Allocating Scarce Medical Resources: Roman Catholic Perspectives

By H. Tristram Engelhardt Jr.; Mark J. Cherry | Go to book overview

What Is Appropriate Intensive
Care? A Roman Catholic
Perspective

Paulina Taboada

In this era of medical progress—which Hans Jonas characterized as dominated by the logic of the “technological imperative” (1979)—questions concerning moral criteria suitable for determining what constitutes appropriate use of biomedical technology have become extremely relevant. Moreover, with the development of advanced life-support technology in intensive care units (ICUs) in the past few decades, the urgency of a practical answer to this question is becoming more and more evident. Medical efforts in ICUs, although motivated by the legitimate desire to offer every opportunity for survival, in some cases may only briefly prolong life and lead to increased suffering both for patients and their families. Furthermore, treatment in ICUs involves a significant investment of medical resources, expending an important part of the gross national product for most countries around the world (Scheiber, Poullier, and Greenwald 1994). Thus, the issue raises important clinical, ethical, financial, and political questions.

Since the famous Quinlan case (Quinlan 1976) many attempts to identify moral and legal criteria for defining the appropriate use of high-technology medicine have been undertaken. Nevertheless, the question is far from being definitely settled. Because decisions to widihold or withdraw life-supporting measures in ICUs often result in the patient's death, reaching the proper degree of moral certainty about their legitimacy becomes extremely important. In fact, a careful distinction between those interventions that have a real chance to benefit the patient, those that lead to an artificial prolongation of agony, and those that in fact represent an acceleration of an unavoidable death is necessary. Drawing this distinction in concrete situations is sometimes very difficult. The necessity of finding substantive criteria delimiting the range of ethically sound decisions is evident.

As a Catholic medical doctor and philosopher, who works at a teaching hospital of the Pontifical University in Chile, I was invited to contribute to this volume to reflect on the specific contributions of Roman Catholic moral teachings to this issue. In order to do so, I will use the traditional sources of Catholicism: the Gospel, the Catechism of the Catholic Church, and some of the official documents of the magisterium, such as encyclicals and pastoral letters. I do not intend to deal with the epistemological questions regarding the va-

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