The National Catholic Bioethics Quarterly

In 2015, the Supreme Court of Canada decriminalized euthanasia. Soon after, the College of Physicians and Surgeons of Ontario enacted the Professional Obligations and Human Rights policy and the Medical Assistance in Dying policy. Neither these policies nor the Medical Assistance in Dying Act, the Ontario law permitting euthanasia, contains a conscientious objection clause. Instead, the policies require objecting doctors to provide an effective referral to a doctor who will euthanize the patient. Objecting physicians brought suit against the college. In a recent decision, the Ontario Superior Court of Justice held against the plaintiffs, finding the infringement of the effective referral policy on physicians’ rights to conscience and religious freedom to be appropriate when balanced against a patient’s right to equitable access to health care. Therefore, Catholic physicians in Ontario now must choose to violate either their religious beliefs or their professional obligations. It is imperative that these policies be struck down on appeal, superseded by an amendment, or revised by the college through the addition of a conscience clause.

In the Summer 2017 NCBQ, Joshua Evans strongly criticized arguments made by Charles Camosy about the possibility of a prenatal child being a material mortal threat to her mother. Here Camosy demonstrates that the formal/material debate remains open for non-dissenting Catholic moral theologians. He also shows that his reference to just-war theory is used to discuss innocence; it is not evidence of a particular methodology. Despite Evans’s claim to the contrary, Camosy notes multiple examples where he affirms the uniqueness of pregnancy and the special duty of parents to children. He argues for full deference to the magisterium in matters where doctrine has been defined and urges solid theological grounding for teachings on abortion when the mother’s life is at risk, especially given the profound personal and political issues at stake.

The financial toxicity of biotherapeutic treatments is examined. Kymriah, a new gene therapy, has a list price of $475,000 per treatment; Yescarta, from Kite Pharma, costs $373,000 per treatment. Such costs are a significant burden on patients, patients’ families, payers, health care systems, and communities. Studies have shown that financial toxicity—the effect of excessive treatment cost—diminishes patients’ quality of life, compliance, and survival. Some pharmaceutical companies promote outcomes-based pricing and other strategies to offset financial toxicity, but these approaches have not been shown to reduce burdens. Catholic teaching holds that the benefits of treatment should outweigh its burdens, and that burdensome treatments are not obligatory. The financial toxicity of treatments should be included in the ethical assessment of burdens on the patient.

Eugenic thinking divides people into groups according to real or perceived genetic traits, identifies some groups as unwanted, and then promotes the elimination of the unwanted groups. Some American medical professionals are pursuing a eugenic agenda that pressures and misleads parents to abort unborn children with Down syndrome. These counselors have a strong, unwar­ranted bias that influences parents’ decisions significantly. The use of prenatal genetic testing and in vitro fertilization increases the number of deaths of unborn children with Down syndrome. The widespread practice of identifying and aborting children with Down syndrome is properly called eugenics.

This March 2018 document replaces an earlier template policy, “Model Clinical Practice Ethics Guidelines for Affiliated Health Care Professionals with Respect to Prescription of Contraceptives,” drafted by The National Catholic Bioethics Center in the 1990s. Instead of a template policy, the new document provides definitions and principles to help health care institutions apply Catholic moral teachings if, for whatever reason, they happen to employ providers who prescribe contraception. The three basic principles are (1) distinguishing responsible agents and maintaining organizational integrity, (2) avoiding immoral cooperation, and (3) avoiding and resolving theological scandal.

Neuroethics is a new and rapidly expanding field in the academy and clinical practice. However, there is no comprehensive treatment of it from a specifically Catholic perspective. Nevertheless, the Catholic tradition contains possible criteria for a systematic approach to neuroethics. The personalist philosophical tradition, specifically modern ontological personalism, provides a framework for organizing and articulating those aspects of personhood that are most relevant to neuroscience and neuroethics

Pope St. John Paul II’s work on the Theology of the Body is well known among his many followers. Less well known is his conception of the human soul. Karol Wojtyla’s intricate philosophy of the soul fully endorses Aristotelian Thomistic psychology. Wojtyla’s main contribution is a phenomenological description of human action, which provides a credible basis for inferring the soul’s necessity. In the papal writings, John Paul II develops other resourceful doctrines, especially about the timing of ensoulment. His unelaborated notion of the genealogy of the person has implications for ethics. Following in the tradition of St. Thomas Aquinas, John Paul II presents an integrated wisdom about the soul that weaves together Christian revelation, modern science, and different modes of philosophical reflection.