Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...) organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

Jennifer Blumenthal-Barby argues the concept of personhood is “unhelpful” and “at worst it is harmful and pernicious” (2024, 3). While I share her concerns about how modern bioethics uses personhoo...

The metaphysical status of the placenta has bearing on several ongoing discussions within Catholic moral theology. Numerous bioethicists and theologians have touched on this topic briefly, but to date no robust metaphysical argument appears in the literature. The authors aim to provide such an analysis. First, they provide an overview of the existing literature on the topic. Second, they briefly review the anatomy and physiology of the placenta. Third, they provide metaphysical and biological reasons why the placenta cannot be a (...) part of the fetus, a part of the mother, simultaneously a part of both, the border at which mother and fetus meet, or a separate individual substance. Finally, they provide reasons that support their claim that the placenta is a quasi-substance that exists in symbiosis with mother and child. National Catholic Bioethics Quarterly 14.2 : 295–333. (shrink)

The Catholic moral tradition has a rich foundation that applies broadly to encompass all areas of human experience. Yet, there is comparatively little in Catholic thought on the ethics of the collection and use of data, especially in healthcare. We provide here a brief overview of terminology, concepts, and applications of data in the context of healthcare, summarize relevant theological principles and themes (including the Vatican’s Rome Call for AI Ethics), and offer key questions for ethicists and data managers to (...) consider as they analyze ethical implications pertinent to data governance and data management. (shrink)

In this essay, some of the signatories to “Medical Intervention in Cases of Maternal–Fetal Vital Conflicts: A Statement of Consensus” respond to “The Placenta as an Organ of the Fetus: A Response to the Statement of Consensus on Maternal–Fetal Conflict,” both recently published in this journal. The response examines Bringman and Shabanowitz’s claims and assumptions about the morally relevant pathologic condition in some cases of peripartum cardiomyopathy complicated by a subsequent pregnancy, the moral status of a normally functioning placenta, and (...) the use of the principle of double effect in these cases. The signatories’ response sets out to demonstrate how Bringman and Shabanowitz do not engage the essential points of the statement of consensus and how their argument is premised on false assumptions. National Catholic Bioethics Quarterly 15.2 : 241–250. (shrink)

At the 2022 Clinical Ethics Unconference, the authors perceived a significant lack of racial and ethnic diversity, which was consistent with their experiences in other clinical ethics settings. As a result, they convened a working group to address the pervasive lack of diversity present in the field of clinical ethics and to propose strategies to increase the representation of people from racial and ethnic minority populations. This article identifies the harms associated with the lack of diversity in the healthcare setting (...) and translates these to the field of clinical ethics. The article then proposes a framework that may be used to help diversify the field of clinical ethics. Specifically, the authors identify existing barriers to appropriate diversity, actionable steps to increase diversity, and tools the field can utilize to systematically assess its progress with respect to achieving diversity. (shrink)

Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian (...) cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine whether the benefits are proportionate to the risks in a particular case. (shrink)