Book Review — More Humane Medicine: A Liberal Catholic Bioethics

March-April 2004

REVIEWED BY PETER J. CATALDO, PhD

James F. Drane
Edinboro University Press, Edinboro, PA, 2003, 399 pp., $24.95 (paperback)

In his new book, James Drane attempts to provide a bioethics text that satisfies both a common view of ethical ("humane") medicine described in terms of certain needs inherent in the experience of illness, on one hand, and a Catholic moral perspective, on the other. Drane supports his vision of a humane medicine with what he characterizes as a liberal Catholic view of natural law ethics. The volume would be of interest to those working in academic and clinical bioethics and, in particular, those in Catholic bioethics.

The contents of the volume are essentially divided into two parts. The first six chapters are on ethical concepts and principles that serve as a foundation for the remaining nine chapters on specific issues in bioethics, such as abortion, HIV/AIDS, euthanasia, and equity in health care. The foundational portion of the book contains chapters on what Drane understands to be a more humane medicine, liberal Catholicism approvingly described in terms of the life and work of five individuals, and natural law theory.

Drane indicates that the split between liberals and conservatives in the Catholic community may be resolved by insisting upon respect for one another, using historical analysis, and engaging in "tough reasoning" (p. xi). He also looks negatively at factionalism (p. 97). However, Drane's own implementation of these standards is lacking. Throughout the volume Drane affirms a dichotomous view of Catholicism between liberals and conservatives (whom he calls "ultra-conservatives"). He explicitly or implicitly refers to conservative Catholics with pejorative language, for example, as being extremists (p. xi), unintelligent (p. 29), dishonest (p. 32), fixated on being right (p. 27), actively opposed to change (p. 25), and mean-spirited (p. 29). On the basis of their conservativism, Drane also impugns the personal motives of certain bishops, claiming that they have acted opportunistically (p. 29) and dishonestly (p. 352). He also argues that conservatives purposely distort Catholic teaching on certain issues in order to give an appearance of consistency with their extremist views (pp. 25, 351). This approach does little to foster the respect Drane states is needed for healing, nor for this reason does it display the "loving and helping behaviors" to which the liberal is more committed than the conservative, according to Drane (p. 20).

Drane describes "Catholic Natural Law" in completely naturalistic terms as consisting in a human understanding of the "constituents of humanness" from which ethical principles are derived (pp. 74-75). On this basis he argues that ethical principles derived from natural law are changeable because both human understanding and human nature evolve. This view of natural law fails to recognize that the natural law is inextricably bound up with the eternal law of God in the Catholic moral tradition, and it also fails to distinguish the three aspects of natural law: law in the mind, in things, and commanded by divine providence. This problem causes Drane to equate differences in the application of the natural law with the evolution of the law itself, and allows him to use a consequentialist approach with certain issues such as contraception and physician-assisted suicide.

Drane's treatment of human sexuality and birth control in the Catholic moral tradition and teaching is representative of his modus operandi of making strong claims against Catholic teaching or nameless "conservatives" with little or no evidence. He argues that Catholic teaching reduces the ethics of sexual relations to a "narrow physiology": "It is all about eggs and sperm and the system for bringing these two cells to procreativity" (p. 123). Drane cites Pope Paul VI and Pope John Paul II, but gives no specific quotation or reference in evidence of his claim, and also effectively ignores the abundant theological personalism that exists in modern Catholic teaching on human sexuality and marriage.

This volume should be a disappointment to those sympathetic to Drane's views as well as to those who disagree with Drane. Those who agree with his conclusions will find a scarcity of specific evidence for many of his claims, sweeping generalizations, and a derogative edge inconsistent with Drane's stated hopes for healing. Those who disagree will find the book wanting in these ways as well, but can also point to ample instances of error about Catholic teaching and the Catholic natural law tradition, question-begging uses of such concepts as "experience" and "reasonableness," and a consequentialism masked in the language of natural law and fiduciary responsibility. Interestingly, two chapters not burdened by the liberal/conservative antagonism—on aging and palliative care—are quite helpful.

Peter J. Cataldo, PhD
Director of Research
The National Catholic Bioethics Center
Boston

Copyright © 2004 by the Catholic Health Association of the United States
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