REVIEWED BY CARL L. MIDDLETON JR., DMin
Kevin D. O'Rourke and Philip Boyle
3rd ed., Georgetown University Press, Washington, DC, 1999, 442 pp., $37.50 (paperback)
In these post-Balanced Budget Act days of belt tightening and fiscal constraint in healthcare, we face another ethical dilemma: Should one buy the third edition of Medical Ethics: Sources of Catholic Teachings, especially if one already has both the 1989 and 1993 editions? Does this book contain significant amounts of new substantive material and modifications to justify its purchase? The answer is yes.
The third edition of Medical Ethics contains the following new material:
- Eleven new chapters, including a chapter on AIDS which focuses on the international ethical problem of the African AIDS crisis
- Church teachings applied to contemporary social and ethical issues, including healthcare reform and assisted suicide
- Recently published encyclicals and magisterial statements such as The Splendor of Truth, The Gospel of Life, and The Catechism of the Catholic Church
- Recent church teachings applied to addiction, anencephaly, artificial reproduction, assisted suicide, suicide, capital punishment, murder, Catholic healthcare, healthcare reform, the principle of cooperation, and the principle of double effect
In addition to these new chapters, O'Rourke and Boyle have made substantive revisions such as the deletion of citations from the earlier chapter on hydration and nutrition and the relocation of the section on the Ethical and Religious Directives to later in the book.
While these changes contribute to the book's excellence, there is the potential misuse of this valuable resource as an ecclesiological proof text. The authors acknowledge this danger and realize that, while most healthcare professionals are knowledgeable in matters of medicine and science, many lack an understanding of the church's teachings. The authors' purpose in the third edition is "to help Catholic healthcare professionals understand, internalize, and apply the principles of Catholic teaching to the many ethical issues they encounter in research and practice." For the reasons stated above it is imperative that a person read the first two chapters before using the book for research purposes.
The first chapter presents the teachings of the church regarding the concept of the human person and human action, which pertains to various issues of medical ethics. The second chapter distinguishes between erroneous notions of ethical norms and conscience and the role of the church's teachings in the appropriately formed and informed conscience. O'Rourke and Boyle emphasize the fact that "decisions of conscience are always about particular actions which involve particular facts and judgements. The teachings of the Church are never to be considered as preconceived solutions to serious problems." The church's teaching are general statements that "reflect the teachings of Christ and Christian wisdom requiring application to difficult situations by compassionate individuals."
Duly noting this caution, the user will find this text indispensable in not only becoming acquainted with the church's teachings but also essential to integrating these teachings in medical ethics.
As O'Rourke and Boyle plan their fourth edition, there are some changes I would suggest. First, I would suggest a change in the title. The title Medical Ethics: Sources of Catholic Teachings suggests a broad inclusion of teachings from other national episcopal conferences as well as excerpts from the works of theologians. The sources used in the book are exclusively from papal/Vatican and the American National Conference of Catholic Bishops documents.
The second change concerns the chapters on capital punishment and murder. The chapter on capital punishment seems out of place in a book on medical ethics, although it is a significant ethical issue for our society. Murder, the title of Chapter 36, seems a misnomer, with "killing" being a more accurate term. The chapter makes the distinction between killing and allowing to die. Murder is often used as a legal term connecting this particular form of killing to a criminal act.
Over the years I have found the previous editions to be most helpful as a handy reference for church teachings pertaining to healthcare issues. The third edition of Medical Ethics: Sources of Catholic Teaching is an excellent, indispensable, and cost-effective research tool that should be in every healthcare professional's resource library.
Reviewed by Carl L. Middleton Jr., DMin, Vice President, Theology and Ethics, Catholic Health Initiatives, Denver
Copyright © 2000 by the Catholic Health Association of the United States
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