Tag Archives: ethics

The evangelical force hiding in plain sight

For decades, Catholics have been working to evangelize neighbors and the broader culture. Unfortunately, we have limited what evangelization means to a very narrow skill set, namely, apologetics. Shortly after publishing my book, Nudging Conversions: Bringing Those You Love Back to the Church, I spoke with a friend about her lukewarm husband. “If only I could find the right argument,” she said to me. So many of us tend to think this way – that evangelization is merely an argument to be won. This was my thinking for years and a motivation behind my doctorate in philosophy. I was rudely awakened by the realization that we truly live in a post-logical, post-rational culture, and even the most perfectly argued points will often miss their intended mark.

Shifting gears, I’ve spent years trying to get to what really works. More than anything, evangelization boils down to relationships. Successful business owners know this, and business book after business book points to the fact that it isn’t intelligence that makes success, but good people edified by good relationships.

As a result of the emphasis of apologetics over relationships, as Catholics, we have overlooked a most promising source of evangelization: women. Women have an incredible capacity to form relationships and to share their faith. Historically, the Church is dotted with Margarets, Theresas, Catherines, Monicas, and Bridgets, who have passed their faith on to their families and neighbors. Moreover, women are the very soil of every civilization. We have to ask how we have been cultivating them.

As I explore in my book, The Anti-Mary Exposed, our culture has embraced decadence largely because of the overwhelming influence magazines, daytime television, Hollywood, and pop music have had upon all women. We don’t notice it because it seems normal, but the corruption of our culture wasn’t because women were reading Marx and Margaret Sanger, but because they were reading Cosmo and Vogue while listening to Madonna and Beyoncé. These are the kinds of sources that have led to our post-logical culture.

By contrast, there are organizations for Catholic women, but they pale in comparison to the tsunami of secular information that paints the pro-choice woman as stylish, smart, and happy, while Catholic women are frequently depicted as out-of-touch, poorly educated, and door-matty. Far too many have bought into this narrative.

Truly supporting and cultivating healthy Catholic women needs to become a priority, with the reminder that simply by living and sharing the faith, WE are evangelizing. We need to go on the offense instead of always feeling like we are merely defending the faith. We need to know that our homes, our families, our warmth, and compassion are gifts to the culture and that they are beautiful, compelling, and vitally important. How much easier it is to share the faith when we realize it isn’t something to be hidden or ashamed of, but an incredible gift to be shared.

This was the approach I took with my co-authors, Noelle Mering and Legate Megan Schrieber, in our book, Theology of Home. Women love the visual, coupled with engaging content, as evidenced by the still-robust print magazine industry. Historically, there has been no greater patron of the arts than the Church. Additionally, years of philosophy and theology ensure that we can answer the questions of why and not just how to live and love. We would love to see more projects like this proliferate to truly give women alternatives beyond the checkout stand.

Catholic women can do the important and rich work of evangelizing; we just need to be reminded that it isn’t what we think it is, and we aren’t who they say we are.

CARRIE GRESS has a doctorate in philosophy from The Catholic University of America. She is the author of seven books, including her most recent, The Anti-Mary Exposed and Theology of Home. Carrie is also the editor of the online women’s magazine, TheologyofHome.com. Expecting her fifth child, Carrie and her family live in Virginia.

Leaders, opt for patience over tolerance

Truth be told, among all the types of Catholic leaders we provide training and formation to, my favorite to work with are seminarians. I’m inspired by their authentic zeal, and despite the seeming narrowness of their perspective, I am grateful for their desire to probe and challenge in order to understand the landscape in which they will, God willing, one day serve. One bright seminarian this year asked me, “Sum it up for us. What’s the biggest leadership challenge you see in the Church.” I answered, “Too much tolerance for mediocrity.” There were head nods and smiles. Then I continued, “And too little patience for people.” Their faces turned from feeling affirmed to feeling challenged.

In my 15 years of serving bishops, priests, deacons, and lay leaders in over 100 dioceses, this is the biggest tension I see at every level and I think it is also applicable for Catholic CEOs (and not only CEOs of Catholic organizations).

Let’s be clear: tolerance and patience are not the same. Tolerance, and especially tolerance for mediocrity, is a test of how much pain we can endure and how much pain we are willing to inflict on others for the sake of not having to change. I see it constantly. I can’t tell Sally she’s rude, that would hurt her feelings. We can’t start that project over, we’ve spent so much time already. We have to keep the pianist, he’s been with us forever. We wait, we complain to others, we wish the person would just leave, and the situation only gets worse. Because not only does the person or people who are the source of the challenge continue to create challenge, other people — especially top performers — become disillusioned, frustrated, and begin to plot their exit or start to exit mentally. Tolerance is often a nefarious condition. While we think we are maintaining, we really are losing.

And yet the other side of the coin can be just as dangerous. We lack patience for the people we lead and serve. We don’t understand why they “don’t just get it,” or we muster the courage to give them some direct feedback and after one conversation, they still don’t change. How dare they! People don’t respond to things in the way we expect. When they don’t seek the truth or understand the context, our impatience turns to frustration, our frustration into malaise or anger, and we tell ourselves “they’re just not worth it. It’s just not worth it.”

Tolerance is a trap. Patience is a virtue. As CEOs we need to be vigilant against tolerating mediocrity in our workplace culture. If we don’t, we begin a race to lowest common denominator which will always result in failure to our bottom lines and more importantly failure to our people who deserve better. Yet as we engage in those hard conversations and challenge assumed constraints, we are called to do so with great patience. Patience not only speaks to who we are, it speaks to who we believe others have the potential to be. It speaks to how much we believe they too are made in God’s image and likeness.

As ambassadors for Christ in the marketplace, one of the most effective things we can do to proclaim the Gospel is to remove the false choice between truth and love. Love is truth. Truth is love. True love and real truth require us to challenge patiently. Lowering the bar will never allow us to achieve our goals. Neither will expecting others to raise the bar without our help. We need only look to our ultimate model of leadership, Jesus Christ, for the playbook as to what it looks like to love people patiently, painfully to the truth.

DAN CELLUCCI is the CEO of the Catholic Leadership Institute (www.catholicleaders.org) which provides leadership training and support to Church leaders throughout the world. Dan is a frequent speaker to Legatus chapters

Is it always better to give? Ethical challenges in tissue donation

It is common for people to be invited to register as an organ and tissue donor at the same time, often in the context of getting or renewing a driver’s license. To agree to both might appear to be a similar, easy decision. However, Christians should discern with care before agreeing to be a tissue donor, or in donating their bodies for research, as there are unique ethical issues involved in each.

Organ donation – of kidneys, livers, hearts, and lungs – is generally well regulated, ethically delineated, and understood by the public in the U.S. The 1984 National Organ Transplant Act makes it illegal to buy or sell human organs, establishes a framework for fair distribution, and even states that “human body parts should not be viewed as commodities.” The Catechism states that “Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity.”

Tissue and body donation after death, however, differ in two key respects, with the result that ethical abuses are more likely. Tissues, human bodies, and body parts can be bought and sold at a profit, by for-profit companies and such transactions, and the treatment of these bodies and tissues are much less closely regulated when they are regulated at all.

Donations of human tissue, such as corneas, skin, tendons, and bones help many patients in need. Over 40,000 cornea transplants each year help people to see (I myself received a cornea transplant). Many burn victims benefit from donated skin, and those suffering from spine or joint injuries are helped by donations of bone and tendons. However, because human tissue can be sold for a profit, some donated tissue goes to cosmetic companies for research and products. And human skin is in such high demand for plastic surgery that sometimes it is hard for hospitals to get the skin they need to treat burn patients.

The revenues that can be generated by tissue sales are significant. In 2012, experts estimated that tissue from a single body could generate from $80,000 to $200,000 in revenue. With such amounts of money at stake, it is no surprise that financial incentives can overwhelm considerations of respect for the human body and even respect for the informed consent process. People do not realize when they agree to be an organ and tissue donor after death that their bodies can become subject to for-profit businesses and commercial enterprises.

The issues encountered in whole-body donation are similar in key respects to those of human tissue. Human cadavers have long been used to teach medical students about human anatomy and now are used to teach basic skills like intubation and to test new surgical techniques. But today human cadavers are being used for a wider range of purposes such as forensic research (by being left in forests to determine how long it takes for victims of foul play to decompose) and car crash testing (the dummies in commercials do not always provide precise-enough data). While the information gained from research can be helpful, it is essential that researchers treat the human cadavers with which they have been entrusted with dignity (including respectful disposition or burial) and that people are able to give informed consent. In a recent case, a man learned that his mother’s body was used by the military in explosives testing despite his having refused this option during the consent process. Unfortunately, given the financial incentives and lack of regulation, it appears that some companies fall far short of meeting these standards.

When deciding whether to be tissue donors, Christians should carefully investigate the institutions that will receive their bodies or tissues, the uses or goals which their donation will serve, and how their remains will be treated with dignity.

JOHN F. BREHANY, PH.D., STL, is director of institutional relations at the National Catholic Bioethics Center, and past executive director of the Catholic Medical Association.

Catholic medicine’s prophetic witness — strong prescription for secular Christianity

One of the greatest challenges of our age is what Thomistic scholar Servais Pinckaers called “secular Christianity.” In The Sources of Christian Ethics, he defines it as “the temptation to adapt to the world and its spirit in the name of sharing its values and hopes.” This is a major threat to Catholic health care. Industry standards, market consolidation, government regulations, financial realities, and medical standards apply serious pressures. Medical associations and public policies misappropriate “dignity,” “rights,” and “treatment” to encourage, demand, and even coerce participation in immoral practices like abortion, sterilization, contraception, “sex reassignment,” and physician assisted suicide. In an effort to keep Catholic ministries going in our pluralistic society, “common values” with non-Catholic entities are quickly emphasized. It becomes easy to conflate the fundamentally Christian notion of dignity with damaging secular doppelgangers.

The integrity, vibrancy, and distinctiveness of the Catholic faith as expressed in health care ministries are paramount. In its 2014 guidelines on collaboration, the Congregation for the Doctrine of the Faith noted that Saints Cosmas and Damian, physicians martyred because of their faith-driven manner of caring for the sick, are examples of the prophetic witness and evangelical spirit that should suffuse Catholic health care. This goes beyond experts identifying the technicalities of what “could be legitimate” or “hasn’t been explicitly condemned by the Magisterium.” It means refocusing on the Church’s primary mission and supreme law: salus animarum, the salvation of souls. With this goal, then-Cardinal Ratzinger’s words to his brother bishops in 1984 ring true: “morality requires not the specialist, but the witness.

The importance of witness is reflected in updates to the Ethical and Religious Directives for Catholic Health Care Services, released last year in its sixth edition by the bishops of the United States. Part Six, dealing with affiliations between Catholic and non-Catholic health care organizations, now repeatedly calls on Catholic health care leaders to consider how their decisions impact efficacious witness. For example, it must be determined whether any alignment with a non-Catholic organization, no matter how promising, “will risk undermining the institution’s ability to fulfill its mission of providing health care as a witness to the Catholic faith.” This is not a simple box to check. It demands careful consideration of the spiritual goods at stake for patients, staff, local communities, and the Church.

What are some ways Catholic health care could give prophetic witness with a view to the salvation of souls? Standards incompatible with the Christian understanding of human dignity— now encountered more frequently—must be identified and firmly rejected as harmful, physically and spiritually, to patients and society. Sound alternatives to immoral practices must be sought and promoted, along with the providers who offer them. A notable example would be fertility awareness-based methods for avoiding or achieving pregnancy, rather than contraception or in vitro fertilization. Education and resources for staff, patients, and the community should be offered, including moral and spiritual concepts. The depersonalization of care delivery—for both doctors and patients— should be minimized. Social and political influence must be directed to protecting providers and patients from unjust policies, while advancing ones that enable the Catholic vision to flourish in health care.

We are living in a challenging time for the Church and for U.S. health care, but also an exciting time. Change is happening. If Catholic health care aims to merely get along with common values, it will end up conforming to this age: the salt will lose its flavor. If it heeds the call to witness, it can help transform society according to the law of the Christ, the Divine Healer.

JOHN A. DI CAMILLO, PH.D., BE.L., is a staff ethicist at The National Catholic Bioethics Center in Philadelphia. He earned his bioethics doctorate and licentiate degrees at the Pontifical Athenaeum Regina Apostolorum in Rome. He lives in Lancaster County, PA, with his wife Serena and their five children.

Latest bishops’ health care directives stress Catholic witness

The ethical and religious Directives for Health Care Services, authored by the U.S. Catholic bishops, is a valuable and unique document. First published in 1971 and now in its sixth edition, this 42-page pamphlet contains specific directions for Catholic patients, physicians, and health care facilities on a wide range of moral issues. The work is divided into six sections devoted to the topics of social responsibility, pastoral care, the professional-patient relationship, the beginning of life, the end of life, and collaborative arrangements between Catholic and non-Catholic health care providers.

The Vatican has published a similar document, though in a very different form, called Charter for Health Care Workers. This appeared in 1994 and was revised in 2016. Remarkably, the American document preceded it by more than 20 years and has been the subject of much more intensive revisions. The two works stand in agreement, of course, but that produced by the U.S. bishops is much more practical in character, with each directive dedicated to a single point of concern; for example, directive 49: “For a proportionate reason, labor may be induced after the fetus is viable.”

Catholic bioethicists must think about how to apply these directives in particular cases. The directives therefore are a subject of constant scholarly debate and sometimes receive different interpretations, but what is noteworthy is that such detailed moral guidance is available. No other religious tradition has such a resource. The existence of the directives reflects the long-standing concern within the Catholic Church for resolving medical-moral questions. Though designed for Catholic health care centers, every Catholic would be well advised to have some knowledge of this small but important booklet because all of us will likely face some serious medical question during our lifetime.

The most recent revision introduces changes only to the last section, “Collaborative Arrangements with Other Health Care Organizations and Providers.” As everyone knows, we live in a time of intense competition among health care centers. The pressure for consolidation and the need to find collaborative partners is common for Catholic institutions as well. These arrangements can be very complex and often pose significant moral challenges. The secular world does not see the human person in the same way as does the Catholic Church. Indeed, the writing of the directives first became necessary when mainstream medical practice diverged in significant ways from what was once the nation’s common moral code.

The most striking change in the sixth edition is its emphasis on “witness.” The new edition stresses that Catholic health care institutions must be able to maintain their witness to Christ and His saving mission in any collaborative venture with a non-Catholic partner. This may seem an obvious point, but health care delivery is big business and the pressure to conform to a secular worldview is enormous. When millions of dollars are at stake — not to mention hundreds, if not thousands of employees’ jobs — tremendous courage is needed to negotiate agreements that are not only financially attractive for the Catholic party but that also preserve the Christian mission to act as a witness to the faith.

Caring for the sick is one of the mandates of Christ, but this aim can also be achieved incidentally by secular institutions whose primary aim is often the mammon of corporate profit rather than the mercy of corporal works. There are many who labor in health care who are not Christians and some who have no faith at all. They do not witness, despite the fact that they share in our mission of healing. We work alongside them, but as Christians we know that all things in this life are ordered to the next. The call to witness makes the presence of Christ known to the world so that this message of salvation can be heard.

EDWARD J. FURTON, PH.D., is director of publications for the National Catholic Bioethics Center (Philadelphia), and among its team of seven ethicists. He’s editor-in-chief of NCBC’s award-winning National Catholic Bioethics Quarterly and Ethics & Medics.

Catholics must be well-trained, operative citizens

“Render to Caesar the things that are Caesar’s and to God the things that are God’s.” Following Christ’s command requires Catholic citizens to know “Caesar” and comply with Caesar’s just commands.

Salvation history shows that God often relied on leaders who knew how civil governmentworked.

Joseph, whose brothers sold him to merchants, was imprisoned and later rose in importance in the government of Egypt to become second in authority under Pharaoh. Joseph’s position enabled him to save the fledgling chosen people from death by famine.

Moses, who was adopted by Pharaoh’s daughter, learned first hand of the operations of the Egyptian government in Pharaoh’s household. That knowledge was critical to the Hebrews leaving Egypt.

When St. Paul was in a fight with the Jewish Sanhedrin to preach Christ crucified, he convinced the Roman governor, Festus (who wanted to turn Paul over to Jewish authorities), that he was a Roman citizen who could appeal to Ceasar to decide the dispute.

Philadelphia Archbishop Charles Chaput noted, “Catholics need to wake up … What we’re watching emerge … is a new kind of paganism, and atheism … and … it is neither tolerant nor morally neutral.” (Public Discourse, 1/24/12)

Anti-Christian zealots are working to prevent the Church from finding families for orphans which it has been doing for nearly 2,000 years until the current imposition of LGBT demands. Now, nine states and Washington, D.C. (96 million people) have laws/policies that require faith-based agencies to place children for adoption or foster care with homosexual couples or have their adoption licenses revoked.

The Church’s social doctrine states, “No power can abolish the natural right to marriage or modify its traits and purpose. Marriage in fact is endowed with its own proper, innate and permanent characteristics,” but the 2015 Obergefell Supreme Court decision assumed that sodomy and other disordered behaviors constitute the predicate for same-sex “marriage.”

In 2017, Sen. Diane Feinstein (D-CA) criticized federal Court of Appeals Trump Appeals Court nominee Amy Barrett, a Catholic, because “many of us … have this very uncomfortable feeling [that] … in your case … the dogma lives loudly within you. And that is a concern …” Apparently, killing roughly 60 million children under the Supreme Court’s 1973 abortion ruling is not a concern for Sen. Feinstein.

Planned Parenthood, LGBTQ activists, socialists, and others are pressuring school boards, courts, state legislatures, and Congress to remove Christians from the public square as was done in the Soviet Union by Joseph Stalin, in China under Chairman Mao, in Germany under Adolph Hitler, and in Mexico under Plutarco Calles.

Abandoning government to secular atheists has dire consequences for our families, friends, country, and the Church. A Woodrow Wilson Foundation poll of 1,000 American citizens found only 19 percent of those 45 or under would pass the citizenship naturalization test. Citizens hostile to the natural law who are ignorant of the Constitution and its due process requirements are easily led by demagogues.

So, starting with our own example and families, we must teach our children to be well-trained citizens knowing how laws are made and elections are won to better defend the “Laws of Nature and Nature’s God” in the public square as our Founders did.

Pope Pius XI (1937) told German parents, “none can free you from the responsibility God has placed on you over your children. … the eternal Judge … will ask. ‘Where are those I confided to you?’”

To love our neighbor we must be the leaven of America, the light of the world, and the salt of the earth as Christ told us, or we will be trampled underfoot by growing, angry mobs.

ROBERT MARSHALL was a member of the Virginia General Assembly from 1992 to 2018, and is the author of Reclaiming the Republic: How Christians and Other Conservatives Can Win Back America. Email him at robertgbobmarshall@gmail.com.

Christmas and the inversion of the family

The most accurate word to describe Christmas is “Nativity.” More than anything else, Christmas is about a birth, the birth of Christ. While this simple fact has occupied a comfortable place in the Christmas tradition, its revolutionary implications might remain hidden to many people. Nonetheless, Christmas has had a decisive revolutionary impact on the ordering of the members of the family.

Pater familias, “father of the family” or “owner of the family estate,” according to Roman law, gave the father autocratic authority over his family. In the family hierarchy, the father came first, the mother a distant second, and the child a far distant third. In contrast to pater familias, the Nativity was revolutionary in that it placed the child first, the mother a close second, and the father a comfortable third. The various images of the Madonna give the Christ- child a centrality, while Joseph is often absent. Mary nourishes, Joseph protects, but the Christ- child, who elicits these virtues, is the centerpiece. The Holy Family inverts the order of pater familias and gives the child a status of pre-eminence.

The Nativity is also a celebration of life, for a new life comes into the world amid widespread rejoicing. It truly brings joy to the world. The shepherds kneel in adoration of the Christ-child, virtually ignoring, though not disrespecting, the parents. Even the angels sing their praises to the newborn. It is not Mother’s Day nor Father’s Day that is celebrated, but the Nativity.

The Nativity affirmed the primary importance of the child. This notion had a deep impact on human history. King Lear, in a moment of uncontrollable rage, pronounces the greatest curse he can imagine on his daughter, Goneril: “Hear, Nature, hear, dear goddess, hear! Suspend thy purpose if thou didst intend to make this creature fruitful. Into her womb convey sterility. Dry up in her the organs of increase, and from her derogate body never spring a babe to honor her” (Act 1, Scene 4). Here, though stated in the negative, is a powerful testimonial to the importance of new life and how it brings joy and fulfillment to a woman. Love always has a forward motion. It does not hold back. It overcomes obstacles and reaches out to new life. Honoring and embracing the Christ-child is an acceptance of the mystery of love and the rewards it confers.

When we look at the contemporary world, we are witnessing a loss of that proper hierarchy of the family in which the child has pre-eminence. The abortion mentality accords the mother absolute dominion over her child, while the father holds, tenuously, to a distant second place. In many instances the child is downgraded into a subhuman. One example from a university textbook entitled Sociology more than illustrates the point. In referring to the neonate, the author writes: “The physical care, emotional response, and training provided by the family transform this noisy, wet, demanding bundle of matter into a functioning member of society.” King Lear retained enough mental clarity not to wish that his daughter would never deliver a “bundle of matter.”

The title of this brief essay employs the word “inversion.” This word is appropriate in relation to pater familias which had viewed the family upside down. A more precise term, however, is “conversion,” for the order of the Holy Family is a conversion from error to truth, from the unholy to the holy, and remains with us forever as the proper hierarchic model of all human families, perhaps more needed in our own time than ever before in human history.

DR. DONALD DEMARCO’S latest book is Apostles of the Culture of Life (TAN Books), and he has also released the recent title, Why I am Pro-Life and Not Politically Correct. He is a senior fellow of Human Life International, professor emeritus at St. Jerome’s University (Waterloo, Ontario), adjunct professor at Holy Apostles College (Cromwell, CT), and regular columnist for St. Austin Review.

On the virtue a philanthropist needs

Suppose a virtuous man inherits a large sum of money. Formerly he lived hand-to-mouth, with only enough cash to meet his daily needs. But he was virtuous in how he used his money, giving or lending when appropriate; not hoarding; not wasting. In this daily use of money, the virtue which came into play was “generosity” (or “liberality,” as it was traditionally called). But now, after he has received his large inheritance, he can easily spend money on a grand scale. He can buy and decorate a house, for instance, or build a church. Are there right and wrong ways of doing this, of spending money on a grand scale? If so, does he need to acquire a new virtue, or is his old virtue of “generosity” enough?

These questions probably sound odd to you. But they were natural for St Thomas Aquinas to ask. He viewed virtues as powers which enabled someone to act well with regard to certain classes of things, in specific circumstances. So it was natural to ask if a virtue which was sufficient in small matters carried over into large matters – as if someone were to ask, suppose I can drive a small car, will that same skill enable me to drive a large truck?

In the case at hand, St. Thomas followed Aristotle and held that, yes, there is a distinct virtue which we specifically need when we are spending money on a grand scale, which is called “magnificence.” Like every virtue, magnificence finds the mean between an error involving excess and an error involving deficiency. When we go to excess in a grand expenditure, we err through “extravagance”; when we are deficient in some way, we err through “niggardliness” or “penny-pinching.

The standard of rightness is different in large expenditures. In the small expenditures of daily life, what matters in our use of money is basically captured by the concept of a budget. We should not spend money that we do not have, or spend money on something not proportionate to its importance and value. Whether it was right to spend $50 on a bottle of wine depends upon rules which involve analogies and comparisons (if $20 for an 88-point wine makes sense, then probably $50 for a 95-point wine makes sense).

But for large expenditures, the nature of the work itself sets a standard. If a mansion in Port Royal, Naples, is to be decorated, the stateliness and setting of the building set a standard for the expenditure. One is not free to improvise for oneself. If a wedding is to be hosted for financiers in mid-town Manhattan — rather than, say, for shopkeepers in Albany — the nature of the event sets the standard. In these cases a different virtue is needed beyond generosity, one which senses the “greatness” of the expenditure and exemplifies good grace and taste.

The high point of magnificence is some expenditure for God’s glory, as St Thomas says: “The intention of magnificence is the production of a great work. Now works done by men are directed to an end: and no end of human works is so great as the honor of God: wherefore magnificence does a great work especially in reference to the Divine honor.”

When I was at Ave Maria University, I taught a course on ethics which met on a patio overlooking the buildings and oratory. Once we were discussing the virtue of magnificence. “Look around you,” I said, “What character do you need to do this sort of thing?” At that moment, magnificence was not a theory for them but something real.


MICHAEL PAKALUK is professor of ethics at the Busch School of Business at the Catholic University of America and an Ordinarius in the Pontifical Academy of St. Thomas Aquinas. He lives with his wife, Catherine, a professor of economics at the Busch School, and seven of their children in Hyattsville. He is author of many books and articles, both scholarly and popular. His new translation and commentary on the Gospel of Mark, The Memoirs of St. Peter, is forthcoming from Regnery Gateway

Discerning neuroethics amid new challenges in bioethics

The field of neuroethics is relatively new, having been formally inaugurated at a conference only in 2002. Neuroethics was created because of new questions and concerns arising out of the rapidly developing fields of neuroscience and neurotechnology. Scientists have been making significant progress in observing previously unobservable operations of the brain. And technologies with the potential to heal, interact with, and perhaps even control elements of the human brain and behavior are rapidly becoming available.

Scientists have long understood that there is a connection between the normal and injured brain, and distinctive human behaviors. One of the first insights into this connection came in the strange case of Phineas Gage, an American railroad worker who was terribly injured in 1848. When Gage used an iron rod to tap down a charge of gunpowder, a premature explosion shot the rod through his cheek and out the top of his head, passing through his left frontal lobe. Gage survived the accident, but his personality underwent a total change. Gage went from being a quiet, even-tempered man to a being a rude man who often indulged in profanities. Since then scientists have sought to better understand the structure and functioning of the brain.

From the late 20th century, cutting -edge technologies have begun fulfilling these aspirations. The use of functional magnetic resonance imaging (fMRI) — using magnetic waves as a kind of “radar” to track the electrical impulses of neurons in the brain — is among the most important. fMRI has been used to learn whether patients in profound states of unconsciousness (a.k.a. PVS) have any awareness (short answer: “probably yes”). fMRI also has been used to locate a part of the brain which appears to be active when people make moral judgments, and then to experiment with disrupting the neurons to see if it changes people’s ability to make those moral judgments. A more recent experiment with animals involves seeding their brains with “neural dust” — hundreds of sensors the size of a grain of rice to monitor brain activity. With emerging nanotechnology, scientists hope to shrink these sensors to a microscopic size and use them to stimulate the brain in various ways to obtain some desired result.

What should Catholics be thinking and doing as the fields of neuroscience and neuroethics develop? They should find ways to become engaged, affirming the good work being done, identifying the potential for abuse, and seeking to keep all of the knowledge and power gained within a framework of Christian anthropology. Advancing a Christian anthropology at this time is critical because trends in neuroscience can support some approaches to the human person which are potentially harmful, such as thinking that humans are essentially machines or objects, or that the soul is nothing but complex matter.

Apart from integrating neuroscience and neuroethics with the Church’s understanding of the dignity of the human person, and with the main tenets of the moral tradition, Catholics should be engaged as new opportunities and issues arise. For example, Catholics should be encouraged to enter these fields, to better understand and help human persons. St. Augustine famously said that “A good and true Christian should realize that truth belongs to his Lord, wherever it is found, gathering and acknowledging it even in pagan literature, but rejecting superstitious vanities . . .” Catholics should feel free to participate in well- designed, safe, and ethical research projects. They should learn the science and skills necessary to use neuroscience for legitimate ends, and then prioritize applications related to healing significant illness and injuries, such as epilepsy, strokes, and significant states of unconsciousness.
The challenges to life and human dignity are not going to diminish. But we can help to improve the field of neuroethics so that neuroscience and neurotechnology contribute to human flourishing in the orders of Creation and Redemption.

JOHN F. BREHANY, PH.D., STL, is director of institutional relations at the National Catholic Bioethics Center (Philadelphia) and past executive director of the Catholic Medical Association.

Alfie Evans Case — poster-child for health care ‘best interest’

Two months ago, the British court senselessly ordered two-year-old Alfie Evans to be taken off life support, despite his parents’ desperate pleas and a worldwide outcry. In the aftermath of Alfie’s government-mandated death, many of us are asking whether our government has the power to determine when life is simply too burdensome to justify saving. But with the federal government’s waning influence over individual health care as a result of the weakening of Obamacare regulations, another question arises: Whether the health care providers and insurance companies could trump the rights of families in cases like Alfie’s. After all, in many cases, providers and insurance companies do have the power to ration health care. The degree to which they do is up to us.

Currently, the federal government prohibits hospitals from withholding or withdrawing infant life support. There are, however, three exceptions. Life support may be withdrawn if: (1) the infant is chronically and irreversibly comatose; (2) life support would merely prolong dying or be futile in terms of the infant’s survival; or (3) the life support itself, under the circumstances, would be inhumane. These exceptions can give doctors too much power to make end-of-life decisions. Given the possibility of coercion or undue influence on parents, the current system is set up for an Alfie Evans-like tragedy here in America.

Moreover, many in the medical profession, including the American Academy of Pediatrics, are advocates for the “best interest standard,” which gives doctors the ability to make arbitrary decisions about what is in the best interest of infants. The standard does give parents a role in the decision making. However, parental rights can be seriously compromised by health care providers and insurance companies that may pressure parents to make the more “economical” choice under the guise of an infant’s “best interest” and against the backdrop of skyrocketing hospital bills.

Another source of pressure can come from hospital “ethics committees,” which many consider to act like “death panels.” For example, the Texas Advance Directives Act empowers hospital administrators to arbitrarily withdraw or withhold care, regardless of the reason and the patient’s condition. The danger of the Texas law is illustrated in the case of Christopher David Dunn. In that case, a “bioethics committee” ruled that a 46-year-old man’s life was not worth living, and it therefore withdrew his life support. His family vigorously pleaded for his life to no avail. While many have defended such committees as an appropriate way to strike a balance between the patient’s right to life and the medical professionals’ reasonable end-of- life treatment, the potential for abuse is enormous. Indeed, many ethics committees have little guidelines and accountability; and, with the pressure of insurance companies and other health care providers, the risk of exploitation is very real.

Most agree that prolonging a painful process of dying for a terminal patient is inhumane, and they argue that doctors should not be forced to provide such treatment. Moreover, there is no constitutional right to receiving medical care paid for by others. But, as advocates for life, we must be vigilant in ensuring that health care providers and insurance companies do not have the arbitrary power to decide if one life is worth more than that of another. Furthermore, the withholding of food and hydration to a patient in need of it can never be morally justified. This is in keeping with the mission of faithful Catholics, who started the hospital system long ago based on the belief that nothing is worth more than the life of a person created in the image and likeness of God.

ATTORNEY CHARLES S. LIMANDRI is a past member of the Legatus board of directors and a recipient of the Legatus “Ambassador of the Year” award. He is the president and chief counsel of the Freedom of Conscience Defense Fund (www.FCDFlegal.org).