The Medical Profession’s War on Christian Ethics

Over a quarter century ago, Richard John Neuhaus coined the phrase “the naked public square” to describe efforts to drive religiously influenced values and their adherents out of public life and policy making. Neuhaus foresaw the intolerance of the “tolerant” hanging out a “practicing Christians/Jews please check your values here” sign. He also rightly pointed out that a naked public square was inherently undemocratic, disenfranchising the vast majority of Americans who did not voluntarily submit to a values tracheotomy, while leaving an ever-shrinking “society” of a minority to pretend that its little echo chamber was the “public consensus.”

Neuhaus looked at the big picture. I think we also need to examine what is occurring in sub-societies. I’m concerned about the “naked public ward” at the local hospital.

In the Journal of Medical Ethics blog of February 26, Brian Earp asks “Does religion deserve a place in secular medicine?” There are lots of people whose answer would be: “no!”

With all due respect, I’d rather ask what gives one school of “medical ethics” the right to decide?

Bioethics is, after all, a relatively recent phenomenon. It came to be more and more prominent starting in the 1970s.

Which is not to say that there were no bioethical dilemmas earlier. Catholic moral theology had a long history of a subfield called “medical ethics,” in which lots of ink had been spilled by the time bioethics began to come into its own. Nor should anyone be surprised: hospitals after all were—like universities—Catholic inventions.

But Catholic medical ethics was not especially supportive of the brave new world into which some researchers and their bioethicist friends were prepared to lead us. The bioethics issues of the 1960s—can you have sex without babies?—turned into the conundrum of the 1970s, represented by Dolly the Sheep and Elizabeth Brown—can you have babies without sex? In the middle of this arrived Roe et al. v. Wade with its highly unscientific nostrums feigning agnosticism about when life begins. Once death ceased being the physician’s enemy and a consumer’s choice, euthanasia also began garnering attention.

For those unwilling to be restrained by a medical ethics rooted in objective moral goods deserving of respect independently of the agent’s will, a new “bioethics” clearly was needed. Adopting either a version of (i) consequentialism or utilitarianism; (ii) a voluntaristic notion of “autonomy”; or (iii) some Kantian principles that could constrain only those not creative enough to circumvent them, a thriving industry was thus born which has since felled at least a minor rain forest.

The point is: bioethics in no small measure sought to displace religiously rooted medical ethics and, given the philosophical schools it preferred, in practice introduced the ethos of a “naked public square” into medicine (all the while acting like a secular priesthood vested in lab coats, repeating its own dogmas, chief of which is a wholly voluntaristic “autonomy”).

At first, on a theoretical level, these shifts may have had limited meta-impact. They had impact on particular patients, e.g., those hatched or dispatched by practitioners of the new art, but they had still not yet colored the overall atmosphere of the medical profession.

That is increasingly not true.

Back in 1988, I wrote an essay in America, “A Dilemma for Institutions with Consciences.” It was a reaction to a New Jersey Supreme Court death case (that Court was on the “leading edge” of “death with dignity” jurisprudence) in which a facility that objected to a particular course of non-treatment—one which would result in the patient’s death—was nevertheless forced to lend itself to the death process. I already asked back then whether an institution could have a conscience on which it could act. The writing was on the wall.

Obamacare is blamed in some quarters for the erosion of institutional conscience rights and it shares no small blame for that process. But, truth be told, the process really commenced in the 1980s when, amongst the misbegotten progeny of that metastasized judicial cancer called Roe v. Wade, numerous courts already decided that hospitals had to open their doors to abortions. One of the reasons why abortion clinics proliferated—and why their advocates so strenuously defend them against rational medical regulation—is that much of the medical profession did not want to be associated with the abortionist.

But, in much of life, the least commonly tolerated practice often aspires to become the normative lodestone. The refusal of so many physicians to sully their hands with the “right” that usually won’t speak its name resulted in various professional groups trying to force mandatory abortion training on medical schools (institutional conscience again) and students (individual conscience). There are already examples internationally of doctors refusing to perform abortions losing their positions. In the brave new world, you cannot not get involved: if you don’t perform an abortion because you honestly (and correctly) see this as killing, you will be professionally forced to send your patients—mother and child—to someone who will kill. Now, in the wake of the February 6 Supreme Court of Canada decision establishing a right to “physician-assisted death,” the professional group of Ontario physicians seems poised to compel doctors to perform—or refer—the killing of the aged, ill, or incapacitated.

All in the name of a voluntaristic “autonomy” that collapses all medical standards (especially in OB-GYN) into “what the patient-consumer wants is what the ‘responsible’ physician should provide.” And don’t try to go AWOL….

In the name of ethical pluralism while chafing at the limits of Catholic medical ethics, secular “bioethics” introduced its own axiological standards. Now, feeling more its oats, some of its practitioners appear quite ready to introduce an ethical monopoly: theirs. And they then ask whether “religion deserve[s] a place” in medicine.

Witold Stawrowski, the contemporary Polish philosopher, rightly calls the bluff on this axiological sleight-of-hand. Secularism, like religion, claims its absolutes, its worldview, and its control. Secularism, in other words, is just as much a religion as the confessions it seeks to exorcise. So why does it “deserve” a place—indeed, a privileged, controlling place—in medicine?

Editor’s note: The image above is a scene from the iconic 1931 horror film “Frankenstein” starring Boris Karloff as Frankenstein’s monster. 

John M. Grondelski

By

John M. Grondelski (Ph.D., Fordham) is former associate dean of the School of Theology, Seton Hall University, South Orange, NJ. All views expressed herein are exclusively his own.

  • Vinny

    “I have set before you life and death, the blessing and the curse.”

    For those interested in Catholic bioethics The National Catholic Bioethics Center is a good resource. One priest who’s work I’m familiar with through his articles in our Diocesan newspaper is Father Tad Pacholczyk. http://www.madisoncatholicherald.org/bioethics/list

  • DrollDog

    “institutional conscience “? Governments, corporations, institutions, etc… are intellectual abstractions. They don’t exist in the real world. They weigh nothing. They have no dimensions. To give them “conscience” or “rights” is absurd. At the most basic level it’s one person directly relating to another person, no more, no less. An individuals’ values can come into play within the context of these interactions. Don’t wave a magic wand over some buildings and documents and claim “institutional conscience”.

    • John Grondelski

      So if all the employees of a “Catholic” institution except for the administration don’t really care about prohibitions on euthanasia, do we just say it’s “rotten to the core” and not defend the “institutional conscience” of the facility–as contained in its Mission Statement–or say: non possumus?

      • DrollDog

        Your reply is non sequitur to my argument. In fact I contend it supports it.

  • Thomas Sharpe

    It is all very obvious now that widespread acceptance of contraception has led to: changing the definition of when life begins (now “implantation” and not conception), acceptance of abortion, acceptance of in vitro fertilization, acceptance of euthanasia….

    Now it seems to me, that unless the root cause of the disease is treated, the patient will not be made well.
    That is if we continue to treat the symptoms of the disease, and not treat the disease itself, things will get worse.

    That said, I have yet to hear a sermon on widespread contraception. The silence is deafening.

    • The separation of sex and procreation , I believe, has also lead to divorce and a lack of commitment to the sacrament of matrimony even when children are involved. If parenthood is optional before birth, the general feeling is that it should be optional after birth as well.

  • St JD George

    I had a Grandfather I never knew, but who was Christian Scientist and died at a young age refusing treatment for something that was initially a minor infection. Sadly he left a widow and three young children. Not a decision most of us would make, but I don’t judge him. On the other side, I know I would hate to be in a situation faced with making a life and death decision. On one side we have the culture of death who will be happy to assist anyone take their life who feels they just can’t cope. On the other side there are those that will go to any length or cost to prolong life, including without quality. I know there are counseling services to help in moments like those, particularly when there is grief and not in the best mind set to make decisions.
    In my journey of faith I’ve come to view life differently, particularly after studying the lives of many saints. Many, particularly those without faith, really fear end of life. Contrarily, those with deep faith don’t necessarily look forward to it, but are at peace and freely accepting of God’s will, looking forward to being united with him. I know I’m not a saint, but that is how I want to be. Content with having lived a fulfilled life in Christ, not looking to unnaturally prolong it, and hopeful to be with him.
    Unfortunately Doctors who have God complexes will never fully understand the divine creation they have before them to heal physically, including the gift of talents given them to be able to perform.

  • Michael Paterson-Seymour

    The kind of difficulties that those who seek to raise conscientious objections is well illustrated by a recent case in Scotland (Greater Glasgow Health Board (Appellant) v Doogan and another (Respondents))

    The Abortion Act 1967 provides that “no person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has a conscientious objection.”

    The courts have previously held that this covers both “being directly involved in the procedures a woman undergoes during the termination of pregnancy whether surgically or medically induced” and also providing pre-operative and post-operative care.

    This case involved two senior midwives (both Catholics), working in the labour ward of a Glasgow hospital, where some medical (as opposed to surgical) abortions were performed and the UK Supreme Court, reversing a unanimous judgment of the highest Scottish court (the Inner House of the Court of Session), held that the conscience clause did not cover such managerial tasks as “assigning staff to work with the patient, supervising and supporting such staff, and keeping a managerial eye on all the patients in the ward, including any undergoing a termination.” To quote an example given by the court, “ensuring that midwives on duty receive break relief, which may mean that the Labour Ward Co-ordinator provides the break relief herself – ensuring break relief is not covered but providing it oneself is covered.”

    In other words, midwives with conscientious objections to abortion will, in effect, be excluded from supervisory and managerial roles.

  • JERD2

    To your question, “So why does it “deserve” a place—indeed, a privileged, controlling place—in medicine?” the answer is that those persons in authority who have a secular orientation have power.

    In the absence of a shared ethic that finds its origin in a transcendent God, there is but one thing left to mold the morality of the population: power. More particularly, the power of those secular few who are privileged, exercised over those many who are religious and powerless.

  • Johnny Rango

    Sister Margaret Mary McBride is no longer excommunicated. However, she was excommunicated for allowing an abortion to a woman who would have died had the abortion not be performed. I judge that the secular view, which informed the Sister’s decision for the patient, was the right one.

    • Stephanie

      The pro-life (and the Church’s) view is that both lives should be treated equally. Neither mother nor baby is more important than the other and they are both the doctor’s patients. If there is no way for both to survive because the baby is too young/small to survive outside the womb (e.g. ectopic pregnancy) then the doctor should save the mother’s life.

      However, there need to be some clarifications.
      1. “Mental illness” is not an excuse for abortion. The mother needs counseling and possibly other help (housing, food, job, clothing, education, etc.), not to murder her child. Otherwise, any woman could claim she’s distressed and get an abortion for any reason.
      2. The way in which the pregnancy is terminated also matters. The baby should be treated with the dignity of a human person: removed in one piece, given baptism and held before he/she passes away (just like a premature baby who isn’t going to make it), and then a proper burial.
      The problem with these “abortions” is not only that they take an innocent life for a non-medically necessary reason but that they do not treat the unborn with the dignity they deserve as members of the human race.

      So in other words, the Church’s view is correct, but fallen human beings do make mistakes in how it is applied. Sister Margaret Mary McBride should not have “aborted” the baby (if it was by the usual means of poisoning or ripping it apart) but the pregnancy did need to end because neither mother nor baby would have survived. I also think that possibly the Church wasn’t given enough information to make an informed decision. If they thought a woman simply wanted an abortion, of course the people involved would be excommunicated. If they knew that both patients would die if the pregnancy continued, then it would not be “pro-life” at all to sentence both patients to death.

  • Jdonnell

    Catholic medical ethics are often seen as the equivalent of the Church’s position re. Galileo–as obstructionist and reactionary. Catholic ethics must take into account the realities of world population, end of life issues, etc. Unless it does, it will be further marginalized and its views on ethical matters will have about the same weight as Jehovah’s Witnesses views on blood transfusions.

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