Two hard cases have generated controversy regarding the application of the principle of double effect in recent years. As regards the first, the case of the conjoined twins of Malta, there has been considerable convergence: most natural law ethicists seem to agree that separation of the twins was morally permissible. By contrast, the so-called “Phoenix case,” involving an abortion at a Catholic hospital for a woman with pulmonary arterial hypertension, has become a touchstone of disagreement between defenders of the so-called (...) “new” natural law theory, and more “traditional” Thomists. I argue in this essay that, contrary to widespread opinion, the two cases were alike in the following respect: in neither need the principal agents have intended the death of anyone. (shrink)

Abstract. We argue that all human beings have a special type of dignity which is the basis for (1) the obligation all of us have not to kill them, (2) the obligation to take their well-being into account when we act, and (3) even the obligation to treat them as we would have them treat us, and indeed, that all human beings are equal in fundamental dignity. We give reasons to oppose the position that only some human beings, because of (...) their possession of certain characteristics in addition to their humanity (for example, an immediately exercisable capacity for self-consciousness, or for rational deliberation), have full moral worth. What distinguishes human beings from other animals, what makes human beings persons rather than things, is their rational nature, and human beings are rational creatures by virtue of possessing natural capacities for conceptual thought, deliberation, and free choice, that is, the natural capacity to shape their own lives. (shrink)

Pregnancy causes maternal pathology by combining maternal predispositions with healthy physiology. In maternal cardiovascular collapse, previable induction of labor is justifiable despite the definition of abortion in directive 45 of the Ethical and Religious Directives for Catholic Health Care Services. Central to this conclusion, the placenta is a fetal organ, and pregnancy is a cardiovascular condition placing new demands on the maternal cardiovascular system. Previable delivery, a morally neutral separation, addresses the cause of pathology even if fetal death is anticipated. (...) This is acceptable under double-effect reasoning. Directive 45 defines all previable deliveries as abortions, so this analysis proposes an alternative definition established by obstetrician/gynecologists. (shrink)

The principle of double effect is often used in bioethics as a tool to evaluate significant cases in obstetrics and gynecology. In this article the author, a Catholic priest, presents and interprets St. Thomas Aquinas’s delineation of the principle and discusses several classical applications, namely, to hysterectomy during pregnancy, ectopic pregnancy, and craniotomy. He explains the medical anatomy and physiology of the conjoined Maltese twins, Jodie and Mary, and then examines the arguments of four moralists on their separation. He concludes (...) by arguing that the principle morally justified the surgical separation of Jodie and Mary. National Catholic Bioethics Quarterly 9.1 : 85–96. (shrink)

The metaphysical status of the placenta has bearing on several ongoing discussions within Catholic moral theology. Numerous bioethicists and theologians have touched on this topic briefly, but to date no robust metaphysical argument appears in the literature. The authors aim to provide such an analysis. First, they provide an overview of the existing literature on the topic. Second, they briefly review the anatomy and physiology of the placenta. Third, they provide metaphysical and biological reasons why the placenta cannot be a (...) part of the fetus, a part of the mother, simultaneously a part of both, the border at which mother and fetus meet, or a separate individual substance. Finally, they provide reasons that support their claim that the placenta is a quasi-substance that exists in symbiosis with mother and child. National Catholic Bioethics Quarterly 14.2 : 295–333. (shrink)

Robert Koons and Matthew O’Brien have leveled a number of objections against the New Natural Law account of human action and intention. In this paper, I discuss five areas in which I believe that the Koons-O’Brien criticism of the New Natural Law theory is mistaken, or in which their own view is problematic. I hope to show, inter alia, that the New Natural Law approach is not committed to a number of theses attributed to it by Koons and O’Brien; that (...) their own view suffers from many ambiguities and difficulties; that passages from St. Thomas on which they draw to support their own view are in fact fully compatible with the New Natural Law account; and that neither the New Natural Law account of the controversial Phoenix abortion case, nor their account of the casuistry surrounding the acceptance of side-effects, is deficient in the ways asserted by Koons and O’Brien. (shrink)

Robert Koons and Matthew O’Brien have leveled a number of objections against the New Natural Law account of human action and intention. In this paper, I discuss five areas in which I believe that the Koons-O’Brien criticism of the New Natural Law theory is mistaken, or in which their own view is problematic. I hope to show, inter alia, that the New Natural Law approach is not committed to a number of theses attributed to it by Koons and O’Brien; that (...) their own view suffers from many ambiguities and difficulties; that passages from St. Thomas on which they draw to support their own view are in fact fully compatible with the New Natural Law account; and that neither the New Natural Law account of the controversial Phoenix abortion case, nor their account of the casuistry surrounding the acceptance of side-effects, is deficient in the ways asserted by Koons and O’Brien. (shrink)

This article considers M. Therese Lysaught’s analysis of an apparent abortion that occurred in Phoenix, Arizona, in 2009. Since Lysaught invokes it, the article considers Rev. Martin Rhonheimer’s theory about the bearing of vital conflict situations on the object of the act performed. A vital conflict situation is present when, for instance, the life of a mother might be spared if her fetus is aborted, otherwise she and the fetus will die. The article argues that the use of such situations (...) in this way by Lysaught and Rhonheimer (and possibly others) is incompatible with Church teaching. The article concludes by suggesting that certain cases might be analyzed in such a way that the mother’s life is saved and the fetus dies but there is no direct abortion. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 691–704. (shrink)

Respected Catholic ethicists have recently defended the use of salpingostomy and methotrexate in the management of ectopic pregnancies.This article examines the arguments for the revised assessments to determine whether there are sound reasons to believe that these two methods do not constitute the direct and immediate killing of innocent human beings. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 65–82.