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PubMed2000

The commerce of human body parts: an Eastern Orthodox response.

The Orthodox Church teaches that the bodies of those in Christ are to be regarded as sanctified by the hearing of the Word and faithful participation in the Sacraments, most particularly the Holy Eucharist; because of the indwelling of the Holy Spirit the consecrated bodies of Christians do not belong to them but to Christ; with respect to the indwelling Holy Spirit there is no difference between the bodies of Christians before and after death; whether before or after death, the Christian body is also to receive the same veneration; and notwithstanding the physical corruptions that the body endures by reason of death, there remains a strict continuity between the body in which the Christian dies and the body in which the Christian will rise again. That is to say, it is the very same reality that is sown in corruption and will be raised in incorruption. Given such consideration, the notion of "selling" and integral part of a human being is simply outside the realm of rational comprehension. Indeed, it is profoundly repugnant to those Orthodox Christian sentiments that are formed and nourished by the Church's sacramental teaching and liturgical worship. One does not sell or purchase that which has been consecrated in those solemn ways that the Church consecrates the human body.

Christianity↗

PubMed1998

A bad disease, a fatal cure: why sterilization is permissible and the autonomy of medicine is not.

The debate in this issue regarding the Roman Catholic condemnation of the morality of sterilization is puzzling for Protestants. As I will argue the puzzlement arises on two grounds. First, why would anyone object to direct sterilization for the cure or prevention of disease? Second, if one wanted to challenge such an objection on moral grounds why would one turn to medicine to do so? For Christian ethics there is nothing wrong in principle with direct sterilization when there are good reasons for precluding the possibility of an additional pregnancy; and it is a serious theological mistake to treat medicine as an independent moral authority.

Catholicism↗

PubMed1998

Sterilization, Catholic health care, and the legitimate autonomy of culture.

Disagreement over the legitimacy of direct sterilization continues within Catholic moral debate, with painful and at times confusing ramifications for Catholic healthcare systems. This paper argues that the medical profession should be construed as a key moral authority in this debate, on two grounds. First, the recent revival of neo-Aristotelianism in moral philosophy as applied to medical ethics has brought out the inherently moral dimensions of the history and current practice of medicine. Second, this recognition can be linked to Catholic morality through Vatican II's affirmation of the legitimate autonomy of culture, including the sciences. A partial precedent for understanding the moral authority of medicine can be found in the recent history of Catholic medical morality, and we further argue that a full contemporary recognition of that authority would weigh against an absolute prohibition of direct sterilizations. Institutionally, we propose the allowance of direct sterilizations in cases where the clinically perceived biomedical good of the patient is at stake.

Altruism↗

PubMed1998

Sexual ethics and communal judgments: on the pluralism of virtues, values, and practices.

Different judgments by Christian communities on issues in sexual ethics involve different weightings of various sources of moral authority, different understandings of the normativity of the natural, and different assessments of the scope of freedom to be exercised in relation to the goods of marriage. These fundamental differences of interpretation can be exemplified by the ongoing Roman Catholic discussion of the legitimacy of voluntary sterilization in certain "hard cases." The contributors to this issue of Christian Bioethics, in their spirited exchange on that issue, exemplify the need for careful attention to the ways that differences of theological emphasis and moral method lead to different judgements in particular cases, both within and between particular Christian communities.

Catholicism↗

PubMed1998

Sterilizations reconsidered?

Cowdin and Tuohey argue for a rethinking of Catholic bioethical principles and the Church's moral authority. Citing the Second Vatican Council for support, they argue that if the Church were to respect the proper autonomy of medicine, it would allow sterilizations. In this essay I argue against Cowdin and Tuohey's understanding that the Church has derived its moral laws independent of consultation with medicine and that it treats medicine simply as a source of technical expertise. I also argue that they misunderstand that nature of autonomy as well as the Church's position regarding the type of autonomy they request for medicine. I will especially argue against their understanding of the principles of totality and double effect as "dispensations" from the moral order. I conclude that they have provided no grounds to cause the Church to reconsider its condemnation of all sterilizations.

Catholicism↗

PubMed1998

There is no moral authority in medicine: response to Cowdin and Tuohey.

Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.

Abortion, Induced↗

PubMed1998

Assisted death and martyrdom.

Against the backdrop of ancient, mediaeval and modern Catholic teaching prohibiting killing (the rule against killing), the question of assisted suicide and euthanasia is examined. In the past the Church has modified its initial repugnance for killing by developing specific guidelines for permitting killing under strict conditions. This took place with respect to capital punishment and a just war, for example. One wonders why in the least objectionable instance, when a person is already dying, suffering, and repeatedly requesting assistance in dying, there is still such widespread condemnation of assisted suicide and euthanasia. In a Gedankexperiment, I suggest that certain stories of martyrdom in the history of the Christian Church shed some light on the role of taking one's life, or putting one's life in danger out of love. I further suggest that requesting assisted suicide and/or euthanasia from the motive of love of one's family or care givers might possibly qualify as one instance of justifiable euthanasia, although I acknowledge that the Church will not be making changes in its stance any time soon.

Attitude to Death↗

PubMed1998

Physician-assisted suicide reconsidered: dying as a Christian in a post-Christian age.

The traditional Christian focus concerning dying is on repentance, not dignity. The goal of a traditional Christian death is not a pleasing, final chapter to life, but union with God: holiness. The pursuit of holiness requires putting on Christ and accepting His cross. In contrast, post-traditional Christian and secular concerns with self-determination, control, dignity, and self-esteem make physician-assisted suicide and voluntary active euthanasia plausible moral choices. Such is not the case within the context of the traditional Christian experience of God, which throughout its 2000 years has sternly condemned suicide and assisted suicide. The wrongness of such actions cannot adequately be appreciated outside the experience of that Christian life. Traditional Christian appreciations of death involve an epistemology and metaphysics of values in discordance with those of secular morality. This difference in the appreciation of the meaning of dying and death, as well as in the appreciation of the moral significance of suicide, discloses a new battle in the culture wars separating traditional Christian morality from that of the surrounding society.

Attitude to Death↗

PubMed1998

Natural death and the work of perfection.

The historic or traditional Christian view of pain (suffering) and death, especially as preserved by the Christians East (i.e., the Orthodox), is radically opposed to the modern secular obsession with avoidance of pain. Everything about this life has its goal or aim in a mystical reality, the Kingdom of Heaven, for which earthly life is a preparation. While neither illness nor health are seen as ends in themselves, both are viewed as proceeding from the will of God for our benefit and have no ultimate meaning or purpose outside of eternal life. Death may be a relief or an ending of suffering, but in itself it is not "good" but evil. Because they are the embodiment of lived theology, saints' lives can be a sure guide to understanding how to die as a traditional Christian. To illustrate this, I have chosen some examples from the lives of relatively recent saints. I myself am from the Russian Orthodox spiritual tradition, so all but one of my examples come from pre-Revolutionary Russia. The question is not so much whether or not a traditional Christian can countenance physician-assisted suicide, but rather, what is the meaning or purpose of pain and suffering in general. Is it part of the "work of perfection" required of those who wish to enter the Kingdom of Heaven and therefore not to be completely denied?

Attitude to Death↗

PubMed1998

Laying down one's life for oneself.

Roman Catholicism has long opposed suicide. Although Scripture neither condones nor condemns suicide explicitly, cases in the Bible that are purported to be suicides fall into several different categories, and the Roman Catholic tradition can show why some of these should be considered morally wrong and some should not. While Christian martyrdom is praised, it is not correct to argue that this Christian outlook invites suicide, or that it recommends physician-assisted suicide for altruistic motives. Church Tradition, from its earliest days, has clearly distinguished martyrdom from suicide. The principles of double effect and cooperation, mainstays in Roman Catholic moral theology, enable one to see the moral difference between martyrdom and suicide, and to appreciate why physician-assisted suicide is wrong for both patient and physician.

Altruism↗

PubMed1999

Institutional identity; sacramental potential: Catholic healthcare at century's end.

Government and market forces have fundamentally transformed the religious healthcare sector. Religious healthcare organizations are struggling to define their identities and determine what it is that makes them different and what implications the differences have for the delivery of social services and for public life. In response to these questions, the defenders of traditional Catholic healthcare make a variety of responses that first defend the continued relevance of the major institutions of Catholic healthcare, especially its hospitals, and second, specify reforms to make these institutions even more relevant to the new healthcare system. This essay argues that these defenses are inadequate to that challenge and that the reforms proposed are too timid. Catholic healthcare needs a better theoretical account of its mission and more creative institutional adaptations.

Catholicism↗

PubMed1999

Catholic health care in the United States: American pluralism and religious meanings.

This essay chronicles the development of Catholic health care in the United States during the Nineteenth and Twentieth Centuries. The author points to the religious pluralism and the respect for that pluralism as well as to the evangelical drive for conversion evident in Catholic hospitals. This essay is a phenomenological study of this commitment to pluralism and the evangelical impulse within the contexts of health care.

Catholicism↗

PubMed1999

Catholic health care: rationale for ministry.

This essay attempts to describe contemporary Catholic sponsored health care in the United States and to describe the purpose and structure of these particular Christian charitable organizations within the broader society. As health care has become more complex, critics claim that there is not a need for Catholic sponsored health care any longer. The author attempts to evaluate critically whether Catholic health care has a place in contemporary society. He reviews some salient biblical, ecclesial, and justice teachings of the Church to demonstrate why religious institutional presence is still needed. The author reviews contemporary health care structures to show how this is accomplished. He also uncovers additional issues which need to be addressed in order for these charitable institutions to carry on the ministry of the Church, to shape social structures, and to proclaim the reign of God.

Catholicism↗

PubMed1999

On the road to Jericho.

Identifying what the differences are or ought to be between Catholic health care organizations and their non-Catholic counterparts is the subject of great debate. The author responds to the essays in this volume by Dennis Brodeur, Clarke E. Cochran and Christopher J. Kauffman, each of which represents a different perspective in the discussion of what is unique about Catholic health care.

Catholicism↗

PubMed1999

Human and institutional transformations: Catholic hospitals becoming 'a light in the the darkness.

Catholic health care institutions in the United States and Canada face internal and external challenges to their continued existence. Confronted by these external and internal challenges, Catholic hospitals in the United States and Canada have been pressed to identify what is distinctive about the Catholic contribution to health care and to consider whether existing institutional structures and partnerships foster what is distinctive. The author looks at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman, and suggests that there is little agreement, even among Catholics, on such fundamental issues. The aim of this article is to highlight three important and often overlooked ideas raised by the authors, to relate them to the Canadian context by means of a story, and to pose questions for further discussion.

Canada↗

PubMed1999

The future of Catholic health care: observations from an Orthodox Christian perspective.

The author reflects on the future of Catholic health care by looking at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman. The author argues that (1) Roman Catholic teaching on the Trinity is defective, yielding an inadequate model of society, (2) Roman Catholic teaching on the Incarnation is defective, yielding an impoverished understanding of the "sacramental," and (3) the institutional orientation of Roman Catholicism combined with the lack of true sacramental vision makes it nearly impossible for Roman Catholic theory to criticize the current structure of health care financing.

Catholicism↗

PubMed1999

"Whose perfection is it anyway?": a virtuous consideration of enhancement.

Discussions of genetic enhancements often imply deep suspicions about human desires to manipulate or enhance the course of our future. These unspoken assumptions about the arrogance of the quest for perfection are at odds with the normally hopeful resonancy we find in contemporary theology. The author argues that these fears, suspicions and accusations are misplaced. The problem lies not with the question of whether we should pursue perfection, but rather what perfection we are pursuing. The author argues that perfection, properly understood, has an enormously positive function in the Roman Catholic tradition. The author examines three sources: the Scriptures, the scholastic tradition, and ascetical theology. He examines contemporary criticisms of perfectionism and suggests that an adequate virtue theory keeps us from engaging perfectionism as such. The author then shows how a positive, responsible view of perfection is an asset to our discussion on enhancement technology.

Anthropology↗

PubMed1999

Indulging anxiety: human enhancement from a Protestant perspective.

At the heart of any ethics of human enhancement must be some normative assumptions about human nature. The purpose of this essay is to draw on themes from a Protestant theological anthropology to provide a basis for understanding and evaluating the tension between maintaining our humanity and enhancing it. Drawing primarily on the work of theologian Reinhold Niebuhr, I interpret enhancement as proceeding from the anxiety that characterizes human experience at the juncture of freedom and finiteness. Religious and moral dimensions of human sinfulness are considered in relation to cultural values that motivate human enhancement generally. I employ these dimensions in a series of benchmarks to suggest a background of theological, anthropological, and moral considerations against which enhancement is not to be condemmed but rather critically evaluated.

Anthropology↗