Reviewed by: Catholic Health Care Ethics: A Manual for Practitioners ed. by Edward J. Furton Basil Cole O.P. Catholic Health Care Ethics: A Manual for Practitioners. Third Edition. Edited by Edward J. Furton. Philadelphia: Catholic Bioethics Center, 2020. Pp. xvii + 753. $49.95 (softcover). ISBN 978-0-935372-70-0. This work is not for beginners in the field of medical moral theology or Catholic bioethics. It presumes that one is already working in the medical field and knows some of the tools for appraising difficult moral questions about health. This reviewer can only indicate what he considers some highlights. This third edition contains studies by thirty-seven new authors, in addition to authors of the second edition whose articles were updated (to varying degrees). The volume consists of six parts with a total of thirty-nine chapters, some of which are divided into many subchapters written by different authors. Part I, "Foundational Principles," focuses on fundamental moral theology, with a new chapter on the Ethical and Religious Directives. Part II places new emphasis on "Health Care Ethics Services," and contains many articles on the importance of bioethical committees and consultation services for hospitals and dioceses. Part III addresses beginning-of life issues such as family planning. Part IV turns to end-of-life issues with some very deep reflections on determining death, care of the dying, advance directives, and solutions to controversies surrounding burial of corpses or the fetal remains of those who perished in the womb, whether by deliberate abortion or otherwise. Part V, "Selected Clinical Issues," attempts to unravel difficult problems, such as concerning organ donation and vaccination development based on previously aborted fetuses or human experimentation, and the interplay of patients with those who care for them. Finally, Part VI, titled "Institutional Issues," discusses, among other problems, the hospital care of newborns, collaborative work with other hospitals, conscientious objections, and gender dysphoria. Due to the size and scope of newer problems facing Catholic bioethics and healthcare, not all pertinent difficulties are, or could have been, included in this admittedly ample third edition. [End Page 493] What happened that such a large amount of bioethical thinking was needed in such a short period of time since the second edition, published in 2009? Scientific discoveries and medical cure and care advances remind us that some parts of ethical thinking are not absolute or stable because new dilemmas emerge, although the cardinal and theological virtues remain the same. Saint Thomas Aquinas, as well as common sense, teaches that one's first natural inclination that guides the desire for happiness is to remain and flourish in existence notwithstanding certain limitations such as illness and death (STh I-II, q. 94). This inclination is the basis for all healthcare and one of the first principles of bioethics. Medical decisions are governed by the principle of totality, that a part of the human body can be sacrificed for the survival and well-being of the whole (STh II-II, q. 65, a. 1). But in practice, medical decisions can be morally right or wrong insofar as they uphold or violate other principles of human flourishing. The order, or teleology, of human nature, knowable by reason and confirmed by divine revelation, contains standards, rules, precepts, and commands, not merely ideals, that indicate what kinds of medical behavior violate the moral domain of a person and the fundamental goods of human nature. Some medical interventions are wrong, not because the Church says so (as if they were simply edicts), but because certain natural goods are diminished, impeded, or harmed within the human person, thereby undermining the dignity of the human person as an image of God. While "autonomy," "beneficence," "nonmalfeasance," and "justice to others" are standard value words that today's hospitals apply to good health care for individuals, these notions do not define what is to be done in a clinical situation. The value of autonomy, for example, could lead a patient to desire something such as euthanasia, which violates the autonomy of the Catholic hospital and a doctor's conscience. Some systems of bioethics have added health maximalization, efficiency, and proportionality to the traditional principalism of Tom Beauchamp and...
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