In John 10:10, Jesus says, “I came that they may have life, and have it abundantly.”

Since the creation of Mankind by God our Father, Humanity has been invited to enter into the fullness of life that is offered by God. This fullness of life has dimensions beyond one’s earthly existence. Intrinsic in this, is a call to partake of and share in the very heart and life of God. According to Pope John Paul II in his encyclical Evangelium Vitae, “The loftiness of this supernatural vocation reveals the greatness and the inestimable value of human life even in its temporal phase. Life in time, in fact, is the fundamental condition, the initial stage and an integral part of the entire unified process of human existence. It is a process which, unexpectedly and undeservedly, is enlightened by the promise and renewed by the gift of divine life, which will reach its full realization in eternity (cf. 1 John 3:1-2). At the same time, it is precisely this supernatural calling which highlights the relative character of each individual’s earthly life. After all, life on earth is not an “ultimate” but a “penultimate” reality; even so, it remains a sacred reality entrusted to us, to be preserved with a sense of responsibility and brought to perfection in love and in the gift of ourselves to God and to our brothers and sisters.” (Pope John Paul II, 1995)

The implications of this are tremendous. Human life is priceless because it is called to communion with God Himself, where everyone through the gift of free will, is called to freely encounter Jesus the Son, through the Grace of the Holy Spirit. It is in this fullness of communion with the Holy Trinity, where man and woman fully become the persons that they were envisioned to be, even before the beginning of time.

In Genesis 1: 26-27, it says, “God created mankind in his image; in the image of God, he created them; male and female he created them. God blessed them and God said to them: Be fertile and multiply; fill the earth and subdue it. Have dominion over the fish of the sea, the birds of the air, and all the living things that crawl on the earth.”

The literature of that time, used to refer to human beings as slaves to the gods, and who existed to provide menial service and mere frivolous entertainment for the divine world. From the onset of Scripture in the first book of Genesis, we see an overturning of popular cultural notions through the elevation of the Human Being in the use of language that denotes that the human being is an heir – “made in the image and likeness of God” and as royalty – with the word “dominion”. Man is given authority and rule over the other creatures of God, and is made as son and daughter of God, in His likeness. However, being allotted a royal status, does not mean that human beings have unlimited power. They are vicars of God’s rule on Earth, and representatives, not God. (United States Conference of Catholic Bishops, n.d.).

In essence, human life is not degraded, nor is it cheap, and the Church’s resounding call has been that we must recognise the immense dignity of a human person from the moment of conception to the time of natural death. (Congregation for the Doctrine of Faith, 2008)

For St. Thomas Aquinas, human beings are subject to a Natural Law, that bases its foundations on an Eternal Law which comes from God. If based on the rationale that the law refers to a dictate of reason or intellect, in other words, normative principles that prescribe necessary means to a necessary end (Rutherford, 2008), then according to St. Thomas Aquinas, God in his unfathomable intellect, has an incomprehensible idea of how to rule the world and this idea of governance is the Eternal Law (St. Thomas Aquinas, 1920). Accordingly, this eternal law is imprinted on to God’s creation through this creation’s essence or nature. As things act according to their nature, they obtain their “respective inclinations to their proper acts and ends” (St. Thomas Aquinas, 1920, final cause) according to the law that is written into their nature (Thomistic Philosophy Page, n.d.). Human nature can be sketched via five basic natural inclinations or parameters: (1) the inclination to the good; (2) the inclination to the knowledge of truth; (3) the inclination to self-preservation; (4) the inclination to live in society; and (5) the inclination to marriage and the rearing of offspring (Pinckaers, 1995). At the same time, above other creatures, human beings, made in God’s own image, reflect the Creator’s truest nature, through the gifts of intellect, reason, and free-will. The human being is subject to Providence, yet also provides for others. It is in our nature to act freely and to discover the best way to act through the exercise of our reason and intellect. This inborn inclination of human beings to attain to their proper end, via reason and free will, is thus the Natural Law (St. Thomas Aquinas, 1920).

With this, we understand that human life is a basic good that cannot be made subject to utilitarian subjugation. “The gift of life which God the Creator and Father has entrusted to man calls him to appreciate the inestimable value of what he has been given and to take responsibility for it…” (Congregation for the Doctrine of Faith, 1987). The dignity of a human person cannot be understated. Life begins at the point of conception until death, and human beings are called to be stewards of this gift of life. The Eternal Law that is imprinted on our hearts provides us with the basis of our moral fidelities and responsibilities and steer us in the right direction surrounding fundamental human rights (Markwell & Brown, 2001). As St. John Chrysostom says, “What is it that is about to be created, that enjoys such honour? It is man—that great and wonderful living creature, more precious in the eyes of God than all other creatures! For him the heavens and the earth, the sea and all the rest of creation exist. God attached so much importance to his salvation that He did not spare his own Son for the sake of man. Nor does He ever cease to work, trying every possible means, until He has raised man up to himself and made him sit at his right hand.” (n.d.).

In recent years, there has once again arisen the debate of the worth and value of human life in courtrooms around the world. There is thus a need for a Catholic to understand what Catholic Bioethics are about.

First, what are Bioethics?

Bioethics may be defined as the systematic inquiry and implementation of the ethical, legal, social, philosophical issues in the fields of Medicine and the Life Sciences (McMillan, 2018; Shannon & Kockler, 2009).

Secular Bioethics would consider the following scenarios as ethical: abortion, medical diagnoses with the intent to abort the possibly differently abled child, euthanasia, human cloning, the formation of human chimeras (cross-breeds between human beings and animals), artificial insemination and in-vitro-fertilisation, contraception, embryonic stem-cell research, and the withholding of food and water as extraordinary means of patient treatment. In contrast, Catholic Bioethics considers the above examples unethical (Irving, 2000).

Catholic Bioethics have their foundations in Scripture and the teachings of the Magisterium and are augmented by theological and scriptural exegesis and philosophical debate (Markwell & Brown, 2001). Contemporary Catholic Bioethics are interested in broad and diverse topics such as human sexuality, end-of-life issues, cloning, vaccination, artificial reproduction methodologies, birth control, reproductive sterilisation of human beings, marriage, suicide, death, and abortion, with the fundamental viewpoint that at the heart of these human issues, is that the value and dignity of human life is at stake. God maintains dominion of our lives, and we as stewards, are accountable to God for this life that has been given to us (Markwell & Brown, 2001; National Catholic Bioethics Center, n.d.).

The Church is neither anti-advancement, anti-technology, anti-medicine, nor anti-Science. Catholic teaching fully respects and recognises the immeasurable benefits of scientific and technological advancements as part of God’ plan for Man to exercise stewardship of the Earth in justice and holiness. Many Scientists and Medical Practitioners are Catholic, and the Church fully supports the progress that is garnered from research and development. Nonetheless, Science and Technology are inspired from the Wisdom of God, come into fruition under the hands of Man, and are directed towards the activity and lives of human beings. Hence, the Church teaches that Science and Technology must always be at the service of humanitarian efforts, and to always  celebrate the dignity of the human beings (Pope Paul VI, 1965).

Catholic Bioethics help to apply Catholic moral teaching and tradition to clinical and medical research, practice, and implementation. These are in turn guided by the following principles:

  1. The Principle of Truth – there is no place for intentional falsehood, prejudices, bias, and hidden agendas. This ensures the upholding of integrity in the Scientific and Medical arenas.
  2. The Principle for the Respect of Life – God, our Father and Maker, is the author of life. God does not relinquish his dominion over our life but shares the fullness of life with human beings. It is everyone’s responsibility to respect life because it is sacred, and understand that everyone has an inviolable right to life. The implication is that we must never wilfully destroy the life of a human being at any stage and age.
  3. The Principle of the Respect for the Integrity of the Person – A person is one whole and health and healthcare must be administered with the view that respects the whole person and the sanctity of that person.
  4. The Principle of Generosity and Justice – Practitioners, Researchers, and Medical Personnel must understand that they are instruments through which God cares for His creation. Their practice needs to be tempered with generosity, gentleness, compassion, and understanding, with the purpose of serving the needs of those who seek out health care, and not for the practitioners’ own needs (The National Catholic Bioethics Center & the Catholic Medical Association, 2008)
  5. The Principle of Double Effect – Although St. Thomas Aquinas did not use the term “double effect” itself, he had spent a considerable amount of time writing about the concept, to which there is a dual aftermath – both good and bad to an act, but the good effect justifies why the act was carried out. For example, can someone kill an attacker to save his life? The answer is yes.  In the Principle of Double Effect, the act must be morally justifiable and take into account the following:
  • The act in itself cannot be wrong or intrinsically evil.
  • The bad effect cannot cause the good effect.
  • The agent cannot intend the bad effect.
  • The bad effect cannot outweigh the good effect or there is a proportional reason to tolerate the bad effect.

In examining acts within the framework of the four conditions, one has to keep in mind that, if the act satisfies the four conditions, then the act is indirect and, therefore, morally permissible. If, however, the act does not fulfill these four, the act is direct and, therefore, the act is not morally permissible (Kockler, 2007).

Having spent a substantial amount of time discussing the dignity of a human being, the following present a few case studies that are salient to our cause. Can you determine which is morally right and permissible, or which is morally wrong and not permissible? These case studies are taken from real life examples around the world (cf. Institute of Clinical Bioethics, n.d.):

Case Study 1:

At a particular cane plantation, women are sent to work to harvest the cane for 13 to 18 hours a day. During their time of menstruation, many of them use rags instead of sanitary pads, which results in infections of the womb. To prevent a drop in productivity, these women are not sent home or allowed to take leave days. At the age of 22, they are sent by the cane plantation owners to undergo a womb hysterectomy, to remove their uterus, to prevent future infections. These women then become perpetual living machines for the rest of their lives.

 

Case Study 2:

A male prostitute, Mr. R, is diagnosed with H.I.V. While he still entertains regular customers, he uses a condom to mitigate the risk of H.I.V. transmission.

 

Case Study 3:

A pregnant mother, Ms. Z, infected by Zika Virus, has been advised by the doctors to abort her child. The foetus is 20 weeks old.

 

Case Study 4:

A couple – Mr. C and Ms. M, had been trying to conceive for some time without success. They read about surrogacy and decide to try implanting an in-vitro fertilised egg into the womb of a stranger woman, so that her womb may bear the couple’s child to full term.

 

Case Study 4:

Mr. K is 95 years old and discovers that he has stage 3 cancer. He asks the doctor to euthanise him. The doctor agrees and carries out the procedure.

 

Case study 5:

“Mrs. P is 25 years old and is about 10 weeks pregnant. She has tuberculous meningitis. Her disease was in an advanced stage when she was admitted to hospital and underwent surgery to relieve the pressure on her brain. She is now clinically brain dead. Her husband — like the patient, a devout Catholic — requests that her body be maintained on life support in the intensive care unit to save her fetus. Other family members concur that she is “pro-life” and would want to carry the fetus to term if possible.” (Markwell & Brown, 2001, Abstract)

 

So which was the right thing, or the wrong thing to do? Who is right and who is wrong? What’s morally permissible according to Catholic teaching, what is not?

The area of Bioethics straddles a grey area that needs to be carefully discerned as the angles of Scripture, Church Teaching, Morality intersect with the realities of the scenarios. Would you make a good Moral Detective?

 

By the Grace of God,

Brian Bartholomew Tan

 

 

References

Congregation for the Doctrine of Faith. (1987). Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation Replies to Certain Questions of the Day. Retrieved from https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html

 

Congregation for the Doctrine of Faith. (2008).  Instruction Dignitas Personae on Certain Bioethical Questions. Retrieved from https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html

 

Institute of Clinical Bioethics. (n.d.). Saint Joseph’s University. Retrieved August 30, 2022 from https://sites.sju.edu/icb/

 

Irving, D. (2000). What is Bioethics? (Quid est ‘Bioethics’?). Tenth Annual Conference: Life and Learning X. Georgetown University, Washington, D.C. Retrieved August 30, 2022 from https://www.catholicculture.org/culture/library/view.cfm?recnum=3320

 

Kockler, N. (2007). The Principle of Double Effect and Proportionate Reason. Virtual Mentor, 9(5): 369 – 374. Retrieved August 30, 2022 from https://journalofethics.ama-assn.org/article/principle-double-effect-and-proportionate-reason/2007-05

 

Markwell, H. J., & Brown, B. F. (2001). Bioethics for clinicians: 27. Catholic bioethics. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 165(2), 189–192.

 

McMillan, J. (2018). What Is Bioethics? The Methods of Bioethics: An Essay in Meta-Bioethics, Issues in Biomedical Ethics. Oxford (online ed.). Oxford Academic. Retrieved August 30, 2022 from https://doi.org/10.1093/oso/9780199603756.003.0002

 

National Catholic Bioethics Center, The. (n.d.). Resource on Bioethics Topics. Retrieved August 30, 2022 from https://www.ncbcenter.org/bioethics-resources

 

Pinckaers (O.P.) S. (1995). The Sources of Christian Ethics. Trans. Sr. Mary Thomas Noble, O.P. Washington, D.C.: Catholic University of America Press: 407.

 

Pope John Paul II. (1995). Evangelium Vitae. [Encyclical letter]. Retrieved from https://www.vatican.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae.html

 

Pope Paul VI. (1965). Gaudium et spes. Retrieved from https://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_const_19651207_gaudium-et-spes_en.html

 

Rutherford, D. (2008) Spinoza and the Dictates of Reason, Inquiry, 51(5), 485-511, DOI: 10.1080/00201740802421402

 

Shannon, T. A. & Kockler, N. J. (2009) An Introduction to Bioethics (4th revised edition). New York: Paulist Press

 

St. John Chrysostom. (n.d.) General sermon 2, 1: 54, 587D-588A

 

St. Thomas Aquinas. (1920) The Summa Theologiæ of St. Thomas Aquinas
(Second and Revised Edition). Trans. Fathers of the English Dominican Province. Retrieved from https://www.newadvent.org/summa/1022.htm

The National Catholic Bioethics Center and the Catholic Medical Association. (2008) A Catholic Guide to Ethical Clinical Research, The Linacre Quarterly, 75:3, 181-224, DOI: 10.1179/002436308803889521

 

Thomistic Philosophy Page. (n.d.). Natural Law. Aquinas Online. Retrieved August 30, 2022 from https://aquinasonline.com/natural-law/

 

United States Conference of Catholic Bishops. (n.d.). Genesis. Bible Commentary in footnotes. Retrieved from https://bible.usccb.org/bible/genesis/1