REVIEWED BY DANIEL J. DALY, Ph.D.
Book Review-Contemporary Catholic Health Care Ethics, 2nd Ed.
BY DAVID F. KELLY, GERARD MAGILL AND HENK TEN HAVE
Georgetown University Press, 2013 288 pages, $39.95
Esteemed Catholic medical ethicist David F. Kelly is joined by his co-authors, Duquesne University colleagues Gerard Magill, Ph.D., and Henk ten Have, MD, Ph.D., on this second edition of Contemporary Catholic Health Care Ethics. The result is an offering that stands up well in the increasingly competitive field of Catholic medical ethics textbooks.
Parts 1 and 2 of the book essentially reproduce the first edition. The first part presents key concepts in foundational theology, with a focus on theological anthropology. The second part addresses ethical methodology. The revised and new material of the second edition is found in part 3, which addresses issues in applied medical ethics. End-of-life ethics receives the lion's share of attention, as the authors devote chapters to the forgoing of treatment by competent and incompetent patients, the distinction between killing and letting die, the ethics of nutrition and hydration, and advanced directives.
New to the second edition are chapters on research ethics, organizational ethics, specific issues in genetics and global bioethics. The chapter on organizational ethics will be of particular interest to hospital administrators. The authors helpfully walk the reader through the church's developing teaching on cooperation with secular medical institutions.
While Kelly, Magill and Ten Have accurately present official Catholic teaching, the text is not a summary of church encyclicals and declarations. In the introduction, they write, "We are convinced that there are problems with the method usually used in traditional Catholic medical ethics….This book is our attempt to present an alternative approach." True to their word, they soon throw their support behind the ethical methodology condemned in Pope John Paul II's encyclical Veritatis Splendor, proportionalism. Later in the text, they level proportionalist critiques of official church teaching on artificial birth control, assisted reproductive techniques and the move toward vitalism in aspects of the church's end-of-life ethics. (See page 32.)
Given that progressive perspective, readers might be surprised to find that the text shines in its articulation of the development of the Catholic ethical tradition. Further, it far outpaces other texts of its kind in its excellent presentation of the legal and scientific aspects related to medical ethics. Professors of college medical ethics are well aware that students often confuse and conflate medical legal and medical ethical questions. This text will be helpful to distinguish between these questions, but also will show the interesting ways in which the questions are interrelated.
As readers have come to expect from Kelly's earlier edition, the authors show themselves to be masterful teachers. They clearly and concisely communicate abstract and complex concepts to a lay audience. The text is readable and well-documented. Students will appreciate the glossary containing a variety of technical concepts within theology, ethics and medicine.
A few mild critiques are warranted. While much of the text has been revised, there are sections on theological anthropology and ethical method that could have reflected contemporary research to a greater degree. Next, given its nature as a college textbook which engages the Catholic tradition, and given that moral analysis is done through the lens of proportionalism, the authors should have afforded more space to Pope John Paul II's critique of proportionalism. As it stands, they refer to it only in a footnote. But the methodological difference between the authors and the magisterium is important to a fuller understanding of official church teaching and why the authors dissent from aspects of it.
Finally, professors of medical ethics and members of ethics committees will wish that the authors had devoted a chapter exclusively to abortion, instead of addressing the issue throughout other chapters.
The text is organized in a way that makes it suitable for a college or university course in medical ethics. Because it is divided into 30 chapters, which average 12 pages each, it easily can be used in a 15-week semester. The relative brevity of the chapters gives room to the professor to assign additional primary source readings, if desired.
Professors and hospital administrators looking for a compendium of official church teaching on medical ethics should look elsewhere. So should those seeking discussion of medical ethics more in line with official church teaching. But those who wish to engage an alternative approach will find such in Contemporary Catholic Health Care Ethics.
DANIEL J. DALY is associate professor and chair of theology at Saint Anselm College in Manchester, N. H. He serves on the ethics committees of Catholic Medical Center and the Elliot Hospital in Manchester.