My Vision for Bioethics
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People I have just met sometimes ask, “What is bioethics?,” after I tell them that I serve as president of The National Catholic Bioethics Center (NCBC). The short answer is that it is mostly medical ethics and discerning what is right or wrong in difficult cases that arise in medicine and the life sciences. Bioethics began as a separate discipline only in the early 1970s. That makes the NCBC one of the oldest institutions in the field, as we were founded in 1972. The world needs education about bioethics because most people still do not know what a bioethicist does. Even some health care professionals have only vague ideas about it.
It doesn’t help that many secular bioethicists out there make a living out of what I call “writing permission slips.” When scientists want to do experiments that involve killing human embryos or performing abortions, a bioethicist with academic credentials is almost always willing to sign off on the activity. Some ethics committees in hospitals rarely deny requests to suspend nutrition and hydration or to approve procedures that the Church could never accept.
My vision of bioethics is that it is a compassionate and objective search for what is true and good when ethical dilemmas arise in medicine or scientific research. Very sad situations do happen in which a bad outcome cannot be avoided. Some of the most heart-wrenching problems are maternal–fetal conflicts. Despite the best efforts of health care professionals and the remarkable advances of modern medicine, cases do occur where saving both the mother and her preborn child is not possible. Some secular bioethicists do not hesitate to approve and even push for abortions in these situations.
Our Catholic bioethics tradition is very clear in its principles. A direct attack on the life of an innocent can never be sanctioned or accepted. Compassion and truth go together as we look at what may be done morally. A classic example is the case where a pregnant mother has a cancerous uterine tumor alongside the child in her womb. If the child cannot be delivered with a chance of survival, and the only effective medical treatment is a hysterectomy, this may be an ethical choice for the parents to make. The hysterectomy would not be a direct abortion, because the object and the objective nature of the act is to heal the mother by removing her uterus and the cancer within it. That her preborn child will not survive can be foreseen, but it is not intended. One way to check the objective nature of the act is to note that the exact same procedure would be performed if the woman were not pregnant. Clearly, the unacceptable practice of bringing about a good end through an evil act is not part of this scenario.
These and other examples of the very fine ethical distinctions to be made in difficult circumstances illustrate why faithful Catholic bioethicists must assist the laity and clergy in moral decision making. This assistance is all the more necessary when patients or family members are distraught and vulnerable in response to physical suffering or emotional distress. People can be manipulated into bad decisions. They need solid and morally clear advice.
The NCBC has for years offered a free ethical consultation service for individuals. As I have done this work, the true nature and value of bioethics have become ever more apparent. Many people face hard choices at the end of life for themselves and loved ones. Modern medicine can do more and more, but what should be done is sometimes unclear. Here a good bioethicist can provide invaluable support. Some choices like euthanasia or assisted suicide are never morally acceptable. The hard discernment comes into play when we look at the shifting line between extraordinary and ordinary means of preserving a patient’s life. Pope Pius XII pointed out this vital ethical distinction as early as the 1950s. We are only morally obligated to use ordinary means to safeguard our lives. Extraordinary means can be chosen as well, but they are morally optional, part of the great freedom we all have as believers.
A wise priest friend of mine told me, “It is hard enough being a good Catholic. We should not place unnecessary burdens beyond what is morally required.” Jesus condemned strongly what he saw in his own day and age, when the Pharisees piled heavy burdens on others but did not lift a finger to help. Bioethicists can help people to discern what is proportionate and what is disproportionate in medical care. Some interventions are burdensome and provide very little benefit. In the most extreme circumstances, frequent violent resuscitations or certain medical interventions can cross the line that separates health care from physical abuse and even disrespect for the human person. Cutting off some basic care, on the other hand—or giving dangerously high doses of pain medication—can cross the line between simply allowing a person to die peacefully and euthanasia.
What I try to do, and urge the other NCBC ethicists to keep in mind, when performing an ethics consultation is to have an attitude of prayerful service. The person on the other end of the phone call may be going through the most painful crisis of his or her life. The caller can be confused or emotionally raw. The good Catholic ethicist should be a pillar of support with good scientific knowledge, but most of all with an excellent grasp of the Church’s Magisterium and her teachings regarding bioethical issues. In some disputed areas a definitive Church teaching has yet to be formulated, so we must explain that lack to the person who contacts us. Then we can share the applicable principles for making a good choice and finally provide the best advice we can. In most of my consults I assure the person asking for bioethical help of my prayers. Those whom we assist need not only knowledge but God’s grace to discern the right path. I find it quite humbling to receive tearful thanks from some people who are so relieved at receiving help to make a good but difficult ethical decision.
Bioethics can be a remarkable force for good and for the Gospel of Life. When it is perverted, however, it loses the vital connection that promotes the unique dignity of the human person in a compassionate and truthful way. Pope St. John Paul II understood the great temptations of our age. Some scientists and doctors are tempted to play God and disregard our just limitations. Good bioethicists are guardians of what is sacred and inviolable in our brothers and sisters.
Please join me in praying that the NCBC continues to carry out well its vital role in defending the dignity of the human person in medicine and the life sciences.
