Pope Francis and the Transformation of Health Care Ethics

Todd A. Salzman and Michael G. Lawler

"The authors arrange a rich buffet, sure to nourish bioethicists and others who cope with contemporary medical moral issues."
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A call to reform Catholic health care ethics, inspired by the teachings of Pope Francis

Since its first edition in 1948, the US Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services (ERD) has guided Catholic institutions in the provision of health care that reflects both the healing ministry of Jesus and the Church’s understanding of human dignity. However, while the papacy of Pope Francis and the clerical sex-abuse scandal both profoundly impacted the Catholic Church, the latest edition of the ERD does not address or reflect these transformations.

Now for the first time, Todd A. Salzman and Michael G. Lawler present an extended critical commentary on the 2018 ERD. They argue that it is problematic in a number of ways. First, the revised ERD continues to prioritize a rule-based over a personalist-based ethical method, with an emphasis on absolute norms that proscribe specific medical acts. Further, it does not take into account Pope Francis’s transforming ecclesiological, methodological, and anthropological visions, neither internally in Catholic health care institutions nor externally in collaborations between Catholic and non-Catholic health care institutions. Finally, the revised ERD provides no evidence that the bishops grasp how the clerical sex-abuse scandal and its cover-up have fundamentally undermined episcopal authority and credibility.

Salzman and Lawler propose new ways forward for US Catholic health care ethics that prioritize human dignity as their guiding principle. As there is pluralism in Catholic definitions of human dignity, there must be pluralism in the norms and directives that facilitate realizing human dignity. Pope Francis’s emphasis on the virtues of mercy and care should move the ERD forward from a focus on absolute norms in medical ethics to a focus on virtues and principles to guide both patients and health care professionals in their discerned conscientious health care decisions.

Table of Contents

Introduction: Overview of the Ethical and Religious Directives for Catholic Health Care Services

1. The Sources of Ethical Knowledge and Tensions in the ERD

2. Anthropological Tensions in the ERD

3. Ethical Methodological Tensions in the ERD

4. Ecclesiological Tensions in the ERD

5. Pastoral and Spiritual Care in the ERD

6. Collaboration between Catholic and Non-Catholic Health Care Institutions

7. Suggestions for a Revised ERD


About the Authors


"In this book, Todd Salzman and Michael Lawler offer an easily accessible, yet sophisticated, introduction to the Ethical and Religious Directives for Catholic Health Care. Its strengths are the focus on foundational questions and the integration of Pope Francis’s recent teachings. I would recommend it to university students, ethics committee members, and those seriously interested in Catholic health care. A wonderful work: honest, critical, and pedagogically friendly."—Roberto Dell’Oro, director of the Bioethics Institute and professor in the Department of Theological Studies, Loyola Marymount University

"The book presents perhaps the most important contribution of Catholic moral theology to health since Vatican II. The masterly analysis highlights the transformative influence of Pope Francis to argue urgently for doctrinal development regarding Catholic Directives in health care. This tour de force invigorates insight, inspires hope, and nurtures virtue."—Gerard Magill, Vernon F. Gallagher Chair and professor in healthcare ethics, Duquesne University

"The authors arrange a rich buffet, sure to nourish bioethicists and others who cope with contemporary medical moral issues."—Catholic Books Review

"[T]his well-researched scholarly volume contains a proposal for reforms in church-based institutions so that their operations reflect the renewed priorities of the first Jesuit pope."—Journal of Jesuit Studies


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About the Author

Todd A. Salzman is the Amelia and Emil Graff Professor of Catholic Theology at Creighton University. He is the author or coauthor of ten books, including The Church in the Modern World and What Are They Saying about Roman Catholic Ethical Method?

Michael G. Lawler is a professor emeritus of Catholic theology at Creighton University. He is the author of twenty-five books, including the award winning The Sexual Person and, most recently, Introduction to Catholic Theological Ethics.

208 pp., 6 x 9

ISBN: 978-1-64712-070-2
Jun 2021

208 pp., 6 x 9

ISBN: 978-1-64712-071-9
Jun 2021

208 pp.

ISBN: 978-1-64712-072-6
Jun 2021

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