Linacre Quarterly最新文献

The concept of human dignity is frequently invoked in contemporary ethical, legal, and political discourse, yet often remains ungrounded in any coherent ontological framework. This article argues that the contemporary fragility and fragmentation of the idea of dignity stem from a deeper metaphysical crisis: the abandonment of a realist conception of human nature and the rise of nominalism. By contrasting nominalism with Aristotelian-Thomistic realism, it shows that human dignity cannot be coherently sustained without recognizing a stable and objective human essence. Through historical and philosophical analysis, the article traces how modern thought has increasingly severed the link between language and being, replacing the classical understanding of personhood with functional, procedural, or relational definitions. As a result, dignity is frequently tied to contingent attributes such as autonomy, sentience, or cognitive performance-criteria that exclude the most vulnerable members of the human family. The article examines how this metaphysical shift affects bioethical deliberations in areas such as embryonic research, end-of-life care, artificial intelligence, and transhumanism. It argues that without a stable ontological foundation, dignity becomes a rhetorical construct, vulnerable to technocratic reductionism and moral relativism. In response to contemporary objections-including pluralism, autonomy, and historicism-the article defends the ongoing relevance of a realist metaphysics. Far from suppressing freedom or diversity, it provides the necessary framework for dialogue, responsibility, and moral coherence. It concludes that defending human dignity in the postmodern age requires more than legal instruments or ethical consensus: it demands a renewed inquiry into the being of the human person, and the metaphysical foundations that make dignity not only intelligible but inviolable.

An intern called in for contingency coverage of a sick colleague for a Christmas Eve shift learns the true meaning of the call to serve Christ.

As the Catholic Church commemorates the sixtieth anniversary of Dei Verbum, the dogmatic constitution on divine revelation, it is a timely opportunity to reflect once again on the place of sacred scriptures in Catholic medical practice. In line with this, I advance that the psalms, in particular, help contextualize Catholic medical practice within the milieu of divine revelation. In this commentary, I will present an overview of sacred scriptures, an examination of the psalms, and an elucidation of revelatory insights from the Psalms that are helpful for Catholic medical practice. While related literature usually focuses on a few psalms, I will compile several here to highlight the creative diversity among the psalms.

As I assisted a surgeon during my third year of medical school, my proximity to a patient's hope for health and the possibility of her death revealed the great power and privilege of the operating room (OR). Although patient safety has improved over the last century, few actions in the OR are harmless. Vigilance, and its role in harm prevention, is reflected in quality improvement literature and the lighthouse logo of the American Society of Anesthesiologists. I propose a related framework that builds on the themes of vigilance and patient safety: The work of the anesthetist can be understood by biblical reference to the close surveillance of a watchman who announces what he sees (Isaiah 21:6). In the Bible, the term watchman recognizes whoever is overseeing from a watchtower, whether a military sentinel, an agricultural caretaker, or a prophet. This essay extends this analogy for anesthetists who are like watchmen of the OR. Like these lookouts of scripture who warn of chariots and swords, safeguard fields and vineyards, and announce the sun's rising, anesthetists are guardians of the patient's body and mind in the night of the OR and welcome the patient to a new day after a "deep sleep" (Genesis 2:21). Anesthetists as watchmen have significant responsibility in their vigilance and duty to respond to threats, and their attentive work contributes to the interdependent goal of restored health for the patient. Through this scriptural analogy to watchmen, anesthesia practitioners might have a theological framework for integrating their work of vigilance and advocacy for patient safety with that of God's prophets and Israel's forebearers.

To advance the debate over the brain death (BD) criteria, Sulmasy and colleagues have recently proposed that the BD criteria can be saved if three things are done. First, they suggest that the philosophical rationale used to justify the BD criteria should be changed to acknowledge that the human body is self-integrated and not integrated by the brain. They then propose that this self-integration is lost when the total functioning of the brain, especially the functioning of the hypothalamus, is lost. Finally, they affirm that medical criteria for BD should be expanded to include a diagnosis of diabetes insipidus to ensure that there has been a total loss of brain function. In response, I agree with Sulmasy and his colleagues that the human organism is a self-integrating system. However, I will also affirm that it is self-integrating because it is self-organized. Next, I will interrogate the claim that loss of total brain function, including loss of all hypothalamic function, can trigger the death of a self-integrating organism. In principle, I agree, but I also think that there are other organs that are also vital for the self--integration of the body. Thus, I affirm that we cannot justify and defend the total BD criteria for death as Sulmasy and his colleagues have attempted to do so without opening ourselves up to other combinations of systemic organ failures that would trigger loss of the inherent capacity to self-integrate: Death by neurological criteria has evolved to death by integrative criteria. Finally, we close with a brief discussion of the impact of Sulmasy and colleagues' proposal on the contemporary BD debate: I believe that it still cannot give us the moral certainty that we are looking for to justify the organ transplantation of vital organs from BD patients because there is already clinical evidence that suggests that some BD patients were able to survive for a long period of time even without hypothalamic function.

In clinical practice today, we are endowed with enormously effective interventions that were unimaginable only a few decades earlier. In light of the fund of knowledge, skills, and competencies that we bring to bear in our experience in caring for patients, the learning curve is never flat, never complete, and never static. As clinicians, we are reasonably well-equipped and experienced in treating physiological or neurological pain. When physical pain has been relieved by pharmaceuticals and other interventions, we often times find the person who is not relieved of psychological, emotional, or spiritual pain. This paper will explore the mind-body connection of patients experiencing pain and suffering, followed by the identification of a framework that will help to understand the importance of the healing relationships between patients and clinicians in responding to the mind-body connection among persons who experience pain and suffering.

Death by neurological criteria, often referred to as "brain death," has been the source of significant controversy in the past decades. The legal definition of brain death focuses on the irreversible loss of all brain function, including the brain stem, leading to an understanding of whole-brain death. Of particular importance for the brain death debate, the American Academy of Neurology has recently asserted that the loss of neuroendocrine function is not necessary for brain death determination. The question becomes whether it is consistent with a sound anthropology to accept brain death despite continuing neuroendocrine function. I argue that it is, as neuroendocrine function depends on the brain as a whole. This will be shown through engaging with the writings of Thomas Aquinas, especially as they relate to a hylomorphic understanding of the human person. Additionally, I will engage with understandings of brain death as the loss of the integrative unity of the human organism, particularly with Maureen Condic's distinction between integration and coordination. Through this, I will demonstrate that arguments that neuroendocrine functions do not in themselves constitute a vital function but, rather, depend on the brain as a whole.

Over the last several years, the idea that aging is inevitable has been replaced by scientific evidence showing that it is rather a malleable process. In this article, the most relevant and promising therapies have been classified into three large groups, based on their possible bioethical implications: (1) nutritional interventions, (2) pharmacological interventions, and (3) gene therapies. After defining the mechanisms of action of each group of treatments, as well as the risks and benefits currently identified, we evaluated each group following guidelines for the ethical assessment of interventions on the human body. These are based on the principles of personalist bioethics, which has allowed us to discern the licitness of such practices. After performing the analysis, we concluded that, at present, only nutritional interventions can be considered acceptable as anti-aging therapies. Drugs and gene therapies are still at too early a stage of development and their application would endanger human life. Finally, some recommendations are proposed in the field of aging founded on health care, based on healthy dietary control that, in turn, allows us to embrace the frailty and weakness of human nature, which become more evident during old age.