Allocating Scarce Medical Resources

Roman Catholic Perspectives

H. Tristram Engelhardt Jr. and Mark J. Cherry, Editors

"Every chapter will be a 'must-read'—not only for those interested in what Catholic moral thought has to say about the allocation of health care resources, but also for those concerned about what makes Catholic health care 'Roman Catholic' and those who seek greater insight into and appreciation for the contribution of Catholic moral thought to public policy."
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Roman Catholic moral theology is the point of departure for this multifaceted exploration of the challenge of allocating scarce medical resources.

The volume begins its exploration of discerning moral limits to modern high-technology medicine with a consensus statement born of the conversations among its contributors. The seventeen essays use the example of critical care, because it offers one of the few areas in medicine where there are good clinical predictive measures regarding the likelihood of survival. As a result, the health care industry can with increasing accuracy predict the probability of saving lives—and at what cost.

Because critical care involves hard choices in the face of finitude, it invites profound questions about the meaning of life, the nature of a good death, and distributive justice. For those who identify the prize of human life as immortality, the question arises as to how much effort should be invested in marginally postponing death. In a secular culture that presumes that individuals live only once, and briefly, there is an often-unacknowledged moral imperative to employ any means necessary to postpone death. The conflict between the free choice of individuals and various aspirations to equality compounds the challenge of controlling medical costs while also offering high-tech care to those who want its possible benefits. It forces society to confront anew notions of ordinary versus extraordinary, and proportionate versus disproportionate, treatment in a highly technologically structured social context.

This cluster of discussions is enriched by five essays from Jewish, Orthodox Christian, and Protestant perspectives. Written by premier scholars from the United States and abroad, these essays will be valuable reading for students and scholars of bioethics and Christian moral theology.

Table of Contents

H. Tristam Engelhardt Jr.

Part I / Moral Responsibility and High Technology: An Introduction

Infinite Expectations and Finite Resources: A Roman Catholic Perspective on Setting Limits to Critical Care, or Can Roman Catholic Moral Theology Say More than Secular Morality Provides?
H. Tristram Engelhardt Jr.

Facing the Challenges of High Technology Medicine: Taking the Tradition Seriously
Mark J. Cherry

Part II / Moral Consensus Statement

Consensus Statement
Working Group on Roman Catholic Approaches to Determining Appropriate Critical Care

Part III / The Challenges of Critical Care: High Technology, Rising Costs, and Guarged Promises

Respect for Human Life in the World of Intensive Care Units: Secular Reform Jewish Reflections on the Roman Catholic View
Michael Rie

What is Appropriate Intensive Care? A Roman Catholic Perspective
Paulina Taboada

Part IV / Moral Theological Perspectives

Limiting Access to Health Care: A Traditional Roman Catholic Analysis
Joseph Boyle

Towards a Personalistic Ethics of Limiting Access to Medical Treatment: Philosophical and Catholic Positions
Joseph Seifert

Equal Care as the Best of Care: A Personalist Approach
Paul T. Schotmans

Quality of Life and Human Dignity: Meaning and Limits of Prolongation of Life
Ludger Honnefelder

Part V / Moral and Public Policy Challenges

Beyond the Questions of Limits: Institutional Guidelines for the Appropriate Use of Critical Care
George Khushf

Developing the Doctrine of Distributive Justice: Methods of Distribution, Redistribution, and the Role of Time in Allocating Intensive Care Resources
M. Cathleen Kaveny

Creating Critical Care Resources: Implications for Distributive Justice
Kevin Wm. Wildes, SJ

Part VI / From a Different Point of View: Jewish, Orthodox, and Protestant Perspectives

Allocation of Scarce Medical Resources to Critical Care: A Perspective from the Jewish Canonical Tradition
Teodoro Forcht Dagi

The Current Medical Crises of Resources: Some Orthodox Christian Reflections
Very Reverend Edward Hughes

The Allocation of Medical Services: The Problem From a Protestant Perspective
Dietrich Rössler

Part VII / Critical Commentary

Between Secular Reason and the Spirit of Christianity: Catholic Approaches to Limiting Access to Scarce Medical Resources
Corinna Delkeskamp-Hayes

Catholicizing Health
James W. Heisig

Roman Catholic Theology and the Allocation of Resources to Critical Care: The Boundaries of Faith and Reason
Mary Ann Gardell Cutter


"Every chapter will be a 'must-read'—not only for those interested in what Catholic moral thought has to say about the allocation of health care resources, but also for those concerned about what makes Catholic health care 'Roman Catholic' and those who seek greater insight into and appreciation for the contribution of Catholic moral thought to public policy."—Health Progress

"Offers a vigorous dialogue regarding the interplay of numerous moral rationalities, not simply a reworking of questions regarding the interplay of faith and reason. This is a collection of essays that fruitfully encompasses a plurality of views often in foundational and impassioned disagreement but nevertheless in dialogue. Readers of whatever religion or of none, whether academic, health care professional or student, should find this a useful volume."—Medicine, Health Care and Philosophy


Supplemental Materials


About the Author

H. Tristram Engelhardt, Jr., is professor in the department of philosophy at Rice University and professor emeritus at Baylor College of Medicine, Houston, Texas, as well as editor of the Journal of Medicine and Philosophy and senior editor of Christian Bioethics.

Mark J. Cherry is assistant professor of philosophy at Saint Edward's University, Austin, Texas.

344 pp., 6 x 9

May 2002

344 pp., 6 x 9

ISBN: 978-0-87840-882-5
May 2002

344 pp.

ISBN: 978-1-58901-234-9
May 2002

Clinical Medical Ethics series
H. Tris Engelhardt and Kevin Wm. Wildes, Series Editors

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