectives are proposed: first, to orient the reader to some of the principal elements of the clinical and bioethical literature on palliative sedation; and second, to describe what we believe to be some of the principal sources for a theological understanding and evaluation of the use of sedation at the end of life. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 263–281.

Consecrated women religious have been shown to be at increased risk for uterine and ovarian cancers. The authors critique a proposal by Kara Britt and Roger Short advocating the distribution of a combined oral contraceptive to women religious as a way of reducing this risk. The authors argue that the proposal is seriously flawed: the data it references attenuate its conclusion, the execution protocol is incomplete, and the proposal fails to address the serious health risks of combined oral contraceptives. As a counterproposal, the authors recommend that women religious be taught to monitor their gynecologic health by charting their menstrual and ovulatory cycles. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 235–239.

Kevin Murphy’s essay “Christians and the New Food Movement” (Autumn 2011) rightly warns about introducing non-Christian ideas associated with certain environmental movements into church practices. However, the essay embraces several errors that ultimately conflict with the Catholic faith. Catholic social doctrine, rooted in the universality of Christ’s salvific act, requires viewing food, agriculture, and the economy through a moral lens. A refusal to engage in such issues because they might bring the Church into contact with heterodoxy leads to a form of protectionism that embraces a reductionist view of creation and, ultimately, the human person. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 217–226.

The Resurrection, like many other fundamental elements of the Christian Creed, stands outside the province of empirical science. If something that constitutes a mainstay feature of a person’s belief system cannot be measured by the standard tools and methods of the day, does this make it any less credible? Does immeasurability require a radical reformation of our understanding of the objects and principles of faith in order that they become more accessible to the reach of contemporary science, or does their immeasurability discount them altogether? This essay reflects on James Carroll’s rejection of the bodily resurrection of Jesus and its implications for Roman Catholic bioethics. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 227–234.

In responding to an unjust legal situation involving human rights abuses, one approach is to seek a selective ban on some abuses if a more comprehensive ban is not feasible politically. While such an approach to embryo research or abortion, for example, can reasonably be applied, much harder to defend is regulation—that is, giving permission or instructions for others to do or prepare to do what we believe is morally wrong. Regulation necessarily involves us in wrongly intending that others choose wrongly, that is, in formal cooperation with evil. We should choose other means of making a bad situation better: selective banning or discouragement by, for example, withholding funding, and the mandating of acts that are good or potentially good in the context in which they are mandated. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 241–248.