Theological basis -- Religion and health care -- The dignity of human life -- The integrity of the human person -- Implications for health care -- Theological principles in health care ethics -- Method -- The levels and questions of ethics -- Freedom and the moral agent -- Right and wrong -- Metaethics -- Method in Catholic bioethics -- Catholic method and birth control -- The principle of double effect -- Application -- Forgoing treatment, pillar one: ordinary and extraordinary means (...) -- Forgoing treatment, pillar two: killing and allowing to die -- Forgoing treatment, pillar three: decisions by competent patients -- Forgoing treatment, pillar three: decisions for incompetent patients -- Forgoing treatment, pillar three: advance directives -- Hydration and nutrition -- Physician-assisted suicide and euthanasia -- Medical futility -- Pain and pain management -- Ethics committees -- Embryonic stem cells and the beginning of human personhood -- Genetic engineering -- Allocating health care resources -- The use and misuse of the allocation argument. (shrink)

Karl Rahner’s analysis of genetic manipulation is found most explicitly in two articles written in 1966 and 1968: “The Experiment with Man,” and “The Problem of Genetic Manipulation.” The articles have received some attention in ethical literature. The present paper analyzes Rahner’s use of theological and ethical principles, comparing and contrasting the two articles. In the first article, Rahner emphasizes humankind’s essential openness to self-creativity. What has always been true on the transcendental level—-we choose our final destiny and thus create (...) ourselves—-may now be possible as well on the categorial or historical level. Thus we Christians have no a-priori theological warrant for rejecting genetic manipulation.But there is a considerable difference in Rahner’s second article. Whereas in the first he makes no immediate ethical application, in the second he introduces both a normative principle—-there ought never be a fundamental separation of procreation and marital intercourse—-and a metaethical concept--his “moral instinct of faith”—-to enable him to deal specifically with artificial insemination by third party donor, a procedure he rejects. There is also a shift in emphasis in his anthropological approach from the first to the second article.A close analysis of his method here discloses some difficulties concerning the “moral instinct of faith” and forces us to ask how principles of theological anthropology are and ought to be applied to questions like genetic manipulation. I conclude with my own proposal for the use of theological principles in medical ethics. (shrink)

Focusing on general texts of moral theology, this study investigates how Roman Catholic medical ethics emerged in North America as a developed and self-conscious discipline. It applies questions that Roman Catholic moralists have been pondering for centuries to the relatively new field of medical ethics.