Ethics & Medics

A major concern of organizations that monitor the practices of hospitals and other health care providers is the rationing of care based on inappropriate criteria. This article explores examples of this trend in health care. First, a tendency during the start of the COVID-19 pandemic to limit care to patients with a Do Not Resuscitate order even though their condition did not require resuscitation. Next, the article explores two cases where doctors were hesitant to give extensive care to patients whose ‘quality of life’ was considered too low to be worth treating, even though the patients and their families were willing to go through the difficult treatments to have more time together. The stories illustrate a departure from patient-centric health care toward a devaluing of individual lives through dispassionate focus on the physician’s perception of a patient’s ‘quality of life.’

The Catholic perspective on end-of-life care focuses on the value of the individual person, rather than the burden a person nearing death might place on family and health care institutions. In a culture where euthanasia is becoming a more accepted act, the Catholic approach to palliative and hospice care is vital to protecting our most vulnerable brothers and sisters. This article was originally posted on May 21, 2021.

On December 23, 2022, the US Food and Drug Administration (FDA) changed its Drug Facts Label for Plan B One-Step (PBOS), removing language that, since 2006, had stated that PBOS “may inhibit implantation (by altering the endometrium).” The FDA’s action has created the impression that PBOS and similar, generic levonorgestrel-based drugs used for “emergency contraception” (LNG-EC) have no effect on the survival of a conceived human being. The FDA did not address all factors relevant to how LNG-EC can impact human life after fertilization. These factors, and other ethical questions surrounding the change, are discussed in this article by the NCBC ethicists

The following story is an excerpt from a forthcoming book on coping with chronic illness. It discusses focusing on the personhood of an individual rather than their illness, particularly in the case of children with cancer. The forthcoming book will be published by the National Catholic Bioethics Center and give a number of perspectives on the difficulties and spiritual benefits of overcoming chronic disease.

The increasing acceptability of euthanasia in American medicine is an alarming trend. Denying a person the opportunity to go through the process of dying is detrimental to both the individual and our society. In this article, the author explores the five stages of dying as presented by Dr. Elisabeth Kubler-Ross, presenting a clear vision of the right way to approach the end of life. Dying is not an event to be hastened so that its impact is lessened, but a process that teaches all of us how to live.

Although we should respect the autonomy of our patients and engage in shared decision-making with them, the debate over Physician Assisted Suicide (PAS) has not given sufficient attention to other principles that need to be addressed in these discussions. In trying to offer a sound ethical analysis of this movement, we must weigh consequences that go beyond the individual patient and the physician. Concerns about the unintended consequences of PAS to the social dimension of human life are explored in this paper.

The nature of the Catholic faith often places practitioners at odds with established order and the specificity of our values may cause us to run afoul of secular sensibilities. What follows is a collection of writings by National Catholic Bioethics Center President, Dr. Joseph Meaney, exploring our place in the public square, the proper way to respond to government driven injustice, and some specific instances in which the current administration has infringed or threatened to infringe upon the conscience and religious rights of not just faithful Catholics, but faithful members of many other religions as well.

One of the most important questions when determining when it is appropriate to procure organs from a deceased organ donor is what can be considered death. Currently, there is significant debate over whether brain death is an appropriate method of declaring an individual dead. As it would be illicit to cause the death of a patient by removing their organs, a medical professional must be certain that a brain dead patient is, in fact, dead before the procedure. In this paper, the author makes the case in support of considering brain death actual death.

Parents have the autonomous right to choose or refuse a treatment for their child, even those that are life sustaining, if it is extraordinary or disproportionate and it is within the best interest and well-being of their child. Pediatric health care is practiced with the goal of promoting the best interests of the child to do so. Treatment is generally rendered under a presumption in favor of sustaining life. However, in some circumstances, the balance of benefits and burdens to the child leads to an assessment that forgoing life-sustaining medical treatment (LSMT) is ethically supportable or advisable. Input from specialists in palliative care, ethics, pastoral care, and other disciplines enhances support for families and medical staff when decisions to forgo LSMT are being considered.

The Supreme Court’s decision in the Dobb’s case has given rise to confusion in the medical community, mostly concerning the specific definition of an abortion and what procedures are acceptable. Catholic bioethics has a long history of examining the ethical issues surrounding procedures used in vital conflict situations and other instances where direct or indirect abortion may be the preferred treatment. This article lays out the important points and ethical dimensions surrounding some of the most common pregnancy related interventions and provides guidance to physicians seeking to treat both patients in a manner that acknowledges their value as human beings.

The Supreme Court’s decision in the Dobb’s case has given rise to confusion in the medical community, mostly concerning the specific definition of an abortion and what procedures are acceptable. Catholic bioethics has a long history of examining the ethical issues surrounding procedures used in vital conflict situations and other instances where direct or indirect abortion may be the preferred treatment. This article lays out the important points and ethical dimensions surrounding some of the most common pregnancy related interventions and provides guidance to physicians seeking to treat both patients in a manner that acknowledges their value as human beings.

This article discusses the shift in recent years of treatment for gender dysphoria, particularly in teens, away from psychotherapy and toward hormonal treatments. The author argues that, especially given the vulnerability of minors and the potentially damaging and lifelong effects of these hormonal treatments, psychotherapy should be preferred. The author also notes that the ability to give consent to such irreversible treatments is lacking or nonexistent in many minors.

Interactions between the media and Catholic institutions can be difficult to navigate, especially given the nuances of Catholic teaching and the desire of media outlets to convey the desired information in a succinct and easily digestible manner. However, these interactions also present an opportunity for evangelization and clarification of Catholic principles. Any instance of communication between Catholic institutions and secular media outfits should be done carefully and deliberately so as to limit the risks of any given statement being taken out of context or otherwise misrepresented.

Church teaching is often difficult to digest for those unfamiliar with its nuances. In particular, teachings related to IVF are seen as insensitive to those who were conceived and born as a result of the process. In this article, Rev. Kizewski explains the difference between primary and secondary causality, as well as defective choices and their results. In short, Catholic teaching on the illicit nature of the processes involved in IVF should in no way be taken as a condemnation of individuals conceived during those processes.

In this article, John Brehany continues his discussion of both the history of the Ethical and Religious Directives for Catholic Health Care Services and what future revisions might be needed. This article focuses on Part 4, the largest section of the ERDs. Part 4 addresses ethical issues related to respect for human life, fertility, assisted reproduction, surrogacy, prenatal testing, and genetic counseling.

The principle of a preferential option for the poor is an oft misunderstood Catholic teaching, in part because it is rarely explored beyond casual invocation. In this article, Christopher Reilly explores this principle as it pertains to Bioethics. In order to clarify the concept, this article puts forth nine points to follow in order to effectively implement this principle.

Brain death is a contentious subject, especially in the area of Catholic bioethics. Answering the question of when an individual is truly dead has a wide application in the field of medicine, particularly when determining when it is licit to begin the process of organ transplantation. Global Ischemic Penumbra raises an additional issue in that it closely mimics brain death, but is not in fact a terminal condition.

Recent years have seen a near exponential expansion of the acceptance of gender as a mutable aspect of the human experience, rather than as an essential property of the human individual. In this article, Pizzo explores this move and the assertions of those who espouse it. In addition, he makes the case that this move is part of a fundamental misunderstanding of human sexuality and the nature of gender in human society.