Health Care Ethics: A Catholic Theological Analysis, Fifth Edition
by Benedict M. Ashley
Georgetown University Press, 2006 Paper: 978-1-58901-116-8 Library of Congress Classification R724.A74 2006 Dewey Decimal Classification 241.642
ABOUT THIS BOOK | AUTHOR BIOGRAPHY | REVIEWS | TOC
ABOUT THIS BOOK
Health Care Ethics is a comprehensive study of significant issues affecting health care and the ethics of health care from the perspective of Catholic theology. It aims to help Christian, and especially Catholic, health care professionals solve concrete problems in terms of principles rooted in scripture and tested by individual experience; however, its basis in real medical experience makes this book a valuable resource for anyone with a general interest in health care ethics.
This fifth edition, which includes important contributions by Jean deBlois, C.S.J., considers everyday ethical questions and dilemmas in clinical care and deals more deeply with issues of women's health, mental health, sexual orientation, artificial reproduction, and the new social issues in health care. The authors devote special attention to the various ethical theories currently in use in the United States while clearly presenting a method of ethical decision making based in the Catholic tradition. They discuss the needs of the human person, outlining what it means to be human, both as an individual and as part of a community.
This volume has been significantly updated to include new discussions of recent clinical innovations and theoretical issues that have arisen in the field:
• the Human Genome Project• efforts to control sexual selection of infants• efforts to genetically modify the human genotype and phenotype• the development of palliative care as a medical specialty• the acceptance of non-heart beating persons as organ donors• embryo development and stem cell research• reconstructive and cosmetic surgery• nutrition and obesity• medical mistakes• the negative effects of managed care on the patient-physician relationship• recent papal allocution regarding care of patients in a persistent vegetative state and palliative care for dying patients
AUTHOR BIOGRAPHY
Benedict M. Ashley, OP, a priest of the Dominican Order, Chicago Province, is Emeritus Professor of Moral Theology at Aquinas Institute of Theology in St. Louis. He is a senior fellow of the National Catholic Bioethics Center in Philadelphia. He has been honored with the medal Pro Ecclesia et Pontifice conferred by John Paul II and the Thomas Linacre Award from the National Federation of Catholic Physicians' Guilds. He is coautor of Ethics of Health Care: An Introductory Textbook, Third Edition (with Kevin O'Rourke, OP).
Jean deBlois, CSJ, is director of the Master of Arts in Health Care Mission program at Aquinas Institute of Theology. She also acts as sponsor liaison to Ascension Health for the Sisters of St. Joseph of Carondelet and serves on the Ascension Health Board of Directors. She is a former Vice President for Mission and Sponsorship at the Catholic Health Association.
Kevin O'Rourke, OP, is professor emeritus and founder of the Center for Health Care Ethics at the Saint Louis University Health Sciences Center. He is a professor of bioethics at the Neiswanger Institute of Bioethics and Public Policy, Stritch School of Medicine, Loyola University, Chicago. He is author of Medical Ethics: Sources of Catholic Teachings, Third Edition and coauthor of A Primer for Health Care Ethics: Essays for a Pluralistic Society, Second Edition.
REVIEWS
-- Vision
-- John F. Kavanaugh, SJ, Director of Ethics Across the Curriculum, Saint Louis University
-- Carol R. Taylor, CSFN, RN, Center for Clinical Bioethics, Georgetown University
-- Catholic Library World
-- America
-- The Thomist
TABLE OF CONTENTS
Table of Contents
Introduction
PART I: Health Care Ethics and Human Needs
1 Bioethics in a Multicultural Age
Overview
1.1 The Emergence of Secular Bioethics
1.2 The Traditional Sources of the Ethics of Health Care
1.3 Current Methodologies in Bioethics
1.3.1. The Varieties of Duty Ethics
1.3.2. The Varieties of Ends-Means Ethics
1.4 Faith and Reason in Health Care Ethics
1.4.1. Catholic Health Care Ethics
1.4.2. How the Church Solves Moral Controversies
1.4.3. Is There a ¿Right to Dissent¿ From Authoritative Church Teaching?
1.5 Conclusion
2 Ethics and Needs of the Common Person
Overview
2.1 An Ethics Based on Innate Human Needs
2.1.1. Innate and Artificial Human Needs
2.1.2. Health Needs
2.1.3. The Unity of the Human Person
2.2 Jesus Christ, Healer, as Ethical Model
2.3 Character and the Major Moral Virtues
2.3.1. Faith and Prudence
2.3.2. Love and Justice
2.3.3. Hope, Temperance, Fortitude
2.4 Prudent Decision Making
2.5 Moral Norms Especially Relevant to Health Care
2.5.1. Double Effect
2.5.2. Legitimate Cooperation
2.5.3. Free and Informed Consent
2.5.4. Confidentiality
2.6 Conclusion
PART II: Clinical Issues
3 Sexuality and Reproduction
Overview
3.1 The Meaning of Human Sexuality
3.1.1. Sexuality and Gender
3.1.2. The Goals of Sexuality
3.1.3. Sexuality and Bioethics
3.2 When Does Human Life Begin?
3.2.1. Semantic Issues
3.2.2. Biological Issues
3.2.3. Philosophical and Theological Issues
3.3 Ethical Issues in Reproduction
3.3.1. Natural Family Planning
3.3.2. Contraception
3.3.3. Surgical Sterilization
3.3.4. Abortion
3.3.5. Disputed Cases
3.3.5.1. Ectopic Pregnancy
3.3.5.2. Anencephaly
3.3.5.3. Treatment of Victims of Sexual Assault
3.3.6. Artificial Human Reproduction
3.3.7. Surrogate Motherhood
3.4 Pastoral Approach to Ethical Problems Arising from Sexuality
3.4.1. Reasons for Concern
3.4.2. Objective and Subjective Morality
3.5 Conclusion
4 Reconstructing and Modifying the Human Body
Overview
4.1 Modifying the Human Body
4.1.1. Cooperation in Creation
4.2 Genetic Intervention
4.2.1. Children by Design
4.2.2. Complex Forms of Intervention
4.2.3. Ecology and New Life Forms
4.3 Genetic Screening and Counseling
4.3.1. Genetic Screening
4.3.2. Genetic Counseling
4.3.3. Parental Responsibility
4.4 Organ Transplantation
4.4.1. Transplants from Deceased Donors
4.4.2. Transplants from Living Donors
4.4.3. Problems Due to Success
4.4.4. Increasing the Supply of Organs for Transplantation
4.5 Reconstructive and Cosmetic Surgery
4.5.1. Reconstructive and Cosmetic Surgery
4.5.2. Sexual Reassignment
4.6 Experimentation and Research on Human Subjects
4.6.1. The Importance of Research on Human Persons
4.6.2. Research and Therapy
4.6.3. Principles of Research on Human Subjects
4.6.4. Experimental Controls
4.6.4.1. Impartiality and Consent in Selecting Subjects
4.6.4.2. Proxy or Vicarious Consent
4.6.4.3. Termination of Experimentation
4.6.5. Psychological Experimentation
4.6.6. Research on Human Embryos
4.6.7. Cloning
4.7 Conclusion
5 Mental Health: Ethical Perspectives
Overview
5.1 What is Mental Health?
5.1.1. The ¿Myth¿ of Mental Illness
5.1.2. Prevalence and Variety of Mental Disorders
5.1.3. The Reality of Mental Illness
5.2 Medico-therapies
5.2.1. Psychosurgery
5.2.2. Electroconvulsive Therapy
5.2.3. Pharmacotherapy
5.2.3.1. Therapy for Mental Illness
5.2.3.2. Psychotropic Drugs for Behavior Modification
5.3 Psychotherapies
5.3.1. Models of Personality
5.3.2. The Empirical Validity of Current Models
5.4 The Christian Model of Mental Health
5.5 Ethical Problems in Mental Therapy and Research
5.5.1. Behavior Control
5.5.2. Co-Dependency
5.5.3. Addiction
5.5.4. Changing the Patient¿s Value System
5.6 Conclusion
6 Suffering and Death
Overview
6.1 Mystery of Death
6.2 Fear of Death
6.3 Defining Death
6.4 Truth Telling to the Dying
6.5 Care for the Corpse or Cadaver
6.6 Suicide, Assisted Suicide, and Euthanasia
6.6.1. Age Old Question
6.6.2. Controlling Death
6.6.3. Physician Assisted Suicide
6.6.4. Euthanasia
6.7 Allowing to Die: Ordinary and Extraordinary Means
6.7.1 Origin and Evolution of Terms
6.7.2. The Difference Between Suicide and Allowing to Die
6.7.3. The Difference Between Medical Therapy and Basic Health Care
6.7.4. Comparison of Terms: Ordinary and Extraordinary, Proportionate and Disproportionate
6.7.5. The Criteria for Forgoing Life Support
6.7.5.1 Benefits
6.7.5.2 Burdens
6.7.5.3 Future Burdens Considered
6.7.5.4 Two Criteria, or One?
6.7.6. Quality of Life Considerations
6.7.7. When Should the Decision to Forgo Life Support be made?
6.7.8. Who Should Make the Decision?
6.7.8.1. Proxy Consent
6.7.8.2. Family Concerns
6.7.9.3. Community Interest
6.8 Care of Permanently Unconscious Patients
6.9 Treatment of Pain
6.10 Conculsion
PART III: Social and Pastoral Responsibilities
7 Social Responsibility
Overview
7.1 Professions: Depersonalizing Trends
7.1.1. A Person-Centered Concept of Profession
7.2 Traditional Characteristics of Medicine as a Profession
7.2.1. Priest of Scientist
7.2.2. Why Did Medicine Develop So Slowly?
7.2.3. The Twenty-First Century Physician
7.2.4. The Christian Physician
7.3 Health Care Counseling
7.3.1. Concern
7.3.2. Knowledge and Skill
7.4 Professional Communication and Confidentiality
7.4.1. Communication
7.4.2. Confidentiality
7.4.3. Preventing Harm
7.4.4. A New Paradigm for Health Care
7.5 The Political Situation of Health Care Today
7.5.1. The Rise of the Health Care Consumer
7.6 Principles of Health Care Policy
7.6.1. The Principle of the Common Good
7.6.2. Subsidarity
7.6.3. Functionalism
7.7 Health Care Ethics and Public Policy
7.8 Ethics Committees in Health Care Facilities
7.8.1. The Need for Ethics Committees
7.8.2. Ethics Committees as Educational
7.8.3. Striving for Catholic Identity
7.9 Conclusion
8 Pastoral Care
Overview
8.1 The Goals of Pastoral Ministry
8.1.1. Preparation of Pastoral Care Professionals
8.1.2. Pastoral Care in Relation to Other Health Care Services
8.2 Pastoral Care of the Healthcare Staff
8.2.1 Chaplain and/or Director
8.2.2 Intra-Staff Problems
8.2.3 Co-Ministry
8.3 Pastoral Care and Ethical Counseling
8.3.1 Respecting the Value Systems of Ill Persons
8.3.2 Subjective and Objective Morality
8.4 Spiritual Counseling in Healthcare
8.4.1 Caring in the Name of the Christian Community
8.4.2 Discernment
8.4.3 Objectives of Spiritual Care
8.5 Celebrating the Healing Process
8.5.1 Word and Sacrament
8.5.2 Anointing the Sick
8.5.3 Communal Nature of the Anointing of the Sick
8.5.4 Special Problems about the Sacrament of the Sick
8.5.5 The Sacrament of Reconciliation
8.5.6 Baptism
8.5.7 Eucharist
8.5.8 Lay Ministries
8.5.9 The Sacraments and Bioethics
8.6 Conclusion
Health Care Ethics: A Catholic Theological Analysis, Fifth Edition
by Benedict M. Ashley
Georgetown University Press, 2006 Paper: 978-1-58901-116-8
Health Care Ethics is a comprehensive study of significant issues affecting health care and the ethics of health care from the perspective of Catholic theology. It aims to help Christian, and especially Catholic, health care professionals solve concrete problems in terms of principles rooted in scripture and tested by individual experience; however, its basis in real medical experience makes this book a valuable resource for anyone with a general interest in health care ethics.
This fifth edition, which includes important contributions by Jean deBlois, C.S.J., considers everyday ethical questions and dilemmas in clinical care and deals more deeply with issues of women's health, mental health, sexual orientation, artificial reproduction, and the new social issues in health care. The authors devote special attention to the various ethical theories currently in use in the United States while clearly presenting a method of ethical decision making based in the Catholic tradition. They discuss the needs of the human person, outlining what it means to be human, both as an individual and as part of a community.
This volume has been significantly updated to include new discussions of recent clinical innovations and theoretical issues that have arisen in the field:
• the Human Genome Project• efforts to control sexual selection of infants• efforts to genetically modify the human genotype and phenotype• the development of palliative care as a medical specialty• the acceptance of non-heart beating persons as organ donors• embryo development and stem cell research• reconstructive and cosmetic surgery• nutrition and obesity• medical mistakes• the negative effects of managed care on the patient-physician relationship• recent papal allocution regarding care of patients in a persistent vegetative state and palliative care for dying patients
AUTHOR BIOGRAPHY
Benedict M. Ashley, OP, a priest of the Dominican Order, Chicago Province, is Emeritus Professor of Moral Theology at Aquinas Institute of Theology in St. Louis. He is a senior fellow of the National Catholic Bioethics Center in Philadelphia. He has been honored with the medal Pro Ecclesia et Pontifice conferred by John Paul II and the Thomas Linacre Award from the National Federation of Catholic Physicians' Guilds. He is coautor of Ethics of Health Care: An Introductory Textbook, Third Edition (with Kevin O'Rourke, OP).
Jean deBlois, CSJ, is director of the Master of Arts in Health Care Mission program at Aquinas Institute of Theology. She also acts as sponsor liaison to Ascension Health for the Sisters of St. Joseph of Carondelet and serves on the Ascension Health Board of Directors. She is a former Vice President for Mission and Sponsorship at the Catholic Health Association.
Kevin O'Rourke, OP, is professor emeritus and founder of the Center for Health Care Ethics at the Saint Louis University Health Sciences Center. He is a professor of bioethics at the Neiswanger Institute of Bioethics and Public Policy, Stritch School of Medicine, Loyola University, Chicago. He is author of Medical Ethics: Sources of Catholic Teachings, Third Edition and coauthor of A Primer for Health Care Ethics: Essays for a Pluralistic Society, Second Edition.
REVIEWS
-- Vision
-- John F. Kavanaugh, SJ, Director of Ethics Across the Curriculum, Saint Louis University
-- Carol R. Taylor, CSFN, RN, Center for Clinical Bioethics, Georgetown University
-- Catholic Library World
-- America
-- The Thomist
TABLE OF CONTENTS
Table of Contents
Introduction
PART I: Health Care Ethics and Human Needs
1 Bioethics in a Multicultural Age
Overview
1.1 The Emergence of Secular Bioethics
1.2 The Traditional Sources of the Ethics of Health Care
1.3 Current Methodologies in Bioethics
1.3.1. The Varieties of Duty Ethics
1.3.2. The Varieties of Ends-Means Ethics
1.4 Faith and Reason in Health Care Ethics
1.4.1. Catholic Health Care Ethics
1.4.2. How the Church Solves Moral Controversies
1.4.3. Is There a ¿Right to Dissent¿ From Authoritative Church Teaching?
1.5 Conclusion
2 Ethics and Needs of the Common Person
Overview
2.1 An Ethics Based on Innate Human Needs
2.1.1. Innate and Artificial Human Needs
2.1.2. Health Needs
2.1.3. The Unity of the Human Person
2.2 Jesus Christ, Healer, as Ethical Model
2.3 Character and the Major Moral Virtues
2.3.1. Faith and Prudence
2.3.2. Love and Justice
2.3.3. Hope, Temperance, Fortitude
2.4 Prudent Decision Making
2.5 Moral Norms Especially Relevant to Health Care
2.5.1. Double Effect
2.5.2. Legitimate Cooperation
2.5.3. Free and Informed Consent
2.5.4. Confidentiality
2.6 Conclusion
PART II: Clinical Issues
3 Sexuality and Reproduction
Overview
3.1 The Meaning of Human Sexuality
3.1.1. Sexuality and Gender
3.1.2. The Goals of Sexuality
3.1.3. Sexuality and Bioethics
3.2 When Does Human Life Begin?
3.2.1. Semantic Issues
3.2.2. Biological Issues
3.2.3. Philosophical and Theological Issues
3.3 Ethical Issues in Reproduction
3.3.1. Natural Family Planning
3.3.2. Contraception
3.3.3. Surgical Sterilization
3.3.4. Abortion
3.3.5. Disputed Cases
3.3.5.1. Ectopic Pregnancy
3.3.5.2. Anencephaly
3.3.5.3. Treatment of Victims of Sexual Assault
3.3.6. Artificial Human Reproduction
3.3.7. Surrogate Motherhood
3.4 Pastoral Approach to Ethical Problems Arising from Sexuality
3.4.1. Reasons for Concern
3.4.2. Objective and Subjective Morality
3.5 Conclusion
4 Reconstructing and Modifying the Human Body
Overview
4.1 Modifying the Human Body
4.1.1. Cooperation in Creation
4.2 Genetic Intervention
4.2.1. Children by Design
4.2.2. Complex Forms of Intervention
4.2.3. Ecology and New Life Forms
4.3 Genetic Screening and Counseling
4.3.1. Genetic Screening
4.3.2. Genetic Counseling
4.3.3. Parental Responsibility
4.4 Organ Transplantation
4.4.1. Transplants from Deceased Donors
4.4.2. Transplants from Living Donors
4.4.3. Problems Due to Success
4.4.4. Increasing the Supply of Organs for Transplantation
4.5 Reconstructive and Cosmetic Surgery
4.5.1. Reconstructive and Cosmetic Surgery
4.5.2. Sexual Reassignment
4.6 Experimentation and Research on Human Subjects
4.6.1. The Importance of Research on Human Persons
4.6.2. Research and Therapy
4.6.3. Principles of Research on Human Subjects
4.6.4. Experimental Controls
4.6.4.1. Impartiality and Consent in Selecting Subjects
4.6.4.2. Proxy or Vicarious Consent
4.6.4.3. Termination of Experimentation
4.6.5. Psychological Experimentation
4.6.6. Research on Human Embryos
4.6.7. Cloning
4.7 Conclusion
5 Mental Health: Ethical Perspectives
Overview
5.1 What is Mental Health?
5.1.1. The ¿Myth¿ of Mental Illness
5.1.2. Prevalence and Variety of Mental Disorders
5.1.3. The Reality of Mental Illness
5.2 Medico-therapies
5.2.1. Psychosurgery
5.2.2. Electroconvulsive Therapy
5.2.3. Pharmacotherapy
5.2.3.1. Therapy for Mental Illness
5.2.3.2. Psychotropic Drugs for Behavior Modification
5.3 Psychotherapies
5.3.1. Models of Personality
5.3.2. The Empirical Validity of Current Models
5.4 The Christian Model of Mental Health
5.5 Ethical Problems in Mental Therapy and Research
5.5.1. Behavior Control
5.5.2. Co-Dependency
5.5.3. Addiction
5.5.4. Changing the Patient¿s Value System
5.6 Conclusion
6 Suffering and Death
Overview
6.1 Mystery of Death
6.2 Fear of Death
6.3 Defining Death
6.4 Truth Telling to the Dying
6.5 Care for the Corpse or Cadaver
6.6 Suicide, Assisted Suicide, and Euthanasia
6.6.1. Age Old Question
6.6.2. Controlling Death
6.6.3. Physician Assisted Suicide
6.6.4. Euthanasia
6.7 Allowing to Die: Ordinary and Extraordinary Means
6.7.1 Origin and Evolution of Terms
6.7.2. The Difference Between Suicide and Allowing to Die
6.7.3. The Difference Between Medical Therapy and Basic Health Care
6.7.4. Comparison of Terms: Ordinary and Extraordinary, Proportionate and Disproportionate
6.7.5. The Criteria for Forgoing Life Support
6.7.5.1 Benefits
6.7.5.2 Burdens
6.7.5.3 Future Burdens Considered
6.7.5.4 Two Criteria, or One?
6.7.6. Quality of Life Considerations
6.7.7. When Should the Decision to Forgo Life Support be made?
6.7.8. Who Should Make the Decision?
6.7.8.1. Proxy Consent
6.7.8.2. Family Concerns
6.7.9.3. Community Interest
6.8 Care of Permanently Unconscious Patients
6.9 Treatment of Pain
6.10 Conculsion
PART III: Social and Pastoral Responsibilities
7 Social Responsibility
Overview
7.1 Professions: Depersonalizing Trends
7.1.1. A Person-Centered Concept of Profession
7.2 Traditional Characteristics of Medicine as a Profession
7.2.1. Priest of Scientist
7.2.2. Why Did Medicine Develop So Slowly?
7.2.3. The Twenty-First Century Physician
7.2.4. The Christian Physician
7.3 Health Care Counseling
7.3.1. Concern
7.3.2. Knowledge and Skill
7.4 Professional Communication and Confidentiality
7.4.1. Communication
7.4.2. Confidentiality
7.4.3. Preventing Harm
7.4.4. A New Paradigm for Health Care
7.5 The Political Situation of Health Care Today
7.5.1. The Rise of the Health Care Consumer
7.6 Principles of Health Care Policy
7.6.1. The Principle of the Common Good
7.6.2. Subsidarity
7.6.3. Functionalism
7.7 Health Care Ethics and Public Policy
7.8 Ethics Committees in Health Care Facilities
7.8.1. The Need for Ethics Committees
7.8.2. Ethics Committees as Educational
7.8.3. Striving for Catholic Identity
7.9 Conclusion
8 Pastoral Care
Overview
8.1 The Goals of Pastoral Ministry
8.1.1. Preparation of Pastoral Care Professionals
8.1.2. Pastoral Care in Relation to Other Health Care Services
8.2 Pastoral Care of the Healthcare Staff
8.2.1 Chaplain and/or Director
8.2.2 Intra-Staff Problems
8.2.3 Co-Ministry
8.3 Pastoral Care and Ethical Counseling
8.3.1 Respecting the Value Systems of Ill Persons
8.3.2 Subjective and Objective Morality
8.4 Spiritual Counseling in Healthcare
8.4.1 Caring in the Name of the Christian Community
8.4.2 Discernment
8.4.3 Objectives of Spiritual Care
8.5 Celebrating the Healing Process
8.5.1 Word and Sacrament
8.5.2 Anointing the Sick
8.5.3 Communal Nature of the Anointing of the Sick
8.5.4 Special Problems about the Sacrament of the Sick
8.5.5 The Sacrament of Reconciliation
8.5.6 Baptism
8.5.7 Eucharist
8.5.8 Lay Ministries
8.5.9 The Sacraments and Bioethics
8.6 Conclusion
ABOUT THIS BOOK | AUTHOR BIOGRAPHY | REVIEWS | TOC
