Diocese of Covington - Messenger at 402 E. 21st Street, Covington, KY 41015 US - Commentary

Catholic Health Care Ministry: Bioethics --- substance or procedure?

The current Bulletin of the Institute for Theological Encounter with Science and Technology (ITEST) reprinted a paper that Dr. Edmund D. Pellegrino had delivered at the Twenty-First Workshop for Bishops, a program sponsored by the National Catholic Bioethics Center. His keynote address was entitled "Catholic Health Care Ministry and Contemporary Culture."

In his lecture Dr. Pellegrino analyzed the growing tensions that have been surfacing between the Catholic vision of the human person and the outlook advanced in contemporary society. The dissonance between the Catholic ethical vision and a postmodern secular ideology on biotechnology stems from differing concepts of "the nature of human good, the ends to which it ought to be directed, and the morality of means used to attain those ends."

The Catholic moral tradition views the dignity of the human person as "an intrinsic, inviolable, God-given quality of all human life." This countercultural core belief upholds the inherent dignity of the person as being "possessed equally by the weakest and most fragile among us as well as the most robust and the strongest."

The Catholic doctrine of human dignity has been historically situated within a Judeo-Christian biblical anthropology and morality as a common ground tenet. Contemporary culture, however, increasingly finds that worldview more and more estranged from the dominant societal ethos. Consequently, that secular milieu is undergoing a gradual but radical revision which interprets the sacredness and sociality of the human person as "a quality conferred by human law."

Thus, Dr. Pellegrino, Professor Emeritus of Medicine and Medical Ethics at Georgetown University, quotes the late Jesuit Father John Courtney Murray (d. 1967) who wrote "civility dies with the death of dialogue." He personally conjectures that "[w]e are not yet at the point of death of dialogue, but we are drifting perilously close to it as the language of bioethical discourse becomes more petulant."

With the escalation of these conflicts, public controversies concerning issues such as embryonic stem cell research and cloning are pointing up the need to recapture "a sustained dialectic and dialogue" in the area of bioethics.

This eminent Catholic philosopher of medicine spells out the contemporary challenge to be confronted by Catholics to maintain Catholic identity and "the integrity of their health care ministries in a democratic, sometimes hostile morally pluralistic society."

A decade ago, in an epilogue to “Jewish and Catholic Bioethics” (1999), Dr. Pellegrino proposed returning to "an updated and reinvigorated natural law ethic with its roots in those things common to all humans as humans." That revitalized natural law ethic would play an important role in building a common ground between a religiously based medical ethics and the secular version.

Dr. Pellegrino expressed a confidence that the insufficiencies of secular perspectives would become a factor to reverse the polarities of the present standoff between religious and nonreligious stances. In his judgment, he hoped that "the playing field promises to be more level."

Moreover, the validation of the place for religious argument in the public square also presupposes regaining the spirit of civility in public debates. In lieu of productive dialogue, the polarization and the concomitant incivility will likely create deeper conflict and isolation "in increasingly narrower communities of shared values."

Over the span of his long and distinguished career, Dr. Pellegrino has been a major voice calling for a restoration of a substantive ethic in clinical bioethics. In particular, he has criticized the "values neutrality" approach in bioethics which, in effect, presupposes that moral beliefs are "mere preferences, changeable and malleable in the face of practical exigencies." In other words, "values neutrality" assesses ethical values as relativistic and situational and thus establishes "secular bioethics --- as the only acceptable 'values' in a pluralistic society."

Without doubt, this unresolved ethical conundrum targets the very nerve center of the contemporary national debate on embryonic stem cell research, cloning, and related issues involved with genetic engineering.

In other words, what shared moral values or commonly held ethical norms can be brought to the public forum?

In "Public Reason, Public Morality," (First Things, 2006), Robert P. George, McCormick Professor of Jurisprudence and director of the James Madison Program in American Ideals at Princeton University, delineates the current "contest of worldviews," which surfaces in "disputes over abortion, embryo-destructive research, and euthanasia, as well as in issues of sex, marriage and family life."  In a position aligned to that of Dr. Pellegrino, Professor George also traces the root causes of such controversies to incompatible philosophical differences about "the nature of morality and the proper relation of moral judgment to law and public policy."

Because "fundamental and nonnegotiable issues of justice are at stake," Professor George argues that "merely procedural solutions are not good enough."

Absent the ability "to make moral sense to one another," a pluralistic society will in the long run evolve from a "society of moral friends" to a "society of moral strangers" or of "spiritual aliens." This phenomenon is especially noticeable in the area of bioethics.

In "Can the Church Convincingly Engage American Culture?"(Church, Spring 2004), Father J. Bryan Hehir, a well-known expert on Church social teaching and public policy, recognizes a new dilemma that encumbers the Church in carrying out its teaching ministry on social issues. The traditional dialogic approach of identifying common ground based on a natural law strategy is becoming more troublesome. According to Father Hehir, the metamorphosis of culture is widening the distance "between our ability to advocate common ground on social, political and economic issues and our capacity to share moral wisdom on bioethical and sexual issues."

An argument can be made that the roots of the present ethical malaise stem from the erosion of ethics from its historic religious perspectives.

For instance, in “Bioethics: A Christian Approach in a Pluralistic Age” (1999), Scott B. Rae and Paul M. Cox map out an extensive overview of contemporary religious and secular approaches to bioethics. Traditional religious ethics has been concerned with substance, with moral right and wrong. Secular ethics tends to be value-neutral and oriented to a procedural morality. There is a risk, then, that correct procedures will override ethical criteria that are anchored in fundamental human goods as well as the common good.

The matrix for the public discussion of bioethical issues today is clearly affected by an unraveling of a consensus that a universal ethic for the life sciences is possible.

In his recent “No One Sees God: The Dark Night of Atheists and Believers” (2008) Michael Novak has entitled a chapter "The End of the Secularist Age." In a discussion on the topic of "A Universal Ethic of Reason?" Novak, who holds the Jewett Chair of Religion, Philosophy and Public Philosophy at the American Enterprise Institute, explains: "The distinguished philosopher Alasdair MacIntyre has observed that there is now so little common ground shared by the various schools of thought that rational debate has been reduced to exclamatory cheering sections erupting into ‘Hurrah!’ or ‘Boo!’”

Professor Novak concretely illustrates the destructive fallout from the impoverishment of moral dialogue in society: "Professors in countless classrooms in many disciplines report that students have already been well taught that, when they are faced with any moral proposition, the proper response is: 'That's just your opinion.' They aver: you choose your goods, and I'll choose mine.' "

The Catholic moral tradition stands at odds with such ethical relativism and subjectivism. The existence of an objective moral order, one that is rooted in reason and in revelation, is the foundation for the obligations which emanate from the demands of intrinsic human goods essential to human dignity.

Pope Benedict XVI, then Cardinal Joseph Ratzinger, spoke of a "dictatorship of relativism" in his homily on April 18, 2005, the opening day of the conclave following the death of Pope John Paul II. Moral relativism remains an overarching pastoral concern in the Holy Father's exercise of the Petrine ministry as Bishop of Rome .

In October 2007, the Holy Father addressed the members at the Plenary Meeting of the Pontifical International Theological Commission (ITC) who were preparing a document on the issue of the natural law.

The moral law is the “higher law,” the prism through which society judges the rightness of its civil laws, institutions and policies. By contrast, “legal positivism” attempts to conflate morality with legality.

Thus, Pope Benedict XVI observes that “a positivist conception of law seems to dominate many thinkers." Such a mentality claims "that humanity or society or indeed the majority of citizens is becoming the ultimate source of civil law." But, the Holy Father counters the argument that relativism serves as a guarantee for tolerance and mutual respect of citizens: "But, if this were so, the majority of the moment would become the ultimate source of law."

At that session, the Holy Father noted that the doctrine of natural law fulfills two essential goals. First, in the doctrine of natural law "the ethical content of the Christian faith does not constitute an imposition dictated to the human conscience from the outside but a norm inherent in human nature itself."

Secondly, and correlatively, the foundations of natural law, a law which is "in itself accessible to any rational creature" and sets forth conditions for engaging in dialogue "with all people of good will and more generally, with civil and secular society."

"In Search of a Universal Ethics: A New Look at Natural Law" was published in June 2009.  (At this point in time, translations of the ITC's document only exist in Italian and French editions.)

At the close of the year 2008, when the ITC's project was approaching the threshold of completion, Pope Benedict XVI reiterated again "the necessity and the urgency, in the present context, to create in culture and in civil and political society the indispensable conditions of the natural moral law."

At that December 2008 Plenary Session of the ITC, Pope Benedict XVI stressed the importance of the ITC's study as a catalyst for returning of a natural law methodology that embodies "the true guarantee offered to each one to live in freedom and in the respect for his dignity as a person, and to feel protected from any ideological manipulation and from all abuse perpetrated on the law of the strongest."

A rehabilitation of the metaphysical concept of the natural law stands as an antidote against the reductionism of legal positivism. A universal ethic can illumine the deepest reality of the meaning of the moral law, namely, that "being itself bears in itself a moral message and an indication for the paths of law."

(Back)