Catholic Physicians Research Articles

Philosophical and Moral Issues of Organ Transplantation at the Close of the Twentieth Century.

Editor's note: Organ transplantation and the associated ethical topics such as the criteria for brain death continue to be of critical interest to Catholics, both physician and lay. Thirty years ago, Fr. Joseph Howard took a look at the philosophical and moral aspects of organ transplantation, and his words are still relevant today. New, recent insights into the residual functioning of the brain in the face of extensive injuries pose an additional question for Catholic physicians: to what extent do we owe a duty to our patients to explain to them the nature of the uncertainties and debates surrounding both donation and transplantation, in order for them to make an informed decision for themselves or their loved ones? Linacre Quarterly. 1994 Nov;61(4):57-64.

The Analogate of the Divine Physician in the Clinic: Understanding the Christian Health Care Professional as a Symbol of Christ.

The Divine Physician is a traditional title that the Church gives to Jesus Christ. This metaphor helps symbolize Jesus's mission to heal our souls of sin and its effects. In this paper, I consider this metaphor as a source for understanding the vocation of the Catholic physician. Understanding that the role of the laity is to communicate the divine law to the world, I argue that this title raises the human physician's dignity to the status of an image of Christ's saving activity in the clinic. This paper roots this dignity in the supernatural life of grace by giving both a philosophical and a theological exposition of the metaphor of the Divine Physician.

Errand Into the Wilderness of Mirrors: Religion and the History of the CIA by Michael Graziano

Reviewed by: Errand Into the Wilderness of Mirrors: Religion and the History of the CIA by Michael Graziano Eva Payne Michael Graziano, Errand Into the Wilderness of Mirrors: Religion and the History of the CIA (Chicago: University of Chicago Press, 2021) Errand into the Wilderness of Mirrors examines the madcap and mundane ways that the US intelligence community sought to harness the power of religion to shape geopolitics. The book uses religious studies as both methodology and subject matter. Graziano frames the intelligence community much like a religious one—a group of people united by ideology and practices. He seeks to understand the worldview that shaped his actors' actions, much as scholars of religion do. But Graziano also focuses on why his historical actors thought that religion was the way to understand the people whom they wanted to control in the interest of US national security. The book traces the development of the "religious approach" to intelligence, a paradigm for understanding religions that paralleled the study of religion in the academy. While the book examines the faith that intelligence agents brought to their work, Graziano is more interested in how the religious approach shaped who the US intelligence community considered to be allies or enemies, how it attempted to sway nations to the side of the US and away from communism, and how it sold the subsequent conflicts to Americans at home. Organized chronologically, the chapters detail the shifting relationship between religion and US foreign intelligence organizations from WWII to the Iran hostage crisis. Chapter one shows how the founders of what would become [End Page 110] the Office of Strategic Services (OSS)—particularly Catholic William J. Donovan—brought a vision of American religious exceptionalism to US intelligence work from its inception. For Donovan, "religion was everywhere, free, and individual: a natural ally in war and diplomacy" (15), and the US was the place where religion had reached its apotheosis as a force for freedom. By developing an intelligence-sharing relationship between the Vatican and OSS, Donovan demonstrated to powerful Protestants that tolerating Catholicism was in the interest of national security, setting the stage for the post-War vision of the US as a bastion of religious pluralism. Chapter two tracks the growth of OSS-Catholic cooperation with Operation Pilgrim's Progress, through which the Catholic International Press shared on-the-ground intelligence from across Europe with the OSS. Chapter three surveys the US intelligence community's use of the religious approach to constrain Japanese imperialism in Asia. Intelligence officers saw Shinto and Buddhism as a means of understanding the "Japanese mind," while also stressing that those religions were incompatible with the Islam practiced by many in South Asia. They worked to convince Muslims to ally with the US and resist the Japanese by framing Islam and Christianity as siblings. Although President Truman dissolved the OSS in 1945, chapter four demonstrates that the religious approach lived on in the bureaucracies that superseded it as the intelligence community worked to fortify religion around the world. If the US was the land of religious freedom and pluralism, the logic went, then religious people everywhere would naturally ally with the US against communism. Chapter five details how the Central Intelligence Agency (CIA) capitalized on the discourse of a "Tri-Faith America" to muster support for the Vietnam War at home and abroad. Catholic physician Thomas Dooley launched a propaganda campaign to develop American sympathy for Vietnamese Catholics, which in turn reaffirmed the place of Catholics in American life, allowing the CIA to project the image of American religious pluralism back out to the world. Chapter six traces the CIA's move from a tri-faith model to the "World Religions Paradigm," mirroring a shift in the academy. As the US launched counterinsurgency campaigns in the Philippines and Vietnam, the CIA sought to understand "Orientals" by understanding practices such as divination and soothsaying, which they believed to be central to Asian religions. Chapter seven explains how the religious approach made US intelligence officials unable to see the coming of the Iranian Revolution. The CIA understood religion and politics as fundamentally separate, and religion to be essentially anti-communist and pro-US. They thus attributed...

Finding Joy in Being Counter-cultural: Lessons for Catholic Medical Professionals.

Catholic medical professionals face increasing challenges to adhering to the faith in the exercise of their professional functions. Growing opposition to traditional Church teaching-particularly with regard to issues of human sexuality and end-of-life care-threaten faithful Catholic clinicians with a form of "white martyrdom," characterized by loss of professional standing. Threats to rights of conscience come from various segments of contemporary society, including professional medical societies and publications that increasingly resemble strident activists rather than dispassionate and measured consensus-builders. Reflection on the relationship between counter-culturalism and joy can be a source of strength for those Catholic physicians facing opposition based on their adherence to the faith in their practice. A review of the historical developments of Christian medicine highlights its counter-cultural stance in contrast to the ancient Greco-Roman traditions that preceded it. Counter-cultural figures such as Ss. Cosmas and Damian, St Basil, and St Philip Neri serve as examples of courageous Christian counter-cultural witnesses in their times. Additionally, St Philip Neri's cheerful ministry in Rome also exemplifies Christian joy as a means of evangelizing in the midst of a culture in decline (as was the Eternal City in the 16th century). The lives of saints who suffered for the Faith remind us that being counter-cultural has consequences. While being called to "speak the truth in love" (Ephesians 4:15), Catholic medical professionals are to show compassion in words and actions as the singular signs of a faithful Christian.

Policy vs. Ethics.

Editor's Note: As Catholic ethics increasingly diverge from those of other religious traditions and from secular principles, it is important to explore how-if at all-Catholic physicians and institutions can work with those whose view of life and faith are very different. This article presents not only an historical vision of how the Ethical and Religious Directives came to be, it raises questions about just how Catholics go about moral reasoning when there are competing interests and principles at play. The author of the article, Warren T. Reich, was, at the time it was written, a Senior Research Scholar in Medical Ethics at the Kennedy Center for Bioethics, Georgetown University. He went on to be a founding member of the Kennedy Institute of Ethics. He was also founder and director of the Project for the History of Care, and is Distinguished Research Professor of Religion and Ethics in the Georgetown University Theology Department and Professor Emeritus of Bioethics in the Georgetown University School of Medicine. This article was prepared for delivery at the Annual Meeting of the National Federation of Catholic Physicians' Guilds, New Orleans, November 27. 1971. The issues he raises and the conflicts he perceives are as relevant now as they were 50 years ago. Reich, Warren T. (1972) "Policy vs. Ethics, "The Linacre Quarterly: Vol. 39: No. 1, Article 8. Available at: http://epublications.marquette.edu/lnq/vol39/iss1/8.

“The kind of doctor who doesn't believe doctor knows best”: Doctors for Choice and the medical voice in Irish abortion politics, 2002–2018

This article examines how the physician advocacy organization Doctors for Choice articulated a collective pro-choice “medical voice” over the course of sixteen years. This voice was central to the successful 2018 campaign to repeal Ireland's Eighth Amendment, which had imposed a virtual ban on abortion in the Republic of Ireland since 1983. I examine how DfC set itself in opposition to the powerful cadre of anti-abortion Catholic physicians who had dominated Irish public discourse on abortion for decades. DfC not only had to provide a strong alternative argument, but also had to distance itself from a legacy of physicians as gatekeepers to abortion. Based on oral histories and documentary sources, I argue that DfC developed a collective pro-choice “medical voice” and a politics of physician advocacy by leveraging the cultural authority of physicians and using discourses of medical expertise and patient autonomy. Doctors have been called upon to use their social position to fight health-related social inequality. By providing a detailed case study based on individual experiences of and perspectives on physician advocacy, this article examines the framework of “physician advocacy” in practice. It identifies affective and structural barriers to physician engagement in abortion politics across medical specialties. Finally, it considers how, in the face of these barriers, a small group of physicians helped to set the terms of a movement for accessible and equitable abortion care in Ireland.

Carried Along.

As a physician, the hardest days in medicine are when I endure great distance from the Lord in my bedside interactions with patients and families. They make me feel like driftwood without vocational direction. Given the enormity of what critically ill patients are experiencing, emotional detachment from Jesus and those I am serving creates swells of grief for me as a Catholic physician. In the intensive care unit, I tend to gravitate to big and bold occurrences. Unfortunately, one tendency I have is to think that small events yield small outcomes, while big events yield big outcomes. Such is not the case with God, whom I tend to force into finite scales when, in truth, the Creator of the universe has no limits. This essay highlights an experience in which God brought a deeper understanding of His grace from a seemingly monotonous patient encounter. I am reminded that because of God's presence in my relationship with each person, "Nothing shall be impossible." (Lk 1:37).

The Experience of Catholic Physicians

Catholic physicians who believe that the Church offers a positive, intellectually compelling, and beautiful religion have a unique experience in their work and life. These physicians often encounter a particular difficulty related to mischaracterization of Catholic doctrines as restrictive, impersonal, or even disrespectful of human freedom. Multiple physician stories are briefly recounted as examples of these experiences. This difficulty is most painfully encountered when professional colleagues absorb scandal, factual errors about the teachings, negative stereotypes, or incompatible ideologies. The Catholic physician can address this difficulty with tact, witness, and gentle discussion of Catholic doctrine and the natural consequences of ethical and ideological missteps in mainstream medicine.

Acts and distance—a commentary on Brummett's ‘when conscientious objection runs amok’

In his ‘When conscientious objection runs amok: A physician refusing human immunodeficiency virus (HIV) preventative to a bisexual patient’, Brummett has argued that Catholic physicians (or indeed any other healthcare practitioner) should not be able to raise conscientious objections to HIV pre-exposure prophylaxis for bisexual patients, as this constitutes discrimination. Brummett argues that such a conscientious objection represents an instance of conscience creep, which he argues is undesirable. Here I re-analyse the case presented by Brummett using a teleological framework and making reference to Catholic teaching on cooperation with evil. While I agree with Brummett that in this case the physician should not have had the right to conscientiously object, I argue that the teleological framework offers advantages over the argument Brummett has presented. I also comment on why only considering empirically measurable harm as a publicly defensible reason for one to hold a conscientious objection is problematic, as well as on the difficulties associated with cases of discrimination in a pluralistic society.

Non-Roman Catholic Physicians Should Be Permitted to Write Prescriptions for Birth Control in Roman Catholic Institutions

The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal respect as negative claims of conscience. This article argues that the prescription of birth control by non-Roman Catholic physicians in Roman Catholic institutions is an example of a positive claim of conscience that can overcome concerns of institutional values and resources, and therefore ought to receive the same ethical respect and legal protection as negative claims of conscience. In making this argument, this article also responds to several of the thoughtful comments raised by Alberto Giubilini and Dominic Wilkinson.

Mission Reborn in the COVID Crisis

The COVID crisis continues to affect many in ways which have led to health, economic, and personal loss of no small consequence. All of us have a unique and personal perspective on the pandemic. I share my experience as a front-line attending physician caring for critically ill COVID patients in the intensive care unit, and how it relates to the call of mission we receive as Catholic physicians.

Médicos-apóstoles de Cristo. La Sociedad Belga de San Lucas y la creación de una identidad médica católica, 1900-1940

This paper examines the medical identity propagated by the Belgian Saint Luc Society. By scrutinizing the society’s journal Saint-Luc Médical, it shows how the society forged and spread a model for being a Catholic physician, a ‘physician-apostle for Christ’. Our analysis reveals that lay apostolate, a central element of the interwar Catholic Action movement, was at the heart of this new professional identity. It imbued an older vocational discourse with decidedly Catholic views of doctors’ social responsibilities. The paper first places the society’s foundation within the broader history of Belgian medical sociability. Secondly, it looks at how the society functioned as a laboratory for unifying Catholicism and Medicine. Here physicians and theological advisors discussed and created Catholic infused medical ideas. Lastly, the article considers how society’s journal transmitted an image of the ideal physician to its readership. Catholic doctors reading Saint-Luc Médical were expected to follow strict deontological advice and theological guidelines. This way, the journal cultivated a sense of moral superiority towards non-religious colleagues.

A Catholic Perspective: Triage Principles and Moral Distress in Pandemic Scarcity.

Striving to be faithful to the moral core of medicine and to spiritual, moral, and social teaching of the church, Catholic physicians see their role as an extension of the healing ministry of Jesus. When faced with a situation in which a large number of gravely ill people are seeking care, but optimal treatment such as ventilation in intensive care unit cannot be offered to all because of scarcity of resources, Catholic physicians recognize the need to consider the common good and to assign a priority to patients for whom such treatments would be most probably lifesaving. Making these evaluations, physicians will use only objective medical criteria regarding the benefits and risks to patients and will be mindful that all persons deserve equal respect for their dignity. Discrimination or prejudicial treatment against patients based on factors such as age, disability, race, gender, quality of life, and possible long-term survival cannot be morally justified. Triage process should incorporate respect for autonomy of both the patient and the professional and opportunity for an appeal of a triage decision. Other principles and values that will affect how a triage protocol is developed and applied are proportionality, equity, reciprocity, solidarity, subsidiarity, and transparency. The current coronavirus pandemic can provide valuable lessons and stimulus for reforms and renewal.Summary:Catholic physicians strive to continue the healing ministry of Jesus Christ and be faithful to the moral core of medicine. In situations such as pandemic, the scarcity of personnel and technological resources create serious challenges and even moral distress. Church teachings on dignity, the common good and protection of the vulnerable help guide decisions based on public medical criteria and shared decision-making.

End-of-Life Options Act Fails to Protect Conscience Rights

In March 2021, New Mexico became the ninth state to legalize physician-assisted suicide. This practice, which allows medical professionals to aid in the intentional death of their patients, is counter to Catholic teaching. As such, it raises concerns regarding the conscience rights of Catholic physicians, as well as physicians who are morally opposed to the practice. In particular, while there ostensibly are protections for those who object, the requirement for physicians unwilling to aid in the deaths of their patients to refer said patients to physicians who will, essentially compels individuals to participate in an act that is intrinsically evil.

Mask and Ye Shall Receive.

A physician engages in a social media debate regarding mask-wearing during the COVID-19 pandemic and searches for truth and virtue, primarily charity. While wearing masks is commonplace and vital during the COVID-19 pandemic to those working in healthcare, the lay perspective on wearing masks is more varied and can be skewed by politicization, pseudoscience, and misinterpretation. The practicing Catholic physician serves as an important witness to the truth of science and Christ as the Way, the Truth, and the Life. The question of mask-wearing is transformed from merely being a scientific question to more of a moral and theological question.

The Journey Within.

A collection of short stories from medical school, graduate school and the first year of residency, with reflections on the personal transformation that occurs along the journey of practicing as a Catholic physician scientist.

Searching for Meaning with Victor Frankl and Walker Percy.

Victor Frankl's Man's Search for Meaning can enlighten clinical encounters for physicians to see patients on a search for meaning, particularly amidst suffering and tragedy in a post-modern world lacking transcendence. As shown in Walker Percy's literature, however, ultimate meaning can only be found in Christian faith where the Word became flesh and continues to dwell among us.

Counteracting Throwaway Culture in Daily Clinical Practice.

Pope Francis had defined a "throwaway culture" in which "Human life, the person, are no longer seen as a primary value to be respected and safeguarded." In this article we present two common situations encountered in clinical practice in which it is essential to counteract throwaway culture and embrace a culture of encounter: in working with patients who are isolation settings and those who require translation services. We conclude that, as Catholic physicians, it is our duty to ensure that we are working to counteract throwaway culture in our daily clinical practice by embracing and exhibiting a culture of encounter.

Should Positive Claims of Conscience Receive the Same Protection as Negative Claims of Conscience? Clarifying the Asymmetry Debate

In the debate over clinicians' conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians' conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on providing physician-aid-in-dying on the basis of conscience. This article outlines arguments against this asymmetry and critiques them for failing to distinguish between positive claims of conscience as positive or negative rights. I suggest the asymmetry debate should be focused on whether positive claims of conscience as positive rights ought to enjoy the same protections as negative claims of conscience. Clarifying the debate in this way helps elucidate some of the best reasons for the asymmetry, which these arguments have not addressed. This article does not take a definitive position on whether the asymmetry is justified, but attempts to bring some focus to the debate by directing arguments against the asymmetry to address the significant differences between positive claims of conscience as positive rights and negative claims of conscience.

Led by the Holy Spirit.

The vocational call to being a physician has been one of the greatest honors and blessings of my life. As a Catholic physician, being a direct extension of the healing hands of our Lord is something this is not easily translated into words. I reflect on two cases that remind me of this great calling.