Clarifying “Double Effect”
February 23, 2011
George Weigel
The recent controversy over the termination of a pregnancy at Phoenix’s St. Joseph’s Hospital, which Phoenix bishop Thomas Olmstead determined to have been a direct abortion and thus a grave moral evil, has generated a secondary controversy over the meaning of the Church’s traditional moral principle of “double effect.” Some have argued—mistakenly, in my view—that what was done in Phoenix satisfied the classic double-effect criteria of Catholic moral theology.
The National Catholic Bioethics Center in Philadelphia, an indispensable source of Catholic information and analysis on bioethical and medical ethical issues, recently issued a statement on the Phoenix case. The statement clarified the double-effect issue in language that people without any special training in moral theology or moral philosophy can understand, and is worth quoting at length:
The principle of double effect in the Church’s moral tradition teaches that one may perform a good action even if it is foreseen that a bad effect will arise only if four conditions are met: 1) The act itself must be good. 2) The only thing that one can intend is the good act, not the foreseen but unintended bad effect. 3) The good effect cannot arise from the bad effect; otherwise, one would do evil to achieve good. 4) The unintended but foreseen bad effect cannot be disproportionate to the good being performed.
This principle has been applied to many cases in health care, always respecting the most fundamental moral principle of medical ethics, primum non nocere, “First, do no harm.”
The classic case of a difficult pregnancy to which this principle can be applied is the pregnant woman who has advanced uterine cancer. The removal of the cancerous uterus will result in the death of the baby but it would be permissible under the principle of double effect.
One can see how the conditions would be satisfied in this case: 1) The act itself is good; it is the removal of a diseased organ. 2) All that one intends is the removal of the diseased organ. One does not want the death of the baby, either as a means or an end. Nonetheless, one sees that the unborn child will die as a result of the removal of the diseased organ. 3) The good action, the healing of the woman, arises from the removal of the diseased uterus, not from the regrettable death of the baby which is foreseen and unintended. 4) The unintended and indirect death of the child is not disproportionate to the good which is done, which is saving the mother’s life.
In the wake of the Phoenix case, other Catholic hospitals have been asked what they would do in the rare and wrenching circumstance where continuing a pregnancy would put the lives of both mother and child at risk. The first answer usually given is the correct one: “We would try to save both lives.” But some have gone on to give a further answer: “But if that were impossible, we would save the life we could save”—by means, one assumes, of terminating the pregnancy.
This is not right. It violates the bedrock principle of “first, do no harm.” There is no moral casuistry that can justify doing the “harm” that is the intentional taking of an innocent human life—period. Attempts to justify termination in such circumstances by redefining the act of termination border on the Orwellian, further confusing the public discussion. (Recent horror stories from the Philadelphia abortuary should have taught us where the language of euphemism leads.) Furthermore, “we’ll save the life we can save” does not meet the standards of the principle of double effect, as outlined above.
The Catholic Church is one of the last major institutions defending the Hippocratic principle that the true physician’s first responsibility is to “do no harm.” Attempts to chip away at that Catholic commitment—by public authorities untutored in the meaning of religious freedom, or by theologians and philosophers advancing speculative views detached from clinical reality—damage the common good and impede the building of a culture of life.
George Weigel is Distinguished Senior Fellow of the Ethics and Public Policy Center in Washington, D.C.
Comments:
2.23.2011 | 12:20pm
Dr. Charles says:
I would hold that the Principle of Double Effect is misapplied in this case. Both possible outcomes were "not acceptable" alternatives in spite of the specious wordsmithing that is used for PDE in cases like ectopic pregnancies and uterine cancers. As Martin Rhonheimer and Germain Grisez have written extensively on this type of dilemma, another framework is needed to be applied to the decision.
The woman was so sick she could not be moved to the Operating Room from the ICU...and if you ask Critical Care physicians, they'll tell you that both patients were actively dying at that point.
Catholic healthcare and Catholic physicians comply and compromise with many federal laws and court rulings that we find problematic (Sacramento Catholic Charities providing birth control employee benefits) as well as many pragmatic realities (3 common vaccinations made from aborted embryos with no alternative vaccines).
The legalistic magisterial and academic theological arguments are far from the pastoral approach that was needed in this phenomenally rare situation for a mother, her family, a Sister of Mercy and a Catholic Ethics Committee. .
The woman was so sick she could not be moved to the Operating Room from the ICU...and if you ask Critical Care physicians, they'll tell you that both patients were actively dying at that point.
Catholic healthcare and Catholic physicians comply and compromise with many federal laws and court rulings that we find problematic (Sacramento Catholic Charities providing birth control employee benefits) as well as many pragmatic realities (3 common vaccinations made from aborted embryos with no alternative vaccines).
The legalistic magisterial and academic theological arguments are far from the pastoral approach that was needed in this phenomenally rare situation for a mother, her family, a Sister of Mercy and a Catholic Ethics Committee. .
2.23.2011 | 1:40pm
Jessie says:
I hope I am never in a position to demand that a pregnant woman whose life is at risk from her pregnancy, go ahead and risk her life, for an embryo.
Today many, many elements of the church tell us that an embryo is human, "from conception." But in actual practice, how many of us would risk, even give up our lives, for the eight human cells that form a blastocyst, for instance?
Today many, many elements of the church tell us that an embryo is human, "from conception." But in actual practice, how many of us would risk, even give up our lives, for the eight human cells that form a blastocyst, for instance?
2.23.2011 | 1:40pm
Dr. Charles says:
An addendum to my comment...
The legalistic magisterial and academic theological arguments are far from the pastoral approach...for a mother, HER UNBORN CHILD, her family, a Sister of Mercy and a Catholic Ethics Committee. There must be an ethical calculus that includes the fetus along with the patient her husband and four children.
Bishop Olmsted's words have heretofore focused on Sister Margaret McBride...he has not to my knowledge stated that the mother, the involved doctors and nurses and Ethics Committee also are excommunicated latæ sententiæ. This was NOT a decision by single person…
The legalistic magisterial and academic theological arguments are far from the pastoral approach...for a mother, HER UNBORN CHILD, her family, a Sister of Mercy and a Catholic Ethics Committee. There must be an ethical calculus that includes the fetus along with the patient her husband and four children.
Bishop Olmsted's words have heretofore focused on Sister Margaret McBride...he has not to my knowledge stated that the mother, the involved doctors and nurses and Ethics Committee also are excommunicated latæ sententiæ. This was NOT a decision by single person…
2.23.2011 | 2:49pm
Thomas says:
I think the Phoenix case requires more analysis than this piece suggests. For one thing, it is unclear to me whether the procedure undertaken in Phoenix was a direct attack on the baby or whether it was directed at the placenta, which was the cause of the medical condition. For more particulars about the Phoenix case, see the link below.
Also, I would be curious to get Mr. Weigel's opinion about the work of orthodox theologians such as Germain Grisez and Martin Rhonheimer, who argue that, in the case where both mother and child will die, certain procedures -- including craniotomy (the direct crushing of the baby's skull), may be permitted. See http://www.commonwealmagazine.org/blog/wp-content/uploads/2010/12/St.-Josephs-Hospital-Analysis.pdf.
Also, please consider the following analysis posted over at InsideCatholic:
"From the perspective of pro-life advocacy, it's not clear to me why Mr. Weigel wants to trumpet the Phoenix case.
First, the situation where both mother and child will die is exceedingly rare, dwarfed by the thousands of abortions that occur each day where the mother's life is not in danger at all.
Second, the upshot of the argument – that "building a culture of life" requires two deaths rather than one in this situation – is a very hard one for most Americans to accept (and particularly for the people most affected – women).
I am quite familiar with the moral principles that are involved, but most Americans don't come to their moral beliefs by careful deductive reasoning and the application natural-law principles. Making this case into a cause célèbre could be a Pyrrhic victory for those of us in the pro-life movement, if it makes people question the motives and arguments of the pro-life movement altogether."
Also, I would be curious to get Mr. Weigel's opinion about the work of orthodox theologians such as Germain Grisez and Martin Rhonheimer, who argue that, in the case where both mother and child will die, certain procedures -- including craniotomy (the direct crushing of the baby's skull), may be permitted. See http://www.commonwealmagazine.org/blog/wp-content/uploads/2010/12/St.-Josephs-Hospital-Analysis.pdf.
Also, please consider the following analysis posted over at InsideCatholic:
"From the perspective of pro-life advocacy, it's not clear to me why Mr. Weigel wants to trumpet the Phoenix case.
First, the situation where both mother and child will die is exceedingly rare, dwarfed by the thousands of abortions that occur each day where the mother's life is not in danger at all.
Second, the upshot of the argument – that "building a culture of life" requires two deaths rather than one in this situation – is a very hard one for most Americans to accept (and particularly for the people most affected – women).
I am quite familiar with the moral principles that are involved, but most Americans don't come to their moral beliefs by careful deductive reasoning and the application natural-law principles. Making this case into a cause célèbre could be a Pyrrhic victory for those of us in the pro-life movement, if it makes people question the motives and arguments of the pro-life movement altogether."
2.23.2011 | 2:51pm
Michael PS says:
I am grateful to Mr Weigel for his clear statement of the principle of double-effect.
The great Catholic Moral Philosopher, Elizabeth Anscombe, whilst defending the principle of double-effect as absolutely essential to Christian ethics, observed that:
“At the same time, the principle has been repeatedly abused from the seventeenth century up till now. The causes lie in the history of philosophy. From the seventeenth century till now what may be called Cartesian psychology has dominated the thought of philosophers and theologians. According to this psychology, an intention was an interior act of the mind which could be produced at will. Now if intention is all important--as it is--in determining the goodness or badness of an action, then, on this theory of what intention is, a marvellous way offered itself of making any action lawful. You only had to 'direct your intention' in a suitable way. In practice, this means making a little speech to yourself: ‘What I mean to be doing is. . .’"
Something she rightly characterized as “double-think about double effect.”
The great Catholic Moral Philosopher, Elizabeth Anscombe, whilst defending the principle of double-effect as absolutely essential to Christian ethics, observed that:
“At the same time, the principle has been repeatedly abused from the seventeenth century up till now. The causes lie in the history of philosophy. From the seventeenth century till now what may be called Cartesian psychology has dominated the thought of philosophers and theologians. According to this psychology, an intention was an interior act of the mind which could be produced at will. Now if intention is all important--as it is--in determining the goodness or badness of an action, then, on this theory of what intention is, a marvellous way offered itself of making any action lawful. You only had to 'direct your intention' in a suitable way. In practice, this means making a little speech to yourself: ‘What I mean to be doing is. . .’"
Something she rightly characterized as “double-think about double effect.”
2.23.2011 | 2:54pm
Fred says:
Jessie,
I wouldn't risk my life by not killing a burglar who broke into my house and threatened my life or the lives of my family, but the burgar is still a human being that, except in that or a similar extraordinary circumstance, it would be immoral to kill.
I disagree with the Church on abortion to save the mother's life. To me, that is a special case similar to self-defense or collateral damage in a just war. But that does not mean that the embryo is not human and shouldn't be protected under all but extraordinary circumstances.
I wouldn't risk my life by not killing a burglar who broke into my house and threatened my life or the lives of my family, but the burgar is still a human being that, except in that or a similar extraordinary circumstance, it would be immoral to kill.
I disagree with the Church on abortion to save the mother's life. To me, that is a special case similar to self-defense or collateral damage in a just war. But that does not mean that the embryo is not human and shouldn't be protected under all but extraordinary circumstances.
2.23.2011 | 5:39pm
norman ravitch says:
Let's pray for Dr. Bernard Nathanson, recently deceased. Science and Grace turned him from an abortionist career to a pro-Life position.
2.23.2011 | 5:39pm
Jessie says:
Fred:
'Should we allow mothers to die?
As you yourself said, you "disagree witht he Church on abortion to save the mother's life." And that's the principle we are discussing here. While you seem to believe that abortion is right - in this case.
So let us focus on this particular case; indeed, who among us is comfortable, telling a mother in such a situation, that she must, perhaps, die?
Perhaps Bishop Olmstead of Phoenix, was simply, wrong. Perhaps we should compare and contrast and balance his remarks, against what other Bishops - and perhaps even the BioEthics folks - say.
'Should we allow mothers to die?
As you yourself said, you "disagree witht he Church on abortion to save the mother's life." And that's the principle we are discussing here. While you seem to believe that abortion is right - in this case.
So let us focus on this particular case; indeed, who among us is comfortable, telling a mother in such a situation, that she must, perhaps, die?
Perhaps Bishop Olmstead of Phoenix, was simply, wrong. Perhaps we should compare and contrast and balance his remarks, against what other Bishops - and perhaps even the BioEthics folks - say.
2.23.2011 | 9:05pm
Dan says:
Really? From a man who has tried at length to promote "pre-emptive war" and an attempt to dismiss the voice of bishops who happen to disagree with his erroneous desires to pursue our current wars?
Articles like this need to start out with: I cannot imagine how difficult this situation is for everyone.....show some compassion for once, Dr. Weigel, for someone other than the uber-traditionalist Catholic who feels there is not enough silence in a Church.
This is a difficult situation. Mr. Weigel's expertise is so limited in this field as only to use this discussion as a weapon against liberals, his life goal. I have yet to read an article in which he offers (as Peter Maurin would note) a pronouncement over a denouncement.
First Things is weakened by his commentary.
Articles like this need to start out with: I cannot imagine how difficult this situation is for everyone.....show some compassion for once, Dr. Weigel, for someone other than the uber-traditionalist Catholic who feels there is not enough silence in a Church.
This is a difficult situation. Mr. Weigel's expertise is so limited in this field as only to use this discussion as a weapon against liberals, his life goal. I have yet to read an article in which he offers (as Peter Maurin would note) a pronouncement over a denouncement.
First Things is weakened by his commentary.
2.23.2011 | 9:05pm
Dan says:
Really? From a man who has tried at length to promote "pre-emptive war" and an attempt to dismiss the voice of bishops who happen to disagree with his erroneous desires to pursue our current wars?
Articles like this need to start out with: I cannot imagine how difficult this situation is for everyone.....show some compassion for once, Dr. Weigel, for someone other than the uber-traditionalist Catholic who feels there is not enough silence in a Church.
This is a difficult situation. Mr. Weigel's expertise is so limited in this field as only to use this discussion as a weapon against liberals, his life goal. I have yet to read an article in which he offers (as Peter Maurin would note) a pronouncement over a denouncement.
First Things is weakened by his commentary.
Articles like this need to start out with: I cannot imagine how difficult this situation is for everyone.....show some compassion for once, Dr. Weigel, for someone other than the uber-traditionalist Catholic who feels there is not enough silence in a Church.
This is a difficult situation. Mr. Weigel's expertise is so limited in this field as only to use this discussion as a weapon against liberals, his life goal. I have yet to read an article in which he offers (as Peter Maurin would note) a pronouncement over a denouncement.
First Things is weakened by his commentary.
2.23.2011 | 9:39pm
John Stockings says:
First of all, the "double-effect" standard that Mr. Weigel cites can become a good example of casuistry. What is the essential difference between uterine cancer and severe pulmonary hypertension as far as saving the woman's life is concerned? Why does the former trump the latter just because it occurs closer to the fetus and requires surgery? Secondly, Mr. Weigel's thinking, here as elewhere, becomes very simplistic when he encounters a fact situation that his ultra conservative mindset cannot accomodate. His use of the work "period" at the end of his sentence pronouncing the therapeutic abortion wrong accentuates his one-sided, defective point of view. He cannot see the illogic of his position on not doing harm (he alludes to the Hippocratic oath): Not to terminate this pregnancy would have done serious harm to the mother--her doctors felt she would lose her life--and only prolong the dying of the fetus. Revealingly, Mr. Weigel, like the woman's bishop, does not have any suggestions on what should have been done in this case. Thirdly, why is it moral casuistry to save the mother's life by performing a therapeutic abortion when it is clearly impossible to save both lives? Mr. Weigel implies that letting the woman die is the best option. This only aids and abets the pro-choice movement by showing insensitivity to women's lives. Lastly, it is immensely easier to write articles or issue excommunication decrees than to be a person participating in the medical decision-making on a thorny case like this. Period.
2.23.2011 | 10:58pm
Dr. Charles says:
Thank you Mr. Stockings. The extreme discomfort of this decision for an individual or committee experienced in ethical decisions demonstrates that constructs of moral theology simply cannot keep pace with technology...(the issue of 500,000+ frozen embryos vs. the church's stance against surrogacy is a great example). Everyone and his brother/sister has weighed on on this case...many to support their broader agendas...because their current position is weakened against a tide of instinctive ethics and the primacy of conscience in the applied world.
So this single case now attracts many inexperienced columnists, journalists, and bloggers who drag all manner of unrelated issues into questioning the bishop' moral authority... just as I have dragged in Sacramento family planning, vaccinations and now surrogacy to show that we do not have the consistency of teaching that can address the many grey areas...(weren't Hagar and Mary herself approved surrogates?)
To stand at a bedside, face a woman in extremis and her husband next to her with their four other children in the waiting room...that calls for courage while feeling the breath of God drawing near...and for the Ethics of Human Virtue...not Double Effect.
So this single case now attracts many inexperienced columnists, journalists, and bloggers who drag all manner of unrelated issues into questioning the bishop' moral authority... just as I have dragged in Sacramento family planning, vaccinations and now surrogacy to show that we do not have the consistency of teaching that can address the many grey areas...(weren't Hagar and Mary herself approved surrogates?)
To stand at a bedside, face a woman in extremis and her husband next to her with their four other children in the waiting room...that calls for courage while feeling the breath of God drawing near...and for the Ethics of Human Virtue...not Double Effect.
2.24.2011 | 3:14am
Michael PS says:
It is easy to overlook the fact that a physical act and its consequences may be identical, while the intention is quite different. To take a hackneyed example: a man jumps off a ten-storey building, in order to kill himself, which is suicide and a man jumps of a ten-storey building (which is on fire) in order to escape from the flames, which is not suicide. In the former case his death is the object of his action; in the latter, it is a doubtless foreseen, but unintended, consequence. It would be a very different matter, if he shot himself to avoid being burnt alive, for there his death would be intended. In fact, it would be his chosen means and, therefore, part of his intention.
Any other analysis strikes me as consequentialism, pure and simple.
Any other analysis strikes me as consequentialism, pure and simple.
2.24.2011 | 12:04pm
Artaban says:
Dr. Charles,
Hagar and Mary were not surrogates. Jesus got his full humanity from Mary, it wasn't as though DNA other than hers was inserted into her womb.
The story of Hagar is not a lesson from God on surrogacy, it had two purposes:
1. To show bad things happen when we fail to have faith in God and seek our own will (as Sarah did by offering Hagar, and Abraham allowed by acquiescing).
2. And to show that even when a mistake is made (say, in the event of an unintended pregnancy), God still loves, cherishes, and will help provide for the child.
Which ought to precipitate acts of faith, hope, and love even in risky or challenging pregnancies.
Hagar and Mary were not surrogates. Jesus got his full humanity from Mary, it wasn't as though DNA other than hers was inserted into her womb.
The story of Hagar is not a lesson from God on surrogacy, it had two purposes:
1. To show bad things happen when we fail to have faith in God and seek our own will (as Sarah did by offering Hagar, and Abraham allowed by acquiescing).
2. And to show that even when a mistake is made (say, in the event of an unintended pregnancy), God still loves, cherishes, and will help provide for the child.
Which ought to precipitate acts of faith, hope, and love even in risky or challenging pregnancies.
2.24.2011 | 1:05pm
Jack B says:
George Weigel's interpretation of "do no harm" would appear to forbid most major surgery, which commonly involves, intentionally and deliberately, significant slashing, burning, and mutilation of the patient in order to achieve its presumably good purpose. This simplistic view evaluating the situation faced by the people on the scene calls to mind the prepared statement of Bishop Olmsted on Dec 21: "In this case, the baby was healthy and there were no problems with the pregnancy; ….". Yet, the sole, entire life support of the fetus was observably collapsing. Pregnancy being a whole-body process, as mothers and doctors affirm, renders the "no problems" decree inexplicable.
http://www.arizonacatholic.org/wp-content/uploads/2010/12/DIOCESE-OF-PHOENIX-STATEMENT-122110.pdf
Publishing purified thoughts like these does nothing for the people who need and deserve help or for the standing of their authors.
http://www.arizonacatholic.org/wp-content/uploads/2010/12/DIOCESE-OF-PHOENIX-STATEMENT-122110.pdf
Publishing purified thoughts like these does nothing for the people who need and deserve help or for the standing of their authors.
2.24.2011 | 2:46pm
ed gleason says:
Mr Weigel [ forgets?] can't explain why 18 bishops and 13 dioceses where Catholic Health Care West has hospitals are all silent two months after the call.
I guess Olmsted is happy to have Weigel standing on the wobbly bridge with him.
I guess Olmsted is happy to have Weigel standing on the wobbly bridge with him.
2.24.2011 | 2:52pm
Jessie says:
The question is: should Bishops like Olmsted be ordering pregnant women, potentially, to their death?
2.24.2011 | 3:52pm
Bernie says:
I note that, among the comments, there appear to be none from women. This seems to mirror the male hierarchy and the primarily male legislators who decide our laws and regulations. Why the predominantly male interest in this subject?
2.24.2011 | 10:18pm
Siger Brabant says:
Artaban says:
"Jesus got his full humanity from Mary, it wasn't as though DNA other than hers was inserted into her womb."
Well, this is somewhat problematic. If it were true, then Jesus and Mary would be identical twins.
"Jesus got his full humanity from Mary, it wasn't as though DNA other than hers was inserted into her womb."
Well, this is somewhat problematic. If it were true, then Jesus and Mary would be identical twins.
2.25.2011 | 11:03am
Artaban says:
@ Ed Gleason: You make several erroneous and presumptuous inferences concerning the 13 other bishops and 18 dioceses. A lot more correction/discipline occurs behind the scenes (one-on-one) than in the public eye. Such action is consistent with what Christ told us to do in the Bible ("settle with your brother along the way, before you get to the judge/[public forum]").
Why is it that some people criticize bishops when they issue public correction, calling them "authoritarian" and "heavy-handed", but then presume they tacitly disagree with a brother bishop when they don't publicly inject themselves into his dioceses' business? I can only conclude that those critics truly have little sense, skill in critical thinking, psychological understanding, and experience in leadership. They are eager to damn the bishops if they do, and if they don't.
Furthermore, why you seem to think those other bishops would be so irrational as to castigate an entire organization for the actions of a few of its employees baffles me. Thank God the bishops have more sense than you credit to them, and are focusing their attentions on issues relevant to their particular diocese, where they are needed.
@Siger Brabant: I don't see that as problematic, though it does raise interesting questions. If he didn't get his humanity from someone, then that is even more problematic, for it would mean the Incarnation didn't happen and we aren't saved. to suggest he wasn't human is one of the old gnostic heresies. As one of the early Church fathers said when arguing for Christ's humanity, "What is not assumed is not redeemed."
Now Siger, are you trying to suggest that if Mary and Jesus were "identical twins", that would mean Mary is God? Such a statement wouldn't really be logical unless one is a materialist and determinist (i.e. the physical is all there is to the universe), which is something Christians clearly are not. It seems to me you're confusing several diametrically opposed worldviews.
We in fact know that even "identical twins" do not stay identical even genetically (over time, genetic damage, whether caused by radiation, toxins, age, or mutation mean that even a clone will have different DNA from it's genetic donor). Furthermore, we know that what we choose to do (exercise, study, eating) can switch the expression of genes on and off, and "identical" twins are very different from each other. Science still can't explain those differences, even in terms of experience and physical environment. Perhaps they come from the spiritual dimension?
No logical person would make a judgment on one twin for the action of the other, or imply they are the same person. Why would someone go and do that for Jesus and Mary?
In summation, I fail to see the "problems" to which you allude.
Why is it that some people criticize bishops when they issue public correction, calling them "authoritarian" and "heavy-handed", but then presume they tacitly disagree with a brother bishop when they don't publicly inject themselves into his dioceses' business? I can only conclude that those critics truly have little sense, skill in critical thinking, psychological understanding, and experience in leadership. They are eager to damn the bishops if they do, and if they don't.
Furthermore, why you seem to think those other bishops would be so irrational as to castigate an entire organization for the actions of a few of its employees baffles me. Thank God the bishops have more sense than you credit to them, and are focusing their attentions on issues relevant to their particular diocese, where they are needed.
@Siger Brabant: I don't see that as problematic, though it does raise interesting questions. If he didn't get his humanity from someone, then that is even more problematic, for it would mean the Incarnation didn't happen and we aren't saved. to suggest he wasn't human is one of the old gnostic heresies. As one of the early Church fathers said when arguing for Christ's humanity, "What is not assumed is not redeemed."
Now Siger, are you trying to suggest that if Mary and Jesus were "identical twins", that would mean Mary is God? Such a statement wouldn't really be logical unless one is a materialist and determinist (i.e. the physical is all there is to the universe), which is something Christians clearly are not. It seems to me you're confusing several diametrically opposed worldviews.
We in fact know that even "identical twins" do not stay identical even genetically (over time, genetic damage, whether caused by radiation, toxins, age, or mutation mean that even a clone will have different DNA from it's genetic donor). Furthermore, we know that what we choose to do (exercise, study, eating) can switch the expression of genes on and off, and "identical" twins are very different from each other. Science still can't explain those differences, even in terms of experience and physical environment. Perhaps they come from the spiritual dimension?
No logical person would make a judgment on one twin for the action of the other, or imply they are the same person. Why would someone go and do that for Jesus and Mary?
In summation, I fail to see the "problems" to which you allude.
2.25.2011 | 3:59pm
Siger Brabant says:
@Artaban: No, I don't mean that if Mary and Jesus were identical twins that this would make Mary God, anymore than one identical twin's winning the Nobel Prize or being sentenced to prison means that the other is. They are distinct persons.
The problem is this:
Two persons with the same DNA are identical twins. Identical twins are the same sex (i.e. both either have XX or XY chromosomes) . Jesus and Mary were not the same sex. Therefore, they did not have always have exactly the same DNA.
I suppose you could imagine that Jesus's DNA was some kind of mutation of Mary's, as we would say. Caused we know not how. And with the fortuitous (miraculous) effect of turning an XX set of chromosomes into an XY set of chromosomes.
Saying that Jesus is a mutated clone or the mutated identical twin of Mary doesn't sound very orthodox. Why insist on the identity of their DNA?
The problem is this:
Two persons with the same DNA are identical twins. Identical twins are the same sex (i.e. both either have XX or XY chromosomes) . Jesus and Mary were not the same sex. Therefore, they did not have always have exactly the same DNA.
I suppose you could imagine that Jesus's DNA was some kind of mutation of Mary's, as we would say. Caused we know not how. And with the fortuitous (miraculous) effect of turning an XX set of chromosomes into an XY set of chromosomes.
Saying that Jesus is a mutated clone or the mutated identical twin of Mary doesn't sound very orthodox. Why insist on the identity of their DNA?
2.25.2011 | 10:14pm
Dr. Charles says:
Well, he said, let's not carry this arguement too far without a sense of humor..
..."parthenogenesis" in animals and some vertebrates is known, but they can only produce females because they cannot mutate an X chromosome into a "Y"...
I wish we could have just a teeny dried blood smidge from the Shroud of Turin to run through a PCR analysis...while mitochondrial maternal nucleic acid fragments may be present even today, we could look like hell for that perfect Y...
Yes if Mary and Jesus were some sort of twinning variation (I am an identical twin) that would mean that we'd have to reconsider the idea of the Trinity...maybe think about a "Holy Quartet"...the Redemptorix proponents have already been building their case...
..."parthenogenesis" in animals and some vertebrates is known, but they can only produce females because they cannot mutate an X chromosome into a "Y"...
I wish we could have just a teeny dried blood smidge from the Shroud of Turin to run through a PCR analysis...while mitochondrial maternal nucleic acid fragments may be present even today, we could look like hell for that perfect Y...
Yes if Mary and Jesus were some sort of twinning variation (I am an identical twin) that would mean that we'd have to reconsider the idea of the Trinity...maybe think about a "Holy Quartet"...the Redemptorix proponents have already been building their case...
2.26.2011 | 12:10am
Ellen says:
Do people (George Weigel) really believe that not providing medical intervention to save the life of the mother (without whose life there is no fetal life) is really adhering to the Hippocratic Oath of doing no harm? Talk about Orwellian.
I thought I read some stuff from Weigel from way back that was more thoughtful than this (decreasing the number of abortions, costly grace, etc.). As far as the principle of double effect goes, isn't number 1) that the act cannot be intrinsically evil (but it can be morally neutral). To start out saying the act itself must be "good" would make the whole double effect part less necessary, since there seems no reason to scrutinize the morality of a good act. Also the application of the principle of double effect above is a bit unclear. For 2) All that is intended in the removal of the diseased organ. The act is the removal of the diseased organ, which is at least morally neutral. The intention of removing the diseased organ is to preserve the life of the woman.
"by theologians and philosophers advancing speculative views detached from clinical reality" Huh? Who is advancing speculative views detached from clinical reality? Weigel? Why not grant that the people who were actually involved in this difficult clinical reality did what good they could by preserving the life of the woman. To argue that the death of this young mother of four and fetus would have been a better outcome (as Weigel does when he says saving the life that could be saved is just wrong) is ridiculous.
Maybe the principle of double effect is inadequate to deal with the omplexity of this situation. John Stockings makes an excellent point: "First of all, the "double-effect" standard that Mr. Weigel cites can become a good example of casuistry. What is the essential difference between uterine cancer and severe pulmonary hypertension as far as saving the woman's life is concerned? Why does the former trump the latter just because it occurs closer to the fetus and requires surgery?" I could offer a purely intuitive response as to why removal of the uterus or fallopian tube is acceptable, but it would be uncharitable.
I thought I read some stuff from Weigel from way back that was more thoughtful than this (decreasing the number of abortions, costly grace, etc.). As far as the principle of double effect goes, isn't number 1) that the act cannot be intrinsically evil (but it can be morally neutral). To start out saying the act itself must be "good" would make the whole double effect part less necessary, since there seems no reason to scrutinize the morality of a good act. Also the application of the principle of double effect above is a bit unclear. For 2) All that is intended in the removal of the diseased organ. The act is the removal of the diseased organ, which is at least morally neutral. The intention of removing the diseased organ is to preserve the life of the woman.
"by theologians and philosophers advancing speculative views detached from clinical reality" Huh? Who is advancing speculative views detached from clinical reality? Weigel? Why not grant that the people who were actually involved in this difficult clinical reality did what good they could by preserving the life of the woman. To argue that the death of this young mother of four and fetus would have been a better outcome (as Weigel does when he says saving the life that could be saved is just wrong) is ridiculous.
Maybe the principle of double effect is inadequate to deal with the omplexity of this situation. John Stockings makes an excellent point: "First of all, the "double-effect" standard that Mr. Weigel cites can become a good example of casuistry. What is the essential difference between uterine cancer and severe pulmonary hypertension as far as saving the woman's life is concerned? Why does the former trump the latter just because it occurs closer to the fetus and requires surgery?" I could offer a purely intuitive response as to why removal of the uterus or fallopian tube is acceptable, but it would be uncharitable.
2.26.2011 | 8:04am
Dr. Charles says:
..again the PDE is the wrong framework for this dilemma...Virtue Ethics should be applied...
2.26.2011 | 8:24am
Anonymous 3 says:
This is a case that possibly gris at hearts of many and thus could helped to make many more aware of Church's teachings .
Thank you to Dr.Weigel for courageously bringing up a controversial topic .
Many readers here also possibly familiar with this article and opinion by neonatologist Paul Byrne M.D - http://www.lifesitenews.com/news/archive/ldn/2010/jun/10062501
Could it be that The Bishop had also similar data to support his stand !
Suppose too that he used the golden rule - ' do unto others ..' ; could he have seen his own niece in a similar predicament in a Catholic hospital and be hurt to know of the negelect, if it was so , of the power of prayer and fasting - thus , negating the 'Catholic' in its name !
Could it have been existing areas of disobediance in place ( use of contraception etc : ) that led to this 'sudden destruction' ...
http://www.spiritdaily.org/AmazingPio_cures.htm Our is a Church of the Living God of miracles and healings ...would other measures of treatments have been made known , esp. in these days of internet and fast communications !
We are faced on one side with threats of loosing life for prophesing the trust in The saving Name of our Lord ...to counter balance , when we are called to call upon His Name when faced with loss of lives and are negligent ( again not evident from news reports if this is so !) - the next best thing is for hearts to be grieved , in atonement ..
The only biblical case of a maternal death related to pregnanacy that comes to mind is that of Rachel , wife of Jacob ..poor Rachel , that had held onto her father's idols ..and was Jacob negligent in not telling her to be rid of same ..
( not by any means implying that this is personally applicable in this case ; whatever info is available seems to support just the opposite , with regard to this mother .)
It was not that long ago that every delivery would have been like a mother in warfare ...and familes had the wisdom , to make use of spiritual armaments , such as the St.Benedict medals .
Hope that the Catholic hospitals could have the Divine Mercy devotions bradcast through the whole place at 3'0 clock , Gregorian chant c.ds at other times etc : and also make available Catholic sacramentals and images for all pts and families too !
Thank you to Dr.Weigel for courageously bringing up a controversial topic .
Many readers here also possibly familiar with this article and opinion by neonatologist Paul Byrne M.D - http://www.lifesitenews.com/news/archive/ldn/2010/jun/10062501
Could it be that The Bishop had also similar data to support his stand !
Suppose too that he used the golden rule - ' do unto others ..' ; could he have seen his own niece in a similar predicament in a Catholic hospital and be hurt to know of the negelect, if it was so , of the power of prayer and fasting - thus , negating the 'Catholic' in its name !
Could it have been existing areas of disobediance in place ( use of contraception etc : ) that led to this 'sudden destruction' ...
http://www.spiritdaily.org/AmazingPio_cures.htm Our is a Church of the Living God of miracles and healings ...would other measures of treatments have been made known , esp. in these days of internet and fast communications !
We are faced on one side with threats of loosing life for prophesing the trust in The saving Name of our Lord ...to counter balance , when we are called to call upon His Name when faced with loss of lives and are negligent ( again not evident from news reports if this is so !) - the next best thing is for hearts to be grieved , in atonement ..
The only biblical case of a maternal death related to pregnanacy that comes to mind is that of Rachel , wife of Jacob ..poor Rachel , that had held onto her father's idols ..and was Jacob negligent in not telling her to be rid of same ..
( not by any means implying that this is personally applicable in this case ; whatever info is available seems to support just the opposite , with regard to this mother .)
It was not that long ago that every delivery would have been like a mother in warfare ...and familes had the wisdom , to make use of spiritual armaments , such as the St.Benedict medals .
Hope that the Catholic hospitals could have the Divine Mercy devotions bradcast through the whole place at 3'0 clock , Gregorian chant c.ds at other times etc : and also make available Catholic sacramentals and images for all pts and families too !
2.26.2011 | 8:47am
Anonymous 3 says:
About the 500,000 frozen embryos too - could there be a connection with the weather ..and another area that we need to be asking for mercy for disobediance ..
http://marianweb.net/archives/flash/image/video.php?id=2 - good talk on the healing Rays and Image .
http://marianweb.net/archives/flash/image/video.php?id=2 - good talk on the healing Rays and Image .
2.26.2011 | 8:50am
Michael PS says:
Talk about the "Principle" or "Doctrine" of double-effect, tends to obsure the kinf oanalysis we are, or should be, doing, which is one into the nature of action and intention.
This is often bedevilled with the fallacy of "directing one's intention," which, as I said earlier, means, in practice, making a little speech to oneself, "What I mean to be doing is... "
Abundant eamples can be found in the opinions of the casuists and in the repeated condemnations of those opinions by the Holy See. - One of my favourites is the servant who holds a ladder to help his master rob a house, whilst only intending to keep his job, or the son who desires and longs for his parents' death, not out of malice, but only for the sake of the inheritance, or the clergyman who gives money for a benefice, not as the price of the benefice (which would be simony) but as an inducement to grant it [All condemned by Innocent XI] - Really, one could not make these things up!
This is often bedevilled with the fallacy of "directing one's intention," which, as I said earlier, means, in practice, making a little speech to oneself, "What I mean to be doing is... "
Abundant eamples can be found in the opinions of the casuists and in the repeated condemnations of those opinions by the Holy See. - One of my favourites is the servant who holds a ladder to help his master rob a house, whilst only intending to keep his job, or the son who desires and longs for his parents' death, not out of malice, but only for the sake of the inheritance, or the clergyman who gives money for a benefice, not as the price of the benefice (which would be simony) but as an inducement to grant it [All condemned by Innocent XI] - Really, one could not make these things up!
2.26.2011 | 11:33am
Lauri says:
I find it interesting that so few people believe that there are worse things than death, especially for Christians. Speaking for myself, in these circumstances, I would follow the teachings of the Catholic Church and I would put my faith and trust in God. God says, "Thou shalt not kill", among many other commandments and injunctions that put human self-interest and self-absorption constantly to the test. Death is never pretty, but it is always inevitable. In my opinion, those who would do any and all things to prevent their own have their priorities in a sorry state.
2.26.2011 | 2:11pm
Anonymous3 says:
This case could help Catholic hospitals to look into ways to make them more Catholic and avoid areas such as use of contraception that could block off grace of wisdom to turn to power of prayer and fasting , use of sacramental etc : as regular matters in patient care , esp. in difficult cases !
We see how so called secular hospitals promoting yoga and such ardently !
The Chaplet of Divine mercy , to be played through out the hospitals at 3' o clock, Gregorian chants at other times , patients and families given Catholic sacramentals and staff too educated on same on an ongoing basis - it is true that many in the health care setting are very good hearted people who genuinly know how to care ; yet it can be augmented !
The two episodes mentioned in Old Testament about maternal issues in this context - Exodus mentions how the Jewish mothers gave birth with no problems and then there is poor Rachel who had kept the idols of her father ; by no means implying a personal cause in the above case but to be able to see the bishop's efforts from such a perspective !
http://www.lifesitenews.com/news/archive/ldn/2010/may/10051712
The above article by Dr.Byrne might be already familiar to many - it also helps to have another perspective ; true , unsure to what extent in the above case !
We see how so called secular hospitals promoting yoga and such ardently !
The Chaplet of Divine mercy , to be played through out the hospitals at 3' o clock, Gregorian chants at other times , patients and families given Catholic sacramentals and staff too educated on same on an ongoing basis - it is true that many in the health care setting are very good hearted people who genuinly know how to care ; yet it can be augmented !
The two episodes mentioned in Old Testament about maternal issues in this context - Exodus mentions how the Jewish mothers gave birth with no problems and then there is poor Rachel who had kept the idols of her father ; by no means implying a personal cause in the above case but to be able to see the bishop's efforts from such a perspective !
http://www.lifesitenews.com/news/archive/ldn/2010/may/10051712
The above article by Dr.Byrne might be already familiar to many - it also helps to have another perspective ; true , unsure to what extent in the above case !
2.26.2011 | 4:43pm
Dr. Charles says:
Michael PS brings us back to the intentions of Sister Margaret and the St. Joseph’s Ethics Committee…PDE can be wordsmithed using common vernacular to different conclusions. Yet the assumption that in this case a greater good by one choice is challenged many…I’d argue both outcomes were unacceptable in church teaching…to allow both mother and fetus to die…or to perform the abortion…the approach of determining ”the moral object of the act” does not help bring a resolution. Some will say Sister Margaret acted in her well-formed conscience…others that her conscience was not authentically formed with church teaching.
Both Martin Rhonheimer and Germain Grisez have addressed this unique dilemma and conclude that the feticide may be an acceptable course…( Vital Conflicts in Medical Ethics: A Virtue Approach to Craniotomy and Tubal Pregnancies, Martin Rhonheimer 2009).
Rhonheimer’s thesis is not out-of-date. Some may remember this from the 1963 movie ”The Cardinal” with Thomas Tryron having to decide with his sister in labor . While craniotomies for a child head in pelvic obstruction are not performed here in the US (secondary to our ability to do emergency Cesarean sections) it probably occurs not infrequently in many areas of the world today (although I have not seen estimates.)
The Phoenix case continues to have everyone who writes and speaks for a living weigh-in…whether they have experience or training in medical ethics, clinical medicine or moral theology...so we will see many more Weigel-ins to come…
Both Martin Rhonheimer and Germain Grisez have addressed this unique dilemma and conclude that the feticide may be an acceptable course…( Vital Conflicts in Medical Ethics: A Virtue Approach to Craniotomy and Tubal Pregnancies, Martin Rhonheimer 2009).
Rhonheimer’s thesis is not out-of-date. Some may remember this from the 1963 movie ”The Cardinal” with Thomas Tryron having to decide with his sister in labor . While craniotomies for a child head in pelvic obstruction are not performed here in the US (secondary to our ability to do emergency Cesarean sections) it probably occurs not infrequently in many areas of the world today (although I have not seen estimates.)
The Phoenix case continues to have everyone who writes and speaks for a living weigh-in…whether they have experience or training in medical ethics, clinical medicine or moral theology...so we will see many more Weigel-ins to come…
2.26.2011 | 5:38pm
Jack B says:
George Weigel's effort to put matters into language understandable by those not in professional moral theology and philosophy should start with "intention". Among the most undesirable results in surgery are effects that are not intentional, whether they be positive, negative, or neutral. An intimate linkage of foresight, intention, and related action, adapting as necessary, is to be hoped for in surgery, notwithstanding the fact that nature seldom allows perfection. To speak as if results may be foreseen and deliberately caused and yet be unintended because of conscious self-deception appears to be playing with words.
Perhaps the experts will define for themselves and the USCCB to use for teaching purposes a new "classic case" involving a woman with pulmonary hypertension, cardiac damage, cardiogenic shock, and pregnancy. Persuasive moral analysis of that should then be easy to adapt to simpler situations like the familiar cancerous uterus and ectopic pregnancy cases.
Perhaps the experts will define for themselves and the USCCB to use for teaching purposes a new "classic case" involving a woman with pulmonary hypertension, cardiac damage, cardiogenic shock, and pregnancy. Persuasive moral analysis of that should then be easy to adapt to simpler situations like the familiar cancerous uterus and ectopic pregnancy cases.
2.28.2011 | 10:12am
Patricia Flynn says:
Why are there so many Comments on anything George weigel writes?I think all he has to say is Good Morning and he would have 100rd comments
3.9.2011 | 2:04pm
Carolann Altobello says:
The Phoenix case continues to have everyone who writes and speaks for a living weigh-inwhether they have experience or training in medical ethics, clinical medicine or moral theology...so we will see many more Weigel-ins to come 2. And to show that even when a mistake is made (say, in the event of an unintended pregnancy), God still loves, cherishes, and will help provide for the child.
3.22.2011 | 11:05am
Popovic Kathey says:
Thank you Mr. Stockings. The extreme discomfort of this decision for an individual or committee experienced in ethical decisions demonstrates that constructs of moral theology simply cannot keep pace with technology...(the issue of 500,000+ frozen embryos vs. the church's stance against surrogacy is a great example). Everyone and his brother/sister has weighed on on this case...many to support their broader agendas...because their current position is weakened against a tide of instinctive ethics and the primacy of conscience in the applied world. @ Ed Gleason: You make several erroneous and presumptuous inferences concerning the 13 other bishops and 18 dioceses. A lot more correction/discipline occurs behind the scenes (one-on-one) than in the public eye. Such action is consistent with what Christ told us to do in the Bible ("settle with your brother along the way, before you get to the judge/[public forum]").
Evidently moral theology does recognize the very difficult questions which arise in the medical fields. Then it seems the code gets artificially and rationalistically bogged down in an effort to chart the right way.