Luminous
A Catholic Woman and Her Thoughts on Life, the Universe, and Everything
Tuesday, June 24, 2008
Fr. Germain Kopaczynski - “A Crash Course in Catholic Medical Ethics”
Fr. Germain Kopaczynski - “A Crash Course in Catholic Medical Ethics”
April 30th 2008 - 4th Annual Healthcare Professionals for Divine Mercy Conference - Medicine, Bioethics and Spirituality - Holy Cross College, Worcester, MA

We say “Catholic Medical Ethics” – however, Truth is the common possession of us all

Every discipline has it’s own “Prime Directive” (a la Star Trek) – the Prime Directive of “non-interference” with “less developed” cultures – ACTUAL behavior – a.k.a. ACTUAL “directive” – interfere whenever you want – just don’t get shot…. We all have our own “prime directives” in our own professional fields. Most of all in the health field we all say “do no harm” – but how do we apply that directive in this day and age?

We aim to support Life – Do Good, avoid Evil. Sounds simple, doesn’t it? But so often, it’s not.

Starting point – we have to start with God. We have to. Even atheistic scientists have recognized that the universe has a beginning, a starting point – for lack of a better term – because they hate to admit it – a point where everything was created and came into being, and before that there was only…. They don’t know what…. WE know….
  1. God is the Creator of us all

  2. Humans are made in the image of God – hence their Dignity is inherent because of their very nature – this is the way we were made to BE – in the image and likeness of God – EVERY human person has an inherent individual and unique dignity that is owed respect.

  3. God is the Lord of Life and Death, as the Creator of all

  4. God stated, quite clearly – Thou shalt not kill – It is a specific command intended to protect the dignity and sanctity of human life, and indeed the whole of God's law protects human life.

  5. The Church states that no one has the right to terminate the life of another person at any stage or circumstance of life. "No one is permitted to ask for this act of killing,(referring to Euthanasia) either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. Nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity."

  6. Life is not ours to take. We cannot create a living soul – we can only cooperate in the birth of a child with God’s grace, as God breathes new life and a soul into existence at the moment of conception. We have no right to take that life – unless the safety of the community is at stake – and in this day and age, that is “rare if not unheard of”.
Christian View of the Human Person
  1. We are created intelligent

  2. We are created free
    a. Humans are intelligent
    b. Humans are free (free will)
    c. Humans are created by God

  3. We are responsible Stewards of this world – not absolute masters
God – creating humans intelligent – with a completely different form of intelligence than that of animals – with the ability to learn, make choices, think, create, etc. – have free will. Knowing and loving God, we can use that free will to be holy people, and live holy lives, in cooperation with God’s will for our lives – or we can choose to live according to the dictates of our own desires.

Technology – can quite often be our “new god” – tempts us to believe that we are “lords and masters of the universe” – that because we can do something, that we have the “right” to do that thing. Prowess then dictates morality, technology then dictates ethics.

Wellsprings

The joining of Faith and Reason – the truth of Faith and the truth of Reason NEVER contradict each other. Great minds have written this throughout history:

Boethius
Aquinas
Pope John Paul II – Fides et Ratio - http://tinyurl.com/46wut Faith and reason are like two wings on which the human spirit rises to the contemplation of truth; and God has placed in the human heart a desire to know the truth—in a word, to know himself—so that, by knowing and loving God, men and women may also come to the fullness of truth about themselves (cf. Ex 33:18; Ps 27:8-9; 63:2-3; Jn 14:8; 1 Jn 3:2).

Respect Truth & Freedom – Bioethics & Moral Principles

Secular
  • Respect for Autonomy
  • Non-malfeasance
  • Beneficence
  • Justice

Christian

  • Sanctity of Life
  • Principle of Double Effect
  • Principal of Totality
  • Ordinary & Extraordinary
Principles of Catholic Ethics:
  • Right to Life
  • Double Effect
  • Human Dignity
  • Informed Consent
  • Integrity & Totality
  • Material Cooperation
  • Ordinary Means
  • Common Good & Subsidiarity
Non-malfeasance
Technical way of stating that we have an obligation not to harm others – this duty prohibits others to simply avoid the risk of harm – the traditional method of examining the legitimatization of risk and any harmful effects is the Principle of Double Effect

Double Effect
It is morally allowable to perform an action that will produce both a good and a negative effect PROVIDED:a. The good effect and not the evil effect is directly intendedb. The action itself is good, or at least indifferentc. The good effect is not produced by means of the evil effectd. There is a proportional reason for permitting the foreseen evil effect to occur

Ethical Directives
The Principle of Double Effect “Troubleshooter” – Ethical and Religious Directives for Catholic Health Care Services http://www.usccb.org/bishops/directives.shtml

Directive 47 – Indirect abortions - Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.

Directive 53 – Indirect sterilization - Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.

Directive 61 – Pain relief – Patients should be kept as free of pain as possible so that they may die comfortably and with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason. Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person's life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.

Sanctity of Life Principle
The view which affirms that physical life is a basic good, even when one is suffering, because it is the fundamental condition which makes it possible to achieve all other values, including holiness and personal sanctity, and it sets limits within which we must work to promote human wellbeing. In short, the Principle of Sanctity of Life promotes a presumption that even a person who is suffering has the right to exist, even a person who is physically handicapped or challenged has the right to exist – and to attempt to achieve personal holiness as best as they can. No one has the right to claim total mastery over one's own life or another's life. To assume that the person who is suffering, or the person who is diminished due to physical limitation is now a “burden to society” or that they have diminished rights as a person is to diminish their worth as a human being, and a great evil.

Totality
The concept that a part can be sacrificed to save the whole. It is therefore licit to sacrifice a human organ, for instance, or limb or body part, for the good of the individual as a whole, to preserve functional integrity of the living person, or to perform a transplant from a living donor.

Informed Consent
Consent to undergo medical procedures or participate in research is considered normally or legally valid as long as the person has adequate information regarding: Effects, Risks, Benefits, Alternatives, the Nature of the Procedures, and their Rights

Other Ethical and Moral Considerations that must be considered:
Confidentiality Ability of the patient to grow through suffering – if they don’t know about this concept – your discipleship as a Christian demands that you attempt to not only comfort them, but teach them this principle Religious Freedom – the ability to practice their own faith as they choose (or not) Personalized sexuality – respect is not condoning practices Stewardship and Creativity WELL-FORMED Conscience

WE ARE FREE – but….

I have set before you life and deathBlessing and curseTherefore choose lifeAnd your descendents may live.Deut. 30:15-20

Culture of Life
Inclusion of the Dependent
The unborn
The aged
Children
Poor
Mentally ill
Addicts
Infirm
Isolated
Emotionally hurting, Frightened
Sick
Homeless

Culture of Death
Exclusion of the Dependent
invisible
insignificant
dehumanizing
"fetus”
“parasite”
“vegetable”
“freeloader”
“needy”
“opportunist”
“med seeker”
“druggie”, “drunk”, “junkie”
“user”
“looking for a hot and a cot”

The way we talk about those who come to us for help tells a lot about US.

What is man that Thou are mindful of him? ~ (excerpted from a Catechism given by Christoph Cardinal Schönborn 2006)

In the modern age, we seem to have lost our sense of having been created in the image and likeness of God and the innate dignity and respect this entitles each of us to. We have come to believe that the universe is unimaginably huge, and we are a tiny part of it. We are simply human animals, little different than any other creature on the planet. We are driven by unconscious forces that we can barely see in these animals, and that drive us mercilessly, like animals. We are the animals that think. Is it any wonder then, that we, the “thinking animals”, have lost our sense of “divine purpose” and even Divine love? That we look on each other and see “utilization’, not care or compassion for our weakest and most helpless members of society? Do we, as Christians, have a responsibility to think any differently than the world thinks? We DO – because we are not simply “human animals”.

(From Catechesis given by Christoph Cardinal Schönborn, 2006) - The earth has lost its central position in the world, it now exists somewhere on the edge of a galaxy of over a hundred billion stars and this galaxy exists on the edge of over one hundred billion galaxies in the universe. We are taught that man comes from the animals… and the supposition has emerged that there is no discontinuity between animal and man, no metaphysical difference between them. Man as a being endowed with spirit is thought to be nothing radically new in the vast world of life. The soul of man has been cast down from its spiritual height, and been debunked as the mask of unconscious drives. Man is determined not by spirit, but by libido. Being thus dethroned in these three ways, the crown of creation is now rolling, as it were, in the dirt. If man remains here in the dirt, then science has definitively dethroned man. Is man a king or a slave? What is man? Psalm 8 prays:

When I consider thy heavens, the work of thy fingers, the moon and the stars which thou has ordained: what is man that thou are mindful of him? And the son of man that thou visitest him?

Is man a piece of nature or the crown of creation? Or is he both? Does he come from the animals, or is he a special creation of God, or is he both?

Modern science has pushed him to the edge of the universe, reducing him to a tiny point on a tiny planet. Is he, on the contrary, the most essential goal of the gigantic event of the coming to be of our world? Or is he both? Is he humiliated as a result of realizing that he is lost in the universe, or is he exalted as a result of being the point in the universe, tiny as the point is, where the universe can become aware of itself and reflect on itself? The psalmist continues in his prayer of praise:

For thou hast made him a little lower than the angels, and hast crowned him with glory and honor. Thou madest him to have dominion over the works of they hands: thou has put all things under his feet: all sheep and oxen, yea, and the beasts of the field; the fowls of the air, and the fish of the sea, and whatsover passeth through the paths of the seas. O Lord our Lord, how excellent is thy name in all the earth!
  1. It is true that our earth is a speck in the universe. But we see more and more clearly how inconceivably privileged this planet is, how life on this planet, which is our home, was incredibly improbable. The earth is not the spatial center, but we live on an exceedingly marvelous "privileged planet" (this was the title of the book by Gonzales and Richards, Washington, 2001). What we should never forget is that we are apparently the only beings on this planet who know about this and know about ever more amazing things.

  2. It is true that we are a part of nature, inserted into the great process of world's becoming. And yet we know about this and can examine our place in this process, we can reflect on it, and we can exercise our unique freedom in drawing consequences from it, whether responsible or harmful consequences.

  3. It is true that we are directed by instincts and conditioned by drives, and yet we can investigate these and come to understand them. In addition we are obliged to raise ourselves above our drives and to order them responsibly.

In a word: on closer examination the "crown" of creation is not dethroned. Our immensely expanded knowledge should just make us more humble, grateful, and responsible.Jewish wisdom is often so vivid, and it always has a note of humor that puts us in our place when we take ourselves too seriously.

"Why was man created only on the sixth day? So that, in case he became too arrogant, he could be told, 'The fly was created before you.'" (Quoted in Urbach, The Sages, Jerusalem, 1975, p. 218.)

"Man outweighs the entire work of creation." (Ibid., p.214.)

From both of these follows a third rabbinical saying (Fr. Georg Sporschill, the great friend of the street children, liked to quote it):

"Whoever saves one life, saves the whole world.”

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Written at 3:53 AM by Luminaria2112.
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