Over the last fifty years, it has become customary to frame moral questions surrounding medicine and the treatment of all forms of life under the rubric of "bioethics". The rapid development of modern technology opens new possibilities and, with them, a whole range of moral issues. At the same time, many in today's increasingly secularized society question or reject traditional Christian teachings on the sanctity of human life. Indeed, Catholics find themselves defending the gospel of life in an often hostile environment. Frequently accused of attempting to impose their religious beliefs on the rest of society, they must also show that the Church's moral teaching on bioethical issues is a matter of right reason and not just Revelation.
In this interview, Fr. Michael Baggot LC presents some of the best books for studying and understanding Catholic bioethics.
Fr. Michael Baggot, PhD is currently Assistant Professor of Bioethics at the Pontifical Athenaeum Regina Apostolorum. He is also Research Scholar at the UNESCO Chair in Bioethics and Human Rights in Rome, Italy. He was Adjunct Professor of Theology at the Christendom College Rome program from 2018-2022. His writings have appeared in First Things, Studia Bioethica, The National Catholic Bioethics Quarterly, and Medicine, Health Care and Philosophy. He is editor of and contributor to the book Enhancement Fit for Humanity: Perspectives on Emerging Technologies (Routledge, 2022).
- Biomedicine and Beatitude: An Introduction to Catholic Bioethics, Second Edition
by Nicanor Pier Giorgio Austriaco - Catholic Bioethics and the Gift of Human Life
by William E. May - Personalist Bioethics: Foundations and Applications
by Elio Sgreccia - Catholic Bioethics for a New Millennium
by Bishop Anthony Fisher - The Gospe of Life (Evangelium Vitae)
by John Paul II
Bioethics is a relatively recent discipline. The term only gained currency from the seventies on. Previously, many of the issues that we currently associate with bioethics were studied as part of medical ethics. Is there any difference between bioethics and medical ethics, and if so, what is it?
That's certainly a controversial question, and I am happy to give my take on the issue. I imagine is the sane take of many of the authors I shall discuss.
There is a prehistory of bioethics. There are many philosophers and Catholic moral theologians—for example the Spanish scholastics— who have explored quite seriously the moral implications of healthcare and the different procedures related to the key moments of life, whether at its initial or final stages. We have a very rich tradition to draw upon and are we should not be caught off guard by the new questions that fill the headlines of the news.
At the same time, there have been some major technological developments over the past decades that have led to an increased interest and focus on these matters. What has come to light in recent developments of bioethics are not only the traditional questions of medical ethics, but also larger issues. Think about ecological matters, the responsibility that we may have to future generations in our approach to procreation in biotechnology, in the genetic engineering of human enhancement. So, there is a long-standing tradition of bioethical reflection. Bioethics is not a completely new discipline. But there are a range of concerns that are unique to our times, or at least to the past few decades.
What led you to teach bioethics?
I began with a great interest in some of the traditional questions of bioethics. Even as a child and in high-school, I would confront concerns about abortion. I am a convert to the faith and entered the Church when I was 17 years old. Prior to that, I was not even a believer in God. Yet sometimes we would have these discussions among friends about major moral issues, abortion especially. I simply assumed that abortion represented a woman's right to choose, and that we had no need to interfere. It was a simple medical procedure and that was that. But I had a very good friend who was also an atheist. He pushed backed on those commonly held positions. He made very strong arguments, based not on an appeal to religion or to the Bible, but upon science and human embryology, to establish that we were not dealing with a lump of cells but a genetically distinct individual who, like all other human beings, deserved to be protected from bodily harm and murder.
I was persuaded by my friend’s scientific and philosophical arguments. For the first time in my life, I had a strong sense that there was objective right and wrong: that certain acts were truly evil, and ought not to be accepted, no matter how popular they were. That experience left a mark on me. Later, I went through my own philosophical and moral journey of conversion. That led me eventually to affirm the existence of God, the divinity of Jesus Christ, the divine foundation and protection of the Catholic Church. So, I entered into the Church, and it was not long before I began to encounter the so-called pro-life movement, this effort to defend the weak and the vulnerable, whether it be the unborn or maybe those subjected to euthanasia, or those who are marginalised in society because of disability.
As I got more involved in the pro-life movement, I started to see that activism and charity work also required serious intellectual formation. It required the formation of a culture. A very important aspect of the culture of life is providing intellectual tools and formation at all levels of society, but especially to those who have the greatest influence, through legislation or teaching, so that these truths about human dignity can be transmitted and reflected in our daily life: at the level of politics, in the family, in hospitals and so forth. I started to see the need for a greater formation.
As I eventually discerned a priestly call, I came into contact with Alberto Garcia, a lawyer and professor at our Pontifical Athenaeum. For many years, he has been director of the UNESCO Chair in Bioethics and Human Rights. He heard of my own interest, of articles that I had written, and news stories I had followed. So, he invited me to begin collaborating with this chair. I was exposed to an even broader range of important bioethical issues and started to attend some of the events, especially the chair’s Bioethics, Multiculturalism and Interreligious Dialogue events.
I began to wrestle more deeply with these issues. I started to see that they required the application of the rich philosophical and theological patrimony that many of us receive, say, in our seminary training and university studies. That patrimony needs to be applied creatively and prudently to new issues that are not always treated so explicitly in the standard track of formation.
After my ordination, I was invited to deepen my studies and began to pursue a doctorate in Rome on these topics. I chose to focus my research primarily on the transhumanist movement, which to many seems like sci-fi: these efforts to radically enhance human capacities, especially at the cognitive, emotive, or physical level.
I started to examine more in depth some of the leading thinkers of this area, especially those professors working in Oxford, who are the most serious philosophers. There are many people in Silicon Valley who do a good job of popularising the ideas, but philosophers like Nick Bostrom, Anders Sandberg, Julian Savelescu, who work in Oxford as professors of philosophy or leaders of important ethics thinktanks, are the ones who offer the most serious presentation of human enhancement and what it means for future generations. That is what I have devoted the bulk of my research to in these past years and hope to continue developing, while exploring other bioethical issues.
As stated in their titles, the first three books on your list are on Catholic Bioethics. Virtually nobody disputes that there is such a thing as Catholic bioethics: that when it comes to issues such as abortion or euthanasia official Catholic teaching is distinctly countercultural and less permissive. For this reason, they believe that Catholics should not influence legislation in such a way that it would impose ethical positions peculiar to their religion on the rest of society. Is this a fair charge? If not, is it helpful to speak of a Catholic bioethics?
We can speak of Catholic bioethics in the sense that I mentioned earlier. Many moral theologians or philosophers in the Catholic tradition have been wrestling with these key issues. We can also speak of Catholic bioethics in another sense. We are convinced that divine Revelation sheds light on many matters and gives great clarity in grounding claims about a universal human dignity. From the data of Revelation, we can see clearly that all are made in the image and likeness of God and called to a divine union with the Lord, in fact to divinization. That is a call that extends to all peoples, no matter their colour, education, or intellectual capacity.
"The Catholic tradition gives clear and certain guidance on very complicated moral matters, even to those who might not have the time or the energy or the intellectual gifts to fully think through all these issues."
So, there are great benefits to be had by looking at these issues from a distinctly Catholic perspective. Of course, that presupposes that one makes an act of divine faith and holds the magisterium as a reliable guide. That is certainly not the case for many members of our pluralistic societies.
At the same time, all of these books are still of value for someone who does not come from the Catholic tradition. Part of our tradition is about appreciating the role and capacity of human reason to come to conclusions regarding the morality of our actions. We can work from the natural moral law tradition in this regard. We can also speak of a virtue ethics tradition. There are certain characteristics, traits of character, that assist us in performing good actions, doing the good, and obtaining those goods that fulfil us as human beings, consistently, with ease, promptness, and pleasure.
So, there are philosophical approaches in these books of Catholic bioethics. To address the questions that you raised, the first book, Nicanor Austriaco’s Biomedicine and Bioethics, wrestles very directly with those concerns. The final chapter is devoted to how a Catholic should engage a pluralistic society. Austriaco is well aware that many people in our societies are not going to simply enact in legislation the claims of the Bible, the Pope, or any magisterial document. He proposes that we should pursue a path of dialogue. He draws heavily on the thought of Alasdair MacIntyre, an extremely influential contemporary philosopher, and thinks that we ought to approach things from a tradition constituted inquiry. Basically, we should acknowledge that people have different moral traditions, first principles, rules of evidence and argumentation. They have different ideas about what counts as a good argument and which sources we can draw on to make this argument. They also might have different understandings of key terms that are shared across traditions. Drawing on MacIntyre’s thought, Austriaco says that we need to make great effort as Catholics to appreciate these different ethical traditions and to learn them, the way that we might learn a foreign language. We should not begin by condemning certain procedures or practices because they are not in accord with magisterial teaching or because they do not fit into the biblical picture. There is no possible dialogue in that sense. Rather, we ought to learn these other traditions as a kind of foreign language and appreciate where there might be real points of common ground and shared values. Then we can offer our critiques of these other traditions, but using the standards of those other traditions, following their own way of reasoning to expose possible inconsistencies or contradictions. After this long process, we can propose that perhaps our own Catholic tradition can offer a fuller, richer approach to these issues.
Now, this is a project that that requires a lot of time and energy. It is not something that can be accomplished in a set of sound bites or a TV interview. But, it is about the only path we have for a real dialogue here.
All of these books that I recommend appreciate that some claims are acceptable only to those who accept the Catholic tradition in its fullness, and those reflections are valuable to the Catholic community. At the same time, they appreciate that the Catholic tradition provides the philosophical resources for a dialogue across cultures, religions, and traditions.
Following up on that last question, what distinguishes Catholic bioethics from its secular counterparts? Would it be the Catholic tradition’s insistence on moral absolutes instead of a set of mere pro tanto norms? Would it be the Catholic tradition’s insistence on the unity of soul and body, in other words, of human embodiment rather than a reduction of the self to autonomous will?
Well, I think that those are very important insights and convictions that are uniquely highlighted in the Catholic tradition. I would say that we can find these truths expressed to some degree in philosophical reflections. There is a great appreciation, in certain strands of philosophical personalism for instance, for human corporality and understanding. Certain strands of neo-Aristotelianism appreciate the hylomorphic unity. But, in practice, the Catholic tradition offers a uniquely robust and consistent articulation of these truths. It makes very strong claims to articulate not only the best fruits of human reason, but also to benefit from the gift of divine revelation. It appreciates certain truths that would be inaccessible to human reason: our creation in the image and likeness of God, the universal call to eternal beatitude. Those truths are accessible only through the light of faith and are transmitted to us through the Catholic Church. At the same time, the benefits of Revelation are also at work in giving us a greater certainty regarding truths which we could reach through human reason but which, for various circumstances, can be obscured. So, we can come to an appreciation of the body-soul union but, because of the limits of our intellect or negative cultural customs, we can lose sight of these truths. As a Catholic bioethicist, I have the benefit of the light of Revelation to confirm without any doubt these philosophical truths. This is tremendous benefit to the faithful. Not every member of the Church has the benefit of dedicating a few years or decades of their lives to serious reflection on these matters. Not all have the luxury to to pursue serious philosophical reflection on the full implications of the natural moral law on these matters, much less to follow the almost daily developments in technology and the new questions they raise. The Catholic tradition gives clear and certain guidance on very complicated moral matters, even to those who might not have the time or the energy or the intellectual gifts to fully think through all these issues.
1.
The first two books on your list are introductory textbooks on Catholic bioethics: the one by the Dominican Fr Nicanor Austriaco, about which you have already spoken, the other by the late William E. May. Why have you chosen these two and what are their respective strengths? Have you listed them in order of preference?
All the books that I have mentioned have their own strengths and their limits, as any work does.
I am quite fond of Biomedicine and Beatitude. It does a very good job of giving a clear, systematic overview of the major issues that concern not only Catholics, but all bioethicists in the Western world. It explores beginning-of-life issues, matters related to procreation, the moral implications of the clinical encounter at a doctor-patient or institutional level, end-of- life issues (i.e. euthanasia, physician-assisted-suicide). It also looks at organ donation and transplantation, and the host of issues that are related to research, especially research that involves experimentation on human beings. In the latest edition, he has added an entire chapter on bodily modification. This has become more newsworthy on account of gender dysphoria. Austriaco treats not only those issues but also looks at other themes of bodily integration, such as cosmetic surgery.
"It is important for Catholics to have a good understanding of what the Church teaches and why she teaches it: to appreciate the intelligibility of her teaching."
He does a very good job in presenting a systematic and fairly comprehensive survey. His writing style is very clear and relatively easy to follow. At the same time, the book is well researched and up to date. He gives a sympathetic treatment to those with whom he disagrees. He tries to take tradition constituted inquiry, which he also considers present in Thomism. Look at St. Thomas’s approach to those with whom he disagreed. He is always searching for elements of truth, common ground, and he always looks to integrate any truth in their perspective into what he considers to be the most appropriate answer, the fullest response to any given question.
Something that makes his work a bit unique, even within the fairly extensive literature on Catholic bioethics, is his emphasis on virtue and on positioning bioethics within the larger project of the renewal of moral theology. He is very much a student of Servais Pinckaers in trying to highlight that moral life is geared toward happiness, flourishing, fulfilment and that morality, in this case bioethics, is not just a series of discrete, unrelated, controversial questions about what we should do in moments of crisis. Morality and bioethics do deal with moments of crisis and need to assist people in making the right decisions in these moments. But even more than that, the moral life has its unity. Each of our decisions contributes to the formation of a moral character. They contribute to the formation of good or bad habits; of virtues or vices. Austriaco emphasises that bioethics is concerned with these major moments of human life, but that we are also called to make daily decisions that shape who we are. So, he proposes different virtues that ought to guide us at any given issue.
To give a brief example, he looks at debates surrounding abortion. He gives a rigorous philosophical analysis of human embryology, identity, and personhood. But he also wants to make sure that we are assisting women or families who are in difficulty when facing an unexpected pregnancy to form the fortitude, the courage, to meet these difficult moments and not to succumb, through weakness of character, to bad decisions, that will harm the life of the unborn and will be ultimately self-destructive too.
2.
The William May book is in many ways similar to Biomedicine and Beatitude. The emphasis is on the formation of virtues is not as strong. One of May’s great strengths is his tremendous familiarity with those thinkers, within the Catholic tradition, who propose a radically new approach to moral theology and bioethics, and which they use as an intellectual justification to dissent from magisterial teaching. May is not content with simply scolding them for being disobedient. Instead, he wants to show that there are philosophical errors in their work. There is an inadequate philosophy that grounds the so-called proportionalist school of thought. It is the one with which he is most concerned with because it has exerted the most influence within Catholic bioethics. With great philosophical rigour, he addresses the implications of proportionalism and cites the authors at great length to avoid a strawman approach. This can seem like Catholic baseball. But it is important for Catholics to have a good understanding of what the Church teaches and why she teaches it: to appreciate the intelligibility of her teaching.
3.
Card. Elio Sgreccia was a leading Italian bioethicist, the vice-president and then president of the Pontifical Academy for Life, the Vatican think-tank founded by John Paul II. What is the hallmark of his Personalist Bioethics: Foundations and Applications?
It was originally written in Italian, but there is a very good English translation. Even though it is quite a large book, it is only the first of two volumes.
Sgreccia was interested in presenting a philosophical understanding of bioethics and engaging in dialogue with the secular world. He spends a lot of time on the foundational philosophical principles needed to give a rational judgement on issues related to genetics, prenatal diagnosis, human sexuality, procreation, and abortion. He would say that his personalist approach is very much open to divine Revelation. He was, very much convinced of divine Revelation and considers his system open to greater development and clarification through faith. However, he wants to present something that is accessible and acceptable to those who do not acknowledge the Catholic Church as a divine institution or the authority of a Pope and his magisterium. This work is helpful in that regard. It is not an easy read. Sgreccia is not only drawing on Thomism, but he is also trying to integrate recent personalist philosophers. Sometimes the philosophical language can be dense. Therefore, I would not recommend it as the very first book to read on bioethics. You will be ready for this work after familiarising yourself with the discipline through my other recommendations.
Sgreccia goes on to apply these fundamental foundational principles to particular bioethical issues in the second volume of his work.
4.
The next book in your list is by another bishop, indeed another Dominican. It is Sydney’s Archbishop Anthony Fisher’s systematic overview of bioethics. Why have you recommended it?
Fisher takes an approach very similar to Austriaco. They belong to the same order. In many ways, they have similar sensibilities.
Like Biomedicine and Beatitude, it is comprehensive, systematic, and addresses the major themes of today. It has less systematic unity than Austriaco, simply because many of its chapters began as articles or as conferences addressing specific issues at different times. Through editing, Fisher has brought the text to a unity. But it is important to be aware that it was not necessarily envisioned as a kind of textbook.
Since Fisher was called to address particular audiences and drawn into specific debates at a very high level, he is able to treat these themes with a greater depth, than Austriaco or May, and a greater engagement with certain authors.
In some of the later chapters, there is a more extensive treatment of what these issues look like at an institutional level. Fisher devotes the final part to the identity and the role of a Catholic hospital, keeping in mind that most such hospitals are working in pluralistic societies and face challenges in how they should or should not collaborate with secular institutions or non-Catholic religious bodies.
In the final chapter, he gives greater attention to regulation, legal issues, and the role of Catholic politicians in promoting legislation that is more consistent with a Catholic vision for bioethics or the natural moral law.
5.
Finally, there is John Paul II’s 1995 encyclical The Gospel of Life (Evangelium vitae).
Yes. This was a landmark document because the Church has been very concerned with tackling abortion, contraception, euthanasia, physician assisted suicide, and medical care. John Paul II gives a manifesto. He presents all these issues in the context of the Church’s overall mission. He wants to make sure that they do not remain the concern of a collection of specialists: the bioethicists. It is not for the faithful to simply sit back passively and wait for pronouncements from the experts, as though these are simply issues that concern a few people in the field. Rather, these issues touch upon the entire mission of the Church.
All of us, in one way or another, are involved in promoting an entire culture of life; in providing conditions for legal remedies against the spread of abortion; in building a society in which women are valued and appreciated in their maternal role and can raise their children with the proper social support of the family; societies in which those who find themselves in a unwanted pregnancy can find financial and psychological assistance. So, he gives us this very inspiring overall vision.
He also makes a profound philosophical theological analysis. He helps us to see that some of these concrete bioethical issues are rooted in a widespread and deep-seated misunderstanding of human freedom, which has come to be seen more as a kind of licence, without any purpose or goal. Appeals to radical personal autonomy over one’s body or life are a dime a dozen in the secular literature on bioethics. John Paul II helps us see the root of this focus. This attachment to radical personal autonomy has become unrooted from any understanding of who the human person is and the human person’s ends, purposes, goals. This radical subjectivism is ultimately self-destructive for the individual and for society. We end up with a set of warring wills: warring claims of radical personal autonomy that are difficult if not impossible to arbitrate. It becomes less a question of ordering society and more a power-struggle.
"Sometimes Catholics are accused, at least in the United States, of being single-issue voters because of a supposed obsession with abortion while ignoring other important life issues. A serious reading of Evangelium vitae shows that this is simply not the Catholic approach."
Based on this philosophical claim, John Paul II makes an even deeper theological claim. If this misunderstanding of human freedom as radical, subjective autonomy is at the root of the culture of death, as he calls it, even deeper is an eclipse of the sense of God. The human creature is unable to really understand himself well without reference to the creator, who has designed him for purposes, happiness, fulfilment.
While these profound philosophical and theological claims resonate most with those of his fold, he is also very insistent that the clash between a culture of life and the culture of death invites us to a greater ecumenism. It calls for a greater collaboration among fellow Christians, who share these fundamental convictions about the dignity of the those who have been created in the image and likeness of God, redeemed by Christ, and called to share in that redemption.
At the same time, there is a call for a collaboration between different religions who, through their own traditions, have come to some appreciation for the weak, the frail, the marginalised, and the vulnerable. John Paul II is very eager to foster these sorts of collaboration, that have come about in the last decades because of the fundamental cultural divide on these key bioethical issues.
Reading, or rereading, Evangelium vitae is very good because the Pope did not simply write a document on abortion or a euthanasia, as important as such documents might have been. He also addresses a whole host of issues. He was a noteworthy for making one of the Church’s strongest appeals to reduce, if not eliminate, capital punishment. He addresses themes of poverty. He begins to explore questions of ecology, that have become of even greater concern in recent years, both within the Church, throughout the pontificate of Francis, and also outside it. He is not a single-issue pope. Sometimes Catholics are accused, at least in the United States, of being single-issue voters because of a supposed obsession with abortion while ignoring other important life issues. A serious reading of Evangelium vitae shows that this is simply not the Catholic approach. There is an array of issues to which one needs to be sensitive. We need to respect human dignity at the beginning of life but also at various other stages. We need to come to the aid of immigrants who are facing injustices; to fight against unjust racial discrimination; to ensure a proper appreciation for women in society; to avoid any unjust persecution or discrimination against a minority religion; to work to against the negative consequences of poverty. John Paul II give us this broad picture to see the interconnectedness of the different themes of bioethics, so that if we are devoted in our research or our activism to one major cause, which is legitimate, we do not lose sight of other important issues in the Catholic tradition.
Read Part Two of this interview.
