Roman Catholic moral theology follows a centuries-old tradition of moral reflection. Contemporary Roman Catholic moral theory applies these traditional arguments to the realm of medical ethics, including the issues of active euthanasia and physician-assisted suicide. Unavoidable moral limits on licit medical intervention sometimes require that the moral duty to treat, cede to the duty to cease treatment when measures become more harmful than beneficial to the patient. This does not reduce the need for the compassionate use of palliative care in (...) response to suffering. However, it does mean that rather than being excessively committed to maintaining mere biological human life, or actively seeking death, that we learn a sober realism about the limits of human life. Catholic moral analysis examines an act objectively, both in its relation to the agent and as a material event in the world. This allows both the virtuous or vicious intentions of the agent and the effects of the action to be included in its moral evaluation. Thus, Catholic moral analysis is both quasi-deontological and quasi-consequentialist. Objectively, active euthanasia and physician-assisted suicide, as acts of deliberate killing, are seen as repugnant, in that they fail to incarnate a benign inner intention or to form an agent in virtue. Catholic moral theology is extremely skeptical that an act of intending death directly can be consonant with a sincere compassion for the dying, suffering person and views it as a direct negation of the precious gift of human life. (shrink)

This article examines Leon Kass's contention that a choice for physician-assisted suicide is “undignified.” Although Kass is Jewish rather than Christian, he argues for positions that most Christians share, and he argues for these positions without presupposing the truth of specific religious claims. I argue that although Kass has some important intuitions, he too readily assumes that these intuitions will be shared by his audience, and that this assumption diminishes the force of his argument. An examination of the limitations of (...) Kass's argument is helpful insofar as it illustrates the real challenge faced by religious believers who wish to defend their beliefs in the “public forum.” For it illustrates that what needs to be made “accessible” is the Judeo-Christian understanding of man and his place in the world. While I do not wish to claim that this task is impossible, I do think that it is far more difficult than most realize. Like all important tasks, however, unless we wrestle with the difficulties it raises, our arguments will strike many as unconvincing. (shrink)

A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics (...) of health care. The moral status of any system of managed care ought to be judged with respect to its congruence with Gospel teachings about the care of the sick, Papal Encyclicals, and the documents of the Second Vatican Council. In this essay, I look at the important conceptual or definitional issues of managed care, assess these concerns over against the source and content of a Catholic ethic of health care, and outline the necessary moral requirements of any licit system of health care. (shrink)

This article explores some of the implications of understanding sin as failure of perception. The theological underpinning of the argument is the choice made in the Garden of Eden to eat the fruit of the tree of knowledge rather than the fruit of the tree of life, or wisdom. This has led to distorted perception, in which all things are seen as having separate, independent existences rather than joined together by their common divine source and their deep interrelatedness in the (...) covenant made with God. The article discusses the fascination with the principle of respect for autonomy in the light of this theology. It also looks at perceptions of the HIV/AIDS crisis in Africa. It finishes with a definition of repentance that makes right perception possible. (shrink)

This paper presents my personal convictions, as an Evangelical, regarding the absolute impropriety of doctor-assisted suicide for Christians. They have been “bought with a price” and are owned by Another. Hence, they must always strive to glorify God in their bodies, both in life and in death. Although they crave the well-being of temporal health, when they are ill seek healing or relief, and may well recoil even from the thought of suffering and dying, they should realize that their values (...) and priorities must be rooted in biblical truths and that their well-being is eternal and not temporal, spiritual and not material. As Christians, their attitudes and responses to suffering and dying must be molded by the reality that their Creator and Sovereign will cause all things to work together for their good and that their Lord has called them into a fellowship of His suffering in which they are sustained by dependence upon Him. Hence, for Christians to take their lives in order to escape from the trials and testings ordained by Him would be a failure of love and a breach of trust. (shrink)

In this article I seek to address some misunderstandings in arguments about same sex-marriage. I do this by evaluating several views on homosexuality and marriage. My central aim is to show that a rejection of same-sex marriage does not depend upon the view that homosexual acts are immoral or disordered. Rather, one must examine sexual acts in light of public goods that are at stake. I also argue that the Christian understanding of marriage and sexuality offers more than a set (...) of prohibitions against certain sexual acts. Rather, it offers reasonable principles by which to evaluate the relationship between sexual acts and the public good. (shrink)

The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called “stewardship argument”: Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist – and even secular – debate on the legitimacy of euthanasia.

Evangelicals are unconditionally opposed to active euthanasia. Indirect euthanasia is seen as simply belonging to the risks inherent in any medical intervention. Passive euthanasia is accepted if used in order to save the dignity of the dying and is seen as merely ceasing to interfere with an irreversible dying process. The basis of evangelical ethics is the Bible supplemented by science and experience as a kind of natural law. Even though natural law comes under Biblicial revelation, its acceptance is the (...) reason for the similarity of the Evangelical and the Roman-Catholic position of Evangelicals. Evangelicals stress the necessity of a better counseling and investment for the deadly ill patient. (shrink)

It seems intuitive to the believer that God intended through instruction in the Law to define morality, intended to lead humankind to “the right and the good.” Further, God's love for humankind, exemplified by the incarnation, atonement and teachings of Jesus, and empowered by the Holy Spirit, should lead to a better world. Indeed, the Christian worldview is a coherent and valid way to look at bioethical issues in public policy and at the bedside. Yet, as this paper explores, in (...) a pluralistic society such as the United States, it is neither possible nor desirable for Christians to try to force their views on others. Still, it is obligatory for Christians to stand up and articulate their views in the public square. We should try to persuade others using either prudential or moral arguments. While we must be willing to live with “the will of the people,” at the same time, we must not be intimidated into accepting the position that our voice is not valid because it has a religious basis. (shrink)

While most people may initially agree that justice is fairness, as an evangelical Protestant I argue that, for many religious comprehensive doctrines, the Rawlsean model does not possess the resources necessary to sustain tolerance in moral decision making. The weakness of Rawls's model centers on the reasonable priority of convictions that arise from private comprehensive doctrines. To attain a free and pluralistic society, people need resources sufficient to provide reasons to tolerate actions that are otherwise intolerable. In addition to arguing (...) for the deficiency of the Rawlsean political model, I sketch out a preliminary model of ambassadorship that offers religious communities, and in particular Protestant evangelicals, the necessary resources to engage the broader society tolerantly while maintaining their religious convictions. As a citizen of the church and a member of another kingdom, Christians serve as ambassadors to those who are not of the heavenly kingdom. I take this model to be more ambitious than that of a sojourner who lives in the land but is isolated as much as possible from society, while more modest than that of reconstructionists who seek to implement their own sacred law on all others. (shrink)

This paper critically explores the path of some of the controversies over public reason and religion through four distinct steps. The first part of this article considers the engagement of John Finnis and Robert P. George with John Rawls over the nature of public reason. The second part moves to the question of religion by looking at the engagement of Nicholas Wolterstorff with Rawls, Robert Audi, and others. Here the question turns specifically to religious reasons, and their permissible use by (...) citizens in public debate and discourse. The third part engages Jürgen Habermas's argument that while citizens must be free to make religious arguments, still, there is an obligation of translation, and a motivational constraint on lawmakers. The final section argues that even though Habermas's proposal fails, nevertheless he recognizes a key difficulty for religious citizens in contemporary liberal polities. Restoration of a full role for religiously grounded justificatory reasons in public debate is one part of an adequate solution to this problem, but a second plank must be added to the solution: recognition that religious reasons can enter into public deliberation not just as first-order justifications of particular policies, but as second-order reasons, to be considered by any polity that respects its religious citizens and, more broadly, the good of religion. (shrink)

The ascendancy of Christian activism in bioethical policy debates has elicited a number of responses by critics of this activism. These critics typically argue that the public square ought to embrace Secular Liberalism, a perspective that its proponents maintain is the most just arrangement in a pluralist society, even though SL places restraints on Christian activists that are not placed on similarly situated citizens who hold more liberal views on bioethical questions. The author critiques three arguments that are offered to (...) defend SL: the golden rule contract argument, the secular reason argument, and the err-on-the-side-of-liberty argument. The author concludes that each of these arguments fail to support SL. (shrink)