In various places we have defended the position that a new human organism, that is, an individual member of the human species, comes to be at fertilization, the union of the spermatozoon and the oocyte. This individual organism, during the ordinary course of embryological development, remains the same individual and does not undergo any further substantial change, unless monozygotic twinning, or some form of chimerism occurs. Recently, in this Journal Jason Morris has challenged our position, claiming that recent findings in (...) reproductive and stem cell biology have falsified our view. He objects to our claim that a discernible substantial change occurs at conception, giving rise to the existence of a new individual of the human species. In addition, he objects to our claim that the embryo is an individual, a unified whole that persists through various changes, and thus something other than a mere aggregate of cells. Morris raises a number of objections to these claims. However, we will show that his arguments overlook key data and confuse biological, metaphysical, and ethical questions. As a result, his attempts to rebut our arguments fail. (shrink)

This book defends the controversial 'absolute view' of lying, which maintains that an assertion contrary to the speaker's mind is always wrong, regardless of the speaker's intentions. Whereas most people believe that a lie told for a good cause, such as protecting Jews from discovery by Nazis, is morally acceptable, Christopher Tollefsen argues that Christians should support the absolute view. He looks back to the writings of Augustine and Aquinas to illustrate that lying violates the basic human goods (...) of integrity and sociality and severely compromises the values of religion and truth. He critiques the comparatively permissive views espoused by Cassian, Bonhoeffer, and Niebuhr and argues that lies often jeopardize the good causes for which they are told. Beyond framing a moral absolute against lying, this book explores the questions of to whom we owe the truth and when, and what steps we may take when we should not give it. (shrink)

In this article, we first give a normative account of the doctor–patient relationship as: oriented to the good of the patient’s health; motivated by a vocational commitment; and characterized by solidarity and trust. We then look at the difference that Christianity can, and we believe, should, make to that relationship, so understood. In doing so, we consolidate and expand upon some claims we have made in a forthcoming book, Ethics and the Healing Profession.1.

This paper asks whether investigation into the ontology of the extended family can help us to think about and resolve questions concerning the nature of the family’s decision-making authority where organ donation is concerned. Here, “extended family” refers not to the multigenerational family all living at the same time, but to the family extended past its living boundaries to include the dead and the not yet living. How do non-existent members of the family figure into its ontology? Does an answer (...) to this question help to resolve questions about the distribution of authority within the extended family? (shrink)

Recent work done at the intersection of classical American pragmatism and bioethics promises much: a clarified self-understanding for bioethics, a modus vivendi for progress, and liberation from misguided and misguiding theories and principles. The revival of pragmatism outside bioethics in the past twenty years, however, has been of a distinctly anti-realist orientation. Richard Rorty, for example, has urged that there is no objective truth or good for philosophy to be concerned with. I ask whether the work in Pragmatic Bioethics follows (...) this perilous Rortyan trend. It will move towards anti-realism if its account of the good abandons any notion of truth or objectivity, and if, in its discussion of specific problems, it divides these problems into public and the private, urging consensus as the goal of the one, and an unconstrained notion of happiness as the goal of the other. In a final section, I suggest that bioethics done in the spirit of Royce's Philosophy of Loyalty might have much to offer to those dissatisfied with anti-realism. (shrink)

This book defends the controversial 'absolute view' of lying, which maintains that an assertion contrary to the speaker's mind is always wrong, regardless of the speaker's intentions. Whereas most people believe that a lie told for a good cause, such as protecting Jews from discovery by Nazis, is morally acceptable, Christopher Tollefsen argues that Christians should support the absolute view. He looks back to the writings of Augustine and Aquinas to illustrate that lying violates the basic human goods (...) of integrity and sociality and severely compromises the values of religion and truth. He critiques the comparatively permissive views espoused by Cassian, Bonhoeffer, and Niebuhr and argues that lies often jeopardize the good causes for which they are told. Beyond framing a moral absolute against lying, this book explores the questions of to whom we owe the truth and when, and what steps we may take when we should not give it. (shrink)

One strategy for arguing that it should be legally permissible to create human embryos, or to use of spare human embryos, for scientific research purposes involves the claim that such embryos cannot be persons because they are not human individuals while twinning may yet take place. Being a human individual is considered to be by most people a necessary condition for being a human person. I argue first that such an argument against the personhood of embryos must be rationally conclusive (...) if their destruction in public places such as laboratories is to be countenanced. I base this argument on a popular understanding of the role that the notion of privacy plays in abortion law. I then argue that such arguments against personhood are not rationally conclusive. The claim that the early embryos is not a human individual is not nearly as obvious as some assert. (shrink)

There are two perspectives available from which to understand an agent's intention in acting. The first is the perspective of the acting agent: what did she take to be her end, and the means necessary to achieve that end? The other is a third person perspective that is attentive to causal or conceptual relations: was some causal outcome of the agent's action sufficiently close, or so conceptually related, to what the agent did that it should be considered part of her (...) intention? Recent goods based views in ethics are divided as to whether only the first person perspective, or a mix of both perspectives, are necessary to understand intention and action. But resolution of the issue is necessary if goods based views are to be able to deploy to principle of double effect; for that principle requires an account of how to distinguish what is genuinely a matter of intention in human action from what is not. I argue that the pure first person account is better than the mixed account. (shrink)

Christopher Tollefsen; Non-Ecumenical Ecumenism, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 5, Issue 3, 1 January 1999, Pages 238–2.

The medical profession’s increasing acceptance of “physician aid-in-dying” indicates the ascendancy of what we call the provider-of-services model for medicine, in which medical “providers” offer services to help patients maximize their “well-being” according to the wishes of the patient. This model contrasts with and contradicts what we call the Way of Medicine, in which medicine is a moral practice oriented to the patient’s health. A steadfast refusal intentionally to harm or kill is a touchstone of the Way of Medicine, one (...) unambiguously affirmed by Christians through the centuries. Moreover, physician aid-in-dying contradicts one of the distinctive contributions that the Christian era brought to medicine, namely, a taken-for-granted solidarity between medical practitioners and those suffering illness and disability. Insofar as medical practitioners cooperate in aid-in-dying, they contradict this solidarity and undermine the trust that patients need to allow themselves to be cared for by physicians when they are sick and debilitated. (shrink)

The gap between Christian and secular bioethics appears to be widening, and inevitably so. In this essay, I identify four areas in which the differences between Christian and secular bioethics are significant, and in light of which secular bioethics, by its inability to attend to key concerns of Christian thought, will inevitably continue to marginalize the latter. How Christian bioethicists should view this marginalization will be the subject of the final section of this paper.

The author focuses on the potential for many healthcare institutions currently called ‘Catholic’ to lose their genuine Roman Catholic identity, and he offers suggestions for the future of the Catholic identity of Catholic healthcare institutions. The author then considers one particular task of the Catholic hospital, that of showing a preferential option for the poor. Some of the threats to this task are highlighted. The author concludes with some suggestions for the renewal of Catholic identity in Catholic healthcare institutions.

This paper critically explores the path of some of the controversies over public reason and religion through four distinct steps. The first part of this article considers the engagement of John Finnis and Robert P. George with John Rawls over the nature of public reason. The second part moves to the question of religion by looking at the engagement of Nicholas Wolterstorff with Rawls, Robert Audi, and others. Here the question turns specifically to religious reasons, and their permissible use by (...) citizens in public debate and discourse. The third part engages Jürgen Habermas's argument that while citizens must be free to make religious arguments, still, there is an obligation of translation, and a motivational constraint on lawmakers. The final section argues that even though Habermas's proposal fails, nevertheless he recognizes a key difficulty for religious citizens in contemporary liberal polities. Restoration of a full role for religiously grounded justificatory reasons in public debate is one part of an adequate solution to this problem, but a second plank must be added to the solution: recognition that religious reasons can enter into public deliberation not just as first-order justifications of particular policies, but as second-order reasons, to be considered by any polity that respects its religious citizens and, more broadly, the good of religion. (shrink)

In Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession, Thomas Cavanaugh focuses on performative aspects of the taking of the oath which bear upon the formation of that community we identify as the medical profession. In this paper, I suggest that we can go further than Cavanaugh does in identifying what the Hippocratic oath makes possible. Given its particular content and what it communicates, the oath makes possible, to a degree few other oaths could, and in a (...) way which might be significantly impaired by the absence of an oath, the form of community we have come to call the physician-patient relationship. In Section I, I will discuss Cavanaugh’s treatment of the oath’s relationship to the community of medical professionals. In Section II, I discuss at a relatively abstract level the relationship between communication and community. In Section III I show how the oath can additionally constitute the primordial moment in the existence of the physician-patient relationship. (shrink)

Doctors often refuse patients' REQUESTS, even when patients request interventions that are legal and permitted by the medical profession. This is a fact about the practice of medicine so familiar that it is easy to overlook.Doctors' refusals are neither new nor infrequent, and only a small minority occasion any controversy. Surgeons refuse to operate when they believe a surgery is unlikely to succeed. Physicians refuse medications when they believe the medications are unlikely to be helpful. Clinicians refuse requested interventions because (...) of concerns about safety or efficacy, and they refuse because of less tangible concerns that are no less real. Some pediatricians refuse to supplement the growth hormone of boys... (shrink)

Robert Koons and Matthew O’Brien have leveled a number of objections against the New Natural Law account of human action and intention. In this paper, I discuss five areas in which I believe that the Koons-O’Brien criticism of the New Natural Law theory is mistaken, or in which their own view is problematic. I hope to show, inter alia, that the New Natural Law approach is not committed to a number of theses attributed to it by Koons and O’Brien; that (...) their own view suffers from many ambiguities and difficulties; that passages from St. Thomas on which they draw to support their own view are in fact fully compatible with the New Natural Law account; and that neither the New Natural Law account of the controversial Phoenix abortion case, nor their account of the casuistry surrounding the acceptance of side-effects, is deficient in the ways asserted by Koons and O’Brien. (shrink)

Recent events concerning the guerilla journalism group Live Action created controversy over the morality of lying for a good cause. In that controversy, I defended the absolutist view about lying, the view that lying, understood as assertion contrary to one’s belief, is always wrong. In this essay, I step back from the specifics of the Live Action case to look more closely at what St. Augustine, and St. Thomas Aquinas, had to say in defense of the absolute view. Their approaches, (...) while rather different, are nevertheless, I believe, complementary, and cast light on both practical and principled reasons for thinking that lying is wrong, even for agood cause. In the final section of the paper, I discuss some of the challenges that a further defense of the absolute view would need to meet. (shrink)

Generic chaplaincy is the result of a devaluing of religious worship and belief to the merely instrumental and experiential. It is an expectable consequence of non-belief in the unique object that would render religious worship intrinsically meaningful and valuable. Generic chaplaincy has no place because all desire God, yet not all have found Him in the fullness with which He has revealed Himself to us, or even in the fullness with which we may be aware of Him through natural reason. (...) In consequence, not all are equally aware of God. A chaplaincy that challenges patients respectfully, and encourages spiritual growth and awareness, including the overcoming of sin and error, is appropriate. (shrink)

What is the relationship between scientific research and ethics? Some think that science should be free from ethical and political considerations. _Biomedical Research and Beyond_ argues that ethical guidance is essential for all forms of inquiry, including biomedical and scientific research. By addressing some of the most controversial questions of biomedical research, such as embryonic research, animal research, and genetic enhancement research, the author argues for a rich moral framework for the ethics of inquiry, based on the ideal of human (...) flourishing. He then looks at other areas of inquiry, such as journalistic ethics, and military investigation, to see how similar they are to the ethics of scientific research. Finally, he looks at the virtues that must play a role in any life that is devoted to research and inquiry as a vocational commitment. (shrink)

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.

I discuss three topics. First, there is a philosophical connecting thread between several recent trends in the abortion discussion, namely, the issue of our animal nature, and physical embodiment. The philosophical name given to the position that you and I are essentially human animals is “animalism.” In Section II of this paper, I argue that animalism provides a unifying theme to recent discussions of abortion. In Section III, I discuss what we do not find among recent trends in the abortion (...) discussion, namely “the right to privacy.” I suggest some reasons why the right to privacy is conspicuous by its absence. Finally, I address Patrick Lee's claim that the evil of abortion involves “the moral deterioration that the act brings to those who are complicit in it, and to the culture that fosters it.”. (shrink)

This paper has three parts; in the first, I look at the question, recently dis­cussed by Mark Murphy, of the role that God plays as an explainer of moral­ity. I argue for a form of explanation that is different from Murphy’s, though I wonder whether there is disagreement here, or simply difference of empha­sis. In the second part, I ask what difference Christianity—and specifically the idea that the Kingdom of heaven is our natural ultimate end—makes to us, as practical and (...) moral agents. I will argue that it makes both a moti­vational and a substantive difference. In the third part I will ask about the way normativity is related to God’s communication of normative matters to us, and I will do this specifically by asking what kinds of speech acts God engages in in communicating normative matters to us. The standard view is that God communicates to us in commands; however, I will suggest some other possibilities. (shrink)

The author shows how, by means of adoption, spouses become parents together and as the fruit of their marital love. The account serves two purposes. First, it allows a rebuttal of two types of objections to embryo adoption: that embryo adoption fails to respect the mutuality of marital love and that it in some way “constructs” parenthood. Second, the account makes it possible to recognize a deficiency in the way Dignitas personae understands embryo adoption, a deficiency indicated by the Instruction’s (...) discussion of embryo adoption in the context of “treatments for infertility.” The author suggests that the Instruction is guilty of a misuse of terms and possibly a misunderstanding of the nature of adoption as such. National Catholic Bioethics Quarterly 10.1 (Spring 2010): 75–85. (shrink)

A March of 2021 “Statement from Pro-Life Catholic Scholars on the Moral Acceptability of Receiving COVID-19 Vaccines,” released by the Ethics and Public Policy Center argued that in accepting one of the Covid vaccines that had recently become available, one would not be “in any way endorsing or con­tributing to the practice of abortion, or... in any way showing disrespect for the remains of an unborn human being.” That statement received criticism from some opponents of abortion. Here, I raise six (...) questions about the claims or implications of the “Statement” in order to defend it in its main assertions, correct it in some minor matters, and extend its analysis as needed. (shrink)

This collection of essays by some of the most prominent Catholic bioethicists addresses the Pope s statements, the moral issues surrounding artificial feeding and hydration, the refusal of treatment, and the ethics of care for those at the ...

Two hard cases have generated controversy regarding the application of the principle of double effect in recent years. As regards the first, the case of the conjoined twins of Malta, there has been considerable convergence: most natural law ethicists seem to agree that separation of the twins was morally permissible. By contrast, the so-called “Phoenix case,” involving an abortion at a Catholic hospital for a woman with pulmonary arterial hypertension, has become a touchstone of disagreement between defenders of the so-called (...) “new” natural law theory, and more “traditional” Thomists. I argue in this essay that, contrary to widespread opinion, the two cases were alike in the following respect: in neither need the principal agents have intended the death of anyone. (shrink)

In this paper, I argue that God never intends a human being’s death. The core argument is essentially Thomistic. God wills only the good; and human life is always a good, and its privation always an evil. Thus, St. Thomas holds that “God does not will death as per se intended,” and he gives an account of the act of divine punishment that conforms to this claim. However, some further claims of St. Thomas are in tension with this position – (...) particularly his claims as regards the permissibility of intentional killing by agents of the state. I argue that alternative conclusions on these matters are in fact more harmonious with St. Thomas’s claims about God and God’s willing than are his own. (shrink)

This new volume from the Polish Christian Philosophy in the 20th Century series focuses on Fr. Tadeusz Ślipko, S.J., born in Lvov, but for most of his academic life a professor in Krakow. His work spanned “general ethics,” concerned with the foundations of morality; “detailed ethics,” which includes both personal and social ethics; and bioethics, to which Ślipko was one of Poland’s earliest philosophical contributors. The volume under review contains two parts, the first serving as an introduction to Ślipko’s life (...) and thought, written by several Polish scholars, and the second containing excerpts from Ślipko’s main works. Most Anglo-American philosophers will be unfamiliar with this work, which is edited by Ewa Podrez and translated by Małgorzata Wójcik for the first time. (shrink)

In this essay, I discuss the role that vocation plays in assessing the proportion of burdens to benefits in end-of-life options. I then look at the case of patients in a persistent vegetative state. What vocational considerations are relevant for persons considering what care to accept should they ever be in a PVS or for those caring for patients in such a state? Ultimately, I argue that the vocational shape of a patient’s life ought not to be a consideration for (...) a caregiver in favor of removing artificial nutrition and hydration. (shrink)