The Linacre Quarterly

The recent publication of the fifth edition of the Ethical and Religious Directives for Catholic Health Care Services on November 17, 2009, by mandate of the United States bishops, witnessed the eruption of a controversy in the U.S. with regard to nutrition and hydration for the seriously ill and dying. ¹

Among the major philosophical and moral thinkers in the field, there are some on the one hand who—out of respect for the wishes of the patient as expressed in normal situations—see no need for nutrition and hydration if such are the patient's wishes, even though they may have been expressed before the patient became ill. On the other hand, there are those who—out of respect for human dignity and with the understanding that any act of euthanasia is morally unacceptable—do not see how the interruption of life support can be acceptable unless it comes to be a burden and no longer a benefit under end-of-life conditions.

In light of all this, the present article aims to provide reflections on the nature of assisted nutrition and hydration (ANH) and the obligation to use it in cases where clinical evidence requires it, with a particular focus on the ongoing bioethical debate in the U.S.

In a recent article in this journal, “Condoms and HIV: The State of the Debate,” William Newton argues that there are basically two issues around which parties dispute. The first is whether the use of a condom by a discordant couple amounts to performing a contraceptive act. At issue here is whether a couple's use of a condom to prevent disease transmission renders the act a contraceptive act. The second issue pertains to whether the use of a condom, apart from whatever the intentions of the agents are, is itself a failure to consummate a marital act. It is the second issue that I wish to address in this paper. I aim to argue that the Canon-Law argument, as I will call it, wishes to argue that because condomistic sex fails to consummate a marriage, the sexual act performed is immoral. I argue against this inference on two grounds: the first is that the conclusion succumbs to counterexamples, and second, the inference must rely on a premise that I show is false.

In this paper, I will first briefly discuss why the Catholic Church has always had and continues to have such a great concern for bioethics or health-care ethics, while I also highlight the biblical roots of this concern. Secondly, I will describe some of the ways in which the Catholic Church in America has exercised a positive influence in the field of bioethics, or what was in the mid-twentieth century often called medical ethics. Thirdly, I will sketch how and why the Church has to a large extent lost this influence, tracing how secularization both inside and outside the Church contributed to the destruction of the so-called “Catholic ghetto” and to the assimilation of ideas from the culture that were often alien to the Gospel and sound moral reasoning. Finally, I will offer some general reflections on how the Church can regain her influence in this area—especially with the goal in mind of building a culture of life in American society—and how Catholic scholars in particular can contribute to this effort by following the lead of the late Pope John Paul II's 1995 encyclical on bioethics, Evangelium vitae, whose twentieth anniversary is fast approaching.

The Church and the clinic, theology and medicine, mutually support one another when the good of the other is justly pursued within an organic context of interdependency. In the midst of rapid change in health care, Catholic health-care workers have much to offer the industry as they bring their spirituality of interdependency into their work environments. Due attention to spiritual nourishment received in the Church via the Eucharist is thus encouraged if Catholic health care is to have the leavening impact it is intended to have in culture. After revisiting Pope John Paul II's social encyclical Laborem exercens (On Human Work, 1981), a spirituality of work is offered for Catholic health-care professionals with particular focus on the Eucharist. Accordingly, this essay presents a theology of the Eucharist that shows how Catholics are bound closely together so that the poverty attending loneliness can be lessened and our mutual efforts at enhancing health may be strengthened. The Church and the clinic, theology and medicine, mutually support one another when the good of the other is justly pursued within an organic context of interdependency bolstered by the Eucharist.

Our vocation is unity. Our affliction is to be in a state of duality, and affliction due to an original contamination of pride and of injustice…. Love is thus the right physician for our original illness…. We have lost this unity, we whose religion should be the most incarnate of any. We must recover it.

—Simone Weil