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Can a war can be just on both sides? Within the Western just war tradition, Catholic theologians traditionally held wars on both sides to be logically impossible. This view went unchallenged until questioned by two seventeenth-century Irish Franciscan Scotists. These were Aodh Mac Cathmhaoil (Hugo Cavellus) and John Punch. In this paper I lay out the Scotist theological grounds that led them to admit to the possibility of wars just on both sides. I also conjecture on possible reasons why Punch refrained from revising traditional just war theory in light of his own far-reaching theological conclusions. more...

This article aims to build awareness of the growing global crisis in social, economic and environmental terms from different disciplinary approaches. The authors respond to the message of Pope Francis presented in his Encyclical Letter published in 2015. The article provides a short current overview of the discourse and presents three hypotheses anchored in the disciplines of Psychology, Health and Theology for a deeper discussion of Pope Francis's viewpoints on the challenges to humankind and how to address them. It thereby contributes to the discourse on health and religion with regard to the Pope's message to the world community. The article leads to an interdisciplinary conclusion and directions for future research and practice. more...

By adressing specifically the issue of handicap at the end of life, I will question theology in the frame of a capability approach. In what sense theology in its analogical sense can find its place in the contemporary approach of capabilization? Can it extend the meaning of capabilities? If it first puts in perspective a relational and contextual web of those who experience a shared experience; I will then argue that it invites to a certain prudence towards the concept of handicap and end of life. The risk of closure, rather than openness to an experience of growth for the subject who is able to confront this experience is to be avoided. more...

This essay considers some of the major theological differences between Eastern and Western traditions of Christianity and puts forward proposals about how these might be related to the divergent trajectories of the formal study of nature in these two cultural contexts. A key difference lies in the “other-worldly” orientation of Eastern Orthodoxy and its emphasis on deification, which contrast sharply with ideas of original sin and fall–redemption theology in the West. These latter ideas came to play a significant role in the rise of Western science, with the sciences being understood as part of a practical redemptive exercise that could help alleviate the material consequences of original sin. more...

This paper discusses from a sociological perspective one of Catholicism's fronts of public intervention in the development and enactment of health legislation. In particular we analyze the debate in parliamentary committees on the so-called "death with dignity" law (No. 26742), for which a group of bioethics experts was convened to counsel senators regarding the scope and limits of the law. The majority of the invited experts advocated a personalist bioethics perspective, which is a theological bioethics development of contemporary Catholicism. In the debate no representatives of other faiths were present, reinforcing the widely studied overlap between Catholicism and politics in Argentina. more...

One challenge to the concept of human dignity is that it is a rootless notion invoked simply to mask inequalities that inevitably exist between human beings. This privileging of humans is speciesist and its weak point is the profoundly disabled human being. This article argues that far from being a weak point, the profoundly disabled person is a source of strength and witness to the intrinsic dignity that all human beings have by virtue of being human. The disabled represent the reality of human existence that is both strong and fragile. Although human dignity can be understood philosophically its depth is rooted in Christian theological insights. The profoundly disabled occupy a privileged position and share in a theology of mission since they testify to the interdependence of every human being and human dependence on God to a myopic world that only values strength, autonomy and independence. more...

Many people look to religion to help resolve the serious moral and legal issues associated with assisted reproductive technologies. Doing so presupposes that religion is the cornerstone of ethics, but this assumption is not well founded. While various faiths are entitled to articulate their views on matters of human reproduction, the contradictions involved in doing so make it unwise to rely on religion in the formulation of law and policy. These contradictions--such as the indeterminacy about what revealed truths means--make moral secular philosophy a better guide for the protection of human welfare., (Copyright © 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.) more...

This article addresses repercussions for Clinical Pastoral Education (CPE) and theological education of the move in pastoral theology from the metaphor of the "living human document" to the "living web" to describe its subject of study, a question pastoral theologians have not explicitly considered. It focuses primarily on the descriptive task of understanding problems in theological education, CPE's turn to the document, and the evolution of the web as a new metaphor. Least controversially, it argues that the image of the web has both problems and undeveloped potential. More radically, it suggests that CPE's gift to theological education may still be its understanding of the document and its development of methods by which to attend to personhood. Ultimately, the "living document within the web" may be the best way to frame the subject matter of both CPE and pastoral theology. more...

Catholic opponents of abortion and embryonic stem cell research usually base their position on a hylomorphic account of ensoulment at fertilization. They maintain that we each started out as one-cell ensouled organisms. Critics of this position argue that it is plagued by a number of intractable problems due to fission (twinning) and fusion. We're unconvinced that such objections to early ensoulment provide any reason to doubt the coherence of the hylomorphic account. However, we do maintain that a defense of ensoulment at fertilization must deny that we're essentially organisms. more...

In this essay, I defend three Simple Views concerning human beings. First, that the human embryo is, from the one-cell stage onwards, a single unitary organism. Second, that when an embryo twins, it ceases to exist and two new embryos come into existence. And third, that you and I are essentially human organisms. This cluster of views shows that it is not necessary to rely on co-location, or other obscure claims, in understanding human embryogenesis. more...

This article examines the account of the relationship between sin and suffering provided by J. L. A. Garcia in "Sin and Suffering in a Catholic Understanding of Medical Ethics," in this issue. Garcia draws on the (Roman) Catholic tradition and particularly on the thought of Thomas Aquinas, who remains an important resource for Catholic theology. Nevertheless, his interpretation of Thomas is open to criticism, both in terms of omissions and in terms of positive claims. Garcia includes those elements of Thomas that are purely philosophical, such as natural law and acquired virtue, but neglects the theological and infused virtues, the gifts and fruits of the Holy Spirit, and the beatitudes. These omissions distort his account of the Christian life so that he underplays both the radical problem posed by sin (and suffering), and the radical character of the ultimate solution: redemption in Christ through the grace of the Holy Spirit. more...

Drawing chiefly on recent sources, in Part One I sketch an untraditional way of articulating what I claim to be central elements of traditional Catholic morality, treating it as based in virtues, focused on the recipients ("patients") of our attention and concern, and centered in certain person-to-person role-relationships. I show the limited and derivative places of "natural law," and therefore of sin, within that framework. I also sketch out some possible implications for medical ethics of this approach to moral theory, and briefly contrast these with the influential alternative offered by the "principlism" of Beauchamp and Childress. In Part Two, I turn to a Catholic understanding of the nature and meaning of human suffering, drawing especially on writings and addresses of the late Pope John Paul II. He reminds us that physical and mental suffering can provide an opportunity to share in Christ's salvific sacrifice, better to see the nature of our earthly vocation, and to reflect on the dependence that inheres in human existence. At various places, and especially in my conclusion, I suggest a few ways in which this can inform bioethical reflection on morally appropriate responses to those afflicted by physical or mental pain, disability, mental impairment, disease, illness, and poor health prospects. My general point is that mercy must be informed by appreciation of the person's dignity and status. Throughout, my approach is philosophical rather than theological. more...

This article looks at the late John Paul II's allocution on artificial nutrition and hydration (ANH) and the implications his statement will have on the ordinary-extraordinary care distinction. The purpose of this article is threefold: first, to examine the medical condition of a persistent vegetative state (PVS); second, to examine and analyze the Catholic Church's tradition on the ordinary-extraordinary means distinction; and third, to analyze the ethics behind the pope's recent allocution in regards to PVS patients as a matter of conscience. Rather than providing clarification, I argue that the papal allocution has raised many difficult questions. People in situations where decisions must be made about withdrawal or continued ANH are in need of guidance. Moreover, additional analysis is needed to determine whether the papal allocution is in conflict with the traditional Catholic medical ethics understanding of the ordinary-extraordinary care distinction. more...

The author examines the history of theological method based on the term locus theologicus, the refinement of this method by Liberation Theologians and U. S. Hispanic/Latino/a Theologians, and describes one experience of using contextual theology to develop curriculum for Second-Year Clinical Pastoral Education (CPE) Residents. more...

The Catholic health ministry's concern for communities stems from the church's belief that human dignity is most fully expressed and recognized within the context of community. We humans are social beings by our very beings, and unless we involve ourselves in relationships with others, we fail to develop our innate human gifts. We who serve Catholic health care recognize that Jesus had a special affection for and ministry for the poor and vulnerable. Our church calls on us to provide service and advocacy for people whose disadvantages put them at society's margins. This obligation arises from the fact that all people--the healthy and the sick, the rich and the poor, the well-educated and the untaught--are children of the same loving God. Sharing that God, we are our "brother's keeper." more...

Catholic movements within the centre of Roman Catholic doctrine recently have discussed Trinitarian theology as applied to sciences, arts, economics, health and other social areas. We explore the possibilities Trinitarian theology offers to bioethical debate, concentrating particularly on genetic screening and testing. It is important therefore to analyse the philosophical implications of this approach onto the bioethical world, where much disagreement occurs on fundamental issues. It is Catholic basic teaching to recognize and see God's hand in plurality, not merely as a cliche and then doing what we feel is right, but to recognize how to live in a pluralistic world. We recognize, in agreement with these theologians, that in order for a Trinitarian mode of understanding to be used by those doing bioethical debate, there is a need to depart from fundamentalism. more...

The cardinal question in Christian moral theory and bioethics is whether the knowledge that Christians have (1) by grace and (2) by revelation (e.g., regarding the character of human and cosmic history as reaching from creation through the Incarnation and the Redemption to the Second Coming and the restoration of all things) makes a crucial contribution to understanding morality, as for example issues such as the good death and the morality of physician-assisted suicide and euthanasia. This article argues that such a contribution is made by grace and revelation. The reduction of Roman Catholic moral theology and bioethics to secular bioethics is explored, as well as the necessity of the unique knowledge possessed by Christians for adequate end-of-life decision-making. more...

In this essay I shall describe and analyse the current debate on physician assisted suicide in contemporary German Protestant church and theology. It will be shown that the Protestant (mainly Lutheran) Church in Germany together with her Roman Catholic sister church has a specific and influential position in the public discussion: The two churches counting the majority of the population in Germany among their members tend to "organize" a social and political consensus on end-of-life questions. This cooperation is until now very successful: Speaking with one voice on end-of-life questions, the two churches function as the guardians of a moral consensus which is appreciated even by many non-believers. Behind this joint service to society the lines of the theological debate have to be ree-discovered. First it will be argued that a Protestant reading of the joint memoranda has to be based on the concept of individual conscience. The crucial questions are then: Whose conscience has the authority to decide? and: Can the physician assisted suicide be desired faithfully? Prominent in the current debate are Ulrich Eibach as a strict defender of the sanctity of life, and on the other side Walter Jens and Hans Kung, who argue for a right to physician assisted suicide under extreme conditions. I shall argue that it will be necessary to go beyond this actual controversy to the works of Gerhard Ebeling and Karl Barth for a clear and instructive account of conscience and a theological analysis of the concepts of life and suicide. On the basis of their considerations, a conscience-related approach to physician assisted suicide is developed. more...

The debate about voluntary euthanasia arises (essentially) from a fundamental anthropological question: do humans own themselves? An answer to this question is developed which starts out from the foundational ethic of Emmanuel Levinas. The metaphysics of the countenance of the Other in Levinas is then related to Karl Rahner's description of God as the absolute enigma which is fated towards us. God, understood as that enigma, is experienced for us concretely in our relationship to the countenance of our neighbor, the other human being. Our being thus referred to the absolutely Other in the countenance of the other human grounds not only the non-disposability of that other human being, but also the non-disposability of myself. This is the decisive point for how one should think about euthanasia. In contrast to the (so-called) voluntary euthanasia, accompaniment in dying takes account of that dialogical constitution of man. more...

The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called "stewardship argument": Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist--and even secular--debate on the legitimacy of euthanasia. more...

This essay addresses the problem of communication between Christianity and the secular world in an area where the latter tends to oppose the moral norms endorsed by the former. How, in the interest of missionary outreach (and with which understandings of what such outreach involves) can the language barriers be bridged? Whereas the Roman Catholic natural law tradition posits a neutral common ground of (traditional or hermeneutical) rationality between Christianity and the world, an Ebeling- and Barth-modified Lutheranism engages in an argument ad hominem by seizing upon an admitted deficiency within that world, and by recommending Christianity for mending that deficiency. Both positions differ from the Evangelical claim that since that which the world politically values is derived from Christianity, it must remain subject to Christianity's moral legislation. An entirely different approach to the communication- and outreach-problem is taken by Orthodox Christianity: The gulf which separates it from the world is acknowledged, and the possibility of trans-gulf-traffic is referred to God's grace. It is only this latter model, however, which preserves Christianity's theological terms (such as "Scripture", "law", and "holiness") from common-ground-securing, deficiency-mending, or authority-imposing secularizing, and thus from compromising that very theological context into which communicative outreach endeavors were to invite. more...

Evangelicals are unconditionally opposed to active euthanasia. Indirect euthanasia is seen as simply belonging to the risks inherent in any medical intervention. Passive euthanasia is accepted if used in order to save the dignity of the dying and is seen as merely ceasing to interfere with an irreversible dying process. The basis of evangelical ethics is the Bible supplemented by science and experience as a kind of natural law. Even though natural law comes under Biblical revelation, its acceptance is the reason for the similarity of the Evangelical and the Roman-Catholic position of Evangelicals. Evangelicals stress the necessity of a better counseling and investment for the deadly ill patient. more...

Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients' wishes, be made in light of commonly shared values, unless these violate the principle of "in dubio pro vita". The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life. more...

The lack of consensus in American society regarding the permissibility of assisted suicide and euthanasia is due in large part to a failure to address the nature of the human person involved in the ethical act itself. For Karol Wojtyla, philosopher and Pope, ethical action finds meaning only in an authentic understanding of the person; but it is through acting (actus humanus) alone that the human person reveals himself. Knowing what the person ought to be cannot be divorced from what he ought to do; for Wojtyla, the structure of the ethical "do"--the act itself--comes first. The current paper will focus on four arguments used to justify assisted suicide and euthanasia: (1) the argument from autonomy, (2) the argument from compassion, (3) the argument from the evil of suffering, and (4) the argument from the loss of dignity. It will seek to answer each claim from the perspective of Karol Wojtyla's philosophical anthropology. Much of this will come from his defining work in pure philosophy, The Acting Person (1969). The final part of the paper will suggest some positive solutions to the stalemate over the euthanasia debate, again drawn from Wojtyla's idea of human fufillment through participation with the other, and with the community itself. more...

Peter Singer's recent appointment to Princeton University created considerable controversy, most of it focused on his proposal for active euthanasia of disabled infants. Singer articulates utilitarian ideas that often appear in public discussions of euthanasia. Drawing on Pope John Paul II's work on ethics and suffering, I argue that Singer's utilitarian theory of value is impoverished. After introducing the Pope's ethic based on the imago dei, I discuss love as self-gift. I show how this concept supports a theory of value in which spiritual goods are preeminent over material goods. I then describe how suffering reveals spiritual goods, discussing how participation in Christ's suffering can alter our perception of value. I also consider how communal responses to suffering provide opportunities for self-giving. Third, I consider Singer's proposal for killing infants with hemophilia, arguing that it arbitrarily ignores spiritual goods. I then discuss proposals to kill anencephalic infants, discussing how parental responses to their suffering can demonstrate an extraordinary love in seemingly hopeless circumstances. I conclude by calling for a more sustained social response to euthanasia initiatives. more...

With rare exceptions, Roman Catholic moral theologians condemn the sale of human organs for transplantation. Yet, such criticism, while rhetorically powerful, often oversimplifies complex issues. Arguments for the prohibition of a market in human organs may, therefore, depend on a single premise, or a cluster of dubious and allied premises, which when examined cannot hold. In what follows, I will examine the ways in which such arguments are configured. For example, Thomas Aquinas' (1224-1274) understandings of embodiment and moral uses of the body are usually interpreted as, and cited in support of, foreclosing a market in human organs. Aquinas' principle of totality requires that one preserve the wholeness of the human body. In approaching Aquinas' texts, I will assume the role of a revisionist who takes seriously his core commitments, while at the same time indicating that one can further develop his understanding of the body in ways which are supportive of the sale of human organs while remaining in conformity with the author's core concerns. Such considerations will provide significant grounds for concluding that a market in human organs for transplantation appreciates the embodied nature of the human person, respects the body and its parts as personal, rather than as mere things, is consistent with acknowledging God's dominion over our lives and bodies, and constitutes an appropriate utilization of God's gifts to us. Moreover, such a market would likely create significant opportunities charitably to help others, to enhance human dignity and to protect against the serious dehumanization of current national bureaucratic procedures for organ donation. more...

My interlocuter is Locke with his reduction of person to personal consciousness. This reduction is a main reason preventing people from acknowledging the personhood of the earliest human embryo, which lacks all personal consciousness. I show that Catholic Christians who live the sacramental life of the Church have reason to think that they are, as persons, vastly more than what they experience themselves to be, for they believe that the sacraments work effects in them as persons that can only be believed but that cannot be experienced within themselves in this life. I also show that Christians and non-Christians alike have an experience of moral good and evil in themselves that implies that they are, as moral persons, far more than they find in their conscious self-presence. It is, therefore, natural to think that if my being a person so far exceeds my consciousness, I may well have once existed as person even before the awakening of consciousness. more...

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. more...

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. more...

Religious discussion of human organs and tissues has concentrated largely on donation for therapeutic purposes. The retrieval and use of human tissue samples in diagnostic, research, and education contexts have, by contrast, received very little direct theological attention. Initially undertaken at the behest of the National Bioethics Advisory Commission, this essay seeks to explore the theological and religious questions embedded in nontherapeutic use of human tissue. It finds that the "donation paradigm" typically invoked in religious discourse to justify uses of the body for therapeutic reasons is inadequate in the context of nontherapeutic research, while the "resource paradigm" implicit in scientific discourse presumes a reductionist account of the body that runs contrary to important religious values about embodiment. The essay proposes a "contribution paradigm" that provides a religious perspective within which research on human tissue can be both justified and limited. more...

Aquinas's conception of the relationship of faith and reason calls into question the arguments and some of the conclusions advanced in contributions to the debate on physician-assisted suicide by David Thomasma and H. Tristram Engelhardt. An understanding of the nature of theology as based on revelation calls into question Thomasma's theological argument in favor of physician-assisted suicide based on the example of Christ and the martyrs. On the other hand, unaided reason calls into question his assumptions about the nature of death as in some cases a good for the human person. Finally, if Aquinas is right about the relationship of faith and reason, Engelhardt's sharp contrast between "Christian" and "secular" approaches to physician-assisted suicide needs reconsideration, although his conclusions about physician-assisted suicide would find support. more...

While legal rights to make medical treatment decisions at the end of one's life have been recognized by the courts, particular religious traditions put axiological and metaphysical meat on the bare bones of legal rights. Mere legal rights do not capture the full reality, meaning and importance of death. End-of-life decisions reflect not only the meaning we find in dying, but also the meaning we have found in living. The Christian religions bring particular understandings of the vision of life as a gift from God, human responsibility for stewardship of that life, the wholeness of the person, and the importance of the dying process in preparing spiritually for life beyond earthly life, to bear on end-of-life decisions. more...

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelations, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian sprituality. In the face of that failure, Christian physicans and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice. more...

Roman Catholic moral theology follows a centuries-old tradition of moral reflection. Contemporary Roman Catholic moral theory applies these traditional arguments to the realm of medical ethics, including the issues of active euthanasia and physician-assisted suicide. Unavoidable moral limits on licit medical intervention sometimes require that the moral duty to treat cede to the duty to cease treatment when measures become more harmful than beneficial to the patient. This does not reduce the need for the compassionate use of palliative care in response to suffering. However, it does mean that rather than being excessively committed to maintaining mere biological human life, or actively seeking death, that we learn a sober realism about the limits of human life. Catholic moral analysis examines an act objectively, both in its relation to the agent and as a material event in the world. This allows both the virtuous or vicious intentions of the agent and the effects of the action to be included in its moral evaluation. Thus, Catholic moral analysis is both quasi-deontological and quasi-consequentialist. Objectively, active euthanasia and physician-assisted suicide, as acts of deliberate killing, are seen as repugnant, in that they fail to incarnate a benign inner intention or to form an agent in virtue. Catholic moral theology is extremely skeptical that an act of intending death directly can be consonant with a sincere compassion for the dying, suffering person and views it as a direct negation of the precious gift of human life. more...