Morality: medical topics
A 2008 Roman Catholic document:
Dignitatis Personae, "The dignity of a person"
About Dignitatis Personae:
The Roman Catholic Congregation for the Doctrine of
the Faith at the
Vatican released "Dignitas Personae" on 2008-DEC-12. 1,2 It is a new Instruction
"on certain bioethical questions" approved by the Pope Benedict XVI. It updates an earlier Instruction "Donum Vitae" issued by Pope
Benedict XVI on 1987-FEB-22 when he was Cardinal Joseph Ratzinger and Prefect of
the Vatican's Congregation for the Doctrine of the Faith.
It is unrelated to an earlier declaration on religious freedom with a
similar name, titled Dignitatis Humanae, issued in 1965.
The new Instruction was felt to be necessary because of the rapid growth over the past
two decades of both research and procedures in the field of bioethics. There
has been major growth in the areas of assisted reproduction technologies, pre-implantation genetic diagnosis (PGD), genetic
research, stem cell research, etc.
Perhaps the most recent bioethical concern involves organ transplants. Doctors
typically wait several minutes after death of the donor before starting to harvest
her/his organs. Some suggest that organs be harvested
prior to the actual death of the donor, assuming that the donor is:
unconscious, have no chance of regaining consciousness, have started the process
of death; and will certainly be dead within minutes. Studies have shown that
organs harvested a few minutes before actual death have a significantly greater
likelihood of being successfully transplanted. This would result in more lives
saved and/or much suffering reduced. However, the procedure raises significant
Catholic beliefs that form the foundation for the Instructions:
Both Instructions are based on a number of fundamental beliefs of the Roman Catholic church
that have a major impact on bioethics. These beliefs are collectively often
referred to as the "Gospel of Life." Some of them are:
A new human person starts at conception when a unique DNA
is formed within the pre-embryo. Her or his right to life begins at that time.
The instruction states:
"The human being is to be respected and treated as a person from the moment
of conception; and therefore from that same moment his rights as a person
must be recognized, among which in the first place is the inviolable right
of every innocent human being to life."
Other religions and secular systems of ethics promote alternate beliefs concerning the beginning of personhood.
Abortion at any time is a profound moral evil even if
it is needed to avoid the death of the pregnant woman. For example, in those rare
circumstances where a physician's choice is between:
An abortion which would probably result in life for the woman and would
certainly and intentionally cause the death for
the fetus, or
No abortion which would result in death for the fetus and almost certainly would also result in the woman's death,
only the latter is morally permissible. The physician is expected to administer
comfort care, and perhaps prayer for a miracle, but otherwise must only stand by as the woman and fetus die. This belief is based on the
Church's fundamental principle that it is never moral to perform an evil deed (e.g. an
abortion that would intentionally kill the fetus) in order to achieve a positive end (e.g.
preserve the life of the woman). Again, most or all other religions and ethical systems
disagree with these concepts. They tend to weigh the positive and negative
results for each option and select the most positive, or least negative.
Human personhood only ends at "natural death." Suicide and physician assisted suicide are profound moral
evils, even if the individual is dying in intense, continuous, and untreatable pain.
That is, a person may not morally commit suicide, nor may anyone help a person
Conception must occur within the the woman's body as the result
of sexual intercourse, which is only moral if performed between a woman and man
who are married to each other. The instruction states:
"The origin of human life has its authentic context in marriage and in the
family, where it is generated through an act which expresses the reciprocal
love between a man and a woman. Procreation which is truly responsible
vis-à-vis the child to be born must be the fruit of marriage."
Every act of sexual intercourse must be open to the possibility of
conception. The use of condoms is immoral even if needed to prevent the
transmission of a inevitably fatal STD like HIV -- the virus which causes AIDS.
Again, if one party is HIV positive, the other party must accept the possibility
of death with every sex act. The only other option is abstinence.
Some teachings of "Dignitatis Personae:"
Some procedures are considered acceptable:
Medical "... techniques which act as an aid to the conjugal act and its
fertility are permitted."
Certain techniques "... aimed at removing obstacles to natural
fertilization" are permitted.
Research into the prevention of sterility should be encouraged.
Adoption should be "... encouraged, promoted and facilitated."
The use of adult stem cells taken -- with due regard for safety -- from a human adult, umbilical cord
blood, or fetuses who have died of natural causes is licit.
Others are considered illicit:
In vitro fertilization: In this procedure, the husband's sperm
is mixed in a fertility lab with perhaps two dozen ova removed from the
wife. Typically, about four of the healthiest fertilized ova are selected and implanted in the woman's
womb in the hopes that one or more will cause a pregnancy. The Instruction
rejects this procedure because the unused fertilized embryos, who the church
consider to be full human persons, are discarded or frozen for potential
future use. All or essentially all will eventually die. The church cannot
find a "morally licit solution regarding the human destiny" of the hundreds
of thousands of "frozen" embryos currently in American fertility clinics.
Intracytoplasmic sperm injection (ICSI): This is a form of in
vitro fertilization in which a single spermatozoon or immature germ cells
taken from the man are physically injected into a ovum to produce conception.
This is also considered illicit because fertilization takes place in a lab "...
outside the bodies of the couple through actions of third parties whose
competence and technical activity determine the success of the procedure.
Such fertilization entrusts the life and identity of the embryo into the
power of doctors and biologists and establishes the domination of technology
over the origin and destiny of the human person."
Embryo reduction: Sometimes multiple pregnancies result from in vitro procedures. Physicians have sometimes recommended
that one or more embryos or fetuses in the womb be selectively aborted in order to
assure that the remaining embryos or fetus will not die and are born healthy. This is a form
of abortion and is thus considered illicit.
Pre-implantation genetic diagnosis (PGD):
This procedure involves an in vitro procedure. A single cell is taken from
each of the healtheist embryos and analyzed for genetic defects. The genes that cause hemophilia A and B, Huntington disease,
muscular dystrophy, cystic fibrosis, sickle cell anemia, and dozens of other
diseases can be detected. Only those embryos that are free of the disease
are implanted in the woman's womb.
This procedure avoids many abortions,
because many women who are aware that they or their partner is a carrier of
one of these serious diseases would otherwise decide to automatically abort any pregnancy. The PGD
procedure is also considered illicit by the church.
Interception and contragestation methods and medications: The
Vatican uses the term:
"Interception" to refers to methods that interfere "with the
embryo before implantation" and result in the death of the embryo. Emergency contraception (a.k.a. EC, Morning
After Pill, MAP) usually prevent the release of an ovum from a
ovary, or prevent conception. However, years ago, doctors believed that there was a slim chance that EC might prevent implantation, thus ending the life of an embryo. Subsequent research has indicated that this is extremely unlikely or impossible. However, the Church continues to reject this research.
Intrauterine Device (IUD) is an example of a real interception device.
"Contragestation" refer to methods that terminate pregnancy after
implantation of the embryo in the womb. The RU-286 abortion pill and surgical
abortions are two such methods.
All of these are considered: "... within the sin of abortion and are
Gene therapy: These offer potential dangers to the recipient
which must be considered.
Human reproductive cloning is "...
intrinsically illicit in that…it seeks to give rise to a new human being
without a connection to the act of reciprocal self-giving between the
spouses and, more radically, without any link to sexuality. This leads to
manipulation and abuses gravely injurious to human dignity."
Human therapeutic cloning is
also illicit because to "... create embryos with the intention of destroying
them, even with the intention of helping the sick, is completely
incompatible with human dignity, because it makes the existence of a human
being at the embryonic stage nothing more than a means to be used and
destroyed. It is gravely immoral to sacrifice a human life for therapeutic
By "human life" we assume they are referring to a pre-embryo or embryo or
fetus, all of which the church considers human persons. The hundreds of
millions of spermatazoon that a man releases during ejaculation and human
ova are forms of human life in that they are alive and contain human DNA.
But presumably the church does not consider their sacrifice a "gravely
Stem cells: Extracting cells from embryos cause the death of
the embryo, and is thus illicit. The use of such stem cells already
extracted by other researchers "... presents serious problems from the
standpoint of cooperation in evil and scandal."
Attempts at hybridization: This refers to embryonic research in
which the nucleus of a human ovum is removed and replaced with the nucleus
of a non-human species. This creates a pre-embryo from which stem cells may
be extracted. "From the ethical standpoint, such procedures represent an
offense against the dignity of human beings on account of the admixture of
human and animal genetic elements capable of disrupting the specific
identity of man."
Use of human "biological material" of illicit origin: This
typically involves the use of body parts from aborted fetuses in order to create
vaccines or other products. This may be considered licit under strictly
controlled conditions, if the need is sufficiently great.
The Instruction states that the Church does not directly enforce its beliefs concerning bioethics:
"The Church, by expressing an ethical judgment on some
developments of recent medical research concerning man and his beginnings, does
not intervene in the area proper to medical science itself, but rather calls
everyone to ethical and social responsibility for their actions."
However, this statement does not appear to necessarily extend from the church to agencies
controlled by the Church. For example, many Catholic
hospitals have a policy of refusing to dispense emergency contraception (EC; a.k.a. the
morning after pill) and/or of refusing to refer women to an agency where they can obtain EC.
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
- "Dignitatis Personae" The Vatican, 2008-DEC-08, at: http://www.vatican.va/
- "Regarding the instruction 'Dignitas Personae'," 2008-DEC-12, at: http://www.vatican.va/
Copyright © 2008 to 2010, by Ontario Consultants on
Originally published on 2008-DEC-24
Latest update: 2010-JUN-20
Author: B.A. Robinson