A call to reform Catholic health care ethics, inspired by the teachings of Pope Francis

Since its first edition in 1948, the US Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services (ERD) has guided Catholic institutions in the provision of health care that reflects both the healing ministry of Jesus and the Church’s understanding of human dignity. However, while the papacy of Pope Francis and the clerical sex-abuse scandal both profoundly impacted the Catholic Church, the latest edition of the ERD does not address or reflect these transformations.

Now for the first time, Todd A. Salzman and Michael G. Lawler present an extended critical commentary on the 2018 ERD. They argue that it is problematic in a number of ways. First, the revised ERD continues to prioritize a rule-based over a personalist-based ethical method, with an emphasis on absolute norms that proscribe specific medical acts. Further, it does not take into account Pope Francis’s transforming ecclesiological, methodological, and anthropological visions, neither internally in Catholic health care institutions nor externally in collaborations between Catholic and non-Catholic health care institutions. Finally, the revised ERD provides no evidence that the bishops grasp how the clerical sex-abuse scandal and its cover-up have fundamentally undermined episcopal authority and credibility.

Salzman and Lawler propose new ways forward for US Catholic health care ethics that prioritize human dignity as their guiding principle. As there is pluralism in Catholic definitions of human dignity, there must be pluralism in the norms and directives that facilitate realizing human dignity. Pope Francis’s emphasis on the virtues of mercy and care should move the ERD forward from a focus on absolute norms in medical ethics to a focus on virtues and principles to guide both patients and health care professionals in their discerned conscientious health care decisions.

Two principles capture the essence of the Catholic tradition on sexual ethics: that each and every marriage act must remain open to the transmission of life, and that any human genital act must occur within the framework of marriage. In the Catholic tradition, moral sexual activity is institutionalized within the confines of marriage and procreation, and sexual morality is marital morality.

But theologians Todd Salzman and Michael Lawler contend that there is a disconnect between many of the Church’s absolute sexual norms and other theological and intellectual developments explicitly recognized and endorsed in the Catholic tradition, especially since the Second Vatican Council. These developments include the shift from a primary static worldview to a historically conscious worldview, one that recognizes reality as dynamic, evolving, changing, and particular. By employing such a historically conscious worldview, alternative claims about the moral legitimacy of controversial topics such as contraception, artificial reproduction, and homosexual marriage can faithfully emerge within a Catholic context. Convinced of the central role that love, desire, and fertility play in a human life, and also in the life of Christian discipleship, the authors propose an understanding of sexuality that leads to the enhancement of human sexual relationships and flourishing.

This comprehensive introduction to Catholic sexual ethics—complete with thought-provoking study questions at the end of each chapter—will be sure to stimulate dialogue about sexual morality between Catholic laity, theologians, and the hierarchy. Anyone seeking a credible and informed Catholic sexual ethic will welcome this potentially revolutionary book.

Two principles capture the essence of the official Catholic position on the morality of sexuality: first, that any human genital act must occur within the framework of heterosexual marriage; second, each and every marriage act must remain open to the transmission of life. In this comprehensive overview of Catholicism and sexuality, theologians Todd A. Salzman and Michael G. Lawler examine and challenge these principles. Remaining firmly within the Catholic tradition, they contend that the church is being inconsistent in its teaching by adopting a dynamic, historically conscious anthropology and worldview on social ethics and the interpretation of scripture while adopting a static, classicist anthropology and worldview on sexual ethics.

While some documents from Vatican II, like Gaudium et spes ("the marital act promotes self-giving by which spouses enrich each other"), gave hope for a renewed understanding of sexuality, the church has not carried out the full implications of this approach. In short, say Salzman and Lawler: emphasize relationships, not acts, and recognize Christianity's historically and culturally conditioned understanding of human sexuality. The Sexual Person draws historically, methodologically, and anthropologically from the best of Catholic tradition and provides a context for current theological debates between traditionalists and revisionists regarding marriage, cohabitation, homosexuality, reproductive technologies, and what it means to be human. This daring and potentially revolutionary book will be sure to provoke constructive dialogue among theologians, and between theologians and the Magisterium.