News and Commentary from the NCBC

Cardinal Donald Wuerl, Vice-chair of the NCBC, Addresses the Law Suit Filed by the Archdiocese of Washington Against the HHS Mandate

Fri, 01 Jun 2012 20:28:00 GMT

Joining with 43 Catholic agencies, engaged in the numerous ministries of the Church, the Archdiocese of Washington is suing the U.S. Department of Health and Human Services (HHS) for violating the Bill of Rights of our Constitution, which protects the free exercise of religion. On May 21, 2012 a total of twelve lawsuits were filed in various jurisdictions of the United States, representing these 43 Catholic ministries. Cardinal Wuerl empathized that the issue is not about contraception, readily available at little or no cost throughout the United States, but about religious liberty. He rightly asserts that this mandate’s religious exemption is the narrowest ever adopted in federal law, citing how it does not include Catholic hospitals, schools and social service program. As Cardinal Wuerl states: “The Catholic faith finds its fullest expression in a loving act of sacrifice by one stranger for another.” He explained: “Imagine the church’s surprise, then, to be told by the federal government that when a Catholic organization serves its neighbors, it isn’t really practicing its religion.” To read his complete Op Ed , see http://www.washingtonpost.com/opinions/protecting-our-catholic-conscience-in-the-public-square/2012/05/23/gJQAj05XkU_story.html.

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Call to Action: Stop the Violation of the Right to Religious Liberty

Mon, 30 Apr 2012 17:23:00 GMT

Last August, the U.S. Department of Health and Human Services (HHS) mandated that under the Patient Protection and Affordable Care Act almost all private health plans are to include with no co-pay “preventive services for women.” These “services” will include sterilization, all FDA-approved birth control (such as the IUD, Depo-Provera, ‘morning-after’ pills, and the abortion-inducing drug Ella), and the “well-women preventive visits,” described as including prenatal screening for genetic or developmental conditions (thus, potentially “preventing” the birth of babies deemed unfit eugenically, since there are presently no available prenatal treatments for most of these conditions). The HHS exemption for a religious employer is so narrow that it is virtually meaningless. Despite an outcry from persons who respect our United States Constitution, on February 10 President Obama adopted this policy as a final rule “without change” (Federal Register, 2/15/12, 8725). Religious organizations which cannot qualify for the exemption will have an extra year to comply; but before the end of that period, an additional rule will be issued to make sure that their employees receive the mandated coverage despite the employer’s objection.

Furthermore, on March 21, 2012, HHS issued a notice proposing additional rulemaking, in which the Administration suggests various ways the new mandate can be applied to religious organizations (Federal Register, 3/21/12, 16501-08). The public has until June 19 to submit comments. The fundamental legal and moral concerns about government intrusion into religious ministries are not addressed. Whatever funding and administrative mechanisms are ultimately chosen, many religious institutions that serve the common good will be forbidden to provide their own employees or students with health coverage consistent with their values.

In response to the HHS mandate, the United States Conference of Catholic Bishops’ (USCCB) Ad Hoc Committee for Religious Liberty released an Easter week statement titled “Our First, Most Cherished Liberty.” The document outlines recent threats to religious liberty in the United States and abroad, while endorsing an upcoming “Fortnight for Freedom” to defend “the most cherished of American freedoms.” It states that “To be Catholic and American should mean not having to choose one over the other.” It continues with an excellent historical review, which begins in 1634 with Maryland’s “experiment in religious toleration” under Catholic Lord Baltimore, and continues that historical review to the present day. The USCCB cautions that we are to learn from history, pointing to when the Colony of Maryland was placed under royal control, and the Church of England became the established religion. Catholics lost political rights, Catholic chapels were closed, and Catholics were restricted to practicing their faith in their homes. The Catholic community lived under these conditions until the American Revolution. However, with the ratification of the United States Constitution, and three years later the ratification of the Bill of Rights, which recognized as the first liberty, religious freedom, religious liberty slowly began to flourish. Thus, by 1887 the Archbishop of Baltimore, Cardinal James Gibbons could report to the Holy See on the great progress the Catholic Church had made in the United States, which he attributed to the "civil liberty we enjoy in our enlightened republic." Indeed, he made a bolder claim, namely that "in the genial atmosphere of liberty [the Church] blossoms like a rose." [Cardinal James Gibbons, Address upon taking possession of Santa Maria in Trastevere, March 25, 1887.] Yet, we are witnessing the erosion of these essential liberties with the recent attacks by our government including: the HHS mandate for contraception, sterilization, and abortion-inducing drugs; state immigration laws; efforts to alter Church structure and governance; discrimination against Christian students on campus; revoking the ministries of Catholic foster care and adoption services; discrimination against small church congregations; and discrimination against Catholic humanitarian services. The USCCB cautions that “religious liberty requires constant vigilance and protection, or it will disappear.”

In recognition of the struggles for religious liberty around the world, even leading to martyrdom, the USCCB highlights how Catholics in America cannot defend the martyrs of our day abroad if we allow the violation of our own religious liberty:

If religious liberty is eroded here at home, American defense of religious liberty abroad is less credible. And one common threat, spanning both the international and domestic arenas, is the tendency to reduce the freedom of religion to the mere freedom of worship. Therefore, it is our task to strengthen religious liberty at home, in this and other respects, so that we might defend it more vigorously abroad. To that end, American foreign policy, as well as the vast international network of Catholic agencies, should make the promotion of religious liberty an ongoing and urgent priority.

The Bishops are calling for a Fortnight for Freedom: specifically that the fourteen days from June 21—the vigil of the Feasts of St. John Fisher and St. Thomas More—to July 4, Independence Day, be dedicated to a great hymn of prayer for our country. They point out that during this period our liturgical calendar celebrates a series of great martyrs who remained faithful in the face of persecution by political power—St. John Fisher and St. Thomas More, St. John the Baptist, SS. Peter and Paul, and the First Martyrs of the Church of Rome. Culminating on Independence Day, this special period of prayer, study, catechesis, and public action would emphasize both our Christian and American heritage of liberty. For more information see http://www.usccb.org/issues-and-action/religious-liberty/our-first-most-cherished-liberty.cfm.

In Congress, the Respect for Rights of Conscience Act (H.R. 1179, S. 1467) would ensure that those who participate in the health care system “retain the right to provide, purchase, or enroll in health coverage that is consistent with their religious beliefs and moral convictions.” On March 1, the Senate voted to table this bill when it was presented as Senate Amendment 1520 to the Transportation Authorization Bill (Vote Number 24). We need to urge Congress to pass the Respect for Rights of Conscience Act, and restore our fundamental right to religious liberty.

Thus, this Call to Action requires that our voices be heard on two fronts: at HHS regarding the March 21 rulemaking notice and in Congress with a message in support of the Respect for Rights of Conscience Act. To have your voice heard go to: http://nchla.org/actiondisplay.asp?ID=292.

For more information on religious liberty and conscience rights, see: www.usccb.org/conscience.

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A Primer on the HHS Preventive Services Mandate

Thu, 29 Mar 2012 20:22:00 GMT

Archbishop William E. Lori, newly appointed Archbishop of Baltimore, and Chair of the U.S. Conference of Catholic Bishops’ Ad hoc Committee on Religious Liberty, has produced an excellent primer on the U.S. Health and Human Services’ mandate. This mandate will force employers to violate conscience and religious beliefs by requiring employers to pay for contraceptives and abortifacients for their employees. The primer is available on the web page of the Bridgeport Diocese, for which Archbishop Lori remains Apostolic Administrator until his installation as Archbishop of Baltimore, MD on May 16, 2012. See: http://www.bridgeportdiocese.com/files/fcc-pdfs/Acalltocatholics.pdf. The NCBC urges all to read this clear explanation of the implications for all Americans of this mandate. Furthermore, this document corrects the false information, provided by some advocates for the violation of natural moral law by the Catholic Church, that the so-called “accommodation” by the White House has rectified these violations of the First Amendment of our precious U.S. Constitution.

The National Catholic Bioethics Center Joins Other Organizations Committed to Protecting the Rights of Conscience in a Friends of the Court Brief

Wed, 28 Mar 2012 17:40:00 GMT

On Friday, March 23, 2012, an amici curiae brief was filed in the Appellate Court of Illinois, Fourth District, in support of the conscience rights of pharmacists and pharmacies, violated by a ruling (Rule) by the State of Illinois [68 Illinois Administrative Code, Section 1330.91(j)]. This Rule mandated that pharmacists and pharmacies stock and dispense emergency contraceptives, such as Plan B and other potentially abortifacient drugs. The National Catholic Bioethics Center, in signing on to this brief, was joined by the Christian Legal Society, the Catholic Medical Association, the Illinois Catholic Conference, the Christian Medical and Dental Associations, and the Christian Pharmacists Fellowship International. These organizations are asking the court to uphold the order of the Circuit Court of the Seventh Judicial Circuit, Sangamon County, Illinois [Morr-Fitz, Inc. v. Blagojevich, No. 05CH495 (Ill. 04/5/11)], which affirmed the rights of religious liberty and conscience of pharmacists and pharmacies unwilling to dispense abortifacient drugs, pursuant to the Illinois Religious Freedom Restoration Act and the Illinois Healthcare Right of Conscience Act. This Circuit Court decision, and these rights of conscience and religious liberty, are being challenged by the State of Illinois, which is refusing to recognize its own laws which respect conscience and religious liberty. In signing on to this brief, Dr. John Haas, President of the NCBC, stated: “On numerous fronts, the very foundational principles upon which this great United States were founded, are being assaulted. Religious liberty and rights of conscience are not privileges, but rights, which no government can violate. The mandates being imposed by the federal government on faith based employers for insurance coverage, as well as by state governments as exemplified here, are subjecting persons of faith to bias and discrimination in employment, business practices, and in engaging in the charitable works that are foundational to the tenets of their faiths. When such discrimination occurs, every American is at risk.”

For more information click to read a press release prepared by the Christian Legal Society.

Religious Freedom from a Founder's Perspective

Wed, 14 Mar 2012 18:15:00 GMT

The National Catholic Bioethics Center posts here Thomas Jefferson’s "Virginia Act for Establishing Religious Freedom," drafted in 1779, and passed by the Virginia Assembly in 1786. The document is recognized as one of the most important precursors to the religion clauses of the First Amendment to the U.S. Constitution. The statement of principle enunciated by Jefferson, especially as summarized in the second to last paragraph, is of particular relevance today.

The administration’s claim that is has the authority to define what is and what is not a religious institution is a violation of the letter and the spirit of this great document. The First Amendment states that "Congress shall make no law respecting an establishment of religion or prohibiting the free exercise thereof." Roman Catholicism is an establishment of religion, and so protected under this amendment, but that has not stopped the U.S. Congress from passing a law, namely, the Affordable Care Act, which the president and the agencies under his executive authority have used to declare that Catholic hospitals, charities, and educational institutions are not religious institutions. A religious institution, according to this administration, is defined as one that hires and ministers solely to members of its own faith. Not only is this a false understanding of the Christian religion, which no member of that faith would recognize, but more importantly, it is not the province of the federal government to make such judgments. That authority has not been given to the Congress under our Constitution. Neither, therefore, does it belong to the president, regardless of whatever laws the legislative branch may enact to the contrary.

Whether the Affordable Care Act will survive judicial scrutiny, we are not qualified to say, but we are certain that it would not survive the scrutiny of America's greatest champion of religious liberty.

The Virginia Act for Establishing Religious Freedom
Thomas Jefferson, 1786

Well aware that Almighty God hath created the mind free; that all attempts to influence it by temporal punishments or burdens, or by civil incapacitations, tend only to beget habits of hypocrisy and meanness, and are a departure from the plan of the Holy Author of our religion, who being Lord both of body and mind, yet chose not to propagate it by coercions on either, as was in his Almighty power to do; that the impious presumption of legislators and rulers, civil as well as ecclesiastical, who, being themselves but fallible and uninspired men, have assumed dominion over the faith of others, setting up their own opinions and modes of thinking as the only true and infallible, and as such endeavoring to impose them on others, hath established and maintained false religions over the greatest part of the world, and through all time; that to compel a man to furnish contributions of money for the propagation of opinions which he disbelieves, is sinful and tyrannical; that even the forcing him to support this or that teacher of his own religious persuasion, is depriving him of the comfortable liberty of giving his contributions to the particular pastor whose morals he would make his pattern, and whose powers he feels most persuasive to righteousness, and is withdrawing from the ministry those temporal rewards, which proceeding from an approbation of their personal conduct, are an additional incitement to earnest and unremitting labors for the instruction of mankind; that our civil rights have no dependence on our religious opinions, more than our opinions in physics or geometry; that, therefore, the proscribing any citizen as unworthy the public confidence by laying upon him an incapacity of being called to the offices of trust and emolument, unless he profess or renounce this or that religious opinion, is depriving him injuriously of those privileges and advantages to which in common with his fellow citizens he has a natural right; that it tends also to corrupt the principles of that very religion it is meant to encourage, by bribing, with a monopoly of worldly honors and emoluments, those who will externally profess and conform to it; that though indeed these are criminal who do not withstand such temptation, yet neither are those innocent who lay the bait in their way; that to suffer the civil magistrate to intrude his powers into the field of opinion and to restrain the profession or propagation of principles, on the supposition of their ill tendency, is a dangerous fallacy, which at once destroys all religious liberty, because he being of course judge of that tendency, will make his opinions the rule of judgment, and approve or condemn the sentiments of others only as they shall square with or differ from his own; that it is time enough for the rightful purposes of civil government, for its officers to interfere when principles break out into overt acts against peace and good order; and finally, that truth is great and will prevail if left to herself, that she is the proper and sufficient antagonist to error, and has nothing to fear from the conflict, unless by human interposition disarmed of her natural weapons, free argument and debate, errors ceasing to be dangerous when it is permitted freely to contradict them.

Be it therefore enacted by the General Assembly, That no man shall be compelled to frequent or support any religious worship, place, or ministry whatsoever, nor shall be enforced, restrained, molested, or burdened in his body or goods, nor shall otherwise suffer on account of his religious opinions or belief; but that all men shall be free to profess, and by argument to maintain, their opinions in matters of religion, and that the same shall in nowise diminish, enlarge, or affect their civil capacities.

And though we well know this Assembly, elected by the people for the ordinary purposes of legislation only, have no powers equal to our own and that therefore to declare this act irrevocable would be of no effect in law, yet we are free to declare, and do declare, that the rights hereby asserted are of the natural rights of mankind, and that if any act shall be hereafter passed to repeal the present or to narrow its operation, such act will be an infringement of natural right.

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Fight for Religious Liberty Is Not Just Catholic

Thu, 01 Mar 2012 15:17:00 GMT

Cardinal Timothy Dolan, president of the U.S. Conference of Catholic Bishops and Archbishop of New York, joined an alliance of over 500 Catholics, Protestants, Eastern Orthodox Christians, Latter-Day Saints, Jews, and Muslims in rejecting the so called accommodation by the U.S. Department of Health and Human Services (HHS) in its mandate requiring employers to pay for, either directly or indirectly, insurance coverage for abortion-inducing drugs, sterilizations, and contraceptives. The statement (available here) is entitled "Unacceptable" and has been signed by leading scholars, religious liberty advocates and religious leaders from a multitude of faiths. Its original drafters are Professor Mary Ann Glendon, of the Harvard Law School; Professor Robert P. George of Princeton; Yuval Levin, Hertog Fellow, Ethics and Public Policy Center; Professor O. Carter Snead of Notre Dame; and, President of Catholic University, John Garvey. The list of signatories also includes people from across the political spectrumCliberals, conservatives, and people fitting into neither category. This is an unprecedented coming together of people to defend religious liberty and the rights of conscience against a deeply misguided and unjust governmental action.

The Science of Dissent

Fri, 24 Feb 2012 05:58:00 GMT

We do not usually bother with the National Catholic Reporter, the newspaper of record for those who place their faith in dissent from the Catholic Church, but a recent column by Jamie L. Manson caught our eye. “What an Abortifacient Is -- and What It Isn't” (Feb. 20, 2012).

If one of the well-known truisms of ethics, as Manson avers at the beginning of her column, is that good moral judgments follow from good facts, then it should come as no surprise that one of the least-known truisms is that bad moral judgments follow from a narrow ideology.

Manson, of course, is flacking for the Obama administration. The US Bishops have come out strongly against the HHS mandate obliging all Catholic institutions to provide free contraception, sterilization, and abortifacient drugs to their employees, in violation of the First Amendment and the rights of conscience. So, naturally, the National Catholic Reporter takes the opposite side.

Manson’s aim is to show that abortifacient drugs do not have abortifacient effects. This is admittedly a difficult task. Consider the following whopper: “Now, just because an egg is fertilized doesn't necessarily mean that it will develop into an embryo. For that to happen, the fertilized egg must be implanted into the endometrium that lines the uterus.”

This is presented as "scientific evidence." I don't know where Ms. Manson purchases her scientific textbooks, but I have the feeling they are printed by the Guttmacher Institute. The National Institute of Health (part of the U.S. Department of Health and Human Services) gives us a clear definition: “Embryo: in humans, the developing organism from the time of fertilization until the end of the eighth week of gestation, when it is called a fetus.”^{^[i]} Implantation does not figure in this definition.

If a fertilized egg is not an embryo, what is it? Fertilization, according to standard medical dictionaries, results in a zygote, which is the earliest stage of the human embryo.[ii] But not for Ms. Manson. For her, fertilized eggs float in fallopian tubes, waiting for a chance to implant and then become human beings. It is a magical transformation. Of course, some of these floating non-embryos implant in the wrong place, such as the fallopian tube, resulting in an ectopic pregnancy. What are we to make of these? Are they human or just implanted balls of tissue? Manson’s science cannot provide an answer.

It is not intended to do so. No one looks to the National Catholic Reporter for scientifically-based argument. What matters for Manson and the newspaper is that the current administration be successful in its effort to force religiously affiliated hospitals, educational institutions, and charities to violate their own religious teachings. That comes first; the facts (such as they are) second.

Thus we are told that “the reality is that there is overwhelming scientific evidence that the IUD and Plan B work only as contraceptives.” The first half of her claim ignores data on the Health and Human Services own website, which states that “if fertilization does occur, the IUD keeps the fertilized egg from implanting in the lining of the uterus.”[iii] The second ignores the product labeling and package inserts that come with Plan B.[iv] But if you think science tells us that fertilization does not produce an embryo, then you have already decided to ignore the facts.

The height of this ideological effort is in Manson’s defense of ellaOne, a drug that makes the uterus hostile to the implantation of the embryo.[v] She seems to think that because women can use this drug and still become pregnant 2% of the time, it is not abortifacient. What about the other 98%? This is like saying that because some people survive airplane crashes, they are not the cause of fatalities.

She admits that "Ella is similar in composition to RU-486," the abortifacient drug, but denies that the two have similar effects. What is her evidence that similar drugs will have dissimilar effects? “Scientists argue that there is no evidence that Ella has this type of effect,” unless, of course, it is taken in sufficient quantities, for then “it could alter the lining of the uterus and theoretically impair an embryo's implantation.” So it is abortifacient, after all.

And didn't she just say that a fertilized egg is not an embryo prior to implantation? Logic is no obstacle to an ideological agenda---yet another one of those wonderful truisms.

Edward J. Furton, Ph.D.
NCBC Director of Publications

[i] See http://stemcells.nih.gov/StemCells/Templates/StemCellContentPage.aspx?NRMODE=Published&NRNODEGUID={3C35BAB6-0FE6-4C4E-95F2-2CB61B58D96D}&NRORIGINALURL=%2finfo%2fglossary.asp&NRCACHEHINT=NoModifyGuest#embryo

[ii] For a comprehensive review of standard medical definitions of “conception” and “pregnancy,” see Christopher M. Gacek, “Conceiving Pregnancy: U.S. Medical Dictionaries and Their Definitions of Conception and Pregnancy,” in The National Catholic Bioethics Quarterly, 9.3 (Autumn 2009), 543–553.

[iii] See U.S. Health and Human Services website: http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm#impdev.

[iv] The external package reads, in bold type: “this product works mainly by preventing ovulation (egg release). It may also prevent fertilization of a released egg (joining of sperm and egg) or attachment of a fertilized egg to the uterus (implantation). See consumer information leaflet.” The insert leaflet reads: "Plan B works like a birth control pill to prevent pregnancy mainly by stopping the release of an egg from the ovary. It is possible that Plan B may also work by preventing fertilization of an egg (uniting of sperm with the egg) or by preventing attachment (implantation) to the uterus (womb), which usually occurs beginning seven days after release of an egg from the ovary." The insert contains a second reference to the inhibition of implantation under the heading of "Clinical Pharmacology": "In addition, it may inhibit implantation (by altering the endometrium)." For a history of the controversy over the product labeling of Plan B, see Thomas J. Davis, Jr., “Plan B Agonistics,” in The National Catholic Bioethics Quarterly, 10.4 (Winter 2010), 741–772. The product disclosure statement resulted from the Federal Drug Administration’s concern that women would not be able to give proper informed consent about the drug’s mode of operation without information about its potential abortifacient effect. See p. 757.

[v] Again, the U.S. Health and Human Services website states that ellaOne (ulipristal acetate) “is an emergency contraceptive available by prescription which can be used to prevent pregnancy up to 120 hours (5 days) after unprotected intercourse or contraceptive failure. Thus, the potential impact on the endometrium, preventing implantation of a conceived embryo is even greater than for LNG.” (LNG is the abbreviation for levonorgestrel, the active ingredient in Plan B.) See also Marie Hilliard, “Ulipristal and Catholic Hospitals,” in Ethics & Medics 35.9 (September2010), 3–4.

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NCBC Statement on the HHS Mandates and the So-called Compromise

Thu, 16 Feb 2012 21:42:00 GMT

The National Catholic Bioethics Center (the NCBC) consistently has voiced its strong opposition to the mandate from the U.S. Department of Health and Human Services that all employers provide insurance coverage free of charge to their employees for contraceptives, surgical sterilizations, and abortifacient drugs and devices. There was widespread outrage to this measure which was seen by many as an attempt to force religious organizations to violate their moral convictions and religious beliefs by providing drugs, procedures and devices that they considered to be immoral because they violated human dignity. The opposition was so strong and from so many different quarters that President Obama proposed what he called a “compromise” on Friday, February 10. The NCBC has been involved in providing analyses of the “compromise” to its various constituents and collaborating with others involved with trying to influence public policy. As soon as the government documents were actually made available and studied, it became obvious that there was no true compromise at all but rather some slight modifications to procedure that left the substance of the mandate entirely intact. In fact, the day the “compromise” was announced, the mandate was entered into the federal register with no changes.

Since the announcement of the “compromise” organizations of varied religious beliefs and political affiliation have called upon President Obama to withdraw the HHS mandate in its entirety.

Some of the fundamental reasons the “Mandate” must continue to be opposed are:

The unacceptable definition of what constitutes a religion for protection under the constitution. HHS has determined that for an organization to qualify for a “religious” exemption it must hire and serve primarily its own co-religionists and try to convert those who do not share the same faith. This unconscionably narrow definition of what constitutes a religion would not cover the Catholic Church in its own self understanding. In other words, it would not even cover the largest religious body in the United States. It is a matter of religious belief that Catholics are commanded to serve all in need not just its own co-religionists. This goes to the heart of the teachings of the Church’s founder who told the pointed story of the man who had fallen among thieves and been left beaten by the roadside. His co-religionists passed him by, but the one who did not share his faith, the Good Samaritan, is the one who stopped to help him and bind up his wounds. Jesus told us to go and do likewise and that even as we have done a service to the least of our neighbors, we have done it to Him. It is unjustifiable for the federal government, by bureaucratic fiat, to make the arbitrary judgment concerning what organization constitutes a religion. This is one area where the mandate violates the free exercise of religion clause of the First Amendment to the Constitution.

It is often pointed out that this narrow definition of religion is in place in a number of states already. That is not accurate: there are only three states with such a narrow definition of religion, with some options for being exempt from state law, e.g., through self-insurance plans. Such options are not available under the HHS mandate. Furthermore, the Catholic Church fought these narrow definitions of religion in the states without success. Why should it simply acquiesce when they are imposed by the federal government?

The unacceptable definition of what constitutes a disease or pathology, in this case, fertility and pregnancy. Contraceptives and surgically mutilating acts such as tubal ligations are included in the Mandate as means of preventing disease rather than being seen for what they are, drugs and surgical interventions that actually destroy or render dysfunctional an otherwise healthy system of the body. Abortifacient drugs and devices are also offered as preventions for disease as though preventing an embryo from implanting in the nurturing womb of his or her mother were the prevention of a pathology. Such errors of fact cannot go unchallenged, no matter who asserts them.

The unacceptable and arbitrary shifting of an unjustifiable federal mandate from one group of citizens to another. In an attempt to forge a compromise the Obama administration first of all created a new category of citizens – those who did not enjoy the HHS religious exemption because they were not really “religious”, such as Catholic hospitals and universities, but who still had religious objections. According to the “compromise”, the proposal to be considered is that they would not have to provide insurance to cover the costs of the contraceptives, mutilations and abortifacient drugs and devices – but now the insurance companies themselves would have to provide them at their cost. Of course everyone understands that insurance companies would be certain to recover their costs through the premiums charged to the (non-exempt, but now indulged) organization that has religious and moral scruples about providing these drugs and devices. Also, no provision was made for many religious organizations who are self-insured. How are they to avoid the coercive measures accompanying the mandate, such as the heavy fines.

As the United States Conference of Catholic Bishops and many others have insisted, this mandate is a violation of the First Amendment and must be rescinded. It is also unnecessary, harmful and in violation of human dignity. Those who have embraced the mandate have ignored the constitutional questions it raises in favor of secondary issues such as women’s access to contraception under the euphemistic and misguided term “women’s health”, or the perceived good of universal health care. The moral issues related to the latter two are significant and should be addressed. This issue, however, must not be allowed to be diluted by arguments about the morality of sterilization, abortifacient drugs and devices, and contraception. Every American should feel challenged by this egregious violation of constitutional freedom.

The United States Conference of Catholic Bishops, The Christian Medical Association, The Southern Baptist Convention, some Jewish groups, the Catholic Medical Association, a group of highly regarded Catholic scholars, individual religious leaders, and many others have all decried the president’s mandate and the so-called “compromise” which leaves the mandate in place as a violation of the Constitution of the United States and potentially of the consciences of the citizens of the United States. We are pleased to provide links to what we believe are some of the best commentaries on this wrong-headed policy of the Obama administration.

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The Santorum Family and the Loss of Gabriel

Thu, 09 Feb 2012 22:20:01 GMT

One claim that has been directed toward Rick Santorum and his family on the campaign trail has been that there is a double-standard or even a hypocrisy regarding his position on abortion, because some have claimed that he would have had an abortion when his wife faced a difficult pregnancy back in 1996. Both the critics of Santorum, as well as Rick and his wife Karen, may not have fully appreciated some of the moral nuances involved in their case.

The details reported in the press included that his wife Karen was fighting an infection, which arose after she had undergone intrauterine surgery to try to correct a serious genetic defect in their unborn child. Following the appearance of the infection, antibiotics were given to target the pathology. The family discussed inducing labor, which would have involved using a drug called pitocin. This would have been done to clear out the source of the infection, surmised to be infected membranes, from her body. According to Rick, "Karen said, 'We're not inducing labor, that's an abortion. No way. That isn't going to happen. I don't care what happens.'"

What ended up happening was that she went into labor spontaneously, without being induced. When she realized it, she requested that an agent be given to block the labor so she could continue the pregnancy since the child was too young to survive outside the womb, but her physicians refused, citing malpractice concerns. Children born before 21-23 weeks are not considered viable, and their child was only in the 19^th or 20^th week of pregnancy.

Gabriel Michael Santorum was born shortly afterwards, and lived for about 2 hours.

Karen’s claim that inducing labor would be the moral equivalent of abortion is not quite correct. In circumstances where an intrauterine infection arises prior to viability, the decision to induce labor does not necessarily constitute an instance of a direct abortion, because in the absence of a suitable alternative or remedy for the infection, and with death looming for both mother and child, the physician who induces labor is seeking to clear and remove the source of the infection by acting pharmacologically on the mother's body, not the child's, through inducing the uterus to contract. One is not attacking the body of the child, as in a direct abortion (like a dilation and evacuation) where the child's body is dismembered with suction or surgical instruments. One is instead delivering the membranes, and thus, also the child, with the foreseen but unintended consequence that the child will probably die subsequently due to prematurity, and due to the other birth defects which were apparently present in the case of the Santorum's child. When no other alternatives are available, this represents a valid application of the principle of double effect, and would be morally permissible.

When interviewed about the matter, Rick Santorum was reported to have said: “The baby was going to die no matter what, and if she hadn’t already gone into labor, it would have been the equivalent of murder not to put her into labor. We did everything medically possible to save both.”

While it is clear the Santorums did indeed do everything they could to save both, Rick’s conclusion that not putting Karen into labor would be the “equivalent of murder” is not quite correct either. To choose not to put her into labor, when there would be benefit to her from doing so, could be a form of negligence, but it would not be murder if there were no evil intent.

The Santorums, clearly, were not involved in any form of a direct abortion. Unless one were to stipulate that the antibiotic was responsible for causing Karen’s labor to begin, which seems doubtful, then they were not involved in any indirect taking of life either, since the labor arose spontaneously as Karen's body reacted to the presence of the infection itself.

However, insofar as the induction of labor and the loss of the child’s life ended up resulting from the original corrective surgical intervention (and co-occurring infection), one could conclude that the Santorums were involved in the indirect and unintended loss of the life of their child because they chose to try the surgery. Because the defect of the child was extremely serious, nevertheless, there appeared to be a proportionate and justifiable reason for choosing that particular high-risk surgery in an attempt to benefit both child and mother.

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NCBC Responds to Komen's Reversal and Urges Catholics to Not Support the Foundation's Events

Fri, 03 Feb 2012 17:40:00 GMT

The Komen Foundation for the Cure has learned the hard way that you do not cross the pro-abortion lobby without suffering a swift reaction. After little more than 24 hours, Komen has reversed itself and will now provide Planned Parenthood with hundreds of thousands of dollars from its massive and well-publicized funding campaign.

The result of this double reversal will be to solidify the opinion of pro-life persons throughout the country that the Komen Foundation cannot be trusted with their donations.

We urge Catholics and all pro-life citizens to refuse to participate in Komen sponsored events.

In addition to the raw fact that Planned Parenthood exists to destroy the lives of unborn children, the organization is being investigated for various fraudulent practices, including the mixing of government money with the practice of abortion and the failure to report child abuse and statutory rape to legal authorities. Abortion is an ugly business. Komen has just reembraced that ugliness in a very public manner.

The irony is that there is considerable evidence that abortion has a direct connection to breast cancer. The publications of The National Catholic Bioethics Center have examined this evidence in some detail. The Komen Foundation contradicts its mission to cure breast cancer when it funds the nation’s largest and wealthiest abortion provider.

There are plenty of other charities out there that will welcome the donations of faithful Catholics.

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Susan G. Komen Foundation Applauded for Severing Relationship with Planned Parenthood

Wed, 01 Feb 2012 19:25:00 GMT

The Susan G. Komen Foundation for the Cure (against breast cancer) has decided to no longer fund Planned Parenthood, which last year received nearly a quarter of a million dollars from the charitable organization. The funds were ostensibly being used for breast examinations but reports were that the breast exams in Planned Parenthood Centers had actually been declining and that they were being conducted without proper equipment, but by a simple physical examination, which is not a very reliable method.Such support to the largest abortion provider in the country also ignored the significant evidence that abortion increases the risk of breast cancer.

This is welcome news. Many Catholic organizations have wanted to support Komen's important work fighting breast cancer, but that charitable effort was hampered by its open association with the largest abortion provider in the United States. Some local chapters of Komen refused to provide funds to Planned Parenthood, but the organization's national directors seemed committed to providing the funding to an organization with such ananti-life agenda until the recent exciting announcement. The reason for the break is apparently that Planned Parenthood is under investigation by a legislative committee of the U.S. Congress for various fraudulent practices, some of which had been exposed by pro-life activists. Great pressure had also been placed directly on Komen by the pro-life community.

Now that that effort has been successful, Catholics and all who support the pro-life cause can freely renew their support for the Susan G. Komen Foundation for the Cure. This step in the right direction should be immediately rewarded by increased pro-life support for the walks and runs that are the centerpiece of its fundraising efforts.

Given this change, the reservations that The National Bioethics Center has repeatedly raised over the years concerning the Komen foundation no longer stand.

We can expect the Komen foundation to come under intense pressure from those who favor abortion in an effort to persuade them to relent on their decision and to once again provide funding for an organization radically committed to the killing of the unborn. We hope and pray that the directors of Komen will have the strength to remain steadfast in their decision.

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The NCBC Expresses Extreme Dismay that Fact-Based Testimony on the Perils of President Obama’s Contraceptive Mandate Have Been Ignored

Fri, 27 Jan 2012 20:34:36 GMT

January 20, the U.S. Department of Health and Human Services (HHS) reaffirmed that virtually all private health care plans must cover sterilization, abortifacients, and contraception. Non-profit religious employers are not exempt under the rule’s extremely narrow definition of a religious employer, and are given one year to comply. The Catholic bishops of the United States called this mandate "literally unconscionable." Responding to the announcement, Cardinal-designate Timothy Dolan, archbishop of New York and president of the U.S. Conference of Catholic Bishops, stated: “In effect, the president is saying we have a year to figure out how to violate our consciences.” The Obama administration “has now drawn an unprecedented line in the sand.” Cardinal-designate Dolan urged that the HHS mandate be overturned. At issue is the survival of a cornerstone constitutionally protected freedom, which ensures respect for the conscience of Catholics and all other Americans. [www.usccb.org/news/2012/12-012.cfm.]

The NCBC provided detailed, and factually based testimony on the hazards of such a mandate, both to the health and dignity of women, and to the very basic rights of freedom and liberty enshrined in the Constitution of the United States of America. Specifically:

Treating pregnancy as a disease that should be prevented is medically, socially, and anthropologically inaccurate and sexually biased. By treating pregnancy as a disease to be prevented one can only conclude that the treatment for such a “disease” is an abortion. Thus, the Rule is acting against the very provision in the PPACA and its legislative history, that state that abortion is not one of the “preventive services” to be included in the “services” provided. Yet the Rule clearly mandates coverage at no cost for contraceptives and sterilizations to prevent the “disease” of pregnancy, genetic screening of existing pregnancies whose ”treatment” will for some include abortion, and abortifacients which cause the termination of the newly conceived human being. These and other contraceptives are presented inaccurately as a deterrent to unplanned pregnancies, when the very data presented by the Institute of Medicine to support such claims belie these claims. Empowering women to know and act with their bodies to manage their fertility in a responsible manner is the real answer to the physiological, social, and psychological problems created by a culture encouraging women to engage in unhealthy life styles. Then, forcing others to participate in and to pay for the life style choices of others, which clearly and demonstrably have been detrimental, is the utmost violation of the United States Constitution. The legislative intent never was to mandate that all insurance plans be required to provide, with no co-pay, contraceptives, abortifacients and sterilizations. This Rule not only is creating new law, but violating the Constitutional protections of religious freedom in the process. At a minimum, a robust protection of religious freedom is needed, to protect the very foundation upon which this country was based; and of great importance to the wellbeing of this county is the recognition that the existing Rule is merely going to replicate and maximize the failed initiatives to address the problem of unplanned pregnancies and sexual irresponsibility. [For the complete testimony with data to support these facts see: NCBC Provides Testimony to Health and Human Services on Coverage of "Preventive Services" (see http://www.ncbcenter.org/page.aspx?pid=482&ncs1277=0.)

The NCBC joins its voice with the U.S. Conference of Catholic Bishops in urging that the HHS mandate be overturned. A first step is to continue to urge Members of Congress to co-sponsor the Respect for Rights of Conscience Act (H.R. 1179, S. 1467). This measure will ensure that those who participate in the health care system “retain the right to provide, purchase, or enroll in health coverage that is consistent with their religious beliefs and moral convictions.” Please see: nchla.org/actiondisplay.asp?ID=292.

The freedom of all Americans has been violated when through the executive branch of government the constitutionally protect right of conscience can be overturned by the very government, which from its very inception, was formed and charged with protecting this sacred right.

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The NCBC and Catholic Healthcare West

Thu, 26 Jan 2012 01:24:00 GMT

By John M. Haas, Ph.D., S.T.L.
NCBC President

January 25, 2012. Archbishop George Niederauer of San Francisco has granted a “nihil obstat”, stating effectively that there are no moral obstacles to the restructuring of Catholic Healthcare West into the secular Dignity Health. Mr. George Wesolek, a spokesman for the Archdiocese, wrote in an email to the California Catholic Daily, “I would like to point out that the Archbishop gave a ‘Nihil Obstat’ after consulting widely with other Bishops and moral theologians (one of them was Dr. John Haas) before making this decision.” The California Catholic Daily then went on to identify me as the President of The National Catholic Bioethics Center and a member of the Governing Board of the Pontifical Academy for Life, to which I was appointed by Pope Benedict XVI in 2010.

It should be noted that the official press release of the Archdiocese made no mention of The National Catholic Bioethics Center or me as having been consulted by the Archbishop. That is as it should be. The Center is called on daily to provide counsel from the moral tradition of the Church on matters related to medicine and the life sciences as well as collaborative arrangements between Catholic and non-Catholic institutions. The Center does its work in complete confidentiality; otherwise few would seek its counsel. It is a research and educational institute that provides advice and counsel through its moral analyses of proposals and actions in light of Catholic moral teaching. It has no executive power to make and enact decisions; that belongs to those who seek its counsel, such as bishops or health care administrators. Those who receive our advice are obviously free to follow it or reject it.

The National Catholic Bioethics Center was indeed consulted with respect to the proposal that Catholic Healthcare West undergo a restructuring, as Mr. Wesolek has stated. However, that fact should not lead anyone to infer what the judgment of the Center may have been with respect to the proposal. The only one who has the authority to render such a judgment and can indeed assume responsibility for having done so is the Archbishop of San Francisco.

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Archbishop Zygmunt Zimowski, President of the Pontifical Council for Health Care Workers in Philadelphia Feb. 11.

Tue, 17 Jan 2012 20:45:00 GMT

On February 11, World Day of the Sick, Archbishop Zygmunt Zimowski, President of the Pontifical Council for Pastoral Assistance to Health Care Workers, will be in Philadelphia and will speak at a one-day conference titled “Stand Up and Go: Your Faith Has Saved You”. The conference theme is taken from Pope Benedict XVI’s Letter for the 20^th World Day of the Sick and will address Catholic identity in health care as well as pastoral and sacramental issues.

The conference will be held at St. Charles Borromeo Seminary and is an excellent opportunity for those in Catholic health care to meet the archbishop. The conference will begin at 11:00 AM with an opening address by Archbishop Zimowski. Lunch will be provided for $5.00, and the conference will conclude with Mass celebrated by the archbishop in the Immaculate Conception Chapel at the seminary at 3:30. Most Rev. Charles J. Chaput, Archbishop of Philadelphia, will be the homilist.

A full schedule of the event can be downloaded here. An invitation letter from Archbishop Chaput may be viewed here.

To register, please call Ms. Connie Scharff at 215-587-0504 or email cscharff@adphila.

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A Win at the Supreme Court for Religious Liberty

Fri, 13 Jan 2012 16:36:00 GMT

The National Catholic Bioethics Center (NCBC) enthusiastically welcomes the unanimous decision of the U.S. Supreme Court to uphold the First Amendment and protect religious liberty.

On January 11, 2012, the Court upheld the right of churches to determine the qualifications of their own ministers, or the 'Ministerial Exception.' The case involved a claim of wrongful termination filed against Hosanna-Tabor Evangelical Lutheran Church. In the decision, the Court recognized that the ministerial exception applies beyond the head of a religious congregation to others, such as a teacher in this case, who are viewed as ministers or those carrying the message of the Church.

The NCBC echoes the words of Bishop William E. Lori of Bridgeport, Connecticut, Chairman of the U.S. Conference of Catholic Bishops' Ad Hoc Committee on Religious Liberty:

The Supreme Court decision marks a victory for religious liberty and the U.S. Constitution. Freedom of Religion is America's First Freedom and the Court has spoken unanimously in favor of it. The Founding Fathers would be proud. Respect for the long-standing "ministerial exception," which is grounded in the Religion Clauses of the First Amendment, prevents the government from interfering in the employment relationship between a Church and its ministers. This decision makes resoundingly clear the historical and constitutional importance of keeping internal church affairs off limits to the government—because whoever chooses the minister chooses the message. It's a great day for the First Amendment.[1]

Indeed, this decision is welcomed, especially in the face of the escalating attacks on religious liberty, even by the very government charged with protecting the First Amendment right to the free exercise of religion.

[1] http://www.marketwatch.com/story/bishops-hail-court-decision-upholding-religious-liberty-2012-01-11.

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In 2011 a Record Number of State Laws Promulgated to Protect Human Life

Wed, 04 Jan 2012 20:30:54 GMT

A record number of laws to protect the free and informed consent of women seeking an abortion, their well being, and the lives of their unborn babies were passed in 2011. Nineteen states passed eighty such protective laws, as compared to 34 laws in 2005.

Protective provisions include providing for true informed consent before an abortion by requiring waiting periods and opportunities for counseling (IN, KS, ND, SD and TX). Furthermore, protection of developing fetuses was enhanced by restricting abortions, especially after it is documented that fetuses can feel pain (AL, ID, IN, KS and OK), or there is the presence of an audible heartbeat (OH). There also was legislation signed into law that restricts abortion coverage in insurance plans implementing the Patient Protection and Affordable Care Act (FL, ID, IN, KS, NE, OK, UT, and VA). Lastly, six states increased protections for women being administered chemical abortifacients (AZ, KS, ND, NE, OK, and TN).

Statistics available at http://www.guttmacher.org/media/inthenews/2011/07/13/index.html.

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Dr. John Haas, NCBC President, Provides Input to the Organ Procurement Organization (OPO) Committee on Proposed Language Change Impacting the Understanding of the Concept of “Informed Consent” in Organ Donation Policies.

Wed, 04 Jan 2012 15:50:00 GMT

In response to a proposal by the OPO Committee, of the United Network for Organ Sharing, to change the term “consent” to “authorization” when referenced in organ donation policy, Dr. John Haas advised caution, as well as opposition to, a policy-wide change in terminology. It is clearly evident that throughout the Uniform Anatomical Gift Act (UAGA), whenever the term “authorize,” or any of its forms, is used the term is referring to the authority given by the principal (e.g., donor) to another to act on the principal’s behalf. It is not a substitute for informed consent, which is clearly a term providing for specific consent for a specific procedure after all relevant information has been shared with the person “authorized” to give that consent.

Dr. Haas cited how invoking such a policy-wide change, substituting “authorization” for “consent,” could negatively impact informed consent. This is particularly true concerning how organs and tissues would be used, as well as for informed consent concerning certain procedures to ensure the viability of parts for transplantation, particularly those initiated prior to death. Dr. Haas states: “It is our belief that the changes in terminology, specifically, substituting the term “authorization” for “consent,” that are being proposed are inconsistent with the language and intent of the UAGA.”

Click to read the full text of the letter.

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The Ohio Senate Will Advance a Measure to Protect from Abortion an Unborn Child with a Beating Heart.

Mon, 05 Dec 2011 19:30:46 GMT

The Ohio Senate is advancing a so-called "heartbeat" bill (HB 125), after supporters of life overcame a four-month impasse since the bill passed the House. The proposal will protect the unborn child from abortion once a fetal heartbeat is detectable. Fetal human heart begins beating at 21-22 days gestation, and can be detected before 6 weeks gestation. Ohio Pro Life Action has been running ads on Fox News programs in some local markets urging senators to act on the bill. The ad states that "every single day the Senate delays a vote on the heartbeat bill, a school bus full of children's lives are lost." However, due to concerns that the bill, if enacted into law, would face court challenges on constitutional grounds, not all groups committed to protect these most vulnerable human beings, are in support of this proposal. For more information see: http://www.cleveland.com/open/index.ssf/2011/11/senate_republicans_planning_to.html.

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The National Catholic Bioethics Center, with it Collaborators, Succeeds in Seeking Reconsideration of Flawed Organ Procurement Policy Revision.

Mon, 05 Dec 2011 19:26:00 GMT

The National Catholic Bioethics Center (NCBC), based upon the teachings of the Church encourages the generosity of organ donation within appropriate policies. The Ethical and Religious Directives for Catholic Health Care Services states:

Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death. (ERD #63)

However, a flawed proposal to amend existing requirements of the Organ Procurement and Transplantation Network (OPTN) regarding organ donation upon cardiac or circulatory death, which was scheduled for consideration by the OPTN/UNOS (United Network for Organ Sharing) Board of Directors at its November meeting, has been withdrawn. The OPTN/UNOS Executive Committee asked the committee sponsoring the proposal to withdraw it from consideration at that Board meeting and reissue it for public comment at a later time. This was done in response to comments provided by a number of organizations collaborating with the NCBC.

A letter from Dr. John Haas, President of the NCBC, highlighting some of the reasons for revising this proposal can be read by clicking here.

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NCBC President, Dr. John Haas to Hold Webinar on Bioethics in Defense of Human Dignity

Tue, 29 Nov 2011 19:20:00 GMT

On December 9 at 8:00 PM Eastern Time the organization LifeLinks will hold a webinar featuring NCBC President, Dr. John Haas on the topic of cloning and in vitro fertilization.

Those interested in participating may register for the webinar at http://www.lifelynks.com/LifeLynks.html.

The objective of this webinar is to instruct participants in easy ways to communicate hard topics like cloning and IVF. Hear how Dr. Haas engages and educates human hearts on topics like abortion and end of life issues.

A pdf of the brochure may be downloaded here

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NCBC Provides Written Testimony Regarding Human Research Protections for Pregnant Women and Fetuses

Thu, 27 Oct 2011 15:12:00 GMT

October 27, 2011. Dr. John Haas, NCBC President, has provided written testimony to the Office for Human Research Protections regarding a proposed revision to the "Common Rule" Human Subject Research Protections: Enhancing Protections for Research Subjects and Reducing Burden, Delay, and Ambiguity for Investigators.

The text of the testimonty with concerns expressed the The NCBC may be read here.

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The NCBC Provides Comment to the American Nurses Association (ANA) on Do Not Resuscitate Orders

Wed, 19 Oct 2011 03:06:00 GMT

Dr. Marie T. Hilliard, MS (Nursing), JCL, PhD, RN, Director of Bioethics and Public Policy has submitted comment to the American Nurses Association on their draft revised position statement: Nursing Care and Do-Not-Resuscitate (DNR) Decisions. The statement was last revised by ANA in 2003.

ANA is seeking comments of nurses, nursing students, and anyone in the general public on this document. If you are interested in participating in this review you can download the draft document and provide comment before 5:00 PM EDT on November 9, 2011 at: http://nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements.aspx.

Dr. Hilliard’s comments can be accessed if you click here.

Healthcare policy is the responsibility of each of us, thus, your comments are critical to our societal wellbeing.

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Dr. Hilliard’s comments can be accessed at:

Healthcare policy is the responsibility of each of us, thus, your comments are critical to our societal wellbeing.

NCBC Provides Testimony to Health and Human Services on Coverage of "Preventive Services"

Tue, 27 Sep 2011 21:04:00 GMT

September 27, 2011. On August 1, 2011 the Department of Health and Human Services (HHS) issued and implemented amendments to the Interim Final Rule (Rule) for group health plans and health insurance issuers, relating to coverage of preventive services under the Patient Protection and Affordable Care Act of 2010 (PPACA). HHS invited comments on the regulation to be submitted on or before September 30, 2011.

The National Catholic Bioethics Center has taken this opportunity to provide comment on the provisions of this Rule. Click here to read the testimony prepared by Dr. Marie Hilliard, NCBC Director of Bioethics and Public Policy.

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Urgent Call to Action to Defend Conscience and Catholic Identity

Wed, 21 Sep 2011 16:34:22 GMT

September 21, 2011. On August 1, the U.S. Department of Health and Human Services (HHS) issued an "interim final rule" that will require virtually all private health plans to include coverage for all FDA-approved prescription contraceptives, sterilization procedures, and related "patient education and counseling for all women with reproductive capacity." These are listed among "preventive services for women" that all health plans will have to include without co-pays or other cost-sharing -- regardless of whether the insurer, the employer or other plan sponsor, or even the woman herself objects to such coverage.

The United States Conference of Catholic Bishops (USCCB) has asked that concerned individuals submit their comments to Health and Human Services by the deadline of September 30, 2011. The USCCB has prepared resources to inform Catholics of the dangers of the pending regulations. A page of those resources may be found at http://www.usccb.org/issues-and-action/religious-liberty/conscience-protection/.

You may also download the USCCB memorandum and bulletin insert from the NCBC website.

Dr. Marie Hilliard, NCBC Director of Bioethics and Public Policy prepared a commentary on the August 1 issuance of the final rule that was sent to NCBC constituents on August 2.

The NCBC encourages its constituents to write to the Department of Health and Human Services before September 30 to express your opposition to the proposed preventative services mandate.

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Dr. Marie T. Hilliard, NCBC Director of Bioethics and Public Policy, Mistress of Ceremonies at National Institutes of Health Event, August 10, 2011, Bethesda, MD

Fri, 26 Aug 2011 21:35:00 GMT

August 26, 2011. The National Institute of Nursing Research, an institute of the National Institutes of Health, hosted a three day National Science Summit, entitled The Science of Compassion: Future Directions in End-of-Life and Palliative Care. Dr. Marie T. Hilliard was designated the Mistress of Ceremonies of the kick-off event for this Summit: “The Ethics of Science at the End-of-Life: A Town Hall Discussion.”

This pre-summit Town Hall Discussion brought together, for the first time, over 700 individuals with a variety of scientific and practice backgrounds, as well as those diagnosed with life-limiting illnesses and their care givers, policy makers and others who are driving scientific research in end-of-life and palliative care. The format was unique in that it allowed expert panelists, including Dr. Hilliard, to engage each other, as well as the audience, in a public dialogue on critical and relevant ethical issues facing current research. Of great significance to this dialogue was the audience Question and Answer period, which provided a unique opportunity for public engagement. The goal of this format was not only to provide awareness and education to the important and timely ethical questions surrounding end-of-life research and practice, but also to propose some direction in seeking answers to these questions.

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The NCBC Expresses Dismay over the Disregard for Conscience in New HHS Regulations Regarding Contraceptive Coverage

Tue, 02 Aug 2011 20:16:00 GMT

August 2, 2011. The National Catholic Bioethics Center has expressed extreme dismay at the apparent utter disregard for the protection of conscience which is exhibited in the final regulations which implement the rules for group health plans and health insurance coverage under the Patient Protection and Affordable Care Act (Health Care Reform).

On August 1, 2011, the U.S. Department of Health and Human Services (HHS), under the signature of its secretary, Kathleen Sebelius, issued new mandates concerning preventive health services to be covered by such insurance plans. http://www.ofr.gov/OFRUpload/OFRData/2011-19684_PI.pdf. These mandates require that all such plans provide the full range of FDA-approved contraceptive methods, as “preventive health services” for women.” These FDA-approved contraceptives include potential abortifacients such as so-called emergency contraception and IUDs, as well as surgical sterilizations. Furthermore, no co-pays are to be charged to beneficiaries. Thus, every insured, insurer, employer, and policy implementer included under the Health Care Reform mandates would be coerced into cooperating through insurance premiums and tax dollars, or through actualizing policy mandates in these state-driven and ideologically based violations of a true understanding of human reproduction.

Pregnancy is not a disease to be prevented, nor is the embryo an enemy who once conceived has no right of access to the nurturing womb of his or her mother. Not only do these mandates apply to all group health plans and health insurance issuers in the group and individual markets; they also apply to self-insured group health plans under the Employee Retirement Income Security Act (ERISA). There are few exemptions, and those pertain to group health plans which were in effect before the Health Care Reform was enacted, and those offered by employers who are deemed by HHS to qualify as a “religious employer.” The definition of a “religious employer,” however, is so narrow that its applicability negates most of the religious employers in this country. To be exempt from these new mandates an employer would have to hire and serve primarily those of one’s own faith and have the inculcation of religious values as its purpose. (Although, it does appear that, after the fact, HHS is willing to accept comment on this definition). The regulations state that this definition is consistent with most state laws in which exemptions for contraceptive coverage are allowed. The actual fact, however, is that there are only seven states with such provisions while a number of states have far more robust conscience protections. It should be noted that the Catholic Church is the largest provider of non-governmental health, education, and social services in this country. Not only are individual employers who have a moral, ethical or conscience objection to paying for contraceptives for college students—a group specially referenced as needing these “preventive health services” before going back to college—not exempt, but also the majority of faith-based ministries in the United States who are committed to serving all persons and not just those of their own faith.

These regulations reflect an utter disregard for the foundational principles of the government promulgating them, i.e., that conscience is sacrosanct. We are left to ask, “What has happened to this great country?” “When did we lose the respect for conscience which inspired the very founding of our country?” As Thomas Jefferson stated: “[O]ur rules can have authority over such natural rights only as we have submitted to them. The rights of conscience we never submitted, we could not submit. We are answerable for them to our God.” [Thomas Jefferson (1743-1826), U.S. President. Notes on the State of Virginia (1787), Query 17, p. 159, ed. William Peden (1954).]

HHS has indicated a call for comment, but the regulations became effective August 1, 2011. It would appear that the only area subject to reconsideration is the very narrow definition of a “religious employer.” Comments should be sent before September 30, 2011 to: E-OHPSCA2713.EBSA@dol.gov. It is critical that the voices of all persons of conscience be heard, noting in particular that pregnancy is not a disease to be prevented and that contraception should not be a mandated “preventive health service.” Respect for conscience is foundational to a just society. At a minimum a robust conscience protection should be granted, not only for all religious employers, but also for all employers, insurers, and policy issuers with moral, ethical, or religious objections. As it is, the limitations contained in the regulations for religious employers make the exemption virtually meaningless.

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Call to Action: Institutes of Medicine Recommend Coverage of Sterilizations, Contraceptives, and Abortifacients

Fri, 22 Jul 2011 14:09:00 GMT

July 22, 2011. The National Catholic Bioethics Center calls for the U.S. Department of Health and Human Services (HHS) to reject the Institute of Medicine’s (IOM) recommendations; Clinical Preventive Services: Closing the Gaps. These recommendations effectively label pregnancy as a disease, which not only represents bad clinical medicine, but also will violate the consciences of persons who will be required to implement them. If these recommendations become law, all Americans will be forced to subsidize surgical sterilizations, contraceptives and abortifacients - all of which are covered under the recommended mandates.

The IOM’s recommendations apply to the Patient Protection and Affordable Care Act (Health Care Reform), and would impact all Americans. They are the culmination of a biased and flawed process conducted by the IOM that involved no invited experts who officially represent the largest provider of non-governmental health care in this country, the Catholic church. The report recommends that “the full range of FDA-approved contraceptive methods” be designated, and thus mandated, as a “preventive care service for women.” Such FDA-approved contraceptives include potential abortifacients such as so-called “emergency contraception” and IUDs. Furthermore, no co-pays are to be charged to beneficiaries. Thus, every insured, insurer, employer, and policy implementer included under the Health Care Reform mandates would be coerced into cooperating through insurance premiums, tax dollars, or through actualizing policy mandates in these state-driven and ideologically based violations of a true understanding of human reproduction.

Pregnancy is not a disease to be prevented, nor is the embryo an enemy who once conceived has no rights to access to the nurturing womb of his or her mother. As the Catholic Medical Association has stated, designating contraceptives and abortifacients as “preventive care services” does not constitute good clinical medicine. It is imperative that the Secretary of Health and Human Services reject these recommendations. This new threat to conscience makes it especially critical for Congress to pass the “Respect for Rights of Conscience Act” (HR 1179)

The National Catholic Bioethics Center calls upon all persons of conscience and reason to engage in these public policy debates to prevent further erosion of conscience protections, and continued distortions of the scientific, anthropological, and sociological understanding of the natural gift of human reproduction.

The NCBC Commends the USCCB on the Prophetic Document To Live Each Day with Dignity: A Statement on Physician-Assisted Suicide

Fri, 17 Jun 2011 13:19:00 GMT

June 16, 2011. In response to the false choices presented by advocates for physician-assisted suicide, that is, the supposed choice between intolerable suffering and abandonment or a “death with dignity” by assisted suicide, the U.S. Conference of Catholic Bishops has adopted a truly compassionate document, To Live Each Day with Dignity.

The document importantly calls for increased emphasis and reliance upon palliative care, not medical assistance for those who would kill themselves. It confronts the myth that lives are diminished in value when faced with significant health challenges. The document also repudiates the notion that assisting persons toward a self-inflicted death reflects compassion, and calls health care workers to provide that which weak and vulnerable persons need most, the love and assistance to assure them of their inherent worth.

Read full the full text of the NCBC commentary here.

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The NCBC Welcomes the passage of HR 3 by the House of Representatives

Thu, 12 May 2011 15:51:00 GMT

May 12, 2011. The NCBC welcomes the passage by the US House of Representatives of HR 3, the No Taxpayer Funding for Abortion, a bill, if passed by the US Senate and if signed by President Obama would update and codify the rights of health care workers not to participate in abortion. It is a fact that over 90% of all unborn babies with Down Syndrome are aborted in the United States. Health care workers should be free to care for children with disabilities, not coerced to kill them before birth. To keep abreast of how you can continue to advocate for the passage of HR 3 see: http://www.nchla.org/actiondisplay.asp?ID=290.

See the United States Conference of Catholic Bishops Fact Sheet on HR 3 for a summary of the bill's provisions

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Call for Input: Health Care Legislation and Mandated Contraceptive Coverage

Thu, 12 May 2011 15:35:00 GMT

May 12, 2011. The National Academy of Sciences, Institute of Medicine, is seeking input on what should be included as mandated “preventive services” under the final rules for implementation of the Patient Protection and Affordable Care Act. Unfortunately, the experts invited by the Institute of Medicine to provide input on this matter were persons who overwhelmingly advocated to treat pregnancy as something to be “prevented,” thus as a disease. The legislative record during passage of the Patient Protection and Affordable Care Act clearly reflects that the intent of such a provision was not for pregnancy prevention. If the decision is made to mandate such coverage of contraceptives and abortifacients as preventing disease, the consciences of health care workers, as well as health care agencies will be compromised. The National Catholic Bioethics Center submitted comment on the proposed Final Rule on May 5, 2011, as well on processes used to gather information on this matter. For reference you may wish to review the original submission of The NCBC on this matter from September 17, 2010. To have your voice heard go to: http://www8.nationalacademies.org/cp/projectview.aspx?key=IOM-BPH-10-13.

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NCBC Announces Position Opening for Ethicist

Thu, 14 Apr 2011 20:06:00 GMT

April 14, 2011. Dr. John Haas, NCBC president, has announced an opening for a qualified ethicist to join the NCBC staff beginning September 1, 2011. The ideal candidate will possess a terminal degree in bioethics, or in Catholic moral theology with a specialization in bioethics.

A full description of the position and list of qualifications may be found here (pdf). Click here to view html version.

The National Catholic Bioethics Center was founded in 1972 to apply the moral tradition of the Roman Catholic Church to developments in health care and the life sciences. The Center's highly trained staff consists of five full time ethicists, each of whom holds at least one doctorate. Applicants are encouraged to familiarize themselves with the work of The National Catholic Bioethics Center by visiting the website at www.ncbcenter.org.

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Group Letter Asking the House Judiciary Committee to Support H.R. 3, the No Taxpayer Funding of Abortion Act

Thu, 03 Mar 2011 20:09:00 GMT

March 3, 2011. On March 3 representatives of leading prolife organizations together submitted a group letter urging legislators to support H.R. 3, the No Taxpayer Funding of Abortion Act, and to oppose all amendments that would weaken H.R. 3 in the Judiciary Committee’s full Committee markup. The bill was, in fact, approved in committee with all hostile amendments defeated.

Read the full text of the letter here.

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NCBC Expresses Disappointment Regarding Revision of Federal Conscience Protections

Tue, 22 Feb 2011 19:21:00 GMT

Marie T. Hilliard, RN, PhD, JCL
Director of Bioethics and Public Policy

February 22, 2011. The National Catholic Bioethics Center, while applauding the federal government's stated commitment to reinforce compliance with federal conscience protection laws, is gravely disappointed by the restriction of the scope of such protection from the original language, now limiting the protections only to abortion and sterilization procedures.

The intent of the Provider Conscience Rule was to reinforce and reaffirm existing federal laws, which prohibit recipients of certain federal funds from coercing individuals in the health care field into participating in actions they find religiously or morally objectionable. Such protection from discrimination ensures a vibrant pluralism in the delivery of health care. Not protecting consciences implicitly endorses a monolithic view of health care delivery in a setting where there is legitimate moral disagreement. By ensuring that consciences are protected, the federal government will help to assure that the people of the United States continue to receive care from a reasonable, thinking, caring and conscience-driven health care force.

Increasingly health care professionals are being coerced to violate conscience in myriad ways, such as in the dispensing or administering the so called "morning after pill," as well as the mandate that pharmacists fill all legal prescriptions in a state where assisted suicide is legal. Furthermore, there is no protection of conscience for refusing to participate in mutilating surgeries, such as transgender surgeries, or for assisting unmarried persons with fertility treatments. Lastly, there is no clarification of the rights of conscience for emergency rooms, as it pertains to abortion, about which the federal law requires conscience protection.

The founders of this great country envisioned a democracy that allows not only for the free exercise of religion, but one that creates an environment free of coercion from the violation of deeply held moral convictions. The absence of the protection from discrimination because of such deeply held beliefs creates an authoritarian environment not dissimilar to oppressive governmental regimes abroad which foster catastrophic violations of human life. ________________________________________________________________________________

NCBC President Dr. John Haas Appointed Consultor to the Pontifical Council for Health Care

Wed, 05 Jan 2011 19:12:00 GMT

On Tuesday, January 4, Dr. John M. Haas, NCBC President was notified by Archbishop Zygmunt Zimowski, President of the Pontifical Council for Health Care Workers, that the Holy Father had appointed him a Consultor to the Council. In 2006 Pope Benedict XVI appointed Dr. Haas an Ordinary Member of the Pontifical Academy for Life and then in June 2010 named him to the eight member Governing Council of the Academy.

Following notice of the appointment Dr. Haas released the following statement:

I am humbled by the expression of trust shown in me by Archbishop Zygmunt Zimowski, President of the Pontifical Council for Pastoral Care to Health Workers, and by the Holy Father in confirming this appointment. It is a clear indication of the high regard in which the Holy See holds The National Catholic Bioethics Center and my colleagues who labor so diligently and who are so committed in their fidelity to the Catholic moral tradition and the magisterium. I pray that this appointment will enable the Center and me to be of greater service to the Holy See, to the Bishops, and to the Catholic healthcare ministry.

The Pontifical Council for Health Care Workers was established by Pope John Paul II in 1985 to coordinate the activities of different dicasteries of the Roman Curia as they relate to the health care sector. It spreads, explains and defends the teachings of the Church on health issues and upholds the moral teaching of the Church in health care practice. It also maintains contacts with the local Churches and especially with the various national bishops' conferences as they interact with the health care industry in their respective countries. Archbishop Zimowski (right) was appointed President of the Council by Pope Benedict XVI in April 2009.

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The National Catholic Bioethics Center Responds to New Medicare Regulations Funding End-of-Life Care Discussions

Wed, 29 Dec 2010 20:41:00 GMT

Marie T. Hilliard, RN, PhD, JCL
Director of Bioethics and Public Policy

Without much public awareness, a new Medicare regulation was promulgated and will go into effect on January 1, 2011. It states, in part:

‘‘Voluntary advance care planning’’ means, for purposes of this section, verbal or written information regarding the following areas: (1) An individual’s ability to prepare an advance directive in the case where an injury or illness causes the individual to be unable to make health care decisions. (2) Whether or not the physician is willing to follow the individual’s wishes as expressed in an advance directive. [The new CMS rule as printed in the Federal Register (Vol. 75, No. 228, Book 1) online at http://tinyurl.com/2wn5vz4. Discussion on "voluntary advance care planning" begins on page 73406.]

The issue is not whether a discussion by a health care practitioner with a patient on end-of-life care issues is a good. It is a good. Encouraging providers to have truly informing discussions with patients on this issue is also a good. The problem that arises in real patient care situations is that such federally reimbursed discussions too often become formula based with a check-off list agreed to, and signed off on, by both patient and practitioner leading to the antithesis of true informed consent. An increasingly common document used for this purpose is a Physician’s Orders for Life Sustaining Treatment, known as a POLST or Medical Orders for Life Sustaining Treatment, known as MOLST. This concern was the significant objection to similar provisions in the Patient Protection and Affordable Care Act. Those provisions, thankfully removed, would have reimbursed for discussions that culminated in actionable medical orders written even five years before any health care scenarios had unfolded. In other words, a patient could complete a POLST/MOLST form before any of the facts that would be appropriate to such decision-making were in play. These orders might indicate the patient did not want life sustaining treatment, which under specific circumstances could simply be an antibiotic, a blood transfusion, or proportionately beneficial assisted nutrition and hydration.

The National Catholic Bioethics Center favors the designation of a health care agent, over an advanced directive, and definitely over a POLST/MOLST form. The designated agent should be one with whom the patient has had a detailed discussion of the principles the patient wishes to guide decision making in the event that the patient becomes unable to communicate such decisions. In that way management of care is determined only as specific situations unfold and is truly respectful of the patient’s wishes. Treatment is not withheld carte blanche, based on a document signed months or years past that did not anticipate the present medical scenario.

Additionally, there are legitimate concerns about what Medicare regulations and requirements for reimbursements might be developed and if they might be made contingent upon completion of advanced directives and POLST/MOLST forms. Certain populations are particularly at risk in such situations. One continually hears of pressures on persons with disabilities and their families to forego life sustaining health care treatments. If the federal reimbursement program (Medicare) has incentives that can be interpreted as fostering more POLST/MOLST form completions, the implications for persons with disabilities and the elderly are significant. All one has to do is to look to European countries, such as Great Britain where Quality Adjusted Life Year formulas are used to determine allocation of health care services. A person in a wheelchair is determined to have 25% less “quality of life” which has an impact on the allocation of health care resources. It is interesting to note that the preamble of the Medicare regulation cites a study published in the British Medical Journal: “The impact of advance care planning on end of life care in elderly patients: randomised controlled trial” (Karen M Detering,et al, BMJ 2010;340: c1345doi: 10.1136/bmj.c1345).

Medicare is a program which funds health care for the elderly and we are told there is a real possibility that it will be bankrupt for future generations. As a society we must be very careful in the remedies we propose to address this problem. Remedies that focus on incentives to withhold proportionately beneficial care are neither humane nor just. If we look at the percentage of Medicare dollars spent on end-of-life care over the last 40 years it has remained stable. Also, the percentage of federal dollars spent on the elderly (13%) is almost identical to the percent of elderly that make up the American population (12.6%). The most significant contributing factor to this funding problem is the catastrophic drop in the birth rate of this country (over 40% in the past 50 years). The real issue, then, with the increasing deficit in Medicare and Social Security funding is that the percentage of the elderly in our population is not balanced by the birth rate.

We can do better as a country than to encourage persons months and years before they face health care crises to sign away care. Health care and end-of-life care discussions are a good, but if they become boiler plate check-off lists that culminate in the signing of a POLST/MOLST form they become the antithesis of true informed consent.

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NCBC Commentary on the "Phoenix Case"

Sun, 26 Dec 2010 14:17:00 GMT

December 24, 2010.The National Catholic Bioethics Center has refrained from any public comment on the procedure that took place at St. Joseph’s Hospital, Phoenix, Arizona in November 2009 and the disagreement which arose between the hospital and the local Bishop, the Most Reverend Thomas Olmsted, as to whether the procedure constituted a direct abortion. Since The National Catholic Bioethics Center has provided counsel to both Catholic Healthcare West (CHW), the system of which St. Joseph’s Hospital is a member, and to the Bishop of Phoenix, it previously made no public statement. However, the time has come that the Center should provide some commentary, particularly since portions of its confidential analysis have been circulated by CHW. It should be noted the following comments deal only with information that is public and not with any confidential information that may have been gained through the consultation services provided by The National Catholic Bioethics Center.

Click to read the full text

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The NCBC Provides Commentary to Government Agencies Regarding Mechanisms of Gathering Information Relative to the Patient Protection and Affordable Care Act of 2010.

Fri, 17 Dec 2010 20:30:00 GMT

December 17, 2010. On July 19, 2010, the Department of Health and Human Services issued an interim final rule for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act of 2010 (PPACA). HHS invited comments on the regulation to be submitted on or before September 17, 2010. The National Catholic Bioethics Center submitted comment on September 17, 2010. Subsequently the Institute of Medicine of the National Academies was charged to gather information in an open session, with invited informants on the issue of what constitutes “preventive services” in the newly promulgated Patient Protection and Affordable Care Act.

Dr. Marie Hilliard, NCBC Director of Bioethics and Public Policy attended the forum but was not one of the invited speakers. With the attached letter drafted by Dr. Hilliard The NCBC is not restating its comments contained in the September 17, 2010 submission. Rather, commentary is provided on the mechanism used to gather information for the agency by the Institute of Medicine.

Click to read the text of the letter of December 9, 2010.

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Clarification of Comments Made to the New York Times

Thu, 25 Nov 2010 15:11:00 GMT

NCBC President, John M. Haas, Ph.D., S.T.L. submitted the following statement to the New York Times today regarding the misrepresentation of comments made during an interview with reporter Rachel Donadio which were published in the Times on November 23.

Dear Editor:

In an article that appeared in the New York Times ("After Condom Remarks, Vatican Confirms Shift", November 23) about the Pope's new book, I was quoted as saying "The Pope's wrong". Frankly that attribution is misleading. In the course of an animated conversation, a New York Times reporter presented me with a hypothetical situation: “What if . . .” I responded to that hypothetical situation with “the Pope’s wrong." It would have more accurately reflected what I said if it read "the Pope would be wrong." The quotation of my words appear to have me disagreeing with what the Pope said in the book whereas I was disagreeing with a hypothetical that was presented to me. For the record, I agree with everything the Pope said in that passage in his book about condoms and AIDS. What I do disagree with is the interpretation that has been given to the Pope’s words."

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The Pope and Condoms

Tue, 23 Nov 2010 15:14:00 GMT

John M. Haas, Ph.D., S.T.L.
NCBC President

November 22, 2010. It is difficult teaching moral truth in a day of instant communication and media manipulation. The publication of a series of interviews with Pope Benedict XVI by the journalist Peter Seewald, Light of the World, is a case in point. In reading an advance copy of the book, one knew the mass media would immediately focus on one thing and one thing alone: the Pope’s remarks on condom use and the struggle to prevent the spread of AIDS.

Indeed, the first headline that I encountered after excerpts of the book were released was: “Pope OK’s Condoms”.

Briefly, this is what the Pope actually said: Condoms are neither the effective way nor the moral way to stop the spread of AIDS (the Church “does not regard it as a real or moral solution”). He also said, “we cannot solve the problem by distributing condoms”. He states that the AIDS epidemic has resulted in large measure from the irresponsible and selfish use of sexuality. Then he expresses hope for the conversion of a sinner by suggesting that the use of a condom MIGHT be an expression of his concern for the “other”. This might be seen therefore a first step toward loving and respecting the “other” so that he would eventually embrace a life of either fidelity or abstinence, the only approaches which have truly proven to be successful.

There has been debate for years over the moral legitimacy of the use of condoms by discordant couples, that is, couples in which one member is HIV positive or has AIDS. There are two fundamental moral problems which stoke this debate. First of all, taking into account the high failure rate of condoms, would it be morally licit for a spouse to put his wife’s health and even life at risk for the sake of sexual intercourse? It is difficult to see how this could be justified. The marital act is to be love-giving and open to life. In the case of a spouse with AIDS, intercourse even with a condom could well be a potentially death-dealing act.

The second fundamental moral problem has to do with the contraceptive character of condoms. It is true that the use of a condom in a single case might diminish the risk of the transmission of the AIDS virus but it could also have a contraceptive effect. The Church’s unchanging and unwavering position on the immorality of contraception is well known. But there were some moral theologians who tried to argue that the condom was not being used to contracept but rather to lower the risk of spreading AIDS. The contraceptive effect was merely foreseen but not intended. With such an understanding, it was argued, the use of the condom would not actually be an act of contraception but of disease prevention.

The matter continues to be debated among theologians but the more common opinion among moralists faithful to the magisterium is that the use of the condom would be wrong because it could endanger the life of the spouse and could be an act of contraception.

It is interesting that the Pope entirely sidesteps this particularly vexing debate by the example he uses to consider condom use. He reflects on the decision of a (presumably homosexual) male prostitute to use a condom. In such a case, there can be no question of the contraceptive effect of the condom. Consequently his example does not relate to the debate over the use of condoms by discordant couples.

But interestingly the Pope does not really reflect on the question of the effectiveness of condom use in reducing the transmission of AIDS. He rather wants to reflect on the moral state of the person who would use it with the hope that that person would begin to assume moral responsibility for his sexual activity. There is no question that the Church considers acts of prostitution and homosexuality to be gravely immoral and disordered. However, the Church in her love of souls always looks for some indication that the sinner might “come to his senses”. In the case at hand, the Pope says the use of a condom in a particular case MIGHT be “a first step in the direction of . . . a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed. . .”

Obviously this first POSSIBLE step in the direction of “moralization” cannot make an act of prostitution or homosexuality or contraception good. But it does indicate that the moral conscience might still be alive and might eventually bring one to conversion and new life.

A careful reading of the text could not possibly lead one to conclude that the Pope has approved condom use. He says quite explicitly: “it is not really the way to deal with the evil of HIV infection.” Indeed, it can aggravate it. Prof. Edward C. Green of the AIDS Prevention Research Project at Harvard University would seem to agree with the Pope. He wrote in a recent book, Affirming Love, Avoiding AIDS: What Africa Can Teach the West (Matthew Hanley and Jokin de Irala, The National Catholic Bioethics Center, 2010), “In fact, [condom use] might actually contribute to higher levels of infection because of the phenomenon of risk compensation, whereby people take greater sexual risks because they feel safer than they really ought to because they are using condoms at least some of the time.”

The interview with Pope Benedict indicates no change in Church teaching but is a renewed call for chastity and abstinence as the most effective means of fighting the spread of AIDS.

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NCBC Submits Written Comments on Proposed Guidelines Related to the Patient Protection and Affordable Care Act of 2010

Tue, 21 Sep 2010 18:44:00 GMT

September 21, 2010. On July 19, 2010, the Department of Health and Human Services issued an interim final rule for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act of 2010 (PPACA). HHS invited comments on the regulation to be submitted on or before September 17, 2010 and in advance of the regulation becoming final. This rule would establish guidelines on “evidence‐informed preventive care and screening” for women, which must be included in/by group health plans and insurance issuers under the PPACA.

Click here to read the comments submitted by NCBC President, Dr. John M. Haas on behalf of The National Catholic Bioethics Center.

New Resources from the USCCB to Protect the Vulnerable

Tue, 31 Aug 2010 19:10:00 GMT

August 31, 2010. The US Conference of Catholic Bishops has released their 2010-2011 Respect Life Program. This is a comprehensive program addressing the need to respect the lives of all vulnerable persons, regardless of their stage of development, from conception (fertilization) until natural death. Materials are available addressing such timely topics as teen suicide, sex trafficking, American youth and the culture of life, population and the environment, assisted reproductive technologies, end-of-life care, and capital punishment. See http://www.usccb.org/prolife/programs/rlp/2010/

Also contained within these materials is a bulletin insert, Caring For Each Other, Even Unto Death, by Dr. Marie T. Hilliard, NCBC Director of Bioethics and Public Policy, which is available on-line from the United States Conference of Catholic Bishops.

The NCBC congratulates the USCCB on the development of these excellent resources.

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The Importance of the August 23, 2010 Federal District Court Decision Blocking Federal Funding of Human Embryonic Stem Cell Research

Wed, 25 Aug 2010 19:20:00 GMT

Rev. Tadeusz Pacholczyk, Ph.D.
NCBC Director of Education

August 25, 2010. In a major revision to public policy on embryonic stem cell research (ESCR), Federal district judge Royce C. Lamberth on August 23 blocked President Obama’s 2009 executive order that had expanded federal funding for human ESCR. The National Catholic Bioethics Center welcomes this decision.

The plaintiffs bringing the case against the government were Drs. James L. Sherley and Theresa Deisher, researchers whose work focuses on adult, not embryonic stem cell research. They sought an order declaring that the Guidelines for Human Stem Cell Research (which had been issued by the National Institutes of Health in response to President Obama’s executive order expanding stem cell research) are contrary to law, were promulgated without observing the procedures required by law, and constitute “arbitrary and capricious agency action.”

In rules announced last year, the Obama administration encouraged financing of research into any embryonic stem cell lines that either had been allowed by the Bush administration or had been created using embryos left over from fertility treatments and in which unpaid donors had provided written consent for the embryos to be used for research. The Guidelines had been drafted after a consultation process in which nearly 50,000 public comments were submitted to the NIH. Many of these comments raised moral objections to the research, and others noted that the expansion of funding appeared to violate the Dickey-Wicker amendment, a law passed every year by Congress since 1996 which precluded federal funding of embryo-destructive research.

Judge Lamberth ruled that the administration’s policy as contained in the Guidelines violated the clear language of the Dickey-Wicker Amendment, a law that bans federal financing for any “research in which a human embryo or embryos are destroyed, discarded or knowingly subjected to risk of injury or death.” The judge noted that the plain sense of the language of the statute demonstrates the unambiguous intent of Congress “to prohibit the expenditure of federal funds on ‘research in which a human embryo or embryos are destroyed.’” At the center of the judge’s decision was the recognition that:

This prohibition encompasses all “research in which” an embryo is destroyed, not just the “piece of research” in which the embryo is destroyed. Had Congress intended to limit the Dickey-Wicker to only those discrete acts that result in the destruction of an embryo, like the derivation of ESCs, or to research on the embryo itself, Congress could have written the statute that way. Congress, however, has not written the statute that way, and this Court is bound to apply the law as it is written.

The effects of the judge’s decision are likely to be significant. Dr. Francis Collins, Agency Director of the NIH, noted in a news conference after the announcement of the federal district judge’s decision that 143 scientific grants worth $95 million, which are now up for annual renewal, will be frozen. In addition, 22 grants totaling $54 million, whose existing research is coming up for renewal in September, will also be frozen. Another 131 grants awarded this year already are out the door and will not be affected until they are up for renewal in a year.

Judge Lamberth’s decision is consonant not only with the plain sense of the Dickey-Wicker amendment, but also with the kind of moral reasoning that rejects a false “criterion of independence” or “radical separation of the act from its subsequent uses and applications.” Both the Bush and Obama administrations had supported a position where federal funding of human embryo destruction itself would not be permitted while research on cells derived from such destruction would be funded. The recent Vatican document Dignitas Personae had already emphasized the contradictory character implicit in such a stance:

In this regard, the criterion of independence as it has been formulated by some ethics committees is not sufficient. According to this criterion, the use of “biological material” of illicit origin would be ethically permissible provided there is a clear separation between those who, on the one hand, produce, freeze and cause the death of embryos and, on the other, the researchers involved in scientific experimentation. The criterion of independence is not sufficient to avoid a contradiction in the attitude of the person who says that he does not approve of the injustice perpetrated by others, but at the same time accepts for his own work the “biological material” which the others have obtained by means of that injustice. (n. 35)

The United States Conference of Catholic Bishops, in their response to the decision, observe how an important duty of good government “is to use its funding power to direct resources where they will best serve and respect human life, not to find new ways to evade this responsibility.” The National Catholic Bioethics Center hopes this important court decision will encourage the federal government and all of its health care agencies to renew and expand their commitment to ethically sound avenues of stem cell research.

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The NCBC joins the USCCB in Calling for Remedies to the Flawed Patient Protection and Affordable Care Act (PPACA)

Tue, 24 Aug 2010 20:00:00 GMT

Marie T. Hilliard, R.N., Ph.D., J.C.L.
Director of Bioethics and Public Policy

The USCCB has called for proposed remedies to the flawed Patient Protection and Affordable Care Act (PPACA). A bipartisan supported US Congressional bill (HR 5939) would permanently ban federal funding for abortion services. Since 1976, Congress has annually attached the Hyde Amendment to US Health and Human Services appropriations’ bills to bar the use of federal funds for abortion procedures in Medicaid. No such provision is contained in the PPACA. Furthermore, President Obama’s Executive Order cannot contravene existing law, and PPACA has been enacted, signed and promulgated as existing law. The title of the health care reform legislation, Patient Protection and Affordable Care Act, would indicate that all patients have the right to legal protection. However, the PPACA, in supporting programs that provide abortion on demand, defies its very title.

The NCBC calls for legislation that assures the protection of all persons, especially the vulnerable, as well as the consciences of health care professionals. See www.usccb.org/prolife/DiNardo-HR5939.pdf. To have your voice heard see: http://nchla.org/actiondisplay.asp?ID=284.

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Prop 8 is Declared Unconstitutional

Mon, 09 Aug 2010 19:22:00 GMT

You may download Judge Walker's opinion here

August 9, 2010. Every media outlet has reported on the decision by Judge Vaughn Walker striking down Prop 8 (Judge Walker who is, interestingly, openly homosexual[1]). Proposition 8 reads: Only marriage between a man and a woman is valid or recognized in California.[2] It was put to a popular vote in the November 2008 election and 52% (~7 million Californians) voted for it. A lawsuit was filed arguing that Prop 8 was unconstitutional. Judge Walker presided over the case.

Before addressing Judge Walker’s opinion, it is important to be clear about why Prop 8 made sense in the first place and to explore why ~ seven million voters voted for it. Proponents of the traditional marriage account make several starting assumptions. First, we understand that for the term ‘marriage’ to be a meaningful term, it must refer to a specific reality. Marriage is not a social construct; it actually precedes logically (not temporally) the formation of society as it is the birthplace for children. You can have families without a society, but you cannot have a society without families.

The reality to which marriage refers is a complementary union ordered to procreation. Everyone must grant that heterosexual intercourse involves two distinctive features: it is complementary – involving opposite sexes – and is, at least, open to procreation. It is the kind of act that is procreative in kind. Even intercourse between a man and a woman where one is infertile is still a case of performing a procreative-type of act. No other type of sexual “union” can say that for itself. Dr. John Haas observes the obvious writing,

The purpose of sex is so self-evident it is bewildering how some do not see it. At the most fundamental level of human existence we can see that there simply would be no perpetuation of the species without a reproductive cell from the man and one from the woman which find themselves joined in one of the most remarkable of human activities.[3]

Heterosexual union is a distinct reality, and this reality is a necessary condition for marriage (the other conditions being lifelong commitment etc., conditions shared by other kinds of relationships). Marriage refers to a distinctive reality; a complementary union ordered to procreation.[4]

Changing the definition of the term to refer to other kinds of relationships or sexual acts would be like changing the definition of cat to include dogs. If the term ‘cat’ is extended to include dogs, it will no longer refer truthfully to the way the world is. As Alexander Pruss observes,

Many sentences using the word “cat” that were previously true will no longer remain true: it will, for example, no longer be true that “it is normal for cats to have retractable claws.” Likewise with the extension of the word “marriage:” it will no longer be true that “it is normal for married couples to be able to have children together.”

And Pruss makes a more technical, but important observation, “Note that the use of the word “normal” in both sentences is the same; it does not state a statistical fact, but asserts what happens barring some physical abnormality or deterioration.”[5] The argument here is logical, not moral. One simply cannot change the meaning of the term marriage without compromising the truth of claims involving the term.

The debate, then, between the supporters of Prop 8 and those who oppose it is not about social policy, it is about objective reality. Pruss asks, “Is it possible for the objective reality of marriage to ever exist between two persons of the same sex?” The answer is clearly no. Homosexual intercourse cannot be a complementary union ordered to procreation. That reality can only be realized by heterosexual couples. This is not discriminatory any more than it is discriminatory (in the pure sense of the term, namely, to discern or distinguish) to call all and only canines “dogs” and all and only felines “cats.” Dogs are really dogs, cats are really cats, and marriage is really a complementary union ordered to procreation.

One last comment is noteworthy before addressing Judge Walker’s opinion directly. The argument I have outlined here does not rely on a deep philosophical position regarding the nature of sexuality or the human person. It relies solely on empirical fact, the way the world is. A modicum of reflection on reality would confirm the analysis just provided. Marriage refers to a particular reality that is more than a commitment, and more than amicable feelings between the partners. It requires for its realization, a complementary union ordered to procreation.

Judge Walker’s Opinion (Hereafter the Opinion)

The Procedures Informing the Opinion
The court heard testimony from 17 witnesses who opposed Prop 8, and only 2 who were in favor. The Opinion argues that though the witnesses for Prop 8 withdrew under threat of their personal safety,[6] their withdrawal remained even after the California Supreme Court declared the trial to be non-public. The Opinion comments that there was simply no reason for the withdrawal remaining after guarantees of a non-public hearing were set. The problem with this reasoning of the Opinion is that there is a public record of who gave testimony, namely, the Opinion itself! The heavy-handed tactics of the homosexual activists noted in footnote 6, illustrate that the climate for an engaged and informed discussion is effectively lost, and the Opinion did not take into account the turbulent and often deleterious features of this climate. Procedurally, there should have been greater guarantees of anonymity given the backdrop of violence against Prop 8 supporters, to ensure a rational and well-represented trial.

Another procedural error, we believe, stems from the fact that the Judge ruling on the case is openly homosexual. Professor Gerard Bradley observes that this alone is not sufficient to count as a conflict of interest, but notes two things: no one even asked the question, and more importantly,

Federal law requires that, whenever a judge knows that he has “any other interest [ that is, besides a financial interest] that could be substantially affected by the outcome of the proceeding” at hand, or when “his impartiality might reasonably be questioned”, he must recuse himself.[7]

The point to be made is that there was no questioning done, and no analysis of the Judge’s fitness to rule over the case. Would we say the same thing if the judge in question was a conservative Mormon or Catholic? Yes.

Finally, neither the Governor, nor the Attorney General, supported Prop 8 in contrast to the majority will of the people. And more startling is that the Attorney General refused to defend Prop 8, even though that is his job. It is the job of the state attorney general to defend the state constitution, the aspects of which included a legally approved constitutional amendment defining marriage as between a man and a woman.

The Content of the Opinion
Summarizing the Opinion, Judge Walker says,

Plaintiffs challenge Proposition 8 under the Due Process and Equal Protection Clauses of the Fourteenth Amendment. Each challenge is independently meritorious, as Proposition 8 both unconstitutionally burdens the exercise of the fundamental right to marry and creates an irrational classification on the basis of sexual orientation.[8]

Attempting to justify this judgment, the Opinion considers a number of factors and makes numerous claims and representations. Too many of these claims deserve rebuttal, but I will focus on three “big ideas” that occur and recur throughout the Opinion. The first idea is the claim that Prop 8 is discriminatory, the second is what I will call the argument from social meaning, and the third is a misunderstanding (throughout) concerning the argument for Prop 8.

There are several assumptions that we must recognize in the Opinion as being agreeable, though even some of the agreeable assumptions need a little clarification. It is acknowledged that marriage is a fundamental right. The question presented to the court is whether homosexual couples can exercise this right, or do they seek recognition of a new right. This much is agreeable, though we would urge a proper understanding of what it means to say that marriage is a fundamental right. It is not a civil right, meaning, it is not a right conferred by the State. A heterosexual couple can marry in the absence of any governments or established political order. Families logically precede societies.

A related point is that in order to know that marriage is a fundamental right, one must know what marriage is. And on this point the Opinion is not altogether clear. It only offers us the following: marriage is “a coming together for better or for worse, hopefully enduring, and intimate to the degree of being sacred.” (114, ln. 3) But this is a description of a lasting friendship – or a best friendship depending on how one interprets “to the degree of being sacred.” In any case, this definition fails to distinguish between marriage and friendship.

Another assumption to which we will advert to throughout is actually an idea borrowed from two other opinions. Citing Romer, 517 US at 632 and Heller, 509 US at 321 the Opinion notes that the “basis for a classification must 'find some footing in the realities of the subject addressed by the legislation.'” We could not agree more.

Turning now to the three big ideas, beginning with the notion that marriage in its traditional sense is discriminatory. I should note first that when the Opinion discusses discrimination (119 20ff) the term is used equivocally. In one sense, it is used to describe the law and denotes the notions of making distinctions, discerning, or to collect and divide things according to kinds. But when we reach ln 26, it is clearly used to denote hatred, disapprobation, or contempt. Of course there is a confusion manifested here even at the level of explaining Prop 8. Lines 18-24 are detailing the effects of Prop 8, but in no way target the reasons why Prop 8 makes sense in the first place. But could the effects alone generate a claim that a law is discriminatory? Even more importantly, just what is the moral problem? In asking this, we of course do not condone any act of disapprobation or hatred toward any group of persons. It appears that the Opinion would have us believe that the reasons informing Prop 8 just are the effects, namely, that same-sex couples may not get married. The reason for Prop 8 is that marriage is a complementary union ordered to procreation. An effect of Prop 8 is that homosexual couples cannot get married. When the Opinion discusses discrimination it is looking only at the effects of the law. The Opinion evinces a gross confusion of categories on this point. There are effects of every law. Homicide has the effect of discriminating against murderers, Judge Walker could say, preventing them from murdering without penalty. Or an anti-bestiality law would discriminate against persons who wanted to “marry” their pets, preventing them from doing so. Would we complain about bestiality laws? Do we think homicide laws manifest evil discrimination? What about laws prohibiting fathers from marrying their sons, (or even their daughters)? Would they count as discriminatory simply because they have the effect of precluding incestuous family members from marrying?

There is something else going on here when the Opinion discusses discrimination. Consider a law requiring a state’s police force to hire only men simply because they are men. Clearly, this would be an instance of unjust discrimination. But suppose instead the law required hiring people who are at least 6’ tall since 6’ and above persons are at an advantage in hand-to-hand struggles – just suppose this for the example.[9] And since the police are expected to engage in such to ensure the safety of its citizens, requiring the police to hire 6’ and above persons is in the public interest. Suppose, though, that as it turns out, very few women are over 6’, but numerous men are. The effect of such a law would be that only men would be hired, but no one would say that it is unjustly discriminatory. Contrasting these two cases gives us a glimpse into what it is to say (truly) that a law is discriminatory: A law is unjustly discriminatory when it applies to a particular set of individuals simply because they are members of a certain group. A similar law that had the same effect of singling out certain individuals, but whose content and intent was tethered to reasons pertaining to the “reality of the subject addressed by the legislation,” would not be discriminatory. And it is clear given the reasons outlined in the beginning of this commentary that Prop 8 is in no way unjustly discriminatory. The reasons for it are tethered to the nature of marriage, an effect being that same-sex couples cannot marry. Given this reasoning, the following sentence is obviously false and inflammatory, “Proposition 8 targets gays and lesbians in a manner specific to their sexual orientation and, because of their relationship to one another…” (120 l.26-28 emphasis mine).

Turning now to the social meaning argument, the Opinion aims to answer the question why domestic partnerships are not enough. It says, “while domestic partnerships offer same-sex couples almost all of the rights and responsibilities associated with marriage, the evidence shows that the withholding of the designation ‘marriage’ significantly disadvantages plaintiffs” (116 l. 10-14). And what is the “disadvantage”? “The record reflects that marriage is a culturally superior status compared to a domestic partnership. California does not meet its due process obligation to allow plaintiffs to marry by offering them a substitute and inferior institution that denies marriage to same-sex couples” (116 l. 14-19). Summarizing the position on this issue, it says, “domestic partnerships are distinct from marriage and do not provide the same social meaning as marriage” (115 l. 27-28 emphasis added).

The key claim here is that marriage, traditionally understood, holds a “culturally superior status” compared to domestic partnerships; so does a Ph.D. compared to a Master’s degree. What is the moral or legal problem? There is something insidious about this section of the Opinion. The argument seems to be that same-sex partnerships are not as well accepted as opposite-sex unions. In making ‘marriage’ available to same sex partners, this cultural impression of favoring opposite-sex unions is hoped to fade or attenuate. The reason, then, for why domestic partnerships are not enough is because alone they fail to create an impression in people’s minds (“social meaning”) of the moral legitimacy of homosexual sex. In this regard, the opinion collapses into a tract aiming to proselytize those in favor of a traditional definition of marriage, and effectively aims to “impose the homosexual agenda” on the rest of society. It is a work in cognitive engineering, an attempt to have homosexual actions gain wider acceptance in society. As such, the Opinion has little to do with the Constitutionality of Prop 8.

Lastly, there are a series of comments meant to rebut the claim that marriage refers to a reality; a complementary union ordered to procreation. Several claims are worth quoting with brief commentary following. From p 111, l. 23 ff. “Never has the state inquired into procreative capacity or intent before issuing a marriage license; indeed, a marriage license is more than a license to have procreative sexual intercourse.” Of course, it is true that marriage is more than being disposed to procreate. Above we noted that the procreative capacity of heterosexual relationships is a necessary condition for marriage, not a sufficient one. So we agree that it is “more than a license to have procreative intercourse.” Our position is simply that it is not less than this either.

We read on page 113 l. 6, “The evidence did not show any historical purpose for excluding same-sex couples from marriage, as states have never required spouses to have an ability or willingness to procreate in order to marry.” This is because heterosexual couples, by virtue of the fact that they are opposite sex, can procreate. No separate inquiry is required. Heterosexual couples may be infertile, but this is not a feature of the kind of relationship they realize, but rather an accidental feature of their bodies.

Most important in regard to the putative rebuttals to the position outlined in the beginning of this commentary is the following: “Proponents did not, however, advance any reason why the government may use sexual orientation as a proxy for fertility or why the government may need to take into account fertility when legislating” (122 l. 6-9 emphasis added). These claims are false on their face. The State would have no interest in regulating the intercourse of citizens unless that intercourse could engender new life since the State has an interest in the safety of our children. What interest does the state have in regulating a relationship that is incapable, in its essence, of engendering children? None. There are no laws governing friendship, or intercourse that is inherently non-procreative. The state only has an interest in governing relationships which are of their nature procreative, because the state has an interest in ensuring the proper rearing and education of children.[10] Homosexual couples may adopt, and in this sense, and in this sense only, can they “raise” children. But they cannot engender children. Without exception, adopted children originate in a heterosexual relationship. Opposite-sex couples have a relationship that is inherently disposed to procreation; homosexual couples do not. It is obvious that we are not talking about what couples (of either sort) choose to do. We are highlighting the nature of their relationship. (The government cannot take an interest in regulating choices directly anyway, at least not in a free democracy. Its laws must take into account “the realities of the subject addressed by the legislation.”) And these realities pertain to the nature of the respective relationships in question. Their natures are fundamentally different with respect to their capacity to engender children.

We should conclude by observing a gross confusion over the concepts of sexuality and gender. The Opinion purports to show that given historical facts concerning evolving gender roles, excluding same-sex couples from marriage is equally an artifact of an atavistic mentality. “The exclusion exists as an artifact of a time when the genders were seen as having distinct roles in society and in marriage. That time has passed” (113 l. 9-11). Though it is certainly true that gender roles – the term gender understood to refer to personality characteristics or social expectations – have changed, what has not changed is that there is still male and female and their respective and distinct contributions to the begetting and rearing of children. Sexual differences still exist as a matter of biological fact. Gender differences may elide and change from person to person and from culture to culture. That there is a difference in sexuality and that each sex must cooperate to engender and rear children, is a distinct feature of the heterosexual relationship; a complementary union ordered to procreation. A marriage cannot be without this distinct feature.

[1] “Judge being gay a nonissue for Prop 8 trial,” San Francisco Chronicle (Feb. 7, 2010), http://articles.sfgate.com/2010-02-07/bay-area/17848482_1_same-sex-marriage-sexual-orientation-judge-walker (accessed August 6, 2010).

[2] VoterGuide, “Text of Proposed Laws,” Proposition 8, Sec. 7.5. http://voterguide.sos.ca.gov/past/2008/general/text-proposed-laws/text-of-proposed-laws.pdf#prop8 (accessed August 6, 2010).

[3] Dr. John M. Haas, “Catholic Church Invites Homosexuals to Choose Life.” Boston Globe (Feb., 25, 1998) Op-Ed page.

[4] Properly understood, it is redundant to say ‘ordered to procreation’ since the union involved entails a procreative purpose. To say that two heterosexuals having intercourse are united, or become ‘one body’ requires explaining why they are one, or form a unity. The unity they realize is not like the unity realized when I stick my finger in someone else’s ear, or if one were to tie two people together. We can only say there is a unity there because there is a shared purpose. The sexual act is essentially reproductive in kind; and being procreative is the unified purpose to which their bodies strive. It is, then, in virtue of the procreative end of the sexual act that grounds the claim that the couple realizes a union, they become one body, one organism, their bodies striving to bring forth human life.

[5] Alexander Pruss , “Not out of Lust but in Accordance with Truth: Reflection on Sexuality and Reality,” (December 6, 2002) Sect. II http://bearspace.baylor.edu/Alexander_Pruss/www/papers/notlust.html (accessed August 9, 2010).

[6] http://en.wikipedia.org/wiki/Protests_against_Proposition_8_supporters#External_links. See also, http://www.christiannewswire.com/news/516158238.html, and http://www.wnd.com/?pageId=80220.

[7] Gerard Bradley, “Why Has the Media Ignored Judge’s Possible Bias in California’s Gay Marriage Case,” http://www.foxnews.com/opinion/2010/08/04/gerard-bradley-proposition-marriage-sex-california-judge/ (Accessed August 5, 2010.)

[8] Perry v. Schwarzenegger, (2010), p. 109, https://ecf.cand.uscourts.gov/cand/09cv2292/files/09cv2292-ORDER.pdf (accessed August 9, 2010).

[9] Something like this law is actually the case for state troopers in certain states.

[10] This is the basic reasoning behind anti-fornication laws, namely, to ensure that children were engendered in a stable home environment. Such laws are unenforceable now, but can one really argue against their basic rationale?

The New Eugenics: Eliminating the “Undesirable” by Prenatal Diagnosis

Mon, 02 Aug 2010 16:48:00 GMT

Dr. Marie T. Hilliard, Director of Bioethics and Public Policy, will Moderate the Upcoming Webinar offered by the National Catholic Partnership on Disability:

Threats to the Life of People with Disabilities, Part 1: Poor Prenatal Diagnosis of Lethal or Non-lethal Conditions & Disability

Tuesday, October 5, 2010, 1:00-2:30 P.M., Eastern; 12:00-1:30 P.M., Central 11:00 A.M. -12:30 P.M., Mountain; 10:00-11:30 A.M., Pacific. See http://www.ncpd.org/.

August 2, 2010. How often do we see a great scientific or therapeutic advance, discovered to enhance life and society, turned against humankind? Prenatal testing and diagnosis was conceived as a “good,” to enhance the wellbeing of mother and child and foster the ability to delivery healthy babies. However, when the intent is accomplished by only delivering healthy babies, while denying life to those deemed less than perfect, a Machiavellian distortion of the good has been achieved.

There are phenomenal advances in prenatal testing: ultrasound; testing for Rh incompatibility; infectious disease testing or testing for antibodies; maternal serum protein testing; amniocentesis; chorionic villus sampling; umbilical cord blood sampling; chromosomal and genetic testing of both parents and fetus. The list continually enlarges; and the question needs to be asked: to what end? The American College [now Congress] of Obstetricians and Gynecologists reports that 90% of their surveyed members justify abortion for fetal anomalies that are fatal; and 63% justify it for nonfatal fetal anomalies. [i] That means that almost two-thirds of the responding physicians responsible for the care of a mother and her unborn child believes in eugenics. The very person who is to be the guardian of the health of the unborn baby, the only professional upon whom that baby can rely, believes in the destruction of that very baby who is less than perfect. This is a frightening prophesy for the future.

Enter the child allowed to be born, who has a disability. There have been egregious examples of denial of basic care to such a child. Thankfully, reports of such abuse have led to the federal “Baby Doe” Child Abuse and Treatment Act (1984), which prohibits withholding nourishment and medically beneficial treatment from infants with a disability solely on the basis of present or anticipated mental or physical impairments. However, such care can be denied if: the infant is chronically and irreversibly comatose; the provision of such care will not improve all of the infant’s life-threatening conditions; or the care is deemed futile in terms of infant survival. Thus, nutrition and hydration could be denied to an irreversibly comatose child, constituting passive euthanasia.

Natural moral law dictates that “As far as the right to life is concerned, every human being is absolutely equal to all others.”[ii] Prenatal testing clearly can accomplish a good: “If prenatal diagnosis respects the life and integrity of the embryo and the human fetus and is directed towards its safeguarding or healing as an individual, then the answer is affirmative.”[iii] However, “Certain attempts to influence chromosomic or genetic inheritance are not therapeutic but are aimed at producing human beings selected according to sex or other predetermined qualities. These manipulations are contrary to the personal dignity of the human being and his or her integrity and identity. Therefore in no way can they be justified on the grounds of possible beneficial consequences for future humanity."[iv] Further guidance is provided by the Ethical and Religious Directives for Catholic Health Care Services: “Prenatal diagnosis is permitted when the procedure does not threaten the life or physical integrity of the unborn child or the mother and does not subject them to disproportionate risks; when the diagnosis can provide information to guide preventative care for the mother or pre- or postnatal care for the child; and when the parents, or at least the mother, give free and informed consent. Prenatal diagnosis is not permitted when undertaken with the intention of aborting an unborn child with a serious defect.”[v] However, the intent to kill the less than perfect child often is the intent of prenatal testing.

The newly enacted federal health care reform legislation, the Patient Protection and Affordable Care Act (PPACA), despite President Barack Obama’s Executive Order, will pay for programs providing abortion on demand. Evidence shows that the unborn baby with a diagnosis of a fetal anomaly increasingly is at significant risk of abortion. The rate of prenatal screening by ultrasonography or amniocentesis before 24 weeks gestation has risen to 89.3%, increasingly resulting in elective termination of pregnancies.[vi] Prenatal diagnosis of Down Syndrome brings with it a 90% chance of being aborted.[vii] With the historic move to allow tax dollars to pay for programs providing elective abortions, tax payers have been forced to be complicit in this new eugenics.

There is a better way. This webinar will explore prenatal testing and eugenics and provide life giving options. Participants will include: Dr. John Bruchalski, OB/GYN, Tepeyac Family Care Center, Fairfax, VA; Fr. Dan Mindling, OFM Cap., Theologian, Academic Dean, Mount St. Mary's Seminary, Emmitsburg, MD; Tracy Winsor, Parent Support Specialist, Charlotte, NC; and Monica Rafie, Founder of BeNotAfraid.net and parent of a child surviving a poor prenatal diagnosis, Chicago, IL. Webinar participants will be able to participate in live questions and answers.

[i] D. Cavanagh, M.D., et al., “Changing Attitudes of American Obstetricians and Gynecologists on Legal Abortion National Survey,” The Female Patient 20 (May 1995).

[ii] John Paul II, Evangelium vitae (March 25, 1995), n. 57.

[iii] Congregation for the Doctrine of the Faith, Donum vitae (Feb. 22, 1987), I,2.

[iv] Ibid, I,6 (quoting Pope John Paul II, World Medical Assoc., 1983).

[v] U.S. Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, 5th ed. (Washington, D.C.: USCCB, 2009), n. 50.

[vi] Allyson J. Peller, MPH, et al., “Trends in Congenital Malformations, 1974-1999: Effect of Prenatal Diagnosis and Elective Termination,” Obstetrics & Gynecology 104:5, Part 1 (November 2004), 957-964.

[vii] Gary Bauer and Daniel Allott, “The Last Acceptable Prejudice: An epidemic of Down Syndrome abortions,” National Review On-Line (October 15, 2008 6:30 A.M), http://article.nationalreview.com/374990/the-last-acceptable-prejudice/gary-bauer-and-daniel-allott, last accessed July 29, 2010.

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Now Available: Made for Each Other: A Catechetical and Educational Aid on Sexual Difference and Complementarity

Wed, 28 Jul 2010 15:57:00 GMT

July 28, 2010. An excellent DVD with an accompanying resource booklet (for clergy, catechists and teachers), as well as a viewer’s guide, are available through the United States Conference of Catholic Bishops (USCCB). These are outstanding materials developed by the USCCB’s Ad Hoc Committee for the Defense of Marriage. The resource booklet and viewer’s guide provide discussion questions and talking points which are ideal for parish and school educational programs, as well as for assisting individual viewers to enhance their understanding of the concepts addressed by the DVD. The complementarity of men and women at a physical, psychological and spiritual level is explored. This complementarity, essential to marriage, is presented through a dialogue between a young couple, Josh and Carrie, who present helpful analogies demonstrating that same-sex unions can never have this same unique character. Excellent citations are provided that the user can utilize for further study. For more information and to access these materials see: http://www.usccb.org/marriageuniqueforareason/.

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The NCBC Welcomes Announcement by the HHS that it Will Not Fund Elective Abortions

Fri, 16 Jul 2010 20:42:00 GMT

Marie T. Hilliard, R.N. Ph.D., J.C.L.
Director of Bioethics and Public Policy

July 16, 2010. The National Catholic Bioethics Center joins the U.S. Conference of Catholic Bishops, in welcoming the agreement by the U.S. Dept. of Health and Human Services (HHS) to exclude elective abortion coverage in the high-risk pool insurance program allocations to states.

Pennsylvania and New Mexico were slated to receive funding which would pay for abortion of demand, consistent with health care reform legislation (Patient Protection and Affordable Care Act or PPACA). Such funding of abortion on demand was to occur pursuant to provisions in the PPACA that excludes from the cost sharing provision certain programs including the high-risk pool insurance programs. These cost sharing provisions required individuals seeking federal health plan coverage that included abortion on demand, to write separate checks for such coverage. The PPACA does not require those participating in the high-risk insurance program to write separate checks. Even if PPACA did require these mechanisms of separate checks and separate payroll deductions for such abortion coverage, for the first time in US history the federal government will fund health care plans that provide abortion on demand. Although President Obama’s executive order concerning the PPACA cannot contravene existing law, in a recent announcement HHS has stated that it will not include coverage of elective abortions in its high risk pool allocations to states. [i]

The NCBC, while welcoming this reversal for these allocations, again stresses the need for Congress to enact legislation, clearly stating once and for all that funds appropriated by PPACA will not pay for abortions or for insurance coverage that includes abortion. [See: : “The National Catholic Bioethics Center Supports Proposed Remedies to the Flawed Patient Protection and Affordable Care Act (PPACA)".

[i]http://npwf.convio.net/site/News2?abbr=daily2_&page=NewsArticle&id=25232&security=1201&news_iv_ctrl=-1.

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US Military May Have to Provide Abortions. Please Act Now to Prevent this Additional Assault on Human Life and Conscience

Wed, 30 Jun 2010 21:29:00 GMT

Marie T. Hilliard, R.N., Ph.D., J.C.L.
Director of Bioethics and Public Policy

June 30, 2010. Current law states that military health care facilities may not be used to perform elective abortions (10 U.S. Code Sec. 1093(b)). This policy was first established administratively in 1988. President Clinton reversed the policy in 1993 but Congress restored it in 1995, and it has remained intact ever since. Now an attempt is being made to repeal this longstanding policy.

An amendment by Sen. Roland Burris (D-IL) to strike this provision from law was approved during committee consideration of the National Defense Authorization Act for Fiscal Year 2011 (S. 3280). For a description of this vote, see: nchla.org/datasource/idocuments/6Burris8a.10.pdf.

In a June 17 letter to the U.S. Senate, the Most Reverend Timothy Broglio, Archbishop for the Military Services, stated that the Burris Amendment “would contravene our military health care providers’ commitment to defending and protecting human life” and “would pressure military physicians, nurses and associated medical personnel to engage in an act of taking innocent human life.” Military medical personnel should be allowed to continue to abide by their commitment to save lives. For text of letter, see: nchla.org/datasource/idocuments/Letter%20to%20Congress%20from%20Archbishop%20Broglio%206.17.2010.pdf.

In a subsequent letter, Cardinal Daniel DiNardo, Chairman of the bishops’ Committee on Pro-Life Activities, urged that the authorization bill not be approved “until the original version of 10 U.S.C. §1093 is restored.” He said it is not the task of the federal government “to directly promote and facilitate elective abortions,” and the longstanding ban on use of these facilities for abortion should be maintained. For text of letter, see: nchla.org/datasource/idocuments/CardinalDiNardoMilitaryLetter.pdf.

S. 3280 is expected to be on the Senate floor after the July 4 recess. The recess will take place during the week of July 4-9.

The House has already passed its version of the National Defense Authorization Act for Fiscal Year 2011 (H.R. 5136), without changing the longstanding military abortion policy. For NCHLA’s Fact Sheet on this issue, see: nchla.org/datasource/ifactsheets/MilAbrtPol.PDF.

ACTION: Please contact your two U.S. Senators by e-mail, phone, or FAX letter:

To send an e-mail message through NCHLA’s Grassroots Action Center click here.

Call the U.S. Capitol switchboard at: 202-224-3121, or call your Senators’ local offices. Contact info can be found on Senators’ web sites at: www.senate.gov.

Senators also should be contacted while visiting their home states during the July 4 recess.

MESSAGE: “Please do not approve the defense authorization bill until the Burris Amendment is reversed and current law on military abortions is upheld.”

WHEN: It is anticipated the Senate will consider S. 3280 after the July 4 recess. Please act today! Thanks!

Pope Benedict XVI Appoints NCBC President to Governing Council of the Pontifical Academy for Life

Tue, 22 Jun 2010 14:06:00 GMT

June 22, 2010. John M. Haas, Ph.D., S.T.L., K.M., President of The National Catholic Bioethics Center, has been appointed by His Holiness, Pope Benedict XVI to serve as a member of the Governing Council of the Pontifical Academy for Life for a period of five years. Dr. Haas was appointed as an Ordinary Member of the Academy by the Holy Father in 2006. The Academy chose to announce the appointment on June 22, the feast of the English martyrs Sts. John Fisher and Thomas More who “gave their lives for principles which are very much still actual and which are deeply relevant for the work of the Academy in the defense of human life.”

The Pontifical Academy for Life was established by Pope John Paul II with his Motu Proprio "Vitae Mysterium" on February 11, 1994. The first President was the noted French physician, geneticist, and Servant of God Dr. Jérôme Lejeune who was an ardent defender of life and the researcher who discovered the chromosomal cause of Down syndrome which came to be called Trisomy 21. The principal objective of the Academy is the study of problems of biomedicine and of law relative to the promotion and defense of life and especially the direct relation that they have with Christian morality and the teachings and directives of the Church's Magisterium. The academy for life is autonomous but collaborates closely with the Pontifical Council for Pastoral Assistance to Health Care Workers and various other dicasteries of the Roman Curia committed to the service of life.

The Governing Council of the Pontifical Academy for Life consists of 8 of the members of the Academy including the President, Archbishop Rino Fisichella, and the Chancellor, Monsignor Ignacio Carrasco de Paula of Spain, who is a moral theologian and physician.

Dr. Haas has said of the appointment, “I am deeply honored and humbled with this appointment from the Holy Father and pray that I, with my colleagues at The National Catholic Bioethics Center, may make some real and lasting contributions to the building up of a Culture of Life worldwide.”

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Two New Members Appointed to the NCBC Board of Directors

Mon, 21 Jun 2010 15:28:00 GMT

At a recent meeting of the Board of Directors of The National Catholic Bioethics Center Archbishop Donald W. Wuerl (Washington D.C.) as chair of the nominating committee of the Board announced the appointment of the Most Reverend Jose Gomez, Coadjutor Archbishop of Los Angeles, and the Most Reverend Gregory Aymond, Archbishop of New Orleans, to the NCBC Board of Directors.

Dr. John M. Haas, President of the NCBC, was present at the Mass of Reception in Los Angles for Archbishop Gomez (see photo at left) on May 26.

Archbishop Gomez holds a doctorate in sacred theology from the University of Navarre in Pamplona Spain. Before being appointed to the Archdiocese of Los Angeles, he had served as Archbishop of San Antonio since February of 2005. He has a great pastoral interest in bioethics, especially issues related to end-of-life care, and is the author of A Will to Live: Clear Answers on End-of-Life Issues. Gomez brings a scholarly and pastoral interest in bioethics to the NCBC Board, and as the Coadjutor Archbishop of Los Angeles, episcopal representation from the west coast.

Archbishop Gregory Aymond, a native of New Orleans, served as President-Rector of Notre Dame Seminary in New Orleans where he also served on the faculty as a professor of pastoral theology and homiletics. He developed a close relationship with The National Catholic Bioethics Center during his tenure as Bishop of Austin, Texas. In June 2009 His Holiness, Pope Benedict XVI appointed Archbishop Aymond to succeed Archbishop Alfred Hughes as the 14^th Archbishop of New Orleans and the first New Orleans native to serve the archdiocese as its Ordinary in its 216 year history.

The NCBC Board of Directors and staff welcome these two distinguished archbishops to our outstanding board of church hierarchy and dedicated lay persons.

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The National Catholic Bioethics Center Supports Proposed Remedies to the Flawed Patient Protection and Affordable Care Act (PPACA)

Tue, 15 Jun 2010 15:03:00 GMT

Marie T. Hilliard, R.N.. Ph.D., J.C.L.
NCBC Director of Bioethics and Public Policy

June 15, 2010. A bipartisan US Congressional bill, H.R. 5111, sponsored by Reps. Joseph Pitts (R-PA) and Dan Lipinski (D-IL) with the support of 91 House members, would address major flaws in the recently enacted federal health care reform legislation, the Patient Protection and Affordable Care Act (PPACA). See www.usccb.org/healthcare. To learn how to have your voice heard see: http://www.nchla.org/actiondisplay.asp?ID=282

The PPACA, despite President Barack Obama’s Executive Order and despite claims to the contrary, will pay for programs providing abortion on demand and provide inadequate conscience protections for health care providers. Furthermore, it will leave unaddressed the health care needs of many immigrants. The Chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, Cardinal Daniel DiNardo urged members of Congress to support H.R. 5111, stating that it “will bring PPACA into line with policies on abortion and conscience rights that have long prevailed in other federal health programs.” H.R.5111 will ensure PPACA funds are covered by the Hyde Amendment, along with other conscience protections covered by the Weldon amendment that has been part of the of the annual Labor/US Health and Human Services appropriations bills since November 2004. This will make certain that federal, state and local governmental entities receiving federal funds under PPACA may not discriminate against health care providers who decline involvement in abortion. It will prevent states from requiring the provision of certain procedures without also providing conscience protections. Furthermore, H.R. 5111 will close a loophole in the PPACA’s non-preemption clause on state laws, so that state laws restricting abortion or protecting conscience rights will not be preempted by PPACA.

Some may assume that President Obama’s executive order of March 21 addresses these flaws in the PPACA. However, the executive order does not address several of the problems cited above. On other issues it even reinforces problematic aspects of the PPACA, such as providing federal subsidies for health plans that provide abortion on demand. Furthermore, an executive order cannot go beyond duly enacted federal legislation. Thus, the provisions of H.R. 5111 will assure that any intention in the executive order to provide protections to human life, human dignity, and conscience will be accomplished in law.

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NCBC Publications Claim 4 Awards from the Catholic Press Association

Wed, 09 Jun 2010 19:08:00 GMT

June 8, 2010. The National Catholic Bioethics Center is the recipient of 4 awards announced by the Catholic Press Association at their 2010 Catholic Media Convocation in New Orleans last week. The National Catholic Bioethics Quarterly, the Centers professional journal, was granted the distinctive honor of 1^st place in the category of General Excellence, Scholarly Magazines. The judges commented that “From cover to cover this journal provides engaging, contemporary writing delineating often very complex issues.” The Quarterly was founded in 2001 with assistance from the Our Sunday Visitor Institute and the American Association of the Order of Malta. It has had the honor of receiving this award for 6 of its 9 years of publication. Additionally, Denis A. Scrandis’ article, “A Demonstration of the Personhood of the Human Embryo”, published in the Winter 2009 issue, received the 2^nd place prize award for Best Essay, Scholarly Magazine.

The Center’s monthly publication, Ethics & Medics received 2 awards, 1^st and 2^nd place in the category of Best Essay, Special Interest Newsletters. Dr. Maureen Condic’s “A Comprehensive Primer on Stem Cells: Reviewing the Science and the Ethics” and Dr. Joel Brind’s essay, “Consuming Secondhand Steroids: The Contraceptive Pollution of Nature” both were noted for presenting controversial subjects in a clear and thought provoking way.

John M. Haas is the publisher of The National Catholic Bioethics Center’s publications, and Edward J. Furton is the Editor in Chief. Rebecca M. Robinson is the Production Manager and Melanie Anderson the Production Editor. Subscription information for both publications can be found at the Center’s website: www.ncbcenter.org, or by calling the Center at 215.877.2660.

Click to read a summary of the awards received by NCBC publications.

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Synthetic Life: Important Technical Achievement But Not Revolutionary

Fri, 28 May 2010 14:21:00 GMT

Stephen Napier, Ph.D.
NCBC Ethicist

May 28, 2010. Craig Venter and his lab successfully altered the genetic structure of a bacterial cell with synthetic DNA.[1] The original bacterial cell was a mycoplasma capricolum but had its DNA stripped – though the original cytoplasm remained – and in its place received a DNA sequence that was structured like mycoplasma mycoides cells using a “digitized” genomic sequence of m. mycoides cells. Explaining just why this is a synthetic living cell, Craig Venter noted that the cell has a computer as its “parent” and behaved like an m. mycoides cell, even self-replicating.[2] That is, a genomic sequence was constructed by a computer model with slight differences from an m. mycoides sequence. Geneticists have been able to “download” genetic sequences of cells for some time. Venter accomplished a feat in the other direction “uploading” a computer modeled genomic sequence resembling an m. mycoides cell into the cytoplasm of an m. capricolumm. mycoides cell with the resulting cell behaving like an m. mycoides cell.

Various news outlets are heralding this as a revolutionary discovery with serious repercussions on our understanding of life and claiming that many theological or religious beliefs may have to be revised. This is overstated. Venter’s study, represents an important technical achievement in that it imported into a cell a wholly synthetic (i.e., computer modeled) genomic sequence manufactured by a machine, and the resulting cell behaved consistent with its new genetic sequence. His experiment did not create life out of non-living matter. The phrase “synthetic life” does not refer to an artificial form of life, as for example the phrase “synthetic wool” refers to an artificial or man-made type of material that imitates wool. Venter began with a living organism, rearranged its genetic sequence, and then called the result “synthetic life.” But the only synthesis he introduced into this existing life form was the new order of the genetic material. Venter did not produce a new form of artificial life that imitates real life. He manipulated an existing living organism.

The work on synthetic life resembles gene therapy, in that what is being proposed is an alteration to the genetic structure of the host organism. What is noteworthy about Venter’s research is that our understanding of how living organisms can be manipulated and altered to manufacture new forms of life may need slight revision. Venter has shown that we can introduce manipulated DNA sequences into cells, effectively changing their characteristic potencies and powers i.e., changing the kind of cell it is. But here again, this is no different in concept from what is being done in gene therapy research. The added technical achievement is that Venter has shown we can do such things with DNA synthesized by a computer model.

Venter’s research on synthetic life is not without potential dangers of a significant magnitude to the environment and with respect to bioterrorism. In principle, the moral quality of this research should be measured against three basic principles: the research should be at the service of the human person in developing effective medical therapies which respect human dignity or ecological preservation technologies. (Venter himself has noted that this is in fact the intent driving the research). It may not destroy young human life in the process nor use or benefit from research that has destroyed innocent human beings. And there should be a specific plan of “containment” to lessen the serious potential risks just noted (i.e., risks to the environment and of bioterrorism).

Venter’s research is an example of scientists participating in the creatio continua of God’s creative activity. Whereas creatio ex nihilo (“creation out of nothing”) emphasizes God’s transcendence, creatio continua (“continuous creation”) draws attention to God’s immanence and the exercise of His sustaining causality. Venter’s research does not tread on God’s ground, but rather participates in His creative activity. The research should be encouraged consistent with the ethical principles just enumerated.

[1] Daniel Gibson, et. al. “Creation of a Bacterial Cell Controlled by a Chemically Synthesized Genome,” Science (Online May 21, 2010), available at, http://www.sciencemag.org/cgi/rapidpdf/science.1190719v1.pdf. (Accessed May 25, 2010).

[2] A longer explanation of what Venter et. al. did is as follows, “[Venter’s] approach to synthetic biology isn’t hacking, it’s programming from the ground up. Yes, this first bacterium was just a copy of a natural organism. But that copy was assembled base pair by base pair. In the future, instead of pain-stakingly slicing in genes from other bacteria, Venter can just change a few parameters in his computer software. When fully developed this technology will let you ‘code’ a new organism.” http://singularityhub.com/2010/05/20/venter-creates-first-synthetic-self-replicating-bacteria-from-scratch/ (accessed May 25, 2010).

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Presumed Consent Legislation in New York

Mon, 10 May 2010 14:59:00 GMT

Ethicists of The NCBC

May 7, 2010. Assemblyman Richard Brodsky of New York State has introduced a bill that would set aside “informed consent” for organ donation and substitute in its place “presumed consent.” Under this legislation, the body of the person would be viewed as the possession of the state, and not that of the family, unless the individual made a specific indication or statement that his organs should not be removed without his permission.

The National Catholic Bioethics Center recognizes that politicians, physicians, patient advocates, and other people of good will are desperately seeking new sources of organs and tissues for the many people who die in need, but laws authorizing presumed consent violate the fundamental dignity of the person and the prior rights of family members who must have the final say on the disposition of the remains. We would urge the members of the New York legislature to oppose this law.

The body of the deceased person belongs first and foremost to the family, who must be confident that they will receive it intact and without the unauthorized prior removal of organs and tissues. The burial of the body is an important part of the grieving process and a period of unity among family members who gather for the internment. The sanctity of this time should not be undermined by the possibility that the state has removed organs and tissues from a loved one without anyone’s permission.

Proposals for presumed consent encourage us to view the human body as a commodity, whose parts can be harvested for the benefit of others. Already we are seeing efforts to encourage organ donation through offers to pay donors for funeral expenses or provide benefits to family members. Payment for organs, other than reimbursement of monies for the cost of the donation itself, violates the inherent dignity of the body, which is an essential component of a human person. Similarly, removing organs without consent treats the body of the deceased in a utilitarian manner.

The Catholic Church promotes the good of organ donation, where “donation” means the freely given decision to transmit the gift of life to another. A program of presumed consent should not be confused with true organ donation. There is no donation when the state presumes to have the authority over the body of the deceased and allows its organs to be removed.

Directive # 63 of the Ethical and Religious Directives for Catholic Health Care Services (2009), issued by the United States Conference of Catholic Bishops, states: "Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death."

Similarly, John Paul II spoke of acts of heroism in Evangelium vitae (1995), #86: “They are a sharing in the mystery of the Cross, in which Jesus reveals the value of every person, and how life attains its fullness in the sincere gift of self. Over and above such outstanding moments, there is an everyday heroism, made up of gestures of sharing, big or small, which build up an authentic culture of life. A particularly praiseworthy example of such gestures is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope.”

A "sincere gift of self" requires freedom of action, and gifts are never obligatory. If there is a social obligation to have one's organs used to save the lives of others, and the state oversees the enforcement of this obligation, how can one speak of "donation" or even "presumed consent"? Tax payers do not "donate" portions of their wages to the state to be distributed for the common good. They are taken by the state with or without our consent. If the state has the obligation to take our organs for distribution to those in need, and we have an obligation to allow them do this, except when we express a prior objection, we cannot speak of virtue or charity with respect to organ extraction and distribution.

Link to the bill:
http://assembly.state.ny.us/leg/?default_fld=&bn=S07725%09%09&Summary=Y&Text=Y

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Adoption of the Uniform Anatomical Gift Act (UAGA)

Thu, 06 May 2010 21:00:00 GMT

Marie T. Hilliard, RN, PhD, JCL
Director of Bioethics and Public Policy

May 6. 2010. The National Catholic Bioethics Center (NCBC) has been in dialogue with some individual State Catholic Conferences facing adoption by their legislatures of the Uniform Anatomical Gift Act (UAGA). A summary of one State Catholic Conference’s experience is contained in the report of the Maryland Catholic Conference. It is important to note that final refinement of amendments are those attached as the UAGA Amendments Agreed Upon by the National Conference of Commissioners on Uniform State Laws and The National Catholic Bioethics Center. These three agreed upon amendments to the UAGA of 2007 were a result of the NCBC engaging in lengthy dialogue with a representative of the National Conference of Commissioners on Uniform State Laws. It is important to note that in the UAGA the succession of persons allowed to make the anatomical donation ends with “any other person having authority to dispose of the decedent’s body.” (Section 9, (10)). The NCBC opposes such a provision, which violates consent as required by the Ethical and Religious Directives for Catholic Health Care Services, #63, and is akin to “presumed consent.” Agreement on this point could not be reached with the National Conference of Commissioners on Uniform State Laws . An additional amendment of a state statute incorporating provisions of the UAGA was achieved by the Kentucky Catholic Conference. This amendment prevents the use of anatomical gifts for the engendering of human beings (embryos) for research or education. Text of the Kentucky legislation is available here: http://www.lrc.ky.gov/record/10RS/SB4.htm.

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NCBC President Dr. John Haas Responds to Peggy Noonan's April 17, 2010 Wall Street Journal Article, "How to Save the Church"

Thu, 22 Apr 2010 20:08:00 GMT

April 18, 2010. Peggy Noonan is usually so good. But I am afraid she is stuck in the past with regard to the Church’s response to sexual abuse. (WSJ, April 17) She charges Vatican officials with complacency and declares, the “more relaxed the institution, the less likely it will reform”.

But Peggy has apparently not noticed that tremendous reform has occurred. In fact, more reform has taken place in the Catholic Church than in any other social institution in which the abuse of minors has occurred. In 2002 the U. S. Bishops approved a Charter for the Protection of Children and Young People. They hired the John Jay College of Criminal Justice to conduct an independent investigation of the problem. They established a National Review Board chaired by a woman (Peggy called for a woman’s touch), Justice Anne M. Burke. The National Review Board monitors the policies of the Secretariat of Child and Youth Protection of the bishops and oversees its annual audit. Five of its current 13 members have that “woman’s touch”. One of the original members of the Review Board was a media representative, William Burleigh, at the time head of the Scripps news agency. This was surely expressive of a desire on the part of the bishops for transparency.

The chairman of the research committee of the original National Review Board, Robert Bennett, said when the report was issued that the sexual abuse of minors was a broad social problem and that a focus merely on the Catholic Church would be a disservice to our children. Regrettably, however, that is exactly what has happened.

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Urgent Need for Comments on American Nurses Association’s Draft Position Statement on Forgoing Nutrition and Hydration by April 28, 2010

Mon, 19 Apr 2010 18:36:00 GMT

Marie T. Hilliard, Ph.D., J.C.L., R.N.
NCBC Director of Bioethics and Public Policy

April 19, 2010. The American Nurses' Association has prepared a draft position statement, Foregoing Nutrition and Hydration, the stated purpose of which is to "clarify the role of the registered nurse and the healthcare systems in which they work pertinent to the support of patients and their surrogates deciding to withdraw or withhold nutrition and hydration".

The National Catholic Bioethics Center has grave concerns pertaining to the draft position statement. Please read the comments on the draft statement provided by The NCBC and the ANA draft statement which can be found at http://nursingworld.org/DocumentVault/NursingPractice/Forgoing-Nutrition-and-Hydration.aspx.

Nurses are encouraged to provide comments by April 28, 2010 to the American Nurses Association through lbadzek@hsc.wvu.edu.

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New NCBC Publication Available. Affirming Love, Avoiding AIDS. What Africa Can Teach the West

Fri, 26 Mar 2010 15:00:00 GMT

March 26, 2010. The experts say that the solution to the rampant spread of HIV/AIDS is not to ask anyone to exercise self-control, but to distribute a prophylactic device that will enable everyone to engage in sexual license without consequence. For those who ascribe to this principle, the claims of Matthew Hanley and Jokin de Irala’s book will seem incomprehensible. “Who could possibly believe that human beings can control their sexual urges? How can anyone remain faithful to a spouse? Doesn’t everyone know that the condom is the solution to the problem of AIDS?”

Hanley and de Irala reject this pessimistic view of human nature in their remarkable book, Affirming Love, Avoiding AIDS: What Africa Can Teach the West (The National Catholic Bioethics Center, 2009). They defend the view that the condom is not the solution to the world-wide AIDS crisis. They offer us instead the virtues of chastity and fidelity. They make their case by citing an abundance of scientific and epidemiological evidence. They show that the thoughtlessness of the AIDS establishment, with its huge budgets and access to influential organizations, such as the United Nations, has promoted a plan of containment that has been disastrous for the health and well-being of large populations.

Africa has been the proving ground for these contrasting theories. The African people have shown that it is morality---and not technological interventions---that is the most effective means of reducing HIV/AIDS. Not surprisingly, human beings are capable of self-control. What they need is moral support, not condoms. They need prevention programs that stress the advantages of sexual abstinence and fidelity in marriage. They do not need government agencies encouraging them to believe that they can engage in high-risk conduct with impunity so long as they put their trust in a piece of latex.

Hardly a week passes without some self-appointed moral authority announcing that more money must now be poured into the world-wide effort to distribute condoms. We are told that programs that stress abstinence and fidelity are dangerous frauds. We are told that people who advance these theories are backwards and ignorant. And yet, the evidence is there, plain to see, not only in the medical literature, but also in common sense. Human beings are capable of prolonged periods of abstinence and can respect the bonds of marriage. this is the solution to the world-wide AIDS epidemic.

A House Divided Against the Common Good

Tue, 23 Mar 2010 22:30:00 GMT

Marie T. Hilliard, Ph.D., J.C.L., R.N.
NCBC Director of Bioethics and Public Policy

March 23, 2010. When the common good takes a back seat to political and corporate interests, all, especially the vulnerable, are at risk. As the largest provider of non-governmental, non-profit health care in this country, the Catholic Church, and those who work as Catholic agencies and organizations, have a special obligation to vulnerable populations, such as the unborn, those with disabilities, and those at life’s end. These populations cannot be compromised in an effort to secure “the greater good.” This is utilitarianism, seeking the greatest good for the greatest number, and never equates to the common good.

It is undeniable that the enacted Patient Protection and Affordable Care Act includes public funding of programs that provide abortion on demand. No accounting practices, or requiring enrollees or employees to write separate checks for abortion coverage, changes that fact. The plan would mandate that in each regional Exchange only one of the qualifying plans not include abortion. Furthermore, there is no restriction on coverage of assisted suicide costs. President Obama’s executive order cannot override federal law. In fact, his Order merely requires adherence to the Act. Specifically, it states: “This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural , enforceable at law or in equity against the United States.” While he attempts to assure us that the seven billion new dollars for Community Health Centers will be applied consistent with the Hyde Amendment, the placement of that language within the Act does not make it subject to the cost-sharing provisions for abortion coverage. Most significantly, Beal v. Doe, 432 U.S. 438 (1977) dictates that, without statutory provisions for the Hyde amendment within each enacted law, “essential services” are to include abortion.

Both individuals and employers will be penalized for the absence of health care coverage. There is no evidence of conscience protections for individuals or employers, who may find themselves having to write separate checks for undesired abortion procedures that happen to be in the plan of choice. There is limited evidence of conscience protections for providers, and the legislation does not provide for protection against coercion of health care providers and employers related to contraceptives or abortifacients. Here we see, most significantly, that a house divided eventually will pay the price for taking compromising positions. Yet, unfortunately, in public opposition to the US Conference of Catholic Bishops’ call for rejection of this legislation as it was written, the Catholic Health Association and fifty-five women religious urged its passage.

The Act will establish a Medicare Commission, which is to develop Medicare cost-saving measures. Providers to Medicare beneficiaries will be rewarded if they reduce the cost of health care services, while maintaining quality. This could foster care disincentives toward some individuals who are elderly or disabled. Broad authority is given to federal agencies to impose binding regulations. Mandates, with penalties, for failure to meet such requirements, could be imposed. The potential impact upon Catholic health care in areas where it is the sole provider, and refuses to engage in procedures destructive to life or natural human functioning, could be ominous.

Nothing is as intimately linked to fostering affordable health care as a moral approach to a global economy. Last year Pope Benedict XVI issued Caritas in Veritate (“Love in Truth”), offering the world a means to evaluate secular economic and social systems through the moral lenses of charity and truth. This new social encyclical focuses on integral human development. Economic activity is called to be people-centered: “This needs to be directed towards the pursuit of the common good.” (N.36). Most notably, Benedict states, “When a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good” (N. 28). Attacks upon life spare no generation: “To the tragic and widespread scourge of abortion we may well have to add in the future – indeed it is already surreptitiously present – the systematic eugenic programming of births. At the other end of the spectrum, a pro-euthanasia mindset is making inroads as an equally damaging assertion of control over life that under certain circumstances is deemed no longer worth living. Underlying these scenarios are cultural viewpoints that deny human dignity.” (N. 75).

One is left to ask, does this health care legislation truly advance the common good? More importantly, when members of a divided house make compromises with principle, has the common good been advanced? The answer is contained in Caritas in Veritate, within which all of the hallmarks of a sound health care reform policy are contained: integral human development; fundamental rights to life and religious freedom; charity with truth; humanistic synthesis; the common good; earth as a gift to humanity to use and protect; civilizing the economy; subsidiarity; a person-based and community oriented culture; people-centered development programs; cooperation of the human family; recognition that every migrant is a human person; and bioethics and human responsibility in human technology. As the encyclical states, in charity and truth, “when a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good.”(N. 28)

The Bishops Speak out on Health Care Reform

Thu, 18 Mar 2010 16:24:00 GMT

March 18, 2010. As the debate on health care reform intensifies prior to an anticipated vote later this week, The NCBC would like to draw particular attention to comments from our bishops regarding the the status of the Senate bill and its provisions for abortion. While there are certainly other troubling issues contained within the proposed legislation, the issue of funding for abortion remains critical and undeniable.

In an attempt to provide health care coverage for all Americans there can be no toleration for the destruction of innocent human life. It has been a desire of the bishops for many years to bring sensible health care reform to our country. The Senate’s refusal to adopt the language of the “Stupak/Pitts Amendment”, which was approved by the House of Representatives, sounds a clear warning that the door remains open to abortion funding and therefore makes the Church’s support for this legislation impossible. There is no greater social good than the protection of human life.

We encourage you to read the following analysis of the legislation provided by the United States Conference of Catholic Bishops and also the public statements of various individual bishops, including the USCCB President and NCBC board member Cardinal Francis George of Chicago.

March 15, 2010 statement of Cardinal Francis George, President of the United States Conference of Catholic Bishops

USCCB Analysis of the Issues in Health Care Reform

The Senate Health Care Reform Bill: Funding Abortions at Community Health Centers http://www.usccb.org/healthcare/communityhealthcenters.pdf

Abortion Funding in the Senate Health Care Reform Bill

What’s Wrong with the Senate Health Care Bill on Abortion? A response to Professor Jost

USCCB Website on Health Care Reform with Additional Resources

Comments and Commentary be Leading U.S. Bishops:

“Health care for life and for all” Bishop William F. Murphy, Cardinal Daniel DiNardo and Bishop John Wester (Washington Post Editorial)

“Catholics, Health Care and the Senate's bad bill”. Archbishop Charles Chaput, Denver. (Denver Catholic Register)

“Letter to the Catholic Community of Northern Colorado”

“Catholics urged to contact 'swing votes' on health care”. Archbishop Joseph Naumann, Kansas City in Kansas (The Leaven)

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Washington D.C. Same Sex Marriage Legislation and the Implications for Catholic Charities

Fri, 05 Mar 2010 20:56:00 GMT

On March 2, 2010 the Archdiocese of Washington ceased offering spousal benefits to new employees of Catholic Charities in order to maintain its service to thousands of vulnerable and poor residents of the District. Under new legislation that mandates recognition of same-sex "marriage", and contains no religious exemption, Catholic Charities would be forced to recognize these immoral but legally sanctioned relationships through the provisions of their employee benefit plan. Catholic Charities in the Archdiocese of Washington serves residents through contracts with the local government which require compliance with all local laws.

The Archdiocese had already been informed in December 2009 that it would no longer be able provide placements for foster children or publicly-funded adoption services. Under the new law, the agency would be required to place children with same-sex married couples and to license the couples as adoptive and foster care families.

You may read the March 1, 2010 statement of the Archdiocese here.

More of the Same: President Obama’s Proposal and the Reconciliation Process

Fri, 26 Feb 2010 18:39:00 GMT

Marie T. Hilliard, Ph.D., J.C.L., R.N.
NCBC Director of Bioethics and Public Policy

February 26, 2010. It is undeniable that President Obama’s plan for health care reform includes a provision for public funding of programs that provide abortion on demand. No accounting practices, or requiring enrollees or employees to write separate checks for abortion coverage, change that fact. It would mandate that in each Exchange in the country only one of the qualifying plans not include abortion. Both individuals and employers will be penalized for the absence of health care coverage. There is no evidence of conscience protections for individuals or employers, who may find themselves having to write separate checks for undesired abortion services that happen to be in the plan of choice. There is limited evidence of conscience protections for providers: only that they cannot be excluded from participating in the plan because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions. Nowhere does it provide for protection against coercion of health care providers and employers related to contraceptives or abortifacients.

The plan also expands Medicaid to all individuals less than 65 years of age, based on income, and is to include essential health benefits. Courts have construed such Medicaid provisions to include abortion: “abortion fits within many of the mandatory care categories, including ‘family planning,’ ‘outpatient services,’ ‘inpatient services, ’ and 'physician's services.’” In fact all basic health plans must provide these “essential health benefits.” While, federal funding of abortion by the US Department of Health and Human Services (e.g., Medicaid) would be in violation of the Hyde Amendment, any health care reform legislation must specifically invoke the Hyde Amendment on all options within the bill to assure its applicability. There is no such invocation in the Obama Plan. Yet proponents of HR 3962 (the Senate bill upon which this proposal builds) insist that provisions for federal funding of abortion are not included. Of particular note is the funding expansion to community health centers to $11 billion dollars. Such centers are the major providers of contraceptives and abortifacients, and referrals for abortion.

The Obama Plan would establish a fifteen member Independent Payment Advisory Board, which is to submit Medicare cost saving measures. While this Board is prohibited from submitting rationing proposals, the Obama Plan will allow providers to high-need Medicare beneficiaries (the elderly and disabled) to share in any savings if they reduce the cost of health care services. This constitutes an incentive not to treat the elderly and disabled. Every three years non-profit hospitals will be required to conduct community needs assessments and develop strategies to meet those needs. Mandates, with penalties, for failure to meet such requirements, as well as requirements pertaining to billing and patient financial assistance, will be imposed. How this will impact areas in which Catholic health care is the sole provider, and refuses to engage in procedures destructive to life or natural human functioning, is unclear.

Nothing is as intimately linked to fostering affordable health care as a moral approach to a global economy. On June 29, 2009 Pope Benedict XVI issued his third encyclical, Caritas in Veritate (“Love in Truth”) , offering the world a means to evaluate secular economic and social systems through the moral lenses of charity and truth. While commemorating the fortieth anniversary of Paul VI’s encyclical, Populorum Progressio, this new social encyclical focuses, not on the development of peoples, but integral human development. Thus, economic activity is called to be people-centered: “This needs to be directed towards the pursuit of the common good, for which the political community in particular must also take responsibility.” (N.36) Most notably, Benedict states: “When a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man's true good.” (N. 28) He also recognizes that the attacks upon life spare no generation: “To the tragic and widespread scourge of abortion we may well have to add in the future — indeed it is already surreptitiously present — the systematic eugenic programming of births. At the other end of the spectrum, a pro-euthanasia mindset is making inroads as an equally damaging assertion of control over life that under certain circumstances is deemed no longer worth living. Underlying these scenarios are cultural viewpoints that deny human dignity.” (N. 75)

The question remains as to whether our “society” is advancing this proposal, when one looks at the proposed “Reconciliation” process, usually reserved for budgetary matters, not policy matters. Such a process of reconciliation limits debate and amendment, and therefore favors the majority party. Specifically, the House would vote on the Senate proposal, which is the basis for the Obama Plan. Then the reconciliation process would be used to develop a separate bill to resolve differences in the House and Senate versions. Voting procedures on this bill would disallow a filibuster, potentially allowing one political party to control the vote and pass the health care reform proposal.

Finally, one is left to ask, does the Obama Plan advance the common good? The answer is in Caritas in Veritate. All the hallmarks of a sound health care reform policy are contained within Caritas in Veritate: integral human development; fundamental rights to life and religious freedom; charity with truth; humanistic synthesis; the common good; earth as a gift to humanity to use and protect; civilizing the economy; subsidiarity; a person-based and community oriented culture; people-centered development programs; cooperation of the human family; recognition that every migrant is a human person; and bioethics and human responsibility in human technology. As the encyclical states, in charity and truth, “when a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good.” (N.28)

Cooperation, Health Care Reform, and Incrementalism

Mon, 22 Feb 2010 20:56:00 GMT

Stephen Napier Ph.D.

February 22, 2010. We are often consulted at The National Catholic Bioethics Center about cooperation questions. Health reform debates are now in the stage of reconciliation. The US Congress will consider (as of 2/22/10) the reconciliation process to advance the anti-life Senate health care reform proposal. We have been asked about the extent to which person’s of conscience can endorse certain health care reform proposals. At issue is the senate version of health care reform which would implicate citizens in cooperating in abortion. Can we support such legislation even if other aspects of it would ensure serious goods to society?

John Paul II in his Encyclical Evangelium vitae says the following about the stance we should take to unjust legislation,

In the case of an intrinsically unjust law, such as a law permitting abortion or euthanasia, it is therefore never licit to obey it, or to "take part in a propaganda campaign in favour of such a law, or vote for it" (n. 73).

What is clear is that voting for a law that expands the access to or availability of abortion is never licit. More complicated is the scenario when the law in question does not completely abrogate the abortion law, but seeks to limit its effects (e.g., parental consent laws, laws requiring ultrasounds before abortions etc.) To these JPII says,

An elected official, whose absolute personal opposition to procured abortion was well known, could licitly support proposals aimed at limiting the harm done by such a law and at lessening its negative consequences at the level of general opinion and public morality. This does not in fact represent an illicit cooperation with an unjust law, but rather a legitimate and proper attempt to limit its evil aspects.

These comments are sufficient to “test” our current health care reform proposal under consideration.

Assuming that the health care reform bill that makes it out of adjudication still entails that those who object to abortion will have to pay for abortions (either through taxpayer dollars or through the “two-checks” compromise), then the legislation should be opposed. Some would argue that imperfect legislation can be supported if it also led to great goods for society. But if the evil it makes possible or expands access to is the destruction of human life, then it would be an inappropriate application of “incrementalism” to vote for it. JPII’s comments say that it is permissible to vote for imperfect legislation when it limits or reduces the effects of an intrinsically unjust law already in place. But when the legislation being proposed expands access to abortion, even if it ensures certain goods to society, the legislation is itself unjust.

Some would advocate a procedure whereby one calculates the goods and evils a piece of legislation entails. The argument may be that the goods ensured by this aspect of the legislation outweigh or trump the evils ensured by another aspect of the legislation. But this approach cannot be justified in that it would amount to an intention to see abortion access expanded. Why? If given an option of endorsing a version of health care reform that does not provide abortion aid, and one endorses a version that does provide abortion aid (all else being equal), there can be but one intention, namely, to expand access to abortion. Endorsing any legislation that furthers abortion prior to being approved must involve an intent to further abortion because prior to approval there are other options, such as amendments to prevent the effect of furthering abortion.

What our legislators need to understand is that a majority of us think that the direct killing of young human life is wrong. Such an action involves killing the most vulnerable members of the human family. None of us has a right to kill our children. Our stance towards human life, at any stage of development, ought to be one of respect and care, and not treated as a problem to be done away with. Endorsing health care reform that expands access to a procedure that kills the innocent simply cannot be justified. If the State pays for a plan which includes abortions, in whatever form/policy/reform bill, it would effectively endorse a controversial moral position whose arguments are excessively dubious and weak.

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Triage Protocols in Cases of Scarce Medical Resources

Mon, 08 Feb 2010 21:24:00 GMT

Often health care professionals can be overwhelmed with casualties resulting from natural disasters, such as the recent earthquake in Haiti, from pandemics, such as the one feared from the H1N1 virus (“Swine Flu”), or from warfare or terrorist attacks. The health care professionals themselves are often taxed beyond normal endurance. But they also face the lack of sufficient medical resources, such as simple anti-biotics or ventilators, to provide life saving interventions. In such situations, very difficult moral decisions have to be made as to who will receive what resources are available. These are often gut-wrenching decisions. The allocation of these scarce resources is often referred to as “triage”.

It is important that hospitals have in place protocols which will enable them to make decisions as objectively as possible, under often horrific conditions, with respect to who will or will not receive the scarce medical resource. In the vortex of a disaster physicians and nurses must often make life-and-death decisions with the medical and the moral resources at hand.

The National Catholic Bioethics Center has not infrequently received requests for help in applying the Catholic moral tradition in such situations, as occurred recently after the devastating earthquake in Haiti. In our discussions with care-givers in the midst of these crises, we point out the need to have an objective policy in place to direct the use of limited resources that would apply equally to all patients. However, an “objective” policy must also be flexible in order to be applied in an extraordinary situation in which circumstances can change by the minute and patients of varying conditions will be brought for treatment and care. Obviously it is best to have these protocols in place prior to a crisis striking.

Let us reflect on this question in terms of the use of ventilators when there are not enough available for all who need one. Some patients would benefit from short-term application of the ventilator; others would require long term use---something often impossible in crisis situations. Furthermore, appropriate reassessments of patients on a periodic basis would be required in the event that a patient shows evidence of being able to benefit from limited medical resources. The hospital would need to determine, by established criteria such as those listed below, what would be a reasonable amount of time and the appropriate circumstances for any one patient to make use of the ventilator. Once that time was up, it could rightly be given to another.

The crisis in Haiti has brought to light the importance of having policies in place to manage crisis situations. A clear policy would help physicians recognize the need to make careful judgments about who would best be helped by short-term use of the ventilator, and who would require more support than could be given. A policy would also diminish the likelihood of arbitrary decisions being made which might appear as favoritism to some over others. We have provided, below, a set of criteria that could be used to guide such a policy. In all cases, when a decision has been made that a patient will not benefit from limited resources, appropriate palliative care should be provided.

We hope that The National Catholic Bioethics Center can assist the suffering victims of sudden and unexpected crises and their care-givers by bringing the highly developed moral tradition and compassion of the Catholic Church to bear in these heart-breaking situations through these reflections on triage.

Criteria for Determining Whether a Patient is a Candidate for Benefitting from Limited Health Care Resources, Including, but not Limited to the Ventilator, as Well as the Resource of Health Care Personnel.

Identify exclusion criteria for the allocation of life sustaining care, including ventilators, e.g.:

End-stage organ failure; repeated cardiac arrest or un-witnessed cardiac arrest, or unresponsiveness to standard measures to maintain cardiac function; incurable malignancy; severe burn >40%; severe inhalation injury.
Assess patients for sequential organ failure (assessment methods that could be used if available are in parenthesis), done initially and at 48 and 120 hours, and daily thereafter, allowing for a re-determination of whether a patient can benefit from the limited resource:

Respiratory and cardiovascular function (PaO2/FiO2); hemopoietic function (platelet level); hypotension; liver function (bilirubin); kidney function (creatinine); neurological status (Glasgow Coma Scale).
Categorize patients based on assessment ¹, e.g.:

Palliate – If there is a presence of any of the exclusion criteria. Furthermore, in the absence of any exclusion criteria there is/are a number of organ failures that the facility pre-determines would present an unsustainable condition for the patient to benefit.

High Priority for Receiving Limited Resources – Single organ failure (the facility may determine that even a single organ failure is not sustainable in the disaster situation).

Intermediate Priority – A patient with more evidence of organ failure than the “High Priority” patient, but less than the patient in the “Palliate” category. Based on the decisions made as to what constitutes “Palliate” and what constitutes “High Priority,” this category could be determined to be somewhere between the two categories.
Develop Priority for Ventilator Access Criteria, e.g.:

With the aforementioned continuing assessment, if a patient remains in the “High Priority” category (thus still able to benefit), that patient should not be removed from the ventilator for another “High Priority” or “Intermediate Priority” patient.

If in the presence of sufficient resources, a patient categorized as in the “Intermediate Priority” category has been ventilated, that ventilator should not be removed for a patient in a “High Priority” category unless the patient in the “Intermediate Priority” category has not improved within a set period of time (e.g., 120 hours).

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¹For a model of how Sequential Organ Failure Assessment Scores can be used in critically ill patients see: Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patientsby Flavio Lopes Ferreira, MD; Daliana Peres Bota, MD; Annette Bross, MD; Christian Mélot, MD, PhD, MSciBiostat; Jean-Louis Vincent, MD, PhD, JAMA. 2001; 286:1754-1758.

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Request for Comments on the American Nurses Association Draft Document: Registered Nurses' Roles and Responsibilities in Providing Expert Care and Counseling at the End of LIfe

Fri, 22 Jan 2010 19:08:00 GMT

Marie T. Hilliard, J.C.L., Ph.D., R.N.

Comments Needed by February 8, 2010

Please Provide Comment on the American Nurses Association Draft Document

Registered Nurses’ Roles and Responsibilities in Providing Expert Care and Counseling at the End of Life

The American Nurses Association is revising its position statement pertaining to end-of-life care, which could impact the understanding of the nurse’s role in states where assisted suicide is legal.

To review the draft document and provide comment see: http://nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements/Public-Comment.aspx

Summary:

The greatest NCBC concerns rest with the fact that the concept of double effect is not articulated accurately. One can never intend the hastening of death. Thus, the NCBC requests the removal of the phrase “sole intention” and substituting the word “intention” as follows (and in other places within the document when “sole intent” or “sole intention” are used): “While nurses should make every effort to provide comprehensive pain control and symptom relief for patients at end-of-life, it is never ethically permissible for a nurse to administer medication with the sole intention of ending a patient’s life.”

One licitly can anticipate a secondary unintended effect of hastening death (with such things as pain control, used for that purpose) while understanding that it could cause respiratory suppression. However, if one intends hastening death either at the time as intending to alleviate suffering, or worse, by causing death, and thus ending all palliative care, such an action clearly is unethical.

Also, the largest provider of non-governmental health care (thus the largest employer of nurses) is the Catholic Church. There is no reference to the ethical framework which guides care in all Catholic health care facilities (The Ethical and Religious Directives for Catholic Health Care Services). At the same time, there is reference to documents from what was known as the Hemlock Society (Compassion & Choices). For a more comprehensive approach to end-of-life care in this document, there should be a reference to The Ethical and Religious Directives for Catholic Health Care Services: http://www.usccb.org/meetings/2009Fall/docs/ERDs_5th_ed_091118_FINAL.pdf.

Lastly and of increasing importance is the issue of conscience rights of the nurse. Health care professionals are not agents of whatever the patient or state wishes. That is the stuff of the Nuremburg Trials. Health care professionals should be able to have the same conscientious objection as provided for those who can refuse to participate in capital punishment.

For a more detailed analysis of the draft document, with comment, see: http://www.ncbcenter.org/Document.Doc?id=96

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U.S. Bishops Call for Action on Health Care Reform

Wed, 13 Jan 2010 14:57:00 GMT

Call of the US Conference of Catholic Bishops for Health Care Reform that Does Not Destroy Lives but Saves Lives

Protect Conscience; Ensure Affordable Health Coverage; Allow Immigrants to Purchase Private Health Insurance

January 12, 2010

The Bishops of the United States have called upon Congress to develop Health Care Reform which:

Is a truly universal health policy with respect for human life and dignity;
Provides access for all with a special concern for the poor and inclusion of immigrants;
Pursues the common good, preserving pluralism including freedom of conscience and variety of options; and
Restrains costs and applies costs equitably across the spectrum of payers.

As long-time advocates of health care reform, the U.S. Catholic bishops continue to make the moral case that genuine health care reform must protect the life, dignity, consciences and health of all, especially the poor and vulnerable. Health care reform should not advance a pro-abortion agenda in our country.

On November 7, the U.S. House of Representatives passed major health care reform that reaffirms the essential, longstanding and widely supported policy against using federal funds for elective abortions and includes positive measures on affordability and immigrants.
On December 24, the U.S. Senate rejected this policy and passed health care reform that requires federal funds to help subsidize and promote health plans that cover elective abortions. All purchasers of such plans will be required to pay for other people's abortions through a separate payment solely to pay for abortion.
Outside the abortion context, neither bill has adequate conscience protection for health care providers, plans or employers.
These two bills must now be combined into one bill that both the House and Senate will vote on in final form. Provisions against abortion funding and in favor of conscience protection, affordability, and immigrants' access to health care must be part of a fair and just health care reform bill, or the final bill must be opposed.

ACTION: Contact your Representative and Senators today by e-mail, phone or FAX.

To send a pre-written, instant e-mail to Congress go to www.usccb.org/action.
Call the U.S. Capitol switchboard at: 202-224-3121, or call your Members' local offices.
Contact info can be found on Members' web sites at www.house.gov & www.senate.gov.

SUGGESTED MESSAGE TO THE HOUSE:

"I am pleased that the House health care bill maintains the longstanding policy against federal funding of abortion. I urge you to work to uphold essential provisions against abortion funding, to include full conscience protection and to assure that health care is accessible and affordable for all. Until and unless these criteria are met, I urge you to oppose the final bill."

SUGGESTED MESSAGE TO THE SENATE:

"I am deeply disappointed that the Senate health care bill fails to maintain the longstanding policy against federal funding of abortion and does not include adequate protection for conscience. I urge you to support essential provisions against abortion funding, similar to those in the House bill. Include full conscience protection and assure that health care is accessible and affordable for all. Until and unless these criteria are met, I urge you to oppose the final bill."

WHEN: Immediately. Votes in the House and Senate on the final bill are expected in January.

For more information and to take action see:
www.usccb.org/healthcare/

Act today! Thank You!

Health Care Reform: Betraying the Unborn for a Few Pieces of Silver

Wed, 23 Dec 2009 16:42:00 GMT

Marie T. Hilliard, J.C.L., Ph.D., R.N.

The use of tax payer dollars to pay for the death of the unborn has been advanced in the Senate by several “pro-life” Democrats, who appear to have yielded to political pressures, and perhaps even to the promise of economic benefits for their states. After putting forth an amendment that would have protected the unborn, Senator Ben Nelson (D-Nebraska) has joined the ranks of Senator Mary Landreau (D-Louisiana) in assuring the sixty votes needed by Senate Majority Leader Harry Reid (D-Nevada) for the Senate to pass landmark federal legislation supportive of American taxpayers’ funding of abortion on demand even as it seeks to make health insurance coverage available to all Americans.

Ultimately all persons will be required to have health insurance. Enrollees can choose from plans within health care Exchanges that meet their needs. However, if that plan also includes abortion coverage, the enrollee must pay for that coverage, whether they want it or not. Despite all of the proposed accounting gymnastics to factor out the premiums and costs for abortion (such as enrollees being required to write a separate premium check to pay for abortion coverage), for the first time in our nation’s history, federally-supported, taxpayer-funded health care plans will provide abortion on demand. One small bit of consolation is that there are some concessions to persons of conscience. States can opt out of providing abortion coverage, and although conscience provisions fall short of the House-passed bill in protecting health care providers who are resolute in not cooperating in the evil of abortion, there are some protections for providers and health care facilities of conscience. Still, all persons will be required to have health insurance, and employers will be fined for not offering such insurance. Furthermore, in states which choose to provide abortion coverage, an enrollee may select from the Exchange options a plan that also includes abortion coverage. Despite the faux mechanisms of separate checks and separate payroll deductions for abortion coverage, employers may be required to facilitate such payments through payroll deductions. Lastly, there is no provision allowing institutions of conscience to provide and purchase health coverage consistent with their moral and religious convictions.

The vote in the Senate is expected by Christmas eve. It is a sad irony that as we celebrate the birth of our Savior, the halls of Congress already are planning His death, again for a few “pieces of silver.”

For information on how to have your voice heard go to: http://www.nchla.org/issues.asp?ID=51.

Copenhagen and Catholic Teaching

Mon, 21 Dec 2009 16:15:00 GMT

Stephen Napier, Ph.D

December 21, 2009. As of late December 2009, the United Nations’ Climate Change Conference in Copenhagen is still underway. In the wake of the conference, climate change and global warming has become a debatable issue – largely in part due to the recent “Climategate” scandal where a series of emails were published that called into question the scientific validity of the claim that global warming is caused by human activity.¹ In this debate, some scoff at the idea of governmental regulation of pollution, others are saying that we have to quell emissions immediately and drastically, and if this involves severely limiting some of our liberties, then so be it. But there is a surprising confusion in this debate. Confusion persists among politicians who may be “pro-life” but are not sympathetic to environmental concerns, or at least not government regulation of industry to curb pollution. And likewise, there are politicians who favor legislation aimed to protect our natural resources but are also committed to a worldview that is actually pernicious to human life – especially young human life. (This is probably due to a perceived link between protecting the environment and over-population.) Consequently, some clarifications are in order about what the Catholic Church teaches on this issue.

First, Catholic teaching is committed to the idea of caring for the environment, protecting our natural resources, and encouraging a diverse eco-system (i.e., endangered species ought to be protected). Recently (December 15, 2009), Pope Benedict XVI in his World Day for Peace address says that our commitment to the created order stems from our commitment to our fellow persons.

The Church has a responsibility towards creation, and she considers it her duty to exercise that responsibility in public life, in order to protect earth, water and air as gifts of God the Creator meant for everyone, and above all to save mankind from the danger of self-destruction. ... Our duties towards the environment flow from our duties towards the person, considered both individually and in relation to others.²

Environmental degradation, pollution, food scarcity etc. obviously contribute to starvation, ill-health, and in general, a failure to promote integral human development worldwide. Quoting Benedict XVI again,

Can we remain indifferent before the problems associated with such realities as climate change, desertification, the deterioration and loss of productivity in vast agricultural areas, the pollution of rivers and aquifers, the loss of biodiversity, the increase of natural catastrophes and the deforestation of equatorial and tropical regions? Can we disregard the growing phenomenon of "environmental refugees", people who are forced by the degradation of their natural habitat to forsake it - and often their possessions as well - in order to face the dangers and uncertainties of forced displacement?³

Clearly, there is a moral imperative to care for the environment and this is rooted in the most basic moral commitments we have to ourselves and others: justice and charity.

A second point of clarification concerns the reason upon which our duty to preserve and protect the environment is based. Fundamentally we owe it to each other. When pollution of either air or water, and other forms of environmental degradation inevitably lead to the destruction of human life, we have failed to act with sobriety and solidarity with our fellow persons.

A third and fundamental point of clarification is to observe that the moral reason for preserving and protecting the environment pertains to our duties to act charitably and justly towards our fellow human beings. Solidarity demands sobriety in our lifestyle. Pope Benedict notes, “This means that technologically advanced societies must be prepared to encourage more sober lifestyles, while reducing their energy consumption and improving its efficiency” and “Specifically, they [our ecological crises] call for a lifestyle marked by sobriety and solidarity,…”⁴ These crises also demand far-sighted policies absent the “pursuit of myopic economic interests.” The cost to society and to the environment needs to be taken into account. The justification for our caring for the environment stems from the respect we owe to ourselves and to other persons.

Notice how different this reasoning is to those who espouse a bio-centric worldview where humans are creatures along a continuum. Those creatures having the most value are those who possess higher-order consciousness or other exercisable mental capacities. An adult monkey, on this view, is more valuable than an immature human being. Such disregard for the value, worth, and distinctiveness of human life is pernicious to a comprehensive life-ethic. “In the name of a supposedly egalitarian vision of the "dignity" of all living creatures, such notions end up abolishing the distinctiveness and superior role of human beings.” ⁵Locating the value of things in what they can do leads to disastrous consequences and is ultimately morally repugnant. Human beings have their inherent dignity and worth in virtue of what we are, not in virtue of what we can do or perform. In fact, a worldview that locates the value of persons in what they can do means that a person’s value comes and goes with what abilities they can exercise. Upon such a flimsy basis for worth, no moral duty can be grounded, at least, not one that would justify sacrificial action that the current environment crises require of us. In the end, the bio-centric worldview is self-defeating when it asserts a moral duty to protect the environment and save people’s lives when the value of people’s lives is not intrinsic or inherent in them. An ethic that locates the value of people in what they are (namely, what is intrinsic and inherent in them), naturally enough grounds certain absolute moral duties to care for and protect them.

¹ See the article and commentary by Richard Stuebi, “On Climate Gate,” The Huffington Post, available at: http://www.huffingtonpost.com/richard-stuebi/on-climate-gate_b_385502.html.
² Pope Benedict XVI, “Message for World Day of Peace (December 15, 2009),” http://seraphin.vatican.va/news_services/press/vis/dinamiche/b1_en.htm.
³ Ibid.
⁴Ibid.
⁵Ibid.

The Revision of Directive 58 of Ethical and Religious Directives for Catholic Health Care Services

Thu, 17 Dec 2009 15:41:00 GMT

Edward J. Furton, Ph.D

December 16, 2009. After careful deliberation, the United States Conference of Catholic Bishops has revised directive 58 of the Ethical and Religious Directives for Catholic Health Care Services (2001). Here is the language of the new directive:

In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally. This obligation extends to patients in chronic and presumably irreversible conditions (e.g., the "persistent vegetative state") who can reasonably be expected to live indefinitely if given such care. Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be "excessively burdensome for the patient or (would) cause significant physical discomfort, for example resulting from complications in the use of the means employed." For instance, as a patient draws close to inevitable death from an underlying progressive and fatal condition, certain measures to provide nutrition and hydration may become excessively burdensome and therefore not obligatory in light of their very limited ability to prolong life or provide comfort.

The bishops also deleted language in the introduction to Part V, “Issues in Care for the Dying,” that indicated the need for “further reflection” on whether nutrition and hydration should be provided for patients in a persistent vegetative state...

(click to read the complete text)

NCBC Opposes Rejection of Nelson-Hatch Amendment in Senate Version of Health Care Reform (H.R. 3590)

Thu, 10 Dec 2009 21:41:00 GMT

December 10, 2009. The National Catholic Bioethics Center received with dismay the news that the US Senate rejected the Nelson-Hatch Amendment (identical to the Stupak-Pitts Amendment in the House version of Health Care Reform legislation), with a vote of 54-45. In fact, the current Senate version of this legislation requires each state to offer a plan that includes abortion coverage. It also provides tax-support of enrollment costs for private plans that cover abortions. Although Senator Henry Reid (D-NV) has indicated a compromise may be crafted to omit the community health insurance option (public option), the current proposal authorizes the Secretary of Health and Human Services to allow abortion coverage in a public option. Even though there is to be a factoring out of the cost of those procedures in the premiums, abortion will be paid for by tax dollars within the options that remain. In reality, then, there is no prohibition of government support for abortion. Rather, the proposal mandates abortion coverage in each region of the country. Also, while the bill prohibits limiting access to end-of-life care, and protects the consciences of health care workers regarding participation in assisted suicide, there is no prohibition against the funding of assisted suicide.

Lastly, but very significantly, while Senator Reid has indicated openness to a compromise which would remove the provision of a public option, the intended compromise will empower the government to reinstate a public option in a final bill by action of a conference committee if private plans fail to meet certain goals. Conference committees are used to rectify any discrepancies between House and Senate versions of legislation.

A public option offered at lower cost creates a strong incentive for private employers to participate, easily leading to the “public option” becoming a national plan. Should that occur, providers would potentially face legal mandates to supply morally illicit procedures, especially in geographic areas where the only health care provider opposes such anti-life procedures.

There is a clear need to remain vigilant in expressing opposition to publicly funded assaults on human life. As the largest provider of non-governmental health care in the United States, Catholic health care is likely to be the only local provider of care in some geographical areas, and thus may become subject to morally-unacceptable mandates in the delivery of care.

Swift action is needed in contacting congressional members through e-mail, phone calls or faxed letters. To view informational sources from the USCCB and to take action go to http://www.nchla.org/issues.asp?ID=51. Our country is at a crossroads, not only in terms how our most vulnerable members will be treated, but also in terms of the future of conscience protections.

NCBC Opposes Omission of Pro-Life Provisions in Senate Version of Health Care Reform (H.R. 3590)

Fri, 20 Nov 2009 15:59:00 GMT

November 20, 2009. The National Catholic Bioethics Center received with dismay the US Senate version of Health Care Reform legislation which does not contain the provisions of the Stupak-Pitts Amendment of the House version of the Health Care Reform proposal (H.R. 3962). In fact, the Senate version of this legislation requires each state to offer a plan that includes abortion coverage. It also provides for tax-support of enrollment costs for private plans that cover abortions. It authorizes the Secretary of Health and Human Services to allow such coverage in the public option. For both the public and private options there is to be a factoring out of the cost of those procedures in the premiums; but the overall public and private option plans that support abortion will be paid for by tax dollars. Thus, in reality this does not represent a prohibition of government support of abortion, especially since the proposal mandates abortion coverage in each region of the country. In addition, the bill prohibits limiting access to end-of-life care, while protecting the consciences of health care workers and entities regarding participation in assisted suicide. However, there is no prohibition against the funding of assisted suicide. Conference committees are used to rectify any discrepancies between House and Senate versions of legislation. Herein rests the need to be vigilant in continuing to express opposition to publicly funded assaults on human life.

Lastly, but very significantly, the creation of the community health insurance option (public option) also raises potential threats to conscience. A pubic option creates a strong incentive, if not a mandate, for private employers, to participate in such an option. Thus, the exception easily could become the national plan. Providers then may be faced with legal mandates to supply morally illicit procedures, especially in areas where the only provider opposes anti-life measures. As the largest provider of non-governmental health care in the United States, Catholic health care is likely to be the only local provider of care in some geographical areas, and thus may become subject to morally-unacceptable mandates in the delivery of care.

Swift action is needed in contacting congressional members through e-mail, phone calls or faxed letters. To take action go to http://www.nchla.org/issues.asp?ID=51. Our country is at a crossroads, not only in terms how our most vulnerable members will be treated, but also in terms of the future of conscience protections.

NCBC Advises Caution Despite Pro-Life Protections in H.R. 3962

Mon, 09 Nov 2009 16:01:00 GMT

November 9, 2009. The National Catholic Bioethics Center applauds the 240 members of Congress who supported The Stupak-Pitts Amendment in the US House of Representatives’ Health Care Reform proposal. This amendment would permanently prevent the funding of abortion within the public option of the plan, consistent with the provisions of the Hyde Amendment.

Also consistent with these same provisions, the Stupak-Pitts Amendment would prohibit the use of public funds for premiums paid to private plans that include abortion. Furthermore, this amendment also contains strong conscience protections for health care workers.

However, the amendment does not provide such protections for pharmacists in the dispensing of abortifacients, nor for private insurance companies, who will be prohibited from discriminating against abortionists who wish to be contracted providers.

The greatest concern rests in the fact that there is no guarantee that the final version of the Health Care Reform legislation will include these pro-life provisions. Conference committees are used to rectify any discrepancies between House and Senate versions of legislation. Two Senate Committees have approved bills that would include public funding of abortion; and the Senate Finance Committee rejected conscience protections for health care workers. Herein rests the need to be vigilant in continuing to express opposition to publicly funded assaults on human life.

Caution also must be exercised in embracing the end-of-life care parameters of the proposals. End-of-life care planning consultations exclude assisted suicide. However, as states embrace and redefine “assisted suicide” as “death with dignity,” and disallow a death certificate to list suicide as the cause of death, consultation for such purposes may be paid for under the plan.

Lastly, but very significantly, the retention of a “public option” also raises potential threats to conscience. A pubic option, for which states will be taxed whether they “opt in” or not, creates a strong incentive, if not almost a mandate, for states, as well as private employers, to participate in such an option. Thus, the “option” easily could become the national plan. Providers then may be faced with legal mandates to supply morally illicit procedures, especially in areas where the only provider opposes anti-life procedures. As the largest provider of non-governmental health care in the United States, Catholic health care is likely to be the only local provider of care in some geographical areas, and thus may become subject to morally-unacceptable mandates in the delivery of care.

The NCBC applauds the passage of the Stupak-Pitts Amendment, while urging continued efforts to assure that all provisions that have an impact on health care provide for the life, dignity, well-being, and conscience rights of all persons.

The National Catholic Bioethics Center Supports the People of Maine in Protecting the Very Essence of Marriage

Wed, 04 Nov 2009 20:41:00 GMT

November 4, 2009. The people of Maine have spoken, joining thirty other states whose citizens, when given the chance to speak through ballot initiatives, have embraced the objective moral order in their recognition of what constitutes marriage. The National Catholic Bioethics Center congratulates them for assuring that their voices were heard and for their vote to protect the very essence of marriage. The NCBC affirms that all persons have innate dignity, regardless of their sexual practices. However, societal recognition of marriage is based upon centuries of understanding concerning the philosophical, social and physical nature of marriage. Such a union receives the protection of law, not because any person can claim such a right; after all, no one has the right to marry their daughter or to have multiple spouses. Marriage receives legal status because of the benefits society receives from a permanent and exclusive union of one man and one woman, and the children they will engender and educate to be productive citizens. No other social construct is equal to this union. The people of Maine have affirmed the value of protecting this sacred institution; and we congratulate them.

NCBC Supports USCCB's Position on Health Care Reform and Asks Advocates for the Vulnerable to Let their Voices be Heard

Fri, 30 Oct 2009 19:39:00 GMT

October 30, 2009. Consistent with the position of the US Conference of Catholic Bishops The National Catholic Bioethics Center supports a health care proposal which is truly universal with respect to protecting human life and dignity. This requirement relates not only to the absolute imperative to exclude provisions that violate human life and dignity, but also to the need to protect conscience rights. Not only should taxpayers not be required to pay for immoral procedures, but provisions also must exist to prohibit mandates on providers. Excluding such provisions is contrary to the integrity of a free and pluralistic society. The NCBC believes that immoral mandates will be imposed if there is no explicit conscience provision, especially in the presence of a public option.

Thus, it is essential that longstanding and widely supported federal restrictions on abortion funding and mandates, and protections for rights of conscience, explicitly be included in any health care reform legislation. No current Congressional proposal has such provisions. The NCBC supports the position of the USCCB that if acceptable language in these areas cannot be found, vigorous opposition to the proposal must occur.

There is a proposed amendment (The Stupak Amendment) that if adopted would address essential pro-life concerns on abortion funding and conscience rights in the House version of the health care reform bill. Since votes on health care reform proposals in Congress could come as soon as early November, the Bishops of the United States have asked that each person contact their Representative and Senators immediately, urging them to amend proposed legislation with pro-life amendments. For more information go to http://www.usccb.org/healthcare/. Parishes across the country will be invited to make use of educational materials, including a web address that allows parishioners to send an e-mail message to Congress with a click of a button.

The bishops have asked for swift action in contacting congressional members through e-mail, phone calls or faxed letters. To take action go to http://www.nchla.org/issues.asp?ID=51. Our country is at a crossroads, not only in terms how our most vulnerable members will be treated, but also in terms of the future of conscience protections.

Cardinal Justin F. Rigali Issues Statement for Respect Life Sunday (2009)

Wed, 30 Sep 2009 20:00:00 GMT

September 30, 2009. Cardinal Justin Rigali, Chair of the USCCB Pro-Life Committee released a statement on September 29, 2009 for Respect Life Sunday, which states, in part: “despite the opposition of 67% of Americans to taxpayer-funded abortion, all current health care proposals being considered by Congress would allow or mandate abortion funding, either through premiums paid into government programs or out of federal revenues.”

Noting that the unborn are not alone in being under attack in current proposals, Cardinal Rigali called for health care that recognizes the humanity of the immigrant. “How can a just society deny basic health care to those living and working among us who need medical attention? It cannot and must not.” [http://www.usccb.org/comm/archives/2009/09-189.shtml] To have your voices heard on this and other important issues impacting the sanctity of human life go to http://www.nchla.org/issues.asp?ID=51.

Evaluating Health Care Proposals in Light of Caritas in Veritate (1)

Fri, 28 Aug 2009 18:20:00 GMT

Marie T. Hilliard, Ph.D., J.C.L., R.N.
NCBC Dir of Bioethics and Public Policy

August 28, 2009. Nothing is as intimately linked to fostering affordable health care as a moral approach to a global economy. On June 29, 2009 Pope Benedict XVI issued his third encyclical, Caritas in Veritate (“Love in Truth”), offering the world a means to evaluate secular economic and social systems through the moral lenses of charity and truth. While commemorating the fortieth anniversary of Paul VI’s encyclical, Populorum Progressio,² this new social encyclical focuses, not on the development of peoples, but integral human development. Thus, economic activity is called to be people-centered: “This needs to be directed towards the pursuit of the common good, for which the political community in particular must also take responsibility.” (N.36)

While the encyclical has as one of its major themes the environment as the created world entrusted to human beings for the good of everyone, it emphasizes that charity is at the heart of the Church’s social doctrine. But as its title suggests, such charity must be based in truth: “a Christianity of charity without truth would be more or less interchangeable with a pool of good sentiments, helpful for social cohesion, but of little relevance.”(N. 4) In so stating, the encyclical renounces relativism and extensively addresses the fundamental rights to religious freedom and to life. Benedict links subsidiarity to freedom: “In order not to produce a dangerous universal power of a tyrannical nature, the governance of globalization must be marked by subsidiarity, articulated into several layers and involving different levels that can work together.”(N. 57) Most notably, Benedict states: “When a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man's true good.” (N. 28) He also recognizes that the attacks upon life spare no generation: “To the tragic and widespread scourge of abortion we may well have to add in the future — indeed it is already surreptitiously present — the systematic eugenic programming of births. At the other end of the spectrum, a pro-euthanasia mindset is making inroads as an equally damaging assertion of control over life that under certain circumstances is deemed no longer worth living. Underlying these scenarios are cultural viewpoints that deny human dignity.” (N. 75) Thus, while this new social encyclical has not been focused on health care reform, it provides an excellent moral measuring stick to analyze federal health care reform proposals.³

It is undeniable that the Federal Health Care Reform Proposal HR 3200 includes a provision for publicly funded abortions. It would mandate that “essential benefits packages” be provided in every region of the country. These benefits, as defined in Section 122, include provisions similar to those included in the Medicaid Act. Courts have construed such Medicaid provisions to include abortion: “abortion fits within many of the mandatory care categories, including ‘family planning,’ ‘outpatient services,’ inpatient services,’ and physicians’ services.’”⁴ Every meaningful amendment offered to remove abortion from these packages has failed. In fact, the Capps Amendment to the bill, passed by the House Energy and Commerce Committee, specifically authorizes the provision of abortion. Federal funding of abortion by the US Department of Health and Human Services would be in violation of the Hyde Amendment.⁵ However, any health care reform legislation must specifically invoke the Hyde Amendment on all options within the bill to assure its applicability, which it does not. Yet proponents of HR 3200 insist that provisions for federal funding of abortion are not included in the bill. While there currently are two provisions within the proposal protective of the consciences and religious liberty of health care providers, mandates inevitably will follow. This is particularly true in regions of the country where Catholic health care is the only provider in a region. Thus, not only is the right to life in great jeopardy, but also the right to religious liberty. These violations of rights will be by the very hand of a government charged to protect them.

Receiving great attention has been concerns related to the care available to the elderly, those with disabilities, and veterans. These concerns are not only related to the potential for the rationing of care. They also are based upon the specific provisions of the proposal that could be seen as encouraging those deemed to be less productive members of society, based on “quality of life” parameters, to deny themselves care which may be beneficial. - Even worse, they may be encouraged to refuse beneficial treatments because they come to be convinced that they are a burden to family and loved ones.⁶

One is left to ask, do such proposals advance the common good? The answer is in Caritas in Veritate. All the hallmarks of a sound health care reform policy are contained within Caritas in Veritate: integral human development; fundamental rights to life and religious freedom; charity with truth; humanistic synthesis; the common good; earth as a gift to humanity to use and protect; civilizing the economy; subsidarity; a person-based and community oriented culture; people-centered development programs; cooperation of the human family; recognition that every migrant is a human person; and bioethics and human responsibility in human technology. As the encyclical states, in charity and truth, “when a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good.” (N.28)

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¹Benedict XVI, Encyclical Letter CARITAS IN VERITATE, June 29, 2009.
²Paul VI, Encyclical Letter Populorum Progressio, 41: loc. cit., 277-278.
³For an excellent specific guide for Catholics in evaluating federal health care reform proposals see Helen M. Alvaré, J.D., and E. Christian Brugger, Ph.D., “HEALTH CARE PROPOSALS PENDING BEFORE CONGRESS: Ethical Questions A Catholic Should Ask,” Culture of Life E-Briefs, August 19, 2009, http://culture-of-life.org//content/view/582/96/.
⁴Planned Parenthood Affiliates v. Engler, 73 F.3d 634, 636 (6th Cir. 1996).
⁵“The Hyde Amendment is a rider to the annual Labor/Health and Human Services (HHS)/Education appropriations
bill which prevents Medicaid and any other programs under these departments from funding abortions, except in limited cases. It is named after Rep. Henry J. Hyde (R-IL) who, as a freshman legislator, first offered the amendment.” See www.nchla.org/datasource/ifactsheets/4FSHydeAm22a.08.pdf.
⁶Robert Brody, et al., Your Life, Your Choices, www.rihlp.org/pubs/Your_life_your_choices.pdf.

Belmont Abbey College Accused of Discrimination in Health Care Coverage

Wed, 12 Aug 2009 18:27:00 GMT

Stephen Napier, Ph.D.
NCBC Ethicist

August 12, 2009. On August 5, 2009, Belmont Abbey College in North Carolina received a letter from the Equal Employment Opportunity Commission (EEOC). The Letter was accompanied by a ruling which stated that Belmont Abbey College had discriminated against women when it excluded coverage for prescriptive contraceptives from its health care plan. Prior to a review of their policy, the College was unaware that their plan covered such immoral drugs and devices. Belmont Abbey is a Benedictine college and committed to preserving and strengthening its Catholic identity in its mission and values. Recognizing that it would be immoral to continue to offer such products that were themselves intrinsically immoral the college requested the exclusion of coverage.

Eight faculty members filed a complaint against the college claiming that the exclusion of such coverage discriminated against women. After initially dismissing the complaint in a March 2009 ruling, the EEOC reversed its decision and stated that “By denying prescription contraceptive drugs, [Belmont Abbey College] is discriminating based on gender because only females take oral contraceptives. By denying coverage, men are not affected, only women.” ¹

Complicating and calling into question the EEOC ruling is the fact that in North Carolina there is a religious exemption for “religious employers.” A religious employer is defined as an employer who satisfies all of the following:

(1) The entity is organized and operated for religious purposes and is tax exempt under section 501(c)(3) of the U.S. Internal Revenue Code.
(2) The inculcation of religious values is one of the primary purposes of the entity.
(3) The entity employs primarily persons who share the religious tenets of the entity.²

One can quibble with the requirements here, for example, (3) seems completely irrelevant in identifying a religious employer. The composition of the employees may hold radically different views from the employer, and yet the religious views of the employer are well known and clearly defined. Furthermore, a strict interpretation of (3) will force religious employers only to hire likeminded employees since the State would then, and only then, allow the institution to act consistent with its religious commitments. In practice, however, this would have the effect of cloistering off religious institutions from secular involvement, further bifurcating our society and closing off dialogue – effects exactly opposite of what the anti-discrimination laws were meant to accomplish. Aside from these complaints, there are grave defects in the reasoning of the EEOC.

First, nowhere is discrimination defined in the EEOC opinion. In fact, discussions of this sort are hard to carry out without a definition. One could easily have argued that the faculty members who complained were discriminating against their Catholic employer by rejecting Catholic teaching on the use of contraceptives.

Second, the reasoning offered by EEOC claims that women would be discriminated against since they are the only ones who would use prescriptive contraceptives. This is curious reasoning. Would objecting to abortion be discriminatory since only women suffer abortions? Would objecting to speech opposing same-sex marriage discriminate against heterosexuals since they likely are the primary ones engaging in such speech? The answer is a resounding “no!” in both cases. The point is, claiming that a policy, by its very nature, does not have universal applicability in itself is not a sufficient justification for the action being discriminatory as illustrated in the above two examples. One needs to focus on what is being objected to, and whether the reasons for objecting to it are good reasons. This was clearly not done in the EEOC-Belmont case. When one considers Catholic teaching with regard to the nature of marriage and the meaning of conjugal love, then it becomes obvious that one would oppose the use of contraceptives or direct sterilizations as an evil. But by this ruling, Belmont Abbey College is prevented from acting in a manner consistent with its religious and moral commitments.

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^1. EEOC Letter Dated July 30, 2009. Charge no. 430-2008-00962. One may access the news report on this here, which also includes a link to the actual letter, “Rebuke for Religion-Driven Policy,” .
^2. 58 3 178. “Coverage for prescription contraceptive drugs or devices and for outpatient contraceptive services; exemption for religious employers.”

A Response to the Federal Health Care Reform Proposal HR 3200 Health Care a Right: Even for the Elderly, Infirm, those with Disabilities, and the Unborn

Fri, 31 Jul 2009 14:54:00 GMT

Marie T. Hilliard, Ph.D., J.C.L., R.N.
Director of Bioethics and Public Policy

July 31, 2009. Christ’s healing ministry directs the Christian’s concern for the sick, particularly the vulnerable, and those who have little or no voice in decisions pertaining to their health care. Cognizant that all of human kind are created in the image of God, the human family must share in the healing ministry manifested by Jesus Christ. The Catholic Church, as the largest provider of non-governmental health care and social services in this country, has responded to this Gospel imperative. However, government has continually intruded in the exercise of this ministry, through mandates that impact the free exercise of religion of those involved in this delivery of health care. Such intrusions have escalated, threatening the well-being of the most vulnerable, most recently by some of the provisions contained in the federal Health Care Reform proposal. The issue is not whether all persons deserve access to affordable health care; the issue is who will decide, particularly for vulnerable populations, what health care is mandated, received, and publicly funded. Intense negotiations to produce health care reform legislation have been taking place in Congress, most recently in the Senate Finance Committee and in the House Energy and Commerce Committee. With the August Congressional recess upon us, constituents have the opportunity to express their concerns to their members of Congress before a final vote occurs in the Fall. The message to Congress is: “Please support amendments that exclude abortion mandates, prevent federal funding of abortion, uphold state laws that regulate abortion, protect the conscience rights of health care providers, and protect the elderly, the infirm, and persons with disabilities from rationing as well as mandates impacting their end-of-life care.” Click for more information.

Analysis of Current Provisions: HR 3200. (clicking on link will open the text of the bill)

Abortion Mandate, Funding, Violations of Conscience: Federal law has long excluded most abortions from federal employees’ health benefits plans and places no requirement on private plans. This could radically change. Current provisions stipulate that there is at least one plan in every region of the country that covers abortion. While public monies will not pay directly for abortion, health plans would receive federal subsidies to help pay enrollment premiums for low-income people, for plans that will cover abortion. Furthermore, provisions such as those requiring timely access to all benefits covered by qualified health plans could be used by courts to override state laws regulating abortion. Thus, it should be clear in the legislation that such laws will not be preempted. Also, federal laws protective of conscience rights of health care providers will be in jeopardy, particularly with this requirement of regional access to abortion. The conscience rights of parents in terms of vaccination requirements could be impacted. There even are provisions for “increasing intervals between pregnancies” of those enrolled (See Sections 1711-1714). Congress should ensure that this legislation will maintain protections for conscience rights.

Rationing and Mandatory End-of-Life Care: The proposal creates a government committee determining allowable benefits and treatments, and restricts enrollment in this plan of persons with special needs. The latter is an attempt to interface with health plans for those with special needs included under the Social Security Act, the outcome of which remains unclear. Hospitals will be penalized for government-deemed preventable readmissions. This constitutes rationing of care. Eligible health care plans will be required to offer Medicare recipients the opportunity to engage in advanced care planning consultations every five years, or more often if there is a change in health status. This could result in actionable medical orders to exclude life affirming and proportionately beneficial care, within an unforeseeable circumstance. Such orders will remain actionable across continuums of care and across all health care settings. Reasonable medical interventions, including certain medications, could be excluded from the plan of care. Persons could inadvertently agree to dehydrate or starve unto death, when reasonable use of assisted nutrition and hydration would be beneficial within the unanticipated health care scenario. With the aforementioned rationing, decisions concerning end-of-life care could be taken away from patients and their families. (See Sections 122, 123, 203, 1151, 1176, 1177, 1233, 1751)

NIH Guidelines for Human Embryonic Stem Cell Research Ignore Public Opinion and the Human Cost

Thu, 09 Jul 2009 20:03:00 GMT

July 9, 2009. July 7, 2009, marked a major ethical shift in United States government-funded research. The National Institutes of Health (NIH) implemented President Obama’s executive order, Removing Barriers to Responsible Scientific Research Involving Human Stem Cells (March 9, 2009). The new NIH Guidelines authorize taxpayer funding of research on human embryonic stem cells (hESCs) harvested from human embryos as of July 7, 2009, or from earlier sources, both domestic and foreign, with the approval of the Working Group of the Advisory Committee to the Director.

Historically, federal funding of research on humans from which they derived no benefit has been prohibited. Now the destruction of human beings in their earliest and most vulnerable stages is promoted and funded by federal taxpayer dollars. Lengthy explanations exist as to how informed consent from the embryo donors will be obtained, and about how conflicts of interest will be handled, but no mention is made about the rights of the embryos themselves. In fact, the guiding principles are listed as follows:

1. Responsible research with hESCs has the potential to improve our understanding of human health and illness and discover new ways to prevent and/or treat illness.
2. Individuals donating embryos for research purposes should do so freely, with voluntary and informed consent. (p. 15).

No mention is made of the destruction of human life that these Guidelines support. Such a lacuna fails to represent the breadth of reasoned public opinion on this issue.

This egregious violation of human life is exacerbated by the fact that there are ethical alternatives (namely induced pluripotent stem cells) that share the same plastic-like properties as embryonic stem cells. Second, there exists wide consensus that stem cell research using adult stem cells, or induced pluripotent stem cells, or stem cells from cord blood should be used and funded. There is not wide consensus on the use of embryonic stem cells. To say that there is, is to ignore a sector of the population and more importantly, the arguments they have against such research. Third, the Guidelines open up funding for research that has yet to show any distinctive therapeutic benefit in humans. Such use of funds is irresponsible.

The NCBC is grateful that the NIH responded to its call for more explicit prohibitions against inducements of parents to donate embryos, and to NCBC’s support of prohibitions against expanding the sources of embryos to be destroyed by this research. However, these Guidelines represent a break in a tradition of respecting human subjects, especially the most vulnerable of human beings, who have no voice. Human embryos are human beings in their earliest stage of development. Their value is not dependent upon age, genetic makeup, development or maturity. Discrimination against these human beings is no less reprehensible and arbitrary than any other form.

The Compensation of Women for Egg Donations for Research Purposes

Mon, 06 Jul 2009 20:08:00 GMT

Rev. Alfred Cioffi, PhD, STD
NCBC Ethicist

July 6, 2009. On June 11, 2009, New York became the first state to pay women for their eggs.

New York’s Empire State Stem Cell Board (ESSCB) has approved the Resolution regarding Recommended Standards for the Compensation of Women Donating Oocytes Solely for Research Purposes. The plan is to pay women up to ten thousand dollars for each harvest of their eggs. The State of New York considers this necessary, since women are not coming forth with altruistic egg donations in sufficient numbers to supply research demands.

The resolution states that a woman’s eggs are to be used “solely for research purposes.” The research, however, requires embryonic stem cells. This means that after harvesting, the women’s eggs will be fertilized in vitro (in a laboratory), and the resulting human embryos will be grown in an incubator for about a week and then destroyed, so that the embryos’ stem cells can be harvested for research in turn. In other words, these human beings will be engendered for the sole purpose of lethal research―and obviously without the embryos’ consent. Needless to say, this is gravely immoral and inhumane.
In addition, this action by the ESSCB has a great potential to exploit women. Given the current economic situation, how many women will not feel pressured to undergo the painful, risky, and occasionally fatal procedure of egg harvesting? And won’t the legislation exploit poor women in particular? On what basis, by what principles, will the ESSCB protect a poor woman from being exploited by this offer of up to $10,000 for her eggs? Truly, the ESSCB has put itself in an impossible situation: It offers to pay women for their eggs but considers disqualifying poor women from the offer to avoid exploiting them. Yet poor women are precisely the ones who would benefit most from the sale of their eggs. If the ESSCB disqualifies poor women from the program because of their tendency to take higher health risks for money, it is discriminating against the poor; if it does not, it is endangering the health and even the lives of the poor disproportionately.

Even the very notion of “compensating women for their donation,” as fair and just as this might sound at first, betrays an underlying contradiction: if a donation is paid for, is it a donation? Notice that part of the “compensation” is for such things as risks, burdens, discomfort, pain, and suffering. How much money are these things worth? Isn’t it, rather, that seeking to put a price tag on a woman’s pain and suffering―or, indeed, risking her very life for no medical reason―further objectifies women, turning them into egg-producing machines that can be marketable for a price?

The National Academy of Sciences and many universities and institutes (Rockefeller University, Cornell University, Sloan-Kettering Institute) prohibit paying women for
their eggs.

Paying women for their eggs is, in fact, a form of organ and tissue trafficking. By adopting the ESSCB Resolution, the State of New York has agreed to engage in such trafficking, and with taxpayers’ money.

Obama’s Declaration of June as “Lesbian, Gay, Bisexual, Transgender (LGBT) Pride Month”

Wed, 17 Jun 2009 15:13:00 GMT

June 17, 2009. On June 2, 2009, President Barack Obama declared “June Lesbian, Gay, Bisexual, Transgender (LGBT) Pride Month”. And with this declaration he has given us an opportunity to comment on aspects of the President’s position.

The declaration begins by noting certain injustices committed against individuals who identify themselves as belonging to a group called the “LGBT community”. The acronym refers to a wide range of sexual dysfunctions, including homosexual activities, cross-dressing, indiscriminate sex with men and women, and mutilating surgery that attempts to change a man into a woman or a woman into a man. Each of these activities raises serious moral concerns. In keeping with the teachings of our faith, we love the sinner and hate the sin, but we certainly do not believe that we should celebrate these unhealthy activities or take pride in them.

The NCBC agrees that any harm, ridicule or harassment aimed at such persons – any person for that matter – ought to be repudiated. In this sense Obama’s position is accurate. The declaration then notes the achievements that such individuals have made to the betterment of American society. Of course, persons of good will come from many different ethnicities, cultures, and beliefs, and there is no doubt that homosexual or “transgendered” persons have made contributions in their professional lives to the construction of a just society.

President Obama then notes his commitment to achieve certain aims on behalf of such persons. Each part of the declaration will be commented on separately for within each part there are fine distinctions. President Obama states, “At the international level, I have joined efforts at the United Nations to decriminalize homosexuality around the world.” Though it is certainly true that harassment or abuse of any individual should be criminal, it is not necessarily the case that certain actions ought to be decriminalized. Homosexual activity is disordered and can pose public health dangers even though each person ought to be the object of dignity and respect – simply because each is a person!

Societies should be free to enact laws pursuant to families, communal life, and the common good. These societies may outlaw homosexual activity because they find it morally offensive or due to a public health concern about the spread of AIDS. Obviously, President Obama views homosexual activity as not only permissible, but laudable. He holds the same view of bi-sexuality and sex reassignment surgery. Some societies do not. Consequently, that President Obama is making an effort to decriminalize these activities “around the world” can only be described as a form of cultural imperialism. President Obama and other members of the United Nations are effectively imposing their views about sexuality upon other societies. The preservation of a true pluralism among nations would allow societies and peoples to follow their established cultural norms and to object to certain acts that are inconsistent with their understanding of the moral law and of the common good.

Next, President Obama notes what he is doing for our country. “Here at home, I continue to support measures to bring the full spectrum of equal rights to LGBT Americans.” Here again, fine distinctions are necessary to separate the wheat from the chaff. It may initially seem obscure about which rights President Obama is speaking. After all, he noted previously that many members of this group are upwardly mobile, and making significant contributions in their professional lives. What rights are they lacking? President Obama specifically cites adoption rights. But many adoption agencies are religiously based, and so historically driven to promote adoption as an alternative to abortion. Many agree with the research showing that optimal child development is fostered with the presence of both a mother and a father. Furthermore, many of these agencies subscribe to the view that homosexual acts are immoral, and they would not want to place children in a setting in which such activity is sanctioned and practiced. Here again, the NCBC must part company with President Obama’s reasoning, in which it would appear he supports the violation of religious freedom in the exercise of these ministries.

One last point is worthy of note. President Obama’s declaration is titled LGBT Pride Month. The Federal Government should not force its citizens to celebrate actions that many, if not a majority, find morally objectionable. In making June LGBT Pride Month, Obama has committed an act of tyranny. Making all Americans celebrate these sexual dysfunctions during the month of June is oppressive. One is left to ask, would President Obama be open to declaring some month: “Traditional Marriage Pride Month”? Until he does, many would not be convinced that the President is interested in preserving a healthy pluralism, but rather is committed to an agenda that favors a view of sexuality at variance with sound moral reasoning, common sense, and the views of the American people.

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1. See the text at, http://www.whitehouse.gov/the_press_office/Presidential-Proclamation-LGBT-Pride-Month/.
2. For a note on the reasons why one may think this, see “Proposition 8 and the Impossibility of Same-sex Marriage,” (November 19, 2008).
3. By optimal development we mean to include development of a child’s sexual understanding and identity. Children of homosexual couples manifest more homoerotic dispositions and are statistically more promiscuous than children raised in heterosexual households. These features of a child’s development are critical from a Catholic understanding of human development. See Walter R. Schumm, “Re-evaluation of the “No Difference” Hypothesis Concerning Gay and Lesbian Parenting as Assessed in Eight Early (1976-1986) and Four Later (1997-1998) Dissertations,” Psychological Reports 103(1) (2008): 275-304. See also Daniel Avila, “Refusing to Assist Same Sex Adoption: Rationale Behind the Church’s Opposition,” Ethics and Medics 31(7) (2006): 1-3.
4. An example of this has already occurred in England. See, “Catholic Care Loses Charity Tribunal Appeal,”

British Parliament, Human-Animal Hybrids and Savior Siblings

Wed, 03 Jun 2009 14:32:00 GMT

Recently, the British parliament approved the creation of human-animal hybrids, and also the creation of “savior siblings” (IVF-created human embryos who are a genetic match to an injured or diseased sibling). These two proposals are contained within a single bill aimed at relaxing current regulations of the Human Fertilisation and Embryology Authority regarding human embryonic experimentation in Great Britain.

Read the news article from the BBC.

Background

In the case of hybrids, the idea is to insert human nuclei into mammalian (cow) enucleated ova, allow the hybrid embryo to grow for up to two weeks (to the blastula stage) and then extract their inner cell mass (embryonic stem cells) for making human cell lines that might cure a number of diseases. Once perfected, the inserted nucleus would come from an actual patient; this way the cell lines obtained would match that patient and there would be little or no immune rejection of the tissue to be transplanted.

In the case of savior siblings, an IVF embryo is selected (through Pre-Implantation Genetic Diagnosis) to match genetically his or her born and diseased sibling as much as possible. Then, this selected embryo would be implanted (maybe in his mother, but not necessarily) and gestated to term. After birth, the “savior child” can then become an organ or tissue donor for the sick brother or sister. For now, the idea is to use only tissue from the savior child that can be obtained with minimal or no invasion, such as his embryonic stem cells contained within his umbilical cord blood at birth, or discarded placenta.

Ethical Analysis

In the case of hybrid embryos, one fundamental concern is that, by introducing a human nucleus (therefore the entire human genome) into a mammalian egg, there is the very real possibility that one is engendering a new human being in the lab. Of course, hybrid proponents counter that, even if that were the case, this new human being would never be allowed to live beyond the blastula embryonic stage (extracting the inner cell mass effectively destroys/kills the embryo). But, ethically, this only compounds the problem because now we have created a human being in the lab for the sole purpose of destroying him to obtain his stem cells.

In the case of savior siblings, the embryo is indeed allowed to live, but only because he will serve as a tissue donor. What if, after he is born, he is no longer a good match –for any number of genetic or environmental reasons? Will he then be rejected? Will he have to live with the stigma for the rest of his life that he was a ‘failure’? It is easy to see an entire constellation of immense expectations, pressures and possible disappointments building up upon this “savior” child: from his sick brother or sister; from his parents; from the rest of his family; from the medical profession; and from society at large.

In both cases, the techniques (IVF and human cloning) involved in the creation of these embryos are grave moral evils and the procedures themselves lead to a large number of procured abortions. For articles on why IVF and human cloning are grave moral evils, and on why these procedures lead to a vast number of procured abortions, please search our webpage under the underlined topics.

Additionally, savior sibling selection introduces quality control upon the unborn: the ‘best’ will be selected, while the ‘lesser’ humans will be discarded, very much like a product of superior or inferior quality. Engendering human hybrid embryos would likewise involve a high degree of “quality control” in order to obtain the desired embryonic cell lines.

One common ethical thread between these two procedures is that the human embryo is treated as a means and not as an end in himself. No one questions the nobility of seeking to cure horrible illnesses or accidental injuries. In fact, the Catholic healthcare tradition defends and promotes this. What is in question –ethically speaking-, is the way in which these cures are sought. Both of these procedures fail to treat human life with the dignity and respect it deserves; both procedures manipulate the most early and vulnerable stages of human life: the first couple of weeks of embryonic development. Any civilized nation should seek to protect rather than endanger this most vulnerable stage of our life. Rather than allowing for more experimentation with human embryos, the NCBC urges all in vitro fertilization and all non-therapeutic human embryo research to be outlawed, nationally and abroad.

NCBC Comments to NIH on Draft Guidelines for Human Stem Cell Research

Thu, 14 May 2009 15:38:00 GMT

May 14, 2009. On May 14, 2009, the NCBC submitted a letter to Dr. Raynard Kingston, the Acting Director of the National Institutes of Health, which was critical of the Draft Guidelines for Human Stem Cell Research. These Guidelines were proposed in the wake of President Barack Obama's Executive Order which provided for federal funding for human embryonic stem cell research.

Click here to read the text of the letter. Acrobat Reader is required.

The Pope Grounds Human Rights in Rational Discourse

Thu, 14 May 2009 15:19:00 GMT

Rev. Alfred Cioffi, Ph.D., S.T.D.
NCBC Ethicist

May 14, 2009. On May 4th, 2009, Pope Benedict XVI addressed the fifteenth Plenary Session of the Pontifical Academy of Social Sciences, which had gathered in the Vatican to study the question of human dignity and human rights. He began by thanking Professor Mary Ann Glendon, current President of the Academy, for her welcoming words to the plenary.

Our Holy Father emphasized that human history, even with all of its inconsistencies, has shown an increasing sensitivity for human dignity and human rights. He highlighted, as an example, three fundamental human rights, and their grounding in our nature. He pointed to, “…the right to life and the right to freedom of conscience and religion as being at the centre of those rights that spring from human nature itself.”

The Pope proceeded to deepen his reasoning by stating that:

Strictly speaking, these human rights are not truths of faith…They receive further confirmation from faith. Yet it stands to reason that, living and acting in the physical world as spiritual beings, men and women ascertain the pervading presence of a logos which enables them to distinguish not only between true and false, but also good and evil, better and worse, and justice and injustice. This ability to discern - this radical agency - renders every person capable of grasping the "natural law", which is nothing other than a participation in the eternal law.

Expanding on the subject of natural law, Benedict XVI stressed its universal appeal and hence the ethical and political relativism that its denial brings:

The natural law is a universal guide recognizable to everyone, on the basis of which all people can reciprocally understand and love each other. Human rights, therefore, are ultimately rooted in a participation of God, who has created each human person with intelligence and freedom. If this solid ethical and political basis is ignored, human rights remain fragile since they are deprived of their sound foundation.

The Roman Pontiff concluded by exhorting all to transcend religious factions, and engage instead in the universal language of reason: “The Church's action in promoting human rights is therefore supported by rational reflection, in such a way that these rights can be presented to all people of good will, independently of any religious affiliation they may have.”

ClickFor the full text of the Pope’s address.

Also, on May 8th, 2009, Archbishop Raymond Burke, current Prefect of the Supreme Tribunal of the Apostolic Signatura, delivered the keynote address at the National Catholic Prayer Breakfast, in Washington, D.C. In it, he made numerous references to the natural moral law and to the discourse of reason, all within the context of the constant Teachings of the Catholic Church, which was this years’ theme.

Click for the full text of Archbishop Burke’s address.

A number of so-called “rights” claimed in society today are without serious grounding in the natural law. For example, the “right” to same-sex marriage cannot really exist, since the natural complementarity of human sexes requires that one be a man and one a woman. Rights are not created by what we desire to do; rather, what we desire to do should conform to our rights.

The Immorality of Same-Sex Marriage

Mon, 13 Apr 2009 15:42:00 GMT

Rev. Alfred Cioffi, STD, PhD
Staff Ethicist

April 13, 2009. On April 3, 2009, Iowa became the third state in the USA to legalize same-sex marriages (Massachusetts and Connecticut are the other two). And, in New England, there is a move to have all six states (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and Connecticut) recognize homosexual marriages by 2012. On April 7, 2009, the Vermont legislature approved same-sex marriage. Also, at least six other states (Illinois, Maryland, Minnesota, New Jersey, New York and Washington) have pending legislation to legalize homosexual marriages.

The Catholic Church is opposed to same-sex marriage because it is against nature, and because it is not what Jesus Christ taught. He did teach, however, respect for the intrinsic dignity of all peoples. He also said regarding marriage: “For this reason a man shall leave his father and mother and be joined to his wife, and the two shall become one flesh. So they are no longer two but one flesh. Therefore what God has joined together, no human being must separate." (Mk 10,7-9)

Same-sex marriage advocates seek the same recognition given to traditional marriage. However, what is recognized about traditional marriage is precisely the fact that it is between one man and one woman. Therefore, what same-sex marriage advocates seek is intrinsically impossible to obtain.

The legalization of marriage is to protect the value that it has to society, to a large extent, by the proper engendering and nurturing of the next generation. It is safe to assume that homosexual activity has always existed among some sectors of society. Yet, no society has ever recognized it as marriage. Why? Because by its very nature, it threatens the core of what marriage and family represents.

If marriage is not between one man and one woman, then it does not have to be between two persons. In other words, if society ―and legitimate government― does not have the right to tell me that I cannot marry my same-sex partner, then with what right does it restrict me to marry only one other person at a time? Similarly, if it cannot tell me to marry only a person of the opposite gender, with what right does it restrict me from marrying a member of another species?

When taken to its ultimate conclusion, same-sex marriage totally dissolves the meaning of marriage into no meaning at all.

If truth be said, same-sex marriage advocates seek to legitimate objectively abnormal behavior, and gravely sinful sexual activity. The NCBC invites Catholics and all people of good will stand up for decency, civility and honesty: same-sex marriage is an immorality and will have disastrous consequences for society.

NCBC Comment to HHS on Proposed Rescinding of Provider Conscience Rule

Thu, 02 Apr 2009 15:51:00 GMT

April 2, 2009. On April 2, 2009, the NCBC provided comments to Acting Secretary, Charles E. Johnson of the U.S. Department of Health and Human Services on the proposed rescinding of the Provider Conscience Rule instituted by President George W. Bush “Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law.”

The text of the letter may be read here. Adobe Acrobat Reader is required.

Human Blood from Human Embryonic Stem Cells

Thu, 26 Mar 2009 16:01:00 GMT

Stephen Napier, Ph.D.
NCBC Ethicist

March 26, 2009. A BBC article dated March 23rd reports that scientists are investigating the potential to derive human blood from human embryonic stem cells. The proposed project aims to “test human embryos left over from IVF treatment to find those destined to develop into the universal "O-negative" blood donor group.”¹ Researchers will then remove the stem cells from the embryo, thus destroying the embryo. They then culture the stem cells to coax them into becoming blood cells. The end result is to have trillions of red blood cells that can be used for blood transfusions.

News reports on the potential for embryonic stem cells to solve a major medical need manifest once again fundamental errors in ethics and science. Regarding ethics, embryonic stem cell research typically destroys young human life. The idea that these young human beings are labeled “left over” or “spare” manifests a complete disregard for their inherent dignity. Embryos are young human beings who, left on their own in a supportive environment, develop in a continuous and unbroken fashion to the adult that you and I are. You are identical to your embryo. Making moral distinctions in the human family between the mature and the immature or between the young and the old is fundamentally discriminatory.

Proponents of embryonic stem cell research would have us believe that because embryos cannot think or feel, or form interests and intentions, they do not bear “moral worth”. Such an idea illustrates three gross errors. First, if this idea were true, then it would be permissible to kill persons who are in a reversibly comatose state, since they cannot think, feel, or form intentions (at that time). But clearly none of us, I hope, would think that that is remotely permissible. Second, the idea of someone possessing “moral worth” in virtue of what that person can do is ridiculous. Fundamental moral worth is not something one has in virtue of what that person can do, but in virtue of what that person is, namely, a member of the human family. The fact that a human embryo (as an embryo) cannot think, or feel, or form interests, only makes the embryo more vulnerable to harm. But being more vulnerable to harm in no way translates into having less moral worth.

A third error is that it is simply false to say that embryos cannot think, feel, or form interests. Human embryos do have, in a certain sense, the ability to think and feel and form interests. Consider the difference between the human embryo and the canine embryo. The human embryo clearly does follow a developmental trajectory in which he or she manifests the ability to think, feel, and form interests, whereas the dog will at no point manifest any of these, or manifests these abilities in a considerably different form. It makes perfect sense then to say that the human embryo has (as an embryo) the capacities to think, feel and form interests, in virtue of having an internally directed developmental course leading to the exercise of these abilities.

More specific to the type of embryonic stem cell research referenced in the BBC article, a further objection is that this type of project, if successful, would force patients who need such transfusions into benefiting from evil. Conscientious patients who are in need of a transfusion and come to know that the blood they are about to receive was developed by killing a young human being, puts such a patient in a difficult moral situation. They may refuse to benefit from a grave injustice committed against young human life, and by doing so, refuse potentially life saving therapy. Readers may have heard the perfunctory cavil made against Christians to “stop shoving your views down my throat.” And yet this research has the sequelae of doing just that by forcing patients to benefit from a grave injustice.

The Catholic Church holds the idea that all human beings are worthy of fundamental respect, and by “fundamental respect” she means the respect owed to another’s very life. The Church also holds the idea that science is properly ordered only when it serves the dignity of every human person. Research that kills vulnerable human beings is morally abhorrent even if such research holds out therapeutic promise. It is contradictory to say both that “this research destroys young human life” and “this research serves the dignity of the human person.” And yet proponents seem to accept this contradiction considering the ideas of ‘fundamental respect for all humans’ and ‘science serving human dignity’ to be outrageous, ridiculous, or meaningless. On the contrary, that all human beings are owed fundamental respect, and that science is properly ordered when it serves the dignity of every human being, are far from outrageous or meaningless. They are ethical pillars of our culture, holding it up, if you will, keeping it from crumbling into amorphous fragments (a consequence we are already witnessing). Abandoning them will not only have deleterious consequences for our young, but for us all.
____________________________________________

¹ See “Synthetic blood from embryos bid.” Accessed March 24th, 2009.

The Pope and Condoms

Mon, 23 Mar 2009 16:06:00 GMT

March 23, 2009. On March 17, a reporter asked Pope Benedict XVI, while en route to Cameroon, to defend the Church’s promotion of monogamy and opposition to condoms in the fight against AIDS, especially since such positions are “frequently considered unrealistic and ineffective.” He responded in part by saying that “the scourge cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem.” This prompted a fresh, if predictable, round of scorn from the western press. France went so far as to say his statements represent a threat to public health. Yet it might surprise the casual observer to learn that empirical record supports the Pope’s assertions.

First, every instance in which HIV rates have fallen in Africa is most attributable to fundamental changes in sexual behavior, most importantly an increase in faithfulness. In contrast, HIV transmission rates have remained high and even grown in other African countries where widespread behavior change has not occurred, despite considerable increases in condom use. An influential article in Science last year lamented that international HIV prevention priorities had not yet shifted to reflect this epidemiological profile.

In recent years, researchers have paid greater attention to the specific issue Benedict raised: the possibility that condom promotion even risks “worsening the problem.” The theory that people may take greater risks in exposing themselves to harm because they feel a new technology grants them a measure of protection in doing so, goes by the names of “risk compensation” or “behavioral disinhibition” in public health circles. A series of recently published articles (including in the Lancet) have concluded that this phenomenon – that condom promotion can lead to greater risk taking - is quite real indeed.

Finally, the track record for condoms – by far the most emphasized approach over the years – has been rather poor in Africa. An exhaustive review of the impact of condom promotion on actual HIV transmission in the developing world concluded that condoms have not been responsible for turning around any of the severe African epidemics. This rigorous study was originally commissioned by UNAIDS, and conducted by researchers at the University of California at San Francisco. Instead of welcoming the findings, and adapting HIV prevention strategies accordingly, UNAIDS first tried to alter the findings, and ultimately refused to publish them. The findings were so threatening to UNAIDS that the researchers were finally forced to publish them on their own in another, peer-reviewed journal.

This episode provides a disturbing glimpse into the priorities of the lead United Nations’ AIDS agency. Though normally quick to insist on the right to “accurate information” about condoms, in this case they placed their own ideological convictions above the welfare of those they are charged with protecting. Still, the New York Times claims, mere hours after the Pope’s remarks, that he “deserves no credence when he distorts scientific findings about the value of condoms in slowing the spread of the AIDS virus.” The informed observer might well conclude that the outrage aimed at the Pope over the fight against AIDS is poorly directed.
Matthew Hanley

The National Catholic Bioethics Center will publish Matthew Hanley’s book, with Jokin de Irala, M.D., “Avoiding AIDS, Affirming Love: What the West Can Learn from Africa,” in the Summer of 2009.

The Suleman Octuplets and the Immorality of IVF

Tue, 10 Mar 2009 16:12:00 GMT

Rev. Alfred Cioffi, Ph.D., S.T.D.
NCBC Staff Ethicist

March 10, 2009. On January 26, Nadya Suleman, a single mother, gave birth by C-section to premature octuplets. Nadya, an only child, was born on October 12, 1975 and studied to be a psychiatry technician. She married in 1996, but separated four years later because the couple was unable to have children. In 2001, she began IVF fertility treatments from Doctor Michael Kamrava, with sperm donated from a friend. This resulted in her bearing 6 children, now aged 7, 6, 5, 3, 2 and 2. She still had 6 embryos frozen from the previous treatments. So, in 2008 she requested that all remaining embryos be implanted in her ―all at once. All implanted, and two of them split into identical twins, resulting in octuplets. A reason Nadya has claimed for having so many children is that, when she was young, she was very lonely due to her being an only child, and that she would not want any child of hers to have to experience that. She has been receiving worker’s compensation from a back injury in 1999.

While some motivations have been laudable ―such as not wanting her children to be alone and not wanting her frozen embryos to be destroyed―, the NCBC considers gravely irresponsible all these actions: undergoing IVF treatment; endangering the life of these 14 children, most especially the octuplets; denying a father to all these children, and; the financial hardship at public expense. It must be noted that, of grave concern, is the general public’s acceptance of IVF. However, IVF is an intrinsic evil because, among other things, it radically separates the unitive from the procreative dimensions of the marital act. This is one more drastic example of the many reasons why IVF is highly unethical. Essentially, it dehumanizes people by turning children into a commodity and it totally obviates the fundamental way in which God intended for a family to come about: by the loving union of spouses who, together, raise the children that the Lord grants them.

Government’s Lethal Exploitation of the Most Vulnerable of Human Beings

Mon, 09 Mar 2009 17:42:00 GMT

March 9, 2009. The National Catholic Bioethics Center received with dismay the news of President Barack Obama’s executive order to allow citizens’ tax dollars to be used to support research that requires the destruction of human embryos in the name of speculative scientific research.

Historically, the government has never permitted the use of federal funds for research on human subjects if it was not for their benefit. Congress extended the same protection to the embryo and fetus as to any other human subject of research. Since 1975 Congress has refused to allow federal funds to be used for research on unborn children at any stage of their development. In 1985 Congress amended the National Institutes of Health reauthorization act to make it clear that the prohibition of the use of federal funds for research on human subjects was "the same for fetuses which are intended to be aborted and fetuses which are intended to be carried to term" (42 USC §289g). In 1996 Congress passed legislation to provide the same protections to the embryo. The Dickey Amendment states that federal funds are not to be used for engendering human embryos for research purposes or for research in which embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for research on fetuses in utero. The ban defined "human embryo" as including any organism that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes (sperm or egg.). The fact that the embryos engendered by their parents are not wanted, in no way lessens their innate dignity. The government must maintain a posture of respect towards human life by not allowing tax payers’ money to be used for research involving the destruction of human beings. It cannot single out certain lives as somehow uniquely suited for harmful or destructive research.

The National Catholic Bioethics Center supports stem cell research which respects innate human dignity. However, this new Obama policy constitutes a misuse of public money for immoral research that has not yielded one single clinical benefit. In fact embryonic stem cell therapy is known to cause tumors and tissue rejection. Recent advances have obviated the need for destroying human embryos to access pluripotent stem cells. Scientists have demonstrated that they can reprogram ordinary human skin skills into pluripotent stems cells which will not cause tumors or rejection. There are several ethical stem cell research alternatives that already have successfully treated thousands of patients. By using adult sources of stem cells (including umbilical cord blood, amniotic fluid and placental sources) it has been possible to treat, and sometimes even cure, numerous maladies and pathologies, from spinal cord injury to cardiac disease, pediatric brain tumors to cerebral palsy, to the widely-known successes in blood diseases.

Each of us was once an embryo. Science makes it clear that from fertilization a new human being exists, distinct from the father or mother, with his or her own internal principle directed toward continuing development towards adulthood. Thus, he/she is a bearer of human rights, with intrinsic dignity which outweighs any utilitarian consideration. Providing public funding to support research on cells obtained through the destruction of human beings, especially at their most vulnerable stages, is an affront to the dignity of all persons, and beneath the moral stature of the United States of America.

A humane policy of prohibition on the use of federal funds for destructive research on innocent human beings has been in place throughout our history until now. However, even it was inadequate. There should be federal laws protecting all human beings from the first moment of their existence.

Commentary on President Obama's Rationale for Rescinding the Mexico City Policy

Tue, 10 Feb 2009 18:45:00 GMT

Rev. Alfred Cioffi, Ph.D., S.T.D.
NCBC Staff Ethicist

February 10, 2009. On Friday, January 23rd, 2009, President Obama rescinded the "Mexico City Policy," and gave the following rationale for doing so:

It is clear that the provisions of the Mexico City Policy are unnecessarily broad and unwarranted under current law, and for the past eight years, they have undermined efforts to promote safe and effective voluntary family planning in developing countries. For these reasons, it is right for us to rescind this policy and restore critical efforts to protect and empower women and promote global economic development.

For too long, international family planning assistance has been used as a political wedge issue, the subject of a back and forth debate that has served only to divide us. I have no desire to continue this stale and fruitless debate.

It is time that we end the politicization of this issue. In the coming weeks, my Administration will initiate a fresh conversation on family planning, working to find areas of common ground to best meet the needs of women and families at home and around the world.

I have directed my staff to reach out to those on all sides of this issue to achieve the goal of reducing unintended pregnancies. They will also work to promote safe motherhood, reduce maternal and infant mortality rates and increase educational and economic opportunities for women and girls.

In addition, I look forward to working with Congress to restore U.S. financial support for the U.N. Population Fund. By resuming funding to UNFPA, the U.S. will be joining 180 other donor nations working collaboratively to reduce poverty, improve the health of women and children, prevent HIV/AIDS and provide family planning assistance to women in 154 countries.

The provisions of the Mexico City Policy ensured that no US public funds were used for either performing or promoting abortions in foreign countries, and these provisions have now been rescinded. Due to the moral gravity of this action, a paragraph-by-paragraph commentary of President Obama’s rationale is warranted.

In the first paragraph, President Obama tells the American people that “the provisions of the Mexico City Policy…have undermined efforts to promote safe and effective voluntary family planning in developing countries.” From the onset, it must remain abundantly clear that, for the aborted children, rescinding this policy is never safe, rather always lethal. Also, to provide or promote abortion as a method of ‘family planning’ is to thoroughly confuse families in developing countries into thinking that killing one’s child in the womb is a legitimate method of ‘avoiding children.’ Also, since it is a well-known fact that expectant mothers in many developing countries preferentially abort their unborn daughters, then stating that reversing this policy will “restore critical efforts to protect and empower women” is a blatant contradiction and deception.

In the second paragraph, President Obama states: “I have no desire to continue this stale and fruitless debate.” Yet, in paragraph three, he states: “my Administration will initiate a fresh conversation on family planning, working to find areas of common ground…” How can one initiate a fresh conversation to find common ground and at the same time have no desire to continue this stale and fruitless debate? Simply, one cannot.

In paragraph three, President Obama states: “It is time we end the politization of this issue.” Again, to be clear, the issue at hand is two-fold. First, to consider abortion as a method of ‘family planning.’ Second, to use public funds for the provision or promotion of abortion, with the expanded view of using abortion as a legitimate method of birth control. It is illegal to do so in the United States, because many Americans rightly believe that abortion is a grave crime and genocide. Hence, Congress has had the minimal prudence not to coerce the American people into paying for something so abominable. This is political in the sense that the body polity ―the wish of the people as expressed through representative government― has spoken and, yes, precisely because the nation is so divided on this issue, politicians are ―up to now― not coercing us to participate in the genocide. This is an extremely serious issue and, consequently, it is a political issue. To “de-politicize” this issue, then, is tantamount to “de-politicize” any other issue of national interest, such as the budget, national defense, or health care. In a democracy, it would be unthinkable to seek to erase any of these vital issues from the public forum.

In paragraph four, President Obama states that he has: “directed [his] staff to reach out to those on all sides of this issue to achieve the goal of reducing unintended pregnancies.” However, the executive order to rescind the Mexico City Policy is already signed, sealed and delivered; what is the purpose, then, of consulting with those who think differently from him on this issue, if the decision is already made? Could it be so as to claim that some sort of consultation took place? To what purpose; so that those who think differently from him on this issue realize that, unless they align their opinion with his, they will never have a say in the matter?

Also in paragraph four, President Obama states that he wants to “promote safe motherhood, reduce maternal and infant mortality rates and increase educational and economic opportunities for women and girls.” But; how can the killing of the unborn possibly reduce the infant mortality rate? And, how can a mother’s realization that she has killed her child through an abortion promote safe motherhood? Evidently, the President’s statement only makes sense if one is to consider the unborn not a human being ―at any stage of development. Then, the “educational opportunity” for women and girls that he is talking about must be exclusively of the sort that denies the basic biological facts about human embryology. This would actually be depriving women and girls of their right to a good education which, in turn, would also seriously compromise their ability to take advantage of the economic opportunities presented to them, since their education would be slanted toward and colored by a pro-abortion ideology.

In paragraph five, President Obama states: “In addition, I look forward to working with Congress to restore U.S. financial support for the U.N. Population Fund.” One main aspect of the UNFPA is precisely the very controversial issue of providing or promoting abortion, contraception and sterilization in developing countries. Notice that there is no mention here of whether the US should restore the funding or not, as a democratic nation would seek to decide in debate. Rather, his interest is only is getting Congress to restore the funding.

Overall, what this new policy does is to coerce all American taxpayers into funding abortions in developing countries. Hence, rescinding the Mexico City Policy not only fails women and families abroad, it fails them here at home, particularly during these difficult economic times.

There is no doubt that President Obama considers that abortion is one of the “best [ways to] meet the needs of women and families at home and around the world.” It is perfectly logical, then, to expect that the next step will be for American taxpayers to fund abortions here at home. This disregards the millions of Americans who believe that abortion is the killing of innocent human beings and therefore a grave crime. Where is the dialogue before the executive order? Is there truly a desire to find a common ground on this issue? Sadly, we are poignantly aware that abortion is legal in the United States; but to coerce the American people into paying for it in other countries takes this issue to an entirely new ―and unacceptable― unethical level.

Testimony Submitted to the Maryland Legislature Opposing Terminal Condition Counseling

Tue, 27 Jan 2009 19:14:00 GMT

January 27, 2009. On January 27, 2009 Dr. Marie Hilliard, NCBC Director of Bioethics and Public Policy and also a the chair of the ethics committee of The National Catholic Partnership on Disability submitted testimony to the Maryland Legislature opposing legislation that would mandate terminal condition counseling.

The text of the testimony may be read here.

FDA Approval of Embryonic Stem Cell Trial

Mon, 26 Jan 2009 19:18:00 GMT

January 26, 2009. On January 23, 2009, it was announced by Geron Corporation that for the first time, embryonic stem cells are to be put to use in clinical trials with humans with the approval of the Food and Drug Administration. It is interesting to note that Geron, at this time, will be using only those cell lines which had been approved by the Bush Administration for stem cell research. The trials will be performed on those suffering spinal cord injury. The aim of this new study is primarily to test for safety, not effectiveness as a treatment. News stories are playing up the potential of the use of embryonic stem cells, as they have been for nearly a decade, despite the lack of significant progress. Meanwhile, great strides are being made using adult stem cells, which are already in extensive clinical use.

Embryonic stem cell lines begin with a destroyed human embryo. The lines then produce cells that are not genetic matches for the patients in whom they are injected, necessitating the use of anti-rejection drugs to suppress adverse reactions. The dangers of using these cells have been noted by several scientists cited by the media in the recent reports, but few are reporting that cells with the same properties and potential as the embryonic are now available through the process of “dedifferentiation.” In this process, adult stem cells are returned to their earlier pluripotent state and take on all of the characteristics of the pluripotent embryonic type. These “induced pluripotent stem cells” do not require the destruction of embryos, but are taken directly from the body of the patient into whom they are later injected, thus also avoiding the problem of immune rejection.

Despite these facts, scientists continue to claim that embryonic stem cells are the “gold standard” in the field of regenerative medicine. Stem cell research is the only scientific discipline where the paradigm for success is a procedure that does not work, and where other avenues that have proven successful are found wanting because they fail to live up to that defective standard.

The HHS Rule Protecting Health Care Consciences

Tue, 23 Dec 2008 19:21:00 GMT

December 23, 2008. Recently, the Department of Health and Human Services (HHS) promulgated into law regulations aimed to protect health care workers’ consciences. The press release on HHS website says that, “The right of federally funded health care providers to decline to participate in services to which they object, such as abortion, is affirmed….” And

Over the past three decades, Congress enacted several statutes to safeguard the freedom of health care providers to practice according to their conscience. The new regulation will increase awareness of, and compliance with, these laws.(1)

In spite of the benign, even laudatory, intentions of HHS, and the clarity of the rule itself, the regulation has been the subject of numerous criticisms, most of which resort to inflammatory language and/or overstatements of the rule.

Consider the following statement from the American College of Obstetrics and Gynecology, “This new HHS regulation places patients' rights directly behind the rights of ideologically-driven physicians and anyone else directly or indirectly involved in their health care.”(2) The National Abortion Rights Action League (NARAL) says that the new rule “would seriously jeopardize patients’ rights to receive quality, comprehensive health-care services.”(3) In point of fact, both NARAL and ACOG misstate the true character of the rule. First, this is not a “new rule” as ACOG indicates, but rather is a rule codifying already existing protections for health care workers. Second, ACOG says that the rule subverts patient’s rights to “ideologically-driven” physicians. Clearly this is inflammatory language. If the rule were described, rather, as protecting a person’s individual moral and religious beliefs, beliefs which constitute the core of a person’s identity, then the new rule looks much more favorable. Likewise for NARAL’s assertion that the rule would jeopardize access to “quality, comprehensive health-care.” If the rule were described, rather, as protecting an individual’s or institution’s conscience objection to what they consider murder (abortion), or mutilation (direct sterilization), then one could more readily understand why one would want to protect conscience

Protecting a health care worker from having to kill a human being or mutilate a patient, is exactly the intention of the rule:

The Department is concerned about the development of an environment in sectors of the health care field that is intolerant of individual objections to abortion or other individual religious beliefs or moral convictions. Such developments may discourage individuals from entering health care professions. Such developments also promote the mistaken belief that rights of conscience and self-determination extend to all persons, except health care providers.(4)

Clearly the intention behind the rule is to preserve the conscientious delivery of health care. Additionally, it recognizes appropriately that health care workers are not mere automatons, doling out health care, but are persons committed to the healing art of medicine. Consider also, that the new rule implements federal regulations already in existence.

[T]his rule implements federal laws protecting health care workers and institutions from being compelled to participate in, or from being discriminated against for refusal to participate in, health services or research activities that may violate their consciences, including abortion and sterilization, by entities that receive certain funding from the Department.(5)

Those who oppose the rule are put into the awkward position of saying that such protection of health care workers or institutions is not just, or that giving due recognition to a person’s or institution’s conscience is not itself a great social good.

The misstatements of what the rule intends to accomplish may not be deliberate. There is, after all, a widespread misunderstanding of what conscience is and this misunderstanding affects one’s ability to appreciate why conscience should be protected. To clarify, conscience is an act of one’s reason whereby a person judges that a particular act is wrong (or right). Conscience claims are bound up with the person’s rational, volitional and spiritual identity and thus, they cannot be considered a “bias,” as some have called it. Disobeying one’s conscience, then, leads to an internal contradiction (i.e., disintegration of the person). Acting against one’s conscience is, in a real sense, acting against oneself. When we are discussing certain acts such as abortion and sterilization, acts that countless health care workers consider murder and mutilation respectively, not protecting the health care worker’s conscience would be tantamount to forcing the worker to do wrong or leave the profession. The medical profession is a healing art, and those who are truly sensitive to this end should be allowed to practice their art knowing that their consciences will be protected. The rule, then is a just law and comports with the art of medicine, aimed as it is at healing the human person.
_________________________________________
Notes:
1. See http://www.hhs.gov/news/press/2008pres/12/20081218a.html.
2. http://www.acog.org/from_home/publications/press_releases/nr12-18-08.cfm.
3. http://www.prochoicemissouri.org/action/alerts/200809241.shtml.
4. See, “The Final Rule,” page 78073, accessed at: http://edocket.access.gpo.gov/2008/E8-30134.htm.
5. See, “The Final Rule,” page 78074 accessed at, http://edocket.access.gpo.gov/2008/E8-30134.htm.

Abortion and the Onus of Proof

Mon, 22 Dec 2008 19:23:00 GMT

Stephen Napier, Ph.D.
NCBC Ethicist

December 22, 2008. With an incoming administration hostile to protecting unborn human life, opponents of abortion are put into the position of defending their anti-abortion position rather than the pro-abortion advocates defending theirs. That is, the default position is, unfortunately, becoming the pro-abortion position. These comments aim to correct this insidious inversion of proper moral reasoning.

The correct understanding of the anti-abortion position is simply this: we accept the commonsensical moral principle that it is impermissible to kill innocent human beings. We then suggest, again consistent with common sense, that human fetuses and embryos are simply young human beings and therefore fall within the scope of the moral principle. Since abortion is the killing of a human fetus or embryo, abortion is impermissible. These claims are straightforward and commonsensical. Furthermore, if one adds the principle that one should err on the side of life, and if there is a doubt about whether fetuses or embryos are human beings, then the default position is that they are human beings. That is, the ‘err on the side of life’ principle resolves any occasion for doubt on the side of life, so any doubt that X is a human being, should, for moral purposes, resolve to X is a human being.

Once we delineate the argument against abortion, in conjunction with the ‘err on the side of life’ principle, we can see that the onus of proof is clearly on those who think that the fetus or embryo is not within the proper scope of the moral principle ‘killing an innocent human being is impermissible.’

Of course, the response from the pro-abortion advocate is that the default position is on the side of liberty or freedom. That is, any freedom limiting policy (such as, making abortion illegal) needs to be defended since freedom is the default value in our society. If this is correct, then the onus of proof is on the anti-abortion position.

Now, this response makes no sense, but it is remarkable in that it is accepted by numerous pro-abortion advocates. To see the error clearly, consider the following two claims:

Individual freedom is a fundamental value in society and should be protected at all cost.
Protecting innocent human life is a fundamental value in society and should be protected at all cost.

If I were to ask the reader, “which one sounds more plausible?” I suspect that everyone will say the second. The first claim admits of too many qualifiers and conditions in order for it to be remotely true, even in our “rugged individualistic” culture. Do I have the freedom to drive 90 miles per hour down a city street? Do I have the freedom to drive drunk? Are these “freedoms,” or many like them, ones society should protect? I doubt it. If this diagnosis is correct, then the response by the pro-abortion advocate loses all plausibility and we are back to the anti-abortion position being the default position. Thus, we are back to the onus of proof being on the pro-abortion advocate.

Another response by the abortion advocate is that embryos or fetuses are not full human beings since they do not manifest intellectual or cognitive abilities that us “full” human beings (i.e., adults) do. Now this response makes no sense either for two reasons. First, falling within the proper scope of the moral principle “killing an innocent human being is impermissible” (hereafter, the principle) does not require manifesting higher-order cognition. For then, it would be permissible to kill persons in a reversibly comatose state, or those who are sleeping, or those who are mentally disabled, or infants! But clearly we would not accept that, and therefore, we should not accept that only those well-developed humans are within the proper scope of the principle. Second, the locution “not a full human being” is itself internally inconsistent. The locution indicates that embryos or fetuses are not fully developed, they are developing human beings. The internal inconsistency is introduced when we ask “what is it that is developing?” Clearly, the proper answer is a human being. The point is, we are human beings that are developing, not developing human beings. A thing is either a human being or not, either a cat or not, either a dog or not. We do not say of a kitten that it is not a cat. We say that it is a cat that is developing. Again, what is it that is developing must refer to the kind of thing it is. And what kind of thing we are is human being and this is fundamental about what we are. Since the proper scope of the principle is tethered to what we are fundamentally, all human beings fall under the principle and should be protected.

If we dig deeper into the pro-abortion mind, we will discover an important root concern: the concern is over the sequelae of teen pregnancies or of pregnancies where the mother (and father) simply do not have the resources to rear a child. But in discovering this, we should be firm in our stance that abortion is not a solution to the problem. One does not solve the problem of teen pregnancies or of limited resources to rear a child by killing the child. After all, the very reason why one is concerned about these things is because the child’s life bears inestimable value and we owe it to the child to properly rear him or her. Abortion, then, ends the life of what an abortion advocate must admit bears inestimable value! The “solution” is internally inconsistent and therefore abortion cannot be a viable solution to concerns about properly caring for a child. The onus of proof, again, is on the abortion advocate, with no plausible argument in sight. Public policy should reflect this onus and protect the lives of the unborn.

NCBC Applauds the Adoption of the Health Care Provider Conscience Rule by the US Dept. HHS

Fri, 19 Dec 2008 19:44:00 GMT

December 19, 2008. The Department of Health and Human Services (HHS) issued a final rule to ensure that HHS funds do not support morally coercive or discriminatory practices or policies in violation of existing federal law. The proposed regulations will reinforce and reaffirm existing federal laws, which prohibit recipients of certain federal funds from coercing individuals in the health care field into participating in actions they find religiously or morally objectionable. These provisions assist in assuring that the First Amendment protections of the free exercise of religion, not only for individuals, but for faith-sponsored ministries, are protected. The National Catholic Bioethics Center (The Center), which provided supportive comment on the proposed regulations (see news posting for Sept 11, 2008), welcomes these protections of religious liberty in the delivery of health care. The Center wishes to thank HHS Secretary Michael Leavitt for this affirmation of existing law, assuring that constitutional protections are afforded to all in the lawful exercise of their profession, regardless of their religious beliefs.

As the largest provider of non-governmental health care in this country, the Catholic Church ministers to the many needs of diverse and vulnerable populations. To address these needs, health care workers from all backgrounds are required. The protection of conscience ensures a vibrant pluralism in the delivery of health care. Not protecting consciences implicitly endorses a monolithic view of health care delivery in a setting where there is legitimate moral disagreement. By ensuring that consciences are protected, the State will help to assure that the people of the United States continue to receive care from a reasonable, thinking, caring and conscience-driven health care force. Those who insist that only those who are willing to violate their consciences in the delivery of health care should enter the health care field may fail to see the dangers of such a position. That approach creates a health care delivery system of professionals who blindly follow directives rather than conscience, putting society at risk. Such an authoritarian environment is what has allowed and continues to allow the catastrophic violations of human life and dignity witnessed in oppressive governmental regimes abroad.

These rules will help to assure that the people of the United States continue to receive care from a reasonable, thinking, caring and conscience-driven health care force. Furthermore, faith-based ministries, the backbone of health and social service programs in the United States, will not be subject to coercive measures which interfere in their delivery of services. The Center gratefully welcomes these rules, and sees them as essential to the continued delivery of quality health care in this country. It is our hope that the new administration will respect and enforce this much-needed HHS rule, precisely due to its claimed interest in pluralism, representation and dialogue. (President-elect Barack Obama, Acceptance Speech, 4 November 2008).

An Introduction to The Instruction Dignitas Personae On Certain Bioethical Questions

Thu, 18 Dec 2008 19:45:00 GMT

December 18, 2008. There are no surprises in Dignitas Personaefor anyone who has been following Catholic teaching in the area of bioethics over the last twenty years. The point of reference in matters of “reproductive technologies” is still Donum Vitae (“The Gift of Life”) issued by the Congregation for the Doctrine of the Faith in 1987. It provided ethical analyses of new means of overcoming infertility, judging some to be ethical (such as the use of hyper-ovulatory stimulation drugs) and others to be in violation of human dignity (such as in vitro fertilization (IVF), that is, engendering embryos in Petri dishes).

Donum Vitae sought to defend two basic fundamental human goods: innocent human life and the dignity of marital intercourse. Dignitas Personae mounts that defense anew. Donum Vitae did anticipate that many new technologies would arise and formulated principles that have continued to serve Catholic moral reflection well. If the intervention assists the marital act achieve its natural end, it might be morally licit. If the intervention replaces the marital act it is immoral. For example, with IVF, technicians, not the married couple, are the ones who engender new life through their manipulation of sex cells in the laboratory. The marital act is replaced.

Also, any intervention which destroys or harms innocent human life was rejected. IVF, for example, invariably sacrifices some human lives in its attempt to overcome infertility. Defective embryos are simply discarded. Usually several embryos are implanted in this procedure. Some babies develop better than others. Those who do not are often simply killed in a process euphemistically called “fetal reduction”.

Donum Vitae remains a useful document. But a great deal has happened since 1987. Back then there were not 500,000 embryos frozen in liquid nitrogen, left over from IVF and saved for possible future use. Stem cells had not yet been isolated, and there was no contentious social debate over embryonic stem cell research. Cloning was not yet an issue.

So with all these developments over the past twenty years it was time for the Church to issue another document as authoritative as Donum Vitae. The teachings of the popes and various Vatican offices over the last two decades addressed new issues as they arose. However, even a statement from a Vatican office or papal remarks at some international gathering does not rise to the same level of authoritative teaching as a formal document issued by the Vatican’s highest doctrinal office, the Congregation for the Doctrine of the Faith, with the specific approval and authority of the Pope. Dignitas Personae rises to this level.

The Vatican continues to affirm that life begins at conception, and asserts that science bears out this conclusion. There is no “change in nature or gradation in moral value” and therefore the human embryo has, “from the very beginning, the dignity proper to a person.”

Despite the fact that the Church has consistently taught that IVF violates human dignity and is therefore immoral many Catholics thought the Church approved IVF because it helps couples have babies. So a lot of Catholics will be learning for the first time through this document what the Church actually teaches in this regard.

The document addressed specific immoral practices that have arisen through attempts at overcoming infertility. The procedure of “fetal reduction” has already been mentioned. But another evil resulting from IVF is the freezing of excess embryos. For example, twelve embryos might be engendered in a Petri dish but only four implanted. In order that the couple avoid going through the process of having their sex cells collected a second time and avoid the costs associated with a second attempt, the remaining eight embryos are frozen in liquid nitrogen for future use. As mentioned, there are reliable estimates that there are more than 500,000 frozen embryos in the United States.

This is a situation of grave injustice for these tiny, vulnerable human beings. Dignitas Personae addresses this deplorable situation and declares that there is ultimately no way in which this grave injustice can be remedied.

Some well intentioned individuals thought that this injustice could be diminished somewhat by making these embryos available to infertile couples or to couples who already have children but who want to be able to “rescue” these embryos from otherwise certain death.

Dignitas Personae clearly rejects the use of these embryos to help couples overcome infertility. “The proposal that these embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable . . .” Although the document does acknowledge that the motives of those who want to rescue these embryos through pre-natal adoption are “praiseworthy”, nonetheless such an act presents “various problems not dissimilar” to those associated with couples using frozen embryos to overcome infertility. One of the most fundamental problems is that such actions are not in accord with the nature of “human procreation. . . [as] a personal act of a husband and a wife, which is not capable of substitution.”

This new document strongly supports the ethical use of science. One of the most contentious issues of our day concerns embryonic stem cell research, that is, research that involves the killing of embryos to obtain undifferentiated cells that can be developed into various kinds of therapies. The Church obviously rejects any research that would involve the destruction if innocent human life no matter how small and vulnerable. So many people think the Church is against stem cell research. Dignitas Personae corrects this misperception. What many people do not realize is that the Church has been a strong supporter of research with “adult” stem cells which can be obtained from a variety of sources and which have already proven to be highly effective in a number of therapies while embryonic cells have not.

While rejecting the use in research of newly-created cell lines that have their origin in human cells or tissue that have been derived from destroyed human beings, the CDF permits the personal use of vaccines or other commercial products developed from these lines, so long as this is justified by a proportionate reason, there are no other sources of the needed product, and one makes one’s objection known to its illicit origins. This is a particularly significant result for parents who have been concerned about whether they may vaccinate their children against certain serious childhood diseases for which there are no products other than those with compromised origins.

The Vatican takes a “wait-and-see” approach to the question of germ line therapy. While acknowledging the value of somatic cell therapy, when directed to treatment and not to enhancement, Dignitas Personae contends that germ line therapy cannot be justified at the present time given the current state of scientific knowledge.

Dignitas Personae almost reads more like a scientific article on biology rather than a religious document. But it is written in defense of two fundamental human goods that the Church has always defended and which are sorely threatened in our day: innocent human life and the dignity of the marital act.

This brief commentary is intended to be a general introduction to Dignitas Personae. Over the next several weeks the NCBC will be developing additional resources and commentary on themes presented in this document. Check back regularly for additional postings.

Proposition 8 and the Impossibility of Same-Sex Marriage

Wed, 19 Nov 2008 19:53:00 GMT

November 19, 2008. November 15 and 16, 2008 witnessed protests in several cities across the nation concerning California’s passage of Proposition 8, an amendment to their state constitution defining marriage as a union between a man and a woman. Interviews with protesters engendered a flurry of slogans, “This is discrimination at its best.” “All we want are equal rights.” “I am straight and I can marry. Why can’t my gay friends marry? It’s ridiculous.” Likewise, well-meaning defenders of Proposition 8 retaliated with their own set of slogans referring to homosexuality as a violation of “God’s Law.” By doing so, defenders of Prop 8 have inadvertently defined the debate as an issue of religious freedom. Describing the debate in this way is woefully inaccurate.(1)

Properly understood, marriage between a man and another man is simply impossible. Two persons of the same sex can no more get married than a man can get pregnant. Marriage is a unity between two kinds of persons, where the result is a composite whole. The man and the woman complement each other, and a necessary condition for this complementarity is that they are sexually different. A difference in sex implies a bodily difference. And if the psychologists are right, there is an interdependence of soul and body. Therefore, male and female are ordered differently in their respective souls. They are both instances of human nature, but manifest that nature in different ways. A male-male relationship cannot achieve a unity and therefore cannot achieve a completeness in terms of uniting each other’s souls. Again, a necessary condition for this is that the genders are distinct. A unity requires complements. Two persons of the same gender do not allow for complementarity.

Of course, the immediate objection will be to point out that many homosexual couples do complement one another. Therefore what I have said above is completely false. In response, it is important to recognize that marriage is not merely a lifelong commitment. The unity referred to in marriage is not one characterized by intense feeling for each person. Thus, the complementarity constituting marriage is not at the level of talents, emotional disposition, or personality. Marriage is a fundamental unity of persons, and the second most important identifying factor about what we are is our sex/gender. The first identifying factor is our nature, namely, human kind. Marriage refers to the unity and complementarity effected at this (i.e., the sexual) fundamental level.

If all of this is correct, then casting the debate as an issue of religious freedom or equal rights is inaccurate. The real issue is that Proposition 8 reflects the way human beings are and the necessary conditions for effecting a fundamental unity between persons. It is not denying rights to homosexuals, for it would be odd for one to demand a right to something he or she cannot have. It is not based on a religious argument with a starting premise in God’s law. It is simply reflecting on the order of nature, and rightly recognizing what marriage really is (a fundamental complementarity between two persons ordered toward children) and that this complementarity and fruitfulness requires a difference in gender.
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(1) It would be accurate, however, to cash out the gay-marriage debate in terms of religious freedom versus equal rights given the sequlae of a successful initiative to redefine marriage. For then homosexuals would have equal protection under the equal protection clause – for example, Catholic elementary schools would be forced to hire homosexuals. For more see the National Organization for Marriage at www.nationformarriage. In particular, see “Why Marriage Matters.”

NCBC Ethicist is Collaborator on National Catholic Partnership on Disability (NCPD) Statement on “Futile Care”

Tue, 28 Oct 2008 18:55:00 GMT

October 28, 2008. The Governance Board of the National Catholic Partnership on Disability issued a statement on September 3, 2008 explaining its position on futile care. Dr. Marie T. Hilliard, Director of Bioethics and Public Policy of The National Catholic Bioethics Center, is a member of the Governance Board of the National Catholic Partnership on Disability and a collaborator on that statement. The term refers to the practice of physicians withholding or withdrawing life-support they consider non-beneficial. Although recognizing that most physicians act with compassion and competence, the Statement acknowledges the reality that physicians are not immune from resting the decision to withhold or withdraw life-support on their patient’s quality of life rather than on the quality of the treatment involved, in relationship to the benefits and burdens on the patient. This is especially true today given the emphasis on containing costs. Since such decisions would impact disabled people disproportionately, NCPD, with its mission to implement the Bishops' 1978 Pastoral Statement on the rights of people with disabilities, decided to provide an analysis of futile care in light of Catholic moral teaching. The statement was featured in the September 18 (Vol. 38, #15) issue of Origins. See www.ncpd.org

Oklahoma Pregnancy Ultrasound Law

Tue, 21 Oct 2008 18:56:00 GMT

October 21, 2008. A new Oklahoma pregnancy ultrasound law, set to go into effect on November 1st, 2008, was challenged in court. The law provides, among other prolife measures, for the expectant woman to see an ultrasound image of her unborn before deciding to have an abortion. The law firm filing the suit, based in the state of New York, is claiming that “giving women more information before an abortion violates privacy rights, endangers womens health, and violates their dignity.” (http://www.lifenews.com/state3543.html)

A pregnancy ultrasound is part of prenatal diagnosis. From a Catholic perspective, it is permissible as long as the results are not used to procure an abortion but rather to either seek to treat a detected anomaly, or to prepare the parents for the birth of a child with a possible handicap (cf. Donum vitae, 1987). More and more, pregnancy ultrasounds are becoming standard medical practice―and are considered non-invasive. Thus, it could be reasonably argued, consistent with basic informed consent procedures, that not allowing the expectant mother to visualize her unborn child is a denial of a patient’s right to have the medical information necessary for making the proper decisions about her pregnancy.

Letter to Sen. Arlen Specter Regarding Proposed Changes in the National Organ Transplant Act

Thu, 09 Oct 2008 19:01:00 GMT

October 9, 2008. On October 8, 2008 NCBC President Dr. John Haas wrote to Sen. Arlen Specter of Pennsylvania discouraging changes in the National Organ Transplant Act which would allow for economic incentives for organ donation.

The text of the letter may be read here. Adobe Acrobat Reader is required.

Genetic Infidelity?

Tue, 23 Sep 2008 19:04:00 GMT

September 23, 2008. A study in the Proceedings of the National Academy of Sciences (PNAS) has reported a possible association between the genetic variant of a single gene to pair-bonding behavior in heterosexual men with women

It is well known that the hormone arginine vasopressin (AVP) plays a role in the monogamous behavior of some mammals (voles and other rodents). Now, the PNAS study tracks a variant (AVPR1A) of the vasopressin gene in 552 twin men regarding the quality of their marriage relationship (pair-bonding behavior). The study reports that men who were homozygous for the variant gene exhibit a double risk of marital crisis when compared to their heterozygous cohorts. However, one of the quantitative instruments used―Partner Bonding Scale (PBS)―is a test that has been standardized in non-human primate social organization, but it is here used for the first time in humans. Even so, the categories are broad enough to be inclusive of human behavior. For example, PBS measures partner-specific affiliative interaction (e.g., play initiation), physical proximity comfort level, and intimate reciprocity between two individuals (e.g., kissing). If validated, this study will be the first one to correlate relational fidelity between a man and a woman down to a single gene.

From the ethical perspective, we maintain that the engagement of reason and will in the human are also essential elements of pair-bonding and marital fidelity. At most, then, one could conclude that some men ―carriers of the AVPR1A variant― might have a lesser propensity for marital fidelity (interpreted as pair-bonding in this study). Similarly, it is known that certain ethnic groups might have less tolerance for alcoholic beverages, which would not excuse inebriation.

It is interesting to note that the authors themselves concede that this study concludes nothing at the individual level, but rather, “by demonstrating a modest but significant influence of this gene on the studied behavior on the group level, we have provided support for the assumption that previous studies at the influence of the gene coding for V1aR on pair-bonding in voles are probably of relevance also for humans.” (p. 14155)

Also at the group or social level, a concern is that, in view of the increasing linkage between the human genome and propensity to an expanding number of physical and psychological predispositions, genetic diagnosis on the human embryo will continue to lead our society toward a eugenic mentality and practice.

NCBC Letter to HHS Supporting Conscience Protections for Health Care Workers

Thu, 11 Sep 2008 19:08:00 GMT

September 11, 2008. On September 11, 2008 NCBC President Dr. John Haas wrote to Secretary Michael Leavitt of the U.S. Department of Health and Human Services in support of President George W. Bush's proposed conscience protections for health care workers.

The text of the letter may be read here. Adobe Acrobat Reader is required.

Reflections on Non-Heart-Beating Donation and Brain Death

Tue, 09 Sep 2008 19:21:00 GMT

September 9. 2008. Recently, several articles were published in the New England Journal of Medicine which address the issue of organ donation. One article was particularly interesting written by Robert Truog and Franklin Miller titled “The Dead Donor Rule and Organ Transplantation,” (NEJM Vol. 359 (7) (2008): 674-675). The authors argue that the so called dead donor rule should be abandoned. The argument essentially is as follows: traditional determinations of death are inadequate in terms of providing good evidence for death. In the case of brain death criteria, some claim that there are patients who give evidence of system wide functioning even with a total absence of brain functioning. In the case of cardio-pulmonary criteria, death is declared if the patient suffers the “irreversible” loss of cardio-pulmonary functioning. However, the authors argue that in the case of non-heart-beating donation if the heart can be restarted in the recipient’s body, then the heart did not satisfy the ‘irreversible’ criterion. The only way around this problem, they assert, is to define ‘irreversible’ with reference to a decision not to attempt resuscitation on the donor. So on their interpretation of ‘irreversible’ a patient satisfies irreversible cessation of cardio-pulmonary functioning if the patient/surrogate elect to withhold CPR measures.

The authors assert that for both the brain death and non-heart beating criteria, the ethical justification for them cannot be that the patients are really dead since, in their judgment, both fail to provide good evidence for death. “Brain dead” patients sometimes continue to give evidence of system wide functioning. Non-heart-beating donors often do not satisfy the ‘irreversible’ criterion understood in the sense that their hearts cannot be resuscitated. In many cases, they most certainly can be. The other way of interpreting ‘irreversible’ is with reference to a decision by the patient or surrogate. If the patient (or surrogate for the patient) has made a decision not to be resuscitated, then when cardio-pulmonary functioning ceases we should consider it irreversible. But this notion of irreversible does not capture our idea of death either because it is based on a decision of the patient and not on the condition of the patient. Therefore, in the authors’ judgments we already are killing patients to extract their organs. And if this practice is permissible, then why not expand the practice to include those who are in a persistent vegetative state or those who are terminally ill? What is ethically relevant according to Truog and Miller is not whether the donors are dead, but whether they or their surrogates consent or decide to donate their organs. If so, then patients dependent upon life support may - through a reliable surrogate or directly - elect to donate their organs even if such donation would in effect kill them. Summarizing this argument the authors state, “Whether death occurs as the result of ventilator withdrawal or organ procurement, the ethically relevant precondition is valid consent by the patient or surrogate” (p. 675).

Truog and Miller offer some interesting reflections, and their argument raises important questions about how to interpret the term ‘irreversible’ in the context of determining death by cardio-pulmonary criteria. But their “solution” to the problem of how to interpret ‘irreversible’ is in the end, not a solution but a complete abandonment of the dead donor rule. Clearly, this way out of the problem is really to dissolve it. What generates the ethical problem is that a just society would not endorse a policy which allows the killing of patients for their organs. By eliminating the dead donor rule, Truog and Miller effectively undercut the reason for ethical concern in the first place. By so abandoning the dead donor rule Truog and Miller recommend that it is permissible to kill patients for their organs so long as the patients consent to it. Obviously, we should resist this conclusion but at the same time thank Truog and Miller for pointing out a difficult issue regarding non-heart-beating organ donation.

How can this issue be resolved? It should be noted first that any determination of death should be based upon the condition of the patient, not on what is technologically possible, and not on a decision to withdraw life support. Neither way of articulating appropriate evidence for death will work since death is a state of the patient. Knowing whether someone is dead requires knowing something about the patient’s overall condition. Second, there is a distinction between what counts as good evidence for death, and what death means. The Catholic tradition considers death as the soul’s separation from the body and a person’s soul is not some separate ghost-like entity, but a principle of organization. John Paul II tells us that death occurs “when the spiritual principle [the soul] which ensures the unity of the individual can no longer exercise its functions in and upon the organism, whose elements, left to themselves, disintegrate.”(1) The soul enables the organism to be an organism. Good evidence for death will be evidence that this separation has taken place in a given patient and disintegration is key evidence.

With these points in mind we can ask, is the irreversible cessation of cardio-pulmonary functioning good evidence that someone is dead? And, how should we interpret the term ‘irreversible’? The term ‘irreversible’ must refer in part to whether the patient’s cardio-pulmonary functioning is capable of auto-resuscitation. If a patient’s cardio-pulmonary functioning loses the capacity for auto-resuscitation, this is evidence that the soul is not exercising its integrative function in the patient. Thus, we have good evidence that death has occurred if the patient’s cardio-pulmonary functioning loses the capacity for auto-resuscitation.

Does this mean that a person who suffers an arrest and who needs CPR satisfies the ‘irreversible’ criterion? Not necessarily. If the patient suffers an arrest due to a manageable infarction, for instance, then the heart itself remains capable of functioning and will function on its own once the infarction is bypassed. A better example may be an arrest due to drug use. We can expect that the heart functions fine without the drugs in the person’s system. Here, too, such a person would not satisfy the criterion of irreversibility even though the person may need CPR at the time of arrest. The heart retains the capacity to function on its own in some cases of an arrest, and in these cases does not satisfy the irreversible criterion.

In other cases of arrest, the heart does not retain this capacity. In the case of a non-heart-beating organ donor (NHBD), the donor requires ventilator support and in some cases pressure support. Such donors have without exception, Do Not Resuscitate orders. If the ventilator is withdrawn the donor’s cardio-pulmonary functioning ceases and is not capable of functioning on its own – in that patient.(2) Once in the recipient, however, cardio-pulmonary functioning may return, but this is not evidence that the donor did not satisfy the “irreversible” criterion, rather it is evidence that the recipient’s soul (i.e., the organizing principle) is still exercising its integrative functioning. After all, the donor and recipient differ in important ways. When life support is withdrawn from the donor, cardio-pulmonary functioning ceases. When the heart or lung is transplanted into the recipient, cardio-pulmonary functioning returns and is maintained. The best way to explain this asymmetry is that the donor’s soul, as the organizing principle, had departed, and the recipient’s soul remained. This asymmetry is not a counter-example to defining the “irreversible cessation of cardio-pulmonary functioning” as the “incapacity to auto-resuscitate in patient X.” Again, any good evidence that death has occurred in a patient has to be tied to the condition of that patient not to the condition of some other patient, not to what is technologically possible, and not to some decision by surrogates regarding transplant options.

Given what has been said, the irreversible cessation of cardio-pulmonary functioning (understood as above) is good evidence that death has occurred in a given patient. Of course, we recommend along with the Institute of Medicine that in order to be morally certain that the cardio-pulmonary functioning cannot auto-resuscitate one must wait five minutes. Some centers only wait two minutes, but this may not be consistent with moral prudence. In the case cited by Truog and Miller, the transplant team based in Denver CO. waited a mere seventy-five seconds. The donors and recipients were infants and no evidence exists that an infant heart cannot auto-resuscitate in such a short time interval. If anything, we should expect younger hearts to be capable of longer intervals wherein auto-resuscitation is possible. We applaud the bioethicists George Annas, and Robert Veatch for repudiating the actions of the Denver team.

What about Truog and Miller’s comments on brain death? They claim that certain patients who satisfy whole brain death manifest evidence of system-wide functioning (e.g., wound healing, and immunological defense). If so, is brain death good evidence for death? The answer to this question is, “yes,” but to explain why requires making several distinctions. First, there is a distinction between the persistent functioning of a sub-system (e.g., endocrine functioning) of a human being and the persistence of the human being. A human being may be dead and a sub-system may persist. Dead bodies may continue to grow hair, and nails, and some bodies satisfying brain death criteria have certain larger sub-systems which continue to function, albeit under external support. Conversely, a sub-system may be “dead,” or severely impaired as in the cases of kidney failure or ventilator dependent persons who otherwise are fully functioning. Thus such persons are fully alive. Consequently, to argue against brain death as an adequate determination of death, one must argue that in the setting of brain death the human being, not just a sub-system, still exists. Second, there is a distinction between sub-systems functioning because of external life support in a non-integrated manner, and sub-systems functioning autonomously in an integrated manner with other sub-systems. Patients satisfying whole brain death need external life support of some sort, typically ventilator support. Therefore if the organism requires artificial life support due to permanent loss of the organism’s own ability to integrate and regulate vital functions, this is good evidence that the soul has departed that body. In admitting that the body needs external support is just to admit that the body has lost its own resources to maintain vital functioning. This should be taken to be evidence for death, not life.

With these two distinctions in mind, I think it is clear that the persistent functioning of a sub-system requiring artificial life support does not indicate that a person is still alive. To see this clearly consider an example from James Dubois. Dubois has us consider a decapitated patient who arrives in the ER. Miraculously, the ER team succeeds in restoring cardio-pulmonary functioning with intensive life support. Is the decapitated patient a human being? Intuitively, we should say no. To say yes would reduce what it means to be a human being to a pitter-patter of disintegrated biological sub-systems.

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Notes:
1. Pope John Paul II, “Discourse of Pope John Paul II,” in Determination of Brain Death and Its Relationship to Human Death, eds. R.J. White, H. Angstwurm, and I Carrasco de Paula (Vatican City: Pontificia Academia Scientarum, 1989), xxvi.

2. In the analysis that follows, it is assumed that a non-heart-beating donor can donate the heart, but this is exceedingly rare for obvious reasons. The only cases we are aware of are cases of “uncontrolled” NHBD. Uncontrolled donation typically involves a patient who arrives in the emergency department and all efforts at resuscitation fail. Uncontrolled donors are typically young and are trauma victims. Though rare, their hearts are capable of functioning in a person who has not experienced the same traumatic injuries. See Institute of Medicine, Non-heart-Beating Organ Transplantation: Medical and Ethical Issues in Procurement (Washington D.C.: National Academies Press, 1997), 27ff.

3. James DuBois, “Avoiding Common Pitfalls in the Determination of Death,” National Catholic Bioethics Quarterly 7(3) (2007): 557. DuBois is commenting on the example as articulated in Kenneth V. Iserson, Death to Dust: What Happens to Dead Bodies? 2nd ed. (Tucson, AZ.: Galen Press, 2001), 19.

President's Emergency Plan for AIDS Relief

Thu, 21 Aug 2008 19:24:00 GMT

August 21, 2008. The XVII International AIDS Conference took place 3-8 August 2008 in Mexico City. The previous conference was in Toronto in 2006, and the next one will be in Vienna in 2010. This year’s theme was: Universal Action Now.

The first conference of this kind was held in 1985 in Atlanta, Georgia, USA, and was partly sponsored by the US Centers for Disease Control and Prevention (CDC), which had first recognized and reported the syndrome in 1981.

This is the second largest conference in over 30 years, with attendance of an estimated 24,000 participants from around the world, representing about 195 nations. Surprisingly, this year it got relatively little media coverage.

Among the main events were: 17 plenary sessions focusing on the latest science, policy and practices; a Global Village networking effort; a Youth Program; a Cultural Program, and dozens of workshops on leadership, advocacy, policy formation and regional successes and failures.

This biannual conference is sponsored and supported by the: World Health Organization (WHO), Joint United Nations Programme on HIV/AIDS (UNAIDS), International AIDS Society (IAS), Global Network of People Living with HIV/AIDS (GNP+), Ford Foundation, Bill and Melinda Gates Foundation, Kaiser Family Foundation, major pharmaceutical and allied public health companies, among many others.

Recently, the UNAIDS 2008 Report on the Global AIDS Epidemic was released, where it is stated that:

In 2007 (latest figures), there were about 33 million people worldwide living with HIV/AIDS;
An average 2.7 million new cases appear each year;
About 2 million people die yearly from complications of HIV/AIDS;
5 new people become infected for every 2 who begin anti-retroviral therapy (ART)

Two highlighted reports of the Mexico City conference were:

The increasing effectiveness of anti-retroviral therapy.
The benefits of male circumcision and basic hygiene in slowing down transmission rates.

To help achieve universal access to prevention, care and treatment by 2010, three main goals were promoted:

The need to eradicate the stigma associated with the disease;
The need to support basic human rights, including gender equality;
The need to dispel the myth that funding for AIDS detracts from public funding of other vital healthcare needs. ;

Notably absent was any plenary session on vaccines, unlike in previous HIV/AIDS conferences.

Dr. Julio Montaner, incoming president of the AIS, said in his closing speech: “The key word emerging from this conference is combination:

Combination prevention strategies tailored to decrease HIV transmission.
Combination antiretroviral therapy to dramatically reduce morbidity and mortality among those infected.
Combination antiretroviral therapy to reduce community viral load as an aid to HIV prevention.
Combination strategies to enhance HIV testing.
Combination strategies to reduce poverty, and discrimination.”

Dr. Pedro Cahn, conference co-chair and outgoing IAS president, said in his closing speech: “Again, it’s time to call on all UN Member States to actively include the most at risk population – men who have sex with men, injecting drug users, sex workers, youth, women and children- in the HIV/AIDS response.”

In 2003, President George W. Bush launched the President's Emergency Plan for AIDS Relief (PEPFAR) to combat global HIV/AIDS - the largest commitment by any nation to combat a single disease in human history. On July 30, 2008, the President re-authorized PEPFAR, thus releasing up to $48 billion to combat global HIV/AIDS, tuberculosis, and malaria. The NCBC joined others, who support public policies respectful of all vulnerable human beings, in preventing the inclusion of family planning and abortion funding through amendments to PEPFAR. This much needed humanitarian aid advanced without such anti-life provisions.

The NCBC applauds Congress for re-drafting PEPFAR in terms that respect the dignity of all human beings, and the President for signing it into law. The NCBC also encourages the participants of the XVII International AIDS Conference to persevere in working collaboratively world-wide with all sectors of society, including faith-based groups, that can make a positive contribution toward stemming ―and eventually eradicating― the HIV/AIDS pandemic.

In line with the USCCB policy on HIV/AIDS: “Called to Compassion and Responsibility: A Response to the HIV/AIDS Crisis”, the NCBC highly encourages all peoples threatened by HIV/AIDS to seriously consider the only combination which is 100% effective in preventing the transmission of HIV: sexual abstinence before marriage and mutual fidelity within marriage, and the avoidance of illicit intravenous drugs. For married couples, one of whom is already infected (discordant), the Vatican is currently studying their predicament and no official pronouncement has yet been made. It is the tentative opinion of the NCBC that discordant couples should abstain from sexual intercourse until the Holy See provides further light on this complex and delicate issue, one that is also life-threatening.

30 Years of IVF: Advanced Technology or Capricious Ethics?

Wed, 30 Jul 2008 19:37:00 GMT

Stephen Napier, Ph.D.
NCBC Ethicist

July 30, 2008. It has been 30 years since the first “test-tube” baby appeared on the scene. Louise Joy Brown was born on July 25th, 1978. Since then, the technology has not advanced much. The same basic procedure is being used today as in 1978 - namely, the mixing of male and female sex cells in a glass dish leading to the engendering of embryos - but the uses and ends to which IVF is employed have certainly grown in number. It is much more common today for couples to pick and choose which embryos to implant, with such a decision based on the traits, gender, or potential for disease the embryo may have. The embryos that are not chosen are either frozen for future implantation or experimentation or they are destroyed. It is more common now for single women who sense that their “clock is ticking” to seek IVF, or for a lesbian couple to choose to have a child through IVF. If one thinks that embryos are nothing but a cluster of cells and not full fledged human beings, then none of these activities would seem objectionable. But then, testing this or that embryo for his/her sex or for certain traits would not make sense unless the embryo were a human being who is either male or female and has certain genetically disposed traits. Mere clusters of cells are not male or female, and they certainly don’t possess traits; human beings do. I say this to clear away certain absurdities in ethically analyzing IVF.

Some other clarifications should be made as well. Though infertility is certainly a cross many couples bear, it is important to distinguish between solving infertility by whatever means, and solving infertility by ethical means. It is also important to be clear that having a child is not a right: it is rather a gift. Being clear about these distinctions will go some distance in adjudicating the moral permissibility of IVF.

The Church’s teaching on IVF comes from her long standing teaching about the nature of the marital act and the inherent dignity of new human life. Consequently, the Church cannot change its teaching, unless the nature of the marital act changes, or new human life does not posses inherent worth. This is to say, the Church’s teaching is not based on a whimsical prudishness, or on “hang-ups” about sex, but rather on the proper order of sexual relations and how an act of procreation ought to respect the dignity of new human life. The Church is merely peering into reality and reading off of it the proper moral order of certain actions. Those who object to the Church’s teaching must say in response that they have peered into the dense forest of reality and have discerned a different order, or no order at all. But such a claim is audacious at worst, and intellectual hubris at best. The Church avoids such hubris because she claims to be the final interpreter of the moral order under the direction and light of the very Creator Himself. These comments are sufficient to rebut the unsupported claim by Art Caplan who in a recent commentary on IVF said, “Even the Catholic Church, which has never approved the break between sex and procreation, has taken a relatively benign view of the use of IVF by married couples.” (Art Caplan “New IVF Dilemmas Make Old Fears Seem Quaint.” MSNBC July 24th, 2008.) The Church has firmly rejected, and continues to reject, all recourse to IVF, whether by married couples or not. Caplan is simply uninformed.

But what is the Church’s objection to IVF? Caplan comes close to understanding the Church’s teaching when he says, “Some maintained that creating children this way was simply unnatural and would stigmatize the child. Others bemoaned the creation of life without sexual intercourse, fearing that in vitro fertilization would degrade human dignity as people became the object of mechanistic creation in glass dishes.” Neither of these reasons truly captures the Church’s position in total – though in fairness Caplan does not say he is recapitulating the Church’s teaching. The Church teaches that the dignity of new human life requires bringing that life about through an act of love, not through an act of manipulation. The marital act is by its very nature an act of self-giving and charity. The procedures associated with IVF are not. For IVF, embryos are typically destroyed because they are not fit enough or because they do not bear the traits desired by the couple. Even if care is taken to implant all that are conceived, the procreative process is still not an act of love shared between spouses. The dignity of the child and the dignity of the act bringing about the child (in IVF) do not comport with one another. The idea behind the Church’s teaching is fairly simple. There is an order and fittingness to the procreation of new human lives, and this order requires the procreative event to be an act of charity between spouses. Those who think that the Church objects to IVF because it is “unnatural,” as if the Church were saying that sexual intercourse per se is the only proper means by which to procreate, miss the point. Not just any act of sexual intercourse is proper to procreation, for example, fornication and adultery certainly are not. What is proper to procreation is an act of charity realized only in the conjugal act.

The 30th anniversary of IVF should be viewed in light of another important anniversary, namely the 40th anniversary of Humanae Vitae. The Church’s teaching on IVF is a mere extension of her teaching about the integrity of the marital act and how preserving such integrity comports with charity. In fact the two teachings can be viewed as following from one and the same teaching. As my colleague Fr. Alfred Cioffi has noted, contraception is an attempt to experience unity without procreation and IVF is an attempt to experience procreation without the unity. Insofar as the Church prohibits such disintegration, the teaching should not then be viewed as a restriction but rather as an invitation to experience the fullness of the goods available to a couple through the sacrament of marriage. The Church’s teachings are not only consistent but fulfilling.

Federal De-Funding of Planned Parenthood

Fri, 25 Jul 2008 19:41:00 GMT

July 25, 2008. On Wednesday, July 9, several members of the U.S. House of Representatives issued a call to de-fund Planned Parenthood (http://www.lifenews.com/nat4037.html).

Planned Parenthood (PP) is the single largest abortion provider in the United States; by their own standard, they do about twenty percent of all U.S. abortions. Its affiliate branch, International Planned Parenthood Federation (IPPF) is the largest abortion provider in the world. Last year, PP reported over 1 billion dollars in revenue (see URL above), with about one-third of that money (about $337 million) coming from U.S. grants and contracts. PP has turned the abortion business into an immensely profitable industry, even placing abortion centers near grocery stores and shopping malls in order to process the large number of pregnant women on their way to or from their daily activities.

Representative Chris Smith and a dozen other U.S. House Members are calling on the U.S. government to get out of the abortion business by seeking to stop all public moneys to Planned Parenthood.

NCBC Publications Win 7 Awards from the Catholic Press Association

Thu, 12 Jun 2008 14:29:00 GMT

June 12, 2008. The National Catholic Bioethics Center is pleased to announce numerous awards from the Catholic Press Association for its two serial publications, Ethics & Medics and The National Catholic Bioethics Quarterly.

The prestigious first prize for general excellence in a scholarly journal was awarded to The National Catholic Bioethics Quarterly, another of several top awards that have been won by this publication over the years.

Also awarded were six additional prizes for authors published in both the Quarterly and Ethics & Medics and for the book review section of the Quarterly.

The awards and reviewer comments are listed below. Congratulations to all of our authors.

For subscriptions to NCBC publications visit our website.

Best Essay
Scholarly

First Place
National Catholic Bioethics Quarterly, Philadelphia,
Pa., “On Marriage and Metaphysics” by Robert E. Rodes, Jr.
The author uses a variety of interesting techniques to frame the discussion of same-sex marriage, from the references to Cole Porter to key legislative developments. The article is well researched and discusses a timely issue.

Second Place
National Catholic Bioethics Quarterly, Philadelphia,
Pa., “The Duty to Care: When Health Care Workers Face Personal Risk” by Marie T. Hilliard, R.N.
"This well-researched article will help health care workers to understand their obligations to care when they face personal risk, such as when caring for patients with SARS. The author incorporates both legal and ethical issues in this thorough discussion."

Best Essay
Special Interest Newsletters
First Place
Ethics and Medics, Philadelphia, Pa., “The Pill and Breast Cancer Risk” by Timothy P. Collins, M.D.
"Dr. Collins lays out the case that birth control pills are bad, not only because they violate the teachings of the Church, but they also pose serious health risks. He states his intention clearly in the opening paragraph, then lays out a convincing case for his thesis. He sums up his argument, showing that the Church and science agree on this subject. This essay stands out in that it is well organized, written clearly, it stays focused, and it effectively proves its point."

Second Place
Ethics and Medics, Philadelphia, Pa., “Spiritual Care in Hospital Policies” by Rev. Christopher M. Saliga, O.P.,
R.N. & Rev. Carlos Quijano, O.P.
"Rev. Saliga and Rev. Quijano’s essay comes in a very close second. It offers an incontrovertible argument for medical professionals and clergy working together to provide for patients’ spiritual as well as medical needs in the hospital environment. The writing is persuasive and the content is backed up with real life examples and suggests actions to address this issue."

Best Book Review Section
Third Place
National Catholic Bioethics Quarterly, Philadelphia,
Pa., “Book Reviews”
"These were exceptionally well-crafted reviews, though sometimes a tad dry. On the whole, however,
they provide the reader with a broad understanding of the subject matter, its context and importance, and the book’s/author’s success (or lack thereof) in adding to that understanding."

Best Feature Article
Scholarly
Second Place
National Catholic Bioethics Quarterly, Philadelphia,
Pa., “Avoiding Common Pitfalls in the Determination of Death” by James DuBois
"This story took a very interesting view of organ donation as it relates to death of an individual. It’s
a difficult question to answer, yet the writer did an outstanding job of supporting the notion of the irreversibility of death before consenting to donation. The author did not have an agenda. The writer shared
the facts, providing the words of those who are involved in the project. There was also no editorializing."

General Excellence
Scholarly Journal
First Place
National Catholic Bioethics Quarterly, Philadelphia, Pa.
"This magazine serves as an excellent example of academic discussion. Contributors keep the journal lively
by debating each other’s points in passionate letters to the editor from issue to issue. For readers interested in bioethics, this magazine provides an excellent resource. Washington Insider keeps readers up to date. Articles do an excellent job at analyzing current affairs and challenging their readers."

The Medicated Child

Tue, 29 Apr 2008 14:34:00 GMT

April 29, 2008. Several weeks ago PBS broadcasted a Frontline report titled “The Medicated Child.” In its own words, the report’s brief says, “Six million American children are taking psychiatric drugs, but most have never been tested on children. Is this good medicine -- or an uncontrolled experiment?”

The report is interesting from an ethical perspective for at least two reasons. First, it highlights the fact that many drugs, especially psychiatric drugs, are being used on children without having been tested on children. The report points out a fairly large lacuna in research regulations, namely, if a scientist wants to study the effects of a drug across a population, the scientist is obliged to follow the regulations governing research on human subjects – regulations which are quite comprehensive and ethically sound. If the scientist does not desire to do a formal study, but instead prescribes drugs based on ‘gut feelings’ or anecdotal evidence, then the drugs he or she prescribes need not be tested (even in the case of children). So long as research is not the intention of the scientist/physician, he or she is free to prescribe medications for off-label use. (Off-label use of a drug is prescribing it for a condition for which it has not been tested, or for a population for which it has not been tested.) From an academic perspective, the Frontline report gives good material for thinking about the current regulations governing research, and to consider ways to protect not only research subjects, but vulnerable populations from untested and potentially harmful “therapies.”

A second reason why the report is interesting is that it provides parents with crucial information regarding the proper upbringing of their children. The report has the viewer seriously consider whether medication is the best option to address behavioral or emotional disorders. Additionally, the report cautions against making such diagnoses in the first place, since it is well known that at certain developmental periods the spectrum of “normal” behavior is quite broad. Granted, there are children who evince disruptive behavior and mood swings, but the problem may be more appropriately addressed through different parenting techniques, or cognitive-behavioral therapy. The report alludes to the potentially serious side effects many medications may have on developing brains. This is important information for parents to consider. For more information see the “Parents Guide” located on the link referenced above.

The Groningen Protocol

Thu, 27 Mar 2008 14:36:00 GMT

March 27, 2008. Recently, the academic journal The Hastings Center Report published an essay defending the practice of infant euthanasia. The article is titled “Ending the Life of a Newborn: The Groningen Protocol”, (H. Lindemann and M. Verkerk, Jan-Feb [2008]: 42-51). Developed in the Netherlands and named after the hospital at which it was originally developed, the protocol outlines five criteria that must be satisfied before an infant may be euthanized. They are (1) the diagnosis and prognosis must be certain; (2) there must be “hopeless and unbearable suffering”; (3) the presence of hopeless and unbearable suffering must be confirmed by a second physician; (4) both parents must give informed consent; and (5) the procedure by which the infant is killed must be performed “in accordance with the accepted medical standard.”

The authors of the article make some startling claims. First, they say that the protocol does not apply to infants who are at risk of dying, but rather applies to infants who “are in no danger of dying” (46). The reasons for killing them would be because the two physicians think the infant’s life will not be worth living. To give context to the second startling claim, an earlier description of the protocol in the New England Journal of Medicine (NEJM) pointed out that numerous infants with only the diagnosis of spina bifida were euthanized. The interpretation of criterion (2) was so broad as to include infants who may likely grow into adulthood and live fulfilling lives. The authors of the present article say without argument that the protocol does not apply to any infant with a fair prospect for a good quality life. They do not address directly the charge that the protocol has been used on infants who had disabilities that were no more serious than spina bifida, and the present article cites no evidence to the contrary. Third, the authors say that satisfaction of criterion (2) is met even if the infant is not at present experiencing unbearable suffering. The authors assert that the assessment of the infant’s future state of health is sufficient to satisfy (2). The reason seems to be that when two physicians can foresee that an infant will be permanently disabled, or unable to communicate, or suffers some similar disability (that does not cause physical pain), then (2) is satisfied (p.48). Properly understood, this is not a reason but rather an appeal to the reader’s moral conscience. The reader is expected to ‘see’ that criterion (2) is legitimate.

Criticisms of the Groningen protocol have focused on numerous contentious aspects. The most common criticism has to do with the opacity of the term “unbearable suffering.” The authors of the present article suggest that suffering involves either a disability (e.g., mental disability), or physical pain. If condition (2) is satisfied by the mere presence of a disability, then the physicians are involved in an outside assessment of the worth of someone else’s (the infant’s) life. If condition (2) is satisfied by the presence of pain, then, granted, the physicians can see that the infant is in pain. But there still is an outside assessment of the worth of the infant’s life, namely, an infant who experiences this much pain has a life not worth living. In either case, the physician who follows the protocol ends up killing an infant, reasoning as follows: “I don’t think that that infant’s life is worth living.” No one would think that this is a reason to kill someone, and yet it is the only reason that could be given in support of infanticide. Likewise, no one ought to think that the worth of a human’s life is determined by how another person views that life. Each human life is inviolable. Once the prohibition against the direct taking of innocent human is breached there can be no reasoned defense against the taking of any life by those who have the power over it. The article merely appeals to the emotions of not wanting to see a child suffer to make make its case rather than trying philosophically to defend what, ultimately, is indefensible.

The UK Human Fertilisation and Embryology Bill of 2008

Mon, 17 Mar 2008 14:47:00 GMT

March 17, 2008. Since the beginning of this year, the Parliament of the United Kingdom (UK) has been involved in an intense debate over their Human Fertilisation and Embryology Bill. The bill aims to relax current government regulations that specify what is legal and what is not regarding artificial human procreation and human embryo research.

If passed, the bill would allow for the creation of artificial sperm (and eggs), and for experimentation with human-animal hybrids Also, it would remove the current provision that requires a child conceived through IVF to have a father. Under the new bill, a single woman could self-fertilize using “sperm” manufactured from her own (bone marrow) stem cells. Biologically, this is different from cloning (asexual reproduction) in that self-fertilization is a type of sexual reproduction. Ethically, however, a similar grave objection (as to human cloning) exists in that the resulting human zygote was not conceived through the marital act, and because it denies the child a father.

At its root, the fundamental divide comes when one sees human procreation either as a utilitarian process of manufacturing the baby that I want here and now, or as the deepest of human mysteries through which God collaborates with a married heterosexual couple in the miracle of creating a new human life.

It is not hard to see that, if human infertility is approached as a practical problem to be solved solely by technology, then no amount of technology will suffice in the most difficult cases, resulting in utter frustration. In contrast to such a utilitarian approach, respect for the dignity of human life requires that each person be treated as a subject and not as an object. It is only logical to include the desired child into the equation of dignified human life.

Increasingly, the bulk of these legislative efforts seem to focus more on not interfering with the supply-and-demand processes of a free market economy rather than on the fact that what is at stake here is the engendering a new human being in the lab. We need to take into consideration the good of the child. What will the child have to say as she grows up and gradually finds out that she was intentionally conceived without a father?

And finally, it should be pointed out that the sperm is not “artificial” as though it were made from synthetic material. Rather, it is the result of the manipulation of existing biological material.

"Creating" Life in the Lab

Tue, 05 Feb 2008 15:58:00 GMT

February 5, 2008. Recently, there have been two controversial news reports involving the beginning of life. First, the United Kingdom’s Human Fertilisation and Embryology Authority (HFEA) officially approved the creation of human-animal hybrids for research purposes. Second, Dr. Craig Venter and associates, here in the United States, announced the completion of crucial steps in the construction of “synthetic life.”

British Hybrids
HFEA is the government agency in England in charge of regulating human fertilization and embryology research and the disbursement of public funds for this research. HFEA has recently approved the manufacture of “cybrids” (cytoplasmic hybrids). In this process, scientists replace the nucleus of a non-human mammalian egg with a nucleus from a human somatic cell such as a skin cell. This type of cloning seeks to circumvent the problem of obtaining human eggs for research which is controversial in part because of its exploitation of women. Animal eggs (cow, rabbit, sheep, goat) are typically discarded by the food industry and so are in abundant supply. The aim is to manufacture embryos for the harvesting of human embryonic stem cells.

Some claim that these cybrids are not human embryos, but that is obviously false because only human embryos can give rise to human embryonic stem cells. Since a human somatic cell nucleus contains the entire human genome---and since all mammalian (placental) embryonic development is rather similar during the first couple of weeks―we have every reason to expect that, in creating a cybrid, one is indeed engendering a human being.

Scientists who pursue this research state that the cybrid embryo will not be allowed to live beyond the very early stages of development and will certainly not be implanted in a (mammalian) womb. But this only means that living human beings, immorally manufactured in laboratories, will not be given the home that is natural to their proper development and survival. As tempting as it is to experiment on defenseless human embryos, a civilized society should rather seek to protect them from harm. We should not allow any blurring of the fundamental distinctions between human and non-human life for the sake of advancing research.

Synthetic Life
Regarding the claim of Dr. Venter and associates to have created synthetic life, we note that there has been considerable confusion on this matter in the media. Venter has not created life, but has used existing life in an effort to produce a new synthetic organism. Several segments of DNA were spliced together according to the specifications of a pre-determined information sequence. The final DNA string was about half a million base-pairs long, which is indeed a considerable amount of genetic information. Venter plans to introduce this into a living bacterium in the hope that the bacterium’s own chemical machinery would translate the inserted information into functional proteins.

Certainly, this would be a new and highly important step in genetic engineering, but it is not the creation of life out of non-living matter. Those who claimed that Venter was on the verge of such a feat simply did not understand what was involved. Specifically, they overlooked the fact that the existing life of a bacterium would power the new synthetic organism. We know that many scientists have conducted experiments which duplicate the primitive conditions necessary for the appearance of organic life on Earth, but no scientist has ever produced life out of non-living matter. Whether that is even possible remains an open question.

As to the usefulness of Venters’ enterprise, yes, it may certainly have many useful applications for biofuels, biodegradants, and bioimmunities, but it may also have dangerous uses in bioterrorism and ecological disaster. Therefore, these experiments should be subjected to rigorous government scrutiny and public debate.

Research Subjects and Informed Consent

Fri, 25 Jan 2008 16:01:00 GMT

Stephen Napier, Ph.D.
NCBC Ethicist

January 25, 2008. A very interesting book has been published on clinical research titled, What the Doctor Didn’t Say: The Hidden Truth About Medical Research, by Jerry Menikoff and Edward P. Richards. The authors offer a very clear, informative, and engaging discussion on the challenges of conducting clinical research. They offer some very important points that anyone thinking about research participation needs to know. I include three here.

First, some research involves drugs that are already on the market but are being researched for alternative uses. Sometimes, potential participants do not know this. This is important since most clinical research trials have a placebo group – a group that does not know that it is receiving a substitute rather than the drug being researched. If the drug is available outside of the research and it may likely benefit the research subject, then one should have knowledge of this in order to make an informed decision. To the extent researchers gloss over that information, the participants may not be able to provide truly informed consent.

Second, many consent forms will tell the potential participant that the study drug “may benefit you." In many cases, the statistical probability of the drug providing an actual benefit is very low - sometimes a mere 1%. When potential participants see this phrase in a consent form, they should ask what it really means statistically.

Third, it is important to know the alternatives to research participation. Informed consent documents are required to provide information on the alternatives to being in the study. Often, however, the only stated alternative is as follows: “The alternative to not being in this study is to not be in this study.” I have actually seen such a statement in research protocols. Some others do better by telling the subject to discuss with a doctor some appropriate alternatives. If potential research subjects do not know their alternatives, then they should certainly discuss them with a doctor.

There are other lessons to be learned from this text, but the most important is this: The authors point out that the attitude that informs these subtly deceptive practices is driven by a concern to have enough research subjects. Researchers are tempted to think that full disclosure will dissuade potential subjects from participating in their studies. The research community is certainly doing something to curtail this attitude, but responsibility falls to potential subjects as well. Potential subjects should actively read informed consent documents and discuss therapeutic options with a doctor not associated with the research staff.

The NCBC encourages involvement in research in that it comports with the virtue of charity. Violations against one’s bodily integrity, however, should be resisted and that responsibility is the responsibility of the potential subject as well as the researcher.

The Revised Uniform Anatomical Gift Act (2006)

Tue, 15 Jan 2008 16:04:00 GMT

January 15, 2008. The National Conference of Commissioners on Uniform State Laws approved in July 2006 and revised in 2007 The Revised Uniform Anatomical Gift Act (UAGA). The purpose of the UAGA is, in part, to address the critical organ shortage for transplantation by providing additional ways for making organ, eye, and tissue donations. Since the original UAGA was promulgated in 1968, and updated in 1987 with only 26 states adopting that version, the diversity of laws is seen as an impediment to transplantation. Thus, there has been a state-by-state effort to encourage the adoption of this most recent revision of the UAGA. At the same time, there is a need to educate the public to the provisions contained in the UAGA to ensure the protection of donors, especially the most vulnerable, while also encouraging this act of charity.

A section by section analysis of the UAGA will follow, however, the overall concerns relate to: the authority for anatomical donations of the person who has “jurisdiction” over the body and has the authority to dispose of the body or anatomical parts and tissue, such as a coroner or medical examiner (perhaps equating to “presumed consent” of the homeless); the difficulty which exists for removing one’s name from a donor registry (See Section, 5 (c) and (d), Page 20, and bullets, attached, pertaining to Sections 5, 7, and 8 ); the ability to use tissue from aborted fetuses (Section 2 (4), Pages 11-12) for such purposes (not a new provision); and the provision to recognize donor consent documents executed in other countries or pertaining to the domicile of a donor (See Section 19 (a) (2) and (3), page 45). One new wrinkle is that in this age of public funding of cloning as well as assisted reproductive technologies, it is not unreasonable to have one’s gametes taken, literally to create one’s offspring for reproductive therapies or for research purposes through in vitro fertilization or somatic cell nuclear transfer. It should be noted that the “Comment” to Section 2 indicates that the UAGA is silent on the donation of blastocysts and embryos (See Page 15). All that means is that use of donations for such research purposes are not prohibited.

There are protections included in these provisions. There is no “presumed” consent, as in Europe. The separation of the role of the transplant physician from the attending who pronounces death is clear. Organs and tissue cannot be sold. Death must be documented, although the standards for Non Heart Beating Death are not specified sufficiently. Dispute resolution methods among prioritized classes of those who can give consent are provided. Provisions for the donor to document refusals of consent are included. However, family members are precluded from overriding a written document of consent by the donor. Specificity is given as to how organs and tissue will be used when a donor only specifies that he will be an “organ donor;” transplant and therapy uses are all that is allowed. Specific consent is required for research and education uses. The ability to use tissue from aborted fetuses has not changed.

For these reasons, the National Catholic Bioethics Center recommends that attempts should be made at the state level to amend proposed legislation, rather than an all out opposition. It is recognized that this is a “uniform” act, intended not to be modified at the state level. However, the vulnerability of the homeless who become the property of coroners is of concern. State Catholic Conferences and diocesan Pro-Life Offices may find that advocates for the homeless will collaborate in opposition to this provision. Also, the recognition of documents executed in other countries or pertaining to the domicile of a donor may open the door to allowing the sale of organs, or assisted suicide. The other concerns that are addressed can be remedied by good public education to assist persons in declaring, affirmatively, to what they are refusing. One overall practical concern may be that proposals such as those contained in this document are likely to cause hardship and dissatisfaction among families, thus leading more patients to refuse to become organ donors in the first place. The section by section analyses are contained in the attached pages.

Analysis of the Uniform Anatomical Gift Act of 2006
(Revised 2007)

• Prefatory Note, Page 5: The 2006 Act preserves the prohibition against the sale and purchase of organs, which is not true in some other countries (see provision, below, recognizing legal parameters of other countries; perhaps this needs to be incorporated in that section, also).
• History of 1968 and 1987 Acts, Page 5: The 2006 Act preserves the donor requirement of irreversible cessation of circulatory and respiratory function, or irreversible cessation of all function of the entire brain, including the brain stem. However, what is not defined are the criteria for determining irreversible cessation of circulatory and respiratory function (e.g., not able to be resumed, naturally, after five minutes; in fact some advocate for a two minute rule, which is problematic). Furthermore, what is not delineated is what interventions, such as high dose heparin and vasodilators, are licit/illicit to be applied to the donor, if they will be detrimental to the donor’s health, before the donor is declared dead. ,
• History of 1968 and 1987 Acts, Page 6: The “opt in” criterion is maintained, except for the person whose remains for disposal are the jurisdiction of such persons as a medical examiner or corner, which is very problematic.
• Summary of the Changes in the Revised Act, Pages 7-11: The list of those who can make a donation on one’s behalf, and what to do if there is a conflict among them is explained well. However, the effort to contact such persons for consent is minimal (“‘Reasonably available’ means able to be contacted by a procurement organization without undue effort and willing and able to act in a timely manner consistent with existing medical criteria necessary for the making of an anatomical gift;” this would equate to being able to reach them by phone, which is nebulous, at best; see Section 2 (23), Page13, and “Comment,” Page 17). One could be declared not “reasonably available” by being unwilling to make a decision for the decedent. Thus, an adult grandchild could have the authority to consent to an anatomical donation when those others listed in priority in Section 9 (Page 30) are “reasonably unavailable.”

There is a provision for a donor to sign a refusal statement which is intended to bar all other persons (other than his/herself) from making an anatomical gift on one’s part (See Section 2 (26), Page 13, and Section 7, Pages 24-26). No one can override a written declaration of the decedent to be a donor of anatomical parts. Family members cannot contravene the written requests of the donor. However, unless the donor specifies to the contrary, the health care agent (and those listed in priority on Page 30) have all such powers to consent to anatomical donations (See “Comment,” Section 4, Page 19). Furthermore, what one “opts in” for can be expanded by those empowered to consent for the decedent if one has not been specific about exclusions. However, how well promulgated these refusal/exclusion provisions are, remains a question. The major ethical concern related to who can consent rests with those who have jurisdiction over remains, as presented above. However, it should be noted that this revision of the UAGA prevents what was permitted in earlier Acts: previously, those having jurisdiction over the body (e.g., coroner, medical examiner) did not need to have authority over the disposal of the body to make a donation of the eyes. Another new provision is that specific consent must be documented for the donation of the total body or anatomical part for research or education. This is not intended to be protective of individual rights, as much as to make the first priority organ donations for transplant.

The last revision of concern is that there is a “default” provision to provide advanced life support despite the Advanced Directive of the donor, to ensure the medical suitability of the organs, until the conflict can be solved pursuant to Section 21(b), Pages 47-48; Section 14 (c), Page 40 and Section 21, Pages 47-49. This could allow for care of the organs (e.g., high doses of heparin) to the detriment of the donor before death. There are those who argue that any interventions must benefit the person to whom they are being administered, if that person has not been pronounced dead (i.e., not declared brain dead). It also is important to note that, by its own admission, the UAGA does not define “transplantation,” “therapy,” “research,” and “education.” The major concerns herein can be addressed by good public education as to what is being given consent. Perhaps if adopted at the state level, there could be a provision for regulations to be promulgated for education of the public.
• Section 5, (c) and (d) (Page 20) indicate how difficult it is to revoke one’s donor status. Any form of cancellation of an identification card does not revoke consent to be a donor. Furthermore, invalidation of a will providing for a donation does not revoke the consent to be a donor. Such a revocation must be in writing, or communicated to two witnesses, one of which must be a disinterested witness. Again, if adopted at the state level, there could be a provision for regulations to be promulgated for education of the public.
• Section 6,”Comment,” Pages 23-24, explains, further the problem in revoking donor status once on a registry. Again, if adopted at the state level, there could be a provision for regulations to be promulgated for education of the public.
• Section 8, (d) and (e), Page 27, indicate further how a revocation of consent by an authorized party does not bar another authorized party from authorizing that gift, or of authorizing the gift of another anatomical part. Relevant “Comment(s)” related to this section are as follows: “For example, suppose an individual who had donated a kidney by a donor card later destroys that card with the intent to revoke the anatomical gift. This revocation will not prevent another person acting under either Section 5 or 10 from making an anatomical gift. A donor who wishes both to revoke and bind others not to make a gift must sign a refusal.” (Page 28); And, “Section 8(e), consistent with prior law, provides that, absent express, contrary indications by the person making an anatomical gift, the gift of a part is neither a refusal to give other parts nor a limitation on the making of gifts of other parts.” (Page 29); and “For example, suppose a donor donates “all organs, eyes, and tissue for transplantation or therapy.” That gift would not bar a gift under Section 10 of the organs, eyes, or tissue for research. The donor can bar an expansion of the gift’s purposes by an express contrary direction. For example a donor’s gift of “organs, eyes, and tissue only for transplantation” would bar others from expanding the purpose of the gift to include research.” (Page 29) Again, if adopted at the state level, there could be a provision for regulations to be promulgated for education of the public.
• Section 9 (Page 30) lists the persons who may make an anatomical gift for a decedent. They appear to be listed in level of priority. However, the issue of “reasonably available” is raised, again. If a spouse is unavailable, an adult child is authorized to make a donation on behalf of the decedent, barring no predetermined exclusions. Recall that reasonably unavailable includes not being able or willing to make the decision once contacted. Furthermore, last on the list of priority persons is “any other person having the authority to dispose of the decedent’s body,” which would include the medical examiner or coroner.
• Section 10 (Page 33) indicates that consent to donate cannot be revoked once invasive procedures have begun to prepare the recipient. Perhaps “life threatening” invasive procedures should be the standard.
• Section 11 (See “Comment,” Pages 36-37) states that an anatomical gift designated for a specific person, if unused, is relegated to an organ procurement agency, unless specified to the contrary. Furthermore, if anatomical parts are not used for transplantation, therapy, research or education, custody of those parts rests in the person who has an obligation to dispose of them. Thus, if a person has designated anatomical tissue for transplantation and it is not used, the anatomical part is under the jurisdiction of the person who is to dispose of it. He could determine it should be used for research, barring specific refusal of the donor. Again, this is an area that could be addressed through good public education.
• Section 14 (i) separates the roles of the transplant physician from the pronouncer of death (Page 41), which is an advisable position.
• Section 19 (Page 45) provides extensive latitude to follow the laws of other countries of donor domicile or where the document was executed. This has significant implications pertaining to the wellbeing of the donor, particularly in countries that allow assisted suicide and sale of organs. For example, the Philippines allows the sale of organs. If the donor is domiciled in the Philippines, would this allow a transplant team in Hawaii to use organs from such a sale?
• Sections 22 and 23 (Pages 49-53) allow the anatomical gifting from a decedent by those who have jurisdiction of the body. This includes a coroner or medical examiner. This means that those who have no one to speak for them at the end of life only will have the state, with an interest in organ and tissue procurement, to decide the fate of their remains. Furthermore, if an organ or tissue is not deemed suitable for a purpose designated by the donor, and the donor has not specifically indicated a refusal provision for use, those who are to dispose of the anatomical gift have the authority to gift it for another purpose.

___________________________________________

Notes:
1. The National Conference of Commissioners on Uniform State Laws, The Revised Uniform Anatomical Gift Act, 2007, http://www.anatomicalgiftact.org/DesktopDefault.aspx?tabindex=1&tabid=63.
2. NCCB/USCC, Ethical and Religious Directives for Catholic Health Care Services (Washington, DC: USCCB, June 15, 2001). Specifically, ERD nn. 30 and 63, addressing consent: “30. The transplantation of organs from living donors is morally permissible when such a donation will not sacrifice or seriously impair any essential bodily function and the anticipated benefit to the recipient is proportionate to the harm done to the donor. Furthermore, the freedom of the prospective donor must be respected, and economic advantages should not accrue to the donor;” and “63. Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death.”
3. Ibid.
4. Ibid, nn. 65 and 66: “65. The use of tissue or organs from an infant may be permitted after death has been determined and with the informed consent of the parents or guardians;” and “66. Catholic health care institutions should not make use of human tissue obtained by direct abortions even for research and therapeutic purposes.”
5. Ibid, nn 38 through 43: “38. When the marital act of sexual intercourse is not able to attain its procreative purpose, assistance that does not separate the unitive and procreative ends of the act, and does not substitute for the marital act itself, may be used to help married couples conceive; 39. Those techniques of assisted conception that respect the unitive and procreative meanings of sexual intercourse and do not involve the destruction of human embryos, or their deliberate generation in such numbers that it is clearly envisaged that all cannot implant and some are simply being used to maximize the chances of others implanting, may be used as therapies for infertility; 40. Heterologous fertilization (that is, any technique used to achieve conception by the use of gametes coming from at least one donor other than the spouses) is prohibited because it is contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child; 41 Homologous artificial fertilization (that is, any technique used to achieve conception using the gametes of the two spouses joined in marriage) is prohibited when it separates procreation from the marital act in its unitive significance (e.g., any technique used to achieve extra-corporeal conception); 42 Because of the dignity of the child and of marriage, and because of the uniqueness of the mother-child relationship, participation in contracts or arrangements for surrogate motherhood is not permitted. Moreover, the commercialization of such surrogacy denigrates the dignity of women, especially the poor; and 43. A Catholic health care institution that provides treatment for infertility should offer not only technical assistance to infertile couples but also should help couples pursue other solutions (e.g., counseling, adoption).”
6. Greg Burke, “A Non-Heart Beating Donor Protocol as a Physician,” Ethics and Medics (April 2000, VOL 25 NO 4).
7. Ibid.
8. NCCB/USCC, n 33: “33. The well-being of the whole person must be taken into account in deciding about any therapeutic intervention or use of technology. Therapeutic procedures that are likely to cause harm or undesirable side-effects can be justified only by a proportionate benefit to the patient.”
9. Burke.

Refuting the Argument to Continue Embryonic Stem Cell Research

Mon, 14 Jan 2008 16:08:00 GMT

January 14, 2008. Several weeks have passed since the major scientific advance involving stem cell reprogramming. For those who missed the (well-warranted) publicity, researchers in Wisconsin and Japan were able to reprogram an adult skin cell into a stem cell that shares similar properties as an embryonic stem cell (i.e., it is pluripotent). Since the new discovery does not involve the destruction of any young human beings and gives the scientist most of what he wants, namely, a pluripotent cell that can turn into numerous others types of cells (e.g., liver cell, heart cell etc.) one would think the ethical debate is over. We need not pursue research that destroys human embryos – we did not need to in the first place. But there are those who are still pushing for embryonic stem cell research. Consider an issue of the Lancet a few weeks ago in which the editors say the following,

“If, however, the technique [of skin cell reprogramming] can be successfully refined to minimise risk and maintain its current potential, a new era in stem-cell research will have begun, one in which the current ethical controversy is moot. Until then, research on human embryonic stem cells must continue.” (“Timeout, not the final buzzer, in the stem cell debate,” Lancet, Vol. 370, December 1, 2007, p. 1802, emphasis added.)

Notice the lack of any ethical argument. There is a buried scientific argument, to be sure. The editors of Lancet and other commentators argue that embryonic stem cell research should be pursued until it is clear that the other alternatives satisfy all of our scientific goals. The argument is that embryonic stem cell research holds potential scientific promise. Unless alternatives hold the same promise and are more easily used, we should continue with embryonic stem cell research. But the objection against embryo-destructive research is not a scientific one, but one based on the fact that young human beings are destroyed. In fact, arguments against destructive human experimentation abound in other domains. No one argues for such research because of the scientific knowledge one would gain from it.

Consider some examples. The Willowbrook experiments on mentally retarded children intentionally inoculated vulnerable children with hepatitis. The purpose was to observe the disease process and potentially find the mechanisms of transition – scientific knowledge! The study was “approved” because of the scientific knowledge that it presented to the medical community. Yet now we unanimously denounce the study as unethical. Bioethicists and researchers of all stripes think the study breached numerous ethical standards. Consider a more recent proposal to do research on the terminally ill and the dying.(1) This research involved administering potentially toxic drugs to a patient who elected to be taken off of life support (one knows of the patient’s wish, of course, through a reliable surrogate). Once life support is withdrawn and death is expected, the research portion begins. Again, bioethicists would allow such a study only if the research intervention would not be likely to kill the patient. Even if important scientific knowledge were to be gained without complying with certain ethical principles, the study would not be permitted. The point is that prohibitions against human experimentation are based on ethical arguments, not scientific ones. The ethical principle relevant to embryonic stem cell research is that it is impermissible to kill human beings – any human being – age and developmental maturity is irrelevant.

The persistence of those who are stating that embryonic stem cell research should continue is attributable more so to persistent rejection of the argument that human embryos are simply young human beings and therefore deserve protection from destructive research. It is interesting to note that the regulations governing human research already protect implanted embryos. Extending such protections to non-implanted embryos would not seem that far of a stretch, especially if one considers the fact that these embryos are human beings.

(1) Rebecca D. Pentz et. al. “Revisiting Ethical Guidelines for Research with Terminally Wean and Brain-Dead Patients,” Hastings Center Report Jan-Feb. (2003): 20-26.

Pope Benedict XVI appeals for restoring God’s creation during his Midnight Mass Homily.

Wed, 02 Jan 2008 16:10:00 GMT

January 2, 2008. Our Holy Father, Pope Benedict XVI, on the occasion of this years’ Christmas Mass Homily, has made reference to ethics and the human body, “which has become worn out and weak, exposed everywhere to pain and suffering.” He then pointed out that our present weakened condition extends to the whole cosmos. Citing Gregory of Nyssa’s Christmas homily, he notes that the analogy of the body also applies to the entire universe, which has been “torn and disfigured by sin.” In other words, our wrongful human actions ―consequences of our sinfulness― are already having world-wide repercussions. In one way or another, this disfigurement of nature is due to the disorder we humans have introduced into our environment. The Pope then asked the question: “What would he [Gregory of Nyssa] say if he could see the state of the world today, through the abuse of energy and its selfish and reckless exploitation?” Appealing to a renewed sense of order in our lives and in our world, Benedict went on to say that, at that first Christmas, “The Earth [was] restored to good order by virtue of the fact that it is opened up to God, it obtains its true light anew, and in the harmony between human will and divine will, in the unification of height and depth, it regains its beauty and dignity. Thus Christmas is a feast of restored creation.” During this new year of grace, may we seek to catch-up with the reality of a restored order in creation which happened on that first Christmas night. Read the full text of the Holy Father’s Midnight Mass Homily.

NCBC Statement on Somatic Cell Reprogramming to Obtain Stem Cells

Tue, 20 Nov 2007 16:20:00 GMT

November 20, 2007. The highly promising strategy of reprogramming human somatic cells, presented in recent papers by the research teams of Dr. Shinya Yamanaka and Dr. James Thomson, represents a significant breakthrough in attempts to obtain pluripotent stem cells, and affects the ethical discussion around stem cells in a very positive way. The studies confirm that human skin cells (fibroblasts) can be used to make pluripotent stem cells sharing essentially all the features of human embryonic stem cells. The technique involves the introduction of 4 genes into the skin cells, thereby "reprogramming" them to a less specialized (pluripotent) state.

The National Catholic Bioethics Center has been exploring and promoting the use of alternative methods of deriving pluripotent stem cells for several years, and the methods outlined in these papers fully conform to what we have hoped to see for some time.

Such strategies should continue to be pursued and strongly promoted, as they should help to steer the entire field of stem cell research in a more explicitly ethical direction by circumventing the moral quagmire associated with destroying human embryos. These strategies also circumvent a second series of moral objections by providing a method for obtaining patient-matched stem cells without cloning human embryos or using women's eggs. Reprogramming also appears to be technically simpler and more straightforward than these other approaches involving embryos.

In response to these developments, Dr. Ian Wilmut, the researcher responsible for cloning Dolly, has decided not to pursue a license to clone human embryos, which he was awarded just two years ago in Britain, but to pursue reprogramming strategies instead. His change of position flowed largely from practical considerations, but he reportedly acknowledged that the reprogramming approach is also "easier to accept socially."

Persistence in seeking creative scientific breakthroughs and actively pursuing alternative approaches can help resolve serious ethical problems and allow us to maintain the ethical integrity of science while achieving important scientific and medical ends. The National Catholic Bioethics Center strongly supports and encourages such morally acceptable alternative approaches to obtaining pluripotent stem cells, in the realization that it is never necessary for laboratory researchers to cross fundamental moral lines in order for science and medicine to make real and enduring advances.

Associated Press Posts Correction

Fri, 12 Oct 2007 15:25:00 GMT

October 12, 2007. The following was received from the Associated Press as a correction to their story which appeared earlier in the day mentioning that Pope Benedict XVI had supported so-called "therapeutic cloning." The NCBC appreciates the correction made by the Associated Press and prints the text of the correction here:

Date: 10/12/2007 06:04 PM

Correction: Pope-South Korea stem cells story
By The Associated Press

VATICAN CITY (AP) _ In an Oct. 11 story about papal reaction to embryonic stem cell research in South Korea, The Associated Press erroneously described a type of stem-cell research supported by Pope Benedict XVI. Benedict said he supported and encouraged "somatic stem-cell research," also known as adult stem-cell research, which involves stem cells that are not derived from embryos. The pope did not say he supported somatic cell nuclear transfer, also known as "therapeutic cloning," which uses human eggs specifically for research from which stem cells are harvested. The Vatican opposes such research.

The Associated Press Gets Its Wrong

Fri, 12 Oct 2007 15:23:00 GMT

October 12, 2007. A recent Associated Press story by Nicole Winfield, posted on the web Friday, October 12, calls out for correction.

The article accurately states that Pope Benedict XVI has asked the South Koreans not to resume embryonic stem cell research, now that the scandal caused by Hwang Woo-suk is receding from their collective memory. Hwang claimed to have cloned human embryos and was lauded as a national hero until his work was proved to be a fraud.

At the end of Winfield’s article, she states: “Benedict noted that the Vatican does not oppose — and in fact encourages — somatic stem cell research — also known as ‘therapeutic cloning’, which uses human eggs specifically for research from which stem cells are harvested.”

This is false. Ms. Winfield has confused the terms. The Catholic Church does support “somatic” stem cell research, if by this Winfield means adult stem cell research. The Church is resolutely opposed to “therapeutic cloning,” which is the production of a cloned human being solely for the purpose of destroying him or her in research. Such glaring errors of fact are inexcusable.

Also problematic is the headline of her article: “Pope to South Korea: No Stem Cell Research.” If the Church encourages adult stem cell research, as Winfield notes, how can it be true to say that the Pope told the South Koreans “no stem cell research”?

This is a clear example of bias. The media casts the Church’s position in absolute terms, ignoring her careful distinction between licit and illicit forms of research. The Pope has not told the South Koreans “no stem cell research.” Rather, he has encouraged the pursuit of ethical stem cell research.

NCBC Statement on Connecticut Legislation Regarding Treatment for Victims of Sexual Assault

Wed, 03 Oct 2007 15:27:00 GMT

October 3, 2007. Recently the Bishops of Connecticut permitted a protocol in Catholic hospitals for the treatment of victims of sexual assault. This action on the part of the Connecticut bishops received national attention and requires some commentary. This is a complex moral matter and does not lend itself to brief explanation. This difficulty was rendered all the worse by inaccurate reporting and inappropriate, indeed misleading, terminology.

Catholic hospitals have always provided contraception for the victims of sexual assault. This was usually done with a medication or medications which would prevent ovulation. If an egg is not released from the ovary, the victim cannot become pregnant. There was a difficulty here, however, because some medications appear to have a negative effect on the lining of the womb that might prevent an implantation of a new human embryo if one is engendered as a result of the assault. This would amount to an early medical abortion that would not be allowed.

In light of these facts, two protocols were generally developed and approved by bishops. One protocol allowed for no use of a medication for contraceptive purposes because it might have an abortive effect.

Another more commonly used protocol tried to take into account the variety of circumstances surrounding a sexual assault in such a way as to allow the use of a contraceptive medication – if it truly worked as a contraceptive.

The protocol with the ovulation test.
A rather simple (ovulation) test is used to determine whether or not a victim has begun to ovulate or has already ovulated. If the victim has not ovulated she is given the drug that will prevent the release of the egg from taking place. If the woman has already ovulated, the drug is not given because 1) it will not have the desired effect of preventing ovulation and 2) it might, if a new life is present, have an effect on the lining of the womb and prevent implantation.

The role of bishops.
Bishops do not write medical protocols; health care professionals and medical institutions do that. If a protocol concerns a procedure that has ethical implications, it will be submitted to a bishop for his ethical judgment reached in consultation with medical and ethical experts. If the bishop is convinced the procedure will not violate the moral law, he will not stand in the way of its being implemented. He will basically grant what is called a “nihil obstat” which basically means there are no moral objections to the implementation of this protocol. Bishops simply do not have the competence to adjudicate between competing scientific claims about the mechanisms of drugs.

Connecticut.
The legislature in Connecticut passed a law that mandated that “emergency contraception” be given to any victim of sexual assault upon her request. This law went into effect October 1, 2007. Catholic hospitals do not object to providing emergency contraception because they had been providing it all along. However, under the new law the state would not allow physicians to give a test to determine if ovulation had occurred and then to refuse to give a drug to prevent ovulation on the medical grounds that the drug could not prevent what had already taken place.

The state does allow a pregnancy test. However, this test can have nothing to do with the sexual assault. This test only identifies a conception that had taken place before the assault. It takes an embryo 5 to 7 days to make its way down the oviduct and implant in the womb. Only then does it secrete a hormone, or chemical, which can be detected in the woman’s urine or blood. It is the pregnancy test that detects this hormone. In fact, there are no tests available that can tell us if a woman has conceived right after the assault and during the time the embryo would travel down the oviduct.

The Catholic hospitals and bishops objected to the Connecticut law because it did not allow a physician to do a simple test to see whether or not the medication he or she was considering prescribing would actually have the effect for which he or she wanted to administer it. In other words, the physician would have to administer a drug preventing ovulation even if ovulation had already occurred. Frankly, that makes no medical sense. The state was preventing a physician from exercising his or her best medical judgment about a procedure he or she was considering.

A second objection centered around the fact that the medication(s) might prevent an implantation if a conception had occurred. To intend and to do such a thing is immoral. However, there was considerable debate among medical and drug experts whether or not the drugs actually had that effect. And everyone agreed there was no test even to know whether a new life had been conceived.

Finally, attention should be drawn to the fact that the Federal Drug Administration includes the intra-uterine device as “Emergency Contraception” which is a misnomer since it is known to have an abortifacient effect.

Unlike the state of Colorado, for example, the state of Connecticut would not allow physicians to exercise their best medical judgment and provided no conscience protection to physicians or hospitals to refuse to administer the drug when requested.

The decision of the Connecticut bishops and hospitals.
The Connecticut Catholic bishops and hospitals, under strong protest, have allowed a new protocol to be used that was developed by Catholic health care institutions. Furthermore, they made it clear that if a test were ever developed that allowed one to detect a conception after an assault, and if it became clear (as is not yet the case) that the medication(s) would work as an abortifacient, they could no longer accept the protocol. Finally, the Connecticut bishops pointed out that the Doctrine Committee of the United States Conference of Catholic Bishops had studied this matter for years and could not come to the conclusion that the protocol previously allowed by the Connecticut bishops (the ovulation test protocol) would have to be used by all Catholic institutions.

The NCBC
In matters that have not yet been decided definitively by the Holy See, The National Catholic Bioethics Center has refrained from adopting one or another position on a disputed question. However, in the matter of protocols for sexual assault, there is virtual unanimity that an ovulation test should be administered before giving an anovulant medication. The protocol the NCBC has supported requires the ovulation test because it provides greater medical and moral certitude that the intervention will have its desired anovulatory effect. The NCBC objects strongly to state mandates, such as those passed by Connecticut and Massachusetts, that do not allow health care professionals and facilities to exercise their best medical judgment and which do not protect the consciences of all parties. We also object to state mandates that do not allow the victim of sexual assault to have all the information necessary for a medical intervention so that she might make an informed judgment. However, the NCBC understands the judgment of the Connecticut bishops that the administration of a contraceptive medication in the absence of an ovulation test is not an intrinsically evil act. However, it is immoral to violate one’s conscience, including the corporate consciences of health care agencies, and the unwillingness of the state to allow an exemption of conscience makes the law unjust and onerous.

Statement of the NCBC On the CDF’s “Responses to Certain Questions Concerning Artificial Nutrition and Hydration”

Fri, 14 Sep 2007 15:30:00 GMT

September 14, 2007. On August 1, 2007, The Congregation for the Doctrine of the Faith issued responses to two questions posed by Bishop William Skylstad on July 11, 2005, then-President of the United States Conference of Catholic Bishops, concerning the 2004 address of Pope John Paul II, “Life-Sustaining Treatments and the Vegetative State: Scientific Progress and Ethical Dilemmas.” Included was a commentary explaining the reasoning and implications of the responses. (click here to read the text of the document).

The responses were intended to settle certain questions that have arisen over the meaning and proper interpretation of John Paul II’s 2004 address. The first response affirms that the provision of food and water is “an ordinary and proportionate means of preserving life” and therefore obligatory so long as it fulfills it purpose, “which is the hydration and nutrition of the patient.” In its response, the CDF does not single out any class of persons, but reaffirms the general teaching of John Paul II that the provision of food and water is “in principle” obligatory for all patients, although the commentary does later list some cases in which this rule does not apply. The second response affirms that one may not remove the artificial provision of food and water from a patient simply because a physician has concluded with certainty that the patient will never regain consciousness. The loss of consciousness is not a sufficient reason to deprive a patient of ordinary care.

The responses provide a clear rejection of the claim of certain theologians that the provision of food and water for patients in the persistent vegetative state is not morally obligatory. Nutrition and hydration are to be considered ordinary care, not an extraordinary means of preserving life.

We would note that it is unusual for the CDF to provide a commentary to its own responses. Typically, a Vatican reply to a “dubium” consists of a short response and that is all. The commentary is left to others. In this case, however, the CDF appended a very thorough explanation of its position that was evidently meant to ensure that there would be no occasion for theological misunderstanding.

A Change in Catholic Tradition?

Whether the provision of food and water for patients in the persistent vegetative state is morally obligatory has been a controverted question within the Catholic Church for several decades. The 2004 statement of John Paul II, “Life-Sustaining Treatments and the Vegetative State,” was meant to provide some resolution to this question, but it received a mixed response from certain theologians in the United States. Of particular note was the claim that John Paul II had broken with 200 years of Catholic tradition and rejected the teaching of Pope Pius XII on when to forgo extraordinary means of treatment. The CDF responses and commentary address these concerns.

The commentary takes pains to note that John Paul II’s address stands in conformity with previous tradition and is not, in any way, an innovation or an abandonment of previous teaching. The commentary reviews a series of high-level statements from Vatican sources all tending toward the same conclusion on the necessity of providing nutrition and hydration to patients in the vegetative state, including the CDF’s Declaration on Euthanasia (May 5, 1980), the Pontifical Council Cor Unum’s “Some Ethical Questions Relating to the Gravely Ill and the Dying (June 27, 1981), an address of John Paul II to the participants of an international forum on leukemia (November 15, 1985), the Charter for Health Care Workers issued by the Pontifical Council for Pastoral Assistance (1995), and an address of John Paul II to bishops of the United States on their ad limina visit to Rome (October 2, 1998). This review of previous statements speaks to the claim of those who have said John Paul II’s address was completely unexpected and without precedent. The commentary notes that the Pope himself made reference to many of these same documents in his address “Life-Sustaining Treatments and the Vegetative State.”

Of greater significance is that the commentary responds to the claim that John Paul II and Pius XII stand in opposition to each other over the question of whether food and water should be provided to patients in a persistent vegetative state. The commentary acknowledges that the address of Pius XII to a Congress on Anesthesiology, “The Prolongation of Life” (November 24, 1957), is often cited in defense of the view that nutrition and hydration may be taken away from these patients; however, it points out that this is clearly a misreading of the text. Pius was addressing the question of resuscitation in those who had suffered a serious illness and were in the process of dying or already dead. Patients in a vegetative state are not dying. They “breathe spontaneously, digest food naturally, carry on other metabolic functions, and are in a stable situation.” When food and water are removed from these patients, “the cause of their death will be neither an illness nor the ‘vegetative state’ itself, but solely starvation and dehydration.”

The cases under discussion by Pius XII and John Paul II differ. One concerns the prolongation of life through possibly extraordinary means in a patient who has suffered a life-ending illness; the other concerns the preservation of life through ordinary means in a patient who is in a seriously debilitated but stable condition (not dying). Providing food and water to those who are in a permanently unconscious state is not an attempt to effect a cure of their disability, but “to keep the patient from dying of starvation and dehydration.”

Some Exceptions to the Rule

The commentary points out that the CDF recognizes certain exceptions to this rule. In places where medical science is not advanced, and the provision of food and water by artificial means is not possible, there is no moral obligation. The same is true of cases in which food and water are not being assimilated by the body because of disease. In rare cases, it is also possible that nutrition and hydration will be excessively burdensome for a patient, for example, when their administration by tube causes medical complications.

The National Catholic Bioethics Center welcomes this clarification of Church teaching.

NCBC Response to UK Approval to Manufacture Human-Animal Hybrids

Wed, 12 Sep 2007 15:32:00 GMT

September 12, 2007. The Human Fertilisation and Embryology Authority (HFEA), the government branch that regulates the human procreation industry and research in the UK, has approved the manufacture of human-animal hybrid embryos for research purposes (Read the BBC Article). This involves enucleating live animal (cow) eggs, and inserting a human somatic nucleus (one with a full set of human chromosomes; the entire human genome). This technique is known as somatic cell nuclear transfer (SCNT), or cloning. This type of experimentation belongs to eugenics, and has been condemned by the international scientific community and the Catholic Church. The NCBC strongly deplores the decision of the HFEA of Great Britain to legalize such experiments.

The Spring 2006 issue of The National Catholic Bioethics Quarterly was devoted to an extensive consideration of the topic of Chimeras and Hybrids.

The Winter 2006 issue of the same publication contained an article called “Ethics and Human-Animal Transgenesis” which explored the question: “Is It Morally Acceptable to Transform an Animal Zygote by Introducing Human DNA into Its Genome So That the Developing Embryo Inherits Some Human Biological Characteristics?”

NCBC Comments on New York Times Series on Organ Donation and Transplantation

Mon, 10 Sep 2007 15:37:00 GMT

September 10, 2007. The New York Times is currently running a series of articles written by Jane E. Brody on organ donation and transplantation (see August 28, 2007 and September 4, 2007 editions.) This series highlights the importance in our society for generous individuals to donate their organs to persons in need. Organ donation saves lives and also helps to stem the commoditization of human organs through trafficking in the international black market. As Ms. Brody writes in her first article: “People typically wait three to five years for donated organs, and each day 17 of them die.”

The Ethical and Religious Directives for Catholic Health Care Services issued by the U. S. Catholic bishops state, in part: “The transplantation of organs from living donors is morally permissible when such a donation will not sacrifice or seriously impair any essential bodily function and the anticipated benefit to the recipient is proportionate to the harm done to the donor” (ERD 30). The NCBC appreciates the New York Times effort to inform the public on the vital issue of organ transplants and donations. One issue of concern regarding cadaveric donation when “brain death”, or neurological criteria, are used is that it be total brain death, including the brain stem. This is in contrast to partial brain death, in which the brain stem is still alive. Only the first of these two standards is appropriate in Catholic teaching.

The NCBC has resources available at our website for further reading on this topic.

NCBC FAQ on “Brain Death” Criteria

Statement of John Paul II to an International Congress on Transplants, August 29, 2000

NCBC Statement on the Regulated Market of Organ Sales, March 15, 2006

“Brain Dead Means Dead” (from Making Sense of Bioethics)

“Bodies in Plastic” (from Making Sense of Bioethics)

Members and subscribers can also search Ethics & Medics and The National Catholic Bioethics Quarterly for past articles dealing with this topic.

National Catholic Bioethics Center Applauds President Bush's Call for Respect toward Human Embryos as "Living Members of the Human Species."

Thu, 21 Jun 2007 15:41:00 GMT

June 21, 2007. The National Catholic Bioethics Center has been vigorous in promoting the dignity of human life from conception until natural death. In the Center's April 9, 2007 letter to the United States Congress (see news posting, April 9, 2007) asking its members to oppose S. 5, the Stem Cell Research Enhancement Act of 2007, the Center indicated its support for stem cell research and therapies that provide healing, without causing the death of other vulnerable human beings in the process.

There is a growing body of scientific knowledge on effective and morally acceptable methods to accomplish this end. Unfortunately, Congress has refused to acknowledge this fact by refusing to support S. 30, the HOPE Act, which would have promoted morally acceptable forms of stem cell research by funding all avenues of stem cell research that do not involve harming or destroying a living human embryo. Unlike S. 5 the HOPE Act gives priority to research that promises genuine benefits for patients rather than speculative embryo research. On June 21, 2007, President Bush vetoed S. 5. At the same time, and with the stated intent of prioritizing "research with the greatest potential for clinical benefit," President Bush issued an executive order fostering research on these morally acceptable alternative sources of pluripotent stem cells (Expanding Approved Stem Cell Lines in Ethically Responsible Ways.) In doing so, President Bush prohibited federal funding of research that subjects the embryo to risk of injury or death.

Significantly, President Bush calls our nation to vigorously move forward with medical research "while also maintaining the highest ethical standards and respecting human life and human dignity." President Bush continues with a profound call for protecting nascent human life from destructive research stating that "no life should be used as a mere means for achieving the medical benefit of another." He continues by stating that "human embryos and fetuses, as living members of the human species, are not raw materials to be exploited or commodities to be bought and sold."

President Bush has focused on the heart of the matter - embryos are human beings. Basic embryology makes it clear that from fertilization a new human being exists as a composite unity with his or her own internal principle directed toward continuing organismic development and growth towards adulthood. From the moment the human zygote is formed a new human being exists, separate from his/her father or mother. Thus, he/she is a bearer of human rights.

Each of us has as our origin that small cluster of cells we call an embryo. Each human being has immeasurable value and intrinsic dignity which outweighs any utilitarian consideration. Providing public funding to support research on cells obtained through the destruction of human beings, especially at their most vulnerable stages, is an affront to the dignity of all persons. Thank you President Bush. For in protecting the most vulnerable among us, the dignity of every person is enhanced.

NCBC Letter to Congress Regarding Status of the "Mexico City Policy"

Mon, 18 Jun 2007 15:55:00 GMT

On June 18, 2007 NCBC President, Dr. John Haas, wrote to members of congress voicing support for the Mexico City Policy which attempts to protect impoverished people from policies of overseas nongovernmental organizations which offer or promote abortion as a method of family planning.

The text of the letter may be read here. Adobe Acrobat Reader is required.

Reversing Human Tragedy in the City of Brotherly Love

Fri, 15 Jun 2007 16:00:00 GMT

June 15, 2007. The National Catholic Bioethics Center applauds the Philadelphia City Council for its vote of June 14, 2007, reversing its designation of Philadelphia as a "Pro-Choice City." (See Celebrating Human Tragedy in the City of Brotherly Love, June 13, 2007.) With a vote of 13 to 4, five Council members, several of whom expressing regret for their initial position, voted to repeal the June 7th resolution. The "Pro-Choice" resolution was crafted with the assistance of Planned Parenthood. Reversing such a conflict of interest vote was essential to representative government. The National Catholic Bioethics Center is grateful that Philadelphia has shown itself to be a community of representative government, wherein the voice of its citizens has been heard. Our hope is that this trend will continue so that the growing opposition of the people concerning elective abortions will influence public policy. In the meantime, we wish to express our gratitude to the Council members voting to repeal this resolution. (See:

http://www.philly.com/inquirer/home_top_stories/20070615_Council_repeals_pro-choice_city_resolution.html)

We also are grateful for the leadership of Philadelphia's Cardinal Justin Rigali, in recognizing this affront, not only to human life and human dignity, but also to the democratic process.

Celebrating Human Tragedy in the City of Brotherly Love

Wed, 13 Jun 2007 16:09:00 GMT

June 13, 2007. The National Catholic Bioethics Center wishes to join its voice of concern for the City of Philadelphia with that of Cardinal Justin Rigali (Archdiocese of Philadelphia, News Release, June 7, 2007). On June 7, the City Council voted to proclaim Philadelphia a "Pro-Choice City." Some would say that this resolution confirms the tragic reality about this great city which is hailed as the "City of Brotherly Love." According to statistics released from the Pennsylvania Department of Health for 2005, over 42.5% of all induced abortions carried out in Pennsylvania were performed in Philadelphia. That represents 14,858 lives violently ended at their most vulnerable stage. The tragedy demonstrated by these numbers increases as we break them down further. Almost half of the abortions performed in Pennsylvania were repeat abortions, with over 1,000 women having been violated by abortion at least four times. It is clear that there is nothing in these facts to be celebrated. At a time when respect for human life in Philadelphia continues to sustain violent blows with an escalating homicide rate (171 homicides so far in 2007, as of June 5), our City Council has the responsibility to foster a culture which respects human life.

The good news concerning this resolution, if there is any, is that the resolution almost failed with a vote of 9 to 8. Those Council Members who refused to proclaim Philadelphia as a city that is committed to continuing this tragic trend in terminating human life should be thanked (see the voting record [http://www.philly.com/philly/hp/news_update/20070608_Now_Phila__is_officially_pro-choice.html]).

What should be of significant concern to all citizens is that the resolution was crafted with the assistance of Planned Parenthood, the agency responsible for the greatest number of induced abortions in this country. Is it not a conflict of interest for government officials to be advocating for the works of the primary provider of a service? What would the outcry be if a resolution were passed by the City Council which had been crafted by a Pro-Life agency, even a non-sectarian one?

Philadelphia deserves much better. We are known as the "City of Brotherly Love and Sisterly Affection." There is nothing loving about the assault on human life that is abortion. It is a tragic violation of both our vulnerable sisters and their never to be born children.

Obtaining Embryonic Stem Cells without Destroying Embryos

Fri, 08 Jun 2007 16:33:00 GMT

June 8, 2007. The National Catholic Bioethics Center would like to add its voice to the many others recognizing the importance of the recent published research from the laboratories of Shinya Yamanaka, Rudolf Jaenisch, and Konrad Hochedlinger. Although the technique they announced has so far only been tested in mice, the studies indicate that cellular reprogramming to obtain stem cells is feasible.

Obtaining pluripotent stem cells through cellular reprogramming raises none of the moral difficulties associated with obtaining such stem cells by destroying human embryos.

In the process of reprogramming, the pluripotent state is conferred on a body cell, such as a skin cell, after removal from a patient. This reprogramming to a pluripotent state establishes a stem cell line compatible with an individual patient. The new research has shown that the reprogramming of cells can be accomplished in mice through the insertion of four genes into the original target cell. If, as expected, this same technique can ultimately be utilized in humans, researchers may eventually be able to obtain pluripotent stem cells suitable for use in patient treatments without the creation and destruction of human embryos. Indeed, this approach would be far easier than the complex and misnamed "therapeutic" cloning, thus making reprogramming the preferred approach even from a purely practical standpoint.

Given the political efforts now underway to provide federal funding for research that will destroy human embryos in order to obtain embryonic stem cells, this discovery represents a major breakthrough on the moral front that could help resolve the serious concerns that many have had concerning embryonic stem cell research. We believe that this is the long-awaited way forward that many scientists thought would eventually arrive, if only we were patient.

We can, of course, continue to expect scientists, researchers, and politicians to say that they still need to destroy human embryos in order to make progress in regenerative medicine. These reprogramming successes, nonetheless, provide a way to achieve important scientific aims that will be acceptable to all citizens and---if properly appreciated---could lead in a new direction, away from the divisive and bitter debates that have consumed so much of our recent politics.

The U.S. Congress and Stem Cell Research: Some Are Listening

Fri, 08 Jun 2007 16:22:00 GMT

June 8, 2007. The U.S. House of Representatives this week passed, for a second time, proposed legislation that would allow federal funding of embryonic stem cell research. S. 5, the Stem Cell Research Enhancement Act of 2007, would fund research that destroys human beings abandoned by their parents in fertility clinics. The bill passed the U.S. House of Representatives with a 247 to 176 vote. Fortunately, President Bush has indicated he will veto, for a second time, this assault on vulnerable human beings.

Also this week the House, with a vote of 204 to 213, failed to achieve even a majority in a required two-thirds vote on proposed legislation erroneously hailed as prohibiting human cloning. In fact, H.R. 2560, the Human Cloning Prohibition Act of 2007 would endorse human cloning as long as the conceived embryo was not allowed to survive. The good news is that neither of these assaults on vulnerable human beings received the requisite votes to become law.

The National Catholic Bioethics Center, in its effort to provide the public with the latest information on cutting edge bioethical questions, had written to Congress expressing the Center's opposition to such legislation. (See NCBC letter to Members of the Senate regarding S5 and S30 at the news posting for April 9, 2007).

The National Catholic Bioethics Center supports stem cell research and therapies that provide healing without causing the death of other vulnerable human beings in the process. There is a growing body of scientific knowledge on effective and morally acceptable methods to accomplish this end. (See NCBC Statement on Obtaining Embryonic Stem Cells Without Destroying Embryos, news posting for June 8, 2007.)

In President Bush's statement, indicating his intent to veto S. 5, he hailed recently published stem cell research that offers a possible method to achieve scientific aims that will be acceptable to all citizens. From the votes in Congress, it would appear that others also are listening not only to the scientific facts, but to the moral imperative: it is never justified to kill innocent human beings for the advancement of science.

NCBC Statement on In Good Conscience: Guidelines for the Ethical Provision of Health Care in a Pluralistic Society A Project of the Religious Coalition for Reproductive Choice

Tue, 01 May 2007 18:41:00 GMT

May 1, 2007. The National Catholic Bioethics Center has grave concerns related to the document: In Good Conscience: Guidelines for the Ethical Provision of Health Care in a Pluralistic Society [Guidelines]. This document claims to respect the pluralism of society, the separation of church and state, and the "inviolability of conscience in making personal health care decisions." (page 1) However, it continues to advocate for the violation of these very principles. Particularly, the inviolability of conscience of the health care provider is not respected. Factual misinformation is provided that ignores the comprehensive quality of care provided by Catholic sponsored health care. In addition, there is no recognition of the true meaning of the separation of church and state, which mandates that the free exercise of religion, including that of the provider, be respected.

Specifically, this document claims "to assist health care institutions to develop policies regarding access to health care in general and reproductive health care in particular." (page 1) However, for the most part it is a single issue document focusing on the misnomer of reproductive "health." In reality the Guidelines justify the violation of the religious liberty of Catholic providers who refuse to engage in reproductive practices that mutilate adults, and their unborn children. While the very title of the Guidelines would indicate a respect for conscience, the Guidelines find the Hyde-Weldon Conscience Protection Amendment "troubling." (page 4) Furthermore, the "Preamble" states, in part, that medical professionals have a right to exercise their professional judgment in the best interest of patients, and that an individual conscience may not control or restrict the exercise of conscience of another. However, it would appear that these principles only apply to those whose consciences are in agreement with the particular ideology promoted by the authors of the Guidelines. Most troubling is the admonition that the law should not be overridden by positions of conscience that are based in religious beliefs. In other words, physicians legally mandated to engage in crimes against humanity would be subject to legal penalties for refusing to violate religiously based conscience positions such as "Thou shalt not kill."

It is frightening, indeed, that a coalition that claims to be religious, would mount an attack on Catholic health care, and its Ethical and Religious Directives for Catholic Health Care Services, under the guise of the separation of church and state. The First Amendment of the United States Constitution protects the religious freedom of patients and providers of health care, of all faiths, including those of the signatories of these Guidelines. By advancing these Guidelines, the authors implicitly are advocating for the violation of the rights of all persons, from pacifists who refuse to engage in combat, to physicians who refuse to assist in executing death through capital punishment. This is not the United States of our founders.

Catholic health care continues to provide a very significant contribution to the common good of the American society. The Ethical and Religious Directives for Catholic Health Care Services provide the operational framework to continue this remarkable service to all those seeking health care, including non-Catholics, from Catholic sponsored agencies.

The NCBC Applauds the Supreme Court Decision to Uphold the Ban on Partial Birth Abortion.

Wed, 18 Apr 2007 18:42:00 GMT

April 18, 2007. The NCBC Applauds the Supreme Court Decision to Uphold the Ban on Partial Birth Abortion.

Philadelphia, April 18. The National Catholic Bioethics Center is gratified that the Supreme Court has voted to retain some safeguards for the unborn in their April 18th decision to uphold the federal ban on partial-birth abortion signed by President Bush in 2003. The National Catholic Bioethics Center especially applauds the separate opinion expressed by Justices Thomas and Scalia that there is no justification in the U.S. Constitution for "the courts abortion jurisprudence, including Casey and Roe v. Wade." The Court's ruling on Roe v. Wade in 1973 virtually removed all restrictions against protecting unborn life from abortion in this country.

This decision by the Supreme Court holds out hope that in the future additional progress might be made to ensure the protection of fetal life by overturning the 1973 decision and halting a gruesome practice that ends over 1 million lives in the U.S. each year.

NCBC Letter to Members of the Senate Regarding Senate Bills 5 and 30

Mon, 09 Apr 2007 18:47:00 GMT

On April 9, 2007 NCBC President Dr. John Haas wrote to members of the U.S. Senate opposing legislation (S5 and S30) that would authorize public funds for embryonic stem cell research.

The text of the letter may be read here. Adobe Acrobat Reader is required.

Assisted Death: The Antithesis of the Healing Arts

Thu, 08 Mar 2007 20:35:00 GMT

March 8, 2007. Since 1994, when Oregon passed the Death with Dignity Act legalizing physician assisted-suicide, several state legislatures have entertained similar legislative proposals. Fortunately, to date, such proposals have not become law. However, currently legislative initiatives are underway in California and Vermont, to decriminalize physician assisted-suicide. If such proposals become law, there will be a dramatic reversal of the healing role of medicine in society.

"Assisted-suicide" usually refers to a professional prescribing a lethal dose of medication for self administration by the patient. It is not the refusal of treatment by a patient, or the withdrawal of treatment at a patient's request. The U.S. Supreme Court provides us with such a distinction between withdrawing life-support and assisting a suicide: "a physician who withdraws, or honors a patient's refusal to begin, life sustaining medical treatment purposefully intends, or may so intend, only to respect his patient's wishes and 'to cease doing useless and futile or degrading things to the patient when [the patient] no longer stands to benefit from them….' [A] doctor who assists a suicide, however, 'must, necessarily and indubitably, intend primarily that the patient be made dead.'.…" [Vacco v. Quill, 521 U.S. 793 (1997)]

Nor is assisted-suicide the administration of pain-relieving or sedating medication, even when the known but unintended side effect may be the hastening of death. Morally licit and legal provisions exist for those situations. Physician assisted-suicide is assisting by a professional in the direct taking of a human life. That medical professional has an obligation always to act in the best interest of the patient, even when the patient's own requests contradict that aim. Since the time of Hippocrates physicians have been charged to protect life under all circumstances. The legalization of physician assisted-suicide constitutes a dramatic shift in the life preserving role of the physician.

Proponents of legalized assisted-suicide claim that it is a humane method of preserving personal dignity for those who are near death or experiencing a severe, debilitating disease. What constitutes personal dignity? Is the one-year old in diapers more dignified than her 85 year old great grandfather, who has dementia and also needs assistance with activities of daily living? Does he deserve less of the family's and society's care and concern than younger members of society? Such abandonment is not only "ageism" but also constitutes the ultimate negation of one's innate dignity. For a compassionate society to survive, it cannot equate personal dignity with the potential to contribute to society. Furthermore, is assisted-suicide really humane for the ill person? Or is this a method to relieve others, including society at large, of personal and financial obligations to truly care for society's most vulnerable members - the frail elderly, infirm, disabled, poor, and underinsured, or those whose treatment regimes are deemed too costly? In the Netherlands, where assisted-suicide is the legal practice, even on neonates, non-voluntary euthanasia is now performed widely.

A study published by Duke University demonstrated that while the frail elderly are strongly opposed to assisted-suicide (only 39.9% supported assisted-suicide), 59.3% of their younger relatives favored it. (Koenig, et al., Archives of Internal Medicine, October 28, 1996). The U.S. Supreme Court has recognized the risks of subtle coercion that can occur. Chief Justice William Rehnquist wrote that "If physician assisted-suicide were permitted, many might resort to it to spare their families the substantial financial burden of end of life health care costs." [Washington v. Glucksberg, 521 U.S. 702 (1997)] Pope John Paul II affirmed that, "To concur with the intention of another person to commit suicide and to help in carrying it out through so-called 'assisted-suicide' means to cooperate in, and at times to be the actual perpetrator of, an injustice which can never be excused, even if it is requested." (Evangelium vitae, no. 66). The truly humane method of caring for such members of our society is not to help them eliminate themselves, but to do all in our power to eliminate their suffering, while affirming their innate dignity and worth through the manner in which we care for them: "Even when not motivated by a selfish refusal to be burdened with the life of someone who is suffering, euthanasia must be called a false mercy, and indeed a disturbing 'perversion' of mercy. True 'compassion' leads to sharing another's pain; it does not kill the person whose suffering we cannot bear." (Evangelium vitae, no. 66). Today, there is no reason for a patient to seek death as a method to control pain. In fact, most persons who request physician-assisted-suicide withdraw that request if their depression and pain are treated.

There is an unwritten social contract that society will care for its most vulnerable members. Extending the legalization of assisted-suicide not only will lead to more deaths among our most vulnerable members of society, it will be the death of society as we now know it: a society that affirms that the lives of the elderly, disabled, and terminally ill are no less valued than those of the young and healthy.

Vaccines and Exemptions Granted by Schools

Wed, 21 Feb 2007 20:49:00 GMT

February 21, 2007. There is a particular concern on the part of Catholic parents about being granted exemptions from immunization requirements for admission to Catholic schools. We offer this brief statement as a clarification of the position of The National Catholic Bioethics Center (NCBC).

There are generally three types of exemptions from immunization requirements for school admission granted by authorities: 1) a religious exemption, 2) a conscience exemption, and 3) a medical exemption. Regrettably legislatures, health care agencies and school systems do not always use the terms consistently and with precision.

Furthermore, there are different kinds of vaccines targeting different kinds of diseases. We make a broad distinction between two types of infectious diseases. These definitions are provided by the Centers for Disease Control and Prevention.

Communicable disease: an infectious disease that that can be transmitted from one source to another by bacteria or viral organisms.

Contagious disease: a very communicable disease capable of spreading rapidly from one person to another by contact or close proximity.

Examples of contagious diseases would be measles, mumps, rubella and chicken pox. Examples of communicable diseases which are behaviorally transmitted would be HPV and HIV. The NCBC supports mandated universal immunization for contagious diseases as defined above. It also supports a requirement that children be immunized against contagious diseases as a condition for admission to a school if a significant threat to the health of others exists. Such a requirement should allow for exemptions under certain conditions as is explained below.

The NCBC does not support mandated universal immunization and immunization as a condition for admission to schools for communicable, behaviorally transmitted diseases such as HPV. The NCBC holds that while there is no moral objection to vaccination against HPV in and of itself, the choice to have a child immunized against HPV must ultimately rest with the parents. The NCBC strongly opposes the mandating of vaccinations for non-highly contagious but communicable diseases because they do not pose the same public health threat as do the highly contagious diseases. The Center also opposes such vaccinations as a condition for admission to public or private schools since the diseases transmitted by behavior do not pose the same public health risks as contagious diseases as defined above.

The exemptions from immunization for admission to school provided by government and school authorities fall generally into three categories. The categories are described below and the position of the NCBC with respect to each category will be briefly explained.

Religious Exemption. A religious exemption from immunization would be granted if the teachings of the Faith of the parents held that vaccinations were immoral and contrary to God's will. Many jurisdictions do not require that there be any specific religious teaching on the matter, but hold that whatever religious parents hold to be contrary to their Faith should be respected and an exemption granted - as long as there is not a clear and present risk to public health by admitting the child to the school. Some Catholic parents know and accept the clear teaching of the Church on the immorality of abortion. When they discovered that the vaccines for measles, mumps, rubella and chicken pox were grown in cell lines that had their origin in tissue from two aborted children decades ago, they feared that they would be cooperating in abortion if they had their children immunized with these vaccines. However, the Catholic moral tradition holds that the parents would not be guilty of immoral cooperation in the evil of abortion if they had their children immunized with these vaccines especially if there were no other vaccines readily available. Since there is no Catholic teaching that the use of these vaccines is sinful, schools cannot allow Catholic parents to claim a religious exemption from the requirement of immunization.

Conscience Exemption. A conscience exemption from immunization would be granted by school authorities if the parents in conscience believed that it was immoral to have their children vaccinated. It is Catholic teaching that one must follow one's practically certain conscience even if one is in error because the conscience is our last best judgment about what is right or wrong. If we would go against our conscience we would show that we were willing to do what was known to be immoral. Some Catholic parents erroneously believe that it would be a sin to have their children immunized with the vaccines with a historical association with abortion. The public schools, and indeed, Catholic schools ought to respect the consciences of these parents and grant a conscience exemption as long as there is not a health risk in doing so. The health risk is to be assessed by public health authorities. To provide an example. If the Centers for Disease Control judge measles to be virtually eliminated and public schools grant conscience exemptions because public health authorities have determined that to do so would not a public health risk, then it is our opinion that Catholic schools should also grant conscience exemptions. However, those in positions of responsibility in Catholic school systems are the ones who have to assess whether or not a risk to public health would exist if non-immunized children were admitted to the schools.

Medical Exemption. A medical exemption from immunization would be granted by the authorities if the child could not be vaccinated without facing serious health risks in the judgment of the physician because of conditions such as certain allergies, immunodeficiency, or neurological disorders. The authorities would grant such an exemption if, in their judgment, admitting such a child posed no serious health risk to the rest of the school community, children and staff. It is the opinion of the NCBC that a medical exemption should most definitely be granted by Catholic school authorities if in their judgment, based on the opinion of public health authorities, admitting the child would not constitute a health risk.

Some Catholic school authorities have read the statements of the NCBC on vaccines and have wrongly concluded that the NCBC did not believe that any exemptions should be granted children. However, it is our opinion that only religious exemptions from vaccination for Catholics should be disallowed because there are no Catholic teachings that vaccinations as such are immoral. It is further our opinion that conscience and medical exemptions should be granted if public health authorities have judged that there is no risk to public health by admitting to school children who have not been immunized. On the other hand we also believe that it would be wrong, and would be following an improperly formed conscience, for parents to refuse to have their children vaccinated against highly contagious diseases unless it were for medical reasons, if in doing so they would place their children - and others - at risk.

We must sound a cautionary note. Fortunately, through systematic programs of vaccination the Centers for Disease Control has declared many diseases virtually eliminated in the United States. It is important to acknowledge, however, that we live in a global society which brings with it certain hazards to unvaccinated populations. In May 2005 there was a serious outbreak of measles in Indiana and Ohio because an adolescent child returning from Romania to her home was infected with the virus causing measles while doing missionary work there. It took intensive efforts by public health authorities to contain the outbreak. Measles, mumps, rubella and chicken pox remain highly contagious diseases and are wide-spread in some parts of the world. Parents must always be aware of the risks to which they subject their children and others if they do not have them immunized.

CORRECTION TO THE FIFTH EDITION OF HEALTH CARE ETHICS "Care of Permanently Unconscious Patients"

Sat, 13 Jan 2007 20:51:00 GMT

January 13, 2007. The fifth edition of Health Care Ethics, by Benedict Ashley, O.P., Jean DeBlois, C.S.J., and Kevin D. O'Rourke, O.P., has recently appeared. This work has long been recognized as an important resource for Catholic health care professionals.

In section 6.8, titled "Care of Permanently Unconscious Patients," the authors suggest that the ethicists of The National Catholic Bioethics Center would view the removal of nutrition and hydration from a patient in the persistent vegetative state (PVS) as a morally appropriate form of action. This does not reflect the position of the Center.

While recognizing a number of exceptions to the presumptive moral obligation to provide nutrition and hydration to patients who cannot receive food and water orally---exceptions which may extend even to patients in the PVS---the Center holds that a diagnosis of the PVS (however carefully done) is not by itself a valid justification for making such an exception. Patients in the PVS have the same right to basic care as do all other patients.

We republish here our statement on the case of Terri Schiavo of March 18, 2005, which expresses our position on this matter.

THE CASE OF TERRI SCHIAVO
March 18, 2005

In view of the continuing controversy over the case of Terri Schiavo, the ethicists of The National Catholic Bioethics Center would like to reiterate their firm conviction that food and water should be provided for all patients who suffer PVS unless it fails to sustain life or causes suffering. We make this judgment based on the Catholic moral tradition, on the 1992 statement of the Pro-Life Secretariat of the United States Conference of Catholic Bishops dealing with hydration and nutrition for patients in PVS, on years of consideration of comparable cases, and in view of Pope John Paul II's March 2004 allocution on life sustaining measures for patients in a persistent vegetative state.

In general, the provision of nutrition and hydration to the patient in PVS is proportionate and morally obligatory. Removal of food and water is permissible only when they no longer attain the ends for which they are provided, namely, providing nourishment and alleviating suffering.

NCBC Comment on FDA Draft Guidance for Industry on Characterization and Qualification of Cell Substrates and Other Biological Starting Materials Used in the Production of Viral Vaccines for the Prevention and Treatment of Infectious Diseases

Mon, 18 Dec 2006 20:59:00 GMT

December 18, 2006. NCBC President, Dr. John Haas, has written to the U.S. Department of Health and Human Services to comment on the FDA Draft Guidance for Industry on Characterization and Qualification of Cell Substrates and Other Biological Starting Materials Used in the Production of Viral Vaccines for the Prevention and Treatment of Infectious Diseases. The purpose of the letter is to express opposition to the tacit approval for the use of tissue from destroyed human embryos.

The text of the letter may be read here. Adobe Acrobat is required.

Dr. John Haas, President of The National Catholic Bioethics Center, named by Pope Benedict XVI to serve as an Ordinary Member of the Pontifical Academy for Life (PAV)

Thu, 14 Dec 2006 21:02:00 GMT

December 14, 2006. Dr. John Haas, President of The National Catholic Bioethics Center, has recently been named by Pope Benedict XVI to serve as an Ordinary Member of the Pontifical Academy for Life (PAV). The PAV was formed in 1994 by the late Pope John Paul II for three specific purposes: to study issues related to the promotion and defense of human life from an interdisciplinary perspective; to foster a culture of life through appropriate initiatives; and to inform the authorities of the Church, those working in the biomedical sciences and social and health care organizations of those initiatives so that they may provide a strong and informed Catholic witness to the world community.

Dr. Haas received his Ph.D. in Moral Theology from The Catholic University of America and his S.T.L. in Moral Theology from the University of Fribourg, Switzerland. Before assuming the Presidency of The National Catholic Bioethics Center in 1996, Dr. Haas was the John Cardinal Krol Professor of Moral Theology at St. Charles Borromeo Seminary of the Archdiocese of Philadelphia and Adjunct Professor at the Pontifical John Paul II Institute for Studies in Marriage and the Family, Washington, D.C. He is in constant demand as a speaker and for several years hosted a television program on the Eternal Word Television Network called The St. Charles Forum. Dr. Haas also serves on the board of the International Federation of Catholic Bioethics Centers founded by Bishop Elio Sgreccia, President of the Pontifical Academy for Life.

The National Catholic Bioethics Center (www.ncbcenter.org) was founded in 1972 to apply the Church's moral teaching to developments in health care and the life sciences. The Center has worked closely with various offices of the Holy See for many years, including the Congregation for the Doctrine of the Faith and the Pontifical Council for Pastoral Care for Health Care Workers. This appointment formalizes the Center's relationship with the Pontifical Academy for Life and provides an opportunity for even closer collaboration of the Center's work with the efforts of the PAV.

Dr. Haas joins three other North Americans as Ordinary Members: Carl Anderson, Supreme Knight of the Knights of Columbus, Dr. Thomas Hilgers, founder and director of the Pope Paul VI Institute for the Study of Human Reproduction and Mercedes Wilson, President of the Family of the Americas Foundation. The membership is comprised of almost 60 individuals from across the globe known to be eminent scholars in their field and for their professional contributions to the Culture of Life.

NCBC Statement in Response to the United States Food and Drug Administration's Approval of Over the Counter Sale of "Plan B"

Fri, 01 Sep 2006 20:14:00 GMT

September 1, 2006. The approval of the over the counter sale of "Plan B," sometimes known as the "Morning After Pill," represents a tragic betrayal of women. The non-prescription availability of this drug which has significant potential for serious side effects raises the question, "Why do women deserve less governmental protections than others?"

The total dosage of levonorgestrel (the active ingredient in "Plan B") taken over twelve hours is six times the daily dosage found in a number of oral contraceptives which are sold by prescription only. All one needs to do is note the potential side effects of such a drug to realize that the health of women is not the driving force for this FDA approval. Women taking this drug without medical oversight may be subjected to serious side effects such as future ectopic pregnancies. Women deserve better.

Supposedly there will be monitoring in place to assure that only teenagers eighteen years of age or older will have over the counter access to this drug. Parents' accounts of the difficulty of limiting their children's access to cigarettes and alcohol demonstrate how difficult it will be to enforce such provisions. Parents also deserve better.

There are many euphemisms used to describe the manner of action of levonorgestrel, from the "Morning After Pill" to "Emergency Contraception." Both terms misrepresent the facts. Contraceptives are to prevent conception. Science tells us that conception occurs upon the union of a mother's egg and a father's sperm. Such a union can occur within minutes of intercourse. There is only a very small window of opportunity for the "Morning After Pill" to act as a contraceptive by the suppression of ovulation - if it is taken just prior to the time a woman ovulates. Otherwise, the "Morning After Pill" has great potential of being an abortifacient by making the womb inhospitable to the new human being engendered by his or her parents. The most vulnerable of human life becomes disposable.

Each of us as a member of this society has the right to expect from our government better protections of human life and dignity. What does the approval of the over the counter sale of this drug say about us as a society? Is the most intimate act between a man and a woman, the natural outcome of which frequently is the creation of a new and unique human being, nothing more than a biological exercise with no responsibilities attached to it? What about the human being brought about through such an act? Does that human person have no rights once engendered by the act of his or her parents?

The National Catholic Bioethics Center receives the news of the FDA approval of non-prescription distribution of "Plan B" with great regret. We all become vulnerable when compromises are made in the processes which have been established by our government to ensure drug safety; by our government which has been charged with protecting its members, especially the most vulnerable.

NCBC On Proposed Method for Extracting Embryonic Stem Cells by Embryo Biopsy

Fri, 25 Aug 2006 20:16:00 GMT

August 25, 2006. The publication of research by scientists from Advanced Cell Technology in the journal Nature shows that there is a strong desire, even in the scientific community, that embryonic stem cells might be derived without the destruction of the embryo. However, this procedure has profound moral problems, not the least of which is the immorality of engendering human beings through in vitro fertilization.

The protocol for blastomere extraction/stem cell derivation published by researchers at Advanced Cell Technology faces at least 3 serious ethical objections which render it unacceptable:

This technique, sometimes referred to as embryo biopsy, requires a non-therapeutic intervention performed on a human embryo. Research carried out on a human subject for the sake of others is subject to special restrictions if the subject cannot give consent, and it is permissible only if it involves minimal risk. In this procedure at least 10 percent of the embyo's body mass is removed for research, not for the purpose of treating that specific embryo-patient for a known medical condition. The embryo is employed as a starting source for harvestable raw materials in a gesture of reducing young humans to commodities or manipulable products.

This method or extraction can only take place following in vitro fertilization. It is a serious violation of human dignity to engender human life apart from the intimacy of the marital union. The only fitting home for a human embryo is in the warmth and shelter of its mother's womb, not in the open lights of the laboratory being violated in Petri dishes.

Human embryonic stem cells must be utilized in co-culture to derive stem cells from the extracted blastomere, so the protocol still relies in a direct way on the destruction of young humans.

This procedure is a clear violation of standard research protocols for the protection of human subjects and would be rejected by any properly constituted institutional review board. In addition to these clear moral difficulties the eventual outcomes of this manipulation on the embryo are not sufficiently known, hence the publication of this experimental protocol fails to provide an ethical avenue to pluripotent stem cell research in the future.

The National Catholic Bioethics Center encourages continued research into other recent studies that indicate the possibility of deriving embryonic stem cells by ethically unquestionable means.

NCBC Statement on Vaccination against Human Papilloma Virus (HPV)

Tue, 11 Jul 2006 18:17:00 GMT

July 11, 2006. The National Catholic Bioethics Center notes that the Advisory Committee for Immunization Practices has recommended that young women be vaccinated against the human papilloma virus (HPV) as a protection against cervical cancer, which is caused by certain strains of this virus. HPV is spread through sexual contact which includes, but is not limited to, sexual intercourse. Consequently, the most effective way to avoid contracting it is to abstain from sexual relations before marriage and to remain faithful within marriage.

"The NCBC considers HPV vaccination to be a morally acceptable method of protecting against this disease, but asks that civil authorities to leave this decision to parents and not make such immunization mandatory. Parents should consider all available information on the safety and efficacy of this vaccine to determine whether it is a worthwhile and safe means of protecting their children from cervical cancer. Many reliable reports are available on the internet and elsewhere."

The prevalence of HPV in the reproductive age population makes exposure to the virus possible, even in a monogamous marriage, due to the possibility of a spouse’s exposure prior to marriage. Furthermore, we live in a society where non-consensual sex remains a threat to young women who deserve to be protected from the effects of exposure to HPV.

Statement of The National Catholic Bioethics Center on the "Regulated Market of Organ Sales"

Wed, 15 Mar 2006 21:19:00 GMT

March 15, 2006. Pope John Paul II has stated that acts of selfless love "are most solemn celebrations of the Gospel of life" and that a particularly praiseworthy example of such love "is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope." Evangelium Vitae [1995] ¶86

The National Catholic Bioethics Center strongly opposes any regulated market of organ sales. Such a scheme would harm the charitable nature of organ donation and substitute in its place a market for the buying and selling of human body parts. The human body is not a commodity, but a gift over which God has given us a limited stewardship. Furthermore, to turn the body and its organs into commodities places at great risk those who are poor and vulnerable by making them susceptible to the allure of monetary gain from a surgical procedure which in no way benefits them medically.

Statement on Gonzales, Attorney General, et al. v. Oregon et al.

Wed, 18 Jan 2006 21:21:00 GMT

January 18, 2006. The Supreme Court of the United States in Gonzales, Attorney General, et al. v. Oregon et al. held with a 6–3 decision that the Controlled Substances Act “does not allow the Attorney General to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide under state law permitting the procedure” (Syllabus of the case).

The NCBC wishes to express its profound disappointment with the Court’s decision to allow physicians in Oregon to abuse their healing art and construe the deliberate administration of a lethal dose of a drug as a “legitimate medical purpose.” In the words of Justice Antonin Scalia’s dissent, “if the term ‘legitimate medical purpose’ has any meaning, it surely excludes the prescription of drugs to produce death.”

We regret that those entrusted with the regulation of controlled substances are being denied the opportunity to carry out a very important exercise of their authority and oversight in a critical medical setting. This restriction will diminish the quality of health care that is ultimately made available to suffering patients by promoting the abuse of controlled substances instead of helping dying patients to live according to their human dignity. Physician-assisted suicide is not an act that directly ends the suffering of a patient. Rather, this act deliberately takes the life of a person who receives his or her life as a gift from God. Physician-assisted suicide represents a fundamental violation of this gift and of human dignity.

Founding President of the NCBC Honored with Library Dedication

Wed, 30 Nov 2005 16:38:00 GMT

November 30, 2005. Father Albert Moraczewski, O.P. founding president of The National Catholic Bioethics Center, was honored at the reception held at St. Katharine's Hall on the evening of November 30. Many bishops, friends and former associates made contributions to the NCBC in Father Albert's honor, and the library was dedicated to him in thanksgiving for his many years of generous service to the Church as a scholar, bioethical researcher; and for more than fifty years as a priest. Houston artist James Seigler, in attendance with his wife Ellen, painted a portrait of Father Albert that will hang in the entrance foyer of St. Katharine's Hall just outside the library. It was Father Albert's initiative and foresight that spawned the beginning of the Pope John XXIII Medical Moral Research and Education Center in St. Louis, MO in 1972. The Center later moved to Boston, changed its name to The National Catholic Bioethics Center in 1998, and relocated to Philadelphia into its permanent home in September of 2004.

NCBC Statement on Recent Developments in Obtaining Embryonic Stem Cells Through Embryo Biopsy

Tue, 18 Oct 2005 15:46:00 GMT

October 18, 2005. It was recently reported in the journal Nature (published online October 16, 2005) that the technique of single-cell embryo biopsy was used to obtain embryonic stem cells from mice without destroying the embryos. Several embryonic stem cell lines were successfully developed from the originating cells, and the biopsied embryos progressed to term. While the attempt to obtain embryonic-like stem cells for the purpose of establishing embryonic stem cell lines without destroying embryos is in principle morally laudable, any procedure that places at risk the health and life of a human embryo for purposes that do not directly benefit the embryo is morally unacceptable.

This moral standard is made clear by the teaching of Donum vitae issued by the Holy See in 1987: "No objective, even though noble in itself, such as a foreseeable advantage to science, to other human beings or to society, can in any way justify experimentation on living human embryos or foetuses, whether viable or not, either inside or outside the mother's womb" (I, 4). Furthermore, whether for research or reproductive purposes, it is morally objectionable and beneath human dignity to engender human life through in vitro fertilization or other procedures which replace the marital act and which place the embryo in a vulnerable position and subject to the willful choices of others even as it comes into being.

2005 Catholic Press Association Awards to NCBC Publications

Fri, 17 Jun 2005 15:49:00 GMT

June 17, 2005. The National Catholic Bioethics Center was the recipient of 8 awards announced by the Catholic Press Association on May 27 at their 2005 Catholic Media Convocation held in Orlando, Florida. The National Catholic Bioethics Quarterly, the Centers professional journal, was granted the distinctive honor of 1st place in the category of General Excellence, Scholarly Magazines. The Quarterly was founded in 2001 with assistance from the Our Sunday Visitor Institute and the American Association of the Order of Malta. It has had the honor of having received this award 3 out of its 4 years of publication. Michelle Barton's article, "Oregon's Oxymoron: The Death with Dignity Act", published in the Winter Issue, received the Quarterly's second 1st prize award for Best Feature Article, Scholarly Magazine. The CPA said that the National Catholic Bioethics Quarterly contains "Powerful, important, relative information and insights into... often puzzling issues," and "helps guide the ...reader through the bioethical maze that confronts us today, issues that are critical to our understanding of Catholic faith at work in the 21st century."

The Center's monthly publication, Ethics & Medics with a total distribution of over 26,000, received a total of 4 awards, including all three awards in the category of Best Essay, Special Interest Newsletters.

John M. Haas is the publisher of The National Catholic Bioethics Center's publications, and Edward J. Furton is the Editor in Chief. Tara L. Seyfer is the Managing Editor and Rebecca M. Robinson is the Production Manager. Subscription information for both publications can be found at the Center's website: www.ncbcenter.org, or by calling the Center at 215.877.2660.

Statement on the Passage of the Stem Cell Research Enhancement Act of 2005 H.R. 810

Thu, 26 May 2005 15:54:00 GMT

May 26, 2005. The National Catholic Bioethics Center is strongly opposed to the decision of the U.S. House of Representatives to relax the funding restrictions imposed by President Bush in 2001 on human embryonic stem cell research. H.R. 810, which President Bush has promised to veto, will provide federal funds for the destruction of frozen embryos to create additional stem cell lines beyond those currently approved for research.

Interestingly, the debate on this bill won the support of some politicians previously, or otherwise, considered to be "pro-life." This raises many questions related to the stability and breadth of support for the pro-life cause in the legislature. Some whose voting record on abortion has been consistent with their pro-life stance in the past have failed to carry over this same commitment to embryonic human life. For others, it seems that their interest in the advancement of cures for their own maladies has swayed their opinion to vote in favor of medical research with no proven success, rather than the preservation of life at its most delicate stage.

Most troubling to pro-life Americans is the fact that the United States Congress has, for the first time in history, voted to override the conscience of millions of Americans by placing them is a situation of funding with their tax dollars research which they find morally repugnant.

Statement on the National Academies' Guidelines for Human Embryonic Stem Cell Research

Thu, 28 Apr 2005 15:55:00 GMT

April 28, 2005. The National Catholic Bioethics Center was dismayed to discover that on Tuesday, The National Academies released guidelines intended to foster "responsible practices" for those engaged in privately funded human embryonic stem cell research. The following statement was offered in response by one of the Center†¢s staff ethicists, molecular biologist Rev. Tadeusz Pacholczyk, Ph.D.:

"The National Academies' decision to sanction the generation of embryonic humans by SCNT (cloning) precisely in order to extract or strip-mine their stem cells is an unethical recommendation that dehumanizes and commodifies human beings at their earliest and most vulnerable stage. Science must adhere to higher standards. It shouldn't promote or encourage in any fashion the destruction of the weaker members of the species in the interests of the powerful and the more developed. These ethically bankrupt guidelines just released by the National Academies remind us how the regulation of certain critical areas within the life sciences may ultimately require independent and extra-scientific bodies in order to achieve any meaningful ethical oversight."

Dr. John Haas, President of the Center, observed that "it is impossible to establish ethical guidelines for fundamentally unethical activities." The NCBC urges the ethical use of adult stem cells for research and therapy, an avenue which has already shown tremendous promise and even successful therapies.

The Case of Terry Schiavo

Fri, 18 Mar 2005 16:57:00 GMT

March 18, 2005. In view of the continuing controversy over the case of Terri Schiavo, the ethicists of The National Catholic Bioethics Center would like to reiterate their firm conviction that food and water should be provided for all patients who suffer PVS unless it fails to sustain life or causes suffering. We make this judgment based on the Catholic moral tradition, on the 1992 statement of the Pro-Life Secretariat of the United States Conference of Catholic Bishops dealing with hydration and nutrition for patients in PVS, on years of consideration of comparable cases and in view of Pope John Paul II’s March 2004 allocution on life sustaining measures for patients in a persistent vegetative state.

In general, the provision of nutrition and hydration to the patient in PVS is proportionate and morally obligatory. Removal of food and water is permissible only when they no longer attain the ends for which they are provided.

STATEMENT OF THE NCBC ON POPE JOHN PAUL II'S ADDRESS ON NUTRITION AND HYDRATION FOR PATIENTS IN PVS

Fri, 23 Apr 2004 17:54:00 GMT

April 23, 2005. The ethicists of the National Catholic Bioethics Center (NCBC) have begun a careful examination of Pope John Paul II's recent allocution on life sustaining measures and patients in a persistent vegetative state which is a welcome clarification of Catholic thinking on one of the most vexing and controversial issues in health care.

The pope did not say anything new in his allocution. There is no change in Catholic teaching. Indeed, in paragraph four of the allocution there are references to three earlier Church documents. The Pope's words correct a serious misunderstanding about the circumstances in which nutrition and hydration could be removed from a patient in a persistent vegetative state. The removal of food and water should never be done with the intention of causing the death of the patient. Removal of food and water is permissible in the case of a patient in the vegetative state only when their provision can no longer attain nourishment.

This statement has implications not only for patients in pvs but for all patients who receive or may receive food and water. Many advance directives, which Catholics formerly signed in good faith, and which require the removal of food and water in cases of a persistent vegetative state, may have to be reconsidered.

The words of the Holy Father should settle three related debates among Catholic moralists:

When dealing with pvs patients, some had contended that the presumption should be not to provide nutrition and hydration artificially [ANH] whereas others insisted that the presumption must be to provide artificial nutrition and hydration, even when delivered artificially. The pope clearly decides in favor of the latter.
The second point of clarification was whether artificial nutrition and hydration is care or treatment? The pope is clear: he considers it care. Its purpose is nourishment.
Points one and two show that in general the provision of nutrition and hydration to the patient in the vegetative state is proportionate and morally obligatory, but that in a particular case nutrition and hydration may be extraordinary and disproportionate, and, therefore, morally optional.

The Pope has also rejected the use of the 'quality of life' standard as the sole principle for medical decision-making on behalf of patients in the vegetative state. He has reaffirmed the complete humanity and dignity of these persons.

Since the pope has a global audience, we may assume that he is also addressing the situation in the Netherlands where euthanasia is now legal. The withdrawal of nutrition and hydration with the intent of killing the patient is euthanasia. The same holds true obviously for an intentional overdose of pain medication.

Since there is no departure from tradition in the Holy Father's remarks, the customary moral categories used in Catholic health care still hold. The pope has articulated a general principle for providing nutrition and hydration to patients, including those in a persistent vegetative state. The allocution should be interpreted to allow for prudential case-specific judgments.

While the pope has settled some debates among Catholics, there are issues he did not address such as the ethical significance of the modes of delivery of ANH, types of coma, the significance of the imminence of death, and who should bear the costs of the continued provision of ANH. These issues will continue to form the basis for reflection by ethicists and theologians applying the Pope's recent articulation of Catholic principles.

While this important discussion goes on, the Holy Father in his allocution of March 20, 2004 has reminded all who are involved in the healing professions that health care must be inclusive rather than exclusive. In this regard, note the lone scriptural citation in the allocution: "Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me" (Mt 25: 40).

Further Commentary by
Peter J. Cataldo, Ph.D.
Director of Research
NCBC

April 8, 2004

The comments below are restricted to the third paragraph of section 4 in the allocution:

I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.[“Address of John Paul II to the Participants in the International Congress on ‘Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas’”]

In this critical paragraph the Holy Father is both articulating a general moral principle about the administration of water and food and applying that principle to the vegetative state patient. There are several concepts and distinctions within the Pope’s articulation of the principle which should be identified.

The principle presumes that the moral good to be sought is the preservation of life.
The means by which this good is fulfilled must be distinguished from the particular acts that implement the means.
The “administration of water and food” refers to the reception of water and food with the assistance of another person or extrinsic source. This is one natural means by which the good of preserving life is achieved.
The mention of “artificial means” refers to the various sorts of medical acts by which the reception of water and food to fulfill the good of preserving life is accomplished.
Thus, one natural means of achieving the end of preserving life is receiving water and food, and this means may be completed by medical acts (or by nonmedical acts).
These distinctions do not preclude a prudential judgment in a particular case that the administration of water and food is extraordinary and disproportionate (as will be shown below). In particular, the distinction between natural means and medical acts indicates that a proper finality or end of administering water and food is nourishment (a “natural means” of preserving life), not that the administration of water and food cannot be disproportionate in particular cases.

The administration of water and food is said to be “in principle, ordinary and proportionate.” There are several additional key concepts and distinctions relevant to this point.

Prescinding from the circumstances of any particular patient’s condition, and considering only the essence of water and food as preserving life, their administration is per se reasonable or proportionate, whereas a toxic substance would not be a per se proportionate means of preserving life.
It is on this level of general principle that the administration of water and food is per se morally obligatory. Consistent with this fact there is a presumption in favor of administering water and food to the patient in a vegetative state.
In some cases the “proper finality” of administering water and food may include helping in the cure of disease as well as providing nourishment. In other cases, such as patients in the vegetative state, the proper finality may be restricted to nourishment. In either case suffering is alleviated.
The administration of water and food is per se ordinary and proportionate, but this does not preclude that per accidens and in the particular case it may be extraordinary and disproportionate. In such a case the presumption in favor of administering water and food would no longer hold and a proportionate means of preserving life would be obligatory. This latter case must be contradistinguished from knowingly and willingly causing the death of a person by withdrawing water and food which would otherwise be beneficial.
A practical consequence of the allocution is that some patients for whom the administration of water and food is ordinary and proportionate may have to be transferred out of Catholic health care facilities due to a conflict with the wishes of these patients.

Click here to read the Pope’s original Address of March 20, 2004

NCBC Statement on Early Induction of Labor

Thu, 11 Mar 2004 18:56:00 GMT

March 11, 2004. BOSTON, MA— The National Catholic Bioethics Center wishes to assist individuals and institutions working with the ethical issue of early induction of labor. The following is the NCBC position regarding the application of Catholic moral teaching and tradition to the issue.

The application of Catholic moral teaching and tradition to this issue is directed toward two specific ends: (1) complete avoidance of direct abortion, and (2) preservation of the lives of both mother and child to the extent possible under the circumstances. Based upon these ends, the Ethical and Religious Directives for Catholic Health Care Services provides directives which set the parameters for the treatment of mother and unborn child in cases of high-risk pregnancies:

47. Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.
49. For a proportionate reason, labor may be induced after the fetus is viable.

The principle of the double effect is at work in each of these two directives. Actions that might result in the death of a child are morally permitted only if all of the following conditions are met: (1) treatment is directly therapeutic in response to a serious pathology of the mother or child; (2) the good effect of curing the disease is intended and the bad effect foreseen but unintended; (3) the death of the child is not the means by which the good effect is achieved; and (4) the good of curing the disease is proportionate to the risk of the bad effect. Fulfillment of all four conditions precludes any act that directly hastens the death of a child.

Early induction of labor for chorioamnionitis, preeclampsia, and H.E.L.L.P. syndrome, for example, can be morally licit under the conditions just described because it directly cures a pathology by evacuating the infected membranes in the case of chorioamnionitis, or the diseased placenta in the other cases, and cannot be safely postponed. However, early induction of an anencephalic child when there is no serious pathology of the mother which is being directly treated is not morally licit, emotional distress notwithstanding. Early induction of labor before term (37 weeks) to relieve emotional distress hastens the death of the child as a means of achieving this presumed good effect and unjustifiably deprives the child of the good of gestation. Moreover, this distress is amenable to psychological support such as is offered in perinatal hospice. Lastly, induction of labor before term performed simply for the reason that the child has a lethal anomaly is direct abortion.

Cell-Line Research at Georgetown, et al.

Wed, 11 Feb 2004 19:01:00 GMT

February 11, 2004. BOSTON, MA— A controversy has arisen over research being done at some Catholic academic institutions using certain human cell lines. Groups and individuals have charged that the research use of cell lines MRC 5 and WI 38 is immoral because the cell lines originated from tissue taken from two different aborted babies approximately forty years ago. One of the abortions occurred in Sweden, and tissue obtained from that abortion was used to develop WI 38. This is a very complex moral issue. As a result, there is some confusion of facts and misunderstanding of some of the most fundamental principles from the Catholic moral tradition, such as the principle of material cooperation with evil.

It must be said that the Center applauds the commitment to the pro-life cause shown by these groups and individuals. The Center, too, is working for the day when direct abortion -- or even in vitro fertilization -- is no longer legal. The Center clearly opposes the use of fetal tissue in research which is obtained from direct abortions and opposes the destruction of human embryos to establish embryonic stem cell lines and calls on Catholic academic and research institutions not to be party to such practices as we all work toward the establishment of a Culture of Life.

Nevertheless, to find something distasteful does not necessarily mean it is immoral. For example, for years The Children of God for Life have lobbied against the immunization of children for measles, mumps, rubella and chicken pox because currently the only vaccines available for these immunizations in the United States are grown in the cell lines MRC 5 and WI 38. (See their website at cogforlife.org.) It is the judgment of The National Catholic Bioethics Center that parents and physicians may have children immunized with vaccines grown in cell lines MRC 5 and WI 38 without doing anything immoral. Furthermore, it is possible that pharmaceutical companies and researchers using these cell lines could also be free of immorality if they had not cooperated in the evil which engendered them and they would not contribute to future abortions for the purpose of advancing their work.

A petition is currently being circulated to the Archbishop of Washington to put a stop to this research being done at Georgetown University. It appeals to church documents in support of its position. We do as well. The authors cite Directive 66 of the Ethical and Religious Directives: “Catholic health care institutions should not make use of human tissue obtained by direct abortions even for research and therapeutic purposes.” And they cite Donum vitae (I.4): “The corpses of human embryos or fetuses, whether they have been deliberately aborted or not, must be respected just as the remains of other human beings. Furthermore, the moral requirements must be safeguarded, that there be no complicity in deliberate abortion and that the risk of scandal be avoided.”

Careful distinctions must be made when dealing with complex moral issues such as this one. There is a biological difference between fetal tissue and cell lines derived from fetal tissue. There can be a moral difference between using fetal tissue obtained from a miscarriage or an indirect abortion and fetal tissue obtained from a direct abortion. There is a moral difference between researchers cooperating with those performing abortions to obtain tissue to establish cell lines and researchers using an established cell line the origins of which they are unaware, or, if aware, in which they played no part. There is a difference between avoiding actions which in and of themselves are wrong and avoiding actions which in and of themselves may be licit but which may appear wrong to others, leading to moral confusion (i.e., scandal).

The directives from the Holy See and the United States Conference of Catholic Bishops appear to refer to Catholic institutions being involved in obtaining fetal tissue from direct abortions for their research. Human cells and tissue can have an existence quite apart from a human being. Biotechnology companies, for example, grow sheets of human skin to be used for burn victims. The human skin cells had to come from a human being initially but have quite an independent existence. What would clearly be immoral would be killing someone to obtain the skin cells. What would clearly be immoral would be killing a fetus in order to obtain cells to start a cell line or killing a fetus to perform fetal tissue transplantation or directly to contribute to future abortions to obtain tissue or organs for research or therapy. What would also be wrong would be arranging for those destructive acts to take place so that one could obtain such tissue. Georgetown University has not engaged in any of those actions. Furthermore, simply knowing the origin of the lines does not make the researcher complicit in the evil act originally committed, and one certainly cannot maintain that the researchers necessarily share in the intention of the perpetrators of the original evil act merely by working with these materials. There is simply no identifiable assistance in the evil act committed 40 years ago by the researchers currently making use of the cell lines.

It is difficult to accuse current researchers or even the pharmaceutical firms manufacturing these vaccines of illicit cooperation in an evil which occurred four decades ago. To use the reasoning of some of those calling for the cessation of the use of these cell lines at Georgetown would require a refusal to use organs and/or tissue from murder victims even if they had previously stated a wish to be an organ donor. It would require pro-life groups to refrain from using pictures or even the knowledge of embryonic development in their presentations because such knowledge and pictures were obtained using immoral means (e.g., through immoral embryological research or in vitro fertilization procedures).

It is much preferable for cell lines to be developed which are not been derived from directly aborted fetuses for use in research and for the manufacture of human vaccines. This would certainly help to avoid the danger of scandal. Nonetheless, even though it is our current judgment that the use of these cell lines is not intrinsically immoral, we hope and pray and work for the day when cell lines will be available for scientific use which did not arise from immoral practices in the past. Researchers and pharmaceutical firms should work toward that as a goal in order to give witness to a societal abhorrence of the direct killing of the innocent.

The Terry Schiavo Case

Wed, 22 Oct 2003 18:04:00 GMT

October 22, 2003. BOSTON, MA— The National Catholic Bioethics Center has been following closely the Florida case of Terri Schiavo. The United States Catholic Bishops, in a 2001 document entitled Ethical and Religious Directives for Catholic Health Care Services, had this to say in Directive 58 about the provision of medically assisted nutrition and hydration: “There should be a presumption in favor of providing nutrition and hydration to all patients, including patients who require medically assisted nutrition and hydration, as long as this is of sufficient benefit to outweigh the burdens involved to the patient.” The above directive provides sure guidance to those having to make difficult ethical decisions in this case.

Based on the facts that we have at this time from media sources, the NCBC holds that the benefits of providing medically assisted nutrition and hydration would clearly outweigh the burdens in the case of Terri Schiavo.

Statement on the "Partial Birth Abortion Ban Act of 2003"

Wed, 22 Oct 2003 18:02:00 GMT

October 22, 2003. BOSTON, MA— The National Catholic Bioethics Center supports the passage of the “Partial-Birth Abortion Ban Act of 2003” by the United States Senate. Partial-Birth abortion is, for all intents and purposes, an act of infanticide and a violation of the sacred and inviolable right to life of the child, a right shared by every innocent human being. The National Catholic Bioethics Center is pleased President George W. Bush has expressed his intent to sign the bill.