Lawler, Ronald D.

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The Linacre QuarterlyVolume 49 | Number 1 Article 122-1-1982[Book Review of ] New Technologies of Birth andDeath - Medical, Legal, and Moral DimensionsRonald D. LawlerFollow this and additional works at: http://epublications.marquette.edu/lnqPart of the Ethics and Political Philosophy Commons, and the Medicine and Health SciencesCommonsRecommended CitationLawler, Ronald D. (1982) "[Book Review of] New Technologies of Birth and Death - Medical, Legal, and Moral Dimensions," The LinacreQuarterly: Vol. 49: No. 1, Article 12.Available at: http://epublications.marquette.edu/lnq/vol49/iss1/12The Psychosurgery Debate: Scientific, Legal, and Ethical Perspectives Elliot S. Valenstein, Ph.D., Editor f W. H. Freeman & Co., San Francisco, 1980, xiv + 594 pp. , In the preface to this volume, Dr. Val enstein set [or himself an impressive task: Because it seemed to me that there was an inadequate amount o[ source material available for courses in biomedical ethics, I decided to take one intensely disputed controversy, the psychosurgery debate, and to explore in depth the scientific, legal, ethical, and social issues raised by this dispute. For the most part this task has been accomplished with admirable clarity, balance, and good sense, As such , it serves as a remarkable benchmark in a burgeoning biomedical literature. The contributors address their separate areas with well- organized and referenced precision from a historical perspective to a careful analysis of the present literature to an entry into the debate over what is a psychiatric disorder. Legal issues are dealt with in a much mOl'e lucid manner than is usually the case and terminology clarified in a fashion that makes one see the polemic in which certain words are often used: for example, the editor suggests that "the label 'experimental' be reserved for studies involving the systematic collection of research data, irrespective of the general acceptance of the thera-peutic procedures employed." Refreshingly, the doctrine of informed consent is addressed by a professor of law who holds a co-equal appointment in the depart-ment of psychiatry at his university. It is evident that he knows what the real world is all about. If the volume has any failings, sadly it is in the part which deals wi th ethical issues. Here logic and well-referenced conclusions give way to opin ion and evident bias. One would have wished that the authors of the chapters in this part had read the rest of the book before stating their case. Anyone with a serious interest in the psychosurgery debate cannot claim such a posture legitimately without owning th is book. Psychiatrists, neurosurgeons and neurologists would do well to be familiar with it. Scholars seriously interested in any bioethical question can learn much from the model presented by this volume. - Michael P. McQuillen, M.D. Medical College of Wisconsin New Technologies 0/ Birth and Death-Medical, Legal, and Moral Dimensions Pope John Center, St. Louis, 1980, xv + 196 pp., $6.95, paperback. This book contains the papers given at a workshop held in Dallas, Tex. from January 28-31, 1980. An extr insic [actor of great importance is that a majority of the bishops of the United States and Canada attended this workshop. There is February, 1982 87 some importance in noting who speaks to the hierarchy of America, and the content of papers addressed to such an audience. The papers cover a wide range of questions. The first section of the book treats new forms of originating human life and recent developments in family planning and abortion. The second section touches problems related to the time of death and /or associated with euthanasia and the prolongation of life. Scientists, moral-ists, and lawyers present various aspects of all the pl"Oblems treated. In an introductory paper, Father Albert Moraczewski speaks of man's duty to rule the world and of the general legitimacy of putting technology at the service of man in questions of birth and death. He surveys some of the questions which the new technologies create; but in a special way he addresses a major difficulty that the Cathol ic communi ty has had in facing new moral issues. The great difficulty is that Catholic moralists have been disastrously divided on the most basic questions of principle. Both on the questions of authority or faith (what is normative in Catholic teaching in moral questions?) and in basic substan-tial principles (should we be consequentialists, or preserve the nuanced doctrine of absolutes traditional in the Church?) there is a sharp division. No reputable moralist before 1960 pretended that thel-e could be a tru ly probable opinion, one that cou ld conscientiously be followed, contrary to the firm judgment of the Holy See. The insistent judgment of the Holy See, defending Catholic teaching, was to be accepted. Vatican II firmly restates this, even in instances where infallibility is not in question (LG35). Similarly, Vatican II speaks in terms of traditional absolutes in condemning unqualifiedly certa in base kinds of actions (see, e.g ., GS27). But today many Catholic moralists seem to encourage Catholics to do deeds which the authentic magisterium declares to be gravely sinful. In the sharp tension such scandalous discord creates, the community of moralists has been discouraged from creative work on new problems; it has been too unsettled in even its most basic principles. Father Moraczewski holds that we should presume that dissenters are "persons of good-will" unless we have special reasons in an individual case to judge other-wise. But I think our view should be far more nuanced than tha t. It is true that we must avoid rash personal judgment, and we should treat individuals with whom we deal personally with sincere courtesy and with the same respect we seek from them, in spite of our own real flaws. In judging whether there is bad faith in dissent from Church teaching (without precisely applying it to this or that individ-ual), we shou ld first accept th e Catholic teaching that dissenting Catholic scholars have an objective duty not to be dissenting. True, they could be in invincible ignorance of that duty. We are not their judges, but we should not canonize a whole dissent movement, either. All Christian scholars have the difficult task of teaching doctrines which confront the presuppositions and deeply felt desires of many hearers, to teach positions which many would like not to hear. Everyone knows how easy it is to fa ll into bad faith in complex situations like this. If some of our associates should be in bad faith, we would be doing them a very great disservice to insist that dissente rs generally are in good faith; this might prevent them fl"Om having the sort of conversion that would really be necessary for them, and benefic ial to the Church. Fathe Benedict Ashley gives an intelligent defense of many sound positions in his "pro- li fe evangelization." He virtually a lways comes to the conclusions which the magisterium proposes in disputed cases, but he has a way of making the posi-tion of dissenters seem more sophisticated and defensible than they are, and at times to make those who (with him) de fend with the magisterial positions, seem naive. For example, he points out that bishops are seeking to support the "mass of Christians in a trad itional faith" (p. 84) (which , everything suggest$, Father Ashley holds to be quite true), while "the theologians are more concerned to reach the number of Christians who speak only a secular language, as well as to 88 Linacre Quarterly I ' open th e faith to no n-Chr istians. " Inevitably, he says, this creates confrontation between the bishops and schola rs. But why should it? His implication is that t he bishops don't quite understand precisely what the theologians are doing simply because they speak in a la nguage which seems so opposed to that of th e bishops. It would seem to m e that the bish ops know very we ll what these theologians whom they must co nfront are doing. The problem is that some of th e scho lars who are seeking to speak to di ssid ent Cath o lics and non-Christians are not only adopting the language of those ou tside (even firmly orthodox scho lars very commonly do that), but are a lso adopting philosophical presuppositions of the alien language (instead of correcting them. ) And having adopted a philosophy that is to some extent alien to Catholic teaching (not qua philosophy but qua t hat part of the content of faith that happens to be naturally knowable), they contradict the pastoral teaching of the Church. But ,it is not a responsible form of Catholic scholarship for one to assume a philosophical stance which contradicts aspects of faith, and to draw from that philosophical stance the conclusion that part of the received teaching is fa lse. Both Moraczewski and Ashley imply that the format of the workshop itself was not very h elpful. At this m eeting only those judged to be in harmony with Catholi c teaching were se lected to present to the bishops nuanced accounts of the difficult questions of the day. I believe that these people did truth fu ll y and intelli-gent ly present the positions of dissenters. But Moraczewski and Ashley hold that in t he current impasse, it would be better if bishops wer!' to ca ll in dissenters as well as scholars affirming Cath olic positions. Since there is the mass of cu rrent dissent in the Church and repetition of magisterial teaching will not stop it, we should resort to d ebate among scholars in contexts establi shed by the bishops to ['eso lve the issues. I think that a fundamenta l misunderstand ing is present here. I am not opposed to such debate, and I would share with Ashley the conviction that the arguments of those defending received teaching are far better than the arguments of dis-senters. But I share none of his sanguine hope that theoretical deba tes between those who do and d o not accept m ag ister ial decision will, in fact, come to harmoniou s conclusions. St. Thomas pointed out that the very reason why reve la-tion is necessary for difficult mora l questions (though some wise men CQuld admittedly come to en t irely certain and correct answers by natural reasoning) is that natural reasoning does not lead the whole community to agreed positions in important m atters in which the Christian community is requi red to live worthily in its calling. Too many human passions and weaknesses impede our rationality in such questions, until we are healed by faith. Only the teaching of the Church is ab le to provide the cultural unity that philosophical d ebate has never really been ab le to provide (see Summa The%gica, I-II , 91, 4c., " Secondly . ... "). One might argue that this is a counsel of despair . If the magisterium does not create uni ty in the Church by its teaching, and rational argumenta tion cannot create unity , are we destined to eternal conflict on the most basic of m oral posi-t ions? Certa inly not. I believe the problem is not that t he magister ia l teaching office has been vigorously exercised in our age and fou nd wanting. Rather, witnessing to the faith in unequivoca l, courageous and generous ways has been fou nd extremely difficult, and not exe rc ised very unambiguously. Within the fam il y o f faith the first need is to have this witnessing more unequivoca l than it has been, not to so encourage the whole movemen t of dissent as to make that witness ing eve n more ambigu ous. CI1l"ist ia n philosophel's should, of course, not lazi ly rely on appeals to authority, but get at the intrins ic grounds for the ir positi ons. But if the fa mil y of faith is to be bound together in unity, it will not be the work of the philosophers as such, but grace-affected teach ing of the witnesses to faith which wil l be decisive in res toring th e longed-for unity. The book has a number of excellent papers. In hi s "Reverencing Huma n Life in February, 1982 89 Its Generation, " William E . May gets to the deepest roots of the questions involved in laboratory generation of human life, and shows why it is morally inappropriate to initiate human life by any act other than marital acts of inter-course. His treatment of conception and abortion in this concise but intelligent article reveals a clear awareness of the mindset that leads many moralists to hold such acts sometimes suitable and also his awareness of the reasons why this mindset is itsel f false to Christian principles. Very valuable also are Dr. Thomas Hilgers's study of " The New Technologies of Birth ," John Noonan's "Is Abortion a Private Choice?" and four brief studies of Father Thomas O 'Donnell on a variety of "death issues." In his article on "Intro-duction to Prolonging Life Issu es, " Father Donald McCarthy persuasively argues against misleading uses of the term "passive euthanasia." But, even after acknowl-edging that one can kill by omission (e.g ., starving to death a defective chi ld) , he strangely insists that the "simple WOl"d 'euthanasia' already means active killing" (p. 142). This hardly belongs in a paragraph calling for linguistic precision. The St. John Center has produced in this volume a useful study of difficult new questions. Its leaders are to be encouraged in their resolve to unite full adher-ence to Catholic teaching with a rigorous rational reflection in treating bioethical questions. - Ronald D. Lawler, O.F.M. Cap_ Center for Thomistic Studies, University of St. Thomas The Emergence of Roman Catholic Medical Ethics in North America David F. Kelly Mellen Press, New York, 1979, vi + 520 pp., $29.95 (paperback). David Kelly, a priest of the diocese of Worcester, Mass., and a teacher of moral theology, traces the history of Catholic medical ethics in the United States. He introduces the subject with a brief history of moral theology during the Christian era and of pastoral medicine from the 18th century. He divides this history into two periods, the first running from about the beginning of the 20th century to 1940 and the second from 1940-1960. The ch ief interest of the author is in the methodologies of the authors who wrote during these periods. While recognizing that fast lines can hardly be drawn, he finds the approach of the authors of the first period predominantly physicalist. In the second period physicalism gives way to ecclesiastical positivism. After Vatican II personalism becomes the prevailing methodology. Those who lived through the period the author covers and who respected the pioneering work of the authors of the time may consider Kelly 's account some-thing of a "putdown." In discussing their methodologies the language the authOl" uses is more accusative than descriptive. Objective (ex objecto) morality becomes physicalism; accepting Church moral teaching becomes ecclesiastical positivism. Had he remained in the same accusatory mood, the author might have reduced the personalism of post-Vatican II to individualism, but he was evidently better dis-posed toward a personalistic methodology. 90 Linacre Quarterly 

[Book Review of] \u3cem\u3eNew Technologies of Birth and Death - Medical, Legal, and Moral Dimensions\u3c/em\u3e

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[Book Review of] \u3cem\u3eNew Technologies of Birth and Death - Medical, Legal, and Moral Dimensions\u3c/em\u3e

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