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Commentary on Gender Identity in Community Planning and Development Programs

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The National Catholic Bioethics Center
Commentary on Gender Identity in Community Planning and Development Programs
February 9, 2016
© 2016 by the National Catholic Bioethics Center

The National Catholic Bioethics Center has joined nine other organizations in filing public comment concerning the proposal by the U.S. Department of Housing and Urban Development: Equal Access in Accordance with an Individual’s Gender Identity in Community Planning and Development Programs.  The proposed regulations would forbid discrimination on the basis of “gender identity.” 80 Fed. Reg. at 72648-49 [§ 5.106]. The regulations define the term “gender identity” as “the gender with which a person identifies, regardless of the sex assigned to that person at birth.” Id. at 72648 [§ 5.100].  The proposal would mandate that a man who asserts that he is a woman may not be refused access to shared women’s sleeping quarters and bathing areas. Similarly, a woman who asserts that she is a man may not be refused access to shared men’s sleeping quarters and bathing areas. These organizations are expressing concern for the privacy needs and sense of perceived security by persons whom they serve, be it in shelters or the variety of housing services in which vulnerable populations are served by Catholic Charities and others, if these regulations are promulgated. To read the NCBC's full commentary on this issue, click

Dismay Regarding the Embryonic Research Decision in the United Kingdom

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The National Catholic Bioethics Center
Dismay Regarding the Embryonic Research Decision in the United Kingdom
February 8, 2016
© 2016 by the National Catholic Bioethics Center


The National Catholic Bioethics Center is dismayed by the decision of the United Kingdom’s Human Fertilisation and Embryology Authority (HFEA) on February 1, 2016, to license a radical new form of research on human embryos by the Francis Crick Institute. Science and technology, and in particular new and powerful forms of technology, can be used to increase human knowledge and promote healing, but only if used ethically. The protocol approved by the HFEA fails this test. 

The Francis Crick Institute applied for the license in fall 2015. A statement on the Institute’s website explains that they intend to use a new gene-editing technology, called CRISPR/Cas-9, to study the effects of specific genes in human embryological development. CRISPR/Cas-9 is the most powerful gene editing tool ever developed, able to identify, cut, and replace genes in DNA, including human DNA, with scalpel-like precision.  The goal of the research protocol is to improve clinical treatments for infertility.

Institute researchers claim to have addressed the significant ethical issues inherent in this research. They contend the research protocol is justified because the embryos are "left over" from assisted reproductive technology attempts; because the parents of these embryos have given informed consent; and because the embryos will be destroyed after seven days (well within the HFEA's 14-day window for human embryo research) rather than being allowed to be born with significant iatrogenic birth defects.

Appealing to such considerations may prove convincing or comforting to some. However, none of these considerations addresses the central ethical principle and harm at hand. This type of research involves the deliberate use and destruction of human beings at the embryological stage of life. The embryos used by scientists will be disabled by having their genes shut down one at a time to see how this affects their human development.

The research licensed by the HFEA involves a profound disregard for human life and for human dignity. The guidance of the Instruction
 Donum vitae (1987) is still relevant today and applicable in this case: 

         [T]he fruit of human generation, from the first moment of its existence, that is to say
         from the moment the zygote has formed, demands the unconditional respect that is
         morally due to the human being in his bodily and spiritual totality. The human being
         is to be respected and treated as a person from the moment of conception; and therefore
         from that same moment his rights as a person must be recognized, among which in the first place
         is the inviolable right of every innocent human being to life. This doctrinal reminder provides the
         fundamental criterion for the solution of the various problems posed by the development of the
         biomedical sciences in this field: since the embryo must be treated as a person,
         it must also be defended in its integrity, tended and cared for, to the extent possible, in the
         same way as any other human being as far as medical assistance is concerned.

In addition to these direct harms to the human embryos involved, the Crick Institute research will have tremendous implications for how CRISPR/Cas-9 will be used for other experimental and clinical applications in other human beings. As a biotech tool, CRISPR/Cas-9 can and should be used with the informed consent of patients to treat diseases and injuries. However, influential scientists, scientific journals, and bioethicists are openly discussing the use of CRISPR/Cas-9 for more radical interventions, including inducing genetic changes in human embryos and introducing genetic changes that can be passed down to future generations. These kinds of proposed interventions cross substantive ethical lines. At a minimum, it is essential to have greater certainty about the long-term implications and a broader ethical consensus before moving forward.

Unfortunately, the United Kingdom’s Human Fertilisation and Embryology Authority has a long track record of approving unethical research protocols, including lethal research on embryos (1990), human cloning (2004), three-parent embryos (2005), and human-animal hybrids (2007). The CRISPR/Cas-9 research protocol currently being promoted by the Crick Institute is profoundly unethical due to its destructive use of human embryos and the unprecedented use of new gene-editing technology on human beings. This research should be condemned and stopped.

                                                         The Ethicists of The National Catholic Bioethics Center

Catholic Nurses File Supreme Court Brief in Support of Women's Health

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The National Catholic Bioethics Center
Catholic Nurses File Supreme Court Brief in Support of Women's Health
January 28, 2016
© 2016 by the National Catholic Bioethics Center


Catholic nurses have file a brief to the U.S. Supreme Court in Support of Women’s Health. The National Association of Catholic Nurses-U.S.A. (NACN-U.S.A.) has joined others in filing an amicus brief to the U.S. Supreme Court in support of the State of Texas, which promulgated a law designed to protect the health of women seeking an abortion.  Dr. Marie T. Hilliard, NCBC Director of Bioethics and Public Policy and a Board member of NACN-U.S.A., facilitated this participation by the Catholic nurses.  This law is being challenged by abortion providers.  The law requires the same health standards for abortion centers as it does for surgical outpatient clinics, as well as requiring the abortion physician to have admitting privileges to a local hospital, in the event that there is a negative outcome to the health of the woman who was undergoing an abortion.  While both NCBC and NACN-U.S.A. stand firmly against laws allowing a direct and intended abortion, it also recognizes that in any abortion situation there are two patients that need protection, the unborn child, as well as the mother.  If this law is upheld, as it should be, approximately half of the abortion centers in Texas would be forced to close. 

To read the full brief--Whole Woman's Health, et al. v. Cole, Comm'r, TX DHS, et al.-- click HERE.

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Gender Identity Mandate Threatens Freedom of Conscience

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The National Catholic Bioethics Center
Gender Identity Mandate Threatens Freedom of Conscience
January 13, 2016
© 2016 by the National Catholic Bioethics Center


The NCBC joined the USCCB in filing concerns over a proposed Gender Identity Mandate, which threatens the freedom of conscience of health care providers The proposed regulations of the Office for Civil Rights in the Department of Health and Human Services could create serious conflicts of conscience for many health care providers, organizations, and insurers. While every individual should be treated with dignity and respect, especially when he or she is in need of health care, the proposed regulations create special privileges based on gender identity that effectively would require the provision of controversial procedures, such as “sex-reassignment” surgery.  Respected health care experts hold that scientific data has not demonstrated that such procedures are effective in addressing the dysphoria of those experiencing gender identity dysphoria.  Such health care professionals and organizations, including insurers, should not be forced to violate well founded standards of care based on the principle, “to do no harm.”

To read the full official public comment defending freedom of conscience, please click

The Continued Defense of Religious Liberty

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The National Catholic Bioethics Center
The Continued Defense of Religious Liberty
January 12, 2016
© 2016 by the National Catholic Bioethics Center


The NCBC Continues to Advocate for Religious Liberty, Violated by the HHS Contraceptive Mandate. The NCBC has joined seven other health care organizations in filing an amicus brief to the U.S. Supreme Court in support of the religious liberty of organizations being violated by the U.S. Department of Health and Human Services “Contraceptive Mandate,” pursuant to the Affordable Care Act. To date, the NCBC has filed twenty-two (22) such briefs in support of the religious liberty rights of numerous organizations being violated by this mandate.

To read Zubik, et al. v. Burwell, et al. in full, and to see the NCBC named on Page 5, click HERE.

The NCBC Comments on Human Subject Research

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The National Catholic Bioethics Center
The NCBC Comments on Human Subject Research
January 6, 2016
© 2016 by the National Catholic Bioethics Center


In order to advocate for the protection of human subjects in biomedical research, the NCBC has filed public comment concerning the revisions proposed by the U.S. Department of Health and Human Services’ Common Rule. The Common Rule initially was promulgated in 1991 for the protection of human subjects in biomedical research.  The NCBC provided comment in support of  the revised definition of human subject, to cover research with biospecimens not initially identified for research purposes when gathered from persons, thus historically not being subject to informed consent rules.  In this way the use in research of any reproductive tissue specimens, such as sperm or ova, would require the informed consent from those from whom they were collected.  Furthermore, the NCBC commented on the need for the research protocols, which require a subject not to get pregnant during the research period or beyond, to allow for abstinence as an alternative to often mandated contraception.

For more details on this issue, read the full commentary, 

The Rights of Embryos as Human Beings, Not Property

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The National Catholic Bioethics Center
The NCBC Supports the Rights of Embryos, as Human Beings, Not to be Treated as Property
December 30, 2015
© 2015 by the National Catholic Bioethics Center


The NCBC is a signatory to an amicus (friend of the court) brief filed by the Thomas More Society concerning a case before the Los Angeles Superior Court (Loeb v. Vergara). The case, involving the mother of the embryos and her ex-fiancé, seeks to resolve the custody of the couple's frozen embryos, engendered through in vitro fertilization. The brief cites the irrefutable scientific proof that human life begins at fertilization and argues that frozen human embryos are not mere chattel, i.e., items of "property" but are rather complete and integral human beings fully deserving of commensurate dignity and respect. The NCBC takes no position on which of the parents’ wishes are to be respected, but on the reality that no offspring, regardless of the stage of development, is to be treated as property, and that any decision concerning these embryos needs to be based on the best interest of these tiny human beings unable to speak for themselves. 

To read the brief in full and see the NCBC's contribution on page 13, click HERE

Call to Action: Protect Conscience Rights of Health Care Providers

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The National Catholic Bioethics Center
Call to Action: Protect Conscience Rights of Health Care Providers
November  19, 2015
© 2015 by the National Catholic Bioethics Center


The NCBC has joined a national coalition in a call-to-action to protect the Conscience Rights of health care providers, especially nurses. On November 5th, the Center and a group of other signatories sent a letter to Congress. In the letter, Dr. Marie Hilliard—Director of Bioethics and Public Policy at the NCBC and a Registered Nurse—asks our elected officials: “What will happen to nurses whose only fault is being unwilling to be compelled by government to be sources of death and destruction?”

Now, you too can lend your voice to the call for conscience rights. Please read the letter below and take action to protect Catholics and all health care professionals of good faith. The National Catholic Bioethics Center and the Committee for a Human Life Amendment (NCHLA) are grateful for your support.

Dear Friends,

The next two to three weeks are critical. We must demand key conscience protections be included in the law Congress must pass by December 11 to fund government programs for the 2016 Fiscal Year. Urge Congress again to protect conscience rights. Click HERE now. Then share this call to action through email and social media.

What if you spent years training to help the sick as a nurse – only to find that to keep your job, and your license you must take part in the killing of a defenseless five-month-old unborn child?

What if a church in your town lived up to its teaching on healing the sick by providing its employees with excellent health coverage – but was told that is illegal, unless it pays for abortions that violate its teaching on life itself?

These are not projections of a nightmare future. Rather, each of these things happened recently in our country – and will keep happening, unless we stand up as citizens and demand a change in the law. Please go to the Human Life Action Center and contact Congress now to urge them to protect the rights of pro-life health care providers.

A solution is available and we should be part of it. The Abortion Non-Discrimination Act (ANDA) will close loopholes in existing law and provide a private right of action, so that healthcare providers, whose freedom of conscience is denied, can defend their rights in court. It is now part of the House of Representatives’ appropriations bill for funding HHS. By early December, Congress needs to pass a law funding government programs in Fiscal Year 2016 – and this urgently needed reform should be part of that final bill.

We must speak up now to protect our cherished right of conscience.

Thank you for acting in defense of life and liberty. Tell everyone you know to join us in raising our voices. Together we will be heard!

Amy McInerny
Executive Director

To learn more about religious rights and protection of conscience, visit the United States Conference of Catholic Bishops website, HERE.

Physician-Assisted Suicide Advances in California

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The National Catholic Bioethics Center
Physician-Assisted Suicide Advances in California
October  7, 2015
© 2015 by the National Catholic Bioethics Center

The National Catholic Bioethics Center Profoundly Regrets Governor Brown’s Signing into Law of ABX2-15, End of Life Option (Physician –Assisted Suicide). 

On October 5, 2015, Gov. Edmund Brown made California the 5th state legalizing physician– assisted suicide, as an “End of Life Option.” In some states such legislation has been entitled “Death with Dignity.” Such labels are clearly misnomers. The harsh reality is that the “options” create victims of physician– assisted suicide (PAS) through social coercion, and have nothing to do with the “dignity” innate in every human being.

A growing body of sociological data demonstrates that when vulnerable persons see suicide as a “good” from which the state no longer provides protection, suicide rates in general rise. For example, in Oregon, the first state to legalize PAS, suicide rates overall (excluding those from PAS) have skyrocketed. Oregon has the second highest suicide rate in the country, again, excluding PAS. Evidence shows that despite supposed restrictions of PAS to those with “terminal illness,” those with disabilities are routinely viewed by social policymakers as less worthy than others of the legal protection against suicide. PAS becomes an open invitation to patient abuse.

Americans hold as self-evident that all men are “endowed by their Creator with certain unalienable rights; that among these [is the right to] life …; [and] that, to secure these rights, governments are instituted among men” [Declaration of Independence, para. 2 (U.S. 1776)]. When government secures such rights for some but not others, when it relaxes laws against aiding the suicide of terminal patients but not the able-bodied, it is saying this class deserves less protection of their lives, its members deserve less safeguards of their unalienable rights —in other words, they deserve less respect because in some way they are less human. In discounting such rights entrusted to its care, government denies, not enhances, human dignity, and thus compromises the very grounds on which government is instituted.

Persons with disabilities have grave concerns for such lack of protection by government. As physical impairments that substantially limit life activities, terminal conditions are disabilities. Those with disabling conditions which can cause death within six months, but only if treatment were removed, are terminal for purposes of ABX2-15 . The high cost of keeping such people alive could provide insurance carriers a powerful incentive to develop reimbursement policies for those with disabilities and terminal illness that become a coercive factor in a patient’s decision to seek the less costly barbiturate prescription to end one’s life.

Governor Brown has stated that the reason he signed ABX2-15 into law was that if persons were “suffering prolonged and excruciating pain … it would be a comfort to be able to consider the options afforded by this bill.” This is a completely fallacious reason for this dangerous change in public policy. The Oregon Public Health Division has been collecting data, annually since 1998, on the reasons persons have availed themselves of PAS. Consistently, the least frequent reasons for such a request are pain and finances. The primary reasons terminal patients give for requesting PAS are loss of autonomy, loss of dignity, and inability to participate in activities that make life enjoyable. Clearly, these reasons speak to why PAS is being sought: fear of social abandonment, now enabled by a government that has removed protections from such abandonment.

There is no mandate in ABX2-15 to assess for the presence of depression or other psychological condition that may trigger a request for PAS. Though either the attending or consulting physician may refer patients for psychological or psychiatric evaluation if they suspect clinical depression or other mental disorders that can impair judgment, many physicians lack training to recognize depression; and nothing in ABX2-15 or its exemplars requires that they have it. Not surprisingly, referrals almost never have been made in the seventeen-year history of the Oregon Act (47 out of 859 deaths) and, thus far, Washington is following suit. Given that the U.S. Supreme Court [Washington v. Glucksberg, 521 U.S. at 730-31] has reported that many people, terminal or not, seeking suicide suffer from clinical depression and often lose the urge when the condition is treated, the absence of reported referrals in these states is most troubling for the future of PAS in California. Furthermore, the law prohibits the physician from informing the patient’s next of kin of the request for PAS without the patient’s consent. Equally troubling is how, in European jurisdictions where PAS has been legalized, non-terminally ill persons with psychological disorders have been allowed to access PAS. 

The potential for abuse is enhanced by the fact that the law allows persons with a financial interest in the patient’s death to be one of the two witnesses to the written request, attesting to the patient’s competence and the lack of coercion. That same person can be the only witness present when the lethal drug is taken since ABX2-15 fails to require an objective observer to the act. Once the prescription is written and the lethal drug dispensed, the attending physician’s duty to the patient ends. He is not obliged to re-evaluate the patient’s competence before the drug is taken, even though weeks or months have passed. This is an open invitation to patient abuse since no one will know if the patient resisted. Astonishingly, under ABX2-15 , information the attending physician must provide the Department of Public Health, including the circumstances and cause of the patient’s death, “shall not be disclosed, discoverable, or compelled to be produced in any civil, criminal, administrative, or other proceeding” [§443.19(a)]. This provision will impede investigations by coroners and prosecutors into whether patients’ deaths involved foul-play, thus supplying a shield to a potential crime.

By purportedly offering safeguards that serve instead to place patients at risk of abuse, this law employs a legal sleight-of-hand. Despite Governor Brown’s statement, rather than providing comfort to those suffering with terminal illness, this law provides a mechanism for the ultimate abandonment of the terminally ill patient to death. True compassion, “leads to sharing another’s pain; it does not kill the person whose pain we cannot bear” [St. John Paul II, Evangelium vitae [Encyclical Letter on the Gospel of Life] ¶ 66 (1995)].

October 7, 2015

NCBC and the NCPD Continue Working to Protect those with Disabilities

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The National Catholic Bioethics Center
NCBC and the NCPD Continue Working to Protect those with Disabilities
September 10, 2015
© 2015 by the National Catholic Bioethics Center

Dr. Marie Hilliard, The NCBC Director of Bioethics and Public Policy, also chairs the Ethics and Public Policy Committee of the National Catholic Partnership on Disability (NCPD). The NCBC and the NCPD continue to collaborate in their efforts to protect from discrimination all persons, especially those with disabilities, by opposing the legalization of Physician-Assisted Suicide (PAS), which targets those deemed by others to be unfit to live.  Evidence shows that despite proposed restrictions of PAS to those with “terminal illness,” those with disabilities are routinely viewed by social policymakers as less worthy than others of the legal protection against suicide.  The California Legislature, after failing to enact PAS legislation earlier this summer, has passed out of its Public Health and Developmental Services Committee another such proposal.  Attached is the letter sent on behalf of the NCPD to the Governor of California and relevant legislative committee members seeking to prevent this proposal from becoming law.

Please have your voice heard by contacting Governor Brown indicating your opposition to AB-15, End of Life Option Act.

    CALL: (916) 445-2841
 and speak out to protect the vulnerable from Physician-Assisted Suicide. 

Commercial Markets Created by Abortion

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The National Catholic Bioethics Center
Commercial Markets Created by Abortion
September 1, 2015
© 2015 by the National Catholic Bioethics Center

Many have expressed shock at the cavalier manner in which those who work for Planned Parenthood speak of the monetary value of fetal parts following abortion. The lives of these innocent human beings were of no value to those who destroyed them, but their remains are treated as an object of profit. From the videos, it is apparent that Planned Parenthood is altering the manner in which it carries out abortions in order to preserve what it sees as more valuable or marketable human materials. The whole episode displays the monstrous depravity of the abortion business, funded each year to the tune of one half billion dollars by the US government. Unfortunately, none of this is new to the Ethicists of The National Catholic Bioethics Center. In an essay that was published in our own Ethics & Medics by Victoria Evans, “Commercial Markets Created by Abortion” (August 2010), and available HERE. The 
sordid practice is examined in considerable detail. Middlemen essentially pay rent to the abortion mill for the privilege of regularly receiving fetal materials, which they then sell to pharmaceutical, biotechnology, and biologic sectors. The same materials can also be used in the production of cosmetics and hawked as having the potential to reverse human aging. Equally insidious, politicians defend this trafficking in the name of medical progress. The business is profitable enough to provide employment for numerous individuals who have no scruples about dealing in aborted baby parts. We invite our visitors to reread this archived article from a full five years ago to understand how this shady practice is conducted. So long as Planned Parenthood and other abortion facilitators are free to ply their murderous trade, there will be hangers-on who seek to benefit from the destruction of human life. Those scientists, researchers, and businesspersons who seeks profit from the destruction of human life are the callous beneficiaries of this heartless and shameful practice.  At the same time, Catholics and all who respect the dignity of each human life should consider not only what concrete actions can help to stop this, but also how we can support alternatives in biomedical research and development. 

The National Catholic Bioethics Center

The NCBC Signs <i>Amicus</i> Brief in Defense of Priest for Life

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The National Catholic Bioethics Center
The NCBC Signs Amicus Brief in Defense of Priests for Life
August 25, 2015
© 2015 by the National Catholic Bioethics Center

NCBC has signed on to an amicus brief in support of the religious freedom of Priests for Life. A panel of the District of Columbia Circuit Court of Appeals allowed a lower court’s ruling to stand, thereby denying religious freedom to Priests for Life by forcing them to comply with the U.S. Department of Health and Human Services’ employer Contraceptive Mandate. The Mandate violates the religious freedom of this faith-based organization by forcing it to be complicit in providing to its employees contraception, including abortifacient drugs and devices. The Court also denied a request for a full court review of this case, compelling Priests for Life to face the choice of violating their faith or paying huge fines. Priests for Life are now petitioning the U.S. Supreme Court to intervene. Religious freedom is the bedrock of this democracy, and the foundation for our very existence as a country. NCBC recognizes that when the religious freedom of one group is violated by the law, all groups, especially faith-based organizations of conscience, are vulnerable to similar violations.  NCBC is happy to stand with Priests for Life in support of their religious freedom.

To see a copy of the amicus brief with The Center mentioned on page three, click HERE.

Coverage of Immoral Procedures under the Affordable Care Act

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The National Catholic Bioethics Center
Coverage of Immoral Procedures under the Affordable Care Act
July 14, 2015
© 2015 by the National Catholic Bioethics Center


The US Department of Health and Human Services, on July 10, 2015, issued Final “Rules” mandating that virtually all employers provide in their employee benefit packages coverage of certain so-called preventive services for women, including contraceptive and abortifacient drugs and devices (“Contraceptive Mandate”). The “Rules” do not provide for any new exemption to the Contraceptive Mandate. They expand the definition of “eligible organization” so that “closely held” for-profit organizations with a religious objection now qualify for the “accommodation,” which was previously limited to religious non-profit organizations. They also provide for an “alternative” method for eligible organizations to report their objections and insurance plan information, which still implicates the employer in the mechanism by which its employees receive the objectionable coverage. The Administration continues to propose an unjust and unlawful mandate with only an arbitrarily narrow exemption for houses of worship, with no exemption at all for most individuals, employers and organizations, and an “accommodation” that still requires employers that fall outside the narrow government definition of “religious employer” to facilitate the objectionable coverage.

The “Rules” modify the eligibility for the existing “accommodation,” originally designed for religious ministries such as Catholic charities and hospitals, which are referred to as “eligible organizations.” Thus, “closely held” family businesses with a religious objection to such a mandate will be eligible for the same “accommodation” as a not-for-profit religiously sponsored organization.  A “closely held” business is a for-profit entity that is not publicly traded, is majority-owned by a relatively small number of individuals, and objects to providing such coverage based on the owners’ religious beliefs. 

However, the case of the Little Sisters of the Poor, who had received a temporary injunction by the US Supreme Court from having to comply with such an “accommodation,” has demonstrated that such an “accommodation” does nothing to correct the violations of religious liberty imposed by the Contraceptive Mandate.  This mandate as presented in the “Rules” continues to substantially burden the religious liberty of all persons with religious objections to the mandated coverage. In fact, within days of the promulgation of these new “Rules,” a three-judge panel of the 10th US Circuit Court of Appeals denied an injunction to the Little Sisters, after the US Supreme Court had temporarily granted such an injunction until the 10th Circuit Court could hear the case. 

These “Rules” do not change the purpose or effect of the EBSA Form 700, the self-certification form for “accommodated” employers.  As under the previous regulation, employers with a religious objection to contraceptive coverage remain subject to the Contraceptive Mandate, but are deemed to be in compliance with it if they provide their insurer or their Third Party Administrator (“TPA”) with a completed Form 700. Receipt of the form by the insurer (or, in the case of a self-insured plan, TPA) authorizes and/or obliges it to provide or arrange payments for abortifacients/contraceptives to persons enrolled in the plan.

These new “Rules” finalize an alternative mechanism that had been temporarily allowed for "eligible organizations" under the Interim Final Rules, permitting them to submit directly to HHS some other notification in writing that accomplishes the same end as Form 700.  The “Rules” state that the “eligible organization” may notify the government in writing of the organization’s objection with accompanying information that ensures that the very coverage to which the employer objects is extended to its own employees.  The government (HHS for contracted plans, and the DOL for self-insured plans) will then contact the organization’s insurance provider or TPA to assure the same coverage is provided to employees.  Thus, an “eligible organization” is still required to facilitate payments and coverage for the contraceptives to which it objects. The “accommodated” organization’s own plan becomes a mechanism which ensures that contraceptives are made available to enrollees, preventing the organization from maintaining a plan consonant with its religious or moral beliefs.

More specifically, the basis on which an “eligible organization” qualifies for an “accommodation” involves the organization in cooperating in a program that facilitates the violation of its own religious tenets.  The organization must indicate in writing to the federal government: that its objections are based on sincerely-held religious beliefs; their insurance plan name and type; the name and contact information of the religious organization’s insurer and/or TPA; and any change or update in the requisite information. Upon receipt of this information and based upon it, the government will contact the organization’s insurer or TPA to inform it of its obligation to provide coverage and arrange payments for contraceptives to plan enrollees.  This facilitates employee access to objectionable coverage in direct contravention of the organization’s sincerely-held religious beliefs. Like the submission of Form 700 to the insurer or TPA, the submission of the “eligible organization’s” alternative notice directly to HHS supplies the insurer or TPA—via the government and its requirements—with all it needs to provide or arrange for the coverage to which that employer objects.  It is the employer’s own health plan that remains the conduit for coverage for contraceptives. Enrollees obtain this coverage precisely because they are enrolled in the plan. The plan itself continues to operate as a “trigger” for contraceptive coverage, and plan premiums appear likely to serve as the funding source for the objectionable “services. 

Furthermore, the “Rules” retain a regulatory scheme in which “preventive” health services are defined to include items that do not prevent disease, but rather are intended to render a woman temporarily or permanently infertile, and may be associated with adverse health outcomes.  Designating contraceptives as “preventive services” does not constitute good clinical medicine. An extensive body of evidence shows hormonal contraceptives pose substantial threats to women, including myocardial infarction, cerebrovascular accidents, deep venous thrombosis, pulmonary emboli, as well as breast cancer, cervical cancer, and liver cancer. The relationship between hormonal contraception use and breast cancer—and in particular the disturbing connection between oral contraception use and triple-negative breast cancer (for which oral contraceptives raise the risk by 2.5 to 4.2 times)—should cause caution and concern.  Furthermore, it is a scientific fact that contraceptive drugs and devices also are associated with an increased risk of AIDS and sexually transmitted diseases.  Designating contraceptives as “preventive services” gives the false impression that these are safe and standard medications. Thus, such contraceptives are not “preventive services,” but put the very women they are purported to protect at significant health risk.

In the end, the objecting employer is prevented from offering its employees a plan that comports with its religious convictions.  It is evident that suppression of religious freedom can take at least two forms. It can take the form of making conscientious objectors actively cooperate with what they see as morally forbidden. But it can also take the form of depriving those objectors of the right (a right that others continue to exercise) to do what they see as morally required. Objecting employers will lose that right, because any plan they offer will be turned into a conduit for the objectionable coverage.

Finally, the practical outcome for employees and their children is exactly the same: the objectionable coverage is obtained by virtue of their enrollment in the employer-provided health plan.  Employees who share the objecting organization’s religious tenets are similarly deprived of the freedom to choose an insurance plan organized according to their own values, and are forced to accept coverage for their families to which they have their own religious or moral objection.  In this way, the “Contraceptive Mandate” completely fails to acknowledge the religious freedom of both individual and institutional conscientious objectors. Because it is not narrowly tailored to accomplish a compelling government interest, the Contraceptive Mandate violates RFRA, as most courts addressing the issue have either held or found likely in granting some form of injunctive relief.


Medicare Funding of Advance Care Planning: The NCBC Raises Caution

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Medicare Funding of Advance Care Planning: The NCBC Raises Caution
July 10, 2015
© 2015 by the National Catholic Bioethics Center


The federal Centers for Medicare and Medicaid Services (CMS) has issued a call for comment in response to their proposal to reimburse physicians and other qualified professionals for engaging with their patients in advance care planning, including the completion of standard forms such as advance directives—see HERE
The National Catholic Bioethics Center (NCBC) supports the fact that a competent adult should have frequent in-depth conversations with a health care provider and a self-designated health care agent, who agree to respect the well-reasoned health care wishes of that competent adult when unable to communicate such wishes.  For Medicare to facilitate such conversations by providing physicians with a payment mechanism is not contradictory to such a position.  However, there are several cautions that need to be considered, that relate to why this very proposal was removed from the Affordable Care Act (ACA).  In reminding readers of this fact, it is important to state that what was not able to be achieved in law, the federal government is attempting to achieve by regulation.  All regulation must have a foundation in law, and this provision was affirmatively negated by Congress.  Thus, this raises serious concerns about the regulatory process. 

There are a number of other concerns that remain, pertaining to the reimbursement by Medicare for the discussion and completion of standard advanced directive forms, as proposed by CMS.  Most problematic are the “standard forms” that are considered optimal by the federal government.  They all involve a system of forced choices of boxes to check concerning treatment to be withheld (usually) or provided.  In the timeframes proposed by ACA, such planning was to be reviewed and revised every five years.  No one can determine, until faced with the specific health care scenario, the risks and benefits of any treatment, especially the proportionate benefit of antibiotics and hydration and nutrition, years, or even weeks before that dilemma is encountered.  That is why a well-informed health care agent is the optimal choice to navigate such decision-making in the situation encountered.  It is not unusual for a person who has what some label a terminal disease, Alzheimer’s disease, who is not anywhere near end-stage disease, to experience a crisis of dehydration, that merely requires short-term intravenous therapy.  Such a system, of respecting these pre-determined check-off boxes, often is used to justify a passive euthanasia mentality of “letting nature take its course,” thus allowing a person who has months to years to live, to die of dehydration, all for the need of a few days of rehydration.  The same is also heard of for the not-infrequent (with the elderly) bladder infection, allowed to advance to a full blown septicemia, because the person has checked, that if they have a terminal disease, they do not want to be given even an oral antibiotic.

Of great concern is the promotion by the federal government of the POLST form (Physicians Orders for Life Sustaining Treatment), which will be included as a “standard form” of the Medicare-reimbursed forms to be signed.  The problem is that these forms are not just stating the wishes of the patient for when the patient can no longer express them, but are actionable orders of a physician from the moment the physician signs the order.  Many forms do not require the patient or health care agent to sign the form, nor does the patient have to be terminal for these forms to be signed.  Thus, they advance, from the concept of patient expressed wishes, to actionable medical orders that must be honored by all providers and can be signed years ahead of the time the health care dilemma is encountered and which no longer reflect the true situation of the patient.  There are real questions as to the appropriate use of such forms, who has the authority to complete them, who must sign them, who must honor them, and how accurate are they to the true informed consent of the patient. 

Thus, while good conversations must occur between the competent adult and the health care provider to insure true informed consent, and to provide reimbursement for such discussions is a good, what forms will be advocated to be completed at the conclusion of such discussions historically has raised grave concerns as to  whether true informed consent will be violated.  There is a tendency, in the face of 55 million persons seeking reimbursable health care from the federal government, to approach such populations with a rationing of care mentality.  That negates the dignity of all human beings, especially those due to age, disability or infirmity who no longer are able to speak for themselves. 

Another point that must be made is that this has been framed by the media as part of a provision debated during consideration of the ACA, known coloquially as “Death Panels”. That clearly is incorrect. That provision pertained to the Independent Payment Advisory Board (IPAB). The US House of Representatives recently voted to eliminate the IPAB provisions of the ACA, a step praised by the Healthcare Leadership Council, an organization comprised of leaders from all US healthcare sectors, including the NCBC. The NCBC was a signatory to a letter requesting this amendment to the ACA. The IPAB is comprised of Presidential appointees, who are not confirmed by the US Senate, charged with making recommendations to cut Medicare expenditures which will not be subject to administrative or judicial review.  The Senate now is responsible for considering this bill — See HERE. However, the very fact that IPAB is opposed so broadly also speaks to the fear of an advancing health care rationing about which we all must be concerned. 

Two Victories for The NCBC in Defense of Human Dignity

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Two Victories for The NCBC in Defense of Human Dignity
July 10, 2015
© 2015 by the National Catholic Bioethics Center


The National Catholic Bioethics Center had two heartening successes this week after striving to defeat unethical legislation in the Capitol and in California while working to defend the life and dignity of our most vulnerable citizens.

First, thanks to the concerted efforts of the NCBC and over 500 others, t
he US House of Representatives voted to eliminate the Independent Payment Advisory Board (IPAB) provisions of the Affordable Care Act (ACA). This step was praised by the Healthcare Leadership Council, an organization comprised of leaders from all US healthcare sectors, including the NCBC. The Center was a signatory to a letter requesting this revision to the ACA. The board is comprised of Presidential appointees, who are not confirmed by the US Senate, charged with making recommendations to cut Medicare expenditures which will not be subject to administrative or judicial review.  The Senate now is responsible for considering this bill. Read the letter from the NCBC and the group, HERE.

Next, after the NCBC's successful push to spread the word and defend the citizens of California, the Center, with the National Catholic Partnership on Disability (NCPD) and numerous national and local disability advocates, has finally prevailed in its efforts to convince the California Assembly’s Health Committee to reject the legalization of physician-assisted death, a proposal that already had passed the state Senate. This proposal was expected to pass the Assembly once the California Medical Association decided not to oppose it. Through letters sent to the California Governor and committee members, the NCPD —whose Ethics and Public Policy Committee is chaired by our own Dr. Marie Hilliard—and the National Catholic Bioethics Center were able to expose the truth of such proposals: Vulnerable persons, including those with disabilities, will be the victims of abuse allowed by such laws. Click HERE to read the full letter that brought about such an incredible success.

To learn more about the NCBC's Public Policy work, please click HERE.

The NCBC Responds to Supreme Court Ruling in <i>Obergefell v. Hodges<i>

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The NCBC Responds to Supreme Court Ruling in Obergefell v. Hodges
June 26, 2015
© 2015 by the National Catholic Bioethics Center



The National Catholic Bioethics Center bemoans the loss of states’ rights and freedom of conscience reflected today by the decision of the U.S. Supreme Court in the case of Obergefell v. Hodges. This decision reflects a growing judicial tyranny, in which the will of the people is overridden by courts intent on making law rather than interpreting the laws and the Constitution. More than two-thirds of the thirty-one states that voted to affirm traditional marriage in their constitutions have now been made subject to judicial usurpation of their right to decide their own laws as established by Article I of the Constitution. Now all fifty states and U.S. territories will be denied their rights of self-governance, guaranteed by the Constitution. The separation of powers and the right of people to establish laws in governing themselves are the foundations of the American republic.

By denying the freedom of the people in individual states to affirm the historical definition of marriage as the union of a man and a woman, the Supreme Court has diminished the freedom of all Americans regardless of their position on same-sex marriage. The Center continues to affirm the dignity, respect, and rights of persons with same-sex attractions. However, there is a fundamental difference between the marital relationship of one man and one woman, with the ensuing rights recognized for the well-being of children and society, and committed relationships between two persons of the same sex. The Supreme Court has callously disregarded these differences, which have been recognized for millennia by diverse populations around the globe. Following this decision, no state or U.S. territory will be allowed to establish sound social policy to protect traditional marriage and families, and all can be compelled to recognize various forms of marriage established in other states. Moreover, the Obama administration has begun to consider revoking the tax-exempt status of nonprofit schools and institutions that refuse to affirm this radical redefinition of marriage. This assault on religious freedom must be resisted by all people of good will.

The Center thanks the states of Ohio, Michigan, Kentucky, and Tennessee for defending the constitutionally guaranteed rights of their people, including the protection of conscience rights concerning the nature of marriage. The Center will continue to work with people committed to enhancing the social, economic, and spiritual well-being of the family, which is vital to every society, and reforming a system that has been violated by the very structures created to protect it.

Response to the Supreme Court Decision in <i>King v. Burwell<i>

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Response to the Supreme Court Decision in King v. Burwell
June 25, 2015
© 2015 by the National Catholic Bioethics Center

The National Catholic Bioethics Center respects the Supreme Court’s decision in King v. Burwell and, at the same time, calls on Congress and President Obama to collaborate in making necessary amendments to the Patient Protection and Affordable Care Act. The core constitutional dispute in King v. Burwell centered on whether clear language in legislation should control the implementation of law and whether the role of courts is limited to interpreting laws rather than helping to make laws. These principles are central to American constitutional governance and the rights it protects. The Supreme Court’s decision demonstrates that the Court is willing to overstep, as it has in the past, the limited role granted to it by the Constitution, in order to promote a social outcome it finds desirable. Such a decision undermines the authority of Congress and the legitimacy of the Court.

While the Supreme Court has settled the case of King v. Burwell, the problems that this one small piece of legislative language has caused—economically and jurisprudentially—should remind us of the significant problems that remain in the Affordable Care Act. While the need for authentic health care reform was apparent long before the Act was approved in 2010, the legislation was poorly drafted and hastily passed in a partisan manner. The confusion about how health insurance should be subsidized pales in comparison with other significant errors written into the Act. We object above all to its provisions for federal funding of abortion, its inadequate protection of conscience rights and religious freedom, and its concentration of health care control in the federal government, which increases the costs of care while disrupting the relationship between patients, doctors, and insurers. These problems are significant and should be addressed promptly and appropriately by the President and Congress through amendment of the Act.

The National Catholic Bioethics Center commits itself to working collaboratively with others to advance health care delivery and promote the health insurance reforms required to provide effective and ethical care for all, especially the most vulnerable in our society. The Center was established in 1972 to promote and safeguard the dignity of the human person in health care and the life sciences. It is unique among bioethics organizations in that its message derives from the official teaching of the Catholic Church, which draws from a moral tradition that acknowledges the unity of faith and reason while building on the solid foundation of natural law.

Official Testimony on Three-Parent Embryos for the Institute of Medicine

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Official Testimony on Three-Parent Embryo for the Institute of Medicine
May 22, 2015
© 2015 by the National Catholic Bioethics Center


On the 15th of this month Dr. Marie T. Hilliard, NCBC Director of Bioethics and Public Policy and registered nurse, shared her clinical and bioethical expertise in providing public testimony to the Institute of Medicine.  Dr. Hilliard explained how detrimental the current research is to women, the unborn, and society.  Though the purpose of the research, purportedly, is to prevent mitochondrial disease, in reality it is focused on a eugenics that destroy less than perfect human life.

To read a full copy of the NCBC Testimony, click HERETo read more on our current work in Public Policy, click HERE. 

Dr. Hilliard states, in no uncertain terms, that: "T his research is a far cry from therapeutic studies to modify in a healthy manner nuclear DNA. Animal studies are advancing in this area, so that one day treatment can occur without destroying or altering a human. Here is where our society's efforts should be concentrated, not on this research whose benefits remain unknown, whose impact on women and even the surviving embryos is blatantly negative, and whose impact on generations to come is uncharted." 

Please be sure to read the full testimony and keep abreast of the many initiatives the Center has undertaken in the area Public Policy.

HHS Mandate Continues to Oppress as The NCBC Defends Religious Freedom

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HHS Mandate Continues to Oppress as the NCBC Defends Religious Freedom
May 20, 2015
© 2015 by the National Catholic Bioethics Center


The NCBC again has been a signatory to an amicus brief in support of the right of organizations, especially faith-based organizations, to the free- exercise of religion guaranteed by both the First Amendment of the United States Constitution, as well as the Religious Freedom Restoration Act of our federal statutes.

To read a copy of the amicus brief and see the National Catholic Bioethics Center mentioned on the cover page and page 4, click HERE.

The U.S. Court of Appeals for the Eight District is hearing the appeal of Ozark College, a Christian college denied injunctive relief by a lower court and with an order of dismal of their complaint by the United States District Court for the Western District of Missouri Southern Division. Ozark College had sought relief from being mandated to violate its religious freedom by the unjust contraceptive mandate imposed by the U.S. Department of Health and Human Services, implementing some provisions of the Affordable Care Act (HHS Mandate). Ozark College is seeking relief from being forced to provide, through the contract with an insurance provider for which the College pays premiums, abortion inducing drugs and devices to their employees.  These egregious attacks on religious liberty continue to escalate, and the NACN-U.S.A. continues to advocate against such unjust mandates.  To date the NCBC has been a signatory to nineteen (19) such amicus briefs against the unjust HHS Mandate.

Transfer of Care vs. Referral: A Crucial Moral Distinction


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Transfer of Care vs. Referral: A Crucial Moral Distinction
May 1, 2015
© 2015 by the National Catholic Bioethics Center

Catholics working in the field of health care increasingly encounter conflicts between living out their religious convictions in good conscience and submitting to the immoral demands of patients, employers, or even the state. Requests for abortion, contraceptive drugs and devices, surgical sterilization, physician-assisted suicide, withdrawal or withholding of ordinary and proportionate treatments or basic human care, or other immoral procedures cannot be followed. This is clearly articulated in more than one directive of the Ethical and Religious Directives for Catholic Health Care Services, 5th ed. (Washington, D.C.: USCCB, 2009). Directives 27, 28, and 59 speak to this matter most directly:

“Free and informed consent requires that the person or the person’s surrogate receive all reasonable information about the essential nature of the proposed treatment and its benefits; its risks, side-effects, consequences, and cost; and any reasonable and morally legitimate alternatives, including no treatment at all.” (Directive 27, emphasis added)

“The free and informed health care decision of the person or the person’s surrogate is to be followed so long as it does not contradict Catholic principles.” (Directive 28, emphasis added)

“The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching.” (Directive 59, emphasis added)

A fundamental question arises when it becomes clear that the person cannot carry out such a request: what can be done if the patient, an employer or supervisor, or the law insists on a referral to another provider who will carry out the procedure? The National Catholic Bioethics Center regularly receives consultation requests regarding these challenging cases, which require the understanding and application of the moral principles governing cooperation with evil. These principles can be very complex and difficult to apply, but for this type of case the fundamental distinction is between formal cooperation, which is always immoral because the cooperator implicitly or explicitly wills the other’s evil action, and material cooperation, in which the cooperator does not will the other’s evil action.

Any form of referral constitutes formal cooperation, and would therefore be immoral. A “referral” in moral terms is when the person who refuses to do the immoral procedure directs the requesting person to another individual or institution because the other individual or institution is known or believed to be willing to provide the immoral procedure in question. Even if the person objecting does not explicitly command the requesting person to act, the provision of information because it is known or believed to enable the other to receive the immoral procedure amounts to a referral in moral terms. The objector implicitly wills the requestor’s accomplishment of the evil act. This would include an action such as providing a list of nearby providers who are known or believed to offer the immoral procedure.

The moral assessment of the referral does not change even if the action is required by one’s employer or by a state law. For example, a hospital regulation requiring a health care provider who objects to prescribing contraception to provide a patient with a list of other gynecologists in the network who will prescribe contraception would not exculpate the physician from formal cooperation with evil. A state law mandating that Catholic hospitals provide patients who request abortion with a list of other facilities or providers that it knows or believes will perform abortions would not exculpate the hospital from formal cooperation with evil.

What can a Catholic health care provider or institution do in these cases without becoming involved in immoral cooperation? First, every attempt should be made through a professional and pastoral effort, using reasonable and prudential judgment, to dissuade the patient from the harmful and morally problematic choice. This imperative is found in the call to explain “any reasonable and morally legitimate alternatives, including no treatment at all” (Directive 27) and to provide “access to medical and moral information and counseling so as to be able to form his or her conscience” (Directive 28); in other words, it is a call to help the patient understand the magnitude of the harms of the immoral procedure, taking into account “the well-being of the whole person” (Directive 33), so as to provide the patient with genuine and holistic health care.

When all else has failed, if the patient is insistent on pursuing the immoral and harmful choice, health care providers and institutions may be unable to prevent this. Ultimately, the patient is an independent moral agent who is free to decide where and from whom he or she will seek care. The provider or institution may remind the patient of this, and may offer to assist the patient with accomplishing a transfer of care to another provider or institution of the patient’s choosing, without stating where the patient might go to receive the immoral procedure or otherwise directing the patient to it. A general list of other providers or institutions based on geographic vicinity or even area of specialty might be provided; however, the list may not be developed based on the criterion of whether they are known or believed to offer the immoral procedure. In practice, this means that the list must include any providers or institutions that fit the chosen criterion (geography, specialty, both, or other) and also oppose the immoral practice. In the case of objections to contraception, for example, a list of local gynecologists should include those who offer only natural family planning.

500 Groups Join the NCBC in Protecting Health Care Coverage

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500 Groups join the NCBC in Protecting Health Care Coverage
May 19, 2015
© 2015 by the National Catholic Bioethics Center

Over 500 healthcare, patient, employer, and veteran rights groups have joined The National Catholic Bioethics Center as signatories in an open letter to Congress calling for the repeal of the Independent Payment Advisory Board (IPAB)IPAB is responsible for making cuts to Medicare expenditures if program spending reaches a certain level established by statute. However, the IPAB is comprised of executive branch appointees.  Their recommendations to the Secretary of Health and Human Services, if implemented, are not subject to judicial review. As the letter to Congress put it, “An unelected board without adequate oversight or accountability would be taking actions historically reserved for the public’s elected representatives in the U.S. House and Senate.”  Clearly, this is not in the best interest of our Nation’s health, especially the health of vulnerable persons whose only health care coverage is through Medicare. 

To read the open letter to congress and see the NCBC named as signatory on page 11, click HERE.

Catholic Nurses get a Voice at the UN

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Catholic Nurses get a Voice at the UN
May 11, 2015
© 2015 by the National Catholic Bioethics Center


Through the efforts of Dr. Marie Hilliard, Director of Bioethics and Public Policy for NCBC, and member of the Board of Directors of the National Association of Catholic Nurses-U.S.A. (NACN-U.S.A.), the International Catholic Committee of Nurses and Medico-Social Assistants (CICIAMS) continues to have a voice at the United Nations.

NACN-U.S.A. is a member of CICIAMS.  CICIAMS collaborates with the Pontifical Council for Health Care Workers, Pontifical Council of the Family and Pontifical Council of the Laity and has been designated as a non-governmental agency (NGA) with ability to speak at the United Nations.  However, CICIAMS’ general secretariat is in Vatican City.  Dr. Hilliard became aware of the inability of CICIAMS to be present to have a voice at the United Nations.  As the Regional Representative of the northeast United States, Dr. Hilliard secured four highly credentialed members of NACN-U.S.A to represent CICAMS at the United Nations: Dr. Patricia Sayers, MSN, DNP, RN; Maria Arvonio, BSN, MA, RN; Dr. Marion Nowak, MEd, MPh DNP, RN; and Patricia Staley, RN.

Dr. Patricia Sayers’ recent intervention on behalf of the well being of vulnerable women in countries around the world can be seen HERE. 

The voice of reason and advocacy for sound policy for true women’s health is greatly needed in all public policy arenas. Thankfully, that voice is now provided by Dr. Sayers, while the NCBC, NACN, and all the representatives  of CICIAMS continue proudly in adding to the chorous.

The NCBC Joins the Official Pennsylvania Coalition to Stop Doctor-Prescribed Suicide

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The NCBC Joins the Official Pennsylvania Coalition to Stop Doctor-Prescribed Suicide
April 22, 2015
© 2015 by the National Catholic Bioethics Center



We, The National Catholic Bioethics Center, have joined the Pennsylvania Coalition to Stop Doctor-Prescribed Suicide. The Coalition, which is an alliance of disability rights, healthcare, civil rights, faith-based, and patient advocacy organizations, is dedicated to preventing legalization of Doctor-Prescribed Suicide in the state of Pennsylvania. This legislative year alone, 16 states and the District of Columbia have introduced proposals to legalize Doctor-Prescribed Suicide. Fortunately, these initiatives have failed in six states so far this legislative year. The misinformation, however, continues to flow into the media about why persons “need” this option. The data support that the reasons for requesting Doctor-Prescribed Suicide have more to do with fear of loss of autonomy, enjoyment in activities of living, and dignity (which a person should never be made to feel, no matter how dependent on others) than the false representations presented by advocates of Doctor-Prescribed Suicide. In fact, data from the Oregon Public Health Division, which gathers statistics for the total period in which Doctor-Prescribed Suicide has been legal in that state (since 1998) indicate that financial concerns and pain are the lowest two reasons, in frequency, for requesting Doctor-Prescribed Suicide (See:

In recent years three states have legalized Doctor-Prescribed Suicide (Oregon, Washington, and Vermont), and another two states have court decisions removing criminal penalties for physician participation (Montana, and one county in New Mexico with that decision under appeal).

The Catholic Church, sponsor of the largest number of non-governmental health care agencies in the United States, has a rich tradition concerning our obligation to walk with others as they journey toward death, and not to abandon them to the hopeless alternative of Doctor-Prescribed Suicide.  The potential abuses of the vulnerable, including the elderly and those with disabilities are real.  Please become informed through the Coalition’s website, which also provides you with a mechanism to have your voice heard by your own legislator: 

For those in other states, contact your State Catholic Conference accessed through:


As Pope Emeritus Benedict has stated in the powerful encyclical Spe Salvi (In Hope We Are Saved, 2007 ):


"The true measure of humanity is essentially determined in relationship to
suffering and to the sufferer. This holds true both for the individual and for
society. A society unable to accept its suffering members and incapable of
helping to share their suffering and to bear it inwardly through “com-passion”
is a cruel and inhuman society. (II, 38.)"

The NCBC Notes the Passing of Cardinal Francis George

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The NCBC Notes the Passing of Cardinal Francis George
April 17, 2015
© 2015 by the National Catholic Bioethics Center


The National Catholic Bioethics Center notes with sadness the passing of its beloved board member His Eminence Francis Cardinal George, OMI.  Cardinal George had been appointed to the board of directors for life and served for the past 22 years.  He was vitally important to the growth of the Center and the development of its many programs.

Cardinal George was an intellectual leader within the Catholic Church and shepherd for Chicago, the third-largest diocese in the United States. He was the eighth archbishop and the spiritual leader of its more than 2 million Catholics, but his influence reached well beyond his episcopal  jurisdiction.

He was a valued advisor to the Holy See, one of the electors of Pope Benedict XVI, and a man who fearlessly advocated the truth of the Catholic Faith, in season and out of season.




The National Catholic Bioethics Center benefitted from his wise counsel while he was with us and it can certainly count on his prayers now that he has returned to his Father’s house.


The National Catholic Bioethics Center

The NCBC Recommends Caution Regarding New Graft/Transplant Proposals

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The NCBC Recommends Caution Regarding New Graft/Transplant Proposals
April 14, 2015
© 2015 by the National Catholic Bioethics Center



At the end of March, The National Catholic Bioethics Center provided public comment to the Organ Procurement and Transplantation Network (OPTN) and voiced concerns about language used in new proposals that could allow for living organ donors to undergo dangerous transplantation procedures. The NCBC's Director of Public Policy, Dr. Marie Hilliard, led a coordinated effort with the National Catholic Partnership on Disability (NCPD) to strongly recommend that the proposals be revised and clarified to explicitly protect the rights of donors, to provide clear and separate applications for dangerous donations that require a deceased donor, and to avoid open-ended language that could allow for living donors to have procedures such as a larynx removal even though a larynx transplant would "most likely lead to the death of a donor."


In our submitted commentary, the Center  fully acknowledges that the Catholic Church seeks to "encourage organ donation as providing a gift of life to those in need" and that,  "in terms of both living and deceased donors, the same generosity of donors is recognized." Yet organ donation is appreciated and accepted fully only so "long as there is respect for true informed consent, donor and recipient safety, and human physical integrity."  The NCPD, for its part, added  that those with disabilities must always be considered, and their rights and needs protected by our government, whenever "any regulatory policy is being developed."


We at the NCBC hope that our comments will be helpful, will defend human dignity, and will secure the public safety that we are all expected to protect.


To read a full copy of the NCBC's submitted commentary, click HERE.


For more information on the new OPTN proposals and rules in questions, click HERE.

The NCBC Completes Successful Seminar in Los Angeles

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The NCBC Completes Successful Seminar in Los Angeles
April 10, 2015
© 2015 by the National Catholic Bioethics Center


At the beginning of this year, in response to a rapid increase in enrollment, the NCBC began offering a Mid-Academic Year schedule for our Certification Program in Catholic Health Care Ethics. To help prepare our new group of mid-year program participants, the NCBC added a new Health Care Ethics Seminar date to the list, this time hosted in sunny Los Angeles. During these weekend intensives — an important element of our yearlong program — participants embark on a two-day journey into the field of bioethics. The seminars cover the fundamentals of Catholic ethics and elucidate Church teaching on health care for both NCBC Students and anyone interested who might choose to attend. This NCBC program provides a truly firm foundation and understanding of key issues in particular topics in bioethics. 

The generosity of the Archdiocese of Los Angeles allowed the NCBC to bring its seminar to beautiful California, and between the active engagement and participation of our new students and the excellent West Coast weather, the Ethicists at the Center all considered the weekend to have been a true success.


New dates for the coming Fall Seminars will be announces soon, so be sure to keep your eye on our programming page at
For more information on our Seminars in Health Care Ethics, click HERE.

Best of luck to our new students!


The NCBC Supports: The National Association of Catholic Nurses

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The NCBC Supports: The National Association of Catholic Nurses
March 11, 2015
© 2015 by the National Catholic Bioethics Center


As the Director of Ethics and Public Policy at the National Catholic Bioethics Center, Dr. Marie Hilliard is always at the forefront of Catholic policy and public health initiatives. From her assistance in defending the rights of organ donors to her active participation with the National Catholic Partnership on Disability, Dr. Hilliard lends NCBC's support, and much of her own time, to numerous important Catholic medical-ethics organizations. Of these, one new and promising group is The National Association of Catholic Nurse - USA.

NACN is one of the fastest-growing Catholic nursing organizations in the United States – it has tripled its growth in the last year and a half – and Dr. Hilliard, who sits on the NACN board, works with NACN members to support their fellow health care workers as they preserve the lives and health of others while upholding Catholic principles and protecting the whole human person. Dr. Hilliard, a registered nurse herself, knows there is no greater need for nurses today than to take strength and courage in knowing that many others share their concerns and struggles.

Please help inform others about the National Association of Catholic Nurse - U.S.A. by sharing the most recent NACN Newsletter, HERE, with any Catholic nurses and health care professionals you may know.

As the National Association of Catholic Nurses continues to grow, we at the NCBC wholeheartedly support its mission to recapture the essence of nursing as a ministry.

We hope you will support them also.
WATCH: Father Tad Live Television Interview -- March for Life Special

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The National Catholic Bioethics Center
WATCH Father Tad Live Television Interview -- March for Life Special
January 28, 2015
© 2014 by the National Catholic Bioethics Center

NCBC Ethicist and Director of Education, Father Tad Pachoczyk, made a special appearance on the annual March for Life Episode of EWTN's The World Over with Raymond Arroyo. Father Tad spoke at length with Raymond about abortion and also covered other topics in bioethics including the importance of well-ordered human sexuality, surrogacy, and even the Pope's 'Rabbit' comments!

Watch the full interview below:

The NCBC Continues to Support Religious Freedom

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The National Catholic Bioethics Center
The NCBC Continues to Support Religious Freedom
January 15, 2015
© 2014 by the National Catholic Bioethics Center


January 15, 2015

The NCBC continues to support the religious freedom of numerous employers being forced to comply with the U.S. Department of Health and Human Services (HHS) Contraceptive Coverage of Employees Mandate. NCBC has signed another amicus brief in support of these rights, in the case of Michigan Catholic Conference, et al., v. Sylvia Burwell, Secretary of Health and Human Services, et al.

NCBC President, Dr. John Haas, Reporting from Rome this Week
Read the whole story on the NCBC Blog, HERE.
Physician-Assisted Suicide and the Death of Brittany Maynard

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The National Catholic Bioethics Center
Physician-Assisted Suicide and the Death of Brittany Maynard
November 5, 2014
© 2014 by the National Catholic Bioethics Center

Brittany Maynard, who was told by doctors that she had only six months to live after being diagnosed with an aggressive form of brain cancer, ended her life last week on November 1, a date she had selected ahead of time. The 29-year-old took a fatal dose of barbiturates, prescribed by her doctor, at her home in Portland, Oregon, surrounded by her husband and other members of her family.

The National Catholic Bioethics Center expresses its sadness and regret over the untimely close of the life of such a vigorous young woman. Her decision to end her life by self-inflicted means reminds us of the tragic reality of suicide and the injustice of laws encouraging physician-assisted suicide. Such laws facilitate the making of unreasonable decisions among those feeling weak and vulnerable as they face a serious disease or old age. Such laws encourage us to abandon the vulnerable to a hastened death, rather than building up the needed human solidarity and mutual support critical to journeying through such important personal moments of crisis. Such laws undermine the noble profession of medicine, redirecting health care workers away from their core mission of healing and toward the works of death and killing.

Suicide has always been recognized as a tragedy, and it is invariably harmful and hurtful on many levels. Brittany argued that she would not really be committing suicide if she chose to take her own life: “They try to mix it up with suicide and that's really unfair, because there's not a single part of me that wants to die,” she told People magazine. “But I am dying.” Clearly her words, that “there’s not a single part of me that wants to die,” indicate that this is a tragedy, enabled by a growing cultural phenomenon that asserts that the only way to eliminate suffering is to eliminate the sufferer. This is a palliative care failure, and Brittany deserved better from the medical community and from society itself.

No one is obligated to use heroic or extraordinary means to stay alive, but one should use ordinary and reasonable measures to treat disease and sickness and to prepare for natural death. However, the honorable profession of medicine never should be used to help a person to directly take his own life or to treat the objective good of life as if it were an evil to be directly extinguished.  This clearly is a disordered and eminently unethical act opposed to the meaning of medicine.

What Brittany chose to do was motivated by fear. She feared suffering. She feared pain. She feared losing control. In a culture that labels assisted suicide as a compassionate choice, she was made to feel that by attacking her own life, she was gaining control over her life, but this was entirely false.

When society fosters such fears so that we believe our best option is to kill ourselves, this is not true compassion. It is a false compassion that does not accompany the sufferer, but relegates him or her to a life without hope. It is, in fact, a form of abandonment by the medical community. It is not a “death with dignity” but the frightening indignity of verbal engineering pretending that violence is not really violence. Her death represents a tragedy that tears at our shared humanity, and a failure on the part of all of us in allowing unjust laws like the one in Oregon through which such violent and hurtful actions are granted legal status and the veneer of social acceptability.

We remember Brittany and we grieve with her family.


The Ethicists of The National Catholic Bioethics Center

The National Catholic Bioethics Center Comments on New HHS Proposed Rules

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The National Catholic Bioethics Center
The National Catholic Bioethics Center Comments on New HHS Proposed Rules
October 22, 2014
© 2014 by the National Catholic Bioethics Center


The National Catholic Bioethics Center submitted comment on the Proposed Rules on coverage of certain preventive services under the Affordable Care Act (“ACA”), known as the “Contraceptive Mandate.” Specifically the Proposed Rules purport to afford an “accommodation” to specific closely-held for-profit companies for compliance with the Contraceptive Mandate, in light of the U.S. Supreme Court rulings in Burwell v. Hobby Lobby Stores, Inc. (“Hobby Lobby”) and Wheaton College v. Burwell.  However, what the federal government is proposing is clearly more restrictive of religious freedom than provided for by the decision of the Supreme Court. 

To read the complete analysis submitted by The National Catholic Bioethics Center, please click HERE.

You can also read what the NCBC stated at the time the proposed rules were first announced

To see a full listing of the NCBC's involvement in current affairs and to keep abreast of the new developments in Bioethics and Public Policy, visit our Advocacy page: HERE

Guidelines from the Congregation for the Doctrine of the Faith Concerning Cooperation between Catholic and Non-Catholic Entities Now Available

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The National Catholic Bioethics Center
Guidelines from the Congregation for the Doctrine of the Faith Concerning Cooperation between Catholic and Non-Catholic Entities Now Available from the NCBCm
September 24, 2014
© 2014 by the National Catholic Bioethics Center


The National Catholic Bioethics Center continues to provide instructive and thought-provoking medical-ethical content to its members and subscribers through its books, journal, and other publications. As a service to all, the Publications Department also provides free access to significant documents through its OpenAccess initiative.

Our most recent 
OpenAccess posting is an instructive resource issued in March by the Congregation for the Doctrine of the Faith concerning Cooperation Between Catholic and non-Catholic Entities in the area of health care. 

For Catholic health care institutions, providing effective health care in the United States often means collaborating with non-Catholic health care organizations. The Congregation for the Doctrine of the Faith produced Some Principles for Collaboration with Non-Catholic Entities in the Provision of Health Care Services to help those who govern Catholic institutions ensure a faithful witness of the Church in joint working arrangements. The document provides guidance for avoiding immoral cooperation and for avoiding the cause of scandal to: "[F]ellow Catholics and Christians, or to other persons of good will who look to the Church ... for moral guidance.” The United States Conference of Catholic Bishops released the Principles to all US bishops in March 2014. It was reprinted, with permission, in the Summer 2014 issue of the National Catholic Bioethics Quarterly and is available to you here

To read the full document from the CDF, please click HERE.

For more OpenAccess, please click HERE.

HHS Mandate Regulatory Updates Fail to Respect Religious Liberty

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The Ethicists of The National Catholic Bioethics Center
HHS Mandate Regulatory Updates Fail to Respect Religious Liberty
August 27, 2014
© 2014 by the National Catholic Bioethics Center

On August 22, 2014, the Department of Health and Human Services announced
 interim final rules regarding mandatory coverage of certain so-called preventive services for women, including contraceptive and abortifacient drugs and devices. The rules modify the existing “accommodation” designed for religious ministries such as Catholic charities and hospitals, which are referred to as “eligible organizations.”


Under the new rules, these organizations may adopt an alternative method of self-certification: they may directly notify HHS of any religious objections, identifying the insurance plan name and type, and naming their third party administrators and insurance issuers. With this information, HHS would direct the latter to provide employees of the organization with the insurance coverage to which the organization has objected.


On the same day, the Centers for Medicare & Medicaid Services announced proposed rules that would modify the definition of “eligible organization” to include “closely held for-profit organizations.”


The HHS interim final rules and CMS proposed rules come in response to the Supreme Court decision inBurwell v. Hobby Lobby, which upheld religious freedom by determining that a closely held for-profit employer—and potentially any for-profit employer—is protected under the bipartisan Religious Freedom Restoration Act of 1993 from being forced to include insurance coverage for practices to which it objects in any employer-sponsored health care insurance.


The National Catholic Bioethics Center regrets that the new rules fail to respect religious freedom and fail to address the underlying injustice in the HHS Mandate. The distinction between a “house of worship” and a mere “eligible organization” remains unchanged, discriminating between two classes of religious exercise: the former is considered worthy of a full exemption from the unjust mandate, while the latter is forced to participate in the government’s mechanism for providing coverage to which it objects. Monasteries may be exempt, but dioceses, hospitals, and universities that put their faith into public action must still be conscripted into a governmental process promoting evils that conflict with their faith and witness.


There also continues to be no provision for the conscience rights of persons and organizations whose objections are not connected with a particular religious belief, but who do not wish to be complicit in the physical, emotional, and spiritual harms of contraceptive drugs and devices, surgical sterilizations, and the destruction of unborn human beings.


Neither has the government abandoned its insistence that employers offer contraception, sterilization, and abortifacient coverage as a condition for providing health care insurance to employees at all. This is contrary to right reason, the natural law, and the interests of universal access to basic health care. It is startlingly similar to the injustice that Saint John Paul II decried as an exploitation of the developing world, and it deserves the same moral condemnation: 


Today not a few of the powerful of the earth...prefer to promote and impose by
whatever means 
a massive programme of birth control. Even the economic help
which they would be ready to give is unjustly made conditional on the acceptance
of an anti-birth policy....Aside from intentions, which can be varied and perhaps can
seem convincing at times, especially
if presented in the name of solidarity, we are in fact faced
by an objective “conspiracy against life"...engaged in encouraging 
and carrying out actual
campaigns to make contraception, sterilization and abortion widely available. Nor can it be
that the mass media are often implicated in this conspiracy, by lending credit to 
that culture which presents recourse to
contraception, sterilization, abortion and even euthanasia
as a mark of progress and a victory of freedom, while depicting
as enemies of freedom
and progress those positions which are unreservedly pro-life. 

(Evangelium vitae, nn. 16-17)


There is no doubt that the new rules require the involvement of religious ministries and objecting for-profit businesses in material cooperation with the evils of contraception, sterilization, and abortion.


The “notice” that these organizations may now provide in lieu of Form 700 requires them to provide the name and type of their insurance plan and the contact information for their third party administrators and insurance issuers, explicitly identifying for the government the entities that will carry out the provision of objectionable coverage in the employer’s stead. The new rules acknowledge that this “represents the minimum information necessary . . . to implement the policies in the July 2013 final regulations.” It is another way of saying that the government needs the employer to provide this information so it can make certain that employees receive the coverage to which the employer has just objected.


The root moral concerns remain the same, regardless of how many levels of intervening bureaucratic cushioning the administration attempts to create. Any employer who wishes to provide comprehensive, good quality, employer-sponsored health care coverage cannot do so without participating in the government’s scheme to provide employees with the very coverage to which the employer objects. Judge Pryor wrote about the role of Form 700 in Eternal Word Television Network v. Sebelius, but his words seem to apply equally well to the newly allowed alternative notice: “It is undeniable that the United States has compelled the Network to participate in the mandate scheme. . . To be sure, federal law requires contraceptive coverage whether or not the Network signs the form. But the problem in this appeal is that federal law compels the Network to act.”


With this eighth iteration of the regulations, the consistent and disturbing refusal of the administration to provide a full exemption to religious ministries—and to any employer with a religious or conscience objection—conveys a distinct lack of respect for religious liberty and conscience rights, and continues to insist on the attachment of unjust and harmful conditions to the provision of basic health care coverage.


regarding the definition of eligible organizations are open for written comments until October 21, 2014.The National Catholic Bioethics Center will submit its comments in support of religious liberty and conscience rights to the appropriate governmental bodies indicated in the respective rules, and strongly encourages all people of good will to do likewise. The HHS interim final rules regarding the accomodation are in effect as of August 27, 2014, the date of official publication in the Federal Register. Written comments must be received by October 27, 2014. The CMS proposed rules 
The Ice Bucket Challenge and Lou Gehrig's Disease Research

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The Ethicists of The National Catholic Bioethics Center
The Ice Bucket Challenge and Lou Gehrig's Disease Reasearch
August 22, 2014
© 2014 by the National Catholic Bioethics Center


The Ice Bucket Challenge aims to raise awareness for amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease. According to the website of the ALS Association (ALSA), here is how it works:


                              The challenge involves people getting doused with buckets of ice water on video,
                              posting that video to social media, then nominating others to do the same, all in 
                              an effort to raise ALS awareness. People can either accept the challenge or make a 
                              donation to an ALS Charity of their choice, or do both.


Posed in this manner, there is nothing morally problematic about the nature of the challenge. Accepting the challenge does not require any donations, but helps promote the primary goal of raising ALS awareness. Those declining the challenge are encouraged to “make a donation to an ALS charity of their choice,” but there is no legal or moral obligation to do so, nor is there any requirement that a donation go to ALSA. Naturally, those who accept the challenge are also free to make a donation to an ALS charity. Some, such as the schools of the Archdiocese of Cincinnati, are choosing to accept the challenge while also making donations to other organizations that promote awareness and support for persons with ALS.


Since the challenge started trending in late July 2014, it has successfully raised awareness about the disease on a dramatic scale, accomplishing its main purpose with great creativity and fun. It has also generated more than 40 million dollars in donations to promote research into causes of ALS and the development of new treatments.


Given its size and the significant amount of research, awareness, and support work with which it is involved, ALSA has been the primary recipient of many if not most donations resulting from the challenge. ALSA has also helped to promote the challenge on its website and through social media in accordance with its good aims as a charitable organization.


The public attention and funds being directed toward ALSA as a result of the Ice Bucket Challenge raise an important, but not widely know moral concern: ALSA also advocates for human embryonic stem cell research, including through funding for specific research projects. As indicated in the Advocacy Archive section of their website, they were active in encouraging expanded funding for embryonic stem cell research as soon as President Obama took office: “Earlier this month, the Coalition for the Advancement of Medical Research, of which The ALS Association is an active member, sent a letter to President Obama urging him to quickly to lift the restrictions on embryonic stem cell research.” Another advocacy group for patients with ALS, called Project ALS, is similarly on record encouraging human embryonic stem cell research.


In its Instruction Dignitas personae, the Congregation for the Doctrine of the Faith speaks clearly to the moral problems with the use of embryonic stem cells, even for noble and therapeutically effective ends:


The obtaining of stem cells from a living human embryo ...  invariably causes the death 
of the embryo and is consequently gravely illicit: “research, in such cases, irrespective of efficacious therapeutic results, is not truly at the service of humanity. In fact, this research advances through the suppression of human lives that are equal  in dignity to the lives of other human individuals and to the lives of the researchers themselves. History itself has condemned such a science in the past and will condemn it in the future, not only because it lacks the light of God but also because it lacks humanity”
(n. 32, quoting Pope Benedict XVI).

ALSA acknowledges that there are relevant ethical concerns surrounding the use of embryonic stem cells: "The discovery that human embryonic stem cells can be isolated and propagated in the lab with the potential of developing into all tissues of the body is a major medical breakthrough. But it has raised ethical concerns." When asked about the ALSA position on human embryonic stem cell research, Carrie Munk, a spokeswoman for the Association, noted in an e-mail to Religion News Service that the organization primarily funds adult stem cell research: “Currently, The Association is funding one study using embryonic stem cells (ESC), and the stem cell line was established many years ago under ethical guidelines set by the National Institute of Neurological Disorders and Stroke (NINDS); this research is funded by one specific donor, who is committed to this area of research,” she said. “The project is in its final phase and will come to an end very soon.” Nonetheless, the organization does not clearly rule out the prospect of funding for ESC research.


Potential donors seeking to support laudable causes, such as research for cures to serious diseases, face the challenge of exercising due diligence, so that their funds are properly utilized and not misdirected or otherwise targeted by an advocacy organization to support immoral projects.


When foundations have a generally sound list of activities but promote an intrinsically immoral activity as well (such as abortion, human embryonic stem cell research, or contraception), donors must consider the serious matter of the fungibility of donated funds. Whenever we participate in fundraising for such organizations, even if they assure us that specified funds will only be used for activities with an ethical profile, it can end up being little more than a shell game. In this sense, there is a real danger that our fundraising activities may not only engender scandal, but may even contribute to the perpetuation of grave evils like abortion and human embryonic stem cell research. The duty to affirm the dignity of human life, and associated questions of scandal resulting from a lack of clarity, can become more significant—with a corresponding need for caution about where the funding is going—when Catholic authorities or institutions such as dioceses and schools are involved.


Donors who are concerned about the misuse of funds by groups such as ALSA, Project ALS, or others should consider notifying those organizations of their reasons for choosing not to donate, encouraging them to cease advocacy and funding for ESC research, raising awareness about the immoral destruction of human life through embryonic stem cell research, and donating to alternative ALS research and advocacy groups that do not support or promote human embryonic stem cell research. Several examples of such groups can be mentioned:


The Cell Therapy Foundation specifically promotes adult stem cell research. On their website, it is possible to donate in a directed way to specific research, including ALS:

Compassionate Care ALS offers much-needed care and treatment for people living with ALS (instead of focusing on scientific research and the development of therapies):

 Massachusetts Citizens for Life reported in a recent newsletter that the ALS Therapy Development Institute (, when asked on the phone about this issue, said they do not support research with embryonic stem cells “because they think induced pluripotent adult stem cells are the best avenue to a cure.” The newsletter also noted that “they do not have a principled objection to using embryonic stem cells but said they understand the gravity of the issue and would be very public if they change their position so donors and potential donors would be aware.”
Dr. John Haas Delivers Successful Presentations on Eugenics in Modern Society

President of the National Catholic Bioethics Center, Dr. John Haas, completed three powerful presentations this month at key events in Texas and Los Angeles. During his address concerning The Face of New Eugenics in Austin at St. John Neumann Parish, Dr. Haas grappled with the seemingly unmitigated­­­­--and ever increasing-- use of medical technology in manipulating humans from the unborn to the aged. The event was held by the Catholic Healthcare Guild of Central Texas and was close to capacity. Later, Dr. Haas went to the Chancery to give a presentation on end-of-life issues in an event sponsored by Seton Healthcare, the Diocese of Austin and the Texas Catholic Conference. This event was very well attended and even ran overtime as Dr. Haas answered numerous excellent questions from the audience.


Following the whirlwind of events in Texas, Dr. Haas headed West once more; this time he was to speak at theEugenics and Ethics Conference of the Archdiocese of Los Angeles. The conference, held last weekend, July 26th, was a cooperative event between the Archdiocese of Los Angeles and the National Catholic Bioethics Center. The event enjoyed the great support and preparation of NCBC board members, The Most Reverend Archbishop Gomez and Doctor Vincent Fortanese. Dr. Haas was happy to report that the event was: "Truly, a success." The event included not only Dr. Haas' presentation on the modern Threats and Challenges of Eugenics, but also from NCBC Director of Education, Father Tad Pacholczyk, who spoke at length on the The Catholic Moral Tradition in Defense of Human Dignity. Dominican Priest and Friend of the NCBC, Nicanor Austriaco, OP, S.T.L., Ph.D.,  also spoke on The New Biotechnologies of the 21st Century and Dr. Fortanasce, gave a talk entitled: The Spin – Hiding the Truth.


The event was followed by an award ceremony, where Dr. Haas had the pleasure of spending time with his colleagues and co-presenters as awards were given to Catholic individuals who have been influential in Los Angeles.



                    Speakers relax during the award ceremony and dinner.
     From Left: Jennifer Lahl, Father Nicanor Austriaco, Father Tad, and Dr. John Haas


Congratulations to all who were involved in such an excellent endeavor.


More photographs from the event will be forthcoming and will appear on the NCBC BLOG, so be sure to check back there soon.


To see a poster from the event, click HERE


Thank you for all your incredible work, Dr. Haas!
The NCBC Response to SCOTUS Decision in Support of Religious Freedom

The National Catholic Bioethics Center hails the decision today of the United States Supreme Court in support of the religious freedom of the owners of Conestoga Wood Specialties Corporation and Hobby Lobby Stores Incorporated. These family-owned businesses took the courageous stand of challenging the assault on their religious freedom, under the guise of preventative health care, by the U. S. Department of Health and Human Services’ contraceptive mandate.  The mandate requires virtually all employers to provide contraceptive, abortifacient, and surgical sterilization insurance coverage, at no cost to the employees, regardless of the deeply held religious objections of employers.  Both Conestoga Wood and Hobby Lobby  argued that their deeply held religious beliefs concerning the sanctity of human life were violated by HHS forcing them to pay for abortifacient drugs and devices for their employees.

The contraceptive mandate represents a significant violation of the Religious Freedom Restoration Act.  The  federal  government had  argued  that  neither  for-profit  corporations,  nor  even  the  individuals  running  them,  have  any rights  guaranteed under the Religious Freedom Restoration Act.  Specifically, in  its  legal  arguments,  the  federal  government  refused  to  acknowledge  that corporations  can  have  a  conscience.   This bias against persons of faith should give every citizen in this country, founded in the name of freedom, great pause.

However, today the Supreme Court affirmed that closely held companies, such as these family-owned businesses, are not to be treated as second class citizens by having their right to religious freedom denied by being subjected to the untenable choice of either abandoning their deeply held religious beliefs or incurring the substantial burden of crippling fines.

In celebrating this reaffirmation of the Religious Freedom Restoration Act , and all that it has been promulgated to protect, The National Catholic Bioethics Center  also wishes to express its gratitude to the families of the Conestoga Wood Specialties Corporation and Hobby Lobby Stores Incorporated for their  courage in defending the sacred right of religious freedom at great fiscal peril.  The NCBC was a party to the amicus brief in support of the rights of these two companies, and finds hope for the continued protection of religious freedom in this decision.   Dr. John Haas, President of The National Catholic Bioethics Center, stated today, “It is indeed a good day for the United States of America and for these families who were willing to assume great personal risk to speak on behalf of justice and religious liberty."
The NCBC Supports The Archdiocese of Philadelphia and Its Lawsuit Against the HHS Mandate

On June 3, 2014, the Archdiocese of Philadelphia announced that it has filed suit, together with its affiliated charitable organizations, against the federal government to secure protection against the HHS Mandate. The Mandate is a regulation of the Affordable Care Act (ACA) requiring that all employer-provided health insurance coverage include contraceptive and abortion-inducing drugs and devices free of cost sharing. A narrow religious exemption in the regulation applies only to houses of worship, excluding charitable ministries such as many Catholic educational institutions and health care ministries. The National Catholic Bioethics Center supports the courageous stance of the Archdiocese against this unjust regulation, which seeks to impose a “choice” between the untenable alternatives of supporting the intrinsic evils of contraception, sterilization, and abortion or ceasing to provide basic health care coverage to its employees.

St. Thomas Aquinas reminds us that “when a law is contrary to reason, it is called an unjust law; but in this case it ceases to be a law and becomes instead an act of violence” (Thomas Aquinas, Summa theologiae, I-II, q. 93, a. 3, ad 2um). The Archdiocese of Philadelphia bears witness to Christ in opposing this violation of the natural moral law and religious liberty. In the words of Pope Saint John Paul II, “it is precisely from obedience to God . . . that the strength and the courage to resist unjust human laws are born” (Evangelium vitae, n. 73). We pray for the success of the court challenge and for the elimination of the unjust regulations.


- The National Catholic Bioethics Center - 

The National Catholic Bioethics Center Supports: The CMA's Medical Student Boot Camp
This Summer, Catholic medical students from across the country can take advantage of a unique opportunity at Saint Charles Borromeo Seminary in Wynnewood, Pennsylvania. The Catholic Medical Association, in primary partnership with St. Charles Borromeo Graduate School of Theology, will be holding a four-day intensive formation experience. The Annual Medical Student Boot Camp will consist of prayer, study, practical training, and mentoring with leading Catholic Physicians, Priests, and Moral Theologians from the area. 

The CMA looks to provide students with the support and the tools to: "Live and thrive as faithful Catholic Physicians," to "develop skills to organize Catholic support groups within medical schools," and to "evangelize the Catholics and non-Catholics encountered throughout medical training.

The NCBC supports the organization of such a program and invites you to spread the word to any Catholic medical students you may know who would benefit from the CMA event.

The Boot Camp will take place from June 17-22 and requires application beforehand. Successful applicants will have 90% of their travel expenses covered by the program sponsors!

If you, or anyone you know would like to participate in this excellent experience, please visit the program website and registration page, HERE.

Thank you for your continued support of The National Catholic Bioethics Center and of Catholic Medical ethics around the area. Please continue to pray for us and for all of our endeavors.

May God Bless you always.

The National Catholic Bioethics Center
New Documents Available From The NCBC


The National Catholic Bioethics Center continues to provide instructive and thought-provoking medical-ethical content to its members and subscribers through its books, journal, and other publications. As a service to all, the Publications Department also provides free access to significant documents through its OpenAccess initiative.

Our most recent 
OpenAccess posting is a powerful essay from the Spring 2014 issue of the National Catholic Bioethics Quarterly. Written by Richard Stryker and titled “Poor Prenatal Diagnosis—A Father’s Journey,”  the piece is a powerful exploration of a father's love for his unborn child. When his daughter is diagnosed in utero with a fatal illness, Mr. Stryker discovers—through his wife’s pregnancy, his daughter’s birth, and the brief hours they have with her after birth—new meanings in the role of father and the wonder of family.

Take a moment to visit our 
OpenAccess page and read Mr. Stryker's moving work, HERE.

Also available today is the Summer edition of the “Washington Insider,” by William Saunders. Among other timely matters, the Summer column discusses the upcoming Supreme Court ruling on the HHS mandate and provides updates on important state-level legislation. You can read the new “Washington Insider,” 

The “Washington Insider”  appears in every issue of 
The National Catholic Bioethics Quarterly and is posted online every three months before print publication. Access is free to all. The “Insider” provides a running commentary on Catholic bioethics and public policy in the United States. A trove of timely legal and legislative information, it offers a fascinating blend of background and insight into the country’s social and policy debates. Its two distinguished authors are Richard Doerflinger, associate director of the USCCB Secretariat of Pro-life Activities, who contributes the Spring and Autumn columns; and William Saunders, senior vice president and senior counsel of Americans United for Life, whose columns appear in the Summer and Winter issues. You can read previous “Washington Insider” columns, HERE.

If you visit our site and enjoy reading our posts, please consider supporting our mission and our 
OpenAccess initiative by making a donation to the NCBC.

As always, please be sure to check back regularly at to find and view new content or to seek ethical guidance. We are here for you.

Pope Francis Affirms Natural Marriage, Not Same-Sex Civil Unions

     Much ado again has been made about the words of Pope Francis, this time on the subject of same-sex civil unions. In anticipation of the one-year anniversary of the election of Pope Francis on March 13th, the Italian national newspaper Corriere della Sera published an interview with the Pope on March 5th.

     That same day, CNN Belief Blog Co-Editor Daniel Burke
 reported that “Pope Francis reaffirmed the Catholic Church's opposition to gay marriage . . . but suggested . . . that it could support some types of civil unions.” Catholic News Service (CNS) correspondent Francis X. Rocca claimed that “Pope Francis suggested the Catholic Church could tolerate some types of nonmarital civil unions as a practical measure to guarantee property rights and health care.” Joshua Norman of CBS News paraphrased theology professor Massimo Faggioli’s thoughts: “The most important part of the Pope's Wednesday interview is the part where he tried to distance himself from the Catholic Church's past views on ‘non-negotiable values.’” On March 10th, David Gibson of Religion News Service, referencing the CNS story, stated “[i]t was the first time a pope had ever held out the possibility of the church accepting some legal arrangement for same-sex couples.”

     The impression is that the Pope has indicated a tentative acceptance or even support for same-sex civil unions as an alternative to same-sex marriage. Yet the Pope did not once mention same-sex couples.

     Pope Francis did explicitly mention marriage, however, in the first statement of his reply to the question about civil unions: “Marriage is between one man and one woman.” That he replied with this statement before entertaining any concept of civil unions speaks volumes. The rest of his response makes no direct reference to same-sex couples, indicates no tentative acceptance or tolerance of any form of civil union, and most definitely does not evince support for same-sex civil unions as an alternative to same-sex marriage, which is distinctly ruled out by his affirmation of marriage as between one man and one woman.

     Sources as varied as
 Cardinal Dolan of the Archdiocese of New York on NBC News, Joshua Bowman with, Elizabeth Dias with Time, and Tyler Lopez with Slate acknowledge that the Pope has not said anything that implies support for gay marriage or for civil unions for same-sex couples. Elise Harris with Catholic News Agency has reported a clarification on the interview by Father Thomas Rosica, C.S.B., a priest connected with the Vatican press office: “Addressing questions from some journalists who have asked whether or not the comments were made in reference to gay civil unions, the priest emphasized that ‘The Pope did not choose to enter into debates about the delicate matter of gay civil unions. . . . Pope Francis spoke in very general terms, and did not specifically refer to same-sex marriage as a civil union.’” Most importantly, notes Father Rosica, “We should not try to read more into the Pope’s words than what has been stated in very general terms.”

     So what exactly was stated by the Pope? What follows is the complete question and answer exchange from the
 interview (my translation from the Italian):


Q: Many countries regulate civil unions. Is this a path that the Church can take? 
     If so, up to what point?


A: Marriage is between one man and one woman. Secular nations want to justify 
civil unions in order to regulate various shared living situations [situazioni di convivenza],
driven by the need to regulate economic aspects among persons, such as ensuring health care. 
These are shared living agreements [patti di convivenza] of various sorts, with different forms 
that I wouldn’t know well enough to list. The different cases need to be seen and assessed in their variety.


     The Pope’s reply is consonant with the tradition of Church teaching on marriage. It describes why so-called civil unions of “various” sorts are being established in different countries, and implies that there is nothing which inherently links the legal concept of “civil union” with same-sex couples and alternatives to same-sex marriage—indeed, the Pope never mentions those terms. A civil union, in his words, is a “shared living agreement” in order “to regulate economic aspects among persons, such as ensuring health care.” This concept would apply equally to an elderly parent living with a caretaker, a brother and sister living together, or even to close friends renting together or co-owning a home. It need not imply any romantic or sexual relationship.

     The Italian term convivenza can and has been translated as “cohabitation,” which in English often has connotations involving romantic, nonmarital relationships; however, convivenza is used more often than its English literal equivalent to simply indicate “living together,” whether as a family of parents and siblings in daily life (convivenza quotidiana), as apartment roommates, as extended and multi-generational families living under the same roof, or as members of society more broadly (convivenza sociale). It can even be used to generally reference all relationships and social interactions as a human family (convivenza umana).

     It would be naïve to suggest that Pope Francis was unaware of the intended reference to same-sex couples in the term “civil union.” Yet he deliberately points to shared living agreements “of various sorts, with different forms I wouldn’t know well enough to list.” If he meant to address only the kind of civil union that is proposed as an alternative to same-sex marriage, which is the well-known elephant in the room, it would have been a one-item list.

     As it stands, he concludes that ”[t]he different cases need to be seen and assessed in their variety.” In other words, shared living agreements between an elderly parent and caretaker child might be seen and assessed as morally licit; shared living agreements between same-sex couples that confer a status resembling that of marriage might be seen and assessed morally illicit. The legal details and context of each type of agreement will clearly impact the outcome of the moral assessment.

     In sum, the Pope did not commit himself one way or the other on any particular type of legal arrangement that might regulate shared living, but he indisputably reaffirmed the natural moral law and the Church’s unchanging teaching on marriage: “Marriage is between one man and one woman.”


John A. Di Camillo, Be.L.

NCBC President, Dr. John Haas, Debates Brain Death on Live Radio

On Wednesday, January 8th, The National Catholic Bioethics Center's President, Dr. John Haas, took to the airwaves to engage in a spirited debate with Paul Byrne, M.D., on the topic of Brain Death.

The live debate aired on the Kresta in the Afternoon show on Ave Maria Radio and a recorded version of the program is now available for streaming through your internet browser. To hear the archived version of the debate, visit Al Kresta's web page, HERE, scroll to the media player labeled "January 8, 2014 Hour 2," click play, and (after a brief ad from Ave Maria), scroll to minute 22:25.


                                         Thank you for your hard work on this issue, Dr. Haas.
Jahi McMath and Catholic Teaching on Determination of Death

A very tragic case in California has gained national notoriety and prompted debates about the determination of death.  It has been reported that at the beginning of December a 13 year old child, Jahi McMath, underwent surgery for breathing problems that occurred while she slept (sleep apnea).  During the surgery her tonsils and other tissues were removed to enlarge the breathing passages.  As she was recovering in the intensive care unit, she began to bleed profusely.  She was reportedly placed on a ventilator to help doctors stabilize her condition.  The physicians finally came to the medical judgment that she had died.  They used neurological criteria for determining death since her heart was still beating. 

Customarily, cardio-pulmonary criteria are used to determine death: the beating heart and the breathing of the patient stop and death is declared.  However, when a patient is on a ventilator the oxygenated blood can enable the heart to continue beating making the patient to appear alive.  Various tests are used to determine death using neurological criteria, including a complete lack of blood flow in the brain, the absence of any electrical activity of the brain, the absence of cranial nerve responses, and the inability of the patient to breathe on her own.  The ability to breathe spontaneously would indicate that the brain stem is not dead, as is in the case of persons in various forms of coma, who are not actually dead.    When the application of these tests confirmed death in the judgement of the physicians, the hospital asked the mother for permission to remove the ventilator from what they now considered to be her daughter’s corpse.  The mother refused, insisting that her daughter was still alive and that the removal of the ventilator would kill her.

The National Catholic Bioethics Center cannot address the accuracy of the facts of the case of Jahi McMath since we have not been a party to the case; but this tragic situation provides an opportunity for the Center to make clear the teaching of the Catholic Church on the question of the determination of death using neurological criteria.  Some media commentators have presented this situation as evidence of the opposition between faith and science since the mother professes to be a devout Christian and believes her daughter can be restored with God’s miraculous intervention.  However, the determination of death by the rigorous application of the neurological criteria is considered legitimate by the Catholic Church, which accepts the findings of science in such a determination.  The Catholic Church does not believe there can be any opposition between faith and science since both are gifts from God, the source of all truth.

In 2000 Pope John Paul II, who will be declared a saint in April, stated the following in an address to an international conference of health care professionals involved in organ transplantation:  “It is a well-known fact that for some time certain scientific approaches to ascertaining death have shifted the emphasis from the traditional cardio-respiratory signs to the so-called ‘neurological’ criterion. Specifically, this consists in establishing, according to clearly defined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum, and the brain stem). This is then considered the sign that the individual organism has lost its integrative capacity. . . . Here it can be said that the criterion . . . for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology.”

The Catholic Church considers the application of these criteria to be a legitimate means of determining death and has always maintained that it is the competency of the medical profession to declare death.  In his 1957 address to anesthesiologists, Pius XII said: “It remains for the doctor to give a clear and precise definition of death and the moment of death of a patient who passes away . . .” Pope John Paul II said the same in his 2000 Address.  The Ethical and Religious Directives for Catholic Health Care Services, published by the United States Conference of Catholic Bishops, summarizes the continuous teaching of the Catholic Church: “The determination of death should be made by the physician or competent medical authority in accordance with responsible and commonly accepted scientific criteria.”

From news reports it appears that Jahi has been declared dead by physicians repeatedly and rigorously applying the neurological criteria, including an independent court-appointed pediatric neurologist from the University of California at Los Angeles, and that the coroner’s office has issued a death certificate.  If this is accurate, at this point there would be no moral obligation for a hospital or physician to perform any procedure on a corpse such as placing a feeding tube or trying to stabilize the bodily functions that are kept working using mechanical means, as some have argued.  This is a very tragic case but in the face of death, the Church proclaims that Jesus Christ has won the victory over death, and she has the obligation to comfort those who mourn with the sure and certain hope of the resurrection of the dead.  We offer our prayers for all who have been so profoundly affected by this tragic event. 

The NCBC Releases Updated Assessment of the Health and Human Services Mandate
Since October 1, 2013, the federal and state-subsidized health insurance exchanges called for by the Patient Protection and Affordable Care Act of 2010 (ACA) have been open for enrollment. In August 2012, the NCBC published a moral analysis of the options for non-exempt employers facing decisions about health insurance for their employees in light of the regulations established by the Department of Health and Human Services (HHS).

In light of the inundating streams of (sometimes conflicting) information that come to the public regarding the manner in which the mandates are being implemented and, in light what the mandates will entail for Catholic Americans, The NCBC is pleased to announce the release of an updated assessment of the HHS Mandate. Our new publication, which will appear officially in the February edition of the monthly bulletin Ethics and Medics, revises the "previous moral analysis of the HHS mandate" published in August.

The new analysis offers: 

"Additional relevant considerations to assist in understanding how employers and [now] individuals may decide, through health care exchanges or private plans, to provisionally purchase health insurance coverage for themselves and/or their employees without illicitly cooperating in evil. We also discuss how employers and individuals must consider a number of important moral and practical concerns as the exchanges become available, including provisions for coverage of direct abortion, uncertainties surrounding implementation, physicians who decline to accept exchange-based insurance, the escalation of costs within and outside the exchanges, the potential impact of scandal, and the serious duty to take action and remain steadfast in opposing the HHS mandate."

This crucial document is of great important for the public and we have given it a proud place as the masthead document of the newly christened OpenAccess page on the NCBC website. It is with pleasure that we provide this document to you for free, ahead of its slated February release. So please, take some time to read our HHS assessment now, before it hits the presses next year. 

Visit the NCBC OpenAccess page HERE.

NCBC President, Dr. John Haas, Gives NPR Interview Defending USCCB


The President of The National Catholic Bioethics Center, Dr. John Haas, gave an incredibly powerful interview today, as he defended the Ethical and Religious Directives for Catholic Health Care Services (ERDs) on NPR's Diane Rehm Show. In the interview, which was part of a larger story concerning an ACLU lawsuit against the Unites States Conference of Catholic Bishops, Dr. Haas gave ample time and consideration to the Church's position on these matters and, in the process, illustrated the utmost importance of interpreting the ERDs properly and using them correctly, whether one is acting in accordance with the ERDs, or simply making judgments concerning them and their nature and purpose in governing Catholic health care facilities.

Dr. Haas cited numerous direct examples from the literature of the Catholic Church in this matter and, in the undeniably hostile environment of a secular radio discussion, acquitted himself impeccably on behalf of The Center and in defense of the position of the USCCB and the Catholic Church.

Please, take some time to listen to the full story and discussion on the Diane Rehm Show's website, HERE. Click the "Listen" link in the upper left hand corner of the page to open the audio stream.

Thank you, Dr. Haas!

The National Catholic Bioethics Center Supports the Success of Its Colleague Matthew Hanley


The National Catholic Bioethics Center extends its deepest congratulations to scholar Matthew Hanley, M.P.H., for the monumental success of his recent presentations at the Catholic Medical Association (CMA) 2013 Conference in Santa Barbara. Mr. Hanley, whose early work has been both supported and published by the NCBC, received two standing ovations from over 500 physicians at the CMA seminar in response to his presentations on The Common Element of Failures to Curb Malaria, AIDS, and Maternal Mortality and the Principles of Catholic Social Justice Applied to the AIDS Epidemic: The Africa Experience. 

Matthew Hanley's past work as an HIV/AIDS technical advisor for Catholic Relief Services informs his specialized view of HIV prevention and influences his extensive writings on the AIDS crisis. The National Catholic Bioethics Center is proud to have published one of his earliest works on the AIDS epidemic: Affirming Love,  Avoiding AIDS: What Africa Can Teach the West and the NCBC is glad to see that Mr. Hanley's dedicated work continues to receive accolades in the public forum.




              Matthew Hanley, M.P.H.

In support of Mr. Hanley's popular work, and in light of his recent success in Santa Barbara, the NCBC is offering Mr. Hanley's book at a discount for a limited time. From now until December 15th, you can take advantage of this offer by heading to the NCBC store and entering the promo code hanley2013 at checkout.

Whether you were present at the CMA conference and saw Matthew Hanley speak, or you have simply had the desire to learn more about what can be done to stop the tragedy of AIDS, you should visit the NCBC Store and pick up your copy of Affirming Love, Avoiding AIDS today.

Congratulations Matthew!
The National Catholic Bioethics Center Joins the National Catholic Partnership on Disability in Their Mutual Attempt to Protect Potential Organ Donors After Circulatory Death (DCD Donors) from Abuses


After a series of small victories in defense of organ donors, as well as a nationally broadcast NPR story, The National Catholic Bioethics Center and NCPD are renewing the organ donation conversation as they continue to collaboratively express their opposition to current drafts of policies drawn by the national Organ Procurement and Transplantation Network.  Specific concerns relate to the potential violation of the so-called “Dead Donor Rule” as well as the true informed consent of potential donors and their families. Persons with disabilities will be particularly vulnerable due to a number of factors, including the proposed change in eligibility criteria for potential donors. Despite the revision of some wording in the OPTN policies (a positive result of the aforementioned NPR story), there remains great potential for coercion and other abuses as explained in the NCBC's two statements to OPTN: HERE and HERE.


Through the tireless efforts of Dr. Marie Hilliard, the NCBC collaborated with NCPD’s past chairperson and current NCPD Board member, Steve Mikochik, JD, in developing a panel response delivered by Professor Mikochik at the 4th International Congress on ECMO (Extracorporeal Membrane Oxygenation) Therapy, at Penn State Hershey Heart & Vascular Institute, Penn State Milton S. Hershey Medical Center, and Penn State College of Medicine on October 19, 2013.  The misuse of Extracorporeal Interval Support for Organ Retrieval (EISOR),  a procedure utilizing modified ECMO to bring about brain and cardiac death of potential organ donors, was identified by Professor Mikochik, whose comments can be read HERE. 

The National Catholic Bioethics Center Cautions Catholic Agencies Considering Assuming Position of ACA Navigator and Other Roles


There has been an increasing amount of coverage regarding the role that local people (and in many cases, sponsoring corporations) can or will play in the orchestration of the Patient Protection and Affordable Care Act (ACA)  and and enrollment of persons in the insurance program at the individual level. Referred to generally as Navigators, these individuals and corporations will be assistants and are claimed to be available to act as unbiased aides who can help individuals as they make decisions about enrolling in the healthcate program.

 The National Catholic Bioethics Center has taken ample time to review the status and the roles of these so-called Navigators and the NCBC is urging Catholic individuals and agencies not to participate in these enrollment programs lest they cooperate with evil in the role of a Navigator:

The National Catholic Bioethics Center (NCBC) has reviewed the various enrollee registration roles developed to implement the Patient Protection and Affordable Care Act (ACA) and is advising Catholic agencies to exercise caution in assuming such roles.

 There are three specific roles to assist consumers in enrolling for health coverage under the ACA:


Navigator: All exchanges (also known as marketplaces)—whether state-based, partnership, or federally facilitated—are required to establish a navigator program. Each exchange will designate entities as navigators and provide them with grants for helping individuals and small employers with the application and enrollment process. Navigators will also conduct public education activities to raise awareness about the exchange and provide referrals to other consumer assistance resources.


In-Person Assisters (IPAs):  In the final exchange blueprint, the Center for Consumer Information and Insurance Oversight (CCIIO) outlined in-person assisters (IPAs) as a second type of assister that is distinct from navigators and other application assistance programs.


Certified Application Counselors (CACs):  Being certified as CACs enables organizations that would likely be engaged in application assistance anyway to help consumers in a more formal capacity. For example, although not all community health centers and community-based organizations will be chosen to serve as navigators or IPAs, they are well-positioned to provide application assistance because they are trusted messengers.

The CAC designation will help expand the network of trained assistance that is available to consumers.


[Excerpted from Enroll America Fact Sheet:]



There is a significant possibility of scandal, which is to be judged by the diocesan bishop, when a Catholic agency participates not only as a Navigator but also in providing In-Person Assisters or Certified Application Counselors for enrollment in coverage by the Exchanges.  This is not just because of the morally illicit drugs and procedures which will be facilitated by implementing the ACA, but also because of the violation of religious liberty occurring pursuant to the U.S. Department of Health and Human Services contraceptive and abortifacient mandate in the implementation of the ACA.

There are also additional concerns, especially for states that have not banned abortion coverage in the Exchanges.  Pursuant to the ACA, only one plan per Exchange must omit such coverage.  Therefore, those enrolling persons that select a plan that includes abortion coverage are cooperating in a manner that would be hard to justify, even if it was mediate material cooperation with evil (which at times can be justified, as addressed, below).  This becomes especially problematic when the enrollee specifically requests abortion coverage (speaking to intent, which constitutes what is always morally illicit formal cooperation).  Explicit formal cooperation in evil occurs when the cooperator (e.g., enroller) has the same evil intent as the principal agent (enrollee who desires insurance coverage of abortion for its potential use). Even if the enroller of an enrollee would prefer that the coverage not include abortion coverage, but acts to assure that the enrollee has such coverage as an In-Person Assister, Certified Application Counselor, or contracted Navigator), this could constitute implicit formal cooperation.  Even in the absence of direct abortion coverage, the enrollee may be a person who intends to use the abortifacient drugs and contraceptive coverage, facilitated by the enroller, presenting a similar moral dilemma as outlined above. 

This is unlike a person accepting a health care insurance plan for his/her family that does include the morally illicit coverage, which cannot be refused, but at the same time knowing that coverage will not be used.  This represents remote mediate material cooperation by which material assistance (payment of premiums) is given, which neither causes another person to commit an evil, nor intends evil.  It may make the evil possible by contributing to the overall financing of the plan, not dissimilar to paying taxes.  For such an enrollee, for the proportionate good of the family’s health care coverage, the remote mediate material cooperation could be justified, with the understanding that the family makes known its objections to such public policy and works in a prudentially appropriate manner to effectuate change.

This is the NCBC opinion on the matter, in which we urge that Catholic agencies not sponsor or assume the roles of Navigator, In-Person Assister, or Certified Application Counselors for the Exchanges because of the implications of these actions for cooperation with evil.  Of course, the final decision rests with the diocesan bishop.
Who is Free to Exercise Religion? Conestoga Wood, Hobby Lobby, and the HHS Mandate


The battle for religious freedom continues as two federal courts of appeal have come to opposite conclusions regarding whether for-profit companies can claim religious liberty protections. All for-profit and most non-profit organizations in the United States continue to be impacted by the legal requirement that was established by a provision of the Patient Protection and Affordable Care Act of 2010, and incrementally clarified by regulations from the Department of Health and Human Services, which has come to be known as the HHS Mandate. The HHS Mandate requires that employers who offer health insurance include, at no cost to employees, the full range of FDA-approved contraceptive drugs and devices, including surgical sterilizations as well as abortion-inducing drugs and devices such as ellaOne, Plan B, and IUDs. Providing this sort of insurance coverage is at odds with the moral values and religious convictions of many U.S. citizens and business owners, especially Catholics.

On July 26, 2013, a three-judge panel of the Third Circuit Court of Appeals based in Philadelphia ruled that Conestoga Wood Specialties, a for-profit cabinet-making enterprise owned by a Mennonite family in Pennsylvania, has no grounds to invoke the First Amendment’s protection of religious freedom or the Religious Freedom and Restoration Act of 1993 (RFRA) against the coercive demands of the HHS Mandate.

On June 27, 2013, in a separate case, the full (en banc) Tenth Circuit Court of Appeals based in Denver had overturned a lower court’s denial of injunctive relief from the Mandate, affirming the likelihood of success of the claim by for-profit Hobby Lobby Stores, Inc. The company continues to argue that the HHS Mandate constitutes a substantial burden on the free exercise of religion. This decision is at odds with the Third Circuit panel’s decision in the Conestoga case. The result is a potential opportunity to take the question to the Supreme Court if the full Third Circuit confirms the panel’s decision.

The conflicting decisions reflect differing interpretations of the identity, purpose, and scope of business entities and the relationship of those entities to their owners and to religious exercise. The Third Circuit’s decision concludes that “the law has long recognized the distinction between the owners of a corporation and the corporation itself. A holding to the contrary—that a for-profit corporation can engage in religious exercise—would eviscerate the fundamental principle that a corporation is a legally distinct entity from its owners.”[1] The two-judge majority held that “the Hahn family chose to incorporate and conduct business through Conestoga” and “the free exercise claims of a company’s owners cannot ‘pass through’ to the corporation.”[2] Simply put, your individual values, conscience, and religious convictions are irrelevant if you want to own and operate a business. If a conflict arises between your beliefs and legal regulations, check your religion at the door or get out of profit-making business.

The Tenth Circuit had affirmed the stark opposite in Hobby Lobby Stores, Inc. v. Sebelius: It determined that Hobby Lobby Stores, Inc. and co-plaintiff Mardel, Inc. are “entitled to bring claims under RFRA, have established a likelihood of success that their rights under this statute are substantially burdened by the contraceptive-coverage requirement, and have established an irreparable harm.”[3] The Third Circuit, though it came to the opposite conclusion, nonetheless acknowledged the weight of the Tenth Circuit’s opinion in a footnote: “the Court of Appeals for the Tenth Circuit, in an eight judge en banc panel, in six separate opinions, recently held that for-profit, secular corporations can assert RFRA and free exercise claims in some circumstances.”[4]

The Tenth Circuit addressed in great detail the question of whether for-profit businesses can invoke religious freedom protections. In short, any organization can invoke the RFRA and the First Amendment regardless of whether it is a nonprofit. Religious protections can extend to for-profits because religious exercise is not limited to tax status; it is afforded to all persons, including both individuals and corporate entities. This conclusion contrasts with the way the government has defined “religious employers” and “religious organizations” in the Final Rule governing the HHS Mandate, since either designation explicitly requires that the entity be “a nonprofit organization described in section 6033(a)(1) and (a)(3)(A)(i) or (iii) of the Code.”[5] The actual text of the Hobby Lobby decision conveys the inadequacy and injustice of the “nonprofit” definition of religious employer and religious organization in the HHS Mandate Final Rule:


We thus turn to the question of whether Hobby Lobby, as a family owned business furthering its religious mission, and Mardel, as a Christian bookstore, can take advantage of RFRA’s protections.

The government makes two arguments for why this is not the case. First, . . . [the government] argues that, as a matter of statutory interpretation, RFRA should be read to carry forward the supposedly preexisting distinction between non-profit, religious corporations and for-profit, secular corporations. Second, the government asserts that the for-profit/non-profit distinction is rooted in the Free Exercise Clause. It suggests Congress did not intend RFRA to expand the scope of the Free Exercise Clause. The government therefore concludes RFRA does not extend to for-profit corporations.

We reject both of these arguments. First, we hold as a matter of statutory interpretation that Congress did not exclude for-profit corporations from RFRA’s protections. Such corporations can be “persons” exercising religion for purposes of the statute. Second, as a matter of constitutional law, Free Exercise rights may extend to some for-profit organizations.

. . .

[T]he next question is whether Congress intended to exclude for-profit corporations, as opposed to non-profit corporations, from RFRA’s scope. Notably, neither the Dictionary Act nor RFRA explicitly distinguishes between for-profit and non-profit corporations; the Dictionary Act merely instructs that the term “persons” includes corporations.

. . .

In conclusion, the government has given us no persuasive reason to think that Congress meant “person” in RFRA to mean anything other than its default meaning in the Dictionary Act—which includes corporations regardless of their profit-making status.[6]


The government continues its attempt to create a division between religious “worship” and “practice” which is foreign to the very core of Christian faith: “For as the body apart from the spirit is dead, so faith apart from works is dead.”[7] The Third Circuit decision even seems to imply that emphasizing a legal distinction between individuals and corporations is more fundamental than protecting religious freedom. Yet if Conestoga Wood Specialties were allowed to exclude morally objectionable forms of insurance coverage from the policy it offers employees, the company would remain incorporated and clearly distinct in its legal and financial liabilities from the individuals of the Hahn family who own and run it. The legal distinction would remain unscathed. But forcing the Hahns to act in a manner contrary to their religious faith in how they run their company “would eviscerate the fundamental principle”—to use the Third Circuit’s terminology—of the free exercise of religion.

The HHS Mandate’s restrictive definition of “religious” remains an unjust infringement upon religious liberty. The Tenth Circuit’s 6-2 majority in Hobby Lobby v. Sebelius offers hope for lasting success; the Third Circuit’s 2-1 majority in Conestoga Wood v. Sebelius reminds us that the stakes are high and the battle must continue. Conestoga Wood Specialties has not given up: they have asked the Third Circuit Court to rehear the case as a full panel of judges. The National Catholic Bioethics Center has signed on to eleven amicus briefs in support of claims against the unjust provisions of the HHS Mandate.

John A. Di Camillo, Be.L

 U.S. Third Circuit Court of Appeals, Conestoga Wood Specialties v. Sebelius, No. 13-1144 (3rd Cir., July 29, 2013), p. 30.

[2] Conestoga Wood Specialties v. Sebelius, p. 28.

[3] Hobby Lobby Stores, Inc. v. Sebelius, p. 7.

[4] Conestoga Wood Specialties v. Sebelius, p. 20.

[5] Department of Health and Human Services, “Coverage of Certain Preventive Services Under the Affordable Care Act,” Final Rules, 78 Fed. Reg. 39870 (July 2, 2013),

[6] Hobby Lobby Stores, Inc. v. Sebelius, p. 25-35.

[7] Jas 2:26.

NCBC Ethicist Reflects on His Recently Published Work: Personalist Bioethics


In February, The National Catholic Bioethics Center proudly announced the release of its newest publication: Elio Cardinal Sgreccia's monumental work, the Manuale di bioetica, under the English title,  Personalist Bioethics: Foundations and ApplicationsThree years of labor reached fruition in this first English-language translation of Cardinal Sgreccia's landmark bioethical treatise, and it is one of the NCBC's most popular publications to date. After taking some time to breathe since the project's publication, the translator of this seminal book, NCBC Staff Ethicist John A. D iCamillo, returned to the work and collected some of his thoughts on it. He has put these reflections to paper with a few words about the book itself, including two powerful excerpts, about how he became involved with its translation, and about what he discovered throughout the joyful, trying, and magnificently rewarding task of bringing the Manuale di bioetica to the English-speaking world.

Taken from  Dappled Things, a Quarterly on Ideas, Art, & Faith:

Art and science are inextricably intertwined. Despite the attempts of modernity to split the human person apart and reduce him to mechanistic cascades of causality, the fundamental intuition of transcendence imbued by art has not been stricken. As a pre-medical undergraduate student steeped in the hard sciences at the University of Pennsylvania, I kept an artistic escape valve for my sanity: a second major in Italian studies. The gap between the often reductive world of the sciences, which I eagerly dissected, and the expansive and nostalgic world of Italian language, culture, literature, and history, which I dearly loved, threatened to one day expand and consume the one or the other. The void seemed unbridgeable.


Then I read G. K. Chesterton’s Orthodoxy. Every phrase seemed to connect dots, and the chapters flew by. One thought in particular struck a chord that resonated profoundly: 

“The poet only asks to get his head into the heavens. It is the logician who seeks to get the heavens into his head. And it is his head that splits.” I understood why I needed the arts to stay sane. I decided I could never lose sight of the arts if I wanted to be a good scientist—the Truth is one, it is easy to lose sight of the forest by focusing on the hydrogenated nicotinamide adenine dinucleotide phosphate (NADPH) produced through photosynthesis by the chlorophyll in the chloroplasts of a tree leaf. By the same token, the lush green trees dotting the rolling hilltops are appreciated much more with the awareness of the minutia at work!


This new realization inspired me to work with Bernardo Aparicio and fellow Catholics in founding the original board of Dappled Things Magazine. I had the honor of serving as managing editor until 2011. The arts did keep me sane through graduation, and I finally found a discipline that would connect the liberal arts and the empirical sciences: bioethics. Better yet, I found a bioethics graduate program at a pontifical institution in Rome! To support myself there I decided to translate and interpret Italian, which I soon found to be another artful science. Terminological exactitude and idiomatic imagination—what strange bedfellows! Or rather, how perfectly marital: different approaches to the one act of communication, each essential to the whole.

I came across Elio Cardinal Sgreccia’s Manuale di bioetica (5th ed., Vita e Pensiero 2007) as part of my bioethics studies in 2007; in fact, this two-volume masterwork totaling some 1500 pages was the core required text for every course I took. Cardinal Sgreccia is currently the president of the International Federation of Bioethics Centers and Institutes of Personalist Inspiration (Federazione Internazionale dei Centri ed Istituti di Bioetica di Ispirazione Personalista, FIBIP), and has been since 2003. He took on the role of president of the Ut Vitam Habeant Foundation and of the Donum Vitae Association in the Diocese of Rome in 2004 and continues to serve in that capacity. He became a spiritual advisor at the Faculty of Medicine and Surgery of the Catholic University of the Sacred Heart in Rome in 1974, and founded both its Bioethics Center (1985) and its Bioethics Institute (1992). He also served on Italy’s National Bioethics Committee from 1992-2006. His vast experience and fidelity to the Magisterium made the work truly monumental.


Cardinal Sgreccia’s Manuale di bioetica had already been published in eight different languages, including Spanish, but an English version was never successfully completed. I had my work cut out for me! I heard that The National Catholic Bioethics Center was working on the translation, and offered my services. Dr. John Haas and Dr. Edward Furton graciously accepted, and I worked with Mr. Michael J. Miller to complete the first complete English translation of Volume I. My editing experience with DT made written translation a natural pleasure. At my suggestion, and with the author and Italian publisher’s approval, the title was changed to Personalist Bioethics: Foundations and Applications.

In short, Cardinal Sgreccia proposes an approach to bioethics that respects both the facts of science and the richness of the Magisterium. He deduces positions through a philosophical approach rather than theological, while giving due respect to the Magisterium and its consonance with reason. He does not appeal to theological or divine authority as the basis for his positions, but shows how theology finds accord with or has even prophetically anticipated experiential or philosophical conclusions. He goes to the heart of the problems with many approaches to bioethics today, which is the inadequacy of an anthropological framework upon which to base claims of moral obligation. He points out the flaws of bioethical paradigms based on utilitarianism, pragmatism, relativism, sociobiologism, contractualism, descriptivism, principlism, and noncognitivism in general. Cardinal Sgreccia proposes ontologically grounded personalism as the proper metaphysical framework for ethical analysis, highlights the false dichotomy between faith and reason, and provides a platform for dialogue on bioethical issues with all people of good will, including those who may not share the faith. His work is a seminal contribution to the growing field of bioethics, and it was both a great challenge and a distinguished honor to contribute to its definitive English translation.

In response to the interest of the editorial board of Dappled Things Magazine, I have chosen to present two excerpts from Cardinal Sgreccia’s work that I believe are reflective of its overall scope and substance. The first excerpt concisely discusses the false dichotomy between Catholic bioethics and secular bioethics as a direct consequence of the false dichotomy between faith and reason. It emphasizes the common language of truth and the rich contributions of Church teaching and history to reasoned analysis, regardless of one’s beliefs:


                                                                                    Secular Bioethics and Catholic Bioethics

Several centers and scholars have raised an issue—in many ways contrived—that sets so-called secular bioethics in opposition to Catholic bioethics.[1] The intent is to contrast a supposedly open and respectful view of everyone’s choices—the secular position—with the Catholic view, which is characterized as closed, intolerant, and therefore unacceptable in a pluralistic and diverse society. Supposedly, secular bioethics is founded on reason and the values of conscience, whereas Catholic bioethics is founded on dogmas and faith, making them irreconcilable with one another.[2]

In reality, the question seems to be formulated improperly and addressed superficially. It should be clear from what has been said thus far that the ontologically grounded personalist approach, to which Catholics also subscribe, is far removed from fideistic positions. It does not ignore the rational justification of values and norms, but does just the opposite. Religious faith does not deaden appeals to reason but rather sharpens and reinforces them while fostering adherence to properly interpreted scientific data. Precisely through their respect for reality, which they maintain is created by God, Catholics take into account the scientific facts and derive from them elements for comparison with the principles of the faith, not vice versa.[3]

On the other side, there is an effort to propose an impoverished and distorted concept of the secular. It is equated with ethical relativism rather than with the affirmation of values common to all of humanity inasmuch as they spring from equal dignity and can be recognized by the light of reason alone through that ethical effort which is responsible for developing the doctrine of human rights. The opposition between Catholic bioethics and secular bioethics is therefore fictitious and misleading. The comparison should instead focus on their respective reference anthropologies and the problem of the foundation for ethical judgments without erecting a “dogmatic fence” around the dispassionate search for the truth.

The real difference in today’s bioethics debate is between those who argue for an ethics without truth (to use the felicitous expression of Scarpelli) and those who maintain, to the contrary, that ethics (and hence bioethics) becomes an empty term unless rooted in truth. “To root ethics in truth is not easy. It involves humility, constant confrontation, and a willingness to recognize one’s errors. It also involves the possibility of dialogue, for if we dialogue in the truth, which belongs to no one but is open to everyone, it is possible to avoid violence and abuses. But if we dialogue apart from the truth, then the temptation can become irresistible to substitute oneself, one’s own authority, and one’s own power for the hard but objective measure of truth itself.”[4]

My intention is to promote an intellectual exchange on the basis of the reasons that support the personalist ethic here proposed. If I cite corroborating statements from magisterial documents, as I intend to do, it is because I find consonance and sometimes a prophetic intuition in them.

If I come to affirm that one finds the Creator and creation in the depths of the person, as the ultimate explanation for his existence and the ultimate reference for his dignity, it is also in light of demands that are not opposed to reason and are therefore rational. Thomas Aquinas’s great confidence in the compatibility of the claims of reason with those of faith is the basis for my confidence that Catholics can dialogue with secular thinkers without feeling obliged to alter or reduce the claims of faith, which should be imposed upon no one but can be proposed with good reasons to anyone.

Moreover, there is no shortage of literature addressing bioethical problems from the starting point of revealed truth, in other words, from within a clearly theological framework. I think that major contributions both in the field of biomedical research and in the cause of humanizing medical care have come from the consideration of religious truth, in historical terms as well, especially in the Christian world and particularly in the Catholic Church.[5]

[Excerpt taken from Elio Sgreccia, Personalist Bioethics: Foundations and Applications, trans. John A. Di Camillo and Michael J. Miller (Philadelphia: National Catholic Bioethics Center, 2012), Chapter 2, pp. 65-66.]


The second excerpt here presented takes up the theme of truth in relation to the plush, interdisciplinary nature of bioethics, and connects it to the very identity of mankind. We are beings at once simple yet vastly complex, singular yet social, and unable to be reduced to mere physicality. He briefly introduces his key concept of ontologically grounded personalism, which acknowledges the objective value of the human person as an integral whole rather than a randomly connected agglomerate of countable parts, taking special care to underscore the crucial interpenetration of faith and reason:


                                                                            Bioethics, Anthropology, and Interdisciplinary Study

Based on the previous discussion, this new discipline cannot be understood as a simple comparison of the different opinions and the various ethical positions that exist; rather, it must propose standard values and effective decision-making approaches, providing objective answers based on rationally valid criteria.

The search for adequate answers demands an interdisciplinary approach to the problem, which is one of the unique characteristics of bioethics. The role played by the biomedical sciences and environmental science (ecology) is evident, but not everyone is aware that this area of study requires a standard philosophical anthropology, which is the framework within which an ethical value is assigned to bodily life, marital love and procreation, and suffering, sickness, and death, as well as to the relationships between freedom and responsibility, individual and society, and individual and nature. This complex interweaving of the experimental and humanistic sciences in search of a “wisdom of science,” to use Potter’s expression, also requires contributions from the philosophy of nature (to adequately establish the role, meaning, and value of the environment and ecosystems in bioethics), the philosophy of science, and law. Finally it is advisable that this interdisciplinary study be open to theology as a “horizon of meaning.”[6] Although they are closely interrelated, each of these disciplines has its own epistemological status, independent of the others.

As far as anthropology is concerned, I will refer to the anthropological concept that, in my opinion, best does justice to the real and objective meaning of man and contributes to a respect for his intrinsic value: ontologically grounded personalism. This presents itself as an integral understanding of the human person, not subject to reductive ideologies or biologistic thinking. Indeed, in order to solve the problems posed by scientific progress and the social organization of medicine and law, I believe it is first of all necessary to answer the question of the value of the human person, with his prerogatives and duties, so as to bar all possibility of exploitation.

The fundamental value of life, the transcendence of the human person, the integral concept of the human person (resulting from the synthesis of physical, psychological, and spiritual values), the relations of priority and complementarity between person and society, and a personalist understanding of marital love as a communion are valid points of reference for bioethics, as well as for human and social ethics in general. These values should enlighten those who attempt to solve the problems resulting from the advances in biomedical science—a science that seems inspired by an optimistic enthusiasm for progress while forgetting great challenges, such as fighting still-untamed diseases and stemming the evils that are typical of that same technological society, which are caused by environmental exploitation. Precisely for this reason, there is a need for a standard philosophical anthropology that takes into account the human person as a whole and the unique, twofold relations that tie the person to his existential conditions: the space in which he dwells and the time in which he lives and will live. In this perspective, then, one comes to understand the great importance of the category of responsibility to which Jonas refers in his previously cited book. The ontologically grounded personalist anthropology is very often criticized as an anthropology that can only be maintained by someone who allows for suprarational knowledge—by someone who admits the possibility of theology. As Fides et ratioreminds us, the importance of metaphysics and of the intelligibility of the faith should be emphasized:

The word of God refers constantly to things which transcend human experience and even human thought; but this “mystery” could not be revealed, nor could theology render it in some way intelligible, were human knowledge limited strictly to the world of sense experience. Metaphysics thus plays an essential role of mediation in theological research. A theology without a metaphysical horizon could not move beyond an analysis of religious experience, nor would it allow the intellectus fidei to give a coherent account of the universal and transcendent value of revealed truth.[7]

In order to avoid equivocation, it seems necessary to establish a distinction between rational theology and revealed theology. Rational theology, traditionally called theodicy or the philosophy of God, is the science that studies, in the light of natural reason, what one can come to know about the Supreme Being through reason alone.Revealed theology, by contrast, has a material object (what it studies) and a formal object (the point of view that it adopts) different from those of rational theology; it is consequently a different science with a different epistemological status. Revealed theology studies the data of revelation in the light of reason as illuminated by faith. The material object partly coincides with that of rational theology, because it is the same God being studied, but is extended considerably to include everything that God has revealed to us about himself. Consequently, only those who have received the same faith can appropriately engage in theology.

It is important to make clear that metaphysics and the rational philosophy of God have many points in common, because both of them manage to reach the ultimate foundation of reality: being. Having clarified this, it is necessary to add that the anthropology and ethics that I am proposing do not take reason illuminated by faith as their point of departure, since the resulting discourse would only be relevant to those who profess the same creed; rather, they take into account a whole range of rational philosophical findings, whether metaphysical or anthropological or ethical in nature. In my opinion, anyone who confuses ontology and ontologically grounded personalism with revealed theology shows that he has misunderstood the meaning of metaphysics itself and of theology.[8] Those who blockade themselves within the walls of an empiricist philosophy, which reduces man to his purely experiential aspects, exhibit intellectual prejudices against a large part of the philosophical tradition, from Plato to the present day, which considers man as body and as spirit. Fides et ratio mentions the important challenge “to move from phenomenon to foundation” (no. 83) and rediscover a way of thinking that is metaphysical in scope (see no. 81). John Paul II recalls that “reality and truth do transcend the factual and the empirical, and [I want] to vindicate the human being’s capacity to know this transcendent and metaphysical dimension in a way that is true and certain, albeit imperfect and analogical” (no. 83).[9]

Every science manifests its own completeness within the parameters defined by the science itself. This does not prevent the sciences from being open to one another; in fact, interrelating the sciences—though each one preserves its distinct epistemological status—contributes to a richer understanding of the object of study. This occurs in much the same way that observing an object not only from the front, but also from the side, from within, and perhaps from above can lead to a thoroughly comprehensive understanding of the object, in keeping with an epistemological approach aimed at integration.[10]

Bioethics also has its own specificity that distinguishes it from the area of moral theology commonly referred to as “medical morals.” This branch of moral theology, aimed at the formation of health care personnel, considers these interventions in the light of faith, and hence in the light of Christian Revelation, as specified by the Magisterium. Its purpose is to reflect on the content of the faith and on the application of divine law to human conduct; its applications are above all within the community of believers, though many of its conclusions happen to fully coincide with those of moral philosophy.

In my opinion, however, it would be inappropriate and not very useful for the faith itself to deny the legitimacy and necessity of rational and philosophical reflection on human life, and therefore on whether physicians and biologists are permitted to experiment on human subjects. Human life is first and foremost a natural value, known rationally by all who make use of reason; the value of the human person is rendered even more precious by grace and by the gift of the Holy Spirit, but it remains an intangible value for everyone, believer or not. It is contrary to Church tradition to deny the value of reason and the legitimacy of rational ethics, also known as natural ethics.

In the debate over abortion, many people run the risk of supposing that it is a question of being a religious believer or not, yet human life is such for all people, and the obligation to respect it is a duty for man inasmuch as he is human, not just insofar as he is a believer. Supernatural reasons will reinforce this duty for a believer, but these reasons must not be used to excuse all people of good will and right reason from reflecting on the human facts in the light of reason.[11]

Over the centuries the Catholic Church herself has condemned any fideist position, which would deprive reason and intelligence of their weight and value, with the same vigor with which she has condemned any heresies in the realm of revealed truth. The Church has instead defended the principle of harmony between science and faith, between reason and Revelation; such a harmony is not always easy and immediate, however, whether because of the weakness of the human mind, ideological pressures, or the intrinsic difficulties of the problems.

This is a delicate yet essential point involving the relationship between man and God, natural and supernatural, and philosophy and theology. Reason and Revelation have the same author, who is God, and therefore merit equal respect and demand reciprocal support.[12] This encounter becomes all the more urgent and necessary the more one works within the field of the experimental sciences, which have this-worldly and corporeal realities as their object and avail themselves of a rational processes. It is ever more urgently needed in the wake of a long period of silence from metaphysics, which abandoned human truth to the clutches of relativism and noncognitivism.

The dialogue between science and faith can take place only through the intermediary of reason, which is the common reference point for both. This led to the need for philosophical and moral reflection in the medical and biological fields as well.

On this topic, we must ask whether there can be a purely rational secular ethics, capable of prescinding from the affirmation of the existence of an Absolute, or whether, precisely in virtue of an ethics grounded rationally upon natural values, it might not be necessary to discover the existence of an Absolute within said values, especially in order to safeguard the value of the person. I share the position of those who affirm the legitimacy of a rational, “secular” ethics on the immediate phenomenological, epistemological, and ontological level; if, however, this discourse is impelled toward the ultimate and mediate metaphysical foundation, as is necessarily the case, then rationality itself must conclude in favor of the existence of the Absolute: God, the ultimate root of the transcendent value of the person and of ethical norms.[13]

This connection with rational ethics, which is based on metaphysics, reasonably affirms the existence of God by affirming the value of the person and sees in Christian revelation a suprarational—not irrational—knowledge, fostering dialogue between reason and Revelation, between science and faith.

In a cultural context characterized by a general “crisis of meaning,” it is important to recover the “sapiential dimension as a search for the ultimate and overarching meaning of life” (Fides et ratio, no. 81). This wisdom-related dimension is indispensable because the immense growth of humanity’s technological power demands a renewed consciousness of the ultimate values. If this technical know-how should become ordered to a merely utilitarian end, it could quickly prove to be inhuman and destructive.

In the field of scientific research, the prevailing positivist mentality ignores or even rules out all reference to a metaphysical or moral perspective. One consequence is that the person and the holistic understanding of his life have become unimportant. Some scientists, aware of the potential that is inherent in technological progress, seem to give in not only to the dynamics of the marketplace but also to the temptation of a godlike power over nature and over human beings themselves.

Alongside utilitarianism and rationalism there is also nihilism, which views research as an end in itself, with no hope or possibility of attaining the goal of truth: “In brief, there are signs of a widespread distrust of universal and absolute statements, especially among those who think that truth is born of consensus and not of a consonance between intellect and objective reality” (Fides et ratio, no. 56).

In this context, a personalist bioethics with an ontological foundation can contribute to the “sapiential dimension” that Fides et ratio evokes. Bioethics is therefore a discipline with a rational epistemological status that is open to theology, which is understood as a suprarational science, the ultimate authority, and the “horizon of meaning.” Starting from a description of the scientific, biological, and medical data, bioethics rationally examines the liceity of man’s interventions on man. This ethical reflection has its immediate point of reference in the human person and his transcendent value, and its ultimate point of reference in God, who is Absolute Value. It is both natural and necessary to investigate Christian revelation while pursuing this line of thought, and a comparison with current philosophical ideas will also be productive.

[Excerpt taken from Elio Sgreccia, Personalist Bioethics: Foundations and Applications, trans. John A. Di Camillo and Michael J. Miller (Philadelphia: National Catholic Bioethics Center, 2012), Chapter 1, pp. 24-29.]



John A. Di Camillo

[1] See the development of the debate in L. Palazzani, “Dall’etica ‘laica’ alla bioetica ‘laica’: Linee per un approfondimento filosofico-critico del dibattito italiano attuale,” Humanitas 4 (1991): 413–446; A. Fiori, “Bioetica laica e bioetica cattolica,” Medicina e Morale 46, no. 2 (1996): 203–207.

[2] A recent example of this interpretation is the “Manifesto di bioetica laica” (Manifesto of secular bioethics) signed by C. Flamigni, A. Massarenti, M. Mori, and A. Petroni. See the development of the extensive debate that followed in the monograph issue of Notizie di Politeia41/42 (1996). See also the posthumous work by U. Scarpelli, Bioetica laica, ed. M. Mori (Milan: Baldini & Castoldi, 1998).

[3] Fiori, “Bioetica laica e bioetica cattolica,” 203.

[4] F. D’Agostino, Bioetica nella filosofia del diritto, 312.

[5] L. Walters, “Religion and the Renaissance of Medical Ethics in USA, 1965–1975,” in Theology and Bioethics, ed. E. E. Shelp (Boston: Reidel, 1985); D. Callahan, “Religion and the Secularization of Bioethics,” Hastings Center Report 6–7, supplement (1990): 2–4; D. Tettamanzi, Bioetica: Nuove frontiere per l’uomo (Casale Monferrato: Piemme, 1990).

[6] F. D’Agostino, “La teologia del diritto positivo: Annuncio cristiano e verità del diritto,” in“Evangelium vitae” e diritto (Vatican City: Libreria Editrice Vaticana, 1997), 121–131.

[7] John Paul II, Encyclical Letter Fides et ratio, no. 83.

[8] See the article “Ragione” by A. Staglianò, in Dizionario di scienza e fede, Tanzella-Nitti and Strumia, 1167–1180, and the article “Metafisica” by A. Livi in the same volume, 939–957.

[9] See also the article by J. Ratzinger, “Fede e ragione,” in the Italian edition of L’Osservatore Romano dated November 19, 1998, p. 8; J. Habermas and J. Ratzinger, Ragione e fede in dialogo(Venice: Marsilio, 2005).

[10] B. Lonergan, Method in Theology (London: Darton and Todd, 1972).

[11] “Respect for human life is not just a Christian obligation. Human reason is sufficient to impose it on the basis of the analysis of what a human person is and should be.” Congregation for the Doctrine of the Faith (CDF), Quaestio de abortu [Declaration on Procured Abortion], November 18, 1974. With regard to the relationship between reason and faith, Fides et ratio is indispensable reading: it describes them as “two wings on which the human spirit rises to the contemplation of truth” (preamble). Also important is the study by R. Fisichella, “Da credente in difesa della ragione,” in D. Antiseri, Cristiano perché relativista, relativista perché cristiano: Per un razionalismo della contingenza (Soveria Mannelli: Rubbettino, 2003), 133–153. See also the article “Fideismo” by P. Poupard in, Dizionario di scienza e fede, Tanzella-Nitti and Strumia.

[12] “If methodical investigation within every branch of learning is carried out in a genuinely scientific manner and in accord with moral norms, it never truly conflicts with faith, for earthly matters and the concerns of faith derive from the same God. . . . We cannot but deplore certain habits of mind, which are sometimes found too among Christians, which do not sufficiently attend to the rightful independence of science and which, from the arguments and controversies they spark, lead many minds to conclude that faith and science are mutually opposed.” Vatican Council II, Pastoral Constitution Gaudium et spes, December 7, 1965, no. 36. “This Sacred Synod, therefore, recalling the teaching of the first Vatican Council, declares that there are ‘two orders of knowledge’ which are distinct, namely faith and reason; and that the Church does not forbid that ‘the human arts and disciplines use their own principles and their proper method, each in its own domain’; therefore ‘acknowledging this just liberty,’ this Sacred Synod affirms the legitimate autonomy of human culture and especially of the sciences.” Ibid., no. 59.

[13] See P. Valori, “Può esistere una morale laica?” La Civiltà Cattolica 3 (1984), 19–29. On the implicit affirmation of God in the ethical experience, see also the reflection by E. Levinas, Etica ed infinito (Rome: Città Nuova, 1984), and, in general, all the speculations of this Lithuanian philosopher, which differ, however, from the Thomistic approach to ethics on some important points.

The NCBC Releases Crucial New Edition of The National Catholic Bioethics Quarterly: "A Critique of the New Natural Law Theory"

Once a year the National Catholic Bioethics Quarterly is published around a particular theme. This current issue addresses, from various perspectives, a very influential moral theory which has developed over the last several decades. It was developed principally by German Grisez and several of his esteemed collaborators who include John Finnis at Oxford University, Joseph Boyle at the University of Toronto, William May, formerly at Catholic University, and Robert George at Princeton University. The proponents of this theory are courageous and faithful Catholics renowned for defending the Faith and the natural moral law in the public forum.

The New Natural Law Theory (NNLT) has been used very effectively, within our generally secularized and legalistic culture, to defend Judeo-Christian teachings on the sanctity of human life from conception to natural death, the nature of marriage as a life-long union between one man and one woman, and the immorality of contraception and of such “reproductive technologies” as in vitro fertilization and surrogacy. The concepts of the NNLT have helped its proponents to engage in constructive moral dialogue with those of other faiths and with those who may have no religious beliefs at all.

Despite the solid reputation for orthodoxy of these writers, there has been concern among some Catholic philosophers and theologians who believe that the NNLT entails certain departures from the generally received Thomistic tradition which might lead to applications in the moral realm that could be problematic. Perhaps the most contentious position espoused by Grisez and some of his colleagues is that in certain limited situations, namely when both mother and child would die because the child cannot pass through the birth canal during delivery, it could be morally permissible to perform a craniotomy. In short, they maintain, the baby’s skull could be crushed in order to facilitate its passage through the birth canal, resulting in the death of the child and the saving of the mother. As Grisez has put it: “The proposal can be simply to alter the child’s physical dimensions and remove him or her, because, as a physical object, this body cannot remain where it is without ending in both the baby’s and the mother’s death.” The death of the child would be outside the intention (praeter intentionem) of the physician and hence would not be a direct abortion.

The debate over whether or not this would constitute the intentional killing of the baby has largely remained in the realm of theory. However, some recent high-profile clinical cases could lead to certain practices being adopted in Catholic health care institutions with appeal to the NNLT. Hence, the debate over the adequacy of the theory has become much more urgent.

This issue of the Quarterly does not address the specifically clinical repercussions of the NNLT. Rather, it aims to address a broad range of fundamental concepts that have been developed by the NNLT theorists such as the relationship between theoretical and the practical (ethical) reason, what constitutes a moral object, and the role of the natural order in the formulation of moral proposals for action. The contributors to this volume are highly respected scholars such as Father Kevin Flannery, S.J., of the Gregorian University in Rome, Dr. Stephen Long of Ave Maria University, and Dr. John Goyette at Thomas Aquinas College in California.

It is hoped that these published critiques of the widely accepted NNLT will generate a vigorous and fruitful discussion of the theory among scholars, who are encouraged to submit their own manuscripts to future issues of the Quarterly. In the long term, it is hoped that a rich debate may contribute to the refinement of practial moral guidance for all those charged with the challenging tasks of health care policy-making and clinical decision-making. Given the profound deference of the authors on all sides to the authority of the Magisterium of the Catholic Church, the NCBC is confident that the discussion will be of great benefit to the faithful.

NCBC Ethicist to Speak this Weekend on Responding to the HHS Mandates


For the past several months, NCBC Staff Ethicist, John A. DiCamillo has been representing the NCBC
while sitting as a member of the Respect Life Leadership Council of the Archdiocese of Philadelphia, which is organized and run by Archdiocesan Office for Life and Family. As part of his active participation with the Archdiocese, John will be presenting at the Pro-Life Summit hosted by the Office for Life and Family this Saturday, July 20th. John will be presenting on the HHS mandate and the ways Catholic
individuals and for-profit employers can respond to the unjust legislation.


John will be part of a series of brief presentations occurring that day. The event will be hosted at the Philadelphia Archdiocesan Pastoral Center and will be open to the public. The event will be preceded by 
Mass with Archbishop Chaput at 9:00 A.M. in the Cathedral.


For more details, see the flyer for the event HERE.


To view a schedule and the full list of Saturday's talks, click HERE. 


If you cannot attend the talks, never fear! You should be able to tune in to local radio stations WISP 1570 and WCOJ 1420 at 10:00 A.M. to hear live updates on the proceedings.

Thank you for all your hard work, John!
Did You Know That The National Catholic Bioethics Center Offers Free Ethics Consultations?
The NCBC guarantees that a credentialed ethicist will be available 24/7 to assist you, or any person, with those most difficult moral health care decisions one must make from the beginning to the end of life.
Dr. John Haas knows from his position as the president of The National Catholic Bioethics Center just how appreciated this service is:
“People have come up to me after mass and have emailed, written me, or even telephoned me just to tell me how grateful they were for the guidance provided by one of our ethicists on consult duty. We must continue this valuable service to those in need.”
We want to be able to continue providing consultation services to our brothers and sisters in Christ and, indeed, to anyone who would turn to the moral wisdom of the Church.
In 2012 alone, the ethicists of the Center helped over 1500 individuals in their time of need; free of charge.
And That Number is Growing.
We are glad to see it grow! The NCBC ethics consultation is so valuable to the public and so vital to our mission that we have worked tirelessly to continue it throughout the tumultuous financial trials of the last few years.
This NCBC service is costly in its own way, both monetarily and hourly. As we approach the end of our fiscal year, the NCBC needs help to ensure that the cost does not exceed our ability to cover our services. Your generosity will help to ensure its future. Thank you for taking some time to read our appeal. We hope that you will donate to support this critically important service.
Please continue to pray for The National Catholic Bioethics Center and support its mission to uphold human dignity every day in medicine and the life sciences.
NCBC Stands with Coalition of Over 100 Religious Leaders and Scholars in Celebrating HHS Delays

Standing Together for Religious Freedom and Welcoming the
Announced Delay in Forcing Employers to Violate Their Consciences

On July 2, 2013, at a press conference at the National Press Club in Washington, DC, Archbishop William E. Lori of Baltimore, chairman of the U.S. Conference of Catholic Bishops' (USCCB) Ad Hoc Committee for Religious Liberty joined over 100 prominent national religious leaders and scholars in releasing an open letter entitled Standing Together for Religious Freedom. The letter calls on the U.S. Administration and Congress to respect conscience rights and religious freedom threatened by the U.S. Department of Health and Human Services (HHS) contraceptive and abortifacient mandate. Despite the fact that the HHS Final Rule with the  Guidance on the Temporary Enforcement Safe Harbor for Certain Employers, issued June 28, 2013, temporarily extended the “Safe harbor” (from faith-based agency implementation) until contract years beginning in 2014, the HHS, by its own admission, states that the Final Rule does little to narrow the breadth of this violation of freedom. Virtually all employers, including faith-based employers with few exempt agencies, are being forced to provide these morally offensive drugs, devices and procedures at no cost to employees. Archbishop Lori explained how this mandate has broad implications for all persons who respect freedom, regardless of a person’s faith, or even their lack of a faith: “As the Catholic bishops have said from the very beginning, the underlying issue with the HHS Mandate is not about any specific teaching. In fact, other signatories on the letter do not share our view on contraception and probably disagree with us in many other ways, but they understand the core religious freedom issue at stake here."

On July 2nd the Administration announced that the mandate for employers of 50 or more employees to provide insurance coverage, including contraceptive and abortifacient coverage under the Patient Protection and Affordable Care Act (PPACA), will not be enforced until January 2015 (from January 2014).  There is no indication of the status of the mandate on individuals to purchase health insurance as mandated by January 2014.  The Administration indicated that it would be providing proposed rules for comment on reporting requirements of employers and insurers pursuant to the PPACA:

However, a company which provides health insurance coverage for employees, regardless of the number of employees, continues to be bound by the HHS Mandate as of August 2012 (unless it is grandfathered or faith-based and exempt - constituting virtually few companies - or if it is faith-based and temporarily safe harbored).


The NCBC is a signatory to eleven amicus briefs in support of employers who object to being forced to violate religious freedom of conscience through these unjust provisions, and receives numerous calls from employers questioning, “What are we to do?” Employers always express concern for the well-being of their employees, citing the untenable position in which our government, founded on the right to protect this sacred freedom, has placed them. This 4th of July, more than ever, calls all people who respect our Constitution, regardless of their faith-tradition, to join together in prayer for the future of this great country.


May God Bless America!
The SCOTUS Got It Wrong: The Defense of Marriage Continues

Following the excellent and on-point response of  NCBC President, Dr. John Haas, regarding the Supreme Court's ruling on DOMA,  all of the ethicists at The National Catholic Bioethics Center, in an effort spearheaded by NCBC Director of Public Policy, Dr. Marie Hilliard, have worked together to produce a follow-up response to the legal ruling:

Yesterday, the Supreme Court of the United States (SCOTUS) failed to recognize that the people of the United States, through their elected legislators and popular referenda, have lawmaking authority under our Constitution. As demonstrated in 38 states, the people of the United States understand, as the courts apparently do not, that it is impossible to redefine marriage. From time immemorial, the unique and life-giving relationship of a man and a woman in marriage has been protected by society because of the unique contribution that marriage makes to the common good, and especially to the good of children. Children are the fruit of marriage, who need protection and nurturing for the benefit of current and future society. Claims of “equal protection” have nothing to do with this issue, as there is nothing equal to the marriage between a man and a woman.


Despite these facts, SCOTUS, in its United States v. Windsor ruling,[1] held that the federal Defense of Marriage Act (DOMA)[2] violates the Equal Protection component of the Due Process Clause of the 5th Amendment of the United States Constitution.  The ruling, while correctly speaking to the procedural right of states to establish their own laws, erroneously finds that DOMA impinges on states’ rights to define marriage. The ruling therefore wrongly forbids the Congress from defining marriage at the federal level.  This not only represents a contradiction in law, but a misunderstanding of the concept of federalism.  If federal policies should not automatically become state policies, neither should state policies automatically become federal policies.


All is not lost, as the SCOTUS ruling stopped short of mandating the recognition of same-sex marriages across state lines: it left intact Section 2 of DOMA allowing each state to continue to recognize or not same-sex marriages contracted in other states. Thus, the discussion and debates will continue, not only at the state level, but also in the United States Congress, which had promulgated DOMA. Yet this is small consolation, given the tenor of the majority opinion, written by Justice Anthony Kennedy. In his opinion, Kennedy held that the view of the millions of his fellow citizens who favor traditional marriage is based on discrimination which demeans and injures homosexuals. This is manifestly false and misleading.


SCOTUS also issued a second ruling, Hollingsworth v. Perry.[3]  This addressed California’s Proposition 8, the second of two ballot initiatives[4] in which the people of that state defined marriage as between one man and one woman. Proposition 8, was upheld by the California Supreme Court.[5]  However, it was ruled unconstitutional under the Due Process and Equal Protection Clauses of the 14th Amendment of the United States Constitution by both the United States District Court for the Northern District of California (a single judge) and the Federal Ninth Circuit Court of Appeals. Thus, both courts refused to uphold the will of the people concerning a legally adopted constitutional amendment within the State of California. Since California state officials refused to defend their own state Constitution, the proponents of Proposition 8 sought and were granted standing as petitioners in both the District Court and the Ninth Circuit Court of Appeals. These same petitioners appealed the ruling of the Ninth Circuit Court of Appeals to SCOTUS.


While not ruling on the merits of the case, SCOTUS refused to recognize the standing of the petitioners, referring the case back to the Ninth Circuit Court of Appeals. SCOTUS also vacated the ruling of the Ninth Circuit Court of Appeals, but not the District Court ruling which applied only to the Northern District of California, thus leaving the rest of the state's law intact. California’s Constitution states that all laws that have not been overturned by a federal court of appeal must be enforced. Thus, since SCOTUS vacated the ruling of the Ninth Circuit Court of Appeals, same-sex marriage remains illegal in most of California. Despite this legal fact, the Governor of California  has directed that all counties in the state of California issue marriage licenses to same-sex couples. Debate will continue at the state level. The citizens of California, and not the courts (and more egregiously not a single trial judge), have the right to decide what they legally will recognize as marriage in their own state.


When the “Equal Protection” clauses are selectively applied by judges no one is protected. One need only review the ever-growing case law  and government policies against those who are attempting to stand up for traditional marriage: Catholic adoption agencies, faith-based marriage pavilions, and private wedding vendors all are facing discrimination under the heading of “equal protection.” The rights of conscience and of religious freedom are at the very core of our nation’s history and the tradition of self-government. We must continue to bring these principles forward as we work to advance the truth concerning marriage and its importance to a well-ordered society.


This is just another example of why it is so important to participate in the U.S. Bishops’ Fortnight for Freedom[6] to defend marriage, freedom and the rule of law.



[1] United States v. Windsor, 570 U.S. ___ (2013).

[2] Pub.L. 104–199, 110 Stat. 2419, enacted September 21, 1996, 1 U.S.C. § 7 and 28 U.S.C. § 1738C.

[3] Hollingsworth v. Perry, 570 U.S. ___ (2013).

[4] The wording of Proposition 8 was precisely the same as that which had passed in Proposition 22 in 2000, as an ordinary statute and not a state constitutional amendment as in Proposition 8.  Proposition 22 had been invalidated by the State Supreme Court in 2008.  See: In re Marriage Cases (2008) 43 Cal.4th 757 [76 Cal.Rptr.3d 683, 183 P.3d 384].

[5] Strauss v. Horton 46 Cal.4th 364, 93 Cal.Rptr.3d 591, 207 P.3d 48.

The Supreme Court "Upholds" the Constitution by Ruling Against Reality


It is often said that one cannot legislate morality.  But of course that is precisely what is legislated.  The state has the responsibility to ensure justice and to help its citizens grow in virtue.  One of the ways in which it does this is through the coercive effects of laws. Just laws are intended not merely to constrain bad behavior but also to foster good behavior for the benefit of the individual citizen and for the benefit of the common good.

Tax laws are passed to determine what citizens ought fairly to contribute financially to the common good, i.e., what their financial moral obligation is with respect to the society in which they live.  Even traffic laws are passed to ensure the safety of every one and to engender a sense of responsibility toward the other.

However, in the United States today we have lost a common sense of morality; we have lost a shared moral vision.  Consequently it is thought that the only thing to which we can now appeal in pursuit of the common good is the “law” since it is universally binding.  However, if the “law” does not give expression to that which is moral, it is merely arbitrary, and it is ultimately based upon the whim of the most powerful.

Despite a denial of the moral character of the law today, those who appeal to its most socially radical applications do so almost exclusively in the language of morality.  Those who advocate for legal access to abortion argue that this respects a woman’s freedom of choice, and free choice is at the heart of morality. Those who advocate for a legal recognition of homosexual unions as marriage began with an appeal to “gay marriage”, then “same sex marriage” over against “opposite sex marriage” and finally they appealed to “marriage equality”.  If states had not recognized the legality of same sex marriage it was claimed that they had “banned” marriage equality.  They all use the language of morality.

The Catholic Church has always recognized the moral character of the law.  In his great encyclical “The Gospel of Life”, Blessed John Paul II, developed the relationship between morality and law at great length.  He recognized the loss of a shared moral vision, particularly as it touched on the life issues:

“The State is no longer the ‘common home’ where all can live together on the basis of principles of fundamental equality, but is transformed into a tyrant State, which arrogates to itself the right to dispose of the life of the weakest and most defenseless members, from the unborn child to the elderly, in the name of a public interest which is really nothing but the interest of one part. The appearance of the strictest respect for legality is maintained, at least when the laws permitting abortion and euthanasia are the result of a ballot in accordance with what are generally seen as the rules of democracy. Really, what we have here is only the tragic caricature of legality; the democratic ideal, which is only truly such when it acknowledges and safeguards the dignity of every human person, is betrayed in its very foundations. . . When this happens, the disintegration of the state has already begun.” (EV, 20)

Democracy, he said, “depends on conformity to the moral law to which it, like every other form of human behavior, must be subject: in other words, its morality depends on the morality of the ends which it pursues and of the means which it employs.” (EV, 70)

Thomas Aquinas wrote that "human law is law inasmuch as it is in conformity with right reason . . . But when a law is contrary to reason, it is called an unjust law; but in this case it ceases to be a law and becomes instead an act of violence".(ST 1a2ae, q 93, a3,r 2)

Marriage has almost universally been seen as consummated, as made fully binding, with the marital act between a man and a woman ordered naturally toward the generation of children.  Same sex couples are incapable of such an act.  The acts they do perform are not ordered toward the generation of life and are disordered.  No state or federal law can change that.  As Pope John Paul said,  “No circumstance, no purpose, no law whatsoever can ever make licit an act which is intrinsically illicit, since it is contrary to the Law of God which is written in every human heart, knowable by reason itself, and proclaimed by the Church. “ (EV, 62)

The state legislates morality to guarantee justice, to protect the weak and the innocent , to foster virtue among its citizens and to contribute to the common good.  What the state cannot legislate is “reality”.  It cannot decree that gravity does not exist or that the sun will rise in the West.  The state cannot decree that the publically pledged friendship between two men or two women is marriage.

Marriage is a reality that precedes the state; indeed that precedes Judaism or Christianity.  It is a natural and universal institution that exists for the sake of the man and woman who enter into it, for the sake of the children arising from the act that consummates the union, and for the sake of the common good of society.

No state legislature or federal government can make marriage anything else or turn something else into it.   As Isaiah declared: “Woe to those who call evil good and good evil, that put darkness for light and light for darkness, that put bitter for sweet and sweet for bitter."

It goes without saying that the Supreme Court cannot legislate morality; it cannot legislate at all.  Its only role is to determine whether or not certain state or federal laws violate the Constitution.  By now declaring that states can recognize in law relationships that have no existence in reality, the Court has handed down a judgment that runs contrary to nature itself and which simply will not be able to endure. Since there cannot be a social order that runs contrary to the natural order, this development places the common good of the United States in grave peril.


John M. Haas
Ph.D, S.T.L, K.M.
The National Catholic Bioethics Center


The NCBC and Organ Donation Policy Changes

The NCBC and Organ Donation Policy Changes

As heard on NPR today
, the nation's organ transplant network will consider a controversial proposal to set new requirements for a form of organ donation known as: Controlled Donation after Circulatory Death (DCD).


The board of directors of the Organ Procurement and Transplantation Network (OPTN), which is operated under the United Network For Organ Sharing  (UNOS), opened a two-day meeting at the organization's headquarters in Richmond, Va., to consider new requirements for DCD, which involves the hastened harvesting of a person's organs (to preserve their good condition) just minutes after the donor has experienced a cardiac arrest, often as a result of withdrawing life support. 


The concerns regarding this procedure are multitudinous; however, a paramount cause for worry is the timing of the evaluation for donor suitability.  The Institute of Medicine and OPTN’s own Ethics Committee advise that the donor’s/family’s decision to remove life support be made before any approach concerning donation is made to the family of the donor, or even the conscious patient.  The proposed Requirements will leave the timing of such evaluation and discussion up to the Organ Procurement Organization and the donor’s health care team.  Furthermore, the time frame to delay in harvesting organs, to determine that the heart has irreversibly stopped beating, will be left up to local policy, without invoking the national standard recommended by the Institute of Medicine.


The National Catholic Bioethics Center, while in full support of the truly amazing and life-saving programs of organ donation and transplantation, has had serious reservations about these proposals and wants to ensure the respect for the human rights and dignity of the donor. The NCBC, while aware of the importance of speed in obtaining critically needed viable organs for transplantation, wants to ensure that one life is not ended prematurely simply to expedite organ harvesting.  At the same time, the NCBC is supportive of programs that enable the ever-important preservation of another life, that of the recipient. To accomplish this, however, organ procurement programs must not violate true informed consent, nor can they violate the the dead donor rule.


The NCBC's Director of Public Policy, Dr. Marie Hilliard, also chairs the Ethics and Public Policy Committee of the National Catholic Partnership on Disability (NCPD), and has been following these developments very closely. Dr. Hilliard has made NCBC’s concerns known to OPTN in preparation for their meeting. You can read her commentary HERE.


Dr. Hilliard coordinated with the NCPD to arrange a successful interview between Rob Stein of NPR and Stephen Mikochik who spoke of behalf of the NCPD.  Dr. Hilliard commented on the interview, saying: “It is gratifying that through the NCBC’s collaboration with the National Catholic Partnership on Disability that there is a growing awareness of the significant threats to informed consent and the dead-donor rule in the proposed organ procurement policies.  The fact that providers and ethicists representing non-faith-based agencies also recognize these concerns demonstrates the breadth of the problem.  We trust that the OPTN will reconsider its proposal.”


The National Catholic Bioethics Center is proud to have hosted Steve Mikochik for the interview, which he conducted, with Dr. Hilliard's coordination, in the NCBC library. 


The program aired on NPR this morning, before the critical meetings, and Mr. Mikochik did an excellent job.


NCBC President, Dr. John Haas, was proud to have The Center so closely involved in these important issues and he was glad that this effort was: 


"Another wonderful example of the contributions being made by all here at the NCBC and a show of how all our varied talents work together to serve the Lord of Life and His loved ones!"


You can listen to the full NPR story and hear Mr. Mikochik's comments HERE.


Let's all pray that the life of each human is protected until its true, complete end.

The NCBC Supports The USCCB and Their "Fortnight for Freedom"

U.S. bishops have asked for a two-week period of prayer and action to address many current challenges to religious liberty. From issues such as the August 1, 2013 deadline marked for compliance with the HHS mandate, to the Supreme Court rulings that could redefine marriage in June; serious infringements to our Faith and our rights are present all around us. Catholic Americans are being called to stand up, engage in this Nation's dialogue, and especially, to pray for our country and leaders in what the Bishops have called the Fortnight for Freedom.


The Director of Bioethics and Public Policy at the National Catholic Bioethics Center, Dr. Marie T Hilliard,  as a citizen, registered nurse, and woman devoted to her faith, wanted to take a moment to speak in support of this effort: 


I hope that all persons who value the rights of conscience and religious liberty, will participate in whatever way they can in the Fortnight for Freedom activities. I simply cannot over-emphasize that many of the increasing number of consult calls the NCBC is receiving are from health care practitioners concerned about their ability to engage in the healing professions. They want healthcare to exist the way it was truly founded and meant to be: A source of healing and life, not destruction and death.


Never before have the threats to the religious freedom and consciences of Americans, including health care professionals, been so evident.  What is especially worrisome is that some of these threats are coming from the very government entrusted with protecting such freedoms. All Americans should be aware that, as these violations escalate, the very country we all love will be changed forever.

The Fortnight begins TODAY; so please, find more about how you can participate in theFornight for Freedom.Visit the USCCB page HERE, and join the fight to protect our Faith and our Liberty.



Dr. Marie Hilliard and The National Catholic Bioethics Center


The Nature of Abortion: What the Gosnell Verdict Reveals

On May 13, 2013, Kermit Gosnell was convicted on three counts of first-degree murder, one count of involuntary manslaughter, twenty-one counts of illegal late-term abortions, and hundreds of other lesser charges. The gruesome setting for these crimes was his now-infamous “House of Horrors” in Philadelphia. Despite limited mainstream media coverage, which began in response to a Twitter campaign, there is no doubt that this case brings one of the most tragic and brutal moral scourges of our time back into focus: abortion.

In an opinion piece in The Wall Street Journal, May 15, 2013,[1] Daniel Henninger flatly acknowledges the “unbearably awful” details of what this man did, which emerged during the trial, and exhorts his readers to keep the verdict sharp in their minds. He characterizes America’s polarized pro-life and pro-abortion political activism as our “second civil war,” and suggests that the Gosnell case can and should seriously impact the debate. “If it doesn’t, we’re in trouble,” he avers. His article elicits two logical reflections spotlighted in the Gosnell case: (1) the distinction between infant homicide and legal abortion is arbitrary; and (2) “what exactly an abortion doctor does to a fetus, using established techniques,” has serious implications for moral and legal assessments.

First, Henninger notes that deliberately killing a baby outside the womb is legally recognized as murder in Pennsylvania, while killing a baby of the same age inside the womb need not be. Yet the “piercing and snipping Gosnell performed,” as Henninger describes it, is not unlike what abortionists may legally do to a child still in the womb through standard procedures such as dilation and evacuation (D&E). In fact, the Partial-Birth Abortion Ban Act of 2003 does not prohibit “disarticulating” a child at the neck if the child happens to enter the birth canal in one piece during the abortionist’s otherwise legally authorized attempt to dismember the child in the womb (a standard D&E).[2]

Descriptions of Gosnell’s murderous acts elicit shock and disgust, yet child dismemberment hidden from view in the womb passes unnoticed. The Gosnell verdict can and should be a call to recognize the arbitrary distinction between legalized child-killing in the womb and brutish infant homicide. As Henninger notes, “any doctor in the U.S. who performs abortions is looking at the Gosnell verdict and wishing there was more clarity about what falls along the spectrum between a day at the office and first-degree murder.” Indeed, such ambiguity bespeaks a false and arbitrary distinction, not a clear-cut truth.

Second, Henninger makes reference to a hard-to-find piece by Cynthia Gorney originally titled “Gambling with Abortion,” which describes in great detail the legal and political battle surrounding the Partial-Birth Abortion Ban of 2003 and the strategies of pro-life and pro-abortion advocates in general. More significantly and to the point, the article’s description of courtroom medical testimony about abortion procedures such as D&E and intact dilation and extraction (IDX or intact D&X) lay bare the reality of what a direct abortion is. In short, the actions that a doctor must undertake in order to complete an abortion procedure—which few  abortion advocates will ever acknowledge or address, preferring to focus on “choice” or “rights” or the mother’s well-being—are as starkly murderous as Gosnell’s born-alive infant “snipping.”

Thankfully, the Partial-Birth Abortion Ban outlaws IDX, but a D&E is still standard practice for second-trimester (and sometimes third-trimester) abortions. Suction D&E, or vacuum aspiration abortion, which typically rips the developing embryo or fetus apart through the powerful suction and the limited opening size of the cannula, is still a standard technique for first- and second-trimester abortions. Dr. Anthony Levatino recently testified to the Subcommittee on the Constitution and Civil Justice about what the doctor does during suction D&E. Abstract concepts and terminology like “terminating the pregnancy” or even “removing the child” conveniently hover above or around the core reality of intrauterine infanticide—a direct attack on a defenseless and innocent human person in the womb.

This is the essence of direct abortion in moral terms: the deliberate killing of an innocent human child who is developing in the womb, whether as an aim or as a means to achieve another aim. Direct abortion is an intrinsic moral evil, as John Paul II made clear in n. 62 of his encyclical Evangelium vitae, in which he reiterates the millenarian moral tradition of the Church:


Pius XII excluded all direct abortion, i.e., every act tending directly to destroy human life in the womb "whether such destruction is intended as an end or only as a means to an end". John XXIII reaffirmed that human life is sacred because "from its very beginning it directly involves God's creative activity". The Second Vatican Council, as mentioned earlier, sternly condemned abortion: "From the moment of its conception life must be guarded with the greatest care, while abortion and infanticide are unspeakable crimes". . . .


Given such unanimity in the doctrinal and disciplinary tradition of the Church, Paul VI was able to declare that this tradition is unchanged and unchangeable. Therefore, by the authority which Christ conferred upon Peter and his Successors, in communion with the Bishops—who on various occasions have condemned abortion and who in the aforementioned consultation, albeit dispersed throughout the world, have shown unanimous agreement concerning this doctrine—I declare that direct abortion, that is, abortion willed as an end or as a means, always constitutes a grave moral disorder, since it is the deliberate killing of an innocent human being. This doctrine is based upon the natural law and upon the written Word of God, is transmitted by the Church's Tradition and taught by the ordinary and universal Magisterium.


No circumstance, no purpose, no law whatsoever can ever make licit an act which is intrinsically illicit, since it is contrary to the Law of God which is written in every human heart, knowable by reason itself, and proclaimed by the Church. 


Horrendous as they are, the Gosnell murders help us to visualize an important moral guideline: slicing apart, scraping to pieces, dismembering, “snipping,” crushing, aspirating, or otherwise directly attacking the life of a child is always an intrinsic moral evil, regardless of whether that child happens to be located inside or outside of the mother’s body. Henninger does not take a pro-life or pro-choice stance in his conclusion; nonetheless, he cites Cynthia Gorney’s admission that a “there is a sober, profoundly difficult public conversation to be had about second- and third-trimester abortion in this country,” and he responds: “No reasonable person could disagree. But let’s make that any-trimester abortion.”

The inherently violent nature of most standard abortion techniques in all trimesters is a natural reflection of an underlying moral reality that remains the same, regardless of a particular child’s developmental age, size, or visibility, and regardless of efforts to veil the carnage, whether visually or verbally. Hiding the act of murder in its most dissonant environment—a mother’s womb—does not cloak it with goodness and legitimacy. It forces it deeper and harder into the heart of our society. Kermit Gosnell has brought it to light—hopefully it will stay there, reminding us of what is truly at stake with abortion.


John A. Di Camillo, Be.L.

[1] Daniel Henninger, “America’s Second Civil War: The Gosnell verdict means that the abortion status quo must change,” The Wall Street Journal Online, May 15, 2013, (accessed May 17, 2013).

[2] Cynthia Gorney, “On the Politics of Partial-Birth Abortion,” Public Theology, January 27, 2005, (accessed May 17, 2013). Reprinted version of “Gambling with Abortion: Why both sides think they have everything to lose,” Harpers Magazine (November 2004).

Questions about Informed Consent: A Recent Case in the News

Research on human subjects is tricky business. One ethical standard, among many, is to have subjects give informed consent to the experimental procedures. Informed consent includes understanding the risks and study design (i.e., whether it is placebo-controlled).

Recently, a study on premature infants has come under attack. The study, “Target Ranges of Oxygen Saturation in Extremely Preterm Infants,” was published in the New England Journal of Medicine (2010; 362:1959-1969). The attacks have come from several quarters and are nicely summarized on the website of the Alliance for Human Research Protections ( At issue is the accuracy of the informed consent documents.

The study tested different levels of oxygen for premature infants. It was known before doing the study that high levels of blood oxygen saturation levels (around 95%) were associated with retinopathy (blindness) and two studies indicated that oxygen toxicity was associated with death as well. Of course, the authors also noted that studies from the 1950s and 1960s, as well as observational studies suggested an increased risk of mortality for infants receiving lower oxygen levels.

So what are the complaints? AHRP summarizes the informed consent issues as follows:

NONE of the 22 consent forms explained that death was a risk—especially for babies randomized to low oxygen levels;

Only two of 22 consent forms disclosed that babies randomized to high oxygen levels were at increased risk of retinopathy or blindness. 

NONE of the 22 consent forms disclosed that the pulse oximeter readings—that neonatologists rely on to determine an infants’ need for supplementary oxygen—were intentionally altered to provide the treating medical teams with either false high or false low oxygen saturation values (SOP2) (

Although the researchers noted in the original article that there was evidence of mortality for babies receiving lower oxygen saturation, this was not mentioned. It was confusing to read the researchers’ defense of the trial in a letter to the editor of the New York Times where they say,

When the study was planned, the best evidence showed that lower oxygen targets — even lower than used in the study — resulted in less eye disease without a higher death rate. The finding of a higher death rate in one study group was not anticipated (
, emphasis added).

And this comment is in tension with the following comment which is culled from the original article, “Despite the increase in mortality when restrictive oxygen supplementation was used in the 1950s and 1960s and the limited data from observational studies,… (emphasis added)” It appears then, that an increased risk of death is enough of a possibility to list it in an informed consent document.

Of course, not every possibility needs to be documented in an informed consent document – if they were, this would actually compromise informed consent as it would involve “information overload,” as they say. Researchers are stuck with making prudential decisions about which risks are most important.

I reserve judgment on this specific study, but it is illustrative of several general points: (i) if you are a research subject, ask for a verbal explanation of the risks; (ii) if you are a researcher, ask yourself two questions: would you want your mother to enroll in your study, and what do you think your mother would want to know before enrolling? (iii) which risks a researcher mentions is a judgment call, but all serious risks, however improbable, should be includedCthe risks should not be translated into terms such as “slight” or “rare”. Evidence strongly suggests that subjects comprehend better risks in terms of both numerical probability (e.g., 1/10) paired with examples from everyday living (for example, “the probability of death for this procedure is similar to the probability of being attacked by a shark while swimming off the coast of Montauk Bay”). 


Stephen Napier Ph.D. CIP. (Certified IRB Professional)
Consultant, National Catholic Bioethics Center
Surrogacy Fractures Bond Between Parents and Creator: An OSV Interview with Dr. Marie Hilliard
Taken with permission from OSV Newsweekly, 5/26/2013
Dr. Marie Hilliard, Director of Bioethics and Public Policy for the National Catholic Bioethics Center recently spoke to Our Sunday Visitor about the ethical issues surrounding surrogate motherhood.

Our Sunday Visitor:
 Please discuss the ethical-moral issues of surrogate motherhood first, and then the peripheral issues such as the psychological and legal. 
Marie Hilliard: If you look at the ethical, moral and legal issues, they are not separate. What the Church teaches is based on what we call natural, moral law: that we can know the good by what we can know by reason. We do not have a distinction between how the good should be expressed in the public arena and what is the good in terms of the moral arena. My mother had a great saying about her version of what Paul, in Romans 2:15, has told us about how certain things are written on the hearts of women and men and can be known by reason: “Sanctity is sanity.” 
OSV: What does Church teaching say about surrogate motherhood? 
Hilliard: The Church has such great scholarship on this and other issues. For example, natural moral law, as it pertains to assisted reproductive technologies, is extremely well addressed in the document Donum Vitae (“The Gift of Life”) from the Congregation for the Doctrine of the Faith (1987). In 2008, the same congregation issued further instruction on such matters in Dignitas Personae. Such documents are an invaluable resource to couples struggling with infertility.
The Church teaches that the child should be conceived as an act of love in the fruitfulness of a marriage. Further, the child has a right to be conceived through that natural act of love that demonstrates the ultimate source of love — the Creator who establishes the laws of nature pertaining to how human life is to be engendered and life is to be lived.
Parents don’t produce: They engender new life through an act of love, which is a sacred act; and they are called, as responsible parents, to love and raise that child. For this reason, we really can’t separate the psychological from the legal, the moral, the physical and the spiritual. The child has every right to be engendered through that natural act of love, and the child actually becomes the fruitfulness of the love of the parents. That triune relationship between the mom, the dad and the Creator is fractured with a surrogate pregnancy. 
OSV: It seems that most surrogate pregnancies these days are achieved through in vitro fertilization rather than artificial insemination. What additional problems arise with in vitro fertilization? 
Hilliard: After the conception of the child in a petri dish or test tube, a technician actually determines who is going to live or die. In vitro fertilization involves a selection by the technician of which embryos will be implanted in the surrogate carrier, based on grading criteria. The embryos not implanted are then frozen or killed.
Then there is sometimes what is termed “selective reduction,” when more than the desired number of embryos survive implantation and the “extras” are aborted.
Here we move into psychological issues also. Imagine a child finding out that one of her brothers or sisters was sold or not allowed to live, or was frozen in time. Imagine knowing that you survived when the parents raising you had determined that two or three babies were too many, and one of your siblings was killed at the will of the parents.
That sacred bond between mother, father and Creator is fractured when a child is sold or destroyed or given away. And it commodifies life; it commodifies the woman and makes her an object, just as it objectifies the child. 
OSV: Have you dealt with people who are considering surrogacy as an option for parenthood? 
Hilliard: We’ve had people who called and were concerned about family members who were considering or had engaged in surrogacy, but, of course, all our consultations are confidential.
We do receive many calls from good people who have no idea about what is really involved in in vitro fertilization. This, of course, also is what is involved with a gestational surrogate who has no biological link to the child. What often has been erroneously presented to couples struggling with fertility issues is that the embryo, which is their child, is a “pre-embryo” and not yet a human being. Thus, these couples do not understand that the embryos that have been engendered are not only human beings, but are their children.
The whole language of the medical community denies the humanity of the human embryo: The American College of Obstetricians and Gynecologists defines pregnancy not to have occurred until after implantation. But there is no such thing as a “pre-embryo.” From the moment of fertilization, the moment the full component of DNA is present in the fertilized ovum — embryo — there is a human being. Every credible biology textbook says this, but for political reasons and to be able to make the unacceptable acceptable, new language is applied to create a false reality. 
OSV: What is it about today’s culture that tries to make the “unacceptable acceptable”? 
Hilliard: In terms of the overall nature of human sexuality, the ultimate gift of human sexuality is a new human being, and that’s why we have marriage laws, to protect the new and vulnerable human life. Much of this problem is caused by is a breakdown of the family that is spilling over into people choosing not to get married or entering into same-sex relationships and thinking they have a right to a child. But a child is a gift, not a right. And the child has a right to be engendered through an act of love and raised in a home in which there is a mom and a dad. When children are engendered through technology, this is a violation of the sacred gift of creation from God.
This does not mean that children cannot do well when raised by a single parent, or grandparents, or relatives, when both parents are not able to do so. And certainly, adoptive parents, who, see parenting not as a right, but as a gift, receive that gift by opening their homes and their hearts to a child through adoption.
Human Stem Cells Created by “Therapeutic Cloning” – Assessing the Ethics
Advocates are quick to point out that stem cell research is about helping those who are living. This is not quite correct. Certainly adult stem cell research is about helping the living. Embryonic stem cell research, on the other hand, is about destroying some of the living, namely those who are still young and vulnerable as embryos, in the name of helping others who may be struggling with diseases. Recent research from the laboratory of Shoukhrat Mitalipov at Oregon Health & Science University involving the production of human embryos by nuclear transfer (a form of cloning) relies on this same immoral step of intentional human embryo destruction in the interest of achieving a therapeutic result.
Prior to this breakthrough, human embryonic stem cell research had largely sought to utilize abandoned embryos frozen in liquid nitrogen, “left over” from fertility treatments, to destructively obtain stem cells. The frozen embryo approach was plagued with a persistent difficulty, however. If Jane Doe were to request that a random embryo, stored in the freezer of a local fertility clinic, be destroyed to obtain stem cells to treat some ailment or disease she had, those cells, when introduced into her body, would be seen as foreign because they came from an embryo to which she was not genetically related, and they would be summarily rejected by her body.
"Therapeutic" cloning of the type reported by the Mitalipov laboratory purports to get around the rejection problem by producing a genetically related embryo, that is to say, an embryonic human clone who is a genetic identical twin of the treatment recipient. Starting from one of Jane’s body cells and an egg cell, this new embryonic twin sister would be grown for about 5 days of gestation in the laboratory before being destroyed to extract the desired stem cells. Because identical twins can exchange kidneys and other organs without rejecting them, stem cells taken from the cloned embryo (the younger genetic twin) would not be rejected upon transplantation into Jane (the older twin). Yet producing our own twin brothers or sisters as embryos merely to harvest them for their desired cells – producing life simply to extinguish it – remains a gravely unethical and morally indefensible proposal. Twenty human eggs were used in the attempt to therapeutically clone a patient with Leigh syndrome in Mitalipov’s work, but only two of the cloned embryos ended up yielding stem cells. Numerous human embryos, produced for the explicit and premeditated purpose of their destruction, are typically required for the success of this technique.
We ought not sanction the creation of a subclass of human beings, comprised of those still in their embryonic or fetal stages, to be exploited by those fortunate enough to have already passed safely beyond those early and vulnerable stages. The research from the Mitalipov laboratory represents a turn in the wrong direction for the future of science, and needs to be repudiated as inherently unethical, even more so in light of the continual and impressive progress being made with morally acceptable alternatives such as induced pluripotent stem cells and various forms of adult stem cells.
NCBC Co-Founder Named to Hall of Fame

Sister Maurita Sengelaub, a member of the Sisters of Mercy, was a co-founder of the Pope John XXIII Medical-Moral Research and Education Center in St. Louis, which is know known as The National Catholic Bioethics Center today.

Sister Maurita was inducted into the Modern Healthcare Hall of Fame at a ceremony held at the Hilton Hotel in Chicago on March 10, 2013.  The first woman head of the Catholic Hospital Association, now Catholic Health Association (CHA), Sister Maurita was recognized for her 60 years of leadership in health care.

The NCBC takes great pride in knowing one of their renowned founders has been extended such an honor.

You can read the entire press release on the Hall of Fame induction HERE

You can learn more about the early history of the NCBC, HERE

In recognition of its founder, the NCBC will be posting a copy of one of our earliest recorded publications: A copy of our monthly Ethics and Medics with a front page letter written by Sister Maurita herself in 1976. This early publication is available to all and can be viewed HERE

Congratulations Sister Maurita!


Pope Francis and Catholic Health Care in the USA

Pope Francis has set the tone for his papacy and for the whole Church in the years ahead with three concise points in his homily on March 14, 2013: “Journeying, building, professing.”[1] I would suggest there is a clear takeaway for institutions whose mission and identity are bound up with Catholic Christian charity: Do not let worldly concerns transform you into mere social assistance programs or utility-driven “service providers.” It is an echo of Benedict XVI’s affirmation in Deus Caritas Est, no. 31, which he repeated and emphasized in the introduction to his motu proprio On the Service of Charity: “The Church’s charitable activity at all levels must avoid the risk of becoming just another form of organized social assistance.” As one of the most predominant forms of the Church’s charitable works in the United States, Catholic health care surely has ears to hear this message.


 Catholic health care has journeyed greatly, both geographically and administratively, through and since its missionary origins in the early days of our country’s history. Much has changed in the way health care is delivered and in the way hospitals and caregivers are organized: medical professional associations, technological and scientific knowledge advancement, costs and payment, and governmental involvement have moved health care in novel directions with respect to that original response to the Catholic Christian calling to care for the sick and the poor. The circumstances and means have changed, but the core vocation of bringing both physical and spiritual healing and comfort must not be lost. Catholic health care should not stop moving, as times continue to change, yet it should be “always journeying, in the presence of the Lord, in the light of the Lord, seeking to live with the blamelessness that God asked of Abraham in his promise.”[2]


Catholic health care has built extensively. According to the Catholic Health Association, “Catholic health care systems and facilities are present in all 50 states providing acute care, skilled nursing, and other services including hospice, home health, assisted living and senior housing.”[3] There are 630 Catholic hospitals in the United States with 641,000 full-time employees, which handle over 5,450,000 patient admissions and 100,000,000 outpatient visits per year.[4] Most significantly, Catholic health care has built in the Church’s spirit of charity: “Catholic hospitals often provide a higher percentage of public health and specialty services than other health care providers. These organizations’ dedication to the common good often leads them to offer these traditionally ‘unprofitable’ services.”[5]

The foundations are solid, and the building continues. How it continues to be built is a serious challenge in light of the recent and upcoming changes in health care in the United States, especially the Patient Protection and Affordable Care Act (2010) with its preventive services mandate requiring the provision of contraception, abortion-inducing drugs and devices, and surgical sterilizations as part of virtually every medical insurance plan, with no exemption to date for Catholic hospitals. The Church condemns these attacks on marriage, family, and life as intrinsic evils. Building Catholic health care is part of building the Church: “We speak of . . . building the Church, the Bride of Christ, on the cornerstone that is the Lord himself.”[6] We should not stop building Catholic health care as times and circumstances change, but we cannot build it properly without “living stones, anointed by the Holy Spirit,”[7] willing to ensure that its foundation is Christ.


Jesus Christ is crucified and we cannot profess him without the Cross. “When we journey without the Cross, when we build without the Cross, when we profess without the Cross, we are not disciples of the Lord, we are worldly.”[8] Catholic health care may journey far and build extensively, “but if we do not profess Jesus Christ, things go wrong.”[9] It is not hard to shift the focus from the fullness of the Christian message to those aspects which will fit with the demands of the world here and now. An organization need not be Catholic to be classified as a non-profit charitable organization. But the government’s definition of charity is not Christ crucified: “We may become a charitable NGO, but not the Church, the Bride of the Lord.”[10] As his Bride, will we accept him fully or only those features of his which fit our interests? Will we proclaim him faithfully or present him in a false light to avoid persecution, to avoid the Cross? We must carefully weigh the words of Pope Francis: “When we do not profess Jesus Christ, we profess the worldliness of the devil.”[11]

Pray for Us

Pope Francis is hardly naïve or unaware of the challenges faced by the Church and her charitable activities. “Things are not always straightforward, because in journeying, building, professing, there can sometimes be jolts, movements that are not properly part of the journey: movements that pull us back.”[12] The way of the Lord may be difficult to discern in Catholic health care today, but the obligation—the need—to find him and to build for, with, and through him, remains stronger than ever. Pope Francis concluded his first homily as the Bishop of Rome by invoking the Holy Spirit to grant the entire Church a fundamental grace, which is essential to the mission and identity of Catholic health care in particular: “to walk, to build, to profess Jesus Christ crucified.”

John A. Di Camillo, Be.L.

[1] Pope Francis, “Homily at the Missa Pro Ecclesia with the Cardinal Electors,” March 14, 2013,

[2] Ibid.

[3] Catholic Health Association, “Catholic Health Care in the United States,”, accessed March 15, 2013.

[4] See ibid.

[5] Ibid.

[6] Pope Francis, “Homily,” March 14, 2013.

[7] Ibid. See 1 Pt 2:5.

[8] Ibid.

[9] Ibid.

[10] Ibid.

[11] Ibid.

[12] Ibid.

There is No Inconsistency: German and American Bishops’ Treatment of Sexual Assault Victims

There is No Inconsistency: German and American Bishops’ 
Treatment of Sexual Assault Victims

Recently the secular media again has insisted that there is a disparity among the teachings of the Catholic Bishops. They cite the recent statements by German bishops concerning sexual assault protocols in Catholic hospitals. However, on a closer examination, it is clear that their position is consistent with the Ethical and Religious Directives for Catholic Health Care Services (ERDs), as promulgated by the U.S. Conference of Catholic Bishops. 

Cardinal Joachim Meissner stated on January 31, 2013, concerning compassionate care of sexual assault victims, that if “a medication that hinders conception is used after a rape with the purpose of avoiding fertilization, then this is acceptable in my view.”[1]  As a follow-up to this statement, the matter was reviewed by the German Bishops Conference, which issued a statement affirming what sexual assault victims may receive from Catholic hospitals treatments: "That can include prescription of the `morning-after pill,' insofar as it has a preventive and not an abortive effect. Medical and pharmaceutical methods which result in the death of an embryo still may not be used."[2]

This is completely consistent with the US Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services:

36. Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.[3]

  • [3] U.S. Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, 4th ed. (Washington, D.C.: USCCB, 2009), n.36.

A woman has the right to protect herself from the unjust aggressor and from becoming pregnant by this terrible act of aggression. Specifically, the ERDs state that compassionate care must be provided to the victims of sexual assault, including physical, psychological, and spiritual; that the hospital must support law enforcement; and that the woman has the right to defend herself against a potential conception from the sexual assault. In fact, Catholic hospitals have had compassionate sexual assault protocols in place long before secular hospitals, because of their awareness of the potential for two innocent victims: the victim and potentially her newly conceived child.

 However, despite secular trends to redefine conception to mean implantation in the uterus of the conceived human being,[4] it is a biological fact, contained in any biology textbook, that the new human being has been conceived at fertilization, which occurs five to twelve days before implantation.[5]  The newly conceived embryo needs his or her mother’s womb to be nourished and to grow.  Thus, drugs which have the potential to prevent implantation of the conceived human being are abortifacient, regardless of the deceptive language used to describe their function.

  • [4] “Conception” historically and more accurately referred to fertilization. See American College of Obstetricians and Gynecologists, Committee on Terminology, Obstetric-Gynecologic
  • Terminology, with Section on Neonatology and Glossary of Congenital Anomalies, ed. Edward Hughes (Philadelphia: F.A. Davis, 1972).
  • [5] Asgerally T. Fazleabas and J. Julie Kim, “What Makes an Embryo Stick?” Science , 299, no. 5605 (January 17, 2003): 355-356. Available at or DOI: 10.1126/science.1081277.  (Last accessed June 1, 2011).

 With appropriate testing, as indicated by the ERDs, emergency contraception may be provided to sexually assaulted women, and should be.  Manufacturers of emergency contraception indicate that it has three potential functions: to prevent ovulation, so that fertilization cannot occur; to alter the woman’s cervical mucus to slow the speed of the sperm reaching the egg (ovum); and to alter the uterine lining to prevent the embryo from implanting and receiving the nourishment it needs to survive.[6]

  • [6] The manufacturer’s webpage for Plan B One-Step states that if administered within 72 hours after sexual intercourse, “Plan B® One-Step works primarily by: Preventing ovulation[,] Possibly preventing fertilization by altering tubal transport of sperm and/or egg[,] Altering the endometrium, which may inhibit implantation.” See

 Credible research tells us that altering sperm mobility and its capacity to fertilize the egg cannot occur quickly enough when these hormones are taken for emergency contraception.[7] Sperm can be at the point of fertilization in a woman in five minutes.[8] Thus, the only function of emergency contraception that does not involve the destruction of the newly conceived human being, that can occur quickly enough, is the prevention of ovulation. 

  • [7] Natalia Novikova et al., “Effectiveness of Levonorgestrel Emergency Contraception Given Before or After Ovulation: A Pilot Study,” Contraception 75.2 (February 2007): 112–118.
  • [8] L. Speroff, et al., Clinical Gynecologic Endocrinology and Infertility (Baltimore: Williams and Wilkens, 5th edition, 1994), p. 232.

 There is no test to determine if conception has occurred until up to 16 days after the embryo has been conceived.  However, there is a simple test to determine if the emergency contraception can be given at a time that may prevent ovulation, and that is a simple, non-invasive urine test for the Luteinizing Hormone.  Research clearly indicates that if this test is positive, emergency contraception cannot stop ovulation.[9]  Thus, Catholic hospitals can use this test as part of a sexual assault protocol to determine if pregnancy can be prevented.  The test is usually positive only for one day, and the egg usually only lives for one day, so there is a very limited period of time in which the emergency contraception should not be administered in order to prevent its potential abortifacient effect (prevention of implantation, which manufacturers indicate is a potential action).

  • [6] Natalia Novikova et al., “Effectiveness of Levonorgestrel Emergency Contraception Given Before or After Ovulation: A Pilot Study,” Contraception 75.2 (February 2007): 112–118.

In all such cases, the patient is provided with all the information she needs for informed consent as to why such testing should be done, and all of the manufacture’s stated potential actions of the emergency contraction.  This is just good medicine.  And if the patient, after being stabilized and provided all of the excellent care available to her at our Catholic hospitals, wishes to be transferred safely to another provider of her choice, the transfer of care is safely provided for her.  In this way the truly informed rights of the patient as well as the sacrosanct rights to religious freedom of health care providers, so critical to the very reason this country was founded, are respected.

The position of the German and American bishops constitutes compassionate and pastoral care of the victim of sexual assault who has the right to protect herself from the unjust aggressor, by preventing conception, as it is accurately defined.  Both statements clearly indicate that anything that is used to cause the death of the embryo after conception is inconsistent with respect for human life. Thus, both the positions of the American bishops and that of the German bishops are totally consistent and do not represent any new teaching of the Catholic Church.


Roe v. Wade: 40 Years After

January 22, 2013, marked the 40th anniversary of Roe v. Wade, the United States Supreme Court Decision that declared unconstitutional state laws banning abortion prior to viability. Its companion case on the same date, Doe v. Bolton, allowed abortion after viability as well for “health” reasons, which it defined as “all factors—physical, emotional, psychological, familial, and the woman’s age—relevant to the wellbeing of the patient.”A brief, authorless article on the website of The Economist commemorated the date. In nine generally uninformative and vague sentences, the article tells the reader that the pro-life cause “duly lost” in Roe v. Wade, and attempts to imply that legal abortion is responsible for significantly safer abortions despite a drop in abortion-related maternal deaths prior to its liberalization.  It then takes a stab at state politicians who have not actively advocated for the removal of presently inactive abortion ban laws that are still on the books. It concludes by suggesting that the record number of abortion restrictions approved in state legislatures across the union in recent years is unwarranted and ineffective: “states have been piling extra regulations on abortion clinics in the past two years, with the aim of reducing an abortion rate that was falling already” (emphasis added). To solidify its succinct and somewhat veiled message, the article includes a graph summarizing the past 40 years of abortion numbers. The article made few references to specific data, so presumably it speaks for itself. What story does the graph tell? Let’s take a look:


The dull brown curve indicates a sudden rise around the time of abortion liberalization followed by an almost linear decline through the present day. The numbers appearing on the right, in brown, are in small denominations spanning from zero to thirty. The bright blue curve represents a visually striking decline. The numbers appearing on the left, in blue, are in larger denominations spanning from zero to two hundred. At first impression, it appears that a minor but temporary spike in abortions (brown curve) has been accompanied by a drastic and long-term reduction in abortion-related deaths (blue curve). In other words, a cursory interpretation would suggest that a foreseeable uptick in abortion numbers (from near zero to thirty and down to twenty) is correlated with an impressive improvement in abortion safety (from one hundred forty down to near zero).

This is misleading.

The graph compares apples to oranges: the numbers are presented on vastly different scales, distorting the shapes of the curves. While abortion-related deaths[1] are presented as an absolute number, the number of aborted children is presented as abortions per one thousand women between the ages of 15 and 44. There are hundreds of millions of women in this category, so the absolute number is vastly greater. A casual reader will not know this number, much less visualize it. To be fair, this way of presenting the data is found at the source from the Guttmacher Institute, which also neglects to show a graph with absolute numbers of abortions.

If we were to compare apples to apples, using the absolute number of abortions per year, the graph presented by The Economist would leave a much different impression on the average observer:


There seems to be only one data curve (in red), not two. The blue curve that appeared in the first chart as an obvious logarithmic decline is an imperceptible, constant, flat line hugging the bottom axis of this graph. In other words, it is too small to reflect any relevant change on the smallest possible major axis scale that the graphing software would permit in light of the enormous range of the abortion curve. The maximum value on the major axis (number of deaths) is 1.62 million or 1,620,000. The highest actual value of abortion-related maternal deaths, reported in 1965, is a mere 200. This does not minimize the great value and worth of each of those lives, but it puts things in proper perspective to note that a reduction by about 140 abortion-related maternal deaths per year since the liberalization of abortion laws (1970 and 1973) has been accompanied by an increase in the number of aborted children on the order of millions.

If a graph must speak for itself, it should do so accurately, keeping in mind the audience. In light of the new graph, there is hardly a need to debate the deceptive contention that legalizing abortion would make it not only safe but also “rare.” The true numbers conflate visual representations that seem contrived for emotional impact on casual readers.

Of course, lest any reader be led to believe this issue is just about numbers, perceptions, and emotions, we should recall that there is no number of lives saved or lost that is large or small enough to justify the taking of an innocent human life, which is exactly what abortion is. Suffice it to cite John Paul II’s encyclical letter Evangelium vitae, no. 72:

Laws which legitimize the direct killing of innocent human beings through abortion or euthanasia are in complete opposition to the inviolable right to life proper to every individual; they thus deny the equality of everyone before the law . . . Laws which authorize and promote abortion and euthanasia are therefore radically opposed not only to the good of the individual but also to the common good; as such they are completely lacking in authentic juridical validity. Disregard for the right to life, precisely because it leads to the killing of the person whom society exists to serve, is what most directly conflicts with the possibility of achieving the common good. Consequently, a civil law authorizing abortion or euthanasia ceases by that very fact to be a true, morally binding civil law.

The 40th annual March for Life to protest the violent injustice of legalized abortion-on-demand was attended by record crowd of people of all ages, especially teens and young adults. The NCBC’s own Dr. Marie T. Hilliard was in attendance, and has shared her story as a Catholic registered nurse when she learned the news of the Supreme Court decision in 1973. We are all called to witness to the dignity of human life, to God’s love for all His children, especially the most vulnerable and voiceless, and to that most beautiful and unbreakable bond between mother and child.

The words of Mother Teresa in her acceptance speech for the Nobel Peace Prize on December 11, 1979, aptly describe abortion as an unfathomable form of destructive warfare:

We are talking of peace. These are things that break peace, but I feel the greatest destroyer of peace today is abortion, because it is a direct war, a direct killing—direct murder by the mother herself. And we read in the Scripture, for God says very clearly: Even if a mother could forget her child—I will not forget you—I have carved you in the palm of my hand. We are carved in the palm of His hand, so close to Him that unborn child has been carved in the hand of God. And that is what strikes me most, the beginning of that sentence, that even if a mother could forget something impossible—but even if she could forget—I will not forget you. And today the greatest means—the greatest destroyer of peace is abortion. And we who are standing here—our parents wanted us. We would not be here if our parents would do that to us. Our children, we want them, we love them, but what of the millions.

We who are standing here must continue to work for the protection of the millions. God bless the efforts of all those working to defend human dignity—and the lives of so many innocents.


[1] The graph legend indicates that the blue curve represents “abortion-related deaths.” This actually refers to abortion-related maternal deaths, since the article refers to it as “the number of women dying from botched abortions.” Of course the reality is that children killed by abortion also fit the category of “abortion-related deaths.” But they are ignored.

New Book - Personalist Bioethics: Foundations and Applications

The National Catholic Bioethics Center is proud to announce the release of its newest publication: Elio Cardinal Sgreccia's monumental work, the Manuale di bioetica, under the English title, Personalist Bioethics: Foundations and Applications. Three years of labor have reached fruition in this first English-language translation of Cardinal Sgreccia's landmark bioethical treatise.

Personalist Bioethics advances "ontologically grounded personalim" in bioethics, that is, ethics built through reason upon the objective value and dignity of every human person. This is an approach that goes beyond any specific religious perspective and invokes human reason, calling us to reflect on the intimate meaning of human existence and the environment in which we live. It presupposes a metaphysics that is rationally grounded in philosophy and anthropology and has a broad range of ethical applications. Sgreccia developed this philosophical approach in response to the cultural context in which bioethics arose in the United States.  This internationally renowned book will be of value to professors of bioethics and their students, members of ethics committees, connoisseurs of bioethics, and experts in any related area, be it law, philosophy, or health care. The National Catholic Bioethics Center invites everyone to explore this seminal work. These pages will provide readers with a discussion of the basic contours of personalist bioethics, comparisons of personalism to other philosophical positions, and investigations of particular ethical topics ranging from genetic engineering to euthanasia.

The work was translated from the Italian by John A. Di Camillo and Michael Miller.

Keeping an Eye on Medical Research

A few weeks ago, Washington Post journalist Peter Whoriskey reported on a growing problem in medical research: money! Beginning with a case study on the development, marketing and eventual disappearance from the market of Avandia (a drug for diabetes), Whoriskey paints a picture of contemporary research on human subjects that is not flattering. One of his many important observations is the following,

Over a year-long period ending in August, NEJM [New England Journal of Medicine] published 73 articles on original studies of new drugs, encompassing drugs approved by the FDA since 2000 and experimental drugs, according to a review by The Washington Post. Of those articles, 60 were funded by a pharmaceutical company, 50 were co-written by drug company employees and 37 had a lead author, typically an academic, who had previously accepted outside compensation from the sponsoring drug company in the form of consultant pay, grants or speaker fees. (Peter Whoriskey, “As drug industry’s influence over research grows, so does the potential for bias,” Washington Post, November 24, 2012 (accessed,

Carl Elliot’s excellent and balanced treatment of human-subjects research comes to a similar conclusion, though his treatment is, of course, more comprehensive and more compelling than what a newspaper report can accomplish. See Elliot’s book White Coat, Black Hat: Adventures on the Dark Side of Medicine. James Marcum has recently published a book entitled The Virtuous Physician (Springer, 2012): A timely book indeed.


Stephen Napier Ph.D. CIP. (Certified IRB Professional)
Consultant, National Catholic Bioethics Center


God and Government: In Whom Shall I Trust?

In response to a law suit filed by the Archdiocese of New York to seek relief from the onerous Health and Human Services Mandate that all employers provide contraception, sterilization, and abortion-inducing drugs and devices, a U.S. federal judge has ruled against the federal government’s attempt to dismiss the challenge, which invokes the First Amendment right to the free exercise of religion. The Department of Health and Human Services had said that the Archdiocese could not seek relief because the Mandate, which has already been entered into the Federal Register and is therefore active law, will be modified by unknown future changes. It is fitting to recall that our country’s motto is pointedly not “In government we trust.” Indeed, as Judge Brian Cogan states in Archdiocese of New York v. Sebelius, “The Bill of Rights itself, and the First Amendment in particular, reflect a degree of skepticism towards governmental self-restraint and self-correction.” More concretely, Judge Cogan continues, “There is no ‘trust us, changes are coming’ clause in the Constitution.” Our country cannot stake the inestimable value of religious freedom, with its connection to the God in whom we trust, on political hearsay.

Yet the present administration has openly argued that plaintiffs claiming violations of their religious liberty have no case because the government has “promised” that the existing law will not be applied to the plaintiffs and will be modified in the future with a so-called accommodation. In other words, the Health Human Services mandate for employers and insurers to cover contraception, sterilization, and abortion-inducing drugs and devices is and would remain active, unjust, coercive, and oppressive, violating the religious liberty and conscience rights of a large segment of the nation’s people, attacking the very core of our society by impugning the First Amendment to our nation’s Constitution. Meanwhile, citizens would have no right to challenge the mandate because the government made a promise to change it. Thankfully, a federal appeals court in Washington, D.C. recognized this absurdity in Wheaton College v. Sebelius, issuing an order that requires the government to fulfill its “binding representations” and to file status reports with the court every 60 days to demonstrate its progress. The NCBC had signed on to an amicus brief for this case.

In addition to the natural and constitutional injustice of this administration’s ill-advised attempt to curtail the conscience protections and religious freedom of the American people, the practical ramifications of the HHS mandate on faith-based ministries and social services are harmful and regrettably familiar to religious congregations with international ministries. For example, the Little Sisters of the Poor, who provide daily care for the elderly poor in many U.S. cities, would certainly not be able to withstand the $100 per day per employee fines they would face to safeguard their religious beliefs and are contemplating abandoning their ministry in the U.S. It is a choice they have already been forced to make in the past, abandoning their apostolic works under oppressive governments in China, Myanmar, and Hungary. It is disturbing that the United States of America is on a path that would add it to that same list, yet many other religious ministries also face a similar choice here in “the land of the free.”

How is it that the government does not seem to fully grasp—or perhaps to fully care about—the grievous implications that would flow from such a violation of constitutionally protected rights? One can only speculate. Yet the Apostolic Nuncio to the United States, Archbishop Carlo Viganò, warns that “great danger to the future of religious freedom lies with religious persecution that appears inconsequential or seems benign but in fact is not. . . . The issues and reservations . . . about the health care mandate dealing with artificial contraception, abortion-inducing drugs, and sterilization are very real, and they pose grave threats to the vitality of Catholicism in the United States.”

In this Year of Faith proclaimed by our Holy Father, we are reminded that “faith by itself, if it has no works, is dead” (James 2:16), which is a way of affirming that our practices, our living, and our works must manifest what we believe. As Benedict XVI forthrightly states in his Motu proprio “On the Service of Charity,” the Church’s charitable activities have a unique character that flows from our Faith and “must avoid the risk of becoming just another form of organized social assistance.” Faith is not worship alone, and the actions of faith ministries cannot be properly understood outside of it. Thus, as George Weigel has written in an article on the HHS Mandate, “In claiming and defending religious freedom in full, the Church is defending the American understanding, with which Catholic teaching is in full accord, that ‘religious freedom’ cannot be reduced . . . to a privacy right to certain lifestyle choices—in this case, the choice to worship. Religious freedom in full is far more than freedom to worship without civil liability, although it surely includes that.”

Encouraged by these recent successes in the courts, there is renewed hope that the government of our great nation will recognize its rightful role as the defender of our natural right to religious freedom, not its usurper. There are now more than 110 plaintiffs in 42 lawsuits (the NCBC has signed on to amicus briefs in four of them) brought by schools, colleges, universities, charities, hospitals, volunteer associations, business, and dioceses, with more on the way, claiming their constitutional right to the free exercise of religion. The Apostolic Nuncio has summarized it best in the conclusion of his November speech: “What God has given, the servant state does not have the competence to remove. And God has given us the truth of His Son, the truth who gives us the most precious freedom of all, which is the desire to be with God forever! This is our destiny, and this is why religious freedom . . . is of paramount importance. It is essential to the exercise of our other rights and responsibilities as citizens of the Two Cities.”

In God we trust, not the federal government.


John A. Di Camillo, Be.L.

NCBC Staff Ethicist

Dr. Marie T. Hilliard appointed Chair of the CLSA Committee on Laity

Dr. Marie T. Hilliard, NCBC Director of Bioethics and Public Policy, has been appointed Chair of the Canon Law Society of America’s (CLSA) Committee on Laity.  Dr. Hilliard, a canon lawyer, ethicists, and registered nurse, has been involved in the application of canon law to the delivery of health care for over 14 years.  The CLSA was established in 1939 as a professional association dedicated to the study and application of canon law in the Catholic Church. Today the Society’s membership includes over thirteen hundred men and women from thirty-five countries. In serving the leadership of the Church and the People of God, the Society and its members fulfill that responsibility by continuous research and study toward a constant renewal of canon law and by offering practical assistance to members of the Church.

A Second Term: The Struggle for Religious Freedom Continues

The people of the United States have elected President Barack Obama to a second term in the highest office of this country, virtually guaranteeing that the full effects of his health care law will come to fruition. The hope for a rapid change against the government infringement on religious freedom presented by the Patient Protection and Affordable Care Act (PPACA), with its Health and Human Services mandate for nearly all insurance plans to cover surgical sterilizations as well as contraceptive and abortifacient drugs and devices, has dissolved. We will experience the full extent of what is actually in the PPACA, not only since it has become law, as Nancy Pelosi indicated, but especially now that the threat of repeal is gone and the time frame for its yet-untested provisions—safely stored away until after election day—will soon be upon us. Catholic hospitals, universities, schools, businesses, and other private institutions must face, now more than ever, the hard reality of conscience and religious freedom violations in the health care law, which contains various harmful provisions that will take effect in January 2014 as well as the notorious HHS Mandate, which is already in effect.

Brave legal challenges against the HHS Mandate are already underway across the country. Cases have been brought by numerous Christian businesses and universities, and even by several Catholic dioceses. The National Catholic Bioethics Center has signed on to an amicus brief in the appeal of Wheaton College and Belmont Abbey College. Some challengers, such Weingartz Supply Company in Michigan and Hercules Industries HVAC in Colorado, have already successfully secured injunctions against the enforcement of the mandate’s penalties until their cases can be heard in court. The certainty of continued support for the HHS Mandate from the executive branch of the federal government intensifies the moral obligation to continue fighting the unjust elements of the law through the ardent pursuit of other legal remedies on the federal and state levels, especially through the courts and lawmakers.

Authentic health care, brought to fulfillment through proper alignment with the natural moral law and the Gospel of Jesus Christ, cannot be achieved through government-required financial support for intrinsic moral evils that contradict the true good of human persons, such as direct surgical sterilization, contraceptive drugs and devices, and abortifacients. Justice, equality, and fairness cannot be achieved through unjust laws. In the reverberating words of Pope John XXIII from his encyclical letter Pacem in terris, “laws and decrees passed in contravention of the moral order, and hence of the divine will, can have no binding force in conscience . . . Indeed, the passing of such laws undermines the very nature of authority and results in shameful abuse.”

Sacrificing religion and conscience rights on the altar of government largess cannot secure genuine respect for the people of the United States of America, a nation founded on the ideal of religious liberty and the importance of moral integrity for proper government. If we do not actively protect the right of free exercise of religion and the true good of all people, as understood in the natural moral law and in the Christian vision of human dignity that undergirds authentic health care, then we may soon find that they have been lost.


John A. Di Camillo, Be.L.
NCBC Staff Ethicist

Dr. Marie Hilliard participated in President's Advisory Council meeting of Aquinas College, Oct 2012

Dr. Marie T. Hilliard, Director of Bioethics and Public Policy, participated in the October 2012 bi-annual meeting of the Aquinas College (Nashville, TN) President’s Advisory Council, of which she is a member.  She also is a member of the Advisory Council for Aquinas College Center for the Study of Human Dignity and Ethics in Health Care.

Click here to read the story regarding the President's Advisory Council meeting of January 2012. The article is on pages 10-11 of the Fall 2012 Magazine.

Personalist Bioethics Foundations and Applications by Elio Cardinal Sgreccia English Translation

Published in its Italian original by Vita e Pensiero in several editions and reprints, Cardinal Sgreccia’s masterwork has also been translated into Spanish, Portuguese, French, and Russian. The National Catholic Bioethics Center is pleased to present this important work in its definitive English translation.




Hastings Bioethicist Speaks the Truth about Physician Assisted Suicide

Ezekiel Emanuel, a prominent bioethicist of the University of Pennsylvania’s School of Medicine and the Wharton School, as well as a Fellow of The Hastings Center, has exposed some of the myths concerning the legalization of physician-assisted suicide.  Dr. Emanuel has identified as fallacies four arguments that are used to justify the violation of the sacred trust of physicians to do no harm.

In an opinion piece in the New York Times (“Four Myths About Doctor-Assisted Suicide,” October 27, 2012), Dr. Emanuel addresses the impending Massachusetts ballot initiative of next Tuesday, which will decide whether to allow doctors to “prescribe medication, at the request of a terminally ill patient meeting certain conditions, to end that person’s life.” He cites how a similar bill is being debated in New Jersey.

The falsehood that pain is a driving cause for seeking physician-assisted suicide is exposed: “Patients themselves say that the primary motive is not to escape physical pain but psychological distress; the main drivers are depression, hopelessness and fear of loss of autonomy and control.”  Furthermore, Dr. Emanuel debunks the myth that the over-use of advanced technology is the impetus for requiring physician-assisted suicide:  “If interest in legalizing euthanasia is tied to any trend in history, it is the rise of individualistic strains of thought that glorify personal choice, not the advances of high-tech medicine.”  A third misconception identified about physician-assisted suicide is that it will improve the end of life for everyone: “And who are the people most likely to be abused if assisted suicide is legalized? The poor, poorly educated, dying patients who pose a burden to their relatives.”  Lastly, but not exhaustively, Dr. Emanuel exposes the fact that physician-assisted suicide does not represent a “good death,” citing how a Dutch study indicates that complications from patients’ ineffective attempts at medication self-administration have resulted in direct interventions by physicians that constitute euthanasia.

This opinion piece is a “must read” for all needing to counter the falsehoods that are the bases for justifying the legalization of physician-assisted suicide. See[BtaIii,4,MAAFtv,1,6

Convention of the National Association of Catholic Nurses, Nashville, March 1-3, 2013

Convention of the National Association of Catholic Nurses
Nashville, March 1-3, 2013


Dr. Marie Hilliard, NCBC Director of Bioethics and Public Policy and Board Member of NACN, invites all who are concerned about the future of health care to the 2013 Convention of the NACN:

"Catholic Nurses on the Front Lines: Christ's Ministry in Action."

Click here for the Flyer
Click here: Call for Posters

HHS mandate’s coercive nature is fact, not opinion

By Archbishop Joseph F. Naumann,  which appeared in the Leaven 10-19-2012

During the Oct. 11 debate, Vice President Joseph Biden looked into the camera and emphatically said: “With regard to the assault on the Catholic Church, let me make it absolutely clear. No religious institution — Catholic or otherwise, including Catholic social services, Georgetown hospital, Mercy hospital, any hospital — none has to either refer contraception, none has to pay for contraception, none has to be a vehicle to get contraception in any insurance policy they provide. That is a fact. That is a fact.”

The United States Conference of Catholic Bishops issued the next day a statement in response to Vice President Biden’s claim that said in part: “This is not a fact. The HHS [Health and Human Services] mandate contains a narrow, four-part exemption for certain religious employers. That exemption was made final in February and does not extend to Catholic social services, Georgetown hospital, Mercy hospital, any hospital, or any other religious charity that offers its services to all, regardless of the faith of those served.

“HHS has proposed an additional accommodation for religious organizations like these, which HHS itself describes as non-exempt. That proposal does not even potentially relieve these organizations from the obligation to pay for contraception and to be a vehicle to get contraception. They will have to serve as a vehicle, because they will still be forced to provide their employees with health coverage, and that coverage will still have to include sterilization, contraception, and abortifacients. They will have to pay for these things, because the premiums that the organizations (and their employees) are required to pay will still be applied, along with other funds, to cover the cost of these drugs and surgeries.

“The USCCB continues to urge HHS in the strongest possible terms, actually to eliminate the various infringements on religious freedom imposed by the mandate.”

Why would Vice President Biden look the American people in the eye and say something that is clearly not true? It is difficult to believe that the vice president does not understand the HHS mandates and what they require from religious institutions. If this were so, it certainly reflects poorly on his competency.

Of course, the only other explanation is that he purposely misled the American people. Congressman Ryan asked the vice president a very pertinent question. If the rights of institutions are not being threatened, then why are Catholic dioceses, hospitals and colleges suing the federal government in 14 different jurisdictions on this very matter? Unfortunately, the vice president did not answer the question and the moderator of the debate failed to press him on this matter.

Just two weeks ago, President Obama, in speaking to campaign supporters at George Mason University, was bragging about the mandates. He said the following to an overwhelmingly friendly audience: “I don’t think a college student in Fairfax or Charlottesville should have to choose between textbooks or the preventive care she needs. That’s why we passed this law. And I am proud of it. It was the right thing to do. And we are going to keep it.”

I am all in favor of college students getting physicals, vaccinations, and other preventive screenings. However, this administration has defined preventive health care to include abortifacient drugs, contraceptives, and sterilizations. For contraceptives and sterilizations to be preventive health care, then fertility and pregnancy have to be considered diseases. If the administration’s definition of preventive health care is permitted to stand, then what is the cure to an unplanned pregnancy when the “preventive care” does not work? Logically, it must be abortion.

Recently, I was at an event where I spoke about the current threats to religious liberty. Afterwards, a man came up to me and said that he disagreed with what I said. I asked him: “What specifically do you disagree with?” He replied that he thought a nurse at a Catholic hospital should be able to get contraception as part of her health coverage.

I said: “Then, you believe that the church and her institutions should be coerced to provide something we believe to be immoral.” He replied: “Well, that’s your opinion.” I replied: “It is not an opinion. It is a fact that must follow if we accept the premise that the government should force Catholic institutions to provide abortion-inducing drugs and contraceptives.”

He replied that he believed contraception actually prevented abortion. This is, indeed, a popular myth. The facts of the past 40+ years, however, contradict this politically correct dogma. As contraception became more readily available and as our government funded its provision to the poor with hundreds of millions of dollars annually, we have experienced epidemics of sexually-transmitted diseases, teen pregnancy, and abortion.
Abby Johnson was so convinced that contraception prevented abortion that she became a director of a Texas Planned Parenthood clinic. A couple years ago, Abby left Planned Parenthood because she was being pressured to increase the number of abortions at her clinic. Abby Johnson said that half of those seeking abortions at her clinic had been using contraceptives when they became pregnant.

Vice President Biden was asked how he squared his support for legalized abortion with his Catholic faith. Again, he looked into the camera and said he believed in the sanctity of human life, but he did not think it right to impose his moral beliefs on others. Afterwards, one of the pundits analyzing the debate applauded the vice president for having such a “thoughtful” position on abortion.

Believing that an unborn child is an innocent human life and supporting the rights of others to kill this innocent child is anything but thoughtful. It is intellectually and morally an incoherent position.

Today, do we think the position of those who knew slavery to be wrong, but upheld the rights of others to own slaves as a “thoughtful” position? Would we consider it “thoughtful” to be personally opposed to rape, but to support someone else’s choice to violate another person’s body? Do we think it is “thoughtful” to be against gangland drive-by shootings, but support another person’s right to gun down people on our streets?
The personally opposed but pro-choice position is not thoughtful. It is a euphemism, a nice sounding way, to describe one’s support for something that is not nice, but very ugly — the killing of an innocent child within a mother’s womb. Mr. Vice President, that is a fact!

© Copyright 2008 - 2012 The Leaven. All Rights Reserved. Any copying, redistribution or retransmission of any of the contents of this service without the express written consent of The Leaven is expressly prohibited.

NCBC Congratulates Nobel Prize Winner

The National Bioethics Center congratulates Shinya Yamanaka for his much-deserved 2012 Nobel Prize in Physiology and Medicine. This scientist from Kyoto University, Japan, was awarded the prize for his discovery that mature cells can be reprogrammed to become pluripotent, that is, can become a highly flexible stem cell that can give rise to most cell types of the human body, but not another whole human being.

With this discovery, science now has an effective means for providing medical researchers with the types of stem cells that are needed for studies that may provide new cures for some of the most debilitating diseases. Of considerable note is the fact that the production of these cells does not involve the destruction of human embryos and so is free of any morally problematic associations with the taking of innocent human life.

Indeed, one of the motivating factors that drove Dr. Yamanaka to turn away from embryonic stem cell research and to make his inquiries into this very promising area was his realization that the embryos he was viewing through the microscope were in fact no different from those embryos who were once his own daughters, now grown and healthy. Other researchers, who had presented themselves as indifferent to the moral dimensions of this issue, also breathed a sigh of relief when this extraordinary new method of producing pluripotent stem cells appeared on the scene.

Sadly, those who seek absolute purity in this fallen world are already calling on their fellow Catholics to forgo any praise for this remarkable scientific achievement. They have detected minor and distant associations with the practice of embryonic stem cell research in Yamanaka's work and this has led them to find fault with virtually the entire field of pluripotent stem cell research. They seem unaware of the Church's teaching on cooperation or unwilling to apply those principles in any coherent way.

The work of Yamanaka, as well as the motivating force behind his efforts, deserves our highest praise and encouragement. We thank him and his entire research team for showing us a path forward through one of the most serious and challenging moral thickets of our times.

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


Bishop Morlino Discusses Intrinsic Evils versus Prudential Judgments in Public Policy Debates

It was no shock at all for me to learn that our diocesan native son, Paul Ryan, had been chosen to be a candidate for the Vice Presidency of the United States. I am proud of his accomplishments as a native son, and a brother in the faith, and my prayers go with him and especially with his family as they endure the unbelievable demands of a presidential campaign here in the United States. It is not for the bishop or priests to endorse particular candidates or political parties. Any efforts on the part of any bishop or priest to do so should be set aside. And you can be assured that no priest who promotes a partisan agenda is acting in union with me or with the Universal Church.

It is the role of bishops and priests to teach principles of our faith, such that those who seek elected offices, if they are Catholics, are to form their consciences according to these principles about particular policy issues.

 However, the formation of conscience regarding particular policy issues is different depending on how fundamental to the ecology of human nature or the Catholic faith a particular issue is. Some of the most fundamental issues for the formation of a Catholic conscience are as follows: sacredness of human life from conception to natural death, marriage, religious freedom and freedom of conscience, and a right to private property.

Violations of the above involve intrinsic evil — that is, an evil which cannot be justified by any circumstances whatsoever. These evils are examples of direct pollution of the ecology of human nature and can be discerned as such by human reason alone. Thus, all people of good will who wish to follow human reason should deplore any and all violations in the above areas, without exception. The violations would be: abortion, euthanasia and physician-assisted suicide, same-sex marriage, government-coerced secularism, and socialism.

Where intrinsic evil is not involved

In these most fundamental matters, a well-formed Catholic conscience, or the well-formed conscience of a person of good will, simply follows the conclusions demanded by the ecology of human nature and the reasoning process. A Catholic conscience can never take exception to the prohibition of actions which are intrinsically evil. Nor may a conscience well-formed by reason or the Catholic faith ever choose to vote for someone who clearly, consistently, persistently promotes that which is intrinsically evil.

However, a conscience well-formed according to reason or the Catholic faith, must also make choices where intrinsic evil is not involved. How best to care for the poor is probably the finest current example of this, though another would be how best to create jobs at a time when so many are suffering from the ravages of unemployment. In matters such as these, where intrinsic evil is not involved, the rational principles of solidarity and subsidiarity come into play. The principle of solidarity, simply stated, means that every human being on the face of the earth is my brother and my sister, my “neighbor” in the biblical sense. At the same time, the time-tested best way for assisting our neighbors throughout the world should follow the principle of subsidiarity. That means the problem at hand should be addressed at the lowest level possible — that is, the level closest to the people in need. That again, is simply the law of human reason.

As one looks at issues such as the two mentioned above and seeks to apply the principles of solidarity and subsidiarity, Catholics and others of good will can arrive at different conclusions. These are conclusions about the best means to promote the preferential option for the poor, or the best means to reach a lower percentage of unemployment throughout our country. No one is contesting here anyone’s right to the basic needs of food, clothing, shelter, healthcare, etc. Nor is anyone contesting someone’s right to work and so provide for self and family. However there can be difference according to how best to follow the principles which the Church offers.

Making decisions as to the best political strategies, the best policy means, to achieve a goal, is the mission of lay people, not bishops or priests. As Pope Benedict himself has said, a just society and a just state is the achievement of politics, not the Church. And therefore Catholic laymen and women who are familiar with the principles dictated by human reason and the ecology of human nature, or non-Catholics who are also bound by these same principles, are in a position to arrive at differing conclusions as to what the best means are for the implementation of these principles — that is, “lay mission” for Catholics.

Thus, it is not up to me or any bishop or priest to approve of Congressman Ryan’s specific budget prescription to address the best means we spoke of. Where intrinsic evils are not involved, specific policy choices and political strategies are the province of Catholic lay mission. But, as I’ve said, Vice Presidential Candidate Ryan is aware of Catholic Social Teaching and is very careful to fashion and form his conclusions in accord with the principles mentioned above. Of that I have no doubt. (I mention this matter in obedience to Church Law regarding one’s right to a good reputation.)

Peace and reconciliation in coming months

I obviously didn’t choose the date for the announcement of Paul Ryan’s Vice Presidential Candidacy and as I express my pride in him and in what he has accomplished, I thought it best to move to discussion of the above matters sooner rather than later. No doubt it will be necessary to comment again on these principles in the days ahead for the sake of further clarification, and be assured that I will be eager to do so.

Above all, let us beg the Lord that divisions in our electorate will not be deepened so as to have a negative impact on pre-existing divisions within the Church during this electoral season. Let there be the peace and reconciliation that flow from charity on the part of all. Thank you for reading this. God Bless each one of you! Praised be Jesus Christ!


Research Exposes the Truth: Abortion Does Not Reduce Maternal Mortality

Studies continue to support the contention that violating a woman by abortion is not a “preventive health service.”  A research article by Dr. Elard Koch and associates studied the impact of the legal prohibition of abortion in Chile.  One of the most significant findings of the study is that, contrary to widely-held assumptions, making abortion illegal in 1989 in Chile did not result in an increase in maternal mortality. In fact, just the opposite occurred: the maternal mortality rate has continued to decrease since that time from 41.3 to 12.7 per 100,000 live births (69.2% reduction).  

The Guttmacher Institute, the education, research, and policy arm of Planned Parenthood, has attempted to refute these findings, citing that significant restrictions on abortion existed before 1989 in Chile.  They further tried to impugn the scientific methodology of Dr. Koch’s study.  Dr. Koch successfully refutes these allegations

Furthermore, research supports the fact that abortion is detrimental to a woman’s psychological health, even when the fetus is experiencing a fatal anomaly:

Research suggests that women who terminate for fetal anomalies experience grief as intense as that of parents experiencing a spontaneous death of a baby (Zeanah 1993) and that aborting a baby with birth defects can be a “traumatic event … which entails the risk of severe and complicated grieving.” (Kersting 2004) One long-term study found that “a substantial number … showed pathological scores for post-traumatic stress.” (Korenromp et al, 2005) And a recent follow up study found that 14 months after the termination, nearly 17 percent of women were diagnosed with a psychiatric disorder such as post-traumatic stress, anxiety or depression. (Kersting 2009) Termination is not a shortcut through grief. In contrast, parental responses to perinatal hospice are “overwhelmingly positive” (Calhoun & Hoeldtke 2000), and parents report being emotionally and spiritually prepared for their infant’s death and feeling “a sense of gratitude and peace surrounding the brief life of their child” (Sumner 2001). From:

In fact, recently the United States Eighth Circuit Court of Appeals in St. Louis upheld a 2005 South Dakota statute that requires doctors to inform women who seek abortion of the significantly  increased risk of suicidal ideation.  Despite claims to the contrary, research supports the right of women, under informed consent, to know of this risk.  Specifically, in a review of the research of abortion-associated suicide, Shadigian and Bauer report that researchers have found that suicide is 3 to 6 times greater in women obtaining an induced abortion than in women who deliver at term (E. Shadigian and S. Bauer, “Pregnancy-Associated Death: A Qualitative Systematic Review of Homicide and Suicide,” OB GYN Survey, Vol. 60, No 3, 2005.)

Thus, not only does abortion not reduce maternal mortality, but in fact, can be detrimental to a woman’s health and endanger her life. 


The NCBC Submits Comments to OPTN/UNOS Concerning Revisions to its Organ Procurement and Transplant Network Policies, and Invites Others to Provide Comment

The National Catholic Bioethics Center (NCBC) has submitted a response to the request for public comment from the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) as OPTN/UNOS seeks to amend the OPTN Organ Procurement and Transplant Network Policies.

The NCBC has grave concerns pertaining to the integrity of the process to assure proper consideration of public comments.  In 2011 a notice for comment was posted by OPTN/UNOS concerning the plan to Update and Clarify Language in the DCD [Donation after Cardiac/Circulatory Death] Model Elements. The original call for comment was to end on June 10, 2011; but due to inadequate notice to assure true public awareness, a second call for comment was issued, with a deadline to receive comments of June 15, 2012. On June 22, 2012, long before any meaningful consideration or vote pertaining to comments already received could occur either by the OPTN/UNOS Board of Directors (which did not meet until June 25–26, 2012) or the OPTN Organ Procurement Committee (OPO Committee) or the OPTN Ethics Committee, yet another call for comment was announced concerning a proposed “OPTN Policy Plain Language Rewrite” (Policies Rewrite). The notice for this call for comment states that the Policies Rewrite did “not make any substantive changes to the content of . . . current policies.”  A review of the current DCD Model Elements and the proposed Polices Rewrite draws into question the accuracy of this statement.  The NCBC has raised significant concerns about policies pertaining to Donation after Cardiac/Circulatory Death (DCD) concerning donor selection,  informed consent, and the Dead Donor Rule.

Currently the Policies Rewrite,  presented as not containing substantive changes, does contain un-adopted proposed changes to the DCD Model Elements. The NCBC is requesting of the OPTN/UNOS, to correct any procedural errors in soliciting public comment concerning the proposed Policies Rewrite, that the OPTN/UNOS should immediately withdraw the proposal  from public review until the portions relating to the DCD Model Elements are revised to reflect current policy accurately. 

Please e-mail OPTN/UNOS by August 31, 2012 requesting that “OPTN/UNOS  correct any procedural errors in soliciting public comment concerning the proposed Policies Rewrite and that OPTN/UNOS immediately withdraw the proposal from public review until the portions relating to the DCD Model Elements are revised to reflect current policy accurately.” 

It is imperative that all of us are engaged in these important regulatory matters.


Options in Response to HHS Mandate

Dear Friends of the NCBC,

What follows is a special edition of our publication Ethics & Medics.  It contains some ethical reflections on possible responses to the implementation of the HHS Mandate.  There could well be other morally licit ways of dealing with this unjust mandate.  The current administration has placed many citizens in a terribly difficult ethical quandry as they struggle to be true to their conscience and still provide for the health needs of those who work for them.  We welcome responses to our reflections and hope they might be helpful as some of our readers attempt to navigate their way through this unjust situation with integrity.

To read the special edition of Ethics & Medics click here.

John M. Haas, Ph.D.

Holy Redeemer Health System and Abington Health: Seeking to Serve the Community

On June 27, 2012, Abington Health and Holy Redeemer Health System made a historic, enthusiastic announcement that these two providers of health care planned to join forces to serve the best interest of the communities in northern Philadelphia and several suburbs. Their expressed aims were “meeting the needs of the communities we serve in the most efficient and effective way possible” and “committing resources to improve the health of the community including the vulnerable and the poor,” pursuing a “shared vision to come together . . . to better serve the community.”1 Yet on July 18, 2012, a mere three weeks later, they conceded that these bold efforts that “would have served our community well” had been halted “in the best interest of both organizations.”2 It is telling to note the best interest invoked in each statement. What caused the change from serving the best interest of the community (by working together) to safeguarding the best interest of each organization (by staying apart)?

The loudest voices opposing the partnership believed that Catholic “restrictions” on culturally and legally accepted medical procedures, specifically on direct abortions, would be an unacceptable form of imposition on a secular entity. Thousands of people, including some outside the community as well as some patients and community members, signed a petition opposing the partnership; indeed, some threatened to boycott the organization by going elsewhere for care.3 Many Abington Health physicians made their opposition to the proposed collaboration vividly clear,4 with several even signaling that they would cease to provide medical services through Abington Health if the proposed limitations on abortion were to materialize.5 It is surely legitimate for these individuals to make their thoughts known, just as pro-life witnesses have long voiced opposition to the provision of direct abortions at Abington Memorial Hospital, yet there is a certain irony that a physician would threaten to withhold his or her medical services from the local community because the organization withholds one disputed “service” (direct abortion) from the community. Clearly, a loss of physicians in various specialties would not aid community access to a full range of health care services, which is the good they contend would be violated. Should one procedure, which is ultimately a disservice to women and their unborn children, be allowed to trump the indisputably vaster array of health care services in this way?

It is truly regrettable that intense outside pressure seems to have caused these thoughtful and well-intentioned efforts at improving health care quality and delivery to fall apart. Some have even called for the resignation of Laurence Merlis, CEO of Abington Health,6 as if to suggest that visionary leadership working to find ways of respectfully collaborating with religious health care institutions were undignified and insulting to the community. How sad.

It is more unfortunate that much of the public and medical furor is based on misinformation and misunderstandings regarding the applications of the United States Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services (ERDs), which are designed to protect patients’ dignity and rights and safeguard the integrity of the profession of healing. This lack of clarity is a real concern throughout the United States, especially as collaborative arrangements have increasingly become a trend in light of rising medical costs, the need for economies of scale, new regulations from the Patient Protection and Affordable Care Act,7 efforts to improve quality of care and access, and the future direction of health care, which will cease to be hospital-centric and will focus on “preserving and improving health across a range of services—from preventive care to physician care to home and long-term care.”8

Collaborative relationships with Catholic health care institutions always require respect for Catholic identity, but that respect does not always mean the cooperating partner must fully comply with the ERDs. Depending on how the collaborative arrangement is structured, it may or may not require restrictions on immoral procedures at the partner institution. For example, a true “merger” will always require full compliance with the ERDs, since the two institutions consolidate into one, but most proposed arrangements are only partnerships or other relationships that involve lesser degrees of institutional integration. These less radical initiatives allow greater respect for the identities of both institutions, Catholic and non-Catholic, so that they can work together in the vast majority of areas in which they share values, while retaining their key differences in other areas. Immoral procedures at the non-Catholic entity may or may not need to be ruled out based on the principle of cooperation with evil and concerns about causing moral scandal. If time and effort are duly devoted to exploring potential business models and proper contractual language, morally licit solutions may be found; however, fine distinctions are crucial. Regrettably, such careful attention is often of little interest to the broader public or the media. This is unfortunate for the many communities that would stand to benefit from such health care partnerships in manifold ways: more comprehensive and coordinated care, higher quality, lower costs, greater long-term health, better chronic disease management, and improved access to services across all ages and demographics.9

Make no mistake: both Abington Health and Holy Redeemer Health System will surely continue to work their hardest “to seek opportunities to enhance the health of the communities,”10 as they always have, independently. Yet a great opportunity for those communities to listen, learn, and engage in reasoned discussion about the actual prospects and consequences of a partnership—and the implications of the Catholic vision regarding the value of the human person and the art of healing—was sidelined by a harsh firestorm of public opposition that left little room for thoughtful exchanges about pros and cons. Surely the leadership of these two health systems, which has been contemplating a partnership for some time, at least deserved the opportunity to develop more details on the specifics of the proposed arrangement. Could it have ultimately worked out? Perhaps. Would it have pleased every single member of the community? Not likely—there is always someone left feeling dissatisfied with any change. But the essential question is this: Would it have been an improvement for the community as a whole in terms of health care access, quality, availability, delivery, efficiency, affordability, awareness, disease treatment and prevention, and the defining facets of medical care, making it worth the necessary sacrifices and challenges for each institution while respecting each one’s identity? The leadership at Abington and Holy Redeemer had the hope and courage to believe so and were working earnestly to find out. Now we will likely never know.

John A. Di Camillo, Be.L., NCBC Staff Ethicist

1 “Abington Health and Holy Redeemer Health System Announce Intent to Create Regional Health System,” Abington Memorial Hospital website, June 27, 2012,

2 “Joint Announcement from Abington Health and Holy Redeemer Health System,” Abington Memorial Hospital website, July 18, 2012,

3 F. R. Savana, “Amid Opposition Abington, Holy Redeemer End Merger Plans,”, July 19, 2012,

4 M. McCullough, “150 Abington Physicians Decry Plan to Stop Abortions,”, July 13, 2012,

5 K. Heller, “Anger at Abington Hospital,” The Philadelphia Inquirer, July 8, 2012, A2.

6 T. Avril, “Abington Health, Holy Redeemer Call Off Merger,” July 19, 2012,,

7 The proposed partnership, inappropriately called a merger, “had been sought in the belief that a larger, more efficient institution would be better equipped to cope with the federal health-care overhaul.” Avril, “Abington Health.”

8 Michael B. Laign, “Abington-Holy Redeemer Hospital Merger Would Have Been Good for Patients,”, July 25, 2012,

9 Ibid.

10 “Joint Announcement.”


The Relationship of the NCBC with Catholic Relief Services

There have been questions raised in some quarters regarding the relationship of The National Catholic Bioethics Center (NCBC) to grants awarded by Catholic Relief Services (CRS). In short, Catholic Relief Services occasionally asks the NCBC to do ethical analyses of grant requests so that CRS can avoid contributing to evil if they provide a grant to an organization to accomplish some great good, such as feeding the starving, but the same organization may also be engaged in immoral activities in other areas. The NCBC does not “approve” or “make” grants. That is the task and the responsibility of the board and the officials of CRS. The NCBC submits its ethical analyses when requested as part of the grant review process of CRS. The NCBC does its consultations in confidence. However, since CRS made its involvement public, the NCBC would like to address the situation in greater detail for the sake of clarity.

CARE and Catholic Relief Services are two of the oldest and most respected international relief agencies in the world. They have a relationship reaching out to the starving, malnourished, and needy that goes back decades. They have worked closely together to serve these populations because there are situations in which CARE has infrastructure, personnel, and capabilities on the ground where CRS does not. Likewise, Catholic Relief Services is a worldwide relief organization with infrastructure and personnel in places that CARE cannot reach. As a result, they often provide grants to one another for very specific charitable purposes that either one of them is incapable of achieving alone.

It is true that CRS provided CARE with $5.3 million in grants to bring food to the starving and malnourished and to provide clean drinking water in situations of great need. The grants, however, went both ways. In 2010 CARE provided CRS with $4 million in grants to provide assistance to those whom Catholic Relief Services could effectively reach and CARE could not.

Regrettably, over time, CARE came to believe that it could address issues of poverty, hunger, and unjust distribution of society’s goods by reducing the number of those who might experience poverty and hunger. CARE sadly came to promote contraception and other policies that are contrary to Catholic teaching in developing nations of the world. This made it more difficult for Catholic Relief Services to continue to collaborate with them. However, to serve those in need through the historic partnership with CARE, Catholic Relief Services carefully assesses the grants and sub-grants involving CARE.

To assist them in this task, CRS sought the assistance of The National Catholic Bioethics Center, which has earned the trust of the bishops for its fidelity to Catholic teaching and which has demonstrated an ability to apply the Church’s moral principles in situations of collaboration with non-Catholics.

The Catholic moral tradition has reflected on and developed what has come to be known as the Principle of Material Cooperation with Evil. Acknowledging that the Church is “in the world but not of the world,” the Principle of Material Cooperation provides guidance for Catholics in a fallen world as they seek to achieve some good purposes which would never be accomplished except for their collaboration with others engaged in activities considered immoral by the Church. This is perhaps most obvious to committed Catholics who pay their taxes even while they realize that the government will be spending some of their tax dollars on activities Catholics find to be immoral and even abhorrent.

The National Catholic Bioethics Center reviewed a number of grants and provided CRS with its moral analyses as to whether or not, in its judgment, these grants were morally acceptable. All the NCBC does, at the request of bishops and others in authority, is to attempt to apply the teachings of the Church to concrete circumstances and to use its best judgment as to whether the possible cooperation would achieve some great good without contributing to the evil that the other party might also be involved in.

If a Catholic would agree with the evil another person were committing and would cooperate with that person, he would be guilty of what the moralists call formal cooperation in evil. This is always unacceptable. If a Catholic were to cooperate with someone to achieve a great good, such as feeding starving populations, even while that other person were doing something immoral, such as providing contraception through another program, could the Catholic do it? It depends on a number of factors. If there were no other effective way to get the food to the starving population and if money were provided only for that purpose with none of it going to contraception, then it might be possible to do so. This would be called mediate (i.e., indirect) material cooperation with evil and could be allowed if there were a great good to be obtained and a great evil avoided and one did not contribute to the evil being done by the other party.

When The National Catholic Bioethics Center carefully reviewed the sub-grant relationship with CARE, it came to the conclusion that the grants would likely save lives and that the funds could not be made available through an agency other than CARE because of the personnel and institutions they had in place.  The NCBC also concluded that the money could not be used for any other purpose than that for which CRS had given it. Indeed, it would be illegal to do so. Consequently the NCBC came to the conclusion that providing such a grant would be acceptable through the application of the Principle of Material Cooperation.

At the core of the NCBC analyses was the belief, based on the facts provided by CRS, that the grants provided would be used exclusively for good purposes that could not be effectively realized by CRS otherwise.

Some have said that CRS was incapable of restricting the use of their funds to the good works which were being done by CARE. Money used for those good works would “free up” funds to be used for immoral purposes. However, the grants given by CRS do not go into some general pool of funds that can be moved around or used for other purposes. This would be in violation of the grant agreement and of federal law, specifically the Code of Federal Regulations 226, which requires that federal funds going to non-governmental entities can only be used for the purposes for which they are given. The NCBC concluded that great care was taken by CRS to see that funds were used only for the purposes designated, i.e., assisting the poor, the malnourished, and the starving.

However, there is another dimension to the Principle of Material Cooperation: the consideration of the risk of scandal. Even if cooperation with an evildoer to achieve some great good were morally legitimate it still could not be done if the action of the Catholic would lead others to believe that the Catholic Church were indifferent to the evil, such as, for example, contraception.

In this case, the NCBC was gravely concerned about the risk of scandal that could arise from a Catholic agency cooperating with an organization that consistently took such strong public positions at odds with the Catholic Church, such as advocating contraception and abortion. We strongly cautioned CRS of the problems of misunderstanding that could arise with a grant to CARE and urged them to repudiate the public advocacy of abortion and contraception by the leadership of CARE. Incidentally, at its website, under Frequently Asked Questions, CARE now states: “CARE does not fund, support, or perform abortions.” The NCBC welcomes that statement which could not be found at the website of CARE when the review was done. At that time there was, however, the congressional testimony of the President of CARE, Dr. Helene Gayle, calling for the rescinding of the “Mexico City Policy,” which forbids the use of U.S. foreign aid for abortions. That statement is still at the website. It was because of such public positions antithetical to the positions taken by the U. S. bishops that the NCBC thought that there should be a public repudiation of such CARE positions by CRS. CRS responded to our concerns about the risk of scandal by incorporating into their mission statement the following:

As a part of the Universal Church, Catholic institutions are our partners of preference in our work. To reach all those who need our help, we also participate in humanitarian initiatives undertaken by a wide range of groups, such as governments, other faith communities and secular institutions. Although some positions and practices of these institutions are not always consistent with the full range of Catholic teaching, CRS' association with them is always and only focused on activities that are fully consistent with Catholic teaching. Furthermore, CRS neither facilitates, endorses nor enables any violation of those teachings. CRS and its board of bishops and laypersons have a careful review system to ensure fidelity to Catholic moral teaching and to ensure that all funds under CRS' direct control are used only for purposes complying with that teaching.

In submitting its report to CRS on January 12, 2012, the NCBC concluded the work it had done for CRS with respect to the CARE grants that it had reviewed. CRS obviously assumes the responsibility for the grants which it awards. 


Ethicist Position Available at the NCBC

Staff Ethicist
Starting date: October 1, 2012

Click to download position description. 

The National Catholic Bioethics Center (NCBC) is seeking a full time ethicist to join its professional staff in Philadelphia beginning October 1, 2012 (or earlier). Applicant must be a practicing Catholic who is committed to magisterial teaching, trained in the Catholic moral tradition and conversant with medical terminology. An earned doctorate or other terminal degree is required. The ideal candidate will have teaching and public speaking experience and be published in a scholarly journal. Reading proficiency in one or more modern languages is desirable and standard computer skills required (esp. MS Word and Power Point).

Additional desirable qualifications include:

• Significant teaching/public speaking experience.
• Excellent verbal and written communication skills.
• Some clinical ethical experience in a health care setting.

Specific responsibilities include:

• Management of institutional consultation services for health systems/hospitals that have agreements of service with The NCBC.
• Participation in ethical consultation services on rotation (telephone and e-mail). This includes 24/7 emergency consultation rotation for one week each month.
• Teaching within The NCBC annual seminars, speaking engagements, and other educational programs.
• Willingness to publish in NCBC publications.
• Other institutional consultation services as assigned.
• Travel as required.

The NCBC 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 and two adjunct ethicists, each of whom holds at least one doctorate, a small publications department, and additional administrative and support staff. Applicants are encouraged to familiarize themselves with The NCBC website (

Applications should include the following:

• Letter of interest with a narrative of the applicant’s background and professional experience.
• Curriculum Vitae.
• Three samples of the applicant’s research and writing on both the popular and academic levels.
• Three letters of recommendation or names of references.

Applications should be directed by surface mail to Dr. John M. Haas, President, or by electronic mail to

All applications will be received and held in confidence.
Deadline: August 16, 2012

Stay Connected & Protect Our Liberty: Text FREEDOM to 377377

The U.S. Conference of Catholic Bishops has created a method of instantaneous notification, via texting and e-mailing, to those committed to protecting the right to religious liberty.  An invitation to stay connected was extended by Archbishop William Lori, Chairman of the USCCB Ad Hoc Committee for Religious Liberty, at the closing Mass of the Fortnight for Freedom on July 4, 2012, at the National Shrine of the Immaculate Conception in Washington, DC. Archbishop Lori invited all interested in protecting religious liberty to stay connected by texting the word FREEDOM (or LIBERTAD in Spanish) to 377377 on their mobile devices. Through this mechanism all interested persons can receive timely information and alerts to stay engaged in this ongoing initiative to protect the First Amendment right to the Free Exercise of Religion.  Also, the USCCB web page contains tremendous resources to help everyone to stay informed, to educate others, and to have voices heard.  These materials, in both English and Spanish, include videos, written resources, and web-based methods of education and action:

The phenomenal homily by Archbishop Charles Chaput (Philadelphia), given at the closing of the Fortnight Mass, also is available: Archbishop Chaput clearly articulated the true meaning of the often misunderstood concepts of religious liberty and the separation of church and state, using the Gospel parable of “Render unto Caesar what is Caesar’s, and to God what is God’s” (Matthew 22: 15-22).  As Archbishop Chaput shared with all at that Mass:

"We need to render unto Caesar those things that bear his image. But we need to render ourselves unto God — generously, zealously, holding nothing back. To the extent we let God transform us into his own image, we will — by the example of our lives — fulfill our duty as citizens of the United States, but much more importantly, as disciples of Jesus Christ." 

—Most Reverend Charles J. Chaput, O.F.M. Cap, Archbishop of Philadelphia, Fortnight Closing Homily, July 4, 2012


NCBC Response to the June 28 Ruling of the U.S. Supreme Court Upholding the Affordable Care Act

The National Catholic Bioethics Center is deeply disappointed to learn that virtually the entire Patient Protection and Affordable Care Act (ACA) remains standing in the wake of the June 28, 2012 U. S. Supreme Court ruling.  The ACA includes provisions that violate respect for human life and dignity and the rights of conscience, and that undermine the principle of subsidiarity.  Of course, the Court did not rule that the law is good in its entirety or even that it can be effectively implemented and sustained.  It merely ruled that it does not violate the Federal Constitution.

We find it odd that the Supreme Court, having found an insufficient basis to judge in favor of the ACA on Commerce Clause grounds, chose to accept the secondary justification offered by the administration, namely, that the mandate is a tax on the American people. As noted in the minority’s dissent, it is dangerous to ignore the legislative intent of the Congress in a case such as this.

The National Catholic Bioethics Center remains opposed to the law not because universal health care coverage is somehow undesirable as a goal, but predominantly because the ACA will provide coverage for abortion on demand and violate the conscience of employers and enrollees who will be forced to subsidize abortion.  There also is little protection of health care providers who may be coerced to provide contraceptives and abortifacients.  Furthermore, the Health and Human Services mandate has come to be woven into the fabric of the ACA as a post-provision that poisons the well of authentic health care and radically contradicts respect for conscience, which is particularly important in healthcare settings where the human person is vulnerable and easily violated. The National Catholic Bioethics Center thus remains compelled to oppose the measure in its entirety until a proper respect for the First Amendment, religious freedom, rights of conscience, and human life are properly incorporated into the law, and safeguarded in medical decision-making.

From the perspective of social justice, this law jeopardizes the principle of subsidiarity, which, like the principle of federalism upon which our Constitution was written, holds that services ought to be provided by those social agencies and instrumentalities of government that are closest to the point of delivery.  Tremendous dangers lie in health care being orchestrated by the highest level of social organization, our federal government.

The Bishops, many Catholics, and others of conscience remain deeply troubled by this law and will continue to work to ensure the protection of the consciences of those providing health care and other social services to those in need.


Are Journalists Now Scientists: A Reporter Loses Sight of Data on Plan B

There has been much talk erroneously concluding that the New York Times has proven that the abortifacient effect of the ingredients in Plan B (levonorgestrel) and ­ellaOne (ulipristal) 1 do not prevent implantation of the ­conceived human embryo.2 Interestingly, the New York Times ­journalist Pam Belluck initially says, “Labels ­inside every box of morning-after pills, drugs widely used to prevent pregnancy after sex, say they may work by ­blocking ­fertilized eggs from implanting in a woman’s uterus. Respected medical authorities, including the ­National ­Institutes of Health, and the Mayo Clinic, have said the same thing on their Web sites.” The journalist then ­proceeds to negate these respected opinions. The facts she uses to support her conclusions are, at best, incomplete....

Click to continue reading



Studies Demonstrate the Need for Greater Rigor in Same-Sex Parenting Science and Reaffirm the Advantages of Traditional Family Structure

The science used to cast homosexual parenting in a neutral or even positive light has proved unsound. Two recent studies, published in Social Science Research, challenge a position that is summarized in the words of the American Psychological Association’s 2005 brief on same-sex parenting:

[T]he evidence to date suggests that home environments provided by lesbian and gay parents are as likely as those provided by heterosexual parents to support and enable children's psychosocial growth.

The first study, called the New Family Structures Study (NFSS), is authored by Mark Regnerus, a sociologist at the University of Texas at Austin. It boasts data from a significantly larger, randomized, heterogeneous, and nationally representative sample with more adequate comparison groups than past studies. The outcomes were reported by adult subjects themselves rather than by parents. Regnerus draws no conclusions about causal relationships, recognizes the major limits of his study, and acknowledges confounding variables. His conclusions can be summarized in two simple points: (1) “the claim that no notable differences exist [in child development outcomes] must go,” and (2) “children appear most apt to succeed well as adults . . . when they spend their entire childhood with their married mother and father, and especially when the parents remain married to the present day.”

The second study, authored by Loren Marks of Louisiana State University, shows how not one of the 59 major same-sex parenting studies cited by the APA in its 2005 brief meets the statistical standards necessary to prove the “null hypothesis,” or the conclusion that there are no significant differences, between same-sex parenting and married biological parenting. In sum, all 59 are likely guilty of a statistical Type II error: an unwarranted conclusion that there are no differences.

The two new studies, taken together, emphasize two points. The first is that more reliable and statistically powerful studies are still necessary to draw meaningful scientific conclusions about the small size effects of same-sex parenting versus other forms of parenting. The Regnerus study, despite various shortcomings, is a dramatic step in the right direction. As an editorial in Deseret News aptly notes, “The NFSS appears to provide researchers a framework for . . . sound rigorous social science with regard to the vital issue of family structure and child well-being.” Despite the recognized imperfections of the Regnerus study, it can surely be said, in the words of Patrick Fagan of the Family Research Council, that “if you can’t draw conclusions from it, there’s not a snowball’s chance in hell you can draw conclusions from those other [same-sex parenting] studies.” Douglas Allen, a Canadian economist and expert on same-sex marriage studies, agrees: “If the Regnerus study is to be thrown out, then practically everything else in the field has to go with it.”

The second point is an affirmation of the traditional family structure. In the words of Charles Cooke of the National Review, “the major takeaway from the [NFSS] report is less an indictment that same-sex households are a negative thing and more an affirmation that intact, biological households are a positive thing.” According to the Deseret News, it confirms “what biology, sociology, custom and religion have long indicated: family structure counts and the intact married biological family is the healthiest structure for nurturing the next generation.” In his conclusion, Regnerus states: “[T]he NFSS clearly reveals that children appear most apt to succeed well as adults—on multiple counts across a variety of domains—when they spend their entire childhood with their married mother and father, and especially when the parents remain married.”

In sum, the existing science does not provide definitive answers and solid empirical support specifically for or against same-sex parenting per se. Regnerus and Marks have opened the doors to greater rigor, but social science researchers expect it will take years—and perhaps decades—before the impact of same-sex parenting becomes apparent. In the meantime, the debate shall go forward based on principles—so let reason, seeking to understand the human person and his true good, take to the field on both sides, ever wary of the manipulative use of scientific data to support unfounded claims that the research available “is accepted beyond serious debate” in the scientific community. Until proven otherwise, one point remains clear: when it comes to children’s outcomes, no other family structure is healthier or even comparable to married biological parenting.

John A. Di Camillo, Be.L., NCBC Staff Ethicist


NCBC Collaborates with the National Catholic Partnership on Disability to Promote the Fortnight for Freedom

The National Catholic Bioethics Center (NCBC), partnering with the National Catholic Partnership on Disability (I Chair the NCPD Ethics Committee) has developed daily activities in which individuals and groups can participate during the Fortnight For Freedom, beginning on June 21 and ending on July 4, 2012.  In response to the U.S. Health and Human Services’ (HHS) mandate, that employers violate their constitutionally protected religious freedom and provide contraceptive coverage to employees, the United States Conference of Catholic Bishops’ (USCCB) Ad Hoc Committee for Religious Liberty released a statement entitled "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.”  The USCCB has asked each of us to participate in some of the many activities the Bishops have suggested to protect this basic right.  The Bishops also have asked us to develop our own individual ways of sharing in this Fortnight For Freedom.  Thus, the NCBC and the NCPD have developed 14 activities, one per day, for you to engage in locally, that demonstrate solidarity with this national initiative. 

Contained on the NCPD website at are materials that can be printed out as daily posters, as well as a Fortnight Calendar that contains the daily activities, which can be printed off and shared with others.

We hope you take advantage of these resources and share them with others.  The threat to religious freedom is real, and our voices, actions, and prayers are urgently needed. 


Dr. Marie T. Hilliard, Director of Bioethics and Public Policy Receives Honorary Doctorate from the Franciscan University of Steubenville

On May 12, 2012, Dr. Marie T. Hilliard, Director of Bioethics and Public Policy for The National Catholic Bioethics Center, received the Doctor of Christian Ethics degree, honoris causa, from the Franciscan University of Steubenville  and provided to the 191 graduate degree recipients the Commencement Address.  Dr. Hilliard is pictured with Franciscan University President, Father Terence Henry, TOR, General Michael V. Hayden, USAF (Ret.), recipient of the Doctor Public Administration degree, honoris causa, on that same day, and Franciscan University Board of Trustees Chair, Fr. Nicholas Polichnowski, TOR.

Please see for the program and text of Dr. Hilliard's address.


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

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


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

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

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:

For more information on religious liberty and conscience rights, see:


A Primer on the HHS Preventive Services Mandate

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:  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.


Religious Freedom from a Founder's Perspective

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.


Fight for Religious Liberty Is Not Just Catholic

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

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

[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:

[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.


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

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.


The Santorum Family and the Loss of Gabriel

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 19th or 20th 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