Connecticut church passes genetics resolution.

KIE: The Connecticut Conference of the United Church of Christ, which represents the largest Protestant denomination in the state, has passed a resolution affirming an ethical duty to do research on human gene therapy and is planning to form local church groups to study the scientific and ethical issues involved. The resolution is intended to counter an earlier one proposed by Jeremy Rifkin to ban all efforts at engineering specific traits into the human germline. The Rifkin proposal had been endorsed by a large number of religious leaders, including the head of the U.S. United Church of Christ, but was subsequently characterized by many of the church leaders as overly restrictive.^ieng

Clerics urge ban on altering germline cells.

KIE: A resolution calling for a ban on genetic engineering of human reproductive cells has been signed by leaders of almost every major church group in the United States. Some of the religious leaders, while not certain that a total moratorium should be placed on altering germline cells, signed the statement in order to stimulate public debate on the issue. Legislation has recently been introduced in Congress to set up a committee to monitor genetic engineering and its human applications, but author Jeremy Rifkin, the impetus behind the church leaders' resolution, argues that such tampering threatens the gene pool and should be banned altogether.^ieng

Hospital religious affiliation and emergency contraceptive prescribing practices.

With access to reproductive health care eroding, examination of prescribing of contraception, including emergency contraception (EC), is important. We examined whether working in a family practice affiliated with a religious institution changes the likelihood of a provider prescribing EC. Our survey asked about EC prescribing practices in a range of situations. As predicted, practitioners in non-religiously affiliated practices reported higher rates of prescribing EC than those in religiously affiliated practices. In both cases, however, the practitioners' prescribing patterns were inadequate.

Stem cell research in a Catholic institution: yes or no?

Catholic teaching has no moral difficulties with research on stem cells derived from adult stem cells or fetal cord blood. The ethical problem comes with embryonic stem cells since their genesis involves the destruction of a human embryo. However, there seems to be significant promise of health benefits from such research. Although Catholic teaching does not permit any destruction of human embryos, the question remains whether researchers in a Catholic institution, or any researchers opposed to destruction of human embryos, could participate in research on cultured embryonic stem cells, or whether a Catholic institution could use any therapy that ultimately results from such research. This position paper examines how such research could be conducted legitimately in a Catholic institution by using an ethical analysis involving a narrative context, the nature of the moral act, and the principle of material cooperation, along with references to significant ethical assessments. It also offers tentative guidelines that could be used by a Catholic institution in implementing such research.

When patients choose faith over medicine: physician perspectives on religiously related conflict in the medical encounter.

BACKGROUND: Patients at times disagree with medical recommendations for religious reasons. Despite a lively debate about how physicians should respond to patients' religious concerns, little is known about how physicians actually respond. We explored the ways in which physicians interpret and respond to conflict between medical recommendations and patients' religious commitments. METHODS: One-to-one, in-depth, semistructured interviews with 21 physicians from a range of religious affiliations, specialties, and practice settings. Interviews were transcribed, coded, and analyzed for emergent themes through an iterative process of textual analysis informed by the principle of constant comparison. RESULTS: Conflict introduced by religion is common and occurs in 3 types of settings: (1) those in which religious doctrines directly conflict with medical recommendations, (2) those that involve an area in which there is extensive controversy within the broader society, and (3) settings of relative medical uncertainty in which patients "choose faith over medicine." In response to such conflict, physicians first seek to accommodate patients' ideas by remaining open-minded and flexible in their approach. However, if they believe patients' religiously informed decisions will cause them to suffer harm, physicians make efforts to persuade patients to follow medical recommendations. CONCLUSIONS: When religiously related conflict arises, physicians appear to intuitively navigate a tension between respecting patients' autonomy by remaining open-minded and flexible and seeking patients' good by persuading them to follow medical recommendations. In such contexts, religion and medicine are intertwined, and moral counsel inheres in physicians' medical recommendations.

Natural law Judaism? The genesis of bioethics in Hans Jonas, Leo Strauss, and Leon Kass.

Leon Kass is much misunderstood. He is not simply a Republican ideologue who tailored his ideas to break out of the ivory tower and into the halls of power. Nor does he look simply to use human nature as a moral guide. When the full range of his writings is considered and set in the tradition of his teachers, Hans Jonas and Leo Strauss, what emerges is a natural law position colored by religious revelation.

Stopping nutrition and hydration technologies: a conflict between traditional Catholic ethics and church authority.

This article focuses on the troubling effects of the secular values of individual freedom and autonomy and their impact on laws regarding suicide and euthanasia. The author argues that in an increasingly secularized culture, death and dying are losing their meaning and are not thought of within a moral framework. The debate regarding the provision of artificial nutrition and hydration is critically considered in light of the history of Catholic morality as well as within the modern healthcare context, and finally with new insight from the recent statements made by the late pope. Drane argues that the pope's insistence on providing artificial nutrition and hydration despite irreversible persistent vegetative states in unconvincing.

Reflections on the papal allocution concerning care for persistent vegetative state patients.

This article critically examines the recent papal allocution on patients in a persistent vegetative state with regard to the appropriate conditions for considering "reformable statements." In the first part of the article, the purpose and meaning of the allocution are assessed. O'Rourke concludes that give consideration of the individual patient's best interest, prolonging artificial nutrition and hydration is not, in every case, the best option. Although he stresses favorability for preservation of the life of the patient through artificial nutrition and hydration, costs and benefits to the patient should be weighed. Ultimately, he argues in favor of leaving the decision to the patient, his caregivers, and others immediately involved in the case.

On the impermissibility of euthanasia in Catholic healthcare organizations.

Roman Catholic healthcare institutions in the United States face a number of threats to the integrity of their missions, including the increasing religious and moral pluralism of society and the financial crisis many organizations face. These organizations in the United States often have fought fervently to avoid being obligated to provide interventions they deem intrinsically immoral, such as abortion. Such institutions no doubt have made numerous accommodations and changes in how they operate in response to the growing pluralism of our society, but they have resisted crossing certain lines and providing particular interventions deemed objectively wrong. Catholic hospitals in Belgium have responded differently to pluralism. In response to a growing diversity of moral views and to the Belgian Act of Euthanasia of 2002, Catholic hospitals in Belgium now engage in euthanasia. This essay examines a defense that has been offered of this practice of euthanasia in Catholic hospitals and argues that it is misguided.

James Drane's More Humane Medicine: a new foundation for twenty-first century bioethics?

James Drane's More Humane Medicine: A Liberal Catholic Bioethics is an outstanding contribution to the study of bioethics in our day. Catholics and others who are interested in the issues discussed here will benefit from this masterful treatment. The author opens with a set of definitions, starting with what he means by a "more humane medicine." Drane contends that a more humane medicine has become necessary and desired, but not because the traditional medical ethic as "a self-declared and self-imposed ethic, outlining what noble service to others entails" is no longer valid. Rather he defines it as an advance on the traditional ethic; a "new foundation" based on a "lived set of obligations derived from a felt commitment to other persons ... an ethics based on the relationship between doctors and patients and essentially an ethics of virtue." Drane's work is a "liberal Catholic Bioethics" in which he challenges his own faith tradition, the Roman Catholic Church, on such topics as sexuality, birth control, abortion, cloning, stem cell research, aging and dying, and euthanasia and physician-assisted suicide. The present article is a critical essay that analyzes the author's statements and conclusions.

Life history, sin, and disease.

On the basis of experiences in pastoral hospital care, the relationship between disease, sin, and guilt in the life of patients is explored. Against the disregard of this subject in medicine, and even in most of pastoral care, it is argued that patients' interest requires that their hidden or manifest questions be addressed, rather than their being exposed to efforts at "helping" through mere attempts at "debt clearance." Only by openly confronting sin and guilt can the patient be taken seriously in his role as subject of his disease. Theological and anthropological background considerations revealing the essence of sin as a disruption or even destruction of the Divine gift of life in its realization through a lived relationship to God and other humans are offered as evidence for this claim.

Not without hope: a Reformed analysis of sickness and sin.

A Reformed understanding of sickness requires that connections be drawn between the structural effects of sin and the ways that sickness is experienced in people's lives. Such an understanding can be an important resource for the bioethicist, both the bioethicist who speaks from the Reformed tradition and the bioethicist who speaks to patients and caregivers who may assume that sin and sickness are connected, but may understand that linkage in overly simplistic ways.

On the connection between sickness and sin: a commentary.

In response to the articles by Eibach and Groenhut in this issue, I argue that there is a general connection between sickness and the entrance of sin into the world. There are times when there is a causal link between more specific sin and sickness, though often the patient is the one who has been sinned against. Illness can also expose sin in a patient's life. Integrating the reality of illness into the life history of a patient is a significant pastoral care issue and can be done with humility and sensitivity if done in accordance with the teaching of Job and Ecclesiastes. These books argue that "under the sun" or this side of eternity, human beings can't grasp the coherence of life, including the "why" of illness. Rather, God provides His loving presence, through His people as a comfort to those suffering from illness.

Disease, suffering, and sin: one Anglican's perspective.

This article explores some of the implications of understanding sin as failure of perception. The theological underpinning of the argument is the choice made in the Garden of Eden to eat the fruit of the tree of knowledge rather than the fruit of the tree of life, or wisdom. This has led to distorted perception, in which all things are seen as having separate, independent existences rather than joined together by their common divine source and their deep interrelatedness in the covenant made with God. The article discusses the fascination with the principle of respect for autonomy in the light of this theology. It also looks at perceptions of the HIV/AIDS crisis in Africa. It finishes with a definition of repentance that makes right perception possible.

Sin, sickness, and salvation.

This article seeks to provide commentary and rationale for Orthodox Christian rites and prayers for the sick as found in the Euchologion, or Book of Needs. The reader needs to understand that the prayers of the Orthodox Church prayed at times of sickness and suffering will often strike the non-Orthodox as harsh and even unjust. References to God willing suffering do not sit well with most Western Christians. However, this is the Orthodox Christian belief, and it is expressed in the prayers of the Orthodox Church. Sickness and suffering are understood to be avenues of salvation and a participation in the glory and joys of the resurrection of Christ and life in the Kingdom of God. This is why the Orthodox Church teaches her faithful to accept suffering as something that has the potential to bring them further along in the process of theosis.

Why patients should give thanks for their disease: traditional Christianity on the joy of suffering.

Patristic teaching about sin and disease allows supplementing well-acknowledged conditions for a Christian medicine with further personal challenges, widely disregarded in Western Christianities. A proper appreciation of man's vocation toward (not just achieving forgiveness but) deification reveals the need to cooperate with the Holy Spirit's offer of grace toward restoring man's pre-fallen nature. Ascetical exercises designed at re-establishing the spirit's mastery over the soul distance persons from (even supposedly harmless) passion. They thus inspire the struggle towards emulating Christ's (self-crucifying) kenotic love, and to accept even secularly "undeserved" suffering as spiritually deserved in view of his (forever) lacking fervor in that struggle. Only in the spirit of that love can the evil Adam's sin brought into this world work its therapeutic impact, the eschatological purpose of which explains God's lovingly permitting that evil. This therapeutic impact is physically manifested already in this life through the transforming energies granted the saints of the church.

Fission and confusion.

Catholic opponents of abortion and embryonic stem cell research usually base their position on a hylomorphic account of ensoulment at fertilization. They maintain that we each started out as one-cell ensouled organisms. Critics of this position argue that it is plagued by a number of intractable problems due to fission (twinning) and fusion. We're unconvinced that such objections to early ensoulment provide any reason to doubt the coherence of the hylomorphic account. However, we do maintain that a defense of ensoulment at fertilization must deny that we're essentially organisms.

Fission, fusion, and the simple view.

In this essay, I defend three Simple Views concerning human beings. First, that the human embryo is, from the one-cell stage onwards, a single unitary organism. Second, that when an embryo twins, it ceases to exist and two new embryos come into existence. And third, that you and I are essentially human organisms. This cluster of views shows that it is not necessary to rely on co-location, or other obscure claims, in understanding human embryogenesis.