James F. Keenan

The Function of the Principle of Double Effect

With considerable frequency moral dilemmas have prompted ethicists to turn to the principle of double effect. Questions concerning sterilization, prophylactic devices, hunger-fasts, military strikes, and euthanasia have made us think of the principle as a handy problem-solving device. Raise a moral conflict, and the principle is profered. The process of applying the principle is disturbing because it suggests that the principle itself justifies moral solutions

Current Theology Note Christian Perspectives on the Human Body

The subject of the human body has appeared recently in debates concerning both the beginning and the end of human life. In order to determine the question of the personhood of the unborn, ethicists ask when it is that a human embryo becomes a body that can be informed by a soul. Despite disagreement about when the embryo actually does become a human body, all agree nowadays, just as medieval writers did, that the condition for ensoulment is the presence of a true human body. Concerning the end of life, ethicists, having debated the respect due to dead human bodies, now ask whether human beings enjoy proprietary rights over their body parts.

The Open Debate: Moral Theology and the Lives of Gay and Lesbian Persons

[In this final section of the Notes on Moral Theology the author explores the extensive work of Catholic moral theologians reflecting on morality and the lives of gay and lesbian persons. He demonstrates that moral theologians not only critically engage a variety of statements by the different offices of the magisterium, but also investigate the topic by using the resources of the tradition: Scripture, the natural law, theological writings, and human experience. The result is a highly responsible open theological debate that studies not only the lives of some believers but the Church itself.]

Ultrasonographic diagnosis of seminal vesicle cysts in polycystic kidney disease.

Autosomal dominant polycystic kidney disease is often associated with cystic changes of other organ systems. Only a few cases of cysts of the seminal vesicles have been reported in patients with ADPKD. These were diagnosed with MR imaging, CT, and transabdominal ultrasonography. This case demonstrates the diagnosis of seminal vesicle cysts in a patient with ADPKD using endorectal ultrasonography.

The Concept of Sanctity of Life and Its Use in Contemporary Bioethical Discussion

I am a Roman Catholic moral theologian and have often seen the term “sanctity of life”, but in preparing the topic, I am surprised at the fact that it receives very little attention in places where I would have expected some. For instance, in the fifteen volume collection of the New Catholic Encyclopedia, it has no entry. It appears as a modest after-thought in the later supplement. It is not found in new theological dictionaries from the United States, England, or Germany: The New Dictionary of Theology, The Oxford Dictionary of the Christian Church, The Theological Dictionary. It did not appear in the German The Concise Dictionary of Christian Ethics; in Palazzini’s Italian Dictionary of Moral Theology there was only “Life, Respect for: see Murder, Suicide.” Only the Anglican, John MacQuarrie who edited two dictionaries, ran entries in both, A Dictionary of Christian Ethics and The Westminster Dictionary of Christian Ethics. Thus, Roman Catholics, who are believed to be the most apt to use it, rarely explicitly analyze it. The oft-quoted words of Edward Shils ([61], p. 2) seem appropriate: “To persons who are not murderers, concentration camp administrators, or dreamers of sadistic fantasies, the inviolability of human life seems to be so self-evident that it might appear pointless to inquire into it.”

Dualism in Medicine, Christian Theology, and the Aging

Distinguishing a persons soul or mind from a persons body describes dualism, the philosophical premise that fails to integrate the person as one, but instead leaves the person as two, usually as souland body or as mindand body. In dualism, one tends to think of the soul or the mind as the person and the body as an appendage. I argue that 1) dualism is rampant in medicine; 2) that Christian theology has fundamentally opposed it, and 3) that cultural dualism today threatens the aging in particular. To deal with this threat, I argue that the moral task of being human is to become one in mind and body. That is, I argue that the unity of the person which is the unity of the mind and body is not really a metaphysical given, but rather the goal or end of being human.Distinguishing a persons soul or mind from a persons body describes dualism, the philosophical premise that fails to integrate the person as one, but instead leaves the person as two, usually as souland body or as mindand body. In dualism, one tends to think of the soul or the mind as the person and the body as an appendage. I argue that 1) dualism is rampant in medicine; 2) that Christian theology has fundamentally opposed it, and 3) that cultural dualism today threatens the aging in particular. To deal with this threat, I argue that the moral task of being human is to become one in mind and body. That is, I argue that the unity of the person which is the unity of the mind and body is not really a metaphysical given, but rather the goal or end of being human.

Notes on Moral Theology: Ethics and the Crisis in the Church

[The author provides a bibliographic study of recent publications concerning the scandal and the crisis in the Catholic Church. He focuses on three groups: priests (who are they?), the laity (how can they more fully participate in the life of the Church?), and bishops (what must they do to lead and govern more effectively?). The article concludes by looking at the need for both church structural reform and professional ethical training of church ministers, clerical and lay.]

Applying the seventeenth-century casuistry of accommodation to HIV prevention

After discussing contemporary commentary on the retrieval of 16th-century high casuistry, the author recalls the conservative, deductive 17th-century casuistry of accommodation that addressed and solved problematic cases while upholding existing principles. In the first generation of AIDS, while casuists utilized conservative casuistry to address HIV-prevention issues, many bishops were reluctant to heed their counsel. As we enter the second generation, consensus is developing toward recognizing both the helpfulness of the conservative casuistry and the need to promote HIV prevention.

Institutional Cooperation and the Ethical and Religious Directives

The topic of institutional cooperation has generated a considerable discussion among ethicists, bishops and administrators of American Catholic health care facilities. In order to advance that discussion, I wish to develop several issues related to the topic: • the inevitable disagreement that cooperation produces • foundational insights for approaching the principle of cooperation • a brief explanation of the principle • a consideration of the cooperating agent and therein an appreciation of the breadth of the principles utility • a reflection on why cooperation is important • a discussion of the particularly difficult issues of duress, immediate material cooperation, and episcopal judgement

The bodily incorporation of mechanical devices: Ethical and religious issues (part 1)

A substantial portion of the developed world’s population is increasingly dependent on machines to make their way in the everyday world. For certain privileged groups, computers, cell phones, PDAs, Blackberries, and IPODs, all permitting the faster processing of information, are commonplace. In these populations, even exercise can be automated as persons try to achieve good physical fitness by riding stationary bikes, running on treadmills, and working out on cross-trainers that send information about performance and heart rate. Still, these examples of everyday human interaction with a mechanized world presuppose an ability to differentiate between ourselves in our organic and bounded embodiedness and the “other” we encounter as an external mechanical artifact of technology. This boundary, which, in actuality, has been permeable for several centuries, may be dissolving further as new mechanical devices are introduced in biomedicine and incorporated in the body. The terrain of contemporary medicine is, in fact, permeated with innovative technologies to restore, repair, rehabilitate, and, in rare cases, enhance our physical and psychological capacities. Consider recent examples about the devices used to assist a soldier who has lost a limb in the war in Iraq and a quadriplegic who was enabled to have neural control over external devices. Sgt. David Sterling lost his right hand and forearm from an IED in Iraq, and now wears a myoelectric forearm (which cost