Health policy generally seeks to improve the overall health of people in society. Since public health policy involves human values, decisions, and actions, it is inescapably ethical. In recent years there has been a growing awareness of the need for a systematic approach to the ethical analysis of public policy. Some government health-policy statements attempt to provide ethical frameworks. In our pluralistic societies, however, these tend to be pragmatic and lack a solid grounding in an adequate understanding of the human person. This could lead to justifying what is popular rather than what is ethical. This article attempts to show how a Catholic moral approach, which provides a solid foundation for ethics, can make a significant contribution to a discussion of health-policy ethics in a pluralistic society.
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References
1.
Cf. Nuffield Council on Bioethics, Public Health: Ethical Issues (2007), http://www.health-policy-systems.com/content/3/1/3/ref. Note: The Nuffield Council on Bioethics includes clinicians, lawyers, scientists, philosophers, and theologians. Among its funders is the Medical Research Council of the United Kingdom. This independent council has achieved an international reputation for providing advice to assist policy making, to address public concerns, and to stimulate debate in bioethics.
2.
I presented a talk on this topic for a conference sponsored by the Calgary Catholic Medical Association on health policy and ethics, Calgary, Alberta, Canada, May, 15, 2010. This article has been developed and expanded from that talk. Besides many other references, both the original talk and this expanded article include a number of sources relevant to the Canadian context. I have left these in this article since I think that these sources are also relevant to other contexts such as that of the United States of America. I would like as well to express my appreciation here to the reviewers of an earlier draft of this article, as well as the editor of The Linacre Quarterly, for their helpful comments and suggestions.
3.
CallahanDaniel“Unsustainable: Hard Truths About the ‘American Way of Life,’”Commonweal135.12 (June 20, 2008): 12–14.
4.
GiacominiMita, KennyNuala, and DeJeanDeirdre“Ethics Frameworks in Canadian Health Policies: Foundation, Scaffolding, or Window Dressing?”Health Policy89 (2009): 66.
5.
The quotes are from Health Policy, 66 and 68, respectively.
6.
The quotes are from Health Policy, 68.
7.
The quotes are from Health Policy, 67.
8.
AshleyBenedict, deBloisJean, and O'RourkeKevinHealth Care Ethics: A Catholic Theological Analysis, 5th ed. (Washington, D.C.: Georgetown University Press, 2006), 226.
9.
Health Care Ethics: A Catholic Theological Analysis, 20–21. Cf. Jonathan Chaplin, Talking God: The Legitimacy of Religious Public Reasoning (London: Theos, 2008).
10.
Cf. Pope John Paul II, encyclical letter Veritatis splendor (Regarding Certain Fundamental Questions of the Church's Moral Teaching) (Ottawa: Canadian Conference of Catholic Bishops, 1993), nn. 46-50; United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, 4th ed. (Washington, D.C.: United States Conference of Catholic Bishops, Inc., 2001), preamble; William E. May, Catholic Bioethics and the Gift of Human Life (Huntington, IN: Our Sunday Visitor, Inc., 2000), 55-63; and Ashley, deBlois, and O'Rourke, Health Care Ethics, 19-30.
11.
Nuffield Council on Bioethics, Public Health, 2.41.
12.
Giacomini, Kenny, and DeJean“Ethics Frameworks in Canadian Health Policies.”
13.
See CurtinLeah, and Josephine FlahertyM.Nursing Ethics: Theories and Pragmatics (Bowie, MD: Brady Communications Co., Inc., 1982), chs. 1-2.
See Ashley, deBlois, and O'RourkeHealth Care Ethics, ch. 2.
18.
Von HildebrandDietrichEthics (Chicago: Franciscan Herald Press, 1972).
19.
Von HildebrandDietrichEthics (Chicago: Franciscan Herald Press, 1972).
20.
Cf. Pope John Paul II, Man and Woman He Created Them: A Theology of the Body, trans. Michael Waldstein (Boston: Pauline Books and Media, 2006).
21.
Cf. John PaulPopeII, “Message to Pontifical Academy of Sciences on Evolution,”Origins: CNS Documentary Service26 (1996): 414–416.
22.
Catechism of the Catholic Church (Toronto: Doubleday, 1997), nn. 385-1060; and United States Conference of Catholic Bishops, Ethical and Religious Directives, general intro.
Nuffield Council on Bioethics, Public Health, 2.44.
25.
Giacomini, Kenny, and DeJean“Ethics Frameworks in Canadian Health Policies,”4.
26.
Medical Research Council of Canada, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada, tri-council policy statement, Ethical Conduct for Research Involving Humans (Ottawa: Medical Research Council of Canada, 1998), i.4. Note: this document provides ethical guidelines and principles for the Medical Research Council of Canada, the Natural Sciences and Engineering Research Council of Canada, and the Social Sciences and Humanities Research Council of Canada.
27.
All scripture quotations in this article are from The Holy Bible: Containing the Old and New Testaments with the Apocryphal / Deuterocanonical Books: New Revised Standard Version (Toronto: Collins Publishers, 1989).
28.
Cf., e.g., Mt 25: 31-46; Rm 2: 5-11 and 3: 8.
29.
Catechism of the Catholic Church, n. 1750; see also nn. 1749-1761.
30.
See PaulJohnII, Veritatis splendor, nn. 71-83; and cf., e.g., Ashley, deBlois, and O'Rourke, Health Care Ethics, 50-54; and Bohr, Catholic Moral Tradition, 224-226.
31.
See, e.g., United States Conference of Catholic Bishops, Ethical and Religious Directives.
32.
Cf. Ethical and Religious Directives., dir. 52.
33.
Some of this section is adapted from FlamanPaul, “Moral Discernment and Culpability,”Linacre Quarterly71 (2004): 34–46.
34.
Cf. United States Conference of Catholic Bishops, Ethical and Religious Directives, dirs. 60–61.
35.
From McMahonLaureen, “Gardasil Vaccine Needs Parental Consent,”Western Catholic Reporter (Edmonton), October 19, 2009, 5. See also Alberta Catholic Bishops, “A Message of the Alberta Catholic Bishops to Parents, Trustees, Superintendents of Catholic Education of Catholic School Boards, and to the Catholic Education Community” (June 23,2008), http://www.edmontoncatholic-church.com/lorlinks/HPVmessage.PDF.
Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church (Ottawa: Canadian Conference of Catholic Bishops, 2005), 50-52 and 89-92. Cf. 1 Jn 4: 7-12.
43.
Catholic Health Association of Canada, Health Ethics Guide (Ottawa: Catholic Health Association of Canada, 2000), 13. Cf. Catechism of the Catholic Church, n. 2263; Bohr, Catholic Moral Tradition, 226-227; and Ashley, deBlois, and O'Rourke, Health Care Ethics, 54-55.
44.
See, e.g., Mt 5: 48; Jn 15: 9-15; Rm 3: 8; 1 Th 5: 15-22; and 1 Jn 3: 2-3.
Catholic Health Association of Canada, Health Ethics Guide, 13–14; cf. United States Conference of Catholic Bishops, Ethical and Religious Directives, part 6.
Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church, 71–79, emphasis added.
49.
Zenit“US Bishops Support Universal Health Care.”
50.
Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church, 81–84.
51.
Catholic Medical Association, “Open Letter to Catholics and Catholic Organizations.” Cf. idem, Health Care in America.
52.
Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church, 84–87.
53.
Cf. Nuffield Council on Bioethics, Public Health, 3.24.
54.
Catechism of the Catholic Church, n. 1941.
55.
See Catholic Health Association of Canada, Health Ethics Guide; cf. United States Conference of Catholic Bishops, Ethical and Religious Directives.
56.
BrinkmannBill“Bridging the Gap: Catholic Health Care Organizations Need Concrete Ways to Connect Social Principles to Practice,”Health Progress87.6 (November–December 2006).
57.
See Nuffield Council on Bioethics, Public Health, chs. 3.35, 3.26, 5, and 6.
58.
Benedict XVI, Caritas in veritate, n. 44.
59.
WestenJohn-Henry“Harvard AIDS Expert Says Pope Is Correct on Condom Distribution Making AIDS Worse,” LifeSiteNews.com, March 19, 2009, http://www.lifesitenews.com/ldn/2009/mar/09031906.html. Cf. Edward C. Green and Norman Hearst, “Was the Pope Wrong?” Lancet 373 (2009): 1603. For a fuller treatment of Catholic teaching on the virtue of chastity, see the Catechism of the Catholic Church, nn. 2337-2400. For a fuller Christian theological treatment of the virtues in the context of the whole Christian life, see, e.g., Jordan Aumann, Spiritual Theology (Manila: University of Santo Tomas, 1989).
60.
Ashley, deBlois, and O'RourkeHealth Care Ethics, 16.
61.
Nuffield Council on Bioethics, Public Health, 2. 33–34.
62.
KennyWhat's Fair, vii.
63.
Cf. United States Conference of Catholic Bishops, Ethical and Religious Directives, part 2.
64.
Catholic Health Association of Canada, Health Ethics Guide, 78.
65.
Cf. United States Conference of Catholic Bishops, Ethical and Religious Directives, preamble and general intro.
