March 23rd to 25th, approximately 80 physicians, philosophers, hospital chaplains, and other medical professionals gathered here at Notre Dame for the 22nd Annual Philip and Doris Clarke Medical Ethics Conference. The aim of the conference is to allow for discussion regarding some of the complex issues that plague the practice of medicine, in a setting not only where participants can come to a deeper understanding of Catholic teaching on these issues, but where diverse viewpoints can be shared, heard, and appreciated.
The conference’s traditional format involves several small-group discussions of case studies provided by members of the conference audience and reflecting current issues in medical practice. In one session, participants discussed three cases where various considerations external to the narrowly medical features of a treatment situation (such as finances or religious commitments) raised ethical questions for the physician acting in the case. In the next session, participants discussed a range of cases concerning requests from patients for treatments that are based on what some might regard as medically irrelevant conditions. For example, one case involved the much-publicized “Pillow Angel” case and in another case, a mother sought human growth hormone treatment for her “undersized,” but medically healthy, son to avoid psychological damage. In another session, attendees examined a series of cases involving reproductive health. As always, the conference included a discussion of recent initiatives in health care reform. In our final session, participants chose among three concurrent break-out sessions. In the first, we considered ethical issues concerned with using body parts either in artistic displays or in religious settings. The second engaged the ethical issues surrounding vaccinations and HIV testing, and in the third, we returned to the ethical dilemmas raised by medical treatment at the end of life.
The only formal lecture of this conference is the annual J. Philip Clarke Family Lecture on Medical Ethics. This year, it was delivered by Margaret Monahan Hogan, the McNerny-Hanson Chair of Ethics, professor of philosophy and Executive Director of the Garavanta Center for Catholic Intellectual Life and American Culture at the University of Portland. Professor Hogan has been a leading figure in Catholic medical ethics for many years, and has contributed in diverse ways to contemporary discussions in the field.
In Professor Hogan’s lecture, “Bioethics and its Gordian Knot,” she posited that, abortion as an elective surgical procedure – what has sometimes been designated as abortion on demand – is similar to the legendary Gordian Knot, which only Alexander the Great could untie by his famous solution: cutting through it with his sword. Professor Hogan explained how this Gordian Knot of bioethics had been tied by a set of Supreme Court decisions, rendered as a seeming compromise to protect a rising consciousness of the rights of women to be free to develop their potential. The knot was then woven by bonds fashioned and tightened by a set of claims – liberty claims and equality claims, enunciated by a regent liberal philosophy and sustained by judicial decree. Finally, the knot has been reinforced by practices – practices by many in the medical profession and by many women who chose abortion. Professor Hogan suggested that the sundering of this Gordian Knot has found no easy Alexandrine solution to loosen its hold on the American culture. She concluded her lecture, hailed by many as one of the best Clarke lectures in the history of the series, with the following words: “Part of the task is the essential work of building the culture of life. To build this culture requires our engagement in the intellectual controversies – if we think we hold the truth, we ought to fear no pursuit of knowledge. To build this culture requires our participation in the deliberations of the democracy and in its political processes – Catholics have a right in the public square as citizens and an obligation to be in the public square as Catholics – the former is a guarantee of the first amendment and the latter the command of Christ that we ‘render to Caesar the things that are Caesar’s.’ To build that culture finally requires that we make abortion unthinkable because it is unnecessary.”
As always, we are grateful to the Notre Dame Alumni Association, and in particular to Mirella Riley, director of the Academic Division, and administrative assistant Janet Miller, for their assistance in coordinating this conference.
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