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    • E. Christian Brugger, D.Phil. – E. Christian Brugger is a Senior Fellow of Ethics and Director of the Fellows Program at the Culture of Life Foundation in Washington, D.C. and the J. Francis Cardinal Stafford Professor of Moral Theology at St. John Vianney Theological Seminary in Denver, Colorado. He has Master degrees in moral theology and moral philosophy from Seton Hall, Harvard and Oxford Universities and received his D.Phil. (Ph.D.) in Christian ethics from Oxford in 2000.  Christian has published over 200 articles in scholarly and popular periodicals on topics in bioethics, sexual ethics, natural law theory, as well as the interdisciplinary field of psychology and Christian anthropology.  He lives on a farm in Evergreen, Colorado, with his wife Melissa and five children.
    • Helen Alvaré, J.D. – Helen Alvaré, J.D. is Honorary Fellow in Law at the Culture of Life Foundation.   Helen is an Associate Professor of Law at the George Mason University School of Law in Arlington, Virginia where she teaches and publishes in the areas of property law, family law, and Catholic social thought. Professor Alvaré serves as Consultor for the Pontifical Council for the Laity, Senior Fellow at the Witherspoon Institute where she chairs the Conscience Protection Task Force, is President of the Chiaroscuro Foundation and most recently Editor and Co-Author of Breaking Through: Catholic Women Speak for Themselves.From 2000 to Spring 2008, Professor Alvare taught at the Catholic University Columbus School of Law. Professor Alvare also lectures widely in the United States and Europe on matters concerning marriage, family and respect for human life. She is a consultant to ABC News and to the United States Conference of Catholic Bishops’ (USCCB) Marriage and Pro-Life Committees. In 2008, Pope Benedict XVI named Professor Alvare a Consultor to the Pontifical Council for the Laity.From 1987-2000, Professor Alvare was an attorney with the USCCB’s General Counsel Office and director of information and planning for the Secretariat for Pro-Life Activities. In these positions, she testified before the…
    • Jennifer Kimball Watson, Be.L. – Jennifer Kimball Watson joined Culture of Life Foundation as Executive Director in November of 2007. She is an Adjunct Professor of Bioethics at the Ave Maria School of Law in Naples, F.L.. Previous to her work with the Culture of Life Foundation Jennifer was a Wilbur Fellow of the Russell Kirk Center for Cultural Renewal located in Michigan. Jennifer earned a Licentiate in Bioethics from the Pontifical Athenaeum Regina Apostolorum School of Bioethics in Rome.  Her prior undergraduate studies were in International Administration and Government Policy at the Evergreen State College in Washington State.Jennifer’s areas of specialization include Eugenics in Artificial Reproductive Technologies, Heterologous Adoption and Transfer of Embryos, The Womb in Reproductive Technologies, and the Role and Significance of The Medical Act. She interviews with National Conservative and Christian Radio Syndicates as well as several foreign and secular reporters. Jennifer has spoken on the dignity of women and women’s social issues to various audiences since 1999 and has spent several years in advocacy work with various international organizations in the field of life sciences. From 2000 to 2006 she recruited and coordinated grass-roots social policy efforts that consisted of a public and private sector network of professionals and academics…
    • Margaret Datiles Watts, J.D. – Margaret Datiles Watts, J.D., is Culture of Life Foundation’s Associate Fellow in Law. Maggie is member of Washington, D.C. and Maryland bar associations.  She holds a B.A. in Philosophy (Phi Beta Kappa and Magna Cum Laude) and a Certificate in Classical Philosophy from the University Honors Program at The Catholic University of America. She earned a Juris Doctorate from Columbus School of Law at The Catholic University of America, where she served as a Research Fellow at CUA Law’s Marriage Law Project. She also studied Roman Law and EU Law at Magdalene College, University of Oxford, England.A former Fellow and Staff Counsel for Americans United for Life, Datiles co-authored an amicus curiae brief to the Supreme Court of the United States in the landmark partial birth abortion case, Gonzales v. Planned Parenthood, et al., companion case to Gonzales v. Carhart (2007). She also advised legislators, policy groups and the media (radio and newspapers) on abortion and bioethics laws and drafted pro-life model legislation.Her areas of research and/or publication include legal issues surrounding abortion, government funding restrictions for abortion, contraception, healthcare rights of conscience, stem cell research, artificial reproductive technology, population decline, physician-assisted suicide, euthanasia, and same-sex marriage.She currently publishes articles…
    • William E. May – William E. May is Senior Research Fellow of the Culture of Life Foundation and emeritus Michael J. McGivney Professor of Moral Theology at the John Paul II Institute for Studies on Marriage and Family at The Catholic University of America in Washington, D.C., where he taught the academic years from 1991 through 2008 after teaching for 20 years at The Catholic University of America. He is the author of more than a dozen books. The 2nd edition of his Catholic Bioethics and the Gift of Human Life was published by Our Sunday Visitor (2008), and a substantively revised 3rd edition is scheduled for publication in 2013. In 2003 Our Sunday Visitor published a revised and expanded edition of his Introduction to Moral Theology. Among his other books are: Marriage: The Rock on Which the Family Is Built (San Francisco: Ignatius, 1995; 2nd revised edition, 2009)); and, with Ronald Lawler OFM Cap and Joseph Boyle, Catholic Sexual Ethics (rev. and enlarged ed. Huntington, IN: Our Sunday Visitor, 1998; 2nd rev. edition, 1998; a 3rd edition, substantively revised by May alone, was published in 2011); Theology of the Body: Genesis and Growth (Boston: Pauline Books & Media, 2010) He has published more…
    • Frank J. Moncher, Ph.D. – Dr. Frank Moncher received his Ph.D. in Clinical-Community Psychology from the University of South Carolina in 1992, following which he spent several years on faculty of the Medical College of Georgia, with a focus on Adolescent Intensive Services. In 2000 he moved to the Washington, DC area to teach at a graduate school of psychology which had a mission of integrating the science of psychology in the context of the Catholic Christian view of the human person. Concurrent with this, over the past 12 years he has consulted with 11 different religious orders and 4 dioceses to provide psychological evaluations of aspirants and candidates, as well as consulting with different diocesan marriage tribunals.His research interests include the integration of Catholic thought into psychotherapy, child and family development issues, and integrated models of assessment of candidates for the priesthood and religious life. Frank is published in Families in Society: The Journal of Contemporary Human Services, Adolescence, Journal of Interpersonal Violence, Edification, and the Journal of Psychology and Christianity, as well as contributing to several book chapters on children, families, and religious issues.Since 2010, Dr. Moncher has worked for the Diocese of Arlington and Catholic Charities as a psychologist and consultant.  His…
    • Steve Soukup – Fellow in Culture and Economy Steve Soukup is the Vice President and Publisher of The Political Forum, an “independent research provider” that delivers research and consulting services to the institutional investment community, with an emphasis on economic, social, political, and geopolitical events that are likely to have an impact on the financial markets in the United States and abroad. Mr. Soukup has followed politics and federal regulatory policy for the financial community since coming to Washington in 1996, when he joined Mark Melcher at the award-winning Washington-research office of Prudential Securities. While at Prudential, he was part of the Washington team that placed first in Institutional Investor magazine’s annual analyst survey for eight years in a row. Mr. Soukup left Prudential with Mr. Melcher to join Lehman Brothers in the fall of 2000 and stayed there for two years, before leaving early in 2003 to become a partner at The Political Forum. While at Lehman, Mr. Soukup authored macro-political commentary and followed policy developments in the Natural Resources sector group, focusing on agriculture and energy policy. He also headed Lehman’s industry-leading analysis of asbestos litigation reform efforts. At The Political Forum, Mr. Soukup was initially the editor and junior partner,…
    • Dr. Pilar Calva, M.D. – Dr. Calva is a medical doctor specializing in Human Genetics with a Cytogenetics subspecialty from The University of Paris, France. In Paris, she was the under-study to the world-renowned Professor Jerome Lejeune, who is considered by some to be the father of modern genetics. In 1958, Lejeune discovered that an extra 21st chromosome is responsible for Down syndrome, or Trisomy 21. Lejeune dedicated his life tirelessly and unfailingly to defend the unborn, especially those with Down syndrome, testifying before scientific conferences and lawmakers. He was appointed by Pope John Paul II as the first President of the Pontifical Academy for Life. In Dr. Calva’s own words: When I arrived in France, I lived a life divided between faith and reason. I thought that from Monday to Saturday, I put on my white coat for my scientific tasks, and Sunday was the day I took off the white coat, put on my crucifix and dedicated myself to my religious duties. Professor Lejeune truly converted me, making me see that one can wear the white coat and the cross, at the same time. That is, one can fly with the wing of faith and the wing of reason. Inspired by the life…
    • Elyse M. Smith – Elyse M. Smith is an associate attorney with a northern Virginia law firm working in nonprofit and church law, estate planning, and civil litigation. Ms. Smith graduated magna cum laude from Ave Maria School of Law in Naples, Florida, where she served on Law Review and was published in the Ave Maria International Law Journal. She was named “Most Dedicated Editor” for her work on Law Review. Ms. Smith earned her bachelor’s degree in Foreign Affairs from the University of Virginia.  
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  >  Issue Briefs  >  Bioethics  >  Therapeutic Decisions

Therapeutic Decisions

Posted: October 1, 2015
By: Dr. Pilar Calva, M.D.
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Today, there is a broadening use of the term “therapeutic,” and it is problematic.  The term is being applied to practices and procedures that intervene upon the human person, but which do not constitute therapy.  For example, there is talk of “therapeutic” abortions, “therapeutic” cloning and even procured death as a “therapy” for various forms of suffering.  But by definition, therapies heal and treat disorders.

If we are to engage each other intelligently, words must have meaning.  Pregnancy is not a disorder.  Killing is not healing.

Principles To Assist In Making Therapeutic Decisions

A doctor’s mission, and the nature of medicine, is to save lives and to heal.  Accordingly, the following two principles must guide his or her actions.

1. “We Must Do Good And Avoid Evil”

The supreme principle for every human act is to do good and avoid evil.  Simple.  Some in bioethics refer to this as the Principle of Beneficence: the true or integral good of the person should always be sought (that of the embryo, or of a terminal patient); or the Principle of Nonmaleficence, i.e. do no harm.  The latter formulation is the equivalent of the Hippocratic primum non nocere (first, do no harm).  What is demanded above all of a health care professional is that he or she not cause more harm than is already being suffered by the patient.

Through the universal value of this principle, we see the error in any procedure that implies choosing an evil (as a means) to obtain any good, be it physical or moral.   In a more familiar formulation: The ends don’t justify the means.  Ever.

For example, one cannot procure an abortion in the form of intentional killing (as a means) for the good end of the mother, or, as is ringing in current headlines, to obtain tissue and parts as a means to develop therapies for other individuals.  There is no such thing as a “therapeutic abortion,” just as there is no “therapy” that would justify the destruction and use of one human life for the benefit of another.  The harvesting and sale of fetal tissues and parts from aborted fetuses, before or after death, unequivocally violates the therapeutic principle.  To say that some good can come from abortion in the way of therapy for others does not diminish the moral gravity of killing human life but further aggravates it.  We will discuss this further in a following brief on the Principle of Double Effect.

The more specific application to the field of bioethics of doing good and avoiding evil can be expressed as “the absolute need to value and respect the human person” in all of its stages, from conception till natural death.  St. John Paul II wrote in Evangelium Vitae:

As explicitly formulated, the precept ‘You shall not kill’ is strongly negative: it indicates the extreme limit which can never be exceeded. Implicitly, however, it encourages a positive attitude of absolute respect for life; it leads to the promotion of life and to progress along the way of a love which gives, receives and serves.

In this sense, one of the fundamental contributions of Evangelium Vitae is what Sgreccia has called the Principle of Moral Tutiorism: “the mere probability that a human person is involved would suffice to justify an absolutely clear prohibition of any intervention aimed at killing a human embryo.”

Furthermore, the need to respect the constitutive structure of human life allows man to intervene in human nature to correct defects or pathologies, but not to alter it.

2. The Therapeutic Principle

This principle assists us in evaluating what is licit or illicit regarding a directly-intended loss of a member as a means to save the whole organism.

As Pius XII wrote:

The decisive point rests not in the fact that the organ which is amputated or paralyzed be itself infected, but that its continued presence or functioning cause either directly or indirectly a serious menace for the whole body.  It is quite possible that in functioning normally a healthy organ could cause harm to one which is unhealthy, in such a way as to aggravate the evil and the repercussions of this last on the organism as a whole.

This principle safeguards surgery by requiring that:

a)     the operation be oriented to the good of the organism that is affected;
b)     the operation is necessary to intervene on the unhealthy member;
c)     there exists no other reasonable means for healing the illness;
d)     improvement is highly probable; and
e)     the patient has consented.

Taking into account all of this, we can analyze the following examples:

When an appendectomy is performed, there is a recognizable good, that is, the appendix cannot be left in place because it is unhealthy.  A surgery causes certain harm, but it is less than the harm that would be caused by leaving the appendix in place.  To heal a part of the body is to treat the patient in all of his or her bodily integrity.

By contrast, tubal ligation or salpingectomy is clearly the mutilation of a healthy organ, the Fallopian tubes, whose continuous presence and state poses no risk whatsoever.  Thus, the procedure cannot be justified.

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