Roman Catholic moral theology is the point of departure for this multifaceted exploration of the challenge of allocating scarce medical resources. This volume begins its exploration of discerning moral limits to modern high-technology medicine with a consensus statement born of the conversations among its contributors. The seventeen essays use the example of critical care, because it offers one of the few areas in medicine where there are good clinical predictive measures regarding the likelihood of survival. As a result, the health care industry can with increasing accuracy predict the probability of saving lives - and at what cost. Because critical care involves hard choices in the face of finitude, it invites profound questions about the meaning of life, the nature of a good death, and distributive justice. For those who identify the prize of human life as immortality, the question arises as to how much effort should be invested in marginally postponing death. In a secular culture that presumes that individuals live only once, and briefly, there is an often-unacknowledged moral imperative to employ any means necessary to postpone death.
The conflict between the free choice of individuals and various aspirations to equality compounds the challenge of controlling medical costs while also offering high-tech care to those who want its possible benefits. It forces society to confront anew notions of ordinary versus extraordinary, and proportionate versus disproportionate, treatment in a highly technologically structured social context. This cluster of discussions is enriched by five essays from Jewish, Orthodox Christian, and Protestant perspectives. Written by premier scholars from the United States and abroad, these essays will be valuable reading for students and scholars of bioethics and Christian moral theology.
H. Tristram Engelhardt, Jr., is professor in the department of philosophy at Rice University and professor emeritus at Baylor College of Medicine, Houston, Texas, as well as editor of the Journal of Medicine and Philosophy and senior editor of Christian Bioethics. Mark J. Cherry is assistant professor of philosophy at Saint Edward's University, Austin, Texas.
PrefaceH. Tristam Engelhardt Jr. Part I / Moral Responsibility and High Technology: An Introduction Infinite Expectations and Finite Resources: A Roman Catholic Perspective on Setting Limits to Critical Care, or Can Roman Catholic Moral Theology Say More than Secular Morality Provides?H. Tristram Engelhardt Jr. Facing the Challenges of High Technology Medicine: Taking the Tradition SeriouslyMark J. Cherry Part II / Moral Consensus Statement Consensus StatementWorking Group on Roman Catholic Approaches to Determining Appropriate Critical Care Part III / The Challenges of Critical Care: High Technology, Rising Costs, and Guarged Promises Respect for Human Life in the World of Intensive Care Units: Secular Reform Jewish Reflections on the Roman Catholic ViewMichael RieWhat is Appropriate Intensive Care? A Roman Catholic PerspectivePaulina Taboada Part IV / Moral Theological PerspectivesLimiting Access to Health Care: A Traditional Roman Catholic AnalysisJoseph Boyle Towards a Personalistic Ethics of Limiting Access to Medical Treatment: Philosophical and Catholic PositionsJoseph Seifert Equal Care as the Best of Care: A Personalist ApproachPaul T. Schotmans Quality of Life and Human Dignity: Meaning and Limits of Prolongation of LifeLudger Honnefelder Part V / Moral and Public Policy Challenges Beyond the Questions of Limits: Institutional Guidelines for the Appropriate Use of Critical CareGeorge Khushf Developing the Doctrine of Distributive Justice: Methods of Distribution, Redistribution, and the Role of Time in Allocating Intensive Care ResourcesM. Cathleen Kaveny Creating Critical Care Resources: Implications for Distributive JusticeKevin Wm. Wildes, SJ Part VI / From a Different Point of View: Jewish, Orthodox, and Protestant Perspectives Allocation of Scarce Medical Resources to Critical Care: A Perspective from the Jewish Canonical TraditionTeodoro Forcht Dagi The Current Medical Crises of Resources: Some Orthodox Christian ReflectionsVery Reverend Edward Hughes The Allocation of Medical Services: The Problem From a Protestant PerspectiveDietrich Rossler Part VII / Critical Commentary Between Secular Reason and the Spirit of Christianity: Catholic Approaches to Limiting Access to Scarce Medical ResourcesCorinna Delkeskamp-Hayes Catholicizing HealthJames W. Heisig Roman Catholic Theology and the Allocation of Resources to Critical Care: The Boundaries of Faith and ReasonMary Ann Gardell Cutter