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Christian bioethics as non-ecumenical.

A community's morality depends on the moral premises, rules of evidence, and rules of inference it acknowledges, as well as on the social structure of those in authority to rule knowledge claims in or out of a community's set of commitments. For Christians, who is an authority and who is in authority are determined by Holy Tradition, through which in the Mysteries one experiences the Holy Spirit. Because of the requirement of repentance and conversion to the message of Christ preserved in the Tradition, the authority of the community must not only exclude heretical teaching but heretical communities from communion. Understanding Christian bioethics requires a focus on the content of that bioethics in terms of its social context within a right-believing, right-worshipping community. Christian bioethics should be non-ecumenical by recognizing that true moral knowledge has particular moral content, is communal, and is not fully available outside of the community of right worship. The difficulty with Roman Catholicism's understandings of bioethics lies not just in its continued inordinate accent on the role of reason apart from repentance (as well as in its defining novel doctrines), but in Roman Catholicism's not recognizing that the contemporary, post-Christian age is in good measure the consequence of its post-Vatican II failure to call for a return to the traditional pieties and asceticisms of the Fathers so that all might know rightly concerning the requirements of Christian bioethics.

Abortion, Induced↗

Classical Anglican moral theology: unavoidably non-ecumenical.

In its specific moral conclusions ecclesiastical Anglican theology shares much with traditional Protestantism, Roman Catholicism, and Eastern Orthodoxy. In its understanding of the method and purpose of moral theology classical Anglicanism sometimes diverges from earlier Roman Catholicism -- and anticipates the most positive developments in contemporary Roman Catholic moral theology -- while sharing a common theological heritage with Rome in its understanding of natural law, the moral agent, and the moral act. Anglicans situate moral reasoning within the Church of the patristic Tradition, which distinguishes them from Protestants, yet do not accept the Roman magisterium's self-understanding. Consequently, the Anglican mode of moral reasoning has strong affinities with the Orthodox churches.

Bioethics↗

Determinants of infant and early childhood mortality levels and their decline in the Netherlands in the late nineteenth century.

OBJECTIVE: To study the relative importance of various determinants of total and cause-specific infant and early childhood mortality rates and their decline in The Netherlands in the period 1875-1879 to 1895-1899. DATA AND METHODS: Mortality and population data were derived from Statistics Netherlands for 16 towns and 11 rural areas. Mortality levels and their decline were estimated with a Poisson regression model. The associations of the estimated levels and declines, and determinants of infant and early childhood mortality were analysed using multivariate linear regression analysis. The causes of death studied were major contributors to infant mortality (convulsions, acute digestive disease, acute respiratory disease) and early childhood mortality (encephalitis/meningitis, acute respiratory disease, measles). RESULTS: Infant mortality rates were high in the south-western part of The Netherlands in 1875-1879. Due to a rapid decline in the western regions, this pattern changed to a north-south gradient in 1895-1899. Early childhood mortality showed an urban-rural gradient in 1875-1879 with mortality high in towns. This gradient had largely disappeared by 1895-1899, due to a rapid decline in mortality in towns. Roman Catholicism was significantly associated with infant mortality (particularly from diarrhoeal disease) in 1875-1879 and 1895-1899. The association with Roman Catholicism was stronger in 1895-1899 because mortality declines were less rapid in Roman Catholic areas in 1875-1879 to 1895-1899. Urbanization was significantly associated with early childhood mortality (particularly from respiratory disease) in 1875-1879 and 1895-1899. This association weakened over time, due to the rapid decline in mortality in towns. CONCLUSIONS: Different determinants of mortality (decline) were important in infant and early childhood mortality and they acted on different causes of death. Therefore, infant and childhood mortality should be studied separately. International comparison of the results showed that findings with respect to determinants of mortality (decline) for one country do not necessarily apply to other countries. The results for The Netherlands with respect to infant mortality differed from England and Wales.

Catholicism↗

Psychoanalysis and the Catholic Church in Italy: the role of Father Agostino Gemelli, 1925-1953.

Agostino Gemelli, a Catholic priest, psychiatrist, administrator, and educator, was an important figure in the early history of psychoanalysis in Italy. He was one of the few establishment figures to grapple with Freud's ideas in Italy during the first half of the twentieth century, a period during which Italy, compared to the rest of Europe and to the United States, was relatively impermeable to psychoanalysis. One of the factors that contributed to this was the opposition of the powerful Catholic Church, which identified in psychoanalysis a challenge to its authority. The author argues that Father Gemelli's shifting positions about psychoanalysis between 1925 and 1953 reflected the exigencies of his historical circumstances. Gemelli was able to identify in psychoanalysis an integrated view of the human condition in stark opposition to the brutal reductionism of psychiatry in Italy at that time, but also encountered in it elements intolerable to the Church. Examining specifically what it is that Gemelli could accept of psychoanalysis, and what needed to be rejected, between 1925 and 1953, illustrates the particular challenge posed by psychoanalysis to Catholicism in Italy.

Catholicism↗

Late fertility decline in the Netherlands: the influence of religious denomination, socio-economic group and region.

The factors affecting the modern decline in fertility in the Netherlands are explored using data from censuses from 1930 to 1971 and additional unpublished sources. Particular attention is paid to the influence of religion, socioeconomic status, and region. The author concludes that "a theory formulated by Lesthaeghe and Wilson on the relation between modes of production and secularization and the pace of fertility decline in Western Europe offers--in combination with van Heek's views on the special position of Dutch Roman Catholicism--a starting point for an explanation of why the fertility decline of Roman Catholics, self-employed and agricultural labourers lagged behind." (summary in FRE)

Agriculture↗

God's laboratory: religious rationalities and modernity in Ecuadorian in vitro fertilization.

Catholicism is the only major world religion that unequivocally bans the use of in vitro fertilization (IVF). Nevertheless, in Ecuador, Catholic IVF practitioners declare God's dominion over their IVF laboratories and clinics in explaining pregnancy outcomes. My analysis of this routine combination of spiritual and material causal models in Ecuadorian IVF contributes to two ongoing discussions about (1) the tensions between "institutional" and popular forms of Catholic religiosity and (2) the proper boundaries of science in modernity. The Catholic Church's historical and contemporary struggle to determine control of the miraculous has usually been characterized as a conflict between educated clergy and humble peasants. In the case of Ecuadorian IVF, we find, instead, educated elites and middle classes participating in this same contestation with the Church, proclaiming their direct ability to harness the power of God to effect material change on earth. This spiritual power to affect clinical outcomes does not take place just anywhere, but in clinic and lab, disrupting another set of presumptions about modern scientific practice and subjectivity. Like other Ecuadorian elites and middle classes, IVF practitioners are heirs to Enlightenment thought, and experience themselves as modern in their participation in these high-tech endeavors. But their spiritual approach to laboratory rationality does not trouble these IVF practitioners' experience of themselves as moderns, prompting a reevaluation of the narratives of scientific modernity that limit their scope to Europe and North America.

Attitude to Health↗

Abortion practices and attitudes in cross-cultural perspective.

This article presents an overview of abortion practices and attitudes in primitive societies and in Western civilization. The changing positions of the major world religions and nations are provided. Attention is given both to restrictions on abortion and to its active promotion, as exemplified by current conditions in the People's Republic of China. A brief history of abortion in the United States is presented, following by the results of two major polls on consumer attitudes. The latter data indicate a growing liberalization of abortion attitudes and an association between such liberal beliefs and the following factors: age under 40 years, higher education, non-Catholicism, irregular church attendance, and positive attitude toward sex education in the schools and availability of contraceptives for teenage girls. It is also shown that people who strongly oppose abortion are more likely than advocates of abortion to lend financial or other forms of tangible support to their cause.

Abortion, Induced↗

Psychosis or faith? Clinicians' assessment of religious beliefs.

This study investigated mental health professionals' assessment of the pathognomonic significance of religious beliefs. A total of 110 participants reviewed 3 vignettes depicting individuals possessing the religious beliefs associated with Catholicism, Mormonism, and Nation of Islam. The religious beliefs of the individuals in the vignettes were identified as either being integral to a religious tradition or not and also as either resulting in a threat to harm another or not. Identifying beliefs as religious resulted in lower ratings of pathology for 2 of the religions, and beliefs that did not involve a threat to harm also were rated lower for the same 2 religions. The results reveal a disjuncture between recommendations of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) and clinicians' judgments.

Adult↗

A Catholic perspective on organ sales.

In this article, I address the issue of the sale of human organs and the moral implications of a market in human organs under the aegis of Christian Bioethics. I argue that moral issues of this kind cannot be adequately be addressed from the point of view of moral frameworks, which point exclusively to procedural norms. Rather, a moral perspective must embody some substantive norms derived from a particular content-full moral or theological perspective. This substantive norms to which I appeal in this article are those of Roman Catholicism. The most important sources cited include the works of Pius XIi (1956) and the works of John Paul II (1985 and 1991). The conclusion reached is that not only is it morally permissible for Catholics to participate in a market in organ sales but it may also be prudent public policy.

Cadaver↗

Laying down one's life for oneself.

Roman Catholicism has long opposed suicide. Although Scripture neither condones nor condemns suicide explicitly, cases in the Bible that are purported to be suicides fall into several different categories, and the Roman Catholic tradition can show why some of these should be considered morally wrong and some should not. While Christian martyrdom is praised, it is not correct to argue that this Christian outlook invites suicide, or that it recommends physician-assisted suicide for altruistic motives. Church Tradition, from its earliest days, has clearly distinguished martyrdom from suicide. The principles of double effect and cooperation, mainstays in Roman Catholic moral theology, enable one to see the moral difference between martyrdom and suicide, and to appreciate why physician-assisted suicide is wrong for both patient and physician.

Altruism↗

The future of Catholic health care: observations from an Orthodox Christian perspective.

The author reflects on the future of Catholic health care by looking at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman. The author argues that (1) Roman Catholic teaching on the Trinity is defective, yielding an inadequate model of society, (2) Roman Catholic teaching on the Incarnation is defective, yielding an impoverished understanding of the "sacramental," and (3) the institutional orientation of Roman Catholicism combined with the lack of true sacramental vision makes it nearly impossible for Roman Catholic theory to criticize the current structure of health care financing.

Catholicism↗

Living the vision: health care, social justice and institutional identity.

This paper will examine the topic of identity in Roman Catholicism from the perspective of topics contained in or absent from mission statements of 25 Catholic health care institutions. In particular, I will look at these from the perspective of social justice as well as how this and other topics such as human dignity, sanctity of life, stewardship, pastoral care and the likelihood of mergers with other institutions will affect the healing ministry of Catholic health care providers. The article will conclude that there are three key dimensions to Catholic health care: leadership in advocating reform of the current health care system, care for the marginalized and under-insured, and the provision of pastoral care in all institutions.

Catholicism↗

Attitudes towards reproduction in Latin America. Teachings from the use of modern reproductive technologies.

The use of modern reproductive technology, such as in-vitro fertilization and its related procedures, has opened new areas of legal, religious and public concern. Thirty years ago, the development of effective methods to control procreation generated a debate on whether couples had the right to enjoy sex in the absence of its procreative effect. Today, assisted reproductive technology (ART) allows couples to have their own children in the absence of a direct intermediation of sex. The Catholic Church has reacted against both contraception and ART, and specific instructions have been directed to the public, the medical profession and legislators. In a recent survey, 88.4% of the population in Latin America claims to be Catholic; therefore, bioethical considerations and legal implications concerning intervention in reproduction are strongly permeated by the moral teachings of Catholicism. In 1996, 83 medical doctors and scientists, participating in the Latin American Network of Assisted Reproduction, produced a consensus document on ethical aspects and legal implications of ART. The document contains minimal ethical guidelines that Latin American professionals have decided to adhere to, even in the absence of legal regulations. This article examines how the medical profession, legislators and the public react to religious influence when confronted by difficult bioethical decisions such as the right to procreate.

Catholicism↗

Adult religiousness and history of childhood depression: eleven-year follow-up study.

This study investigates the association between childhood depression and the protective qualities of adult religiousness. Subjects were 146 (65 female and 81 male) adults with a history of childhood depression and 123 (61 female and 62 male) adults without a history of childhood depression interviewed as part of a long-term follow-up study (mean years of follow-up, 11.2; SD = 1.4). Depression in childhood and adulthood was assessed by blind and independent clinical interviews by using the Schedule for Affective Disorders for School Aged Children and the Schedule for Affective Disorders Life-time Version, respectively. Religiousness was assessed by report on the personal importance of religion, frequency of attendance of religious services, religious denomination, and child-adult concordance of report. Findings showed adult personal importance of religion to be associated with a decreased risk for depression in women without a history of childhood depression but an increased risk for depression in women with a history of childhood depression. Adult Catholicism as compared with Protestantism was associated with a decreased risk for depression in male childhood depressives, but this association was not found in men without childhood depression. The findings potentially suggest a reciprocal-influence process between childhood pathology and the development of religiousness.

Adolescent↗

Scrupulosity: religious attitudes and clinical presentations.

The attitudes of Catholicism and Judaism to scrupulosity are presented and the similarity between their management programmes and present-day behavioural psychotherapy is noted. Two famous cases are presented from 16th-century Europe and a further four cases from our 20th-century clinic in Jerusalem. Certain common features are noted, typical of obsessive-compulsive disorders, while some features, typical of scrupulosity, are best understood by considering both their religious and psychological importance.

Adult↗

"Natural family planning": effective birth control supported by the Catholic Church.

During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty.

Catholicism↗

The place for individual conscience.

From a liberationist, feminist, and Catholic point of view, this article attempts to understand the decision of abortion. People are constantly testing their principles and values against the question of abortion. Advances in technology, the rise of communitarianism and the rejection of individualism, and the commodification of children are factors in the way in which the abortion debate is being constructed in society. The paper offers solutions to end the ugliness of the abortion debate by suggesting that we would be able to progress further on the issue of abortion if we looked for the good in the opposing viewpoint. The article continues with a discussion of Catholics For a Free Choice's position on abortion, and notes firstly that there is no firm position within the Catholic Church on when the fetus becomes a person; secondly that the principle of probablism in Roman Catholicism holds that where the church cannot speak definitively on a matter of fact (in this case, on the personhood of the fetus), the consciences of individual Catholics must be primary and respected, and thirdly that the absolute prohibition on abortion by the church is not infallible. In conclusion, only the woman herself can make the abortion decision.

Abortion, Legal↗

The chapel and the operating room: the struggle of Roman Catholic clergy, physicians, and believers with the dilemmas of obstetric surgery, 1800-1900.

By 1800, the Roman Catholic Church and organized medicine faced the dilemma of how to resolve cases of obstructed births. American physicians usually practiced destructive operations, like craniotomy, in an attempt to save the lives of mothers. The church allowed such operations after the death of the infant. A new technique of surgery, the cesarean operation, offered hope that both patients would survive childbirth. Medical progress, and an emerging Catholic belief that the fetus was human, prompted Catholic physicians to advocate the new operation, and stirred a renewed debate among European theologians on the propriety of craniotomy. In America, the broad Christian tradition promoted by the Catholic Church began to inform medicine on the moral and ethical parameters of surgery. American physicians, for their part, engaged in their own debate on the propriety of the cesarean operation. This article, focusing on the cesarean debate, reveals the intersections of Catholicism and medical progress amid the growth of obstetric surgery from 1800 to 1900.

Abortion, Therapeutic↗