Name: Rigo Azanwi OFM Cap
TRS 632D Midterm Exam, Fall 2017
Part 1: Short Answers
Please write a short answer (medium length paragraph) providing both an argument for and against locating the beginning of the protection of life at each of the following times. Don’t use the same argument for every answer. Some answers will be longer than others. (25 points – 5 points each)
1. 7 years old
According to Joseph Fletcher, one of the factors that characterize personhood is rationality, or other higher cognitive properties such as free will, self-consciousness, and language. Since rationality appears to be a central component of the human as created in the Imago Dei, Fletcher thinks that life should be protected from the moment an individual is able to undergo cognitive processes. Given that Fletcher is an Episcopalian priest, I’ll presume that his tradition, like the Catholic tradition, will say that an individual’s ability to reason morally begins at age 7. Following this proposition, we could infer from Fletcher that life should be protected from age 7.
From the above position, it is obvious that protecting life based on rationality and the ability to reason could be too expansive and yet exclusive. This means that certain animals with a high ability of self-awareness such as dolphins could be likened to humans, while some humans such as children who are younger than 7 will be excluded all together.
2. 23 weeks of development
Based on current law, a fetus after 23 weeks of development is considered viable. This means that it could survive on its own without the support of its mother. Consequently, it will be illegal for the mother to undergo an abortion because at this point, the child’s right to life outweighs the bodily autonomy of the mother. In this light, it is held that life should be protected from this point.
However, this position seems limited when it comes to dignity. From the above position, it could be inferred that dignity is directly proportional to the capability of independent existence.
3. 20 weeks of development
20 weeks of development is the time when most people think that sentience arises in a fetus. Given that sentience is the ability to feel pain and pleasure, this implies that aborting will inflict pain on the child. Since individuals like Peter Singer think that pleasure and pain are fundamental reasons for protecting life, life should be protected from this moment.
However, protecting life just at 20 weeks of development based on sentience seems exclusive and hence problematic. For example, those with brain damages or who are in a coma are generally not capable of feeling any pain or pleasure. Protecting life based on sentience will imply that these individuals will not have the right to live.
4. 14 days of development
For Anthony Kenny, an embryo prior to 14 days after conception cannot be granted the status of personhood. He stipulates that during the early embryonic development, twinning or chimerism could occur. Consequently, the fetus cannot enjoy the rights and protection attributed to persons. From his view, it will be admissible to abort a fetus before the 14th day after conception since there are uncertainties regarding the cells splitting to become twins, or twins fusing to form one individual through a chimerism.
However, some of the arguments that ground Kenny’s position seem to be the exact reason why a fetus should be protected from conception and not just after the 14th day. Since there is a potentiality of twinning occurring, there’s even a greater need to protect the fetus because this will be protecting two lives. Although a chimerism could also occur, it is still a life that needs protection. Thus, it is always best to give life the benefit of the doubt.
5. Conception
According to Joseph Fletcher, three factors characterize the definition of personhood: Rationality (or other higher cognitive properties such as free will, self-consciousness, and language), Sentience which is the ability to feel pain, and Relationality which defines our social existence. From the moment of conception, most if not all of these factors are absent. Based on Fletcher’s argument, it would be ok to abort a fetus right after conception since we cannot say it is a person.
However, the Catholic magisterial model of potentiality holds that the three factors mentioned by Fletcher already exist in potentiality from the moment of conception. Most fetuses during the course of their development will come to possess these capacities. Thus, the Church holds that personhood starts at conception. Hence, life should be protected from conception.
Part 2: Essays
Write short essays (1-2 pages) on 3 of the following 4 questions (25 points each – 75 points total)
1. A bioethical controversy has arisen at a local Catholic hospital. A woman who underwent fertility treatment through a non-Catholic fertility specialist started to see an obstetrician at the hospital for her pregnancy. To increase the odds of a successful pregnancy, the fertility doctor had implanted 4 embryos fertilized through IVF. All of them implanted, and now the obstetrician is afraid that the woman’s uterus will be too crowded, meaning that her health will suffer and the fetuses will not get enough nutrients. The health of all 5 are in danger. A bioethicist at the hospital argues that the obstetrician would be justified in removing one or two of the fetuses, even it means their death, because the object of the action would be to make more room in the uterus, and the death of the fetuses would be merely a foreseen consequence. The obstetrician and the local bishop have asked you for an ethical analysis of the case. Provide an analysis both for and against the bioethicist’s argument using the resources of the Catholic tradition that we have discussed in class. Make a recommendation for the case based in your understanding of the Tradition.
According to current Catholic Church teachings, human life should always be protected from the moment of conception. Although the Church has not declared personhood from this first seconds of life, She however strongly holds that at the time of conception, the fetus has the potential of becoming a person and hence should be protected. Nevertheless, a woman during pregnancy might have certain complications which might be health related. Consequently, the mother and the child’s lives are both in danger of death if certain measures are not taken. Sometimes, this involves the sacrifice of one of the lives.
In such a situation, it is often difficult to decide which of the lives to save since both the mother and the child have equal rights to life and dignity. Faced with these challenges, Holy Mother Church has laid out certain criteria that must be met when dealing with situations like this. Generally, the Church inclines towards the application of the principle of double effect which we will see later.
The present case of the woman with her quadruplet pregnancy mirrors the aforementioned complications that could arrive in pregnancy. Furthermore, the case consists of 5 individuals whose lives are in danger. However, the lives of the four fetuses are dependent on the mother. This implies that saving the mother’s life is essential for saving the lives of the fetuses since they cannot survive on their own. Thus, the present controversy seems legitimate since choices have to be made on people's lives. Who is to live and who is to lay down their lives for the others?
The hospital’s bioethicist’s argument that the obstetrician would be justified in removing one or two fetuses, even if it means their death, seems plausible. According to Martin Rhonheimer, the bioethicist could justify his argument by saying that the intension behind the removal of one or two of the fetuses is not to kill them, but rather to save the life of the mother. As such, it would be morally right to proceed in this way. Furthermore, he says the object of the act is the creation of adequate room for the other fetuses. This in itself is a great reason since the remaining fetuses will be well nourished and the mother’s life will be saved in the process. Finally, the death of the fetus(es) is a merely foreseen consequence, which implies that it wasn’t wished for yet it was inevitable.
On the contrary, the bioethicist’s argument when looked under the lens of the principle of double effect, seems to have several problems. According to Thomas Aquinas, the application of the principle of double effect requires the fulfilment of the following criteria: the object of the act, the intention driving the act, and the means to its achievement must all be good. Finally, the good outcome must outweigh the bad outcome.
When we apply this principle to the bioethicist’s argument, the object of the act: the creation of more room, is good. The intention driving the act is to save the life of the mother and the fetuses that will be left in the process. At the end, at least three out of five lives will be saved. This implies that the good outcome is greater than the bad one since a maximum of two fetuses will be lost in the process. However, the means towards the achievement of the goal is a bad one. There is a direct attack on the lives of the fetuses which is killing. Hence, the principle of double effect fails when applied to the bioethicist’s argument.
Nevertheless, I think that something has to be done regarding the current situation. Five lives are in danger and failing to act will still be making a decision which seems to be a less morally justified one. In my opinion, I think the principle of double effect could still be applicable. However, the means used during the process will have to be different. Instead of directly taking out one or two of the fetuses as a means to create more room for the others, the obstetrician could induce labor so that the mother gives birth to one or two of the fetuses prematurely. Since not all medical interventions that result in the death of the unborn child are necessarily illicit, such an action will be morally indifferent. Hence, the death of the fetuses will be random and natural.
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2. Jim is a 42 year old man with a wife and 4 young children who has just been diagnosed with stage 3 cancer. Without treatment, he will most likely die within the year, but he will not be in pain until the last few weeks. His only treatment option is an aggressive and painful course of chemotherapy. With his cancer, this treatment regimen secures remission rates in only 15% of cases. Jim wants to live to help his children grow up, but he also does not want to waste whatever time remains in a futile fight against death and knows about the problems of medicalized dying. Knowing your familiarity with bioethics, he asks you to help him analyze whether he should undergo the chemotherapy. Help him examine his situation and recommend what you think would be the most ethically and spiritually appropriate option.
Humanity for centuries has sought to answer several questions which include our beginning and our end. In our world today, there seems to be a greater focus on where humanity is heading, and this can be seen through the numerous researches in medicine and the strife to prolong life and possibly live forever. With such a mindset, the general tendency today is to approach death as something fundamentally evil which should be avoided.
Although death could be considered an evil since it brings about the end of one’s life here on earth, it is at the same time a good when viewed from the angle of individuals who believe in eternal life with the Creator. As such, death is viewed as a gateway to a life that is more fulfilling.
Nevertheless, the stages that often lead to death seem to justify those who think that it is a fundamental evil and should be avoided. Often, an individual before death suffers from some form of illness, be it short or long term. Also, death sometimes comes at unexpected moments. This often suggests some form of injustice, as for example, the death of children, and individuals who die in accidents. There seems to be no justification for this to happen.
Jim is only 42 years old and his life seems to have just arrived its climax as he enjoys the presence of his wife and four children. However, his recent diagnosis with stage 3 cancer seems unfair as his life is at stake. Despite the misfortune that has befallen Jim, he seems to be taking it in good faith. He is considering possibilities regarding his current health situation. As humans, it is our duty to care for our health, which is exactly what Jim is doing. Furthermore, he also acknowledges that this duty does not override other aspects of his life such as his family.
On the one hand, it would be great for Jim to be well again and go back to his family. But looking at the options for treatment, his survival is far from evident. Jim needs to undergo an aggressive and painful chemotherapy. However, this treatment appears to have just a 15% success rate, implying the chances of survival are very minimal. Hence, I think considering this treatment would be a futile fight against the disease as Jim himself has thought.
On the other hand, Jim could have a great and joyous life for the remaining months he has until his death, except for the last weeks. Given that there is excessive pain involved with no reasonable hope for survival, I think it will be ethically right for Jim to forgo the treatment option. The proposed treatment qualifies as extraordinary means and hence is not required. In doing this, Jim would be able to enjoy the last months of his life with his family. With the treatment option, he is likely to suffer all the pain arising from the treatment which is still likely to end in death. This seems to be a double lost on his part and that of his family.
By choosing to decline treatment, Jim would be in line with the church’s teaching regarding such questions. In Salvifici Doloris §57, Pope John Paul II states that “A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or which entail an excessive burden, or impose excessive expense on the family or the community.” Hence, Jim will be making a wise and good decision.
Furthermore, it would be good for him to look at his terminal cancer and the suffering he is undergoing as redemptive. Also, he could view it as his participation in the cross of Christ. By so doing, he will come to find meaning in his own suffering and death. The passion and death of Jesus Christ was unfair. Nevertheless, he accepted it for our sake.
Finally, Jim should remember that “we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not disappoint us, because God's love has been poured into our hearts through the Holy Spirit which has been given to us.” Romans 5:3-5 With this, he is assured of the life that awaits him after death, and the knowledge that the same God in whom he trusts will watch over his family.
3. In 2004, Italy passed a law on assisted reproductive technologies that limited their use to stable heterosexual couples with diagnosed infertility. The law does not allow surrogacy or the use of donated eggs and sperm for IVF, does not allow the cryopreservation of embryos, allows only a maximum of three eggs to be fertilized and transferred at a time, and requires that all embryos be transferred, and prohibits pre-implantation genetic diagnosis and prenatal genetic screening. Provide an ethical and theological evaluation of this law. What is good or bad about each of the provisions of the law? Are there problems with the law from the perspective of the Catholic bioethical tradition?
The Catholic tradition has always taught that when it comes to marriage, there are two fundamental goals that must be met –complementarity which implies that it must be unitive, and procreation or at least the openness to procreation. At any given time when the marriage of a couple is being consumated, there ought to be a mutual self-giving of the spouses and they must be open to bringing forth new life.
The Italian 2004 law regarding reproductive technologies seems to be morally right as it has in mind the preservation and the protection of life. However, when considered within the perimeters of Catholic teachings, there seem to be a few problems. Thus, there are good as well as bad aspects of this recent law, depending on our view point.
The above law strictly involves a homologous ART. Thus, it requires that only stable heterosexual couples with a diagnosed infertility are eligible for the IVF technology. This requirement seeks to protect the unitive nature of the couple. Given that only infertile couples are involved, the law aims at helping the couple have their own biological children. Thus, it is an attempt by the state to help the couple fulfill the procreative aspect of marriage.
Also, this law forbids the donation of sperms and eggs, and does not permit surrogacy. It is designed to let children be reared in harmonious relationship. Donation of sperms and eggs or the inclusion of surrogates will multiply the number of parents and this could lead to problems regarding the children’s upbring and development from several dimensions.
Furthermore, the State is fully aware of the need to protect all life. Hence, there is a ban on cryopreservation. Permitting this will be similar to promoting other forms of research which will only end in the destruction of the lives of the embryos. Thus, the State’s decision that only three eggs be fertilized and all implanted appears to be a great move towards the protection of life, especially that of the unborn. Finally, the State’s prohibition of pre-implantation genetic diagnosis and prenatal genetic screening is a fair and legitimate law since it aims at preventing a right to life based on secondary aspects such as IQ or health.
From a theological perspective, and specifically within the Catholic tradition, the above law violates one of the fundamental aspects of sacramental marriage. As mentioned above, sacramental marriage has to be both unitive and procreative. Although the present law meets both criteria, the Catholic Church requires that all should occur within the consummation of the marriage by the spouses.
With the involvement of homologous ART, several elements come into play. Firstly, fertilization occurs outside sexual intercourse. Secondly, it is possible that the man would have to masturbate so that the best sperm gets chosen for fertilization. Masturbation in itself is a sin. However, a perforated condom could be used as an alternative. Thus, the most problematic factor will be the fact that new life takes place outside of legitimate marital intercourse..
The problems with this is that the spouses tend to be objects, the sole purpose of which is reproduction. Furthermore, it will suggest that life depends on technology and is not received as a gift from God. Procreation should be seen as the fruit of marriage. But when this occurs outside the consummation of marriage, it is unnatural, thereby ruling out the aspect of fruition. Since this form of reproduction is rejected by the magisterium and the Holy Mother Church, the law is considered immoral.