Medical Ethics

In a single convenient resource, this revised and updated edition of a classic text organizes and presents clearly the documents of the Catholic Church pertaining to medical ethics. Introductory chapters provide the context for interpreting the Church's teachings and theological values, guiding the reader in how to apply the teachings to particular ethical dilemmas and helping the reader to understand the role of conscience within the Catholic tradition.

The teaching of the Church in regard to health care ethics is pertinent not only for health care professionals and students, but for all who are concerned about the common good of society. Medical Ethics examines specific teachings of the Church on over seventy issues in clinical and research ethics, including abortion, AIDS, artificial insemination, assisted suicide, cloning, contraception, euthanasia, gene therapy, health care reform, organ donation and transplantation, organizational ethics, stem cells, surrogate motherhood, and withholding and withdrawing life support.

O'Rourke and Boyle bring this fourth edition up to the present day by incorporating recent papal documents regarding the social aspects of health care, assent to Church teaching, and the 2008 papal instruction Dignitas personae, an extremely influential document that illuminates such controversial dilemmas as prenatal adoption, frozen embryos, and genetic diagnosis.

Table of Contents

Part I: Understanding Church Teachings

1: The View of the Person
Moral Norms
Nature and Cultural Needs
Person in Community
The Notion of Health
The Notion of Sickness and Death
The Notion of Sexuality
Conclusion

2: Normative Concepts
The Conditions for Double Effect
Concept of Legitimate Cooperation
Scandal
Informed Consent
Totality
Dignity of the Person
Common Good
Preferential Option for the Poor
Subsidiarity
Participation
Association
Solidarity
Justice

3: Formation of Conscience
Mistaken Notions of Conscience
Forming Conscience
Faith in the Formation of Conscience
Following Conscience
Conscience is Not Infallible
Various Levels of Teaching
Assent is Prompted by the Spirit
Withholding Assent and Dissent
Summary

Part II: Specific Teachings of the Church

4: Abortion
"The Gospel of Life"
"Declaration on Procured Abortion"
Ethical and Religious Directives for Catholic Heath Care Services
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation"
"Pastoral Guidelines for the Catholic Hospital and Catholic Health Care Personnel"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

5: Advanced Directives
Ethical and Religious Directives for Catholic Health Care Services
"The Rights of the Terminally Ill"
"Pastoral Letter"

6: Aging
"Society and the Aged: Toward Reconciliation"

7: AIDS
"Africa's AIDS Crisis"
"The Many Faces of AIDS: A Gospel Response"
"On Implementation of the Declaration of Commitment on HIV/AIDS"

8: Alternative Therapies
"Guidelines for Evaluating Reiki as an Alternative Therapy"

9: Anencephaly
"Moral Principles Concerning Infants with Anencephaly"
Ethical and Religious Directives for Catholic Health Care Services

10: Artificial Insemination and Assisted Reproductive Technologies (ART)
"Instructions on Respect for Human Life in Its Origin and on the Dignity of Procreation"
"Christian Norms of Morality"
"The Gospel of Life"
Ethical and Religious Directives for Catholic Health Care Services

11: Assisted Suicide
Catechism of the Catholic Church: Assisted Suicide
"Living and Dying according to the Voice of Faith"
"Living and Dying Well"
Ethical and Religious Directives for Catholic Health Care Services

12: Autonomy
"Evangelium vitae"

13: Autopsy
"Moral Problems in Medicine"

14: Brain Death
"Address of the Holy Father John Paul II to the 18th International Congress of the Transplantation Society"
"The Prolongation of Life"
"Guidelines for the Determination of Brain Death"
Ethical and Religious Directives for Catholic Health Care Services

15: Care for the Poor, or, Option for the Poor
"Deus caritas est"
Ethical and Religious Directives for Catholic Health Care Services
Ethical and Religious Directives for Catholic Health Care Services

16: Catholic Health Care
God Is Love
"Health Care: Ministry in Transition"
"Making the Case for Not-for-Profit Health Care"
"The Rationale of Catholic Health Care"
Ethical and Religious Directives for Catholic Health Care Services

17: Catholic Identity
Ethical and Religious Directives for Catholic Health Care Services
Ethical and Religious Directives for Catholic Health Care Services

18: Cloning
"Document of the Holy See on Human Cloning"
"Life-giving Love in an Age of Technology"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

19: Confidentiality
"Christian Principles and the Medical Profession"
"The Intangibility of the Human Person"
Ethical and Religious Directives for Catholic Health Care Services

20: Contraception
"Encyclical Letter on the Regulation of Births"
"The Christian Family in the Modern World"
"Evangelium vitae"
Ethical and Religious Directives for Catholic Health Care Services

21: Death, Determination of
"Determining the Moment When Death Occurs"
"Address to Participants at an International Congress Organized by the Pontifical Academy for Life"
"Address to the 18th International Congress on the Transplantation Society"
Ethical and Religious Directives for Catholic Health Care Services

22: Dignity of Person
"Evangelium vitae"
"Pastoral Constitution on the Church in the Modern World"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day"

23: Do Not Resuscitate (DNR)
"Evangelium vitae"
Ethical and Religious Directives for Catholic Health Care Services

24: Durable Power of Attorney
"Pastoral Letter"
A Catholic Perspective on Advance Directives in Illinois

25: Ectopic Pregnancy
Ethical and Religious Directives for Catholic Health Care Services

26: Embryos

I. Nature of the Embryo
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation"

II. Embryos: Stem Cells
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

III. Research on Embryos
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day"
Ethical and Religious Directives for Catholic Health Care Services

IV. Freezing Embryos
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

V. Reduction of Embryos
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

27: Emergency Contraception
"Emergency Contraception"
Ethical and Religious Directives for Catholic Health Care Services

28: Ethical and Religious Directives (ERD)
Ethical and Religious Directives for Catholic Health Care Services
Ethical and Religious Directives for Catholic Health Care Services

29: Ethics Committees
Ethical and Religious Directives for Catholic Health Care Services
Contemporary Catholic Health Care Ethics

30: Euthanasia
"Evangelium vitae"
"Declaration on Euthanasia"
"The Mystery of Life and Death"
Ethical and Religious Directives for Catholic Health Care Services

31: Fertility Assistance
Ethical and Religious Directives for Catholic Health Care Services
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

32: Fetal Remains, Disposal of
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day"

33: Futile Care
"Evangelium vitae"
"Declaration on Euthanasia"
"Mindful of the Common Good: Elections in New Zealand"

34: Gene Therapy
"The Ethics of Gene Manipulation"
"Moral Aspects of Genetics"
Ethical and Religious Directives for Catholic Health Care Services
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

35: Genetic Testing and Counseling
"Critical Decisions: Genetic Testing and Its Implications"
Ethical and Religious Directives for Catholic Health Care Services

36: Gamete Intra-Fallopian Transfer (GIFT)
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day"

37: Government Mandates
"State Mandates Employers Provide Contraceptive Benefits"
"State Mandated Emergency Contraception"
"The San Francisco Solution"

38: Handicapped, Access and Therapy
"Pastoral Statement of the United States Catholic Bishops on Handicapped People"

39: Health Care Professionals
"Evangelium vitae"
Ethical and Religious Directives for Catholic Health Care Services

I. Physicians
"The Exalted Character of the Medical Profession"
"Catholic Doctors: Higher Witnesses"

II. Nurses
"The Nursing Vocation"
Questions of Ethics Regarding the Fatally Ill and Dying

III. Pharmacists
"The Responsibility of the Pharmacist"

IV. Administrators
Ethical and Religious Directives for Catholic Health Care Services

40: Health Care Reform
"Resolution on Health Care Reform"
"Criteria for Evaluating Health Care Reform, United States Catholic Conference"
"Labor Day Statement 2009: Rebuilding the Economy, Reforming Health Care"
"USCCB's Vision of Health Care Reform"
"Health Care Coverage: Whose Responsibility?"

41: Hospice
"Pastoral Care of the Sick and Imprisoned"
Ethical and Religious Directives for Catholic Health Care Services

42: Hydration and Nutrition, Assisted
"To Participants in the International Congress on 'Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas'"
"Commentary"
Ethical and Religious Directives for Catholic Health Care Services

43: Induction of Labor
Ethical and Religious Directives for Catholic Health Care Services

44: Infertility
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day"

45: Informed Consent
Ethical and Religious Directives for Catholic Health Care Services
"The Intangibility of the Human Person"

46: Intracytoplasmic Sperm Injection (ICSI)
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"

47: In Vitro Fertilization and Embryo Transplant (IVF and ET)
"Gospel of Life"
Ethical and Religious Directives for Catholic Health Care Services
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation"

48: Joint Ventures
Ethical and Religious Directives for Catholic Health Care Services
"Catholic Health Care Collaborative Relationships"

49: Labor and Management Relations
"Respecting the Just Rights of Catholic Health Care Workers"
"Health Care Workers' Conscience Rights Should Be Protected"
"A Fair and Just Workplace: Principles and Practices for Catholic Health Care"
Ethical and Religious Directives for Catholic Health Care Services

50: Living Will

51: Natural Family Planning
"Why Natural Family Planning Differs from Contraception"
"Natural Family Planning"
"Married Love and the Gift of Life"
Ethical and Religious Directives for Catholic Health Care Services

52: Non-Heart-Beating Donors
Ethical and Religious Directives for Catholic Health Care Services

53: Ordinary and Extraordinary Measures to Preserve Life
"Evangelium vitae"
"The Prolongation of Life"
"Declaration on Euthanasia"
Ethical and Religious Directives for Catholic Health Care Services

54: Organ Donation and Transplantation
"Gospel of Life"
"Blood and Organ Donors"
"Many Ethical, Legal, and Social Questions Must Be Examined in Greater Depth"
Ethical and Religious Directives for Catholic Health Care Services

55: Pain Relief
"Gospel of Life"
"Declaration on Euthanasia"
"Christian Principles and the Medical Profession"
Ethical and Religious Directives for Catholic Health Care Services

56: Palliative Care
"Evangelium vitae"
Ethical and Religious Directives for Catholic Health Care Services

57: Pastoral Care
Ethical and Religious Directives for Catholic Health Care Services
Ethical and Religious Directives for Catholic Health Care Services

58: Physician-Assisted Suicide
"Evangelium vitae"
"Living and Dying Well"

59: Preimplantation Diagnosis
"Instruction Dignitas Personae: Bioethical Questions and the Dignity of the Person"
"Evangelium vitae"

60: Prenatal Adoption
"Instruction Dignitas Personae: Bioethical Questions and the Dignity of the Person"

61: Proxy Consent
"Declaration on Euthanasia"
Ethical and Religious Directives for Catholic Health Care Services
"The Prolongation of Life"

62: Psychotherapy
"The Moral Component of the Therapeutic Task"
"The Image of God in People with Mental Illness"
On Psychotherapy and Religion

63: Rape, Treatment of Victims
Ethical and Religious Directives for Catholic Health Care Services
"Guidelines for Catholic Hospitals Treating Victims of Sexual Assault"
"Using the 'Morning-After Pill' in Cases of Rape"

64: Research on Human Subjects
Ethical and Religious Directives for Catholic Health Care Services
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation"
"Biological Experimentation"

65: Right to Health Care
"Pastoral Letter on Health and Health Care"
"The Right to Health Care"

66: RU-486
"RU-486: The Abortion Pill"

67: Scandal
Ethical and Religious Directives for Catholic Health Care Services

68: Sexual Abuse
Ethical and Religious Directives for Catholic Health Care Services

69: Stem Cells
"Instruction Dignitas personae: Bioethical Questions and the Dignity of the Person"
"Statement on Embryonic Stem-Cell Research"

70: Sterilization
"Removal of a Healthy Organ"
"Sterilization in Catholic Hospitals"
"Responses to Uterine Isolation and Related Matters"
Ethical and Religious Directives for Catholic Health Care Services

71: Suffering
"The Christian Meaning of Human Suffering"
"Evangelium Vitae"
"Christian Principles and the Medical Profession"

72: Suicide
"Gospel of Life"
"Declaration on Euthanasia"

73: Surgery
"Surgery"
"Removal of a Healthy Organ"
"The Intangibility of the Human Person"
Ethical and Religious Directives for Catholic Health Care Services

74: Surrogate Mothers
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation"
"New Jersey Bishops' Statement 'On Surrogate Motherhood'"
Ethical and Religious Directives for Catholic Health Care Services

75: Terminal Sedation
Ethical and Religious Directives for Catholic Health Care Services

76: Truth Telling
"Christian Principles and the Medical Profession"
Questions of Ethics Regarding the Fatally Ill and the Dying
Ethical and Religious Directives for Catholic Health Care Services

77: Uterine Isolation
"Responses on Uterine Isolation and Related Matters"

78: Withholding and Withdrawing Life Support
"Gospel of Life"
"Declaration on Euthanasia"
Ethical and Religious Directives for Catholic Health Care Services

Index

Reviews

"A clear and practical guide that informs faithful and serious moral thinking about important medical choices . . . a trusted resource and proven roadmap to guide us along an important and challenging moral path."—Theological Studies

"This fine book is primarily about the sources, both theological and moral, or Catholic moral teachings. The reader will find a clear and practical guide that informs faithful and series moral thinking about important medical choices. . . . This new edition of a now classic book remains a trusted resource and proven roadmap to guide us along an important and challenging moral path."—Theological Studies

"If in your research or teaching, you’ve ever asked, 'Where does that teaching come from?' this book will provide the answer. Like its predecessors, the fourth edition provides direct references with ample textual citations from a multitude of official Church documents ranging from papal encyclicals to the ERDs to statements by national bishops’ conferences. The expansion of introductory sections on values, normative concepts and conscience in Church teaching as well as the integration of documents that relate to organizational ethics are both valuable additions. This text is an indispensable resource for ethicists, teachers of health care ethics, and health care professionals. For graduate students it provides ready access to source documents and context that internet searches cannot provide. In fact, it is a great find for anyone who wants a deeper understanding of the reasoning behind the Church’s moral tradition on health care."—Charles Bouchard, OP, Ascension Health

"This updated edition of O'Rourke and Boyle's highly regarded compendium of Roman Catholic teachings and documents on medical ethics is an indispensable resource for health professionals in their daily work and for scholars and students wishing to stay abreast of the full range of professional discourse in bioethics."—Edmund D. Pellegrino, MD, professor emeritus of medicine and medical ethics, Georgetown University

"This fourth edition is an invaluable volume. It brings together two seasoned theologians/ethicists, seasoned both in their intellectual preparation and experience in the clinical settings. They give us the Church's teaching in the Church's own words and an explanation of what it means in the clinical realities of today. Many clinicians, board members, and sponsors will benefit from this wonderful work."—Carol Keehan, DC, president and chief executive officer, Catholic Health Association

Contributors

Supplemental Materials

Awards

About the Author

Kevin O'Rourke, OP, is a professor of bioethics at the Neiswanger Institute of Bioethics and Public Policy in the Stritch School of Medicine at Loyola University, Chicago. He is the coauthor of Health Care Ethics: A Theological Analysis, Fifth Edition and Ethics of Health Care: An Introductory Textbook, Third Edition.

Philip J. Boyle is vice president of mission and ethics at Catholic Health East, a multi-institutional Catholic health care system. He is the coauthor of Organizational Ethics in Health Care.