All material reality is simply plastic to be used, dominated and ultimately shaped by human freed... more All material reality is simply plastic to be used, dominated and ultimately shaped by human freedom. Thus the fundamental purpose of the entire physical universe, including human biological nature, is to serve as the instrument for human purposes. The body is subordinated to the spiritual aspect of humanity, and humans view themselves as possessing an unrestricted right to dominate and shape not only the body but also its genetic heritage (Callahan, 1972). T his quotation takes on an interesting dynamic in the context of the current genomic revolution in medicine. Although some of the cri-tiques of the Human Genome Project (HGP) tend to focus on who
The Catholic moral tradition has a rich foundation that applies broadly to encompass all areas of... more The Catholic moral tradition has a rich foundation that applies broadly to encompass all areas of human experience. Yet, there is comparatively little in Catholic thought on the ethics of the collection and use of data, especially in healthcare. We provide here a brief overview of terminology, concepts, and applications of data in the context of healthcare, summarize relevant theological principles and themes (including the Vatican’s Rome Call for AI Ethics), and offer key questions for ethicists and data managers to consider as they analyze ethical implications pertinent to data governance and data management.
Scholars and professional organizations in bioethics describe various approaches to "quality... more Scholars and professional organizations in bioethics describe various approaches to "quality assessment" in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes "quality" in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, iin this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring dis...
Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian ... more Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine w...
Health care ethics USA : a publication of the Center for Health Care Ethics, 2005
This essay seeks to address the role of human experience in moral discourse. The authors propose ... more This essay seeks to address the role of human experience in moral discourse. The authors propose that it is precisely through incorporating a collective experience of what it means to be human in moral discourse that we come to understand the relevance of moral norms in ethical decision-making. We conclude by offering a number of recommendations for ethics committees and hospital administrators.
The Catholic moral tradition asserts an intrinsic moral value of all human life that is endowed b... more The Catholic moral tradition asserts an intrinsic moral value of all human life that is endowed by its creator and inheres from the earliest stage of its development to the end of its biological existence. This understanding of human dignity has significant practical implications when one contrasts it with a secular approach to decision-making regarding fetuses with anomalies incompatible with life, such as anencephaly. Within the secular framework the primary focus is on weighing the burdens and benefits exclusively to the mother. In this chapter, we argue that the Catholic tradition actually provides a framework that takes full account of both the inherent dignity of the child and the maternal burdens and benefits. After reviewing the clinical circumstances of anencephaly, we review the contemporary theological debates in light of Catholic moral teaching. Next, we propose a re-conceptualized understanding of viability relative to the role of “proportionate reasoning” within the fr...
The traditional characterization of the patient-physi- cian relationship as a friendship has been... more The traditional characterization of the patient-physi- cian relationship as a friendship has been given vast attention in the ethics literature. (1) Negative critiques of this view attest to the growing alienation between the physician and the patient. (2) Aristotle's work on the ethics of virtue friendship offers a unique perspective on defining the term "friendship," thereby providing a more robust analogy to characterize the patient-physician rela- tionship. This more robust characterization of friendship is grounded in the nature of the virtue friendship via benevolence, mutual concord and beneficence. The goal of part one of this essay is twofold: (1) to examine the concept of friendship in Aristotle's ethics, relying heavily on the Nichomachean Ethics; and (2) to recover the nuances in Aristotle's ethics through an exa- mination of virtue friendship. This analysis will lay the foundation for part two of this work, which will examine Aristotle's ethics...
t the same time they look for ways to use resources more efficiently, Catholic health care’s admi... more t the same time they look for ways to use resources more efficiently, Catholic health care’s administrators and managers also seek to construct financially sound organizational practices to strengthen their ministry’s market presence in a manner consistent with Catholic social thought. Given these somewhat competing interests, it is relevant to examine the issue of workforce reduction. This article will focus on workforce reduction in the context of employment-at-will as most health care organizations use this model. A
All material reality is simply plastic to be used, dominated and ultimately shaped by human freed... more All material reality is simply plastic to be used, dominated and ultimately shaped by human freedom. Thus the fundamental purpose of the entire physical universe, including human biological nature, is to serve as the instrument for human purposes. The body is subordinated to the spiritual aspect of humanity, and humans view themselves as possessing an unrestricted right to dominate and shape not only the body but also its genetic heritage (Callahan, 1972). T his quotation takes on an interesting dynamic in the context of the current genomic revolution in medicine. Although some of the cri-tiques of the Human Genome Project (HGP) tend to focus on who
The Catholic moral tradition has a rich foundation that applies broadly to encompass all areas of... more The Catholic moral tradition has a rich foundation that applies broadly to encompass all areas of human experience. Yet, there is comparatively little in Catholic thought on the ethics of the collection and use of data, especially in healthcare. We provide here a brief overview of terminology, concepts, and applications of data in the context of healthcare, summarize relevant theological principles and themes (including the Vatican’s Rome Call for AI Ethics), and offer key questions for ethicists and data managers to consider as they analyze ethical implications pertinent to data governance and data management.
Scholars and professional organizations in bioethics describe various approaches to "quality... more Scholars and professional organizations in bioethics describe various approaches to "quality assessment" in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes "quality" in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, iin this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring dis...
Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian ... more Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine w...
Health care ethics USA : a publication of the Center for Health Care Ethics, 2005
This essay seeks to address the role of human experience in moral discourse. The authors propose ... more This essay seeks to address the role of human experience in moral discourse. The authors propose that it is precisely through incorporating a collective experience of what it means to be human in moral discourse that we come to understand the relevance of moral norms in ethical decision-making. We conclude by offering a number of recommendations for ethics committees and hospital administrators.
The Catholic moral tradition asserts an intrinsic moral value of all human life that is endowed b... more The Catholic moral tradition asserts an intrinsic moral value of all human life that is endowed by its creator and inheres from the earliest stage of its development to the end of its biological existence. This understanding of human dignity has significant practical implications when one contrasts it with a secular approach to decision-making regarding fetuses with anomalies incompatible with life, such as anencephaly. Within the secular framework the primary focus is on weighing the burdens and benefits exclusively to the mother. In this chapter, we argue that the Catholic tradition actually provides a framework that takes full account of both the inherent dignity of the child and the maternal burdens and benefits. After reviewing the clinical circumstances of anencephaly, we review the contemporary theological debates in light of Catholic moral teaching. Next, we propose a re-conceptualized understanding of viability relative to the role of “proportionate reasoning” within the fr...
The traditional characterization of the patient-physi- cian relationship as a friendship has been... more The traditional characterization of the patient-physi- cian relationship as a friendship has been given vast attention in the ethics literature. (1) Negative critiques of this view attest to the growing alienation between the physician and the patient. (2) Aristotle's work on the ethics of virtue friendship offers a unique perspective on defining the term "friendship," thereby providing a more robust analogy to characterize the patient-physician rela- tionship. This more robust characterization of friendship is grounded in the nature of the virtue friendship via benevolence, mutual concord and beneficence. The goal of part one of this essay is twofold: (1) to examine the concept of friendship in Aristotle's ethics, relying heavily on the Nichomachean Ethics; and (2) to recover the nuances in Aristotle's ethics through an exa- mination of virtue friendship. This analysis will lay the foundation for part two of this work, which will examine Aristotle's ethics...
t the same time they look for ways to use resources more efficiently, Catholic health care’s admi... more t the same time they look for ways to use resources more efficiently, Catholic health care’s administrators and managers also seek to construct financially sound organizational practices to strengthen their ministry’s market presence in a manner consistent with Catholic social thought. Given these somewhat competing interests, it is relevant to examine the issue of workforce reduction. This article will focus on workforce reduction in the context of employment-at-will as most health care organizations use this model. A
Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian ... more Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine whether the benefits are proportionate to the risks in a particular case.
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