Biomedicine and Beatitude: An Introduction to Catholic Bioethics

Biomedicine and Beatitude: An Introduction to Catholic Bioethics

by Nicanor Pier Giorgio Austriaco

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Biomedicine and Beatitude: An Introduction to Catholic Bioethics by Nicanor Pier Giorgio Austriaco

Nicanor Pier Giorgio Austriaco, O.P., is assistant professor of biology and instructor of theology at Providence College. In biology, he and his students are investigating the genetic regulation of programmed cell death in several model unicellular eukaryotes. In theology, he has published essays on bioethics and on the interaction between science and religion.

Product Details

ISBN-13: 9780813218823
Publisher: Catholic University of America Press
Publication date: 12/05/2011
Series: Catholic Moral Thought Series
Edition description: New Edition
Pages: 336
Sales rank: 626,809
Product dimensions: 6.00(w) x 8.90(h) x 1.00(d)

About the Author

Nicanor Pier Giorgio Austriaco, O.P., is assistant professor of biology and instructor of theology at Providence College. In biology, he and his students are investigating the genetic regulation of programmed cell death in several model unicellular eukaryotes. In theology, he has published essays on bioethics and on the interaction between science and religion.

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Biomedicine and Beatitude

An Introduction to Catholic Bioethics
By Nicanor Pier Giorgio Austriaco

The Catholic University of America Press

Copyright © 2011 The Catholic University of America Press
All right reserved.

ISBN: 978-0-8132-1882-3

Chapter One

Bioethics and the Pursuit of Beatitude

According to a widely used textbook in the tradition of secular bioethics, the field of bioethics has a recent provenance. The textbook traces the founding of the field to an influential article authored by Dan Callahan in 1974 entitled "Bioethics as a Discipline." As contemporary histories of bioethics often do, however, the text fails to acknowledge the long tradition of bioethical reflection in the history of the Catholic Church, from the early condemnation of abortion in the Didache, written in the first century, to the recent papal pronouncement on euthanasia in Evangelium vitae, written during the twentieth. Rooted both in faith and in reason, Catholic bioethics is a rich tradition informed by scriptural exegesis, by theological reflection, and by philosophical argument, a tradition that counts St. Augustine, St. Thomas Aquinas, and St. Alphonsus Ligouri among its most distinguished contributors. Today, Catholic bioethics has become a distinctive and mature field of inquiry—there are now several scholarly journals devoted primarily to Catholic bioethics, including the National Catholic Bioethics Quarterly and the Linacre Quarterly, that strive to apply the principles of Christian morality to the profound and deeply human questions regarding the meaning of life, its beginning, its continuation, and its end, that are raised by the life sciences.

In this chapter, where I summarize the foundational principles of Catholic moral theology, we begin with an overview of the Catholic moral vision that places bioethics within the context of each individual's pursuit of beatitude. It is a moral vision that strives to remain faithful to the moral life described by the Lord Jesus Christ in His Sermon on the Mount. Since the pursuit of beatitude is governed by the actions that shape our moral character, we then move to a moral analysis of human action that answers several questions: What is a human act? How do we judge the morality of human acts? How do we distinguish good acts from evil ones? Then I will discuss the moral principles that are used to make sound moral judgments according to right judgment, not only in bioethics but also in every sphere of human activity. At the same time, I discuss four dimensions of moral agency and society—the governing role of the virtues, the power of prayer, the experience of suffering, and the teaching charism of the Church—that can and often do shape our actions. Finally, I turn to the principle of double effect, a principle that will help us to act well when we are confronted with choosing acts that have both good and evil effects.

The Pursuit of Beatitude

Bioethics and the Catholic Moral Vision

On August 6, 1993, the Feast of the Transfiguration of the Lord, Blessed John Paul II signed Veritatis splendor, his moral encyclical addressed to the bishops of the Catholic Church. It remains an eloquent articulation and defense of the Catholic moral vision. In this encyclical, which calls for a renewal in Catholic moral theology, the pope reminds the Church and the world of three constitutive elements of Christian morality.

First, Blessed John Paul II teaches that the Catholic moral vision begins with and ends in the person of Jesus Christ. Since Christ is the Way, the Truth, and the Life, the decisive answer to every human being's questions, his religious and moral questions in particular, is given by Jesus Christ, or rather, is Jesus Christ Himself. Jesus opens up sacred Scripture, teaches us the truth about moral action by fully revealing the Father's will, and then gives us the grace to pursue and to live that truth. He is also the one who reveals the authentic meaning of freedom by living it fully in the total gift of Himself and shows us how obedience to universal and unchanging moral norms can respect the uniqueness and individuality of the human being without threatening his freedom and dignity. In all of this, the Lord remains the beginning and the end of an authentic Christian morality.

Next, the pope explained that the human being attains a happy life, what the classical authors called beatitude, only in the following of Christ along the path of perfection. Here, happiness, or beatitude, is understood to signify the fulfillment of every human yearning, spiritual, moral, and emotional. It goes beyond the modern-day notion of happiness as either the emotional wellness or the positive affective mood of the individual. Rather, beatitude is the perfection of the human being as the kind of creature that he is. By focusing on beatitude, Blessed John Paul II places Catholic moral theology within the moral tradition that emphasizes the happiness and the perfection of the human agent as the goal of the moral life. It is a tradition that challenges the human agent to live in such a way as to attain the perfective ends that define a good life. This tradition traces its origins to the ancient Greeks and counts St. Thomas Aquinas as one of its proponents.

As Blessed John Paul II narrates in the encyclical, in response to the rich young man's question—Teacher, what good must I do to gain eternal life? (Mt 19:16)—the Lord Jesus Christ invites the young man, as He invites every human being, to seek God "who alone is goodness, fullness of life, the final end of human activity, and perfect happiness." In doing so, Christ reveals that the young man's moral question is really a religious question. In seeking what is good, in seeking beatitude, the human being is seeking God. According to the encyclical, the Lord also reveals that the desire for God that is at the root of the rich young man's question is implanted in every human heart, reminding us that, created by God and for God, we are called to communion with our Creator. Moreover, as the pope notes, it is a desire that can be assuaged only by accepting Jesus' challenge in the Sermon on the Mount to follow Him on the path of perfection: "If you wish to be perfect, go, sell what you have and give to [the] poor, and you will have treasure in heaven. Then come, follow me" (Mt 19:21). Thus, Christian morality is not a list of commands, obligations, or prohibitions. Rather, it "involves holding fast to the very person of Jesus, partaking of his life and his destiny, sharing in his free and loving obedience to the will of the Father." The imitation of Christ, particularly in the practice of charity, constitutes the moral rule of the Christian life and remains the essential and primordial foundation of Christian morality. It is the only authentic path to the happy life.

Third, the pope teaches that we imitate Christ by seeking, with God's grace, to perfect ourselves through our actions and the virtues they engender. Created by God as rational and free creatures, human beings perfect themselves and establish their identities as moral creatures through their free choices. We make ourselves the kinds of persons we are, in and through the actions we freely choose to do. As the pope put it in the encyclical, "It is precisely through his acts that man attains perfection as man, as one who is called to seek his Creator of his own accord and freely to arrive at full and blessed perfection by cleaving to him." Our freely chosen acts, the pope continues, "do not produce a change merely in the state of affairs outside of man but, to the extent that there are deliberate choices, they give moral definition to the very person who performs them, determining his profound spiritual traits." As Jesus Christ reveals, "man, made in the image of the Creator, redeemed by the Blood of Christ and made holy by the presence of the Holy Spirit, has as the ultimate purpose of his life to live 'for the praise of God's glory' (cf. Eph 1:12), striving to make each of his actions reflect the splendor of that glory." This is the reason why the pope and the Catholic moral tradition put much emphasis on the morality of individual human acts and of the virtues they engender. They are our proximate means toward growing in perfection and toward attaining of beatitude. By highlighting the importance of human action and virtue in the moral life, Blessed John Paul II associates Catholic morality with other moral theories that emphasize the virtues, or moral character, of the human agent, in contrast to those theories that emphasize either duties or rights (deontological theories) or to those theories that emphasize the consequences of actions (utilitarian theories).

Finally, given the vision of the moral life outlined above, it should not be surprising that Catholic bioethics focuses upon the acts of the individual patient, clinician, or scientist in order to evaluate their morality: Which ones would respect the dignity of the person and promote his well-being and ultimate beatitude? Which ones would be detrimental to the perfection of his nature? Thus, when the Catholic bioethicist asks whether it is morally permissible to do experiments with human embryos, he does so by reflecting upon how this type of research would contribute to the personal and spiritual development of the scientist. Much emphasis is placed upon how individual acts affect the acting person because it is through these acts that the human agent attains beatitude. In this way, Catholic bioethics differs from other contemporary approaches to bioethics, several of which will be described in chapter 8, which focus upon either the outcomes of human acts or the procedures that protect the autonomy of the human agent.

Natural Inclinations and the Structure of Human Acts

Created by God and for God, we are called to communion with our Creator. Therefore, it is not surprising that in His providence, God has imprinted natural inclinations within our hearts that move us to our beatitude in Him. Preexisting elicited desire, these inclinations direct us to those ends that are constitutive of the human good. They help us to understand our perfection precisely as human beings. Not unexpectedly, developmental psychologists have identified these inclinations, which direct us to our self-preservation, to true and certain knowledge of the world, to life in society, and to God, even in newborn infants and young toddlers.

Our natural inclinations provide the ground and ultimate intelligibility for our actions. They move and motivate us to act. As Blessed John Paul II explained in Veritatis splendor, the moral challenge is to use our reason, with the help of grace, to order our actions in accordance with these natural inclinations so that together they can achieve our authentic good and the good of our society. Actions are at the heart of the moral life. Thus, I begin our exposition of Catholic bioethics by reflecting upon the structure of human acts to answer the following questions: What is a human act? What exactly are we doing when we act? How do acting persons act? This analysis of moral agency will form the backdrop for our later discussion of the morality of human action.

For St. Thomas Aquinas, the process of human action can be distinguished into three basic stages, three moments, of the human act: intention, decision, and execution. There is also an optional stage involving deliberation that is required when an acting person has to select one means among several alternative means to attain his purpose. Each of the stages is made up of two components, one involving the intellect and another involving the will, though it is important to emphasize the interpenetration of the two basic capacities of the human agent at each moment of the human act. It is neither the intellect nor the will separately, but the whole human being, who is acting.

Intention, the first stage, is the aiming of an action toward something. Here the acting person not only apprehends something that becomes the purpose of his action but also desires it. Thus, a young lacrosse player who wakes up hungry is motivated by the good of a satiated body that he not only apprehends but also desires as the purpose of his acting. This is the intention behind his act to eat. The next stage of human action, called decision, is a process of practical reasoning, again involving both the intellect and the will, whereby the acting person chooses to realize a particular means to achieve the desired purpose. In our example, our hungry lacrosse player sees a box of Kellogg's Rice Krispies on the kitchen table and decides that he will have a bowl of cereal here and now in order to attain the purpose of a satiated body. He understands that eating this bowl of cereal is a means that will allow him to attain that purpose, and thus, he chooses it. The last stage of human action is execution. It follows decision and is the actual carrying out of the decision into action. After deciding to eat the bowl of cereal, our athlete actually executes his act. He pours the cereal into a bowl and begins to consume it. His act is complete. Finally, there is an additional stage, a fourth stage called deliberation, which is not a necessary part of human action. It becomes a moment in the human act when the acting person is not sure if he should choose one particular means or another to achieve his purpose. When this happens, deliberation follows intention and precedes decision. It is a process of practical reasoning from purpose to means that leads the acting person to choose the best of many possible means to achieve the purpose of his action. In our example, our athlete would have to deliberate when he is confronted with two different boxes of cereal on the kitchen table. He would have to figure out if attaining the good of a satiated body is best achieved from eating either the Kellogg's Rice Krispies or the General Mills Lucky Charms. Once he picks one as the better of the two means, eating the Rice Krispies, in our example, the young man would then have to decide to choose to eat the cereal, and then to execute his act.

The Role of the Virtues

In health care and in scientific research, as in all other areas of the moral life, acting persons often struggle to act well. Obstacles to human action often arise because of ignorance in the intellect, weakness in the will, or disorder in our desires. They can arise at any moment of the human act. Some individuals find it easy to intend ends—for example, they find it easy to make New Year's resolutions—but then find it difficult to execute their acts to accomplish their purposes. In contrast, others may become incapacitated when they are faced with a plethora of possible means. Deliberation is difficult for them, and they simply cannot decide. Finally, others may not be able to even motivate themselves to intend purposes for their acts. They lack the drive to pursue goals in their life, and therefore, they are unable to act.

Given the common difficulties that prevent the acting person from acting well, the moral life in general, and moral reasoning in bioethics in particular, require the virtues—stable dispositions in the human agent that enable him to know, to desire, and to do the good—to help us to act well. Classically, the virtues can be divided into three categories: the intellectual, the moral, and the theological virtues.

First, the intellectual virtues allow the human agent to perfect his scientific, artistic, and technical abilities. Particularly important in bioethics, the three virtues of understanding, sure knowledge, and wisdom perfect the intellect so that the human person can know truth well. Understanding or intuitive insight, intellectus in Latin, allows the person to grasp the necessary truths expressed in first principles, such as the whole is greater than its parts. Sure knowledge, scientia in Latin, perfects the speculative intellect so that the human agent can reason well. Finally, wisdom, sapientia in Latin, disposes the human being so that he can understand reality from the divine perspective. These virtues would allow the bioethicist and the patient to know the truths that are necessary prerequisites for moral judgment, and would enable the scientist to excel at his task to understand the world. Last, the intellectual virtues of art, ars in Latin, and of prudence, prudentia in Latin, perfect the intellect and predispose the human agent to produce works of skill that are done well—including, for the physician, a healed patient, or for the scientist, an elegant experiment—and to act well, respectively. As we will see below, prudence is a unique virtue because it is numbered among both the intellectual and the moral virtues, because a prudent individual needs not only to know the true good, but also to act in order to attain it.

Next, the moral virtues order our desires so that we routinely desire the good and then act to attain it. They can be acquired by human effort and are the fruit of repeated morally good acts. The ancients emphasized that these virtues could become like a second nature after long conditioning and constant practice. However, for St. Thomas Aquinas, these natural virtues still require God's grace for them to function well. Significantly, he also proposed that there are infused virtues that correspond to the acquired moral virtues and that elevate the human being so he can perform supernatural acts that transcend reason and duty in light of the Cross. As Michael Sherwin, O.P., has convincingly argued, the infused cardinal virtues must exist because they explain well the experience of those acting persons, especially former addicts, who struggle with the lingering effects of their acquired vices. By definition, these infused virtues are gifts that can be received only from God along with sanctifying grace. They order the human agent toward his ultimate beatitude, which is the life of the Triune God.

The moral virtues are also important because they help the acting person to regulate his emotions, those bodily movements the classical tradition called the passions of the soul. As Etienne Gilson, the distinguished medievalist, observed: "When the moralist comes to discuss concrete cases, he comes up against the fundamental fact that man is moved by his passions. The study of the passions, therefore, must precede any discussion of moral problems." In themselves, these passions—and they could include love, pleasure, hatred, fear, despair, or anger, among others—are morally neither good nor evil. However, when they contribute to good action, they are morally good, and when they contribute to evil action, they are morally evil. For example, fear, in one case, fear of cancer, may incline an individual to give up an unhealthy habit like smoking, while fear, in another case, fear of prolonged pain, may incline another patient to ask his physician to kill him. The former passion would be morally good, while the latter passion would be morally evil. Not surprisingly, therefore, the acting person is called to order his passions so that they are directed toward his authentic good.


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Table of Contents

Abbreviations ix

Acknowledgments xiii

Introduction 1

1 Bioethics and the Pursuit of Beatitude 7

2 Bioethics at the Beginning of Life 43

3 Bioethics and Human Procreation 73

4 Bioethics and the Clinical Encounter 112

5 Bioethics at the End of Life 135

6 Bioethics, Organ Donation, and Transplantation 170

7 Research Bioethics from the Bench to the Bedside 207

8 Catholic Bioethics in a Pluralistic Society 247

Appendix: Church Documents on Bioethics 277

Selected Bibliography 281

Scripture Index 307

Subject Index 308

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