Chapter 3. Ethical Decision-Making Models Consistent with Catholic Ethics
A. The Normativity of the Ethical and Religious Directives for Catholic Health
1. Different Categories of Normative Catholic Teaching
The Catholic Church, drawing on both faith and reason, strives to create an integral vision of the human vocation incorporating everything that is good in human activity. The Magisterium considers “science an invaluable service to the integral good of
the life and dignity of every human being.”160 Additionally, the Church desires to reach out to every human being that is suffering in mind, body or spirit bringing them comfort as well as light and hope.161
To pursue this vision, the Catholic Tradition provides “authoritative teaching” through four kinds of magisterial statements, as codified in Canon Law. The four levels of authoritative teaching establish “the order of truths to which the believer adheres.”162 They are: (1) truths taught as divinely revealed, (2) definitively proposed statements on matters closely connected with revealed truth, (3) ordinary teaching on faith and morals, and (4) ordinary prudential teaching on disciplinary matters. To aid in clarity, these four magisterial statements have been given the names: (1) definitive dogma, (2) definitive doctrine, (3) non-definitive, authoritative doctrine, and (4) prudential admonitions and provisional applications of church doctrine.163
In the first category, “divinely revealed" or definitive dogma deals with truths contained in the word of God and which the Magisterium affirms to be divinely revealed, requiring the faithful to give obedience of faith. Examples of this category are the articles of the Creed, the Christological dogmas, and the Marian dogmas, the sacraments, the Real Presence, the existence of Original Sin, the immortality of the human soul, the inerrancy of Holy Scripture.164
The definitive doctrines are not explicitly contained in the sacred deposit of Scripture and Tradition. They are rooted in the primary points of secondary truths which necessarily follow either logically or historically, and which are needed to expound them faithfully. St. John Paul II (d. 2005) explains that such truths are the result of the
connected to divine revelation, illustrating the Holy Spirit’s inspiration for the Church’s deeper understanding of the truth concerning faith and morals. Although scripture is indispensable for morality, it does not necessarily provide concrete answers to current issues. Scripture must be supplemented by reason, tradition, and the magisterium
otherwise it becomes a form of moral fundamentalism.165 In Catholic teaching, scripture is not read as an independent document.166 In this regard, Church tradition helps to interpret scripture. The more classical interpretation of this tradition is that the
magisterial authority safeguards the “deposit of faith.” These truths are to be shown the assent of faith, but one technically distinguished as a “firm and definitive assent.”167 The third category is ordinary teaching on faith and morals that spells out Christian doctrines. All these teachings on faith and morals are presented as true, even though they have not been defined infallibly with a solemn judgment or proposed as definitive by the ordinary magisterium. This category is called the “authentic magisterium.” The authority of the “authentic magisterium” is different from Papal Infallibility. Vatican I emphasized that infallibility belongs to Papal ex-cathedra teachings.168 This category of Church teachings encompasses the Ethical and Religious Directives for Catholic Health Care Services.169
The fourth category for Magisterial teaching, “interventions in the prudential order,” or prudential admonitions and provisional applications of church doctrine would include any of the routine publications of the Holy See and Bishops in their diocese. The key element in this category is its contingency upon circumstances of time and place. The possibility of error at this level of teaching is stronger than any previous category.170
Each person must form a correct conscience based on moral norms. Conscience is the individual capacity to discern what is good to ascertain morally what action should occur. In Pope Francis’s exhortation, Amoris Laetitia, the Church has been called to help form conscience by church teaching. Conscience can recognize with "a certain moral security" what God is asking of individuals. The role of the conscience is paramount in moral decision-making reflecting the tradition that the conscience is the final arbiter.171 The Church respects conscience as having a crucial role in moral discernment,172 as clearly expressed in Vatican II: “deep within his conscience man discovers a law which he must obey…his dignity lies in observing this law, and by it will be judged.”173 “It is through his conscience that man sees and recognizes the demands of divine law. He is bound to follow this conscience faithfully in all its activity. Therefore, he must not be forced to act contrary to his conscience.”174 Thus, man’s informed conscience is the final arbiter. Finally, the well-formed conscience will develop not only through knowledge of the moral teachings but also through the development of and the practice of the Virtue of Prudence. Prudence enables us “to discern our true good in every circumstance and to choose the right means of achieving it.”175
In light of these categories of Church teachings, Papal Encyclicals have special significance. A Papal Encyclical is a letter written by the Pope to address moral, doctrinal, or disciplinary issues to the universal church. Encyclicals have become the standard means for popes to exercise their ordinary (not infallible) teaching authority. The Catholic faithful is morally obligated to comply unless their conscience prudentially prevents doing so. Several points can be noted regarding papal encyclicals: (1) they carry less authority than dogmatic pronouncements made infallibly (by the Pope ex-cathedra),
(2) because they do not contain infallible teaching, acceptance can theoretically be conditional (to respect prudential decisions of individual conscience), but in practice the faithful should usually comply, and (3) the theological issues examined are not
considered to be closed.176 Many Papal Encyclicals have been used in the Ethical and Religious Directives to formulate Church teaching: Donum Vitae, Pacem in Terris, Sollicitudo Rei Socialis, Gaudium et Spes, Humanae Vitae, and Veritatis Splendor.
In the preamble of the Ethical and Religious Directives for Catholic Health Care Services, reference is made to the emergence of moral principles expressing the Church's teaching on medical and moral matters that developed throughout the centuries. In a statement from the United States Conference of Catholic Bishops, Health and Health Care presented the theological principles that guide the churches vision of health care. In that statement, all Catholics are called to share in the healing mission of the church, offer encouragement, and make a full commitment to the health care ministry.177 Further, in the General Introduction, the laity is invited to a much more intense and broader field of ministries.178 To continue the church’s ministry of healing and compassion, by their baptism, the laity is called to participate in the health care mission.179 With new medical discoveries, coupled with technological developments and social change. Church leaders in consultation with medical professionals review and judge these developments
according to the principles of right reason and revealed truth, as explained above. Hence, the Ethical and Religious Directives represent a form of normative Church Teaching, representing the ordinary magisterium of the Church, in this case, the United States Bishops insofar as their teachings are consistent with universal Church teaching in the Papal encyclicals, (as mentioned above).180
2. History of the Ethical and Religious Directives for Catholic Heath Care