Jason Eberl

Stephen R. L. Clark has authored twelve books covering three philosophical themes: religion, duties toward animals, and politics—“Unfortunately, however, those familiar with one realm of his work, tend not to be familiar with what he has done in other areas”. Even those who may be familiar with the whole of Clark’s corpus may find it difficult to discern a coherent philosophical message among these disparate themes. Dombrowski seeks to present a comprehensive overview of Clark’s thought, and to elucidate Clark’s primary philosophical concerns and prejudices, which run through all his works. However, Dombrowski’s admiration for Clark’s philosophy does not preclude him from offering his own unique analysis and critique.

Thomas Aquinas was concerned with developing a metaphysical account of the article of Christian faith which asserts that a human person will experience a bodily resurrection at some point after death. This article of faith is prima facie in line with Aquinas’ Aristotelian assertions that a human soul is incorruptible per se and that it is in its natural state only when it is united to a material body of which it is the informing principle. But how is personal identity maintained between the pre-mortem union of body and soul, the soul in its separated state, and the post-resurrection union of body and soul? In this paper, I will address and attempt to show Aquinas’ answer to this question and its dependence on his metaphysics.

I support Abram Brummett’s contention that there is a need for secular clinical ethics to acknowledge that various positions typically advocated for by ethicists, concerning bedside decision-making and broader policy-making, rely upon metaphysical commitments that are not often explicit. I further note that calls for “neutrality” in debates concerning conscientious refusals to provide legal health care services—such as elective abortion or medical aid-in-dying—may exhibit biases against specific metaphysical claims regarding, for instance, the ontological and moral status of fetuses or the valuing of the phenomena of life, suffering, and dying/death, as constitutive of medicine’s internal morality as a profession. I conclude that there is an operative distinction between metaphysical views founded essentially upon religious tenets and those founded upon rationally defensible premises.

We argue against Christopher Meyers’s call for clinical ethicists to participate in deceiving patients, surrogate decision-makers, or family members. While we acknowledge that some forms of deception may be ethically appropriate in highly circumscribed situations, the type of case Meyers describes as involving justifiable deception differs in at least two important ways. First, Meyers fails to distinguish acts of deception based on the critical feature of who is being deceived—patient, surrogate, or family member—and the overarching duty to respect the autonomy of relevant decision-makers to make rationally-informed decisions. Second, Meyers’s analysis relies on an assessment of harm, a value-laden concept which health care professionals and ethicists should not presumptively assess without considering how the patient, surrogate, or family might assess specific harms.

Recently, Edward Furton commented on an article that we published in Health Care Ethics USA concerning the philosophical and theological anthropology informing the discussion of appropriate care for individuals with gender dysphoria and intersex conditions. We appreciate the opportunity to clarify the points we made in that article, particularly the metaphysical mechanics underlying our contention that, as part of a unified human person, the human rational soul is sexed. We hope this more in-depth metaphysical explanation shows that Furton’s concern, while valid insofar as our position may have needed clarifying, is nevertheless ill-founded with respect to our contention that actually existent human rational souls are sexed.

In this paper, I confront Engelhardt’s views—conceptualized as a cohesive moral perspective grounded in a combination of secular and Christian moral requirements—on two fronts. First, I critique his view of the moral demands of justice within a secular pluralistic society by showing how Thomistic natural law theory provides a content-full theory of human flourishing that is rationally articulable and defensible as a canonical vision of the good, even if it is not universally recognized as such. Second, I defend the principles of Roman Catholic social teaching (RCST) against Engelhardt’s objection that it constitutes a watered-down version of the Christian moral vision which opens the door to intolerable moral compromises. While I acknowledge that Engelhardt’s criticism of RCST is well-grounded in certain abusive compromises that have been made by some Catholic healthcare institutions, I contend that such abuses are not endemic to RCST and avoidance of them is practically feasible in contemporary secular pluralistic societies. My primary aim is to show how continued dialogue between Engelhardtian libertarians and more communitarian-inclined RCST proponents may constructively yield a vision of healthcare allocation that ensures succor for the least advantaged within an authentically Christian social ethic.

Turner Nevitt’s elucidates and critically engages with what he describes as the “deeper and more problematic disagreements between survivalists and corruptionists about how to understand some of the most basic principles of Aquinas’s metaphysics,” his goal being to “advance some more systematic reasons for thinking that corruptionists are right and survivalists are wrong—both about how to understand the basic principles of Aquinas’s metaphysics, and about how to apply them to the question about the status of human beings or persons between death and resurrection.” In responding to Nevitt’s argument on behalf of survivalism, I have two goals: first, to defend a particular survivalist interpretation and application of Aquinas’s basic metaphysical principles, and second to argue that, even if Aquinas himself was a corruptionist, he (and we) ought to be survivalists.

Meeting the needs of individuals who experience vulnerability due to cognitive impairment presents significant challenges to caregivers. Primary caregiver responsibility is often relegated to professionals in hospitals or long-term care facilities, while proxy decision-making responsibility lies with families. The complex relationship among patients, professional caregivers, and families may be further complicated by the relative cognitive capacity of different patients. While some experience diminished cognitive capacity to such an extent that they cannot make any informed voluntary decisions, others may be able to express global preferences and participate more actively in rehabilitative efforts. With reference to Catholic social teaching, I briefly establish the intrinsic dignity of human persons who experience cognitive impairment and then analyze how the web of relationships and responsibilities among patients, professional caregivers, families, and communities ought to be defined. Finally, I consider how these relationships may be optimized to enhance participation in mutually reinforced caregiving and decision making.

Debate over whether health care institutions or individual providers should have a legally protected right to conscientiously refuse to offer legal services to patients who request them has grown exponentially due to the increasing legalization of morally contested services. This debate is particularly acute for Catholic health care providers. We elucidate Catholic teaching regarding the nature of conscience and the intrinsic value of being free to act in accord with one’s conscience. We then outline the primary positions defended in this debate and respond to critics of Catholic teaching. In so doing, we show how Catholic health care providers’ claims to conscientiously refuse to offer specific health care services are not essentially faith-based, but are founded upon publicly defensible reasons. We also address the question of whether conscientiously refusing health care providers may become complicit in moral wrongdoing or potentially cause scandal by means of disclosure or referral to another provider.

Do extraordinary crisis situations requiring life-and-death decisions create a “state of exception” in which ordinary social, political, and ethical norms must be altered or suspended altogether? Daniel Sulmasy contends that the extraordinary circumstances of a pandemic do not require abandoning or altering ethical values and principles. Rather, “ethics as usual” ought to guide policy formation and clinical decision-making. One critical question raised by the current pandemic, and which stresses ordinary ethical standards, is whether ventilators or other scarce life-sustaining resources may be unilaterally withdrawn from a patient in order to be reallocated to another who is estimated to have a superior chance of survival or better satisfies other triage criteria. In this type of situation, it is unclear what constitutes “ethics as usual.”

Recently, debate over whether health care providers should have a protected right to conscientiously refuse to offer legal health care services—such as abortion, elective sterilization, aid in dying, or treatments for transgender patients—has grown exponentially. I advance a modified compromise view that bases respect for claims of conscientious refusal to provide specific health care services on a publicly defensible rationale. This view requires health care providers who refuse such services to disclose their availability by other providers, as well as to arrange for referrals or facilitate transfers of care. This requirement raises the question of whether providers are being forced to be complicit in the provision of services they deem to be morally objectionable. I conclude by showing how this modified compromise view answers the most significant objections mounted by critics of the right to conscientious refusal and safeguards providers from having to offer services that most directly threaten their moral integrity.

Pope Francis has not put himself at the forefront of tendentious issues in bioethics, such as abortion, human embryonic stem cell research, cloning, contraception, and euthanasia. Nevertheless, his various addresses and magisterial documents such as Evangelii Gaudium and Laudato Si’ make clear that Pope Francis affirms the Church’s teaching on these issues. He has, though, proffered an additional moral lens through which to view such issues, namely, how they factor into the “culture of waste” that informs global society’s “sin of indifference” in contrast to a “consistent ethic of life.” The moral conclusions Pope Francis draws, far from advancing a shift in Catholic teaching, provide a stronger foundation for supporting a “culture of life.” This paper elucidates the continuity and development of the Catholic bioethical vision in Pope Francis’s writings, interviews, and addresses, and the implications for various bioethical issues.

I approach the subject of human enhancement—whether by genetic, pharmacological, or technological means—from the perspective of Thomistic/Aristotelian philosophical anthropology, natural law theory, and virtue ethics. Far from advocating a restricted or monolithic conception of “human nature” from this perspective, I outline a set of broadly-construed, fundamental features of the nature of human persons that coheres with a variety of historical and contemporary philosophical viewpoints. These features include self-conscious awareness, capacity for intellective thought, volitional autonomy, desire for pleasurable experiences, and the necessity of healthy biological functioning. On this basis, I contend that there may be legitimate forms of human enhancement for specific purposes related to the physical, cognitive, and emotive dimensions of human existence. However, wider philosophical considerations call into question whether societal attitudes towards enhancement and the differences that may emerge between those who are enhanced versus the unenhanced may raise insurmountable questions of justice, as well as a loss of virtues associated with what Alasdair MacIntyre refers to as our “acknowledged dependency.” This presentation will navigate towards conclusions differentiating principled from practical objections to specific forms of, and means towards achieving, enhancement of certain human capacities. While critical of some forms of human enhancement, I nevertheless argue that other forms of enhancement are, in principle, morally permissible—and for which any practical concerns may be surmountable—insofar as they positively support human flourishing according to our nature as living, sentient, social, and rational animals.

With the published report of the Ad Hoc Committee of the Harvard Medical School (1968), many scholars and medical practitioners began to abandon the traditional cardio-pulmonary criterion for determining when a human being has died and to argue that, since the brain is the central organ which regulates the body’s vital metabolic functions, irreversible cessation of the functioning of the brain as a whole—cerebral cortex, cerebellum, and brain stem—constitutes death. This “whole-brain” criterion is based on the understanding that a human organism cannot function as a unified whole without a functioning brain. The whole-brain criterion has received nearly universal legislative approval, beginning with a report by the U.S. President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1981). Soon thereafter, the Catholic Magisterium began to affirm this criterion following the conclusions of two interdisciplinary working groups sponsored by the Pontifical Academy of Sciences (Chagas 1986; White et al. 1992). Pope John Paul II (2001) later reaffirmed magisterial support of the whole-brain criterion for determining when a human being has died.

Some bioethicists have argued that moral bioenhancement, complementing traditional means of enhancing individuals’ moral dispositions, is essential if we are to survive as a species. Traditional means of moral enhancement have historically included civil legislation, socially recognized moral exemplars, religious teachings and disciplines, and familial upbringing. I explore the necessity and feasibility of pursuing methods of moral bioenhancement as a complement to such traditional means, grounding my analysis within a virtue-theoretic framework. Specifically, I focus on the essential intellectual virtue for proper moral reasoning, prudence, and whether proposed methods of moral bioenhancement could facilitate the cultivation of this virtue within the psyches of moral agents. I conclude that certain means of bioenhancement may serve to augment the ability to reason prudentially and assist moral agents to align their wills with their higher-order rational desires, though such means require those higher-order desires to already have been formulated independently.

This volume comprises various viewpoints representing a Catholic perspective on contemporary practices in medicine and biomedical research. The Roman Catholic Church has had a significant impact upon the formulation and application of moral values and principles to a wide range of controversial issues in bioethics. Catholic leaders, theologians, and bioethicists have elucidated and marshaled arguments to support the Church’s definitive positions on several bioethical issues, such as abortion, euthanasia, and reproductive cloning. Not all bioethical issues, however, have been definitively addressed by Catholic authorities, and some Church teachings allow for differing applications in diverse circumstances. Moreover, as new biomedical technologies emerge, Church authorities rely on experts in science, medicine, philosophy, theology, law, and other disciplines to advise them. Such experts continue to debate issues related to reproduction, genetics, end-of-life care, and health care policy. This volume will be a valuable resource for scholars in bioethics or Catholic studies, who will benefit from the nuanced arguments offered based on the latest research. This volume is also instructive for students entering the field to become aware of the founding philosophical and theological principles informing the Catholic bioethical worldview.

‘When did I, a human person, begin to exist?’ In developing an answer to this question, I utilize a Thomistic framework, which holds that the human person is a composite of a biological organism and an intellective soul. Eric Olson and Norman Ford both argue that the beginning of an individual human biological organism occurs at the moment when implantation of the zygote in the uterus occurs and the ‘primitive streak’ begins to form. Prior to this point, there does not exist an individual human organism, but a cluster of biological cells which has the potential to split and develop as one or more separate human organisms (identical twinning). Ensoulment (the instantiation of a human intellective soul in biological matter) does not occur until the point of implantation. This conception of the beginning of human personhood has moral implications concerning the status of pre‐implantation biological cell clusters. A new understanding of the beginning of human personhood entails a new understanding of the morality of certain medical procedures which have a direct affect on these cell clusters which contain human DNA. Such procedures discussed in this article are embryonic stem cell research, in vitro fertilization, procured abortion, and the use of abortifacient contraceptives.

Contemporary arguments concerning the permissibility of physician-assisted suicide [PAS], or suicide in general, often rehearse classical arguments over whether individual persons have a fundamental right based on autonomy to determine their own death, or whether the community has a legitimate interest in individual members’ welfare that would prohibit suicide. I explicate historical arguments pertaining to PAS aligned with these poles. I contend that an ethical indictment of PAS entails moral duties on the part of one’s community to provide effective means of ameliorating physical and existential suffering. I further elucidate how such duties have been affirmed by the Roman Catholic Church. My aim is to provide reasons why the expanding legalization of PAS should not preclude social investment in effective palliative care and providing a communal presence to the dying as they confront their subjectively experienced suffering.

Many debates in arenas such as bioethics turn on questions regarding the moral status of human beings at various stages of biological development or decline. It is often argued that a human being possesses a fundamental and inviolable moral status insofar as she is a “person”; yet, it is contested whether all or only human beings count as persons. Perhaps there are non-human person, and perhaps not every human being satisfies the definitional criteria for being a person. A further question, which will be the primary focus of this paper, concerns what essential features of personhood endow persons, human or otherwise, with their moral status and the inherent rights they concomitantly possess. A survey of the history of philosophical theorizing on what it means to be a person yields a broad consensus upon the key capacities being rational thought, self-consciousness, and autonomous volition. It is not sufficient, however, simply to cite these capacities, but to explain why these particular capacities bear moral import. A more recent concern has developed regarding the possible future existence of so-called “post-persons” who, due to their enhanced cognitive and emotive capacities, may be morally superior to mere persons and thereby possess a higher moral status. This paper will conclude with an analysis of the extent to which this concern is warranted.

As a director, writer, and producer, Christopher Nolan has substantially impacted contemporary cinema through avant garde films, such as Following and Memento, and his contribution to wider pop culture with his Dark Knight trilogy. His latest film, Interstellar, delivered the same visual qualities and complex, thought-provoking plotlines his audience anticipates. The Philosophy of Christopher Nolan collects sixteen essays, written by professional philosophers and film theorists, discussing themes such as self-identity and self-destruction, moral choice and moral doubt, the nature of truth and its value, whether we can trust our perceptions of what’s “real,” the political psychology of heroes and villains, and what it means to be a “viewer” of Nolan’s films. Whether his protagonists are squashing themselves like a bug, struggling to create an identity and moral purpose for themselves, suffering from their own duplicitous plots, donning a mask that both strikes fear and reveals their true nature, or having to weigh the lives of those they love against the greater good, there are no simple solutions to the questions Nolan’s films provoke; exploring these questions yields its own reward.