In this critique, Martha Nussbaum argues that our dominant theories of development have given us policies that ignore our most basic human needs for dignity and self-respect.

Previous edition, 1st, published in 1971.

Debate over whether health care institutions or individual providers should have a legally protected right to conscientiously refuse to offer legal services to patients who request them has grown exponentially due to the increasing legalization of morally contested services. This debate is particularly acute for Catholic health care providers. We elucidate Catholic teaching regarding the nature of conscience and the intrinsic value of being free to act in accord with one’s conscience. We then outline the primary positions defended in this (...) debate and respond to critics of Catholic teaching. In so doing, we show how Catholic health care providers’ claims to conscientiously refuse to offer specific health care services are not essentially faith-based, but are founded upon publicly defensible reasons. We also address the question of whether conscientiously refusing health care providers may become complicit in moral wrongdoing or potentially cause scandal by means of disclosure or referral to another provider. (shrink)

Since it appeared in 1971, John Rawls's A Theory of Justice has become a classic. The author has now revised the original edition to clear up a number of difficulties he and others have found in the original book. Rawls aims to express an essential part of the common core of the democratic tradition--justice as fairness--and to provide an alternative to utilitarianism, which had dominated the Anglo-Saxon tradition of political thought since the nineteenth century. Rawls substitutes the ideal of the (...) social contract as a more satisfactory account of the basic rights and liberties of citizens as free and equal persons. "Each person," writes Rawls, "possesses an inviolability founded on justice that even the welfare of society as a whole cannot override." Advancing the ideas of Rousseau, Kant, Emerson, and Lincoln, Rawls's theory is as powerful today as it was when first published. (shrink)

Profoundly important ethical and political controversies turn on the question of whether biological life is an essential aspect of a human person, or only an extrinsic instrument. Lee and George argue that human beings are physical, animal organisms - albeit essentially rational and free - and examine the implications of this understanding of human beings for some of the most controversial issues in contemporary ethics and politics. The authors argue that human beings are animal organisms and that their personal identity (...) across time consists in the persistence of the animal organisms they are; they also argue that human beings are essentially rational and free and that there is a radical difference between human beings and other animals; criticize hedonism and hedonistic drug-taking; present detailed defenses of the prolife positions on abortion and euthanasia; and defend the traditional moral position on marriage and sexual acts. (shrink)

Appealing to reason rather than religious belief, this book is the most comprehensive case against the choice of abortion yet published. _The Ethics of Abortion_ critically evaluates all the major grounds for denying fetal personhood, including the views of those who defend not only abortion but also infanticide. It also provides several justifications for the conclusion that all human beings, including those in utero, should be respected as persons. This book also critiques the view that abortion is not wrong even (...) if the human fetus is a person. _The Ethics of Abortion_ examines hard cases for those who are prolife, such as abortion in cases of rape or in order to save the mother’s life, as well as hard cases for defenders of abortion, such as sex selection abortion and the rationale for being “personally opposed” but publically supportive of abortion. It concludes with a discussion of whether artificial wombs might end the abortion debate. Answering the arguments of defenders of abortion, this book provides reasoned justification for the view that all intentional abortions are morally wrong and that doctors and nurses who object to abortion should not be forced to act against their consciences. (shrink)

Natural Law and Natural Rights is widely recognised as a seminal contribution to the philosophy of law, and an essential reference point for all students of the subject. This new edition includes a substantial postscript by the author responding to thirty years of comment, criticism, and further work in the field.

Discussions concerning whether there is a natural right to health care may occur in various forms, resulting in policy recommendations for how to implement any such right in a given society. But health care policies may be judged by international standards including the UN Universal Declaration of Human Rights. The rights enumerated in the UDHR are grounded in traditions of moral theory, a philosophical analysis of which is necessary in order to adjudicate the value of specific policies designed to enshrine (...) rights such as a right to health care. We begin with an overview of the drafting of the UDHR and highlight the primary influence of natural law theory in validating the rights contained therein. We then provide an explication of natural law theory by reference to the writings of Thomas Aquinas, as well as elucidate the complementary “capabilities approach” of Martha Nussbaum. We conclude that a right to health care ought to be guaranteed by the state. (shrink)

A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to fair equality of opportunity are in (...) tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls’s original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy. (shrink)

IN THIS PAPER, I PROVIDE A FORMULATION of Thomas Aquinas’s account of the nature of human beings for the purpose of comparing it with other accounts in both the history of philosophy and contemporary analytic philosophy. I discuss how his apparently dualistic understanding of the relationship between soul and body yields the conclusion that a human being exists as a unified substance composed of a rational soul informing, that is, serving as the specific organizing principle of, a physical body. I (...) further address the issue of Aquinas’s contention that a human rational soul can exist without being united to a body and show how this ability of a human soul does not contradict the thesis that a human being exists naturally as embodied. I will also respond to two related questions. First, what accounts for the individuation of human beings as distinct members of the human species? Second, what is the principle of identity by which a human being persists through time and change? (shrink)

Pope Francis has not put himself at the forefront of tendentious issues in bioethics, such as abortion, human embryonic stem cell research, cloning, contraception, and euthanasia. Nevertheless, his various addresses and magisterial documents such as Evangelii Gaudium and Laudato Si’ make clear that Pope Francis affirms the Church’s teaching on these issues. He has, though, proffered an additional moral lens through which to view such issues, namely, how they factor into the “culture of waste” that informs global society’s “sin of (...) indifference” in contrast to a “consistent ethic of life.” The moral conclusions Pope Francis draws, far from advancing a shift in Catholic teaching, provide a stronger foundation for supporting a “culture of life.” This paper elucidates the continuity and development of the Catholic bioethical vision in Pope Francis’s writings, interviews, and addresses, and the implications for various bioethical issues. (shrink)

H. Tristram Engelhardt, Jr.; The DeChristianization of Christian Health Care Institutions, or, How the Pursuit of Social Justice and Excellence can Obscure the.

Advocates of active euthanasia and physician-assisted suicide argue that a patient’s intractable pain and suffering are a sufficient justification for his life to end if he autonomously so chooses. Others hold that the non-utilization of life-sustaining treatment, the use of pain-relieving medication that may hasten a patient’s death, and palliative sedation may be morally acceptable means of alleviating pain and suffering. How a patient should be cared for when approaching the end of life involves one’s core religious and moral values, (...) particularly concerning whether pain and suffering can have some sort of instrumental value. The author reasons why a patient who is terminally ill can find his suffering valuable for both religious and nonreligious goals. National Catholic Bioethics Quarterly 12.2 (Summer 2012): 251–261. (shrink)

Contributing theologians and social scientists reflect on Joseph Cardinal Bernardins major addresses on the consistent ethic of life.

Thomas Aquinas argues that matter is informed by a rational soul to compose a human person. But a person may survive her body’s death since a rational soul is able to exist and function without matter. This leads to the typical characterization of Aquinas as a dualist. Thomistic dualism, however, is distinct from both Platonic dualism and various accounts of substance dualism offered by philosophers such as Richard Swinburne. For both Plato and Swinburne, a person is identical to an immaterial (...) soul that is contingently related to a human body. For Aquinas, a human person is composed of her soul and the matter it informs, but is not identical to either metaphysical component. I explicate Thomistic dualism while critically analyzing Swinburne’s account. I conclude that Aquinas’s account has theresources to address a central issue that arises for substance dualism. (shrink)

Contemporary arguments concerning the permissibility of physician-assisted suicide [PAS], or suicide in general, often rehearse classical arguments over whether individual persons have a fundamental right based on autonomy to determine their own death, or whether the community has a legitimate interest in individual members’ welfare that would prohibit suicide. I explicate historical arguments pertaining to PAS aligned with these poles. I contend that an ethical indictment of PAS entails moral duties on the part of one’s community to provide effective means (...) of ameliorating physical and existential suffering. I further elucidate how such duties have been affirmed by the Roman Catholic Church. My aim is to provide reasons why the expanding legalization of PAS should not preclude social investment in effective palliative care and providing a communal presence to the dying as they confront their subjectively experienced suffering. (shrink)

H. Tristram Engelhardt, Jr.; Discerning the Signs of the Times: Recognizing the Dangers of Reckless Social Justice and Advocating With Responsibility, Christian.

Black Natural Law offers a new way of understanding the African American political tradition, and it argues that this tradition has collapsed into incoherence. Vincent William Lloyd revives Black politics by telling stories of its central figures in a way that exhibits the connections between their religious, philosophical, and political ideas.

The author considers the capacity of Catholic Social Teaching (CST) to contribute to the public debate about health care and then remarks on the capacity of CST to assist in the formation of “intentionally Christian institutions.” The author argues for two main points. First, there are some serious obscurities in CST's account of the derivation and interrelation of various rights. Hence, it is not altogether clear what ideal CST is seeking to promote in the public order. Second, the author argues (...) that there is a serious political conflict in CST's commitment to both subsidiarity and the preferential option for the poor. He also claims that it does not follow from these criticisms that CST is useless as a guide for the formation of “intentionally Christian institutions.” Reflection on financing in the light of subsidiarity and the preferential option suggests that there is a need for Christian wealth-producing institutions and schemes of investment that will provide subsidium for healthcare enterprises. In the final portion of the paper, the author sketches out a few dimensions of that sort of vision. (shrink)

Edmund D. Pellegrino, John Collins Harvey, Kevin T. Fitzgerald, SJ; Must the Church be Mute Lest Its Truths be Distorted? A Response to Engelhardt, Christian bi.

The author considers the issue of what it is for a health care institution to be intentionally Christian. He begins with a review of Catholic social teaching, and considers how this perspective is shaping Catholic thought and action regarding health care management and public policy reform. He then proposes some standards for intentionally Christian institutions.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelation, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a (...) commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian spirituality. In the face of that failure, Christian physicians and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice. (shrink)