An article by Mark Repenshek and a letter by Edward Delaquil published recently in The National Catholic Bioethics Quarterly underscore the urgent need for further moral and magisterial clarification regarding a number of highly complex and difficult bioethical issues. These involve ex utero therapeutic genomic interventions, the practice of in vitro fertilization and embryo transfer, and the ongoing debate over the morality of embryo adoption to help resolve the “absurd” fate of countless, cryopreserved human embryos. This essay critiques and argues against the use of therapeutic IVF, helps clarify why embryo transfer and embryo adoption do not violate the sacred bond of marriage, and uses key magisterial passages from both Donum vitae and the Catechism of the Catholic Church to defend the practice of embryo transfer. National Catholic Bioethics Quarterly 14.2 (Summer 2014): 227–234.

Today, Catholic health care involves complex medical professional organizations, incredible technological and scientific accomplishments, prohibitive costs, and interfering governmental participation. Notwithstanding the challenges presented by the structural transformation of Catholic hospitals in recent years, Pope Francis’s instruction revives the duty of health care professionals to act as missionaries. This essay explores why Francis maintains the importance of building Catholic health care during these changing circumstances. Confronting the penchant of our modern medical culture to marginalize the weakest members of our society, Francis addresses the perils that follow when health care professionals are no longer seen as servants to the dignity of all life. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 421–428.

The development of hormonal contraception introduced a new era in medical practice, marked by the suppression of female fertility by interventions in the hormonal system. The interventions are very grave, as sex hormones are of existential importance both to preserve human life and to preserve the human species. This article conducts an ethical evaluation of the use of hormonal contraception through two ethical theories: natural law theory and virtue ethics. Based on philosophical reflection, the author examines what effects hormonal contraception has on primary goods and whether its use is congruent with the cardinal virtues. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 491–524.

When the delivery of a baby at the edge of viability (twenty-two to twenty-five weeks) is imminent, gestational age is usually the primary indi­cator for resuscitation. However, four other variables—female sex, antenatal corticosteroid therapy, singleton birth, and increased birth weight—are also associated with better infant survival and neurologic outcome in intensive care, and the combination of all five variables provides a stronger prognostic tool. An ethical framework is provided here for use in determining whether proposed treatments are likely to defend the dignity and sanctity of a fragile periviable life. The framework is based on the principle of ordinary/propor­tionate and extraordinary/disproportionate medical treatment. The author recommends using the most recent outcome data and this ethical framework together to make perinatal resuscitation decisions. Use of gestational age alone is insufficient and ethically immoral. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 429–439.

This article explores the evolution of Principles of Biomedical Ethics by Tom Beauchamp and James Childress over its seven editions (1979–2013). Many changes have occurred in the text over the last thirty-five years, including the expansion of the section on virtue ethics, the modification of the authors’ position on physician-assisted suicide, and the addition of many other ethical theories to the original two (deontology and utilitarianism) found in the first editions. The basis for these changes and others seems to be their development of the theme of the “common morality.” The author suggests that Beauchamp and Childress develop the connection between their common morality and metaphysics, as it would serve to strengthen their theory and make it less susceptible to changes in society’s opinions and traditions. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 459–475.

Approximately 800,000 human embryos are currently in cryostorage in the United States. The Catholic Church holds that in vitro fertilization (IVF) and cryopreservation of human embryos are intrinsically evil. IVF continues to increase at a rate of approximately 9 percent per annum. Many Catholic couples have used IVF as a means to conceive a child. There are typically additional embryos that are cryopreserved for later use. Once a couple has reached the number of children they desire, they are faced with a very difficult moral decision regarding the disposition of their remaining frozen embryos. The biological parents must choose one of four options. Three result in death of their frozen embryos. Only one can possibly result in life. The only moral option is embryo adoption, a life-giving choice that is strongly supported by Sacred Scripture and Sacred Tradition. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 441–447.

Catholic ethical teaching has increasingly relied on a concept of the common good for making and evaluating social decisions. The authors have argued that the common good is a maximal and ideal concept about which people and communities differ fundamentally. In practice, it does not resolve moral and social disagreements. The concept of the common harm is preferable because it is a minimal standard that can be more clearly identified and agreed for individuals and society, providing a basis for legislative and social action. Bioethics and public health both have strong roots in doing no harm and preventing harm to both individuals and communities in society. The authors argue that the application of the concept of the common harm from these disciplines into wider use in the health professions and public policy would be beneficial. National Catholic Bioethics Quarterly 14.3 (Autumn 2014): 449–455.

Catholic ethicists faithful to the magisterium of the Church are currently divided on the permissibility of using methotrexate to treat ectopic pregnancies. This paper examines the defenses of Rev. Albert Moraczewski, OP, and Christopher Kaczor, who argue that its use is morally permissible, in an attempt to demonstrate that methotrexate constitutes a direct abortion by virtue of its object. Specifically, the paper challenges the claims that methotrexate is aimed at inhibiting pathological tissues, that the trophoblast is not an organ of the embryo, and that direct removal of a nonviable fetus is not a direct abortion. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 625–635.

Although two documents from the Congregation for the Doctrine of the Faith have given instruction on the moral problems of artificial reproductive technologies and the importance of respecting the lives of cryopreserved embryos, no definitive judgment has been made regarding the possibility of rescuing those embryos by means of embryo transfer into the uterus of a willing woman. This essay offers an analysis of the morality of embryo transfer in light of the ethical principles of St. Thomas Aquinas and argues that the proper use of our generative potential is only safeguarded by being restricted to marital intercourse. The arguments of those who favor the adoption model are considered and rejected in light of a Thomistic analysis of the categories of paternity, maternity, and filiation. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 673–695.

Elderly persons are living longer with debilitating illnesses and are at risk for suicide. They are also more likely to have a living will with a DNR order. With the medical culture’s emphasis on patient autonomy, an ethical approach that respects the dignity of these suffering human persons is needed. Suicide must be viewed as an act against the principle of life and the intrinsic good of the human being. Beneficence outweighs autonomy in such cases. Medical providers are at risk of mediate material cooperation with the evil of such an act if they fail to preserve a life that can be saved. DNR orders should be reversed in these situations until these patients receive psychological treatment and pain relief. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 661–671.

Untreated depression at the end of life may affect treatment and raise ethical concerns. Patients with a major depressive disorder may desire a hastened death, may refuse reasonable and beneficial medical care, or may present with cognitive distortions that hinder their ability to make decisions about care. Treating depression can avert or minimize these problems in many cases. For a patient who does not respond to antidepressant medications and other interventions, however, the unrelieved depression could tip the balance and make additional medical treatments burdensome. In such cases, a proposed medical treatment might be considered extraordinary. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 697–710.

Despite billions of dollars spent in risk-reduction measures, the HIV rate in men who have sex with men (MSM) continues to soar. Although MSM represent approximately 4 percent of the male population in the United States, in 2010 male-to-male sex accounted for 78 percent of new HIV infections among males. More emphasis needs to be given to risk-avoidance measures. The Catholic Church is both courageous and medically correct in stating that homosexual acts are harmful. The health risks of homosexual sex are scarcely mentioned in the public debate, as misguided political correctness seems increasingly to hold science and medical data hostage. Our brothers should be informed about the dangers of an active homosexual lifestyle and encouraged to live chastely. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 637–645.

By its central terms, the language of the culture of death sends signals that produce life-accepting associations and at the same time mask its intentions against life. On the one hand, the culture of death includes certain behaviors. On the other hand, it includes those social and legal structures that strive to make killing socially acceptable by camouflaging it as a medical service or a social assistance. The culture of death wants to remove killing from condemnation, so that it is no longer cursed as a crime. In the center of the culture of death is the battle for the legalization of abortion, euthanasia, and embryonic stem cell research. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 647–657.

Examination of the bioethical concept of futile-care theory reveals its deleterious effects on patients when put into practice. Futile-care policies and laws unilaterally locate health care decision making in persons and committees other than the patient and his surrogate(s). Although not voluntarily ceded by the patient, this authority is assumed by third parties whose interests and goals do not contribute to the material and spiritual flourishing of the individual patient. A prime example is the Texas medical futility law, which blatantly disregards the natural right of patients to decide the course of their own health care. Christians are called on to oppose this unprecedented assault on human dignity, freedom, and life itself. National Catholic Bioethics Quarterly 14.4 (Winter 2014): 619–624.