Response to the 'Consensus Statement of the Working Group on Roman Catholic Approaches to Determining Appropriate Critical Care'.
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Biomedical subjects
Publications and source records attributed to S Hauerwas.
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Health care in this nation is becoming multitiered--with the poor in jeopardy of being excluded from even minimal care--because of the mistaken belief that money can buy unlimited health care for everyone. But our medical resources are finite, and choices must be made on how to distribute those resources. These choices should be based on a carefully reasoned concept of distributive justice; but even more important, they should be rooted in a Christian sense of community and in the conviction that service to others is more important than life itself. At least three basic models of justice can be identified. Market justice follows the general rule, To each according to his or her ability to pay. Merit justice holds that medical care should be apportioned relative to patients' efforts to stay healthy. Needs-based justice maintains that individuals' needs should be the sole criterion for allocating health care. Developing and testing such concepts of justice is necessary, but it is not enough. As those with economic and social power increasingly capture society's medical resources to keep their own deaths at bay through costly and extraordinary forms of treatment, Christians may well be impelled to take a stand in behalf of those who are being deprived of basic care. This stand may even include forgoing extraordinary treatment for themselves and accepting the appropriateness of their own deaths. Such a witness to the world, however, must be founded in faith and in Christian belief regarding the meaning of death.
Christians have so far failed to show why abortion is an affront to Christian convictions. Rather than arguing when life begins, Christians must show that Christianity as a way of life which recognizes God as Lord of life makes abortion unthinkable.
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Decisions regarding the care of deformed and retarded infants pose difficult ethical and moral dilemmas for both physicians and parents. Ethical inquiry regarding such questions must be concerned with how we see and understand the dilemma for conceptualization of the problem often shapes the decisions that are made. The fundamental issue that provides the background for the kind and amount of care defective newborns should receive is the obligation parents have to care for their children. New medical technology has so extended the limits of care that the extent of parental (and societal) obligation is unclear. In dealing with the problem of defective newborns, the action of both physicians and parents is determined in part by concern to act in a manner congruent with assumed roles and identity. With no moral consensus regarding the care of defective newborns, the doctor is put in a precarious position. What is revealed is how dependent medicine is on its underlying moral community to give it moral direction in instances of ambiguity and uncertainty.
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