WORCESTER MEDICAL ETHICS

A Roman Catholic Perspective

Monsignor Peter R. Beaulieu, M.A., S.T.L.

LIVING THE GOOD LIFE – LIVING IT RIGHT

Introduction
Medical decisions, at every stage of life, are complex; however, the issues and alternatives that surround life’s beginnings have never been more so. In treatment decisions, the general public suffers from an information deficit—physicians and nurses have spent years in studying diseases and how to treat the sick and hospitalized and, so, in the hospital room, emergency room, or doctor’s office, they are usually the only ones who really know what is going on. Yet, making an informed decision, weighing the alternatives, balancing the risks and benefits is only something healthcare professionals expect you to do. Moreover, the dominant method of reaching a decision for healthcare professionals includes respecting your autonomy, doing the least amount of harm necessary (or nonmaleficence), willingness to do what is beneficial to you overall, and justice considerations. Catholic morality operates out of a very different set of guiding norms or principles: (1) the sanctity of human life from the moment of conception until death by natural causes; (2) the God-given (or innate) dignity of every person because, as innate, it does not have to be earned nor is it ever lost; (3) accounting for the common good of all; (4) use of the three-font principle of morality: analyzing any action (or omission) being considered by looking at the act itself, the intention, and the circumstances surrounding the act; (5)intrinsically evil acts can never be done, even for a good end.


Beginning of Life

Ever-increasing developments in embryology, coupled with technological improvements have made human conception and procreation into a moral quagmire. Abortion and surgical sterilization are, unfortunately, commonplace and legal. Procedures involving the beginning of life, whether manipulating the building blocks of life at the genetic level or technological treatment of infertility, things unheard of twenty years ago have moved from the breakthrough stage and beyond the experimental period to become routine: In vitro fertilization (IVF), homologous (by husband) or heterologous  (by donor) artificial insemination, surrogate motherhood, stem cell research, cryopreservation of human embryos, genetic manipulation, and the specter of human cloning dominant the scientific literature. Despite claims to the contrary, science and technology are not morally neutral. For Catholics, the moral criteria used to judge medicine and technology is determined by an understanding of the total view of the human person—a unity of body and soul, as well as in conformity with the natural law. In medico-moral matters, the natural law articulates what it means to be fully human and does so in an integral (or total) manner. This is not merely biological; no, it incorporates all the relationships which constitute the human person, which reveals God’s original plan in creating man and woman in their complementarity and as body/soul creatures.


Procured Abortion

The sanctity of life position—life itself was sacred and must be safeguarded—dominated medicine and had legal sanction until 1973. Then, one year later, in the Declaration on Procured Abortion, the Church restated her age-old position that direct abortion (not indirect) was intrinsically evil—never morally legitimate except in cases where the principle of double effect determined the agent’s intention to be curing a pathological condition, no other medical option was available, the removal of the diseased organ (usually the uterus) happened simultaneously with the removal of the human embryo and that there was a proportionate reason for this having to be done. Then, almost three decades later, writing in the encyclical Evangelium vitae, John Paul II stated, “Procured abortion is the deliberate and direct killing, by whatever means it is carried out, of a human being in the initial phase of his or her existence, extending from conception until birth. The moral gravity of procured abortion is apparent in all its truth if we recognize that we are dealing with murder….No circumstance, no purpose,  no law whatsoever can ever make licit an act which is intrinsically illicit, since it is contrary to the law of God which is written in every human heart, knowable by reason itself and proclaimed by the church” (EV, nn. 58-62). The terms the Holy Father used: procured, deliberate, direct are morally significant. While exceptionless when the agent (whether physician or patient) only intends to indirectly attack innocent human life, this indirect abortion (e.g., removal of cancerous uterus in a woman who is pregnant) implies that the aim is something other than abortion, namely, removing a diseased organ that cannot be postponed until after the birth of the child. In the encyclical, while lamenting the destruction of human life, John Paul II recognized thinking that skews such a decision, “a desire to protect..her own health,” but this cannot justify abortion