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1. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Edward J. Furton

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2. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Philip Cerroni

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essays

3. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Rev. Cory Catron

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In 2018 the Congregation for the Doctrine of the Faith issued a responsum ad dubium, addressing the question of whether a hysterectomy is morally licit in cases wherein miscarriage is foreseen with medical certainty if the woman were to conceive. The CDF responded in the positive, explaining that “it does not regard sterilization.” The responsum provoked great controversy, with some commentators wondering at the prudence of issuing the teaching, and others questioning whether it represented a departure from the Catholic moral tradition. This paper looks at a further area of concern in the reasoning of the responsum, namely that it departs from an essentialist account of the human person and of the organs and systems within the human body, and it moves toward a functionalist account of the meaning of the body and bodily systems as arising from whether they are functional. This represents a distressing shift in language from the previous hermeneutic employed by the magisterium, which could open the door to further controversy.
4. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
William Matthew Diem

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The National Catholic Bioethics Center’s (NCBC) commentary on the Congregation for the Doctrine of the Faith’s 2018 responsum concerning hysterectomy fails to address the explicit reasoning that the CDF offers to justify its response. The CDF does not condone the hysterectomies in question as indirect sterilizations, justified by double effect. Rather, it defines procreation—and consequently sterilization—such that the moral categories of direct and indirect sterilization are not applicable in such cases. The CDF responsum is far more radical and consequential than the NCBC commentary acknowledges. The responsum provides Catholic ethicists with an occasion for a necessary conversation that can be had only once the reasoning of the 2018 responsum is taken seriously in its own right.
5. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Br. Columba Thomas, OP, MD

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In Evangelium vitae, Pope St. John Paul II addresses euthanasia and physician-assisted suicide by striking a balance—maintaining the inherent dignity of all persons while considering the lived experience of those struggling to see dignity amidst suffering. Subsequently, a debate about the word dignity has led to clarifications from the President’s Council on Bioethics (under President George W. Bush) regarding different uses of the word. This essay relies on the work of the council, especially an essay by Edmund Pellegrino, to provide a basis for reflecting on John Paul II’s approach to dignity in Evangelium vitae in terms of concept and lived experience. To further develop these insights, an alternative framework is proposed for thinking about dignity in the practical setting.
6. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Tyler Wittenmyer

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Empirical evidence has led some philosophers to question total brain death (TBD), because a brain-dead patient’s body remains integrated; it can still grow and age. Catholic philosophers have based arguments for and against TBD on Thomist principles of hylomorphism. Given such principles, the arguments against TBD appear stronger. Blessed John Duns Scotus provides an alternative set of principles. Specifically, Scotus is a pluralist regarding substantial form. However, his pluralism is distinct in that he denies a substantial form to the body as a whole and instead speaks of part-substances that are integrated with each other by efficient and final causal chains. Scotus’s hylomorphism, unlike St. Thomas Aquinas’s, can both defend TBD and adequately describe the physical characteristics of the totally brain-dead patient.

articles

7. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Graciela Ortiz

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One’s understanding of compassionate care and one’s response to suffering depend on one’s bioethical framework. This paper contrasts the principlist bioethical model with the personalist bioethical model. These emphasize different principles, definitions, and understandings of concepts such as autonomy, compassion, suffering, harm, and help. The principlist model regards euthanasia and physician-assisted suicide as acts of autonomy and compassion that eradicate suffering. This perspective fails to keep in mind that autonomous patients do not always act for their own good. Conversely, the personalist perspective emphasizes the integral good of the person, not just his or her autonomous choice, which is important but not unlimited. Since support for euthanasia and physician-assisted suicide often is motivated by a fear of suffering, being a burden, or depending on others, addressing the underlying factors that drive people to contemplate a hastened death is a more genuinely compassionate response than merely respecting people’s autonomous choice for a hastened death.
8. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Rev. Tadeusz Pacholczyk, Stephen Hannan, MD

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Ethical concerns regarding the conceptual framework for the determination of death by neurological criteria, including several clinical and diagnostic practices, are addressed. The significance of a diagnosis of brain death, diagnostic criteria, and certain technical aspects of the brain-death exam are presented. Standard and ancillary tests that typically help achieve prudential certitude that an individual has died are indicated. Ethical concerns surrounding interinstitutional variability of testing protocols are evaluated and considered, as are potential apnea-testing confounders such as hypotension, hypoxemia, hypercarbia, and penumbra effects during ancillary testing. Potential adjustments to apnea-testing protocols involving capnography, thoracic impedance monitors, or spirometers to assess respiratory efforts are discussed. Situations in which individuals determined to be brain dead “wake up,” or fail to manifest the imminent cessation of somatic functioning typically seen when supported only by a ventilator, are also briefly reviewed.
9. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Kevin Wilger

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Genetic engineering is a rapidly evolving field of research with potentially powerful therapeutic applications. The technology CRISPR-Cas9 not only has improved the accuracy and overall feasbility of genome editing but also has increased access to users by lowering cost and increasing usability and speed. The potential benefits of genetic engineering may come with an increased risk of off-target events or carcinogenic growth. Germ-line cell therapy may also pose risks to potential progeny and thus have an additional burden of proof for safety. Persons responsible for evaluating the ethics of genetic-engineering research programs or clinical trials should do so in light of the nature, integrity, and totality of the human person. Recent news of the implantation and birth of genetically engineered human embryos is just one example of increased rogue science. Health care institutions should consider what steps can be taken to prevent or slow this trend.

notes & abstracts

10. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Stacy Trasancos

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11. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Vince A. Punzo

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12. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Christopher Kaczor

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book reviews

13. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Joshua Evans

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14. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Brian Welter

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15. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Sarah Bartel

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16. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Elio Sgreccia

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17. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Perry J. Cahall

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18. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4
Robert E. Hurd

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19. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 4

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20. The National Catholic Bioethics Quarterly: Volume > 19 > Issue: 3
Greg Schleppenbach

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