The director of Courage International talks about the work of the apostolate in addressing homosexuality according to the mind and heart of the Church, which he calls “one of the most demanding aspects of education, formation, and pastoral care today.” But it is also an opportunity to attend to the often acute and persistent wounds of those who need healing within what Pope Francis calls the “field hospital” of the Church. The author points out that the work of Courage is not first about homosexuality but about what it means to be human. It is an invitation to consider the question of the fulfillment of the human heart according to God’s gracious plan. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 221–230.

In Evangelium vitae, Pope St. John Paul II recognized that scientific progress would bring about new attacks on the dignity of the human person. Since that time, remarkable expansion in our knowledge and understanding of the human genome has brought forth questions of ownership rights via patents on human genes and related technology. This article argues that patenting human genes is incompatible with human dignity as it commodifies that which is priceless. In contrast, granting patents to manipulations of human genes does not violate human dignity so long as it is utilized toward the common good. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 265–285.

A recent consensus statement claimed that double effect can justify induction of labor before viability when life-threatening pathological complications arise from the interaction of a normally functioning placenta with the diseased heart of the mother. The authors of this essay agree. They analyze two pieces published in response, using the framework of the first and fourth criteria of double effect; identify and attempt to clarify inaccuracies and other sources of ambiguity in the discussion; and acknowledge practical implications for other scenarios previously considered illicit. They conclude that more thorough medical and moral discussion is needed regarding the fourth criterion, even if the act itself is not intrinsically evil. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 251–261.

In this essay, some of the signatories to “Medical Intervention in Cases of Maternal–Fetal Vital Conflicts: A Statement of Consensus” respond to “The Placenta as an Organ of the Fetus: A Response to the Statement of Consensus on Maternal–Fetal Conflict,” both recently published in this journal. The response examines Bringman and Shabanowitz’s claims and assumptions about the morally relevant pathologic condition in some cases of peripartum cardiomyopathy complicated by a subsequent pregnancy, the moral status of a normally functioning placenta, and the use of the principle of double effect in these cases. The signatories’ response sets out to demonstrate how Bringman and Shabanowitz do not engage the essential points of the statement of consensus and how their argument is premised on false assumptions. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 241–250.

Torbjörn Tännsjö has argued that the practice of palliative, or terminal, sedation can be distinguished from the practice of euthanasia in a morally relevant way. He seeks to develop a coherent conceptual model for those who accept the sanctity-of-life doctrine, affirm the ethical permissibility of palliative/terminal sedation, and reject various forms of euthanasia. The author argues that Tännsjö has not sufficiently distinguished the practices of palliative/terminal sedation and euthanasia in a morally relevant way for those who accept sanctity-of-life values in end-of-life health care. His argument is a philosophical critique of the soundness of Tännsjö’s conceptual model. With respect to moral theology, the author claims that, in Tännsjö’s attempt to make his case, he uses the wrong conceptual tools, and the tools he does use, he uses wrongly. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 287–301.

This article offers an exposition and critical discussion of the account of the truth of practical reason in the natural-law theory of Germain Grisez, Joseph Boyle, and John Finnis. The exposition rests mainly on an article published by these authors in 1987. There they argue that “true” is said of theoretical and practical knowledge in radically diverse senses. They also distinguish, within practical knowledge, between two kinds of truth, practical and moral. This distinction is tied to their understanding of relations that obtain among the first principles of practical reason. The essay’s critical discussion raises problems for the account in all three areas and favors the view that “true” means the same for all knowledge. National Catholic Bioethics Quarterly 15.2 (Summer 2015): 303–329.

The biblical healings by Jesus and the primitive Church, the liturgical development of the Roman Rite of Exorcism, and the current practice of exorcists reflect a relationship between exorcism and the medical healing arts. Since mutuality characterizes all healer–sufferer interactions, informed consent is a central concept in physician–patient and exorcist–energumen relationships. Informed consent requires adequate information, decision-maker competence, and freedom from coercion. The determination of freedom from coercion is a particular challenge in exorcism, and guidelines for its assess­ment are discussed. While proxy decision making in medical care is generally driven by concerns over competence, foreseeable periods of demonic coercion will necessitate establishing proxies in exorcism. This places a moral duty on the exorcist to establish a substitute decision maker even in cases where the energumen would be considered competent. Discussion of this need through the process of informed consent builds the trust necessary for mutual decision making.

The statistics and studies speak clearly to a need for the pro-life movement to embrace opposition to contraception as a means of reducing our culture’s resort to abortion. What are some policies that may help us to confront the contraceptive orthodoxy in ways that are politically viable in the face of near-universal acceptance of contraception?

Previously conducted research has determined that physiological and psychophysiological communications evident during pregnancy are vital to the bond formed prenatally. These innate biological responses are further enhanced through psychophysiological factors, such as maternal prenatal stress, which attest to the essential communication between a mother and child in maternal–fetal attachment. A consideration of these factors is necessary with the increase in assisted reproductive technology, such as in vitro fertilization, surrogacy, and elective cesarean section, as this may affect the development of the maternal–fetal bond. It would be of benefit to the child, the mother, and every society to seek a more complete understanding of the intricate maternal–fetal bond, as the first friendship developed at the beginning of human life.

In Catholic moral theology, the principle of double effect has been an effective normative tool for centuries, and it can be used to determine the ethicality of actions that contain both good and evil consequences. The principle of double effect is especially useful in end-of-life care, because many end-of-life treatment options inherently have both good and evil conse­quences. The principle of double effect can be used to make both practical and moral distinctions between the acts of euthanasia, physician-assisted suicide, palliative sedation, and the withholding and withdrawal of life-sustaining treatment, which can be classified as either unjustified acts of killing or jus­tifiable acts of allowing to die.

Sexual activity between spouses in long-term care settings has received increasing attention recently. This article considers the special case of sexual activity between spouses in long-term care when one spouse has dementia. The complex and interrelated issues of aging, sexuality, and dementia are reviewed, first through examination of a recent court case. Then, issues of sexuality and aging, assessment of capacity and competency in dementia, and institutional responses to these situations are considered in light of Catholic bioethical tradition. The argument is made that Catholic long-term health care facilities ought to proactively address these issues, and some concrete suggestions are offered to address clinical care and risk management in these settings.

There exist a variety of biological variations known as intersex conditions (ICs) or disorders of sex development (DSDs), which cause a per­son’s sex as male or female to be uncertain at birth. In the past several decades, cosmetic surgery aimed at “normalizing” the infant’s body has become an increasingly controversial treatment for an infant with an IC or DSD. While ICs and DSDs are not addressed directly by Catholic moral teaching, the Catholic Tradition has a number of tools (prudence, dignity, and hospitality) that can undergird a Catholic response to the suffering of people with ICs and DSDs and support improved medical, pastoral, and spiritual care for them and their families.

The author argues that genetic technologies can never be fully sepa­rated from their eugenic ends. Because of this, the Church’s sexual ethic must be integrated with its social teaching to respond faithfully to ethical issues that arise with the use of genetic technologies. The author discusses, first, the Catholic opposition to eugenics from the turn of the twentieth century to the official papal condemnation of eugenics in 1930; next, the Church’s reaction to advances in DNA research in the 1950s and 60s; and finally, the shift from optimism to caution from the 1970s on, as new genetic technologies emerged in embryonic stem cell research, genetic counseling, and gene therapy. The author explores both the sources on which the Church has drawn in responding to genetic advances and the social issues that should prove fruitful for con­templation in the future.

As moral standards, natural law and the notion of properly functioning human nature have persisted in Western cultures from the dawn of civilization. Medieval Christians developed it in their theologies. However, Enlightenment criticism of medieval thought undermined the credibility of natural law and its authority for modern man. Jacques Maritain (1882–1973) developed a rational foundation for natural law and sought to provide objectivity to natural law precepts. His theory also reestablishes the divine authority of natural law for a world without faith. Maritain locates the primary disclosure of natural law in the conscience’s moral reflection in a controversial act of pre-conceptual or non-conceptual knowledge called connatural knowledge.