Bioethical advice valuable in discerning health care options

In his 2009 encyclical letter Caritas in Veritate, Pope Benedict XVI asserts the field of bioethics is “a particularly crucial battleground in today’s cultural struggle between the supremacy of technology and human moral responsibility” (74). While this struggle is certainly found at the professional level among academics, health care professionals, and scientists, it becomes deeply personal when it is a patient or his proxy who struggles to discern moral responsibility when facing a medical dilemma. 

In cases like these, a consultation with a trusted bioethicist is invaluable.

John Di Camillo’s article published in the July issue of Legatus magazine shined a much-needed light on the essential work of the National Catholic Bioethics Center’s personal consultations department. I know firsthand about this essential work, having had the privilege of working with Di Camillo, first as a postdoctoral ethicist fellow, and now as a personal consultations ethicist fellow. The ethicists at NCBC respond to questions that touch on contraception and sterilization, assisted and artificial reproductive technologies, genetic testing, body modification, life-sustaining treatments, and death. Each question is nuanced with the unique features of the individual case. 

In a typical response, a concise answer would be given first, followed by an in-depth explanation of the magisterial teaching on the subject. This is done with reference to the Catechism of the Catholic Church, documents from the Dicastery for the Doctrine of the Faith, papal writings (both encyclicals and apostolic exhortations), the U.S. bishops’ Ethical and Religious Directives for Catholic Health Care Services, along with various pastoral letters and other writings of the U.S. bishops. This thorough analysis is intended to inform and explain the moral teachings of the Catholic Church as they apply to health care. 

An example of a question that we often receive is whether a woman can take oral contraceptives to treat a disorder of her reproductive system (e.g., polycystic ovary syndrome or endometriosis). This question is further complicated when the woman is married and sexually intimate with her spouse. 

We would respond by clarifying several points of principle and practice. First, the principle of double effect would be explained, and then applied to her specific situation as it is described. Several Catholic resources would be used to distinguish between the moral use of oral contraceptives as a hormone-based medicine and the immoral use of oral contraceptives used to prevent pregnancy (e.g., Catechism of the Catholic Church, 2399; Humanae Vitae, 14-15; Ethical and Religious Directives, 53; Fr. Tad Pacholczyk’s column on the subject; etc.). 

Then, the woman and her spouse are advised to consider the risk that oral contraceptives may impede implantation of a conceived child (causing a spontaneous abortion) and how they can prudently reduce or eliminate that risk.

Finally, the “proportionate reason” requirement and the duty to consider any reasonable and morally legitimate alternatives would be emphasized (see Ethical and Religious Directives, 27). This is important because oral contraceptives are associated with serious side effects. Information on several Catholic health care professionals and Catholic practices would be given should the woman wish for a consultation or a second opinion. 

As you can see, significant time, detail, and prayer go into each consultation response, and rightly so. Responding to such intimate and consequential questions is a tremendous responsibility, one that can only bear good fruit when it is founded in prayer. We should unite our prayers with Pope Francis’ prayer intention for March of last year, namely, “Let us pray that we may give a Christian response to bioethical challenges.” In Christ’s name, Amen!