Linacre Quarterly最新文献

Health care is marked by numerous "liturgies"; many are no different whether they occur in secular or Catholic spaces. This article explores how health care's liturgies, namely the practice of cardiopulmonary resuscitation, offers Catholic health care the opportunity to offer care that is uniquely Catholic. By living into its theological commitments-including its rich eschatological heritage-Catholic health care can create a social imaginary that supports patients, families, and caregivers in their experience of death.

Medical schools have an obligation to provide a well-rounded, comprehensive education for their students, including reproductive healthcare. The Ethical and Religious Directives for Catholic Healthcare Services (ERDs) provide guidance and directives for hospitals sponsored by the Catholic Church. The ERDs prohibit performing abortions, including material cooperation with abortion. We examined whether teaching medical students about abortion in Catholic medical schools is ethically permissible under the ERDs. Literature for ethical frameworks, theology, and medical education standards was examined. We also sought to identify whether medical students at a Catholic medical school were satisfied with the current abortion curriculum. An Institutional Review Board approved survey was distributed to fourth-year medical students at a Catholic medical school evaluating satisfaction with the current curriculum. Students indicated that abortion education is an important aspect of the medical school curriculum. We propose that it is ethically permissible to provide comprehensive didactic reproductive education, including abortion, in Catholic medical schools while still respecting the ERDs.

The first heart transplantation, performed by Christiaan Barnard in 1967, was one of the most important medical events of the twentieth century. The real significance of the operation, beyond the surgical feat, was setting a precedent for the reinterpretation of death and introduction of the controversial concept of "brain death." Contemporary public acceptance of this concept was supported by the general belief that, according to the newly created criteria, Denise Darvall, the first heart donor had been brain-dead, and her heart was procured when cardiac arrest occurred after stopping mechanical ventilation. However, there are doubts whether Denise was really brain-dead. Moreover, Barnard's brother, Marius confessed that Denise's heart was stopped with potassium injection, although he later retracted this claim. To clarify these issues, data related to the first heart transplant were collected. Taken together, the data suggest that the first heart donor, whose case set a precedent for organ removal from "brain-dead" patients, was not in fact "brain-dead" in today's term, and, moreover, her heart may have been arrested artificially, similarly to a non-voluntary active euthanasia.

Non-technical summary: According to a widely held view, Denise Darvall, the donor of the world's first heart transplant, was a brain-dead victim of a car accident, and her organs were explanted when cardiac arrest occurred. However, there are serious doubts both about her brain death and spontaneous cardiac arrest. This research revealed that Denise, whose case set a precedent for organ removal from brain-dead patients, was almost certainly not brain-dead and her heart was arrested with potassium injection. These results suggest that Denise Darvall's death was similar to a non-voluntary active euthanasia.

Short summary: Data related to the first heart transplant suggest that the donor was not brain-dead and her heart was arrested artificially, similarly to a non-voluntary active euthanasia.

Through the cultivation of virtues and the development of a deeply reflective and well-formed conscience, physicians can uphold patients' dignity and safeguard the sanctity of life amid the ethical dilemmas arising from continuous advancements in medical techniques and procedures, guided by both medical expertise and moral wisdom grounded in truth.

With incidences of cesarean scar ectopic pregnancies on the rise, physicians are increasingly encountering situations where medical or surgical intervention is necessary to save the life of the mother. In some cases, a laparoscopic wedge resection of the cesarean scar ectopic pregnancy is an appropriate treatment option, but tragically this surgical intervention results in the unintended, yet foreseen consequence that the embryo will die. While there is no possible way to save the life of the embryo, it may be possible for the surgeon to penetrate the gestational sac during the surgery in a manner that allows for the possibility of baptizing the embryo. This paper examines the Roman Catholic Church's teaching on baptism in the context of cesarean scar ectopic pregnancies and argues that it is possible, permissible, and praiseworthy for the surgeon to baptize the embryo while performing a wedge resection.

Gender-affirming care has emerged as the dominant model of healthcare for adolescents with gender dysphoria, replacing the historical model of watchful waiting. In gender-affirming care, the healthcare professional affirms the gender with which the patient identifies. Often, with minimal clinical evaluation or investigation into underlying mental health and psychosocial issues, the young person is sent on a path of social transition, puberty blockers, cross-sex hormones, and surgery. This paper addresses the ethics of gender-affirming care through the lens of the ethical principles of beneficence, nonmaleficence, and autonomy. An evaluation of the research and data reveals that gender-affirming care is not an ethical approach to the treatment of adolescents with gender dysphoria. It violates the principle of beneficence because gender transition has not been shown to be beneficial. It violates nonmaleficence because these interventions harm patients. It violates autonomy because, although these interventions are provided at the patient's request, there is inadequate informed consent.

Individuals with intersex conditions are biological males and females who have, through various disorders/differences of sexual development, an (epistemically) unclear biological sex. Intersex pediatric surgery (IPS) is clarification surgery which seeks to restoratively, functionally, and aesthetically clarify or disambiguate the sex of a child with intersex conditions. IPS is performed in healthcare institutions by a urologist, ideally one with technical certification in pediatric urology. The pediatric urologist is (or may be) part of the multidisciplinary healthcare team assigned to the child with intersex conditions and his or her family. Formal philosophical arguments against IPS have been found to be implausible. As such, contemporary clinical recommendations for the care of individuals with intersex conditions head in this direction. Because surgical moratoria over IPS are consequently inappropriate, regulatory ethical principles serve to protect and promote the flourishing of children with intersex conditions. This commentary has two goals: the first is to articulate and philosophically challenge Kevin G. Behrens' principled ethical approach to IPS, which stands to date as a novel and strong approach to IPS, and the second is to articulate and defend five plausible ethical principles to govern IPS decision-making that partially replace Behrens'.

Organ transplantation remains an ethically complex issue, in part due to the growing disparity between organ supply and demand. This paper applies a casuist ethical framework to analyze the moral justifications of two models of organ procurement by comparing organ donation to inheritance and public resources. The opt-in model aligns with the principle of bodily autonomy, treating organ donation as a personal decision akin to leaving behind an inheritance. It ensures explicit consent, allowing individuals full control over their postmortem bodily integrity. However, this model often results in lower donation rates due to inaction. Conversely, the routine-salvage model views organs as a public resource, prioritizing societal welfare by increasing the donor pool and reducing organ shortages. This approach raises ethical concerns about presumed consent and potential violations of autonomy. Casuist analysis suggests that while bodily autonomy remains a crucial ethical principle, it is not absolute. The opt-out model presents a pragmatic solution, forcing society to weigh the ethical importance of individual autonomy against the moral imperative to save lives.

It is well-established that adolescence, for both girls and young men, is a period of anatomical and functional transformation of the brain, enabling them to acquire the aptitudes of adults, that is, for girls, the aptitudes of adult women and mothers. According to several scientific studies, the hormones secreted by the ovaries, estrogen and progesterone contribute to this brain development during adolescence. Therefore, there is concern that hormonal contraceptives may modify the temperament of adolescent girls by altering their hormonal balance. In this article, we presented research showing that: (1) brain changes during adolescence occur in parallel with changes in sex hormone levels; (2) the gradual establishment of natural cycles during adolescence creates an estrogenic environment that is very different from that produced by hormonal contraceptives; and (3) hormonal contraceptives can cause changes in temperament and, consequently, personality. These facts are little-known in the medical community. It is therefore necessary to disseminate this information within the medical profession. It is also essential to provide young girls and their parents with comprehensive information before prescribing hormonal contraceptive treatment. This will enable them to make informed decisions.

Nontechnical summary: Adolescence is a period of brain transformation that prepares girls for their lives as women and perhaps mothers. The hormones of the menstrual cycle contribute to this brain change. The level of these hormones comes from the gradual establishment of the female cycle. The evolution and nature of these hormones are very different from those produced by hormonal contraception. We conclude that it is necessary to inform young girls and their parents about these effects before prescribing hormonal contraception.

Short summary: Scientific evidence suggests that contraceptive hormones may pose a risk to brain development in young girls.