August 31, 2010. The US Conference of Catholic Bishops has released their 2010-2011 Respect Life Program.  This is a comprehensive program addressing the need to respect the lives of all vulnerable persons, regardless of their stage of development, from conception (fertilization) until natural death.  Materials are available addressing such timely topics as teen suicide, sex trafficking,  American youth and the culture of life, population and the environment, assisted reproductive technologies, end-of-life care, and capital punishment.  See http://www.usccb.org/prolife/programs/rlp/2010/  

Also contained within these materials is a bulletin insert, Caring For Each Other, Even Unto Death, by Dr. Marie T. Hilliard, NCBC Director of Bioethics and Public Policy, which is available on-line from the United States Conference of Catholic Bishops.

The NCBC congratulates the USCCB on the development of these excellent resources.

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August 25, 2010. In a major revision to public policy on embryonic stem cell research (ESCR), Federal district judge Royce C. Lamberth on August 23 blocked President Obama’s 2009 executive order that had expanded federal funding for human ESCR. The National Catholic Bioethics Center welcomes this decision.

The plaintiffs bringing the case against the government were Drs. James L. Sherley and Theresa Deisher, researchers whose work focuses on adult, not embryonic stem cell research. They sought an order declaring that the Guidelines for Human Stem Cell Research (which had been issued by the National Institutes of Health in response to President Obama’s executive order expanding stem cell research) are contrary to law, were promulgated without observing the procedures required by law, and constitute “arbitrary and capricious agency action.”

In rules announced last year, the Obama administration encouraged financing of research into any embryonic stem cell lines that either had been allowed by the Bush administration or had been created using embryos left over from fertility treatments and in which unpaid donors had provided written consent for the embryos to be used for research. The Guidelines had been drafted after a consultation process in which nearly 50,000 public comments were submitted to the NIH. Many of these comments raised moral objections to the research, and others noted that the expansion of funding appeared to violate the Dickey-Wicker amendment, a law passed every year by Congress since 1996 which precluded federal funding of embryo-destructive research.

Judge Lamberth ruled that the administration’s policy as contained in the Guidelines violated the clear language of the Dickey-Wicker Amendment, a law that bans federal financing for any “research in which a human embryo or embryos are destroyed, discarded or knowingly subjected to risk of injury or death.” The judge noted that the plain sense of the language of the statute demonstrates the unambiguous intent of Congress “to prohibit the expenditure of federal funds on ‘research in which a human embryo or embryos are destroyed.’” At the center of the judge’s decision was the recognition that:

 This prohibition encompasses all “research in which” an embryo is destroyed, not just the “piece of research” in which the embryo is destroyed. Had Congress intended to limit the Dickey-Wicker to only those discrete acts that result in the destruction of an embryo, like the derivation of ESCs, or to research on the embryo itself, Congress could have written the statute that way. Congress, however, has not written the statute that way, and this Court is bound to apply the law as it is written.

The effects of the judge’s decision are likely to be significant. Dr. Francis Collins, Agency Director of the NIH, noted in a news conference after the announcement of the federal district judge’s decision that 143 scientific grants worth $95 million, which are now up for annual renewal, will be frozen. In addition, 22 grants totaling $54 million, whose existing research is coming up for renewal in September, will also be frozen. Another 131 grants awarded this year already are out the door and will not be affected until they are up for renewal in a year.

Judge Lamberth’s decision is consonant not only with the plain sense of the Dickey-Wicker amendment, but also with the kind of moral reasoning that rejects a false “criterion of independence” or “radical separation of the act from its subsequent uses and applications.” Both the Bush and Obama administrations had supported a position where federal funding of human embryo destruction itself would not be permitted while research on cells derived from such destruction would be funded. The recent Vatican document Dignitas Personae had already emphasized the contradictory character implicit in such a stance:

 In this regard, the criterion of independence as it has been formulated by some ethics committees is not sufficient. According to this criterion, the use of “biological material” of illicit origin would be ethically permissible provided there is a clear separation between those who, on the one hand, produce, freeze and cause the death of embryos and, on the other, the researchers involved in scientific experimentation. The criterion of independence is not sufficient to avoid a contradiction in the attitude of the person who says that he does not approve of the injustice perpetrated by others, but at the same time accepts for his own work the “biological material” which the others have obtained by means of that injustice. (n. 35)

The United States Conference of Catholic Bishops, in their response to the decision, observe how an important duty of good government “is to use its funding power to direct resources where they will best serve and respect human life, not to find new ways to evade this responsibility.” The National Catholic Bioethics Center hopes this important court decision will encourage the federal government and all of its health care agencies to renew and expand their commitment to ethically sound avenues of stem cell research.

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Marie T. Hilliard, R.N., Ph.D., J.C.L.
Director of Bioethics and Public Policy

The USCCB has called for proposed remedies to the flawed Patient Protection and Affordable Care Act (PPACA). A bipartisan supported US Congressional bill (HR 5939) would permanently ban federal funding for abortion services. Since 1976, Congress has annually attached the Hyde Amendment to US Health and Human Services appropriations’ bills to bar the use of federal funds for abortion procedures in Medicaid. No such provision is contained in the PPACA.  Furthermore, President Obama’s Executive Order cannot contravene existing law, and PPACA has been enacted, signed and promulgated as existing law. The title of the health care reform legislation, Patient Protection and Affordable Care Act, would indicate that all patients have the right to legal protection. However, the PPACA, in supporting programs that provide abortion on demand, defies its very title.   

The NCBC calls for legislation that assures the protection of all persons, especially the vulnerable, as well as the consciences of health care professionals. See www.usccb.org/prolife/DiNardo-HR5939.pdf.  To have your voice heard see: http://nchla.org/actiondisplay.asp?ID=284.

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You may download Judge Walker's opinion here

August 9, 2010. Every media outlet has reported on the decision by Judge Vaughn Walker striking down Prop 8 (Judge Walker who is, interestingly, openly homosexual[1]). Proposition 8 reads: Only marriage between a man and a woman is valid or recognized in California.[2] It was put to a popular vote in the November 2008 election and 52% (~7 million Californians) voted for it. A lawsuit was filed arguing that Prop 8 was unconstitutional. Judge Walker presided over the case.

 Before addressing Judge Walker’s opinion, it is important to be clear about why Prop 8 made sense in the first place and to explore why ~ seven million voters voted for it. Proponents of the traditional marriage account make several starting assumptions. First, we understand that for the term ‘marriage’ to be a meaningful term, it must refer to a specific reality. Marriage is not a social construct; it actually precedes logically (not temporally) the formation of society as it is the birthplace for children. You can have families without a society, but you cannot have a society without families.

 The reality to which marriage refers is a complementary union ordered to procreation. Everyone must grant that heterosexual intercourse involves two distinctive features: it is complementary – involving opposite sexes – and is, at least, open to procreation. It is the kind of act that is procreative in kind. Even intercourse between a man and a woman where one is infertile is still a case of performing a procreative-type of act. No other type of sexual “union” can say that for itself. Dr. John Haas observes the obvious writing,

The purpose of sex is so self-evident it is bewildering how some do not see it. At the most fundamental level of human existence we can see that there simply would be no perpetuation of the species without a reproductive cell from the man and one from the woman which find themselves joined in one of the most remarkable of human activities.[3]

Heterosexual union is a distinct reality, and this reality is a necessary condition for marriage (the other conditions being lifelong commitment etc., conditions shared by other kinds of relationships). Marriage refers to a distinctive reality; a complementary union ordered to procreation.[4]

 Changing the definition of the term to refer to other kinds of relationships or sexual acts would be like changing the definition of cat to include dogs. If the term ‘cat’ is extended to include dogs, it will no longer refer truthfully to the way the world is. As Alexander Pruss observes,

Many sentences using the word “cat” that were previously true will no longer remain true: it will, for example, no longer be true that “it is normal for cats to have retractable claws.” Likewise with the extension of the word “marriage:” it will no longer be true that “it is normal for married couples to be able to have children together.”

And Pruss makes a more technical, but important observation, “Note that the use of the word “normal” in both sentences is the same; it does not state a statistical fact, but asserts what happens barring some physical abnormality or deterioration.”[5] The argument here is logical, not moral. One simply cannot change the meaning of the term marriage without compromising the truth of claims involving the term.

The debate, then, between the supporters of Prop 8 and those who oppose it is not about social policy, it is about objective reality. Pruss asks, “Is it possible for the objective reality of marriage to ever exist between two persons of the same sex?” The answer is clearly no. Homosexual intercourse cannot be a complementary union ordered to procreation. That reality can only be realized by heterosexual couples. This is not discriminatory any more than it is discriminatory (in the pure sense of the term, namely, to discern or distinguish) to call all and only canines “dogs” and all and only felines “cats.” Dogs are really dogs, cats are really cats, and marriage is really a complementary union ordered to procreation.

One last comment is noteworthy before addressing Judge Walker’s opinion directly. The argument I have outlined here does not rely on a deep philosophical position regarding the nature of sexuality or the human person. It relies solely on empirical fact, the way the world is. A modicum of reflection on reality would confirm the analysis just provided. Marriage refers to a particular reality that is more than a commitment, and more than amicable feelings between the partners. It requires for its realization, a complementary union ordered to procreation.

Judge Walker’s Opinion (Hereafter the Opinion)

The Procedures Informing the Opinion
The court heard testimony from 17 witnesses who opposed Prop 8, and only 2 who were in favor. The Opinion argues that though the witnesses for Prop 8 withdrew under threat of their personal safety,[6] their withdrawal remained even after the California Supreme Court declared the trial to be non-public. The Opinion comments that there was simply no reason for the withdrawal remaining after guarantees of a non-public hearing were set. The problem with this reasoning of the Opinion is that there is a public record of who gave testimony, namely, the Opinion itself! The heavy-handed tactics of the homosexual activists noted in footnote 6, illustrate that the climate for an engaged and informed discussion is effectively lost, and the Opinion did not take into account the turbulent and often deleterious features of this climate. Procedurally, there should have been greater guarantees of anonymity given the backdrop of violence against Prop 8 supporters, to ensure a rational and well-represented trial.

Another procedural error, we believe, stems from the fact that the Judge ruling on the case is openly homosexual. Professor Gerard Bradley observes that this alone is not sufficient to count as a conflict of interest, but notes two things: no one even asked the question, and more importantly,

Federal law requires that, whenever a judge knows that he has “any other interest [ that is, besides a financial interest] that could be substantially affected by the outcome of the proceeding” at hand, or when “his impartiality might reasonably be questioned”, he must recuse himself.[7]

The point to be made is that there was no questioning done, and no analysis of the Judge’s fitness to rule over the case. Would we say the same thing if the judge in question was a conservative Mormon or Catholic? Yes.

Finally, neither the Governor, nor the Attorney General, supported Prop 8 in contrast to the majority will of the people. And more startling is that the Attorney General refused to defend Prop 8, even though that is his job. It is the job of the state attorney general to defend the state constitution, the aspects of which included a legally approved constitutional amendment defining marriage as between a man and a woman.

The Content of the Opinion
Summarizing the Opinion, Judge Walker says,

Plaintiffs challenge Proposition 8 under the Due Process and Equal Protection Clauses of the Fourteenth Amendment. Each challenge is independently meritorious, as Proposition 8 both unconstitutionally burdens the exercise of the fundamental right to marry and creates an irrational classification on the basis of sexual orientation.[8]

Attempting to justify this judgment, the Opinion considers a number of factors and makes numerous claims and representations. Too many of these claims deserve rebuttal, but I will focus on three “big ideas” that occur and recur throughout the Opinion. The first idea is the claim that Prop 8 is discriminatory, the second is what I will call the argument from social meaning, and the third is a misunderstanding (throughout) concerning the argument for Prop 8.

There are several assumptions that we must recognize in the Opinion as being agreeable, though even some of the agreeable assumptions need a little clarification. It is acknowledged that marriage is a fundamental right. The question presented to the court is whether homosexual couples can exercise this right, or do they seek recognition of a new right. This much is agreeable, though we would urge a proper understanding of what it means to say that marriage is a fundamental right. It is not a civil right, meaning, it is not a right conferred by the State. A heterosexual couple can marry in the absence of any governments or established political order. Families logically precede societies.

A related point is that in order to know that marriage is a fundamental right, one must know what marriage is. And on this point the Opinion is not altogether clear. It only offers us the following: marriage is “a coming together for better or for worse, hopefully enduring, and intimate to the degree of being sacred.” (114, ln. 3) But this is a description of a lasting friendship – or a best friendship depending on how one interprets “to the degree of being sacred.” In any case, this definition fails to distinguish between marriage and friendship.

Another assumption to which we will advert to throughout is actually an idea borrowed from two other opinions. Citing Romer, 517 US at 632 and Heller, 509 US at 321 the Opinion notes that the “basis for a classification must 'find some footing in the realities of the subject addressed by the legislation.'” We could not agree more.

Turning now to the three big ideas, beginning with the notion that marriage in its traditional sense is discriminatory. I should note first that when the Opinion discusses discrimination (119 20ff) the term is used equivocally. In one sense, it is used to describe the law and denotes the notions of making distinctions, discerning, or to collect and divide things according to kinds. But when we reach ln 26, it is clearly used to denote hatred, disapprobation, or contempt. Of course there is a confusion manifested here even at the level of explaining Prop 8. Lines 18-24 are detailing the effects of Prop 8, but in no way target the reasons why Prop 8 makes sense in the first place. But could the effects alone generate a claim that a law is discriminatory? Even more importantly, just what is the moral problem? In asking this, we of course do not condone any act of disapprobation or hatred toward any group of persons. It appears that the Opinion would have us believe that the reasons informing Prop 8 just are the effects, namely, that same-sex couples may not get married. The reason for Prop 8 is that marriage is a complementary union ordered to procreation. An effect of Prop 8 is that homosexual couples cannot get married. When the Opinion discusses discrimination it is looking only at the effects of the law. The Opinion evinces a gross confusion of categories on this point. There are effects of every law. Homicide has the effect of discriminating against murderers, Judge Walker could say, preventing them from murdering without penalty. Or an anti-bestiality law would discriminate against persons who wanted to “marry” their pets, preventing them from doing so. Would we complain about bestiality laws? Do we think homicide laws manifest evil discrimination? What about laws prohibiting fathers from marrying their sons, (or even their daughters)? Would they count as discriminatory simply because they have the effect of precluding incestuous family members from marrying?

There is something else going on here when the Opinion discusses discrimination. Consider a law requiring a state’s police force to hire only men simply because they are men. Clearly, this would be an instance of unjust discrimination. But suppose instead the law required hiring people who are at least 6’ tall since 6’ and above persons are at an advantage in hand-to-hand struggles – just suppose this for the example.[9] And since the police are expected to engage in such to ensure the safety of its citizens, requiring the police to hire 6’ and above persons is in the public interest. Suppose, though, that as it turns out, very few women are over 6’, but numerous men are. The effect of such a law would be that only men would be hired, but no one would say that it is unjustly discriminatory. Contrasting these two cases gives us a glimpse into what it is to say (truly) that a law is discriminatory: A law is unjustly discriminatory when it applies to a particular set of individuals simply because they are members of a certain group. A similar law that had the same effect of singling out certain individuals, but whose content and intent was tethered to reasons pertaining to the “reality of the subject addressed by the legislation,” would not be discriminatory. And it is clear given the reasons outlined in the beginning of this commentary that Prop 8 is in no way unjustly discriminatory. The reasons for it are tethered to the nature of marriage, an effect being that same-sex couples cannot marry. Given this reasoning, the following sentence is obviously false and inflammatory, “Proposition 8 targets gays and lesbians in a manner specific to their sexual orientation and, because of their relationship to one another…” (120 l.26-28 emphasis mine).

Turning now to the social meaning argument, the Opinion aims to answer the question why domestic partnerships are not enough. It says, “while domestic partnerships offer same-sex couples almost all of the rights and responsibilities associated with marriage, the evidence shows that the withholding of the designation ‘marriage’ significantly disadvantages plaintiffs” (116 l. 10-14). And what is the “disadvantage”? “The record reflects that marriage is a culturally superior status compared to a domestic partnership. California does not meet its due process obligation to allow plaintiffs to marry by offering them a substitute and inferior institution that denies marriage to same-sex couples” (116 l. 14-19). Summarizing the position on this issue, it says, “domestic partnerships are distinct from marriage and do not provide the same social meaning as marriage” (115 l. 27-28 emphasis added).

The key claim here is that marriage, traditionally understood, holds a “culturally superior status” compared to domestic partnerships; so does a Ph.D. compared to a Master’s degree. What is the moral or legal problem? There is something insidious about this section of the Opinion. The argument seems to be that same-sex partnerships are not as well accepted as opposite-sex unions. In making ‘marriage’ available to same sex partners, this cultural impression of favoring opposite-sex unions is hoped to fade or attenuate. The reason, then, for why domestic partnerships are not enough is because alone they fail to create an impression in people’s minds (“social meaning”) of the moral legitimacy of homosexual sex. In this regard, the opinion collapses into a tract aiming to proselytize those in favor of a traditional definition of marriage, and effectively aims to “impose the homosexual agenda” on the rest of society. It is a work in cognitive engineering, an attempt to have homosexual actions gain wider acceptance in society. As such, the Opinion has little to do with the Constitutionality of Prop 8.  

Lastly, there are a series of comments meant to rebut the claim that marriage refers to a reality; a complementary union ordered to procreation. Several claims are worth quoting with brief commentary following. From p 111, l. 23 ff. “Never has the state inquired into procreative capacity or intent before issuing a marriage license; indeed, a marriage license is more than a license to have procreative sexual intercourse.” Of course, it is true that marriage is more than being disposed to procreate. Above we noted that the procreative capacity of heterosexual relationships is a necessary condition for marriage, not a sufficient one. So we agree that it is “more than a license to have procreative intercourse.” Our position is simply that it is not less than this either.

We read on page 113 l. 6, “The evidence did not show any historical purpose for excluding same-sex couples from marriage, as states have never required spouses to have an ability or willingness to procreate in order to marry.” This is because heterosexual couples, by virtue of the fact that they are opposite sex, can procreate. No separate inquiry is required. Heterosexual couples may be infertile, but this is not a feature of the kind of relationship they realize, but rather an accidental feature of their bodies.

Most important in regard to the putative rebuttals to the position outlined in the beginning of this commentary is the following: “Proponents did not, however, advance any reason why the government may use sexual orientation as a proxy for fertility or why the government may need to take into account fertility when legislating” (122 l. 6-9 emphasis added). These claims are false on their face. The State would have no interest in regulating the intercourse of citizens unless that intercourse could engender new life since the State has an interest in the safety of our children. What interest does the state have in regulating a relationship that is incapable, in its essence, of engendering children? None. There are no laws governing friendship, or intercourse that is inherently non-procreative. The state only has an interest in governing relationships which are of their nature procreative, because the state has an interest in ensuring the proper rearing and education of children.[10] Homosexual couples may adopt, and in this sense, and in this sense only, can they “raise” children. But they cannot engender children. Without exception, adopted children originate in a heterosexual relationship. Opposite-sex couples have a relationship that is inherently disposed to procreation; homosexual couples do not. It is obvious that we are not talking about what couples (of either sort) choose to do. We are highlighting the nature of their relationship. (The government cannot take an interest in regulating choices directly anyway, at least not in a free democracy. Its laws must take into account “the realities of the subject addressed by the legislation.”) And these realities pertain to the nature of the respective relationships in question. Their natures are fundamentally different with respect to their capacity to engender children.

We should conclude by observing a gross confusion over the concepts of sexuality and gender. The Opinion purports to show that given historical facts concerning evolving gender roles, excluding same-sex couples from marriage is equally an artifact of an atavistic mentality. “The exclusion exists as an artifact of a time when the genders were seen as having distinct roles in society and in marriage. That time has passed” (113 l. 9-11). Though it is certainly true that gender roles – the term gender understood to refer to personality characteristics or social expectations – have changed, what has not changed is that there is still male and female and their respective and distinct contributions to the begetting and rearing of children. Sexual differences still exist as a matter of biological fact. Gender differences may elide and change from person to person and from culture to culture. That there is a difference in sexuality and that each sex must cooperate to engender and rear children, is a distinct feature of the heterosexual relationship; a complementary union ordered to procreation. A marriage cannot be without this distinct feature.

Dr. Marie T. Hilliard, Director of Bioethics and Public Policy, will Moderate the Upcoming Webinar offered by the National Catholic Partnership on Disability:

Threats to the Life of People with Disabilities, Part 1: Poor Prenatal Diagnosis of Lethal or Non-lethal Conditions & Disability

 Tuesday, October 5, 2010, 1:00-2:30 P.M., Eastern; 12:00-1:30 P.M., Central 11:00 A.M. -12:30 P.M., Mountain; 10:00-11:30 A.M., Pacific. See http://www.ncpd.org/.

 August 2, 2010. How often do we see a great scientific or therapeutic advance, discovered to enhance life and society, turned against humankind? Prenatal testing and diagnosis was conceived as a “good,” to enhance the wellbeing of mother and child and foster the ability to delivery healthy babies. However, when the intent is accomplished by only delivering healthy babies, while denying life to those deemed less than perfect, a Machiavellian distortion of the good has been achieved.

There are phenomenal advances in prenatal testing: ultrasound; testing for Rh incompatibility; infectious disease testing or testing for antibodies; maternal serum protein testing; amniocentesis; chorionic villus sampling; umbilical cord blood sampling; chromosomal and genetic testing of both parents and fetus. The list continually enlarges; and the question needs to be asked: to what end? The American College [now Congress] of Obstetricians and Gynecologists reports that 90% of their surveyed members justify abortion for fetal anomalies that are fatal; and 63% justify it for nonfatal fetal anomalies. [i] That means that almost two-thirds of the responding physicians responsible for the care of a mother and her unborn child believes in eugenics. The very person who is to be the guardian of the health of the unborn baby, the only professional upon whom that baby can rely, believes in the destruction of that very baby who is less than perfect. This is a frightening prophesy for the future.

Enter the child allowed to be born, who has a disability. There have been egregious examples of denial of basic care to such a child. Thankfully, reports of such abuse have led to the federal “Baby Doe” Child Abuse and Treatment Act (1984), which prohibits withholding nourishment and medically beneficial treatment from infants with a disability solely on the basis of present or anticipated mental or physical impairments. However, such care can be denied if: the infant is chronically and irreversibly comatose; the provision of such care will not improve all of the infant’s life-threatening conditions; or the care is deemed futile in terms of infant survival. Thus, nutrition and hydration could be denied to an irreversibly comatose child, constituting passive euthanasia.

Natural moral law dictates that “As far as the right to life is concerned, every human being is absolutely equal to all others.”[ii]  Prenatal testing clearly can accomplish a good:  “If prenatal diagnosis respects the life and integrity of the embryo and the human fetus and is directed towards its safeguarding or healing as an individual, then the answer is affirmative.”[iii]  However, “Certain attempts to influence chromosomic or genetic inheritance are not therapeutic but are aimed at producing human beings selected according to sex or other predetermined qualities. These manipulations are contrary to the personal dignity of the human being and his or her integrity and identity. Therefore in no way can they be justified on the grounds of possible beneficial consequences for future humanity."[iv] Further guidance is provided by the Ethical and Religious Directives for Catholic Health Care Services: “Prenatal diagnosis is permitted when the procedure does not threaten the life or physical integrity of the unborn child or the mother and does not subject them to disproportionate risks; when the diagnosis can provide information to guide preventative care for the mother or pre- or postnatal care for the child; and when the parents, or at least the mother, give free and informed consent. Prenatal diagnosis is not permitted when undertaken with the intention of aborting an unborn child with a serious defect.”[v] However, the intent to kill the less than perfect child often is the intent of prenatal testing.

The newly enacted federal health care reform legislation, the Patient Protection and Affordable Care Act (PPACA), despite President Barack Obama’s Executive Order, will pay for programs providing abortion on demand.  Evidence shows that the unborn baby with a diagnosis of a fetal anomaly increasingly is at significant risk of abortion. The rate of prenatal screening by ultrasonography or amniocentesis before 24 weeks gestation has risen to 89.3%, increasingly resulting in elective termination of pregnancies.[vi]  Prenatal diagnosis of Down Syndrome brings with it a 90% chance of being aborted.[vii] With the historic move to allow tax dollars to pay for programs providing elective abortions, tax payers have been forced to be complicit in this new eugenics.

There is a better way. This webinar will explore prenatal testing and eugenics and provide life giving options. Participants will include: Dr. John Bruchalski, OB/GYN, Tepeyac Family Care Center, Fairfax, VA; Fr. Dan Mindling, OFM Cap., Theologian, Academic Dean, Mount St. Mary's Seminary, Emmitsburg, MD; Tracy Winsor, Parent Support Specialist, Charlotte, NC; and Monica Rafie, Founder of BeNotAfraid.net and parent of a child surviving a poor prenatal diagnosis, Chicago, IL. Webinar participants will be able to participate in live questions and answers.

July 28, 2010. An excellent DVD with an accompanying resource booklet (for clergy, catechists and teachers), as well as a viewer’s guide, are available through the United States Conference of Catholic Bishops (USCCB). These are outstanding materials developed by the USCCB’s Ad Hoc Committee for the Defense of Marriage. The resource booklet and viewer’s guide provide discussion questions and talking points which are ideal for parish and school educational programs, as well as for assisting individual viewers to enhance their understanding of the concepts addressed by the DVD. The complementarity of men and women at a physical, psychological and spiritual level is explored. This complementarity, essential to marriage, is presented through a dialogue between a young couple, Josh and Carrie, who present helpful analogies demonstrating that same-sex unions can never have this same unique character. Excellent citations are provided that the user can utilize for further study. For more information and to access these materials see: http://www.usccb.org/marriageuniqueforareason/.

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July 16, 2010. The National Catholic Bioethics Center joins the U.S. Conference of Catholic Bishops, in welcoming the agreement by the U.S. Dept. of Health and Human Services (HHS) to exclude elective abortion coverage in the high-risk pool insurance program allocations to states. 

 Pennsylvania and New Mexico were slated to receive funding which would pay for abortion of demand, consistent with health care reform legislation (Patient Protection and Affordable Care Act or PPACA).  Such funding of abortion on demand was to occur pursuant to provisions in the PPACA  that excludes from the cost sharing provision certain programs including the high-risk pool insurance programs.  These cost sharing provisions required individuals seeking federal health plan coverage that included abortion on demand, to write separate checks for such coverage. The PPACA does not require those participating in the high-risk insurance program to write separate checks.  Even if PPACA did require these mechanisms of separate checks and separate payroll deductions for such abortion coverage, for the first time in US history the federal government will fund health care plans that provide abortion on demand. Although President Obama’s executive order concerning the PPACA cannot contravene existing law, in a recent announcement HHS has stated that it will not include coverage of elective abortions in its high risk pool allocations to states. [i]

 The NCBC, while welcoming this reversal for these allocations, again stresses the need for Congress to enact legislation, clearly stating once and for all that funds appropriated by PPACA will not pay for abortions or for insurance coverage that includes abortion.  [See: : “The National Catholic Bioethics Center Supports Proposed Remedies to the Flawed Patient Protection and Affordable Care Act (PPACA)".

June 30, 2010. Current law states that military health care facilities may not be used to perform elective abortions (10 U.S. Code Sec. 1093(b)). This policy was first established administratively in 1988. President Clinton reversed the policy in 1993 but Congress restored it in 1995, and it has remained intact ever since. Now an attempt is being made to repeal this longstanding policy.

An amendment by Sen. Roland Burris (D-IL) to strike this provision from law was approved during committee consideration of the National Defense Authorization Act for Fiscal Year 2011 (S. 3280). For a description of this vote, see: nchla.org/datasource/idocuments/6Burris8a.10.pdf.

In a June 17 letter to the U.S. Senate, the Most Reverend Timothy Broglio, Archbishop for the Military Services, stated that the Burris Amendment “would contravene our military health care providers’ commitment to defending and protecting human life” and “would pressure military physicians, nurses and associated medical personnel to engage in an act of taking innocent human life.” Military medical personnel should be allowed to continue to abide by their commitment to save lives. For text of letter, see: nchla.org/datasource/idocuments/Letter%20to%20Congress%20from%20Archbishop%20Broglio%206.17.2010.pdf.

In a subsequent letter, Cardinal Daniel DiNardo, Chairman of the bishops’ Committee on Pro-Life Activities, urged that the authorization bill not be approved “until the original version of 10 U.S.C. §1093 is restored.” He said it is not the task of the federal government “to directly promote and facilitate elective abortions,” and the longstanding ban on use of these facilities for abortion should be maintained. For text of letter, see: nchla.org/datasource/idocuments/CardinalDiNardoMilitaryLetter.pdf.

S. 3280 is expected to be on the Senate floor after the July 4 recess. The recess will take place during the week of July 4-9.

The House has already passed its version of the National Defense Authorization Act for Fiscal Year 2011 (H.R. 5136), without changing the longstanding military abortion policy. For NCHLA’s Fact Sheet on this issue, see: nchla.org/datasource/ifactsheets/MilAbrtPol.PDF.

ACTION: Please contact your two U.S. Senators by e-mail, phone, or FAX letter:

To send an e-mail message through NCHLA’s Grassroots Action Center click here.

Call the U.S. Capitol switchboard at: 202-224-3121, or call your Senators’ local offices. Contact info can be found on Senators’ web sites at: www.senate.gov.

Senators also should be contacted while visiting their home states during the July 4 recess.

MESSAGE: “Please do not approve the defense authorization bill until the Burris Amendment is reversed and current law on military abortions is upheld.”

WHEN: It is anticipated the Senate will consider S. 3280 after the July 4 recess. Please act today! Thanks!

 June 22, 2010. John M. Haas, Ph.D., S.T.L., K.M., President of The National Catholic Bioethics Center, has been appointed by His Holiness, Pope Benedict XVI to serve as a member of the Governing Council of the Pontifical Academy for Life for a period of five years. Dr. Haas was appointed as an Ordinary Member of the Academy by the Holy Father in 2006. The Academy chose to announce the appointment on June 22, the feast of the English martyrs Sts. John Fisher and Thomas More who “gave their lives for principles which are very much still actual and which are deeply relevant for the work of the Academy in the defense of human life.”

The Pontifical Academy for Life was established by Pope John Paul II with his Motu Proprio "Vitae Mysterium" on February 11, 1994. The first President was the noted French physician, geneticist, and Servant of God Dr. Jérôme Lejeune who was an ardent defender of life and the researcher who discovered the chromosomal cause of Down syndrome which came to be called Trisomy 21. The principal objective of the Academy is the study of problems of biomedicine and of law relative to the promotion and defense of life and especially the direct relation that they have with Christian morality and the teachings and directives of the Church's Magisterium.  The academy for life is autonomous but collaborates closely with the Pontifical Council for Pastoral Assistance to Health Care Workers and various other dicasteries of the Roman Curia committed to the service of life.

The Governing Council of the Pontifical Academy for Life consists of 8 of the members of the Academy including the President, Archbishop Rino Fisichella, and the Chancellor, Monsignor Ignacio Carrasco de Paula of Spain, who is a moral theologian and physician.

Dr. Haas has said of the appointment, “I am deeply honored and humbled with this appointment from the Holy Father and pray that I, with my colleagues at The National Catholic Bioethics Center, may make some real and lasting contributions to the building up of a Culture of Life worldwide.”

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At a recent meeting of the Board of Directors of The National Catholic Bioethics Center Archbishop Donald W. Wuerl (Washington D.C.) as chair of the nominating committee of the Board announced the appointment of the Most Reverend Jose Gomez, Coadjutor Archbishop of Los Angeles, and the Most Reverend Gregory Aymond, Archbishop of New Orleans, to the NCBC Board of Directors.

Dr. John M. Haas, President of the NCBC, was present at the Mass of Reception in Los Angles for Archbishop Gomez (see photo at left) on May 26.

Archbishop Gomez holds a doctorate in sacred theology from the University of Navarre in Pamplona Spain. Before being appointed to the Archdiocese of Los Angeles, he had served as Archbishop of San Antonio since February of 2005. He has a great pastoral interest in bioethics, especially issues related to end-of-life care, and is the author of A Will to Live: Clear Answers on End-of-Life Issues. Gomez brings a scholarly and pastoral interest in bioethics to the NCBC Board, and as the Coadjutor Archbishop of Los Angeles, episcopal representation from the west coast.

Archbishop Gregory Aymond, a native of New Orleans, served as President-Rector of Notre Dame Seminary in New Orleans where he also served on the faculty as a professor of pastoral theology and homiletics. He developed a close relationship with The National Catholic Bioethics Center during his tenure as Bishop of Austin, Texas. In June 2009 His Holiness, Pope Benedict XVI appointed Archbishop Aymond to succeed Archbishop Alfred Hughes as the 14^th Archbishop of New Orleans and the first New Orleans native to serve the archdiocese as its Ordinary in its 216 year history.

The NCBC Board of Directors and staff welcome these two distinguished archbishops to our outstanding board of church hierarchy and dedicated lay persons.

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Marie T. Hilliard, R.N.. Ph.D., J.C.L.
NCBC Director of Bioethics and Public Policy

June 15, 2010. A bipartisan US Congressional bill, H.R. 5111, sponsored by Reps. Joseph Pitts (R-PA) and Dan Lipinski (D-IL) with the support of 91 House members, would address major flaws in the recently enacted federal health care reform legislation, the Patient Protection and Affordable Care Act (PPACA). See www.usccb.org/healthcare. To learn how to have your voice heard see: http://www.nchla.org/actiondisplay.asp?ID=282

The PPACA, despite President Barack Obama’s Executive Order and despite claims to the contrary, will pay for programs providing abortion on demand and provide inadequate conscience protections for health care providers. Furthermore, it will leave unaddressed the health care needs of many immigrants. The Chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, Cardinal Daniel DiNardo urged members of Congress to support H.R. 5111, stating that it “will bring PPACA into line with policies on abortion and conscience rights that have long prevailed in other federal health programs.” H.R.5111 will ensure PPACA funds are covered by the Hyde Amendment, along with other conscience protections covered by the Weldon amendment that has been part of the of the annual Labor/US Health and Human Services appropriations bills since November 2004. This will make certain that federal, state and local governmental entities receiving federal funds under PPACA may not discriminate against health care providers who decline involvement in abortion.  It will prevent states from requiring the provision of certain procedures without also providing conscience protections. Furthermore, H.R. 5111 will close a loophole in the PPACA’s non-preemption clause on state laws, so that state laws restricting abortion or protecting conscience rights will not be preempted by PPACA.

Some may assume that President Obama’s executive order of March 21 addresses these flaws in the PPACA.  However, the executive order does not address several of the problems cited above.  On other issues it even reinforces problematic aspects of the PPACA, such as providing federal subsidies for health plans that provide abortion on demand.  Furthermore, an executive order cannot go beyond duly enacted federal legislation. Thus, the provisions of H.R. 5111 will assure that any intention in the executive order to provide protections to human life, human dignity, and conscience will be accomplished in law.

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June 8, 2010

The Center’s monthly publication, Ethics & Medics received 2 awards, 1^st and 2^nd place in the category of Best Essay, Special Interest Newsletters. Dr. Maureen Condic’s “A Comprehensive Primer on Stem Cells: Reviewing the Science and the Ethics” and Dr. Joel Brind’s essay, “Consuming Secondhand Steroids: The Contraceptive Pollution of Nature” both were noted for presenting controversial subjects in a clear and thought provoking way.

John M. Haas is the publisher of The National Catholic Bioethics Center’s publications, and Edward J. Furton is the Editor in Chief. Rebecca M. Robinson is the Production Manager and Melanie Anderson the Production Editor. Subscription information for both publications can be found at the Center’s website: www.ncbcenter.org, or by calling the Center at 215.877.2660.

Click to read a summary of the awards received by NCBC publications. 

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May 28, 2010. Craig Venter and his lab successfully altered the genetic structure of a bacterial cell with synthetic DNA.[1] The original bacterial cell was a mycoplasma capricolum but had its DNA stripped – though the original cytoplasm remained – and in its place received a DNA sequence that was structured like mycoplasma mycoides cells using a “digitized” genomic sequence of m. mycoides cells. Explaining just why this is a synthetic living cell, Craig Venter noted that the cell has a computer as its “parent” and behaved like an m. mycoides cell, even self-replicating.[2] That is, a genomic sequence was constructed by a computer model with slight differences from an m. mycoides sequence. Geneticists have been able to “download” genetic sequences of cells for some time. Venter accomplished a feat in the other direction “uploading” a computer modeled genomic sequence resembling an m. mycoides cell into the cytoplasm of an m. capricolumm. mycoides cell with the resulting cell behaving like an m. mycoides cell.

Various news outlets are heralding this as a revolutionary discovery with serious repercussions on our understanding of life and claiming that many theological or religious beliefs may have to be revised. This is overstated. Venter’s study, represents an important technical achievement in that it imported into a cell a wholly synthetic (i.e., computer modeled) genomic sequence manufactured by a machine, and the resulting cell behaved consistent with its new genetic sequence. His experiment did not create life out of non-living matter. The phrase “synthetic life” does not refer to an artificial form of life, as for example the phrase “synthetic wool” refers to an artificial or man-made type of material that imitates wool. Venter began with a living organism, rearranged its genetic sequence, and then called the result “synthetic life.” But the only synthesis he introduced into this existing life form was the new order of the genetic material. Venter did not produce a new form of artificial life that imitates real life. He manipulated an existing living organism.

The work on synthetic life resembles gene therapy, in that what is being proposed is an alteration to the genetic structure of the host organism. What is noteworthy about Venter’s research is that our understanding of how living organisms can be manipulated and altered to manufacture new forms of life may need slight revision. Venter has shown that we can introduce manipulated DNA sequences into cells, effectively changing their characteristic potencies and powers i.e., changing the kind of cell it is. But here again, this is no different in concept from what is being done in gene therapy research. The added technical achievement is that Venter has shown we can do such things with DNA synthesized by a computer model.

Venter’s research on synthetic life is not without potential dangers of a significant magnitude to the environment and with respect to bioterrorism. In principle, the moral quality of this research should be measured against three basic principles: the research should be at the service of the human person in developing effective medical therapies which respect human dignity or ecological preservation technologies. (Venter himself has noted that this is in fact the intent driving the research). It may not destroy young human life in the process nor use or benefit from research that has destroyed innocent human beings. And there should be a specific plan of “containment” to lessen the serious potential risks just noted (i.e., risks to the environment and of bioterrorism).

Venter’s research is an example of scientists participating in the creatio continua of God’s creative activity. Whereas creatio ex nihilo (“creation out of nothing”) emphasizes God’s transcendence, creatio continua (“continuous creation”) draws attention to God’s immanence and the exercise of His sustaining causality. Venter’s research does not tread on God’s ground, but rather participates in His creative activity. The research should be encouraged consistent with the ethical principles just enumerated.  

Ethicists of The NCBC

May 7, 2010. Assemblyman Richard Brodsky of New York State has introduced a bill that would set aside “informed consent” for organ donation and substitute in its place “presumed consent.” Under this legislation, the body of the person would be viewed as the possession of the state, and not that of the family, unless the individual made a specific indication or statement that his organs should not be removed without his permission.

The National Catholic Bioethics Center recognizes that politicians, physicians, patient advocates, and other people of good will are desperately seeking new sources of organs and tissues for the many people who die in need, but laws authorizing presumed consent violate the fundamental dignity of the person and the prior rights of family members who must have the final say on the disposition of the remains. We would urge the members of the New York legislature to oppose this law.

The body of the deceased person belongs first and foremost to the family, who must be confident that they will receive it intact and without the unauthorized prior removal of organs and tissues. The burial of the body is an important part of the grieving process and a period of unity among family members who gather for the internment. The sanctity of this time should not be undermined by the possibility that the state has removed organs and tissues from a loved one without anyone’s permission.

Proposals for presumed consent encourage us to view the human body as a commodity, whose parts can be harvested for the benefit of others. Already we are seeing efforts to encourage organ donation through offers to pay donors for funeral expenses or provide benefits to family members. Payment for organs, other than reimbursement of monies for the cost of the donation itself, violates the inherent dignity of the body, which is an essential component of a human person. Similarly, removing organs without consent treats the body of the deceased in a utilitarian manner.

The Catholic Church promotes the good of organ donation, where “donation” means the freely given decision to transmit the gift of life to another. A program of presumed consent should not be confused with true organ donation. There is no donation when the state presumes to have the authority over the body of the deceased and allows its organs to be removed.

Directive # 63 of the Ethical and Religious Directives for Catholic Health Care Services (2009), issued by the United States Conference of Catholic Bishops, states: "Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death."

Similarly, John Paul II spoke of acts of heroism in Evangelium vitae (1995), #86: “They are a sharing in the mystery of the Cross, in which Jesus reveals the value of every person, and how life attains its fullness in the sincere gift of self. Over and above such outstanding moments, there is an everyday heroism, made up of gestures of sharing, big or small, which build up an authentic culture of life. A particularly praiseworthy example of such gestures is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope.”

A "sincere gift of self" requires freedom of action, and gifts are never obligatory. If there is a social obligation to have one's organs used to save the lives of others, and the state oversees the enforcement of this obligation, how can one speak of "donation" or even "presumed consent"?  Tax payers do not "donate" portions of their wages to the state to be distributed for the common good.  They are taken by the state with or without our consent.  If the state has the obligation to take our organs for distribution to those in need, and we have an obligation to allow them do this, except when we express a prior objection, we cannot speak of virtue or charity with respect to organ extraction and distribution.

Link to the bill:
http://assembly.state.ny.us/leg/?default_fld=&bn=S07725%09%09&Summary=Y&Text=Y

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May 6. 2010. The National Catholic Bioethics Center (NCBC) has been in dialogue with some individual State Catholic Conferences facing adoption by their legislatures of the Uniform Anatomical Gift Act (UAGA). A summary of one State Catholic Conference’s experience is contained in the report of the Maryland Catholic Conference. It is important to note that final refinement of amendments are those attached as the UAGA Amendments Agreed Upon by the National Conference of Commissioners on Uniform State Laws and The National Catholic Bioethics Center. These three agreed upon amendments to the UAGA of 2007 were a result of the NCBC engaging in lengthy dialogue with a representative of the National Conference of Commissioners on Uniform State Laws. It is important to note that in the UAGA the succession of persons allowed to make the anatomical donation ends with “any other person having authority to dispose of the decedent’s body.” (Section 9, (10)). The NCBC opposes such a provision, which violates consent as required by the Ethical and Religious Directives for Catholic Health Care Services, #63, and is akin to “presumed consent.” Agreement on this point could not be reached with the National Conference of Commissioners on Uniform State Laws . An additional amendment of a state statute incorporating provisions of the UAGA was achieved by the Kentucky Catholic Conference. This amendment prevents the use of anatomical gifts for the engendering of human beings (embryos) for research or education.  Text of the Kentucky legislation is available here:  http://www.lrc.ky.gov/record/10RS/SB4.htm.

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April 18, 2010. Peggy Noonan is usually so good. But I am afraid she is stuck in the past with regard to the Church’s response to sexual abuse. (WSJ, April 17) She charges Vatican officials with complacency and declares, the “more relaxed the institution, the less likely it will reform”. 

But Peggy has apparently not noticed that tremendous reform has occurred. In fact, more reform has taken place in the Catholic Church than in any other social institution in which the abuse of minors has occurred. In 2002 the U. S. Bishops approved a Charter for the Protection of Children and Young People. They hired the John Jay College of Criminal Justice to conduct an independent investigation of the problem. They established a National Review Board chaired by a woman (Peggy called for a woman’s touch), Justice Anne M. Burke. The National Review Board monitors the policies of the Secretariat of Child and Youth Protection of the bishops and oversees its annual audit.   Five of its current 13 members have that “woman’s touch”.  One of the original members of the Review Board was a media representative, William Burleigh, at the time head of the Scripps news agency. This was surely expressive of a desire on the part of the bishops for transparency.

The chairman of the research committee of the original National Review Board, Robert Bennett, said when the report was issued that the sexual abuse of minors was a broad social problem and that a focus merely on the Catholic Church would be a disservice to our children. Regrettably, however, that is exactly what has happened. 

Continue reading...

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Marie T. Hilliard, Ph.D., J.C.L., R.N.
NCBC Director of Bioethics and Public Policy

April 19, 2010. The American Nurses' Association has prepared a draft position statement, Foregoing Nutrition and Hydration, the stated purpose of which is to "clarify the role of the registered nurse and the healthcare systems in which they work pertinent to the support of patients and their surrogates deciding to withdraw or withhold nutrition and hydration".

The National Catholic Bioethics Center has grave concerns pertaining to the draft position statement. Please read the comments on the draft statement provided by The NCBC and the ANA draft statement which can be found at http://nursingworld.org/DocumentVault/NursingPractice/Forgoing-Nutrition-and-Hydration.aspx.

Nurses are encouraged to provide comments by April 28, 2010 to the American Nurses Association through lbadzek@hsc.wvu.edu.

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March 26, 2010. The experts say that the solution to the rampant spread of HIV/AIDS is not to ask anyone to exercise self-control, but to distribute a prophylactic device that will enable everyone to engage in sexual license without consequence. For those who ascribe to this principle, the claims of Matthew Hanley and Jokin de Irala’s book will seem incomprehensible. “Who could possibly believe that human beings can control their sexual urges? How can anyone remain faithful to a spouse? Doesn’t everyone know that the condom is the solution to the problem of AIDS?”

Hanley and de Irala reject this pessimistic view of human nature in their remarkable book, Affirming Love, Avoiding AIDS: What Africa Can Teach the West (The National Catholic Bioethics Center, 2009). They defend the view that the condom is not the solution to the world-wide AIDS crisis. They offer us instead the virtues of chastity and fidelity. They make their case by citing an abundance of scientific and epidemiological evidence. They show that the thoughtlessness of the AIDS establishment, with its huge budgets and access to influential organizations, such as the United Nations, has promoted a plan of containment that has been disastrous for the health and well-being of large populations.

 Hardly a week passes without some self-appointed moral authority announcing that more money must now be poured into the world-wide effort to distribute condoms. We are told that programs that stress abstinence and fidelity are dangerous frauds. We are told that people who advance these theories are backwards and ignorant. And yet, the evidence is there, plain to see, not only in the medical literature, but also in common sense. Human beings are capable of prolonged periods of abstinence and can respect the bonds of marriage. this is the solution to the world-wide AIDS epidemic.

Read more about the book here.

Affirming Love, Avoiding AIDS: What Africa Can Teach the West is available from The National Catholic Bioethics Center’s online store or by calling 215-877-2660. NCBC Members will receive this book in the mail as their member benefit publication for 2009.

March 23, 2010. When the common good takes a back seat to political and corporate interests, all, especially the vulnerable, are at risk. As the largest provider of non-governmental, non-profit health care in this country, the Catholic Church, and those who work as Catholic agencies and organizations, have a special obligation to vulnerable populations, such as the unborn, those with disabilities, and those at life’s end. These populations cannot be compromised in an effort to secure “the greater good.” This is utilitarianism, seeking the greatest good for the greatest number, and never equates to the common good.

It is undeniable that the enacted Patient Protection and Affordable Care Act includes public funding of programs that provide abortion on demand. No accounting practices, or requiring enrollees or employees to write separate checks for abortion coverage, changes that fact. The plan would mandate that in each regional Exchange only one of the qualifying plans not include abortion. Furthermore, there is no restriction on coverage of assisted suicide costs. President Obama’s executive order cannot override federal law. In fact, his Order merely requires adherence to the Act. Specifically, it states: “This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural , enforceable at law or in equity against the United States.” While he attempts to assure us that the seven billion new dollars for Community Health Centers will be applied consistent with the Hyde Amendment, the placement of that language within the Act does not make it subject to the cost-sharing provisions for abortion coverage. Most significantly, Beal v. Doe, 432 U.S. 438 (1977) dictates that, without statutory provisions for the Hyde amendment within each enacted law, “essential services” are to include abortion.

Both individuals and employers will be penalized for the absence of health care coverage. There is no evidence of conscience protections for individuals or employers, who may find themselves having to write separate checks for undesired abortion procedures that happen to be in the plan of choice. There is limited evidence of conscience protections for providers, and the legislation does not provide for protection against coercion of health care providers and employers related to contraceptives or abortifacients. Here we see, most significantly, that a house divided eventually will pay the price for taking compromising positions. Yet, unfortunately, in public opposition to the US Conference of Catholic Bishops’ call for rejection of this legislation as it was written, the Catholic Health Association and fifty-five women religious urged its passage.

The Act will establish a Medicare Commission, which is to develop Medicare cost-saving measures. Providers to Medicare beneficiaries will be rewarded if they reduce the cost of health care services, while maintaining quality. This could foster care disincentives toward some individuals who are elderly or disabled. Broad authority is given to federal agencies to impose binding regulations. Mandates, with penalties, for failure to meet such requirements, could be imposed. The potential impact upon Catholic health care in areas where it is the sole provider, and refuses to engage in procedures destructive to life or natural human functioning, could be ominous.

Nothing is as intimately linked to fostering affordable health care as a moral approach to a global economy. Last year Pope Benedict XVI issued Caritas in Veritate (“Love in Truth”), offering the world a means to evaluate secular economic and social systems through the moral lenses of charity and truth. This new social encyclical focuses on integral human development. Economic activity is called to be people-centered: “This needs to be directed towards the pursuit of the common good.” (N.36). Most notably, Benedict states, “When a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good” (N. 28). Attacks upon life spare no generation: “To the tragic and widespread scourge of abortion we may well have to add in the future – indeed it is already surreptitiously present – the systematic eugenic programming of births. At the other end of the spectrum, a pro-euthanasia mindset is making inroads as an equally damaging assertion of control over life that under certain circumstances is deemed no longer worth living. Underlying these scenarios are cultural viewpoints that deny human dignity.” (N. 75).

One is left to ask, does this health care legislation truly advance the common good? More importantly, when members of a divided house make compromises with principle, has the common good been advanced? The answer is contained in Caritas in Veritate, within which all of the hallmarks of a sound health care reform policy are contained: integral human development; fundamental rights to life and religious freedom; charity with truth; humanistic synthesis; the common good; earth as a gift to humanity to use and protect; civilizing the economy; subsidiarity; a person-based and community oriented culture; people-centered development programs; cooperation of the human family; recognition that every migrant is a human person; and bioethics and human responsibility in human technology. As the encyclical states, in charity and truth, “when a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good.”(N. 28)

March 18, 2010. As the debate on health care reform intensifies prior to an anticipated vote later this week, The NCBC would like to draw particular attention to comments from our bishops regarding the the status of the Senate bill and its provisions for abortion. While there are certainly other troubling issues contained within the proposed legislation, the issue of funding for abortion remains critical and undeniable.

In an attempt to provide health care coverage for all Americans there can be no toleration for the destruction of innocent human life. It has been a desire of the bishops for many years to bring sensible health care reform to our country. The Senate’s refusal to adopt the language of the “Stupak/Pitts Amendment”, which was approved by the House of Representatives, sounds a clear warning that the door remains open to abortion funding and therefore makes the Church’s support for this legislation impossible. There is no greater social good than the protection of human life.

We encourage you to read the following analysis of the legislation provided by the United States Conference of Catholic Bishops and also the public statements of various individual bishops, including the USCCB President and NCBC board member Cardinal Francis George of Chicago.

March 15, 2010 statement of Cardinal Francis George, President of the United States Conference of Catholic Bishops

• The Senate Health Care Reform Bill: Funding Abortions at Community Health Centers http://www.usccb.org/healthcare/communityhealthcenters.pdf


• Abortion Funding in the Senate Health Care Reform Bill 


• What’s Wrong with the Senate Health Care Bill on Abortion? A response to Professor Jost
  


• USCCB Website on Health Care Reform with Additional Resources
  

• “Health care for life and for all” Bishop William F. Murphy, Cardinal Daniel DiNardo and Bishop John Wester (Washington Post Editorial)
  


• “Catholics, Health Care and the Senate's bad bill”. Archbishop Charles Chaput, Denver. (Denver Catholic Register)
  

“Letter to the Catholic Community of Northern Colorado”. Archbishop Charles Chaput, Denver


• “Catholics urged to contact 'swing votes' on health care”. Archbishop Joseph Naumann, Kansas City in Kansas (The Leaven)

On March 2, 2010 the Archdiocese of Washington ceased offering spousal benefits to new employees of Catholic Charities in order to maintain its service to thousands of vulnerable and poor residents of the District. Under new legislation that mandates recognition of same-sex "marriage", and contains no religious exemption, Catholic Charities would be forced to recognize these immoral but legally sanctioned relationships through the provisions of their employee benefit plan. Catholic Charities in the Archdiocese of Washington serves residents through contracts with the local government which require compliance with all local laws.

The Archdiocese had already been informed in December 2009 that it would no longer be able provide placements for foster children or publicly-funded adoption services. Under the new law, the agency would be required to place children with same-sex married couples and to license the couples as adoptive and foster care families.

You may read the March 1, 2010 statement of the Archdiocese here.

February 26, 2010. It is undeniable that President Obama’s plan for health care reform includes a provision for public funding of programs that provide abortion on demand. No accounting practices, or requiring enrollees or employees to write separate checks for abortion coverage, change that fact. It would mandate that in each Exchange in the country only one of the qualifying plans not include abortion. Both individuals and employers will be penalized for the absence of health care coverage. There is no evidence of conscience protections for individuals or employers, who may find themselves having to write separate checks for undesired abortion services that happen to be in the plan of choice. There is limited evidence of conscience protections for providers: only that they cannot be excluded from participating in the plan because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions. Nowhere does it provide for protection against coercion of health care providers and employers related to contraceptives or abortifacients.

The plan also expands Medicaid to all individuals less than 65 years of age, based on income, and is to include essential health benefits. Courts have construed such Medicaid provisions to include abortion: “abortion fits within many of the mandatory care categories, including ‘family planning,’ ‘outpatient services,’ ‘inpatient services, ’ and 'physician's services.’” In fact all basic health plans must provide these “essential health benefits.” While, federal funding of abortion by the US Department of Health and Human Services (e.g., Medicaid) would be in violation of the Hyde Amendment, any health care reform legislation must specifically invoke the Hyde Amendment on all options within the bill to assure its applicability. There is no such invocation in the Obama Plan. Yet proponents of HR 3962 (the Senate bill upon which this proposal builds) insist that provisions for federal funding of abortion are not included. Of particular note is the funding expansion to community health centers to $11 billion dollars. Such centers are the major providers of contraceptives and abortifacients, and referrals for abortion.

The Obama Plan would establish a fifteen member Independent Payment Advisory Board, which is to submit Medicare cost saving measures. While this Board is prohibited from submitting rationing proposals, the Obama Plan will allow providers to high-need Medicare beneficiaries (the elderly and disabled) to share in any savings if they reduce the cost of health care services. This constitutes an incentive not to treat the elderly and disabled. Every three years non-profit hospitals will be required to conduct community needs assessments and develop strategies to meet those needs. Mandates, with penalties, for failure to meet such requirements, as well as requirements pertaining to billing and patient financial assistance, will be imposed. How this will impact areas in which Catholic health care is the sole provider, and refuses to engage in procedures destructive to life or natural human functioning, is unclear.

Nothing is as intimately linked to fostering affordable health care as a moral approach to a global economy. On June 29, 2009 Pope Benedict XVI issued his third encyclical, Caritas in Veritate (“Love in Truth”) , offering the world a means to evaluate secular economic and social systems through the moral lenses of charity and truth. While commemorating the fortieth anniversary of Paul VI’s encyclical, Populorum Progressio, this new social encyclical focuses, not on the development of peoples, but integral human development. Thus, economic activity is called to be people-centered: “This needs to be directed towards the pursuit of the common good, for which the political community in particular must also take responsibility.” (N.36) Most notably, Benedict states: “When a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man's true good.” (N. 28) He also recognizes that the attacks upon life spare no generation: “To the tragic and widespread scourge of abortion we may well have to add in the future — indeed it is already surreptitiously present — the systematic eugenic programming of births. At the other end of the spectrum, a pro-euthanasia mindset is making inroads as an equally damaging assertion of control over life that under certain circumstances is deemed no longer worth living. Underlying these scenarios are cultural viewpoints that deny human dignity.” (N. 75)

The question remains as to whether our “society” is advancing this proposal, when one looks at the proposed “Reconciliation” process, usually reserved for budgetary matters, not policy matters. Such a process of reconciliation limits debate and amendment, and therefore favors the majority party. Specifically, the House would vote on the Senate proposal, which is the basis for the Obama Plan. Then the reconciliation process would be used to develop a separate bill to resolve differences in the House and Senate versions. Voting procedures on this bill would disallow a filibuster, potentially allowing one political party to control the vote and pass the health care reform proposal.

Finally, one is left to ask, does the Obama Plan advance the common good? The answer is in Caritas in Veritate. All the hallmarks of a sound health care reform policy are contained within Caritas in Veritate: integral human development; fundamental rights to life and religious freedom; charity with truth; humanistic synthesis; the common good; earth as a gift to humanity to use and protect; civilizing the economy; subsidiarity; a person-based and community oriented culture; people-centered development programs; cooperation of the human family; recognition that every migrant is a human person; and bioethics and human responsibility in human technology. As the encyclical states, in charity and truth, “when a society moves towards the denial or suppression of life, it ends up no longer finding the necessary motivation and energy to strive for man’s true good.” (N.28)

February 22, 2010. We are often consulted at The National Catholic Bioethics Center about cooperation questions. Health reform debates are now in the stage of reconciliation. The US Congress will consider (as of 2/22/10) the reconciliation process to advance the anti-life Senate health care reform proposal. We have been asked about the extent to which person’s of conscience can endorse certain health care reform proposals. At issue is the senate version of health care reform which would implicate citizens in cooperating in abortion. Can we support such legislation even if other aspects of it would ensure serious goods to society?

John Paul II in his Encyclical Evangelium vitae says the following about the stance we should take to unjust legislation,

In the case of an intrinsically unjust law, such as a law permitting abortion or euthanasia, it is therefore never licit to obey it, or to "take part in a propaganda campaign in favour of such a law, or vote for it" (n. 73).

An elected official, whose absolute personal opposition to procured abortion was well known, could licitly support proposals aimed at limiting the harm done by such a law and at lessening its negative consequences at the level of general opinion and public morality. This does not in fact represent an illicit cooperation with an unjust law, but rather a legitimate and proper attempt to limit its evil aspects.

Assuming that the health care reform bill that makes it out of adjudication still entails that those who object to abortion will have to pay for abortions (either through taxpayer dollars or through the “two-checks” compromise), then the legislation should be opposed. Some would argue that imperfect legislation can be supported if it also led to great goods for society. But if the evil it makes possible or expands access to is the destruction of human life, then it would be an inappropriate application of “incrementalism” to vote for it. JPII’s comments say that it is permissible to vote for imperfect legislation when it limits or reduces the effects of an intrinsically unjust law already in place. But when the legislation being proposed expands access to abortion, even if it ensures certain goods to society, the legislation is itself unjust.

Some would advocate a procedure whereby one calculates the goods and evils a piece of legislation entails. The argument may be that the goods ensured by this aspect of the legislation outweigh or trump the evils ensured by another aspect of the legislation. But this approach cannot be justified in that it would amount to an intention to see abortion access expanded. Why? If given an option of endorsing a version of health care reform that does not provide abortion aid, and one endorses a version that does provide abortion aid (all else being equal), there can be but one intention, namely, to expand access to abortion. Endorsing any legislation that furthers abortion prior to being approved must involve an intent to further abortion because prior to approval there are other options, such as amendments to prevent the effect of furthering abortion.

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 Often health care professionals can be overwhelmed with casualties resulting from natural disasters, such as the recent earthquake in Haiti, from pandemics, such as the one feared from the H1N1 virus (“Swine Flu”), or from warfare or terrorist attacks. The health care professionals themselves are often taxed beyond normal endurance. But they also face the lack of sufficient medical resources, such as simple anti-biotics or ventilators, to provide life saving interventions. In such situations, very difficult moral decisions have to be made as to who will receive what resources are available. These are often gut-wrenching decisions. The allocation of these scarce resources is often referred to as “triage”.

It is important that hospitals have in place protocols which will enable them to make decisions as objectively as possible, under often horrific conditions, with respect to who will or will not receive the scarce medical resource. In the vortex of a disaster physicians and nurses must often make life-and-death decisions with the medical and the moral resources at hand.

The National Catholic Bioethics Center has not infrequently received requests for help in applying the Catholic moral tradition in such situations, as occurred recently after the devastating earthquake in Haiti. In our discussions with care-givers in the midst of these crises, we point out the need to have an objective policy in place to direct the use of limited resources that would apply equally to all patients. However, an “objective” policy must also be flexible in order to be applied in an extraordinary situation in which circumstances can change by the minute and patients of varying conditions will be brought for treatment and care. Obviously it is best to have these protocols in place prior to a crisis striking.

Let us reflect on this question in terms of the use of ventilators when there are not enough available for all who need one. Some patients would benefit from short-term application of the ventilator; others would require long term use---something often impossible in crisis situations. Furthermore, appropriate reassessments of patients on a periodic basis would be required in the event that a patient shows evidence of being able to benefit from limited medical resources. The hospital would need to determine, by established criteria such as those listed below, what would be a reasonable amount of time and the appropriate circumstances for any one patient to make use of the ventilator. Once that time was up, it could rightly be given to another.

The crisis in Haiti has brought to light the importance of having policies in place to manage crisis situations. A clear policy would help physicians recognize the need to make careful judgments about who would best be helped by short-term use of the ventilator, and who would require more support than could be given. A policy would also diminish the likelihood of arbitrary decisions being made which might appear as favoritism to some over others. We have provided, below, a set of criteria that could be used to guide such a policy. In all cases, when a decision has been made that a patient will not benefit from limited resources, appropriate palliative care should be provided.

We hope that The National Catholic Bioethics Center can assist the suffering victims of sudden and unexpected crises and their care-givers by bringing the highly developed moral tradition and compassion of the Catholic Church to bear in these heart-breaking situations through these reflections on triage.

• Identify exclusion criteria for the allocation of life sustaining care, including ventilators, e.g.:
  
  End-stage organ failure; repeated cardiac arrest or un-witnessed cardiac arrest, or unresponsiveness to standard measures to maintain cardiac function; incurable malignancy; severe burn >40%; severe inhalation injury.
  
  
• Assess patients for sequential organ failure (assessment methods that could be used if available are in parenthesis), done initially and at 48 and 120 hours, and daily thereafter, allowing for a re-determination of whether a patient can benefit from the limited resource:
  
  Respiratory and cardiovascular function (PaO2/FiO2); hemopoietic function (platelet level); hypotension; liver function (bilirubin); kidney function (creatinine); neurological status (Glasgow Coma Scale).
  
  
• Categorize patients based on assessment ¹, e.g.:
  
  Palliate – If there is a presence of any of the exclusion criteria. Furthermore, in the absence of any exclusion criteria there is/are a number of organ failures that the facility pre-determines would present an unsustainable condition for the patient to benefit.
  
  High Priority for Receiving Limited Resources – Single organ failure (the facility may determine that even a single organ failure is not sustainable in the disaster situation).
  
  Intermediate Priority – A patient with more evidence of organ failure than the “High Priority” patient, but less than the patient in the “Palliate” category. Based on the decisions made as to what constitutes “Palliate” and what constitutes “High Priority,” this category could be determined to be somewhere between the two categories.
  
  
• Develop Priority for Ventilator Access Criteria, e.g.:
  
  With the aforementioned continuing assessment, if a patient remains in the “High Priority” category (thus still able to benefit), that patient should not be removed from the ventilator for another “High Priority” or “Intermediate Priority” patient.
  
  If in the presence of sufficient resources, a patient categorized as in the “Intermediate Priority” category has been ventilated, that ventilator should not be removed for a patient in a “High Priority” category unless the patient in the “Intermediate Priority” category has not improved within a set period of time (e.g., 120 hours).

¹For a model of how Sequential Organ Failure Assessment Scores can be used in critically ill patients see: Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patientsby Flavio Lopes Ferreira, MD; Daliana Peres Bota, MD; Annette Bross, MD; Christian Mélot, MD, PhD, MSciBiostat; Jean-Louis Vincent, MD, PhD, JAMA. 2001; 286:1754-1758.

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The American Nurses Association is revising its position statement pertaining to end-of-life care, which could impact the understanding of the nurse’s role in states where assisted suicide is legal.

To review the draft document and provide comment see: http://nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements/Public-Comment.aspx

Summary:

The greatest NCBC concerns rest with the fact that the concept of double effect is not articulated accurately. One can never intend the hastening of death. Thus, the NCBC requests the removal of the phrase “sole intention” and substituting the word “intention” as follows (and in other places within the document when “sole intent” or “sole intention” are used): “While nurses should make every effort to provide comprehensive pain control and symptom relief for patients at end-of-life, it is never ethically permissible for a nurse to administer medication with the sole intention of ending a patient’s life.”

One licitly can anticipate a secondary unintended effect of hastening death (with such things as pain control, used for that purpose) while understanding that it could cause respiratory suppression. However, if one intends hastening death either at the time as intending to alleviate suffering, or worse, by causing death, and thus ending all palliative care, such an action clearly is unethical.

Also, the largest provider of non-governmental health care (thus the largest employer of nurses) is the Catholic Church. There is no reference to the ethical framework which guides care in all Catholic health care facilities (The Ethical and Religious Directives for Catholic Health Care Services). At the same time, there is reference to documents from what was known as the Hemlock Society (Compassion & Choices). For a more comprehensive approach to end-of-life care in this document, there should be a reference to The Ethical and Religious Directives for Catholic Health Care Services: http://www.usccb.org/meetings/2009Fall/docs/ERDs_5th_ed_091118_FINAL.pdf.

Lastly and of increasing importance is the issue of conscience rights of the nurse. Health care professionals are not agents of whatever the patient or state wishes. That is the stuff of the Nuremburg Trials. Health care professionals should be able to have the same conscientious objection as provided for those who can refuse to participate in capital punishment.

For a more detailed analysis of the draft document, with comment, see: http://www.ncbcenter.org/NetCommunity/Document.Doc?id=96

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Call of the US Conference of Catholic Bishops for Health Care Reform that Does Not Destroy Lives but Saves Lives

Protect Conscience; Ensure Affordable Health Coverage; Allow Immigrants to Purchase Private Health Insurance

The Bishops of the United States have called upon Congress to develop Health Care Reform which:

• Is a truly universal health policy with respect for human life and dignity;
• Provides access for all with a special concern for the poor and inclusion of immigrants;
• Pursues the common good, preserving pluralism including freedom of conscience and variety of options; and
• Restrains costs and applies costs equitably across the spectrum of payers.

As long-time advocates of health care reform, the U.S. Catholic bishops continue to make the moral case that genuine health care reform must protect the life, dignity, consciences and health of all, especially the poor and vulnerable. Health care reform should not advance a pro-abortion agenda in our country.

• On November 7, the U.S. House of Representatives passed major health care reform that reaffirms the essential, longstanding and widely supported policy against using federal funds for elective abortions and includes positive measures on affordability and immigrants.
• On December 24, the U.S. Senate rejected this policy and passed health care reform that requires federal funds to help subsidize and promote health plans that cover elective abortions. All purchasers of such plans will be required to pay for other people's abortions through a separate payment solely to pay for abortion.
• Outside the abortion context, neither bill has adequate conscience protection for health care providers, plans or employers.
• These two bills must now be combined into one bill that both the House and Senate will vote on in final form. Provisions against abortion funding and in favor of conscience protection, affordability, and immigrants' access to health care must be part of a fair and just health care reform bill, or the final bill must be opposed.

ACTION: Contact your Representative and Senators today by e-mail, phone or FAX.

• To send a pre-written, instant e-mail to Congress go to www.usccb.org/action.
• Call the U.S. Capitol switchboard at: 202-224-3121, or call your Members' local offices.
• Contact info can be found on Members' web sites at www.house.gov & www.senate.gov.

SUGGESTED MESSAGE TO THE HOUSE:

"I am pleased that the House health care bill maintains the longstanding policy against federal funding of abortion. I urge you to work to uphold essential provisions against abortion funding, to include full conscience protection and to assure that health care is accessible and affordable for all. Until and unless these criteria are met, I urge you to oppose the final bill."

SUGGESTED MESSAGE TO THE SENATE:

"I am deeply disappointed that the Senate health care bill fails to maintain the longstanding policy against federal funding of abortion and does not include adequate protection for conscience. I urge you to support essential provisions against abortion funding, similar to those in the House bill. Include full conscience protection and assure that health care is accessible and affordable for all. Until and unless these criteria are met, I urge you to oppose the final bill."

WHEN: Immediately. Votes in the House and Senate on the final bill are expected in January.

Act today! Thank You!

The use of tax payer dollars to pay for the death of the unborn has been advanced in the Senate by several “pro-life” Democrats, who appear to have yielded to political pressures, and perhaps even to the promise of economic benefits for their states. After putting forth an amendment that would have protected the unborn, Senator Ben Nelson (D-Nebraska) has joined the ranks of Senator Mary Landreau (D-Louisiana) in assuring the sixty votes needed by Senate Majority Leader Harry Reid (D-Nevada) for the Senate to pass landmark federal legislation supportive of American taxpayers’ funding of abortion on demand even as it seeks to make health insurance coverage available to all Americans.

Ultimately all persons will be required to have health insurance. Enrollees can choose from plans within health care Exchanges that meet their needs. However, if that plan also includes abortion coverage, the enrollee must pay for that coverage, whether they want it or not. Despite all of the proposed accounting gymnastics to factor out the premiums and costs for abortion (such as enrollees being required to write a separate premium check to pay for abortion coverage), for the first time in our nation’s history, federally-supported, taxpayer-funded health care plans will provide abortion on demand. One small bit of consolation is that there are some concessions to persons of conscience. States can opt out of providing abortion coverage, and although conscience provisions fall short of the House-passed bill in protecting health care providers who are resolute in not cooperating in the evil of abortion, there are some protections for providers and health care facilities of conscience. Still, all persons will be required to have health insurance, and employers will be fined for not offering such insurance. Furthermore, in states which choose to provide abortion coverage, an enrollee may select from the Exchange options a plan that also includes abortion coverage. Despite the faux mechanisms of separate checks and separate payroll deductions for abortion coverage, employers may be required to facilitate such payments through payroll deductions. Lastly, there is no provision allowing institutions of conscience to provide and purchase health coverage consistent with their moral and religious convictions.

The vote in the Senate is expected by Christmas eve. It is a sad irony that as we celebrate the birth of our Savior, the halls of Congress already are planning His death, again for a few “pieces of silver.”

For information on how to have your voice heard go to: http://www.nchla.org/issues.asp?ID=51.

Stephen Napier, Ph.D

December 21, 2009. As of late December 2009, the United Nations’ Climate Change Conference in Copenhagen is still underway. In the wake of the conference, climate change and global warming has become a debatable issue – largely in part due to the recent “Climategate” scandal where a series of emails were published that called into question the scientific validity of the claim that global warming is caused by human activity.¹ In this debate, some scoff at the idea of governmental regulation of pollution, others are saying that we have to quell emissions immediately and drastically, and if this involves severely limiting some of our liberties, then so be it. But there is a surprising confusion in this debate. Confusion persists among politicians who may be “pro-life” but are not sympathetic to environmental concerns, or at least not government regulation of industry to curb pollution. And likewise, there are politicians who favor legislation aimed to protect our natural resources but are also committed to a worldview that is actually pernicious to human life – especially young human life. (This is probably due to a perceived link between protecting the environment and over-population.) Consequently, some clarifications are in order about what the Catholic Church teaches on this issue.

First, Catholic teaching is committed to the idea of caring for the environment, protecting our natural resources, and encouraging a diverse eco-system (i.e., endangered species ought to be protected). Recently (December 15, 2009), Pope Benedict XVI in his World Day for Peace address says that our commitment to the created order stems from our commitment to our fellow persons.

The Church has a responsibility towards creation, and she considers it her duty to exercise that responsibility in public life, in order to protect earth, water and air as gifts of God the Creator meant for everyone, and above all to save mankind from the danger of self-destruction. ... Our duties towards the environment flow from our duties towards the person, considered both individually and in relation to others.²

Can we remain indifferent before the problems associated with such realities as climate change, desertification, the deterioration and loss of productivity in vast agricultural areas, the pollution of rivers and aquifers, the loss of biodiversity, the increase of natural catastrophes and the deforestation of equatorial and tropical regions? Can we disregard the growing phenomenon of "environmental refugees", people who are forced by the degradation of their natural habitat to forsake it - and often their possessions as well - in order to face the dangers and uncertainties of forced displacement?³

A second point of clarification concerns the reason upon which our duty to preserve and protect the environment is based. Fundamentally we owe it to each other. When pollution of either air or water, and other forms of environmental degradation inevitably lead to the destruction of human life, we have failed to act with sobriety and solidarity with our fellow persons.

A third and fundamental point of clarification is to observe that the moral reason for preserving and protecting the environment pertains to our duties to act charitably and justly towards our fellow human beings. Solidarity demands sobriety in our lifestyle. Pope Benedict notes, “This means that technologically advanced societies must be prepared to encourage more sober lifestyles, while reducing their energy consumption and improving its efficiency” and “Specifically, they [our ecological crises] call for a lifestyle marked by sobriety and solidarity,…”⁴ These crises also demand far-sighted policies absent the “pursuit of myopic economic interests.” The cost to society and to the environment needs to be taken into account. The justification for our caring for the environment stems from the respect we owe to ourselves and to other persons.

Notice how different this reasoning is to those who espouse a bio-centric worldview where humans are creatures along a continuum. Those creatures having the most value are those who possess higher-order consciousness or other exercisable mental capacities. An adult monkey, on this view, is more valuable than an immature human being. Such disregard for the value, worth, and distinctiveness of human life is pernicious to a comprehensive life-ethic. “In the name of a supposedly egalitarian vision of the "dignity" of all living creatures, such notions end up abolishing the distinctiveness and superior role of human beings.” ⁵Locating the value of things in what they can do leads to disastrous consequences and is ultimately morally repugnant. Human beings have their inherent dignity and worth in virtue of what we are, not in virtue of what we can do or perform. In fact, a worldview that locates the value of persons in what they can do means that a person’s value comes and goes with what abilities they can exercise. Upon such a flimsy basis for worth, no moral duty can be grounded, at least, not one that would justify sacrificial action that the current environment crises require of us. In the end, the bio-centric worldview is self-defeating when it asserts a moral duty to protect the environment and save people’s lives when the value of people’s lives is not intrinsic or inherent in them. An ethic that locates the value of people in what they are (namely, what is intrinsic and inherent in them), naturally enough grounds certain absolute moral duties to care for and protect them.

December 16, 2009.  After careful deliberation, the United States Conference of Catholic Bishops has revised directive 58 of the Ethical and Religious Directives for Catholic Health Care Services (2001). Here is the language of the new directive:

In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally. This obligation extends to patients in chronic and presumably irreversible conditions (e.g., the "persistent vegetative state") who can reasonably be expected to live indefinitely if given such care. Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be "excessively burdensome for the patient or (would) cause significant physical discomfort, for example resulting from complications in the use of the means employed." For instance, as a patient draws close to inevitable death from an underlying progressive and fatal condition, certain measures to provide nutrition and hydration may become excessively burdensome and therefore not obligatory in light of their very limited ability to prolong life or provide comfort.

The bishops also deleted language in the introduction to Part V, “Issues in Care for the Dying,” that indicated the need for “further reflection” on whether nutrition and hydration should be provided for patients in a persistent vegetative state... 

(click to read the complete text)

December 10, 2009. The National Catholic Bioethics Center received with dismay the news that the US Senate rejected the Nelson-Hatch Amendment (identical to the Stupak-Pitts Amendment in the House version of Health Care Reform legislation), with a vote of 54-45. In fact, the current Senate version of this legislation requires each state to offer a plan that includes abortion coverage. It also provides tax-support of enrollment costs for private plans that cover abortions. Although Senator Henry Reid (D-NV) has indicated a compromise may be crafted to omit the community health insurance option (public option), the current proposal authorizes the Secretary of Health and Human Services to allow abortion coverage in a public option. Even though there is to be a factoring out of the cost of those procedures in the premiums, abortion will be paid for by tax dollars within the options that remain. In reality, then, there is no prohibition of government support for abortion. Rather, the proposal mandates abortion coverage in each region of the country. Also, while the bill prohibits limiting access to end-of-life care, and protects the consciences of health care workers regarding participation in assisted suicide, there is no prohibition against the funding of assisted suicide.

Lastly, but very significantly, while Senator Reid has indicated openness to a compromise which would remove the provision of a public option, the intended compromise will empower the government to reinstate a public option in a final bill by action of a conference committee if private plans fail to meet certain goals. Conference committees are used to rectify any discrepancies between House and Senate versions of legislation.

A public option offered at lower cost creates a strong incentive for private employers to participate, easily leading to the “public option” becoming a national plan. Should that occur, providers would potentially face legal mandates to supply morally illicit procedures, especially in geographic areas where the only health care provider opposes such anti-life procedures.

There is a clear need to remain vigilant in expressing opposition to publicly funded assaults on human life. As the largest provider of non-governmental health care in the United States, Catholic health care is likely to be the only local provider of care in some geographical areas, and thus may become subject to morally-unacceptable mandates in the delivery of care.

Swift action is needed in contacting congressional members through e-mail, phone calls or faxed letters. To view informational sources from the USCCB and to take action go to http://www.nchla.org/issues.asp?ID=51. Our country is at a crossroads, not only in terms how our most vulnerable members will be treated, but also in terms of the future of conscience protections.

 
(1) The entity is organized and operated for religious purposes and is tax exempt under section 501(c)(3) of the U.S. Internal Revenue Code. 
(2) The inculcation of religious values is one of the primary purposes of the entity. 
(3) The entity employs primarily persons who share the religious tenets of the entity.²  

 
1. Responsible research with hESCs has the potential to improve our understanding of human health and illness and discover new ways to prevent and/or treat illness. 
2. Individuals donating embryos for research purposes should do so freely, with voluntary and informed consent. (p. 15).  

May 14, 2009. On May 14, 2009, the NCBC submitted a letter to Dr. Raynard Kingston, the Acting Director of the National Institutes of Health, which was critical of the Draft Guidelines for Human Stem Cell Research. These Guidelines were proposed in the wake of President Barack Obama's Executive Order which provided for federal funding for human embryonic stem cell research.

Click here to read the text of the letter. Acrobat Reader is required.

May 14, 2009. On May 4th, 2009, Pope Benedict XVI addressed the fifteenth Plenary Session of the Pontifical Academy of Social Sciences, which had gathered in the Vatican to study the question of human dignity and human rights. He began by thanking Professor Mary Ann Glendon, current President of the Academy, for her welcoming words to the plenary. 
 
Our Holy Father emphasized that human history, even with all of its inconsistencies, has shown an increasing sensitivity for human dignity and human rights. He highlighted, as an example, three fundamental human rights, and their grounding in our nature. He pointed to, “…the right to life and the right to freedom of conscience and religion as being at the centre of those rights that spring from human nature itself.” 
 
The Pope proceeded to deepen his reasoning by stating that: 

April 13, 2009. On April 3, 2009, Iowa became the third state in the USA to legalize same-sex marriages (Massachusetts and Connecticut are the other two). And, in New England, there is a move to have all six states (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and Connecticut) recognize homosexual marriages by 2012. On April 7, 2009, the Vermont legislature approved same-sex marriage. Also, at least six other states (Illinois, Maryland, Minnesota, New Jersey, New York and Washington) have pending legislation to legalize homosexual marriages. 
 
The Catholic Church is opposed to same-sex marriage because it is against nature, and because it is not what Jesus Christ taught. He did teach, however, respect for the intrinsic dignity of all peoples. He also said regarding marriage: “For this reason a man shall leave his father and mother and be joined to his wife, and the two shall become one flesh. So they are no longer two but one flesh. Therefore what God has joined together, no human being must separate." (Mk 10,7-9) 
 
Same-sex marriage advocates seek the same recognition given to traditional marriage. However, what is recognized about traditional marriage is precisely the fact that it is between one man and one woman. Therefore, what same-sex marriage advocates seek is intrinsically impossible to obtain. 
 
The legalization of marriage is to protect the value that it has to society, to a large extent, by the proper engendering and nurturing of the next generation. It is safe to assume that homosexual activity has always existed among some sectors of society. Yet, no society has ever recognized it as marriage. Why? Because by its very nature, it threatens the core of what marriage and family represents. 
 
If marriage is not between one man and one woman, then it does not have to be between two persons. In other words, if society ―and legitimate government― does not have the right to tell me that I cannot marry my same-sex partner, then with what right does it restrict me to marry only one other person at a time? Similarly, if it cannot tell me to marry only a person of the opposite gender, with what right does it restrict me from marrying a member of another species? 
 
When taken to its ultimate conclusion, same-sex marriage totally dissolves the meaning of marriage into no meaning at all. 
 
If truth be said, same-sex marriage advocates seek to legitimate objectively abnormal behavior, and gravely sinful sexual activity. The NCBC invites Catholics and all people of good will stand up for decency, civility and honesty: same-sex marriage is an immorality and will have disastrous consequences for society. 
 

April 2, 2009. On April 2, 2009, the NCBC provided comments to Acting Secretary, Charles E. Johnson of the U.S. Department of Health and Human Services on the proposed rescinding of the Provider Conscience Rule instituted by President George W. Bush “Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law.”

The text of the letter may be read here. Adobe Acrobat Reader is required.

March 10, 2009. On January 26, Nadya Suleman, a single mother, gave birth by C-section to premature octuplets. Nadya, an only child, was born on October 12, 1975 and studied to be a psychiatry technician. She married in 1996, but separated four years later because the couple was unable to have children. In 2001, she began IVF fertility treatments from Doctor Michael Kamrava, with sperm donated from a friend. This resulted in her bearing 6 children, now aged 7, 6, 5, 3, 2 and 2. She still had 6 embryos frozen from the previous treatments. So, in 2008 she requested that all remaining embryos be implanted in her ―all at once. All implanted, and two of them split into identical twins, resulting in octuplets. A reason Nadya has claimed for having so many children is that, when she was young, she was very lonely due to her being an only child, and that she would not want any child of hers to have to experience that. She has been receiving worker’s compensation from a back injury in 1999. 
 
While some motivations have been laudable ―such as not wanting her children to be alone and not wanting her frozen embryos to be destroyed―, the NCBC considers gravely irresponsible all these actions: undergoing IVF treatment; endangering the life of these 14 children, most especially the octuplets; denying a father to all these children, and; the financial hardship at public expense. It must be noted that, of grave concern, is the general public’s acceptance of IVF. However, IVF is an intrinsic evil because, among other things, it radically separates the unitive from the procreative dimensions of the marital act. This is one more drastic example of the many reasons why IVF is highly unethical. Essentially, it dehumanizes people by turning children into a commodity and it totally obviates the fundamental way in which God intended for a family to come about: by the loving union of spouses who, together, raise the children that the Lord grants them.
 

January 27, 2009. On January 27, 2009 Dr. Marie Hilliard, NCBC Director of Bioethics and Public Policy and also a the chair of the ethics committee of The National Catholic Partnership on Disability submitted testimony to the Maryland Legislature opposing legislation that would mandate terminal condition counseling.

The text of the testimony may be read here.

 

• Individual freedom is a fundamental value in society and should be protected at all cost.  
  
• Protecting innocent human life is a fundamental value in society and should be protected at all cost.

The text of the letter may be read here. Adobe Acrobat Reader is required.

The text of the letter may be read here. Adobe Acrobat Reader is required.

• In 2007 (latest figures), there were about 33 million people worldwide living with HIV/AIDS;
• An average 2.7 million new cases appear each year;
• About 2 million people die yearly from complications of HIV/AIDS;
• 5 new people become infected for every 2 who begin anti-retroviral therapy (ART)

• The increasing effectiveness of anti-retroviral therapy. 
• The benefits of male circumcision and basic hygiene in slowing down transmission rates.

• The need to eradicate the stigma associated with the disease;
• The need to support basic human rights, including gender equality;
• The need to dispel the myth that funding for AIDS detracts from public funding of other vital healthcare needs. ;

• Combination prevention strategies tailored to decrease HIV transmission.
• Combination antiretroviral therapy to dramatically reduce morbidity and mortality among those infected.
• Combination antiretroviral therapy to reduce community viral load as an aid to HIV prevention.
• Combination strategies to enhance HIV testing.
• Combination strategies to reduce poverty, and discrimination.”

July 30, 2008. It has been 30 years since the first “test-tube” baby appeared on the scene. Louise Joy Brown was born on July 25th, 1978. Since then, the technology has not advanced much. The same basic procedure is being used today as in 1978 - namely, the mixing of male and female sex cells in a glass dish leading to the engendering of embryos - but the uses and ends to which IVF is employed have certainly grown in number. It is much more common today for couples to pick and choose which embryos to implant, with such a decision based on the traits, gender, or potential for disease the embryo may have. The embryos that are not chosen are either frozen for future implantation or experimentation or they are destroyed. It is more common now for single women who sense that their “clock is ticking” to seek IVF, or for a lesbian couple to choose to have a child through IVF. If one thinks that embryos are nothing but a cluster of cells and not full fledged human beings, then none of these activities would seem objectionable. But then, testing this or that embryo for his/her sex or for certain traits would not make sense unless the embryo were a human being who is either male or female and has certain genetically disposed traits. Mere clusters of cells are not male or female, and they certainly don’t possess traits; human beings do. I say this to clear away certain absurdities in ethically analyzing IVF.  
 
Some other clarifications should be made as well. Though infertility is certainly a cross many couples bear, it is important to distinguish between solving infertility by whatever means, and solving infertility by ethical means. It is also important to be clear that having a child is not a right: it is rather a gift. Being clear about these distinctions will go some distance in adjudicating the moral permissibility of IVF.  
 
The Church’s teaching on IVF comes from her long standing teaching about the nature of the marital act and the inherent dignity of new human life. Consequently, the Church cannot change its teaching, unless the nature of the marital act changes, or new human life does not posses inherent worth. This is to say, the Church’s teaching is not based on a whimsical prudishness, or on “hang-ups” about sex, but rather on the proper order of sexual relations and how an act of procreation ought to respect the dignity of new human life. The Church is merely peering into reality and reading off of it the proper moral order of certain actions. Those who object to the Church’s teaching must say in response that they have peered into the dense forest of reality and have discerned a different order, or no order at all. But such a claim is audacious at worst, and intellectual hubris at best. The Church avoids such hubris because she claims to be the final interpreter of the moral order under the direction and light of the very Creator Himself. These comments are sufficient to rebut the unsupported claim by Art Caplan who in a recent commentary on IVF said, “Even the Catholic Church, which has never approved the break between sex and procreation, has taken a relatively benign view of the use of IVF by married couples.” (Art Caplan “New IVF Dilemmas Make Old Fears Seem Quaint.” MSNBC July 24th, 2008.) The Church has firmly rejected, and continues to reject, all recourse to IVF, whether by married couples or not. Caplan is simply uninformed.  
 
But what is the Church’s objection to IVF? Caplan comes close to understanding the Church’s teaching when he says, “Some maintained that creating children this way was simply unnatural and would stigmatize the child. Others bemoaned the creation of life without sexual intercourse, fearing that in vitro fertilization would degrade human dignity as people became the object of mechanistic creation in glass dishes.” Neither of these reasons truly captures the Church’s position in total – though in fairness Caplan does not say he is recapitulating the Church’s teaching. The Church teaches that the dignity of new human life requires bringing that life about through an act of love, not through an act of manipulation. The marital act is by its very nature an act of self-giving and charity. The procedures associated with IVF are not. For IVF, embryos are typically destroyed because they are not fit enough or because they do not bear the traits desired by the couple. Even if care is taken to implant all that are conceived, the procreative process is still not an act of love shared between spouses. The dignity of the child and the dignity of the act bringing about the child (in IVF) do not comport with one another. The idea behind the Church’s teaching is fairly simple. There is an order and fittingness to the procreation of new human lives, and this order requires the procreative event to be an act of charity between spouses. Those who think that the Church objects to IVF because it is “unnatural,” as if the Church were saying that sexual intercourse per se is the only proper means by which to procreate, miss the point. Not just any act of sexual intercourse is proper to procreation, for example, fornication and adultery certainly are not. What is proper to procreation is an act of charity realized only in the conjugal act.  
 
The 30th anniversary of IVF should be viewed in light of another important anniversary, namely the 40th anniversary of Humanae Vitae. The Church’s teaching on IVF is a mere extension of her teaching about the integrity of the marital act and how preserving such integrity comports with charity. In fact the two teachings can be viewed as following from one and the same teaching. As my colleague Fr. Alfred Cioffi has noted, contraception is an attempt to experience unity without procreation and IVF is an attempt to experience procreation without the unity. Insofar as the Church prohibits such disintegration, the teaching should not then be viewed as a restriction but rather as an invitation to experience the fullness of the goods available to a couple through the sacrament of marriage. The Church’s teachings are not only consistent but fulfilling. 
 

June 12, 2008. The National Catholic Bioethics Center is pleased to announce numerous awards from the Catholic Press Association for its two serial publications, Ethics & Medics and The National Catholic Bioethics Quarterly. 

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