Posts in Essays on Ethics
Detransitioning

Detransitioning is being discussed more frequently in the news. This is the process whereby persons who previously went through a “sex change” do their best to reverse that procedure. From a Catholic perspective (and also the common view of nearly all cultures and religions until very recently), a person is either male or female, and this biological fact is good and should be accepted. LGBTQ+ activists and their theorists have come up with the idea that one is only “assigned” a sex by our biology and that a person can therefore experience gender dysphoria, a sense of “being in the wrong body.” Their solution to this mental anguish is to dress and interact as a member of the gender they identify with and frequently take hormones, drugs, and surgery to “transition” their bodies so that they transform themselves into their self-perceived gender.

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The FDA and Mifepristone Abortions

Direct abortion is never ethically acceptable from a Catholic perspective. The grave intrinsic evil can be made even worse, however, under some circumstances. The US Food and Drug Administration (FDA) has found ways to do so with its approval of and subsequent loosening of restrictions on mifepristone or so-called medication abortions. The National Catholic Bioethics Center (NCBC) recently joined an amicus curiae or “friend of the court” brief in support of a reversal of the FDA’s approval of mifepristone as a drug for causing abortions.

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The Credibility Crisis at the FDA

An unfortunate result of the response to the COVID-19 pandemic has been a crisis of credibility of many government, scientific, and health care institutions. There is neither time nor space to explore the issue here. I will focus instead on how the US Food and Drug Administration (FDA) is adding fuel to this crisis. The FDA recently changed its Drug Facts Label for Plan B One Step (PBOS), known to the public as Plan B “emergency contraception,” in ways that create suspicion that this process was not so much guided by objective scientific facts as it was by political pressure and other extraneous factors.

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The Verdict on COVID Vaccine Mandates and the Common Good

The New York Supreme Court declared the state COVID-19 vaccine mandate for medical staff “null and void,” striking it down. This is especially significant since this is not Florida but liberal New York. A big part of the reasoning behind the ruling was the now-acknowledged scientific fact that the various COVID vaccines do not stop transmission of the disease. This undercut the main basis for the mandate, that it was a major public health benefit.

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In Memoriam Pope Benedict XVI

Pope Benedict XVI was a special friend of The National Catholic Bioethics Center (NCBC) going back to the years when he served as prefect of the Congregation for the Doctrine of the Faith (CDF). He spoke at the NCBC workshop for bishops in 1984 and in 1991, and we published a book with his words of wisdom entitled “On Conscience” that is available for purchase. Pope Benedict XVI appointed our past NCBC president, Dr. John Haas, as a member of the Pontifical Academy for Life and a consultor to the Pontifical Council for the Pastoral Care of Health Care Workers.

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Ethics and the Police Power of the State

Governments should exist to provide security and ensure justice for their citizens. These services necessitate high ethical standards because the lives and freedoms of the people are at stake. A basic assumption in democratic societies is that the police should serve and protect the people and the rule of law. We rightfully become upset when there are abuses of police power or similar injustices.

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The Ethics of Pilgrimage

Over the centuries many writers have compared our earthly lives to a pilgrimage with heaven as our destination. Clearly the great ethical command of the natural law to do good and avoid evil is a key component of this journey. Having experienced the blessings of going on many Catholic pilgrimages and working as a bioethicist, I think it worthwhile to reflect on ethics for pilgrims.

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Medicine is a Moral Enterprise

“Medicine is a moral enterprise.” This quotation from the late professor Edmund Pellegrino, one of the pioneers of Catholic bioethics, encapsulates a key insight. All are called to lead a moral life and to achieve the holiness of the saints. This obviously means that ethics is important in all professions and walks of life. Yet, we rightly hold physicians and other health care workers to higher standards of professional ethics. It is profitable to reflect in a deeper way on this moral intuition.

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The Manipulation of EMTALA

How sad when beneficial measures are twisted by those with a manipulative political agenda. The Emergency Medical Treatment and Labor Act (EMTALA) was passed by Congress and signed into law by President Reagan in 1986. Its purpose was to ensure that Americans had access to emergency medical services even if they lacked financial means or health insurance. This is very much in conformity with the Catholic view that basic health care is a human right, especially in emergency situations. Now the Biden administration is using EMTALA to force an abortion mandate onto physicians.

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The Totalitarian Fiasco of the HHS 1557 Rule

It is hard to know where to begin in a critical response to the over 300-page proposed revised regulations recently published by the Federal Department Health and Human Services (HHS) on Nondiscrimination in Health Programs and Activities. The proposed federal rule would “force health care workers to perform gender transition procedures, require health insurance issuers to cover them, and entertain a mandate to perform elective abortions,” in the words of a statement by the United States Conference of Catholic Bishops.

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The Silent Plague of Vasectomies 

There is a silent moral plague: the seldom preached about grave violation of sexual ethics represented by male sterilization through a vasectomy. In this procedure the two vas deferens tubes are severed or blocked so that sperm cannot exit the testicles, rendering the man sterile. Catholic moral teaching is quite clear that contraception is a mortal sin and sterilization is an even more serious sin since it involves the mutilation of healthy organs in both male vasectomies and female fallopian tube ligations. (Catechism of the Catholic Church, 2399 and 2297)

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The Ethics of Protesting

There are ethical rules for protesting, just as there are for everything else that one does. Resorting to violence and vandalism are two of the most unethical actions associated with modern protests. I have participated in many marches, life chains, and other public denunciations of abortion over the years. Peaceful protesting is a valid and even meritorious way to make one’s concerns and beliefs known to the wider public in a free society. In fact, we have an ethical duty to not simply allow injustices to continue.

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A Source of Guidance and Comfort

Watching a loved one suffer and die is painful beyond words. And that pain often clouds judgment, leading to confusion and doubt about what medical interventions are truly the most caring and appropriate. For 45 years I have been associated with The National Catholic Bioethics Center and have taught moral theology in two seminaries. I have given talks on care at the end of life, on advanced medical directives, and on a Power of Attorney for Health Care Decisions when a patient becomes incompetent. Over the years, I also counseled individuals having to make difficult health care decisions. None of that, however, even begins to have the existential relevance when it is one’s own loved one who is suffering and dying.

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Conscientious Objection and Abortion

A shocking news headline grabbed my attention recently: “Conscientious objection ‘may become indefensible’ according to new WHO guidance.” Rights of conscience, like all other fundamental human rights, do have limits and certain conditions that must apply for their exercise, but what could possibly justify the World Health Organization (WHO) rhetorically condemning conscientious objection?

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The Bioethics of High-Risk Pregnancy

Two lives are frequently in danger in high-risk pregnancies, making the right ethical course of action difficult at times to see. Respect for the equal dignity of all human beings leads Catholic bioethicists and the Church to strive for solutions that rescue mother and child while acknowledging difficult circumstances where it is not possible to save both. Here there is a marked contrast to much secular and utilitarian thinking that frequently defaults to prioritizing protecting the life of the person who can most easily be preserved, usually the mother. Prior to viability outside the womb, the extreme vulnerability of preborn babies makes killing them frequently the easiest path to follow in terms of what is least medically risky.

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Prenatal Diagnosis and Counseling

Prenatal Diagnosis and the counseling that goes with it are fraught with ethical challenges. It is one of the areas of medicine where the Catholic and pro-life perspectives sharply contrast with the approach of many secular institutions and health workers. A lack of good ethical practice in this area is evidenced by the extraordinarily high rates of abortion when preborn children test positive for Trisomy 21 or Down Syndrome.

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