1. Foley, “Competent Care for the Dying...” (New England Journal of Medicine, 1997).

2. May, ch. 7, pp. 259-284.

3. SCDF, Jura et Bona (Vatican Document on Euthanasia), [full text of document available on course website].

4. Emanuel, E.J., “Euthanasia: Historical, Ethical, and Empiric Perspectives”. Archives of Internal Medicine, 1994.

The following are optional readings:

5. “Assisted Suicide in Switzerland”, Swissinfo, (2008).

6. Monti, “Willful Modulation of Brain Activity in Disorders of Consciousness”, New England Journal of Medicine, 2009.

1. How would you respond to the complaint, frequently voiced in the secular media, that the unavailability of physician-assisted suicide limits personal freedom and individual autonomy?

2. A clinical case often used to teach bioethics to medical students is that of Dax Cowart, a 25-year old former air force pilot, who was badly burned in an accident. Rendered blind, without the use of his hands, he felt hopeless and depressed and, despite the fact that he would certainly recover with treatment, he asked to be allowed to die. How would you respond to Dax, and what would you recommend in terms of his care, if you were a chaplain at the hospital where he was treated?

POPE John Paul II’s address on “Nutrition and Hydration in the Persistent Vegetative State” was followed several months later by an address on palliative care. This second papal allocution is less-familiar to most Catholics, but of great importance. “Palliative care” refers to the treatment of symptoms, usually pain and psychological distress associated with illness, rather than an attempt to cure the underlying illness. We will focus on palliative care at the end of life, “hospice care” as it is sometimes called. However, it is important to note that palliative medicine will play an increasingly-important role in the practice of medicine in all stages of life as advances are made in methods of controlling pain and alleviating symptoms of chronic and incurable diseases. We will particularly emphasize, that the Catholic Church encourages and commends palliative care as an important and unselfish kind of love, “a special form of disinterested charity” (Catechism §2279: formam constituunt excellentem caritatis gratuitae).

1. Pope John Paul II: Address on the Persistent Vegetative State and Address on Palliative Care (on course website).

2. May, ch. 7, pp. 285-301 (review from prev. weeks)

3. SCDF: Responses to Certain Questions of the USCCB concerning Artificial Nutrition and Hydration.

4. Broeckaert, Bert, “Euthanasia and Physician-Assisted Suicide” in Walsh, Palliative Medicine, 1st ed., ch 21 (2008 Saunders/Elsevier).

5. Additional Documents of the Magisterium on Palliative Care (on course website: Catechism § 2279, 1994; John Paul II, Evangelium Vitae, 1985; Addresses of Benedict XVI 2006 & 2007; USCCB Physician-Assisted Suicide - Threat to Improved Palliative Care 2011).

The following are optional readings:

6. Z. Zylicz, “Palliative Care and Euthanasia in the Netherlands: Observations of a Dutch Physician,” in K. Foley and H. Hendin, The Case Against Assisted Suicide: For the Right to End-of-Life Care (Johns Hopkins University Press 2002), 122-43.

7. USCCB, “Life Matters - to the End of Our Days”.

1. How would you respond to the argument that Pope John Paul II’s teaching on the requirement of nutrition and hydration in the persistent vegetative state is not part of the authentic magisterium of the Catholic Church, since it was only offered in the context of a papal “allocution” and not in an encyclical or apostolic constitution?

2. How would you respond to the accusation that palliative care is “just another name for euthanasia”?

IN this final section we will consider again the question of informed consent in light of the practice of organ donation and end-of life decisions. Will will note the strong approval of organ donation accorded by the Catholic Magisterium, while at the same time observing the very serious potential that exists for abusing this unique form of charitable self-offering.

[All the articles from the New England Journal are discussed on the assigned webpages]

1. May, ch. 7, pp. 302-314 (advance directives); ch. 8, pp. 351-360, (organ donation)

2. Bernat, James L., “The Boundaries of Organ Donation after Circulatory Death,” The New England Journal of Medicine, Aug 14, 2008, pp. 669-671.

3. Delmonico, Arnold, & Scheper-Hughes ,”Ethical Incentives — Not Payment — For Organ Donation,” New England Journal of Medicine, June 20, 2002, pp. 2002-2005.

4. Gillick, Muriel R., “Reversing the Code Status of Advance Directives?,” The New England Journal of Medicine, April 1, 2010, 1239-1240.

5. Steinbrook, Robert, “Organ Donation after Cardiac Death,” The New England Journal of Medicine, July 19, 2007, pp. 209-213.

6. Truog, Robert D. “Consent for Organ Donation — Balancing Conflicting Ethical Obligations,” The New England Journal of Medicine, March 20, 2008, pp. 1209-1211.

1. What are your reactions to the practice of organ donation after cardiac death? What sort of pastoral and moral issues could you foresee arising in a Catholic hospital where this is practiced?

2. It is being increasingly argued that financial compensation of organ donors should not be forbidden, but rather closely regulated. One author observed: “For many of the poor in the developing world it is a question of whether to sell an organ or a child.” How would you respond to someone who claimed that the poor have a right to recompense for an act of self-sacrifice?