Allocating Scarce Medical Resources: Roman Catholic Perspectives

Front Cover
H. Tristram Engelhardt Jr. MD, PhD, Mark J. Cherry
Georgetown University Press, 2002 M05 20 - 344 pages

Roman Catholic moral theology is the point of departure for this multifaceted exploration of the challenge of allocating scarce medical resources.

The volume begins its exploration of discerning moral limits to modern high-technology medicine with a consensus statement born of the conversations among its contributors. The seventeen essays use the example of critical care, because it offers one of the few areas in medicine where there are good clinical predictive measures regarding the likelihood of survival. As a result, the health care industry can with increasing accuracy predict the probability of saving lives—and at what cost.

Because critical care involves hard choices in the face of finitude, it invites profound questions about the meaning of life, the nature of a good death, and distributive justice. For those who identify the prize of human life as immortality, the question arises as to how much effort should be invested in marginally postponing death. In a secular culture that presumes that individuals live only once, and briefly, there is an often-unacknowledged moral imperative to employ any means necessary to postpone death. The conflict between the free choice of individuals and various aspirations to equality compounds the challenge of controlling medical costs while also offering high-tech care to those who want its possible benefits. It forces society to confront anew notions of ordinary versus extraordinary, and proportionate versus disproportionate, treatment in a highly technologically structured social context.

This cluster of discussions is enriched by five essays from Jewish, Orthodox Christian, and Protestant perspectives. Written by premier scholars from the United States and abroad, these essays will be valuable reading for students and scholars of bioethics and Christian moral theology.

 

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Contents

A Roman Catholic Perspective on Setting Limits to Critical Care or Can Roman Catholic Moral Theology Offer More than Secular Morality Provides?
3
Taking the Tradition Seriously
19
Working Group on Roman Catholic Approaches to Determining Appropriate Critical Care
35
Secular and Reform Jewish Reflections on the Roman Catholic View
43
What Is Appropriate Intensive Care? A Roman Catholic Perspective
53
A Traditional Roman Catholic Analysis
77
Philosophical and Catholic Positions
96
A Personalist Approach
125
Implications for Distributive Justice
200
A Perspective from the Jewish Canonical Tradition
215
Some Orthodox Christian Reflections
237
The Problem from a Protestant Perspective
263
Approaches to Limiting Access to Scarce Medical Resources
275
Catholicizing Health
297
The Boundaries of Faith and Reason
310
Contributors
321

Meaning and Limits of Prolongation of Life
140
Institutional Guidelines for the Appropriate Use of Critical Care
157
Methods of Distribution Redistribution and the Role of Time in Allocating Intensive Care Resources
177

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About the author (2002)

H. Tristram Engelhardt, Jr., is professor in the department of philosophy at Rice University and professor emeritus at Baylor College of Medicine, Houston, Texas, as well as editor of the Journal of Medicine and Philosophy and senior editor of Christian Bioethics.

Mark J. Cherry is assistant professor of philosophy at Saint Edward's University, Austin, Texas.

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