The Analogate of the Divine Physician in the Clinic: Understanding the Christian Health Care Professional as a Symbol of Christ.

The Divine Physician is a traditional title that the Church gives to Jesus Christ. This metaphor helps symbolize Jesus's mission to heal our souls of sin and its effects. In this paper, I consider this metaphor as a source for understanding the vocation of the Catholic physician.

Tipping Point: Pathogenic Stress and the Biopolitics of Euthanasia.

Hopelessness and demoralization following a terminal diagnosis can affect the capacity for self-governance. Such dispositions can increase the allostatic load-the cumulative burden of stress and anxiety-resulting in a neurophysiologic decline that can impair autonomy and influence the desire to end one's life deliberately. An allostatic overload is characterized by the inability to autoregulate stress and is associated with pathological changes to the hypothalamic-pituitary-adrenal axis and hippocampus.

Let the foxes run free: Arresting bioethics' inward turn.

As bioethics matures, a number of voices have called for a narrowing of what officially "counts" as bioethics. Bioethics defined broadly, they argue, creates a space that lacks objectivity and rigor, jeopardizing the credibility of the profession. Although a variety of proposed solutions exist, most advance a definitional narrowing of bioethics.

Ritual and Power in Medicine: Questioning Honor Walks in Organ Donation.

Honor walks are ceremonies that purportedly honor organ donors as they make their final journey from the ICU to the OR. In this paper, we draw on Ronald Grimes' work in ritual studies to examine honor walks as ceremonial rituals that display medico-technological power in a symbolic social drama (Grimes, 1982). We argue that while honor walks claim to honor organ donors, ceremonies cannot primarily honor donors, but can only honor donation itself.

The Reasonable Content of Conscience in Public Bioethics.

Bioethicists aim to provide moral guidance in policy, research, and clinical contexts using methods of moral analysis (e.g., principlism, casuistry, and narrative ethics) that aim to satisfy the constraints of public reason.

Ethics, Abortion Access, and Emergency Care Post-Dobbs: The Gray Areas.

Clinical management of emergency pregnancy care, such as ectopic pregnancy or heavy bleeding with pregnancy of unknown location, includes upholding legal and ethical standards. For health care providers unwilling to provide evidence-based life-saving abortion care due to personal beliefs, clear guidance dictates disclosure of these limitations to the patient and colleagues, followed by immediate referral for appropriate care. However, this decision-making pathway may not be engaged due to a variety of factors: providers' beliefs preclude adherence to referral responsibilities, political discourse confuses patients as to their options and rights, and a constantly changing state and national legal landscape leads providers to question their ability to practice to their full scope of clinical care.

Subsidiarity and Participation in an Age of Catholic Mega-Systems.

While the number of Catholic healthcare facilities has held stable over the last several decades, Catholic healthcare has followed the trend of merging facilities and systems into "mega-systems." These consolidations can be beneficial for creating continuums of care, lowering operating costs, ensuring long-term viability, and sharing physical, digital, and human resources. However, with larger systems comes a practical need to be integrated to some degree, and the pressure to standardize policies and practices across regions is present.

Ethicizing history. Bioethical representations of Nazi medicine.

The article presents and analyzes different approaches of U.S. bioethicists in comprehending the Nazi medical crimes after 1945.

Fairness and COVID: Conducting research during the crisis.

The COVID-19 pandemic forced Principal Investigators (PIs) to make rapid and unprecedented decisions about ongoing research projects and research teams. Confronted with vague or shifting guidance from institutional administrators and public health officials, PIs nonetheless had to decide whether their projects were "essential," who could conduct on-site "essential" research, how to continue research activities by remote means if possible, and how to safely and effectively manage personnel during the crisis. Based on both narrative comments from a federally sponsored survey of over a thousand NIH- and NSF-funded PIs and their personnel, as well as follow-up interviews with over 60 survey participants, this study examines various ways PI and institutional decisions raised issues of procedural and distributive fairness.

Triage Policies at U.S. Hospitals with Pediatric Intensive Care Units.

Objectives: To characterize the prevalence and content of pediatric triage policies.

Methods: We surveyed and solicited policies from U.S.

A lack of race and ethnicity data in the treatment of hereditary hemorrhagic telangiectasia: a systematic review of intravenous bevacizumab efficacy.

Background: For extreme hereditary hemorrhagic telangiectasia (HHT) disease, treatments such as intravenous bevacizumab are often utilized. However, whether its efficacy is similar across diverse races and ethnicities is unclear.

Methods: In this systematic review, we performed a search for English-language articles identified through PubMed, Embase, and Scopus databases whose research occurred in the United States (US).

The many metaphysical commitments of secular clinical ethics: Expanding the argument for a moral-metaphysical proceduralism.

The rich moral diversity of academic bioethics poses a paradox for the practice of giving moral recommendations in secular clinical ethics: How are ethicists to provide moral guidance in a pluralistic society? The field has responded to this challenge with a "procedural approach," but defining this term stirs debate. Some have championed a contentless proceduralism, where ethicists work only to help negotiate resolutions among stakeholders without making any moral recommendations. Others have defended a moral proceduralism by claiming that ethicists should make moral recommendations that are grounded in bioethical consensus (e.

Clinical reasoning as midwifery: A Socratic model for shared decision making in person-centred care.

Shared decision making has become the standard of care, yet there remains no consensus about how it should be conducted. Most accounts are concerned with threats to patient autonomy, and they address the dangers of a power imbalance by foregrounding the patient as a person whose complex preferences it is the practitioner's task to support. Other corrective models fear that this level of mutuality risks abdicating the practitioner's responsibilities as an expert, and they address that concern by recovering a nuanced but genuinely directive clinical role.

Catholic Perspective on Decision-Making for Critically Ill Newborns and Infants.

In this paper, we discuss the foundational values informing the Catholic perspective on decision-making for critically ill newborns and infants, particularly focusing on the prudent use of medical technologies. Although the Church has consistently affirmed the general good of advances in scientific research and medicine, the technocratic paradigm of medicine may, particularly in cases with severely ill infants, lead to decision-making conflicts and breakdowns in communication between parents and providers. By exploring two paradigm cases, we offer specific practices in which providers can engage to connect with parents and avoid common technologically mediated decision-making conflicts.

Techniques of Ordering and the Dynamism of Being: A Critique of Standardized Clinical Ethics Consultation Methods.

Clinical ethics consultation (CEC) has become all about right technique. When we encounter a case of conflict or confusion, clinical ethicists are expected to deploy a standardized, repeatable, and rationally defensible method for working toward a recommendation and/or consensus. While it has been noted previously that our techniques of CEC often foreclose on its internal goods, there remains an assumption that we must just find the right efficient technique and the problem would be solved.

Empathy and structural injustice in the assessment of patient noncompliance.

Empathy is generally considered important because it is linked to prosocial helping behaviors. To the extent that humans are thought to be social creatures, empathy is regarded as an important component of our general well-being. Meanwhile, empathy skeptics argue that empathy is not as important as its proponents believe.

Anatomy of Being, Metaphysics of Death: The Case of Avicenna's Logical Dissection.

Elucidating a metaphysics of medicine is vital for framing a coherent medical ethics. In this paper, I examine the historical case of Avicenna, the eleventh century physician-philosopher. Avicenna radicalizes the dissective power of reason using a logicized Aristotelian metaphysics to clarify concepts at the metaphysical level, which I call his anatomy of being.