Editor's Comments
We are pleased to present, first of all, an article by John Paul Slosar of Ascension Health on what "non-ethicists" need to know about ethics. His thoughtful remarks are geared to "spread the joy" of ethical thinking to more than just ethics professionals. As our beloved former colleague Jack Glaser used to say, "There are no ethics-free zones."
Even though some of us do have specialized education and background in this area, the publicity surrounding ethical issues in health care and the vastly expanded involvement of patients and families in ethical decision making demands that we think of ways to create greater awareness and broader participation.
We then return to our discussion of issues in transgender health care. Previous articles by Carol Bayley, Kevin FitzGerald and Beckett Gremmels made it clear that ethical issues surrounding transgender persons and their health care are complex and multifaceted. There are psychological aspects, medical aspects (including hormone therapy, cosmetic and urogenital surgery, and ordinary care for non-TG related conditions1) and legal issues. Transgenderism also involves genetics and embryology because we do not yet fully understand the origin of this condition. Legal issues have become more pressing since the final HHS non-discrimination regulations took effect on July 18.2 These rules require that we examine both our clinical and human resources policies.
Finally and perhaps most importantly for us, there are philosophical and theological questions. These pertain directly to transgender persons, but they also raise fundamental questions about what it means to be human. Elliott Bedford and Jason Eberl present an exploration of philosophy, personhood and the soul. E. Christian Brugger of St. John Vianney Seminary in Denver and the Culture of Life Foundation in Washington, D.C., responds to Bayley and Gremmels.
Our purpose in publishing these articles is to deepen our understanding of what is in many ways a new issue. Transgender persons have always been among us, of course, but our awareness of them and of the many issues that impact them are new. Our assumption is that there is no definitive magisterial church teaching on transgenderism or gender dysphoria. Our conviction is that our Catholic tradition has the resources to address these questions and we hope this ongoing dialogue will help to do that.
Despite questions that remain, we can affirm the following:
1) We provide health care services to anyone who comes to us, regardless of gender, sex, race or any other personal quality.
2) We guarantee equitable access to services for all persons.
3) We are committed to respect the dignity of each person and to "meet them where they are" — socially, psychologically, pastorally and economically.
4) We will remain faithful to our mission and values and will maintain our corporate integrity as we deal with these issues in a pluralistic society.
The final article is a discussion of ethical issues around direct-to-consumer advertising of prescription medication. This began as a pet peeve for me. I am part of a generation that still gets much of its news in traditional ways, e.g., newspapers and TV. I still watch the evening news on network television and have been annoyed by the increasing number of ads for prescription drugs. That annoyance eventually led ethical curiosity. My article is the result of my investigation. It is an overview of some of the ethical questions that surround direct-to-consumer advertising. I believe this trend deserves much closer attention.
- See the World Professional Association for Transgender Health "Standards of Care" available in E. Coleman et al., "Standards of Care for the Health of Transsexual, Transgender and Gender-Nonconforming People," Version 7 (International Journal of Transgenderism, 2011, v. 13:165-232) and also on the WPATH web page (www.wpath.org).
- A summary of the new HHS regulations are available in the June issue of the United States Conference of Catholic Bishops' Law Briefs (June 2016), pp. 6-18, "HHS Issues Final Regulations on Nondiscrimination in Federally-Funded Health Programs and Activities." The Kaiser Family Foundation has an online summary of the regulations at http://kff.org/disparities-policy/issue-brief/summary-of-hhss-final-rule-on-nondiscrimination-in-health-programs-and-activities/
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