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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Ethical Blindness and the “Women’s Health Protection Act”

I should not be surprised or shocked, but I still shook my head in disbelief when the radical abortion “Women’s Health Protection Act” (H.R. 3755) failed to advence in the US Senate by only two votes this week. I do not by any means want to imply that selective ethical blindness is a uniquely liberal phenomenon. It is widespread, and I recognize a version of it in myself when I am tempted to rationalize a bad action of mine that I would never defend when I see others doing the same. Fallen human nature, a consequence of Original Sin, is in evidence all around us, and perhaps most distressingly, in our own hearts.

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Fifty Years of The National Catholic Bioethics Center

Fifty years is a venerable age for a bioethics center, especially since the academic discipline only came into being in the 1970s. The original name of the NCBC when we were founded in 1972 was the Pope John XXIII Medical-Moral Research and Education Center. It was the year before Roe v. Wade unleashed abortion-on-demand across the USA. We are fervently praying that 2022 will be the year that the US Supreme Court reverses itself and allows states to ban abortion again. Yet, even if the enormous ethical issue of abortion moves towards resolution, there are vast and growing areas where bioethical reasoning and guidance are needed in health care and biomedical research. The COVID-19 pandemic, for instance, has led to the busiest time in our Center’s history.

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