SURROGACY: A CATHOLIC PERSPECTIVE

Transcription

1 1617 SURROGACY: A CATHOLIC PERSPECTIVE RICHARD A. MCCORMICK, S.J.t A few prenotes are in order prior to my substantial presentation. First, I have entitled my remarks a Catholic perspective, not the Catholic perspective. I do this not because there is not an official Catholic perspective. There is. It is presented briefly in Donum vitae ("Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation").' Rather, I do it because the theologian's task is not simply to repeat official formulations, but to assimilate them critically so that the very assimilative effort contributes to the purification of these formulations. To say anything else would be to wrap these formulations in a non-historical immobility that is untrue to reality. Second, "a Catholic perspective" means to underline the fact that the perspective is not merely presented by a Catholic, but is one that attempts to draw on the riches and worldview identified with an historical believing community. As we say in theological shorthand, "reason informed by faith." This is not to suggest that all Catholics will or must share these analyses and conclusions. Nor is it to suggest that non-catholics will not or cannot share them. It simply means that "Christ...through his life, death and resurrection has given a new meaning to human existence," 2 and that this meaning will shape our consciousness as we deliberate together about what is morally appropriate human conduct. A sound Catholic methodology will begin by stating its criterion of judgment when dealing with new technologies. Vatican II is of great help here. Dealing with marital morality, it stated that the "moral aspect of any procedure...must be determined by objective standards which are based on the nature of the person and the person's acts." 3 The official commentary on this wording noted two things: that in the expression there is formulated a general principle that applies to all human actions, and that the choice of this expression means that "human activity must be judged insofar as it refers t Richard A. McCormick, S.J., is the John A. O'Brien Professor of Christian Ethics at the University of Notre Dame. A curriculum vitae of the author and a partial bibliography are included at the end of the essay. 1. Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation (Vatican City: Vatican Polyglot Press, 1987). 2. Declaration on Euthanasia (Vatican City: Vatican Polyglot Press, 1980), 4; see also Origins 10 (1980), Documents of Vatican II, ed. Walter Abbott, S.J., (New York: America, 1966), 256.

2 1618 CREIGHTON LAW REVIEW [Vol. 25 to the human person integrally and adequately considered." '4 I fully accept this criterion. Indeed, I take responsibility for its use in the American Fertility Society's Ethical Considerations of the New Reproductive Technologies. 5 That document stated: 'Integrally and adequately' refers to the sum of dimensions of the person that constitute human well-being: bodily health; intellectual and spiritual well-being, which includes the freedom to form one's own convictions on important moral and religious questions; and social well-being in all its forms: familial, economic, political, international and religious. Actions (policies, laws, omissions, exceptions) that undermine the human person, integrally and adequately considered, are morally wrong. Actions that are judged to be promotive and supportive of the human person in the sum of his or her essential dimensions are morally right. 6 The document notes of this criterion that "in principle it calls for an inductive approach based on experience and reflection." I note here that Donum vitae reproduced this personal criterion. Repeatedly it refers to the integral good of the human person, or some such phrase. In this sense it is one with Vatican II. One may legitimately question, however, whether Donum vitae actually uses this criterion when it draws concrete conclusions about reproductive technologies. Now let us turn to surrogacy. At the very outset we should distinguish surrogate gestational mothers from surrogate mothers. A surrogate gestational mother provides the gestational but not the genetic component for reproduction. A surrogate mother provides both the female genetic component and the gestational component. Once this distinction has been made it may be temporarily shelved because most of the ethical pros and cons apply quite similarly to both forms of surrogacy. One can see this by reviewing the American Fertility Society's document on surrogacy. There are at least two general approaches to our subject that can be identified. The first views surrogacy under the rubric of the use of third parties in genere, as but a single example of a general practice. The second views surrogacy in specie and underlines the advantages and drawbacks of this specific instance of third party usage. THIRD PARTY PARTICIPATION IN GENERAL Under the title of "third party participation" several different 4. Schema constitutionis pastoralis de Ecclesia in mundo huius temporis: Expensio modorum partis secundae (Rome: Typ. pol. Vat., 1965) Fertility and Sterility, vol. 53, n.6, 1 S (Supp ). 6. Cf id.

3 1992] CATHOLIC PERSPECTIVE 1619 procedures are possible: donated sperm, donated ovum, donated embryo, donated uterus, or combinations of these. Most discussions have centered around donated sperm (AID-artifical insemination by donor) because this is by far the most common of these procedures; so I will use it to review some of the issues of third party participation in reproductive technologies. The most thoughtful and stimulating recent study on AID is that of Paul Lauritzen. 7 Lauritzen examines some contemporary works on AID. One is by Lisa Sowle Cahill. 8 Cahill rejects third party participation in reproductive technologies because they separate genetic and social parenthood. There are moral responsibilities that are directly contingent on genetic connection. They are inalienable and cannot be completely transferred to others. Thus, in Lauritzen's words: Thus it could never be morally acceptable to create a child with the intention of separating genetic and social parenthood, for to do so would require an individual to create a set of moral obligations he or she had no intention of discharging. 9 For Cahill, the responsibilities of parenthood do not root entirely in human choice. They root also in biological genetic connections. For this reason, "biological relationships can and should exercise some constraints upon freedom to choose (or not to choose) the parental relation."' 0 And for Cahill, biological restraints restrict the freedom to choose AID and surrogate motherhood. Lauritzen criticizes this view on the ground that it assumes that to separate genetic and social parenthood is to abandon all constraints on reproductive choice. As he says: Yet in disagreeing with Cahill about the normative ideal, I am not abandoning all restraints on reproductive choice. Rather I am simply drawing the line of acceptable choice at a different place." What is not clear to me in Lauritzen's fine study is where he is drawing the line and above all why. The major ethical obstacles he sees to the responsibility of parenthood in AID are secrecy (deception at the heart of the parent-child relationship) and the problem of 7. Paul Lauritzen, "Pursuing Parenthood: Reflections on Donor Insemination," Second Opinion, July 1990, at For responses to Lauritzen, see Second Opinion, January 1992, at Lisa Sowle Cahill, "The Ethics of Surrogate Motherhood: Biology, Freedom and Moral Obligations," Law, Medicine and Health Care 16, (1988). 9. Lauritzen, supra note 7, at Cahill, supra note 8, at Lauritzen, supra note 7, at'65.

4 1620 CREIGHTON LAW REVIEW [Vol. 25 asymmetry. When dealing with secrecy, he cites the work of Baran and Pannor: For most of the men we interviewed, the choice of donor insemination had been an acute response to the pain they were experiencing. They never permitted themselves the time and opportunity to explore their feelings about the devastating ego blow. They prevented themselves from becoming comfortable with and accepting of their handicap. Instead, they cast the handicap in concrete, and their feelings of inadequacy were continuously reinforced by visual proof: their donor off-spring. With this enormous deficit in place, the relationship between the husband and wife had to be realigned. The husband became weaker and more passive; the wife became stronger and more powerful. The wife was the real mother of the children, and this message, although never spoken, was clearly given to the husband in many ways. The husband could be devoted and caring toward the children, while, at the same time, recognizing the difference between his parental role and his wife's. 12 Lauritzen seems to treat this scenario as a problem of secrecy and therefore one that could be dispersed by candid revelation and discussion. Actually, I believe it will be seen by many as an intrinsic problem and as inseparable from AID itself whether secrecy is there or not. Whatever the case, if secrecy and asymmetry are the two obstacles to responsible parenthood in using AID, and if both can be overcome, it is not clear where and why Lauritzen would "draw the line of acceptable choice." This exchange between Cahill (emphasizing the basic importance of genetic connections) and Lauritzen (emphasizing the superior importance of the parenting function) is a kind of symbol of the way the ethical discussion is conducted. For instance, Donum vitae regards the use of third party gametes as "a violation of the reciprocal commitment of the spouses and a grave lack in regard to that essential property of marriage which is its unity." 1 3 How is this unity to be understood? There are at least two possibilities. The first is at root nonconsequentialist in character. It appeals to the nature of marriage - or at least that is how I read Donum vitae's presentation of the argument. After noting that the 12. A. Baran and R. Pannor, Lethal Secrets: The Shocking Consequences and Unsolved Problems of Artificial Insemination (New York: Warner Books, 1989), Cf. note 1, at 24. Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation 24 (1987).

5 1992] CATHOLIC PERSPECTIVE 1621 child must be the fruit and sign of the mutual self-giving of the spouses, of their love and fidelity, it states: "The fidelity of the spouses in the unity of marriage involves reciprocal respect of their right to become a father and a mother only through each other."' 1 4 A certain notion of marriage as exclusive at all levels seems to undergird that statement, though I admit that if one pushes hard enough (e.g., "Why must unity be so understood?") one gets to consequentialist considerations. The second possibility is that of Lauritzen. AID introduces life experiences that cannot be fully shared and "this lack of mutuality may interfere with the couple's ability to care for and to love the child that is created."' 15 But is this disunity an overwhelming obstacle? Lauritzen thinks not. At this point, I would like to introduce a consideration I have rarely heard discussed. It will be recalled that Donum vitae rejected any reproductive technology that is a substitute for sexual intercourse. My own experience with couples who have undergone IVF and ET (in vitro fertilization with embryo transfer) is that they do not regard these procedures as a substitute for sexual intimacy, but as a kind of technological continuation or extension of it. Now if that is indeed the case, then we must ask: Is it appropriate for third parties to be involved in such continuation? Let me summarize here. There are two key issues on which there is likely to continue to be strong disagreement: (1) Does third party involvement (via gametic donation or surrogate gestation) infringe on conjugal exclusivity? and (2) Does having a jointly raised child justify such infringement? My own answers are yes to the first, no to the second. I hold these positions because I believe the notion of conjugal exclusivity should include the genetic, gestational, and rearing dimensions of parenthood. Separating these dimensions (except through rescue, as in adoption) too easily contains a subtle diminishment of some aspect of the human person. To argue that marital exclusivity ought to include the genetic, gestational, and rearing components can be argued in at least two different ways. First, it can be argued that third party involvement is itself violative of the marriage covenant independent of any potential damaging effects or benefits. This is the thrust of Lisa Cahill's analysis, as well as that of Pius XII. The view might be argued in purely ethical terms (Cahill) or in religious terms. An example of the latter is the distinguished Paul Ramsey. He writes: "To put radically asunder what God joined together in parenthood when He made love pro- 14. Id.. supra note 7, at Lauritzen, 72.

6 1622 CREIGHTON LAW REVIEW [Vol. 25 creative, to procreate from beyond the sphere of love.., or to posit acts of sexual love beyond the sphere of responsible procreation (by definition, marriage) means a refusal of the image of God's creation in our own." '16 As I just noted above, there is a simpler way of making this point. Many couples regard in vitro fertilization not as a replacement for their sexual intimacy, but as a kind of continuation or extension of it. On that view, third party presence (via egg or sperm) is presence of another in the intimacy itself, a thing that ought not to be. One need not call this adultery to make the point. The second form of the argument is that any relaxation in marital exclusivity will be a source of harm to the marriage (and marriage in general) and to the prospective child. For instance, the use of donor semen means that there is a genetic asymmetry in the relationship of husband and wife to the child, with possible damaging psychological effects. If a surrogate mother is used, then conflicts could arise that damage both the marriage and the surrogate. William J. Winslade and Judith Wilson Ross recently raised some of the questions I have in mind, including: Is the child to know about the method of its birth? If so, how much information should the child have - only that which is deemed to be health-related data, or all of the other biological information about its heritage that most of us value? Whose interests, whose preferences, whose needs count here? Born into a society that is already fragmented by divorce and confused about alternative life styles, morals and sexual choices, the child may well have serious identity problems at a later time. Does such a possibility have to be seriously considered by those who want to undertake unusual reproductive methods? 1 7 The Winslade-Ross essay concludes: "The interests and well-being of the baby-to-be-made seem to be the last issues considered, and sometimes (when physicians promise anonymity to the donor or parents require it of the surrogate) seem not to be considered at all. ' 'i s Another form of this first approach is the assertion that thirdparty involvement separates procreation from marriage in principle. That opens the door, both by human proclivity and the logic of moral justification, to a litany of worrisome problems such as single-women insemination and insemination of a lesbian couple. An argument built on possible harmful consequences is one sub- 16. P. Ramsey, Fabricated Man: The Ethics of Genetic Control (New Haven: Yale University Press, 1970) Winslade and Ross, N.Y Times, Feb. 21, 1986, Id.

7 1992] CATHOLIC PERSPECTIVE 1623 ject to empirical verification. It must be admitted in all honesty that the data are thin at best, often even conjectural. Fears of what might happen once marital exclusivity is relaxed are legitimate even if they do not always lead to clearly established absolute prohibitions. In the past I have argued that the risks and potential harms involved would support a safeside moral rule (procreation should be restricted to marriage at all levels - genetic, gestational, and social) against the slide to abuse. This is a prudential calculus which gives greater weight to institutional risk of harm than to individual benefit. SURROGACY IN SPECIE There are two levels at which one might approach this problem, the individual and the social. By "this problem" I am referring to surrogate motherhood, not surrogate gestation only because the circumstances for this latter are likely to be extremely rare. First, the individual level. I will simply list here some of the concerns noted by the American Fertility Society ("AFS"). The AFS report lists potential harms under these categories: the surrogate, the couple, and the child The surrogate. -Physical hazards in carrying a pregnancy for other persons. -Psychological harm in giving up one's own genetic child. -Exploitation of the surrogate, especially if she is poor. 2. The couple. -Woman could be harmed by not having access to medical advice that could help her solve infertility in other ways. -Risk of harassment from surrogate. -Continued involvement of surrogate could harm couple's relationship. -Financial risk to couple because of uncertain legal status of the procedure. -Pain if surrogate decides to keep the child. 3. The child. -Child could be physically harmed by a surrogate's genetic defect. -Surrogate who knows she has no rearing responsibility might be careless during pregnancy. -Concerns about child's sense of identity and clarity about parenthood. The benefit to be expected is that a surrogate arrangement would allow the otherwise infertile (because of lack of a uterus, for 19. Cf. note 5 at 59 S. Fertility and Sterility 50 S (Supp ).

8 1624 CREIGHTON LAW REVIEW [Vol. 25 example) couple to rear a child with a genetic relationship to one of them. Weighing the pros and cons of this procedure, the AFS ethics committee concluded that if surrogate motherhood is to be pursued, then it should be "pursued as a clinical experiment." By this the committee meant to designate "an innovative procedure that has a very limited or not historical record of whether any success can be achieved. ' 20 Being a member of this committee, I can confidently assert that this is about as close as the committee would come to outright condemnation. Indeed, committee member C. Alvin Paulsen stated his dissent by noting that "the risk/benefit ratio of the surrogacy procedures does not justify their support. '21 There is one important aspect of surrogate motherhood that should be noted: The potential harms are inherent in the procedure. They are not the result of inadequate protocols, etc. This point has been noted by others. 22 Now let me turn to the social level. There will naturally be some overlap here with considerations already mentioned. At the time of the Baby M. case, Daniel Callahan wrote: "We are caught in the middle of a major social experiment without the faintest idea how it should be conducted. The case reveals why the attendant problems are so hard and why surrogate motherhood was probably a bad idea from the outset. ' 23 By the "attendant problems," Callahan refers to the kinds of problems our society would be better off without. He refers to three above all. 1) Surrogacy represents yet another mode of producing children that is less than desirable, and at a time when we are not underpopulated. 2) We court confusion about parentage with the accompanying uncertainty about responsibility for the welfare of the child. 3) We introduce a cadre of women whose prime virtue is what we now take to be a vice - "the bearing of a child one does not want and is prepared not to love." '24 These considerations of Callahan's open another issue of social concern: The impoverishment of women by their reduction to their child-bearing capacity. I find it difficult to see how any surrogacy arrangement does not reduce a woman to a means. Considerations like the above led me to entitle the only article I have written on this 20. Id. at vii. 21. Id. at 73 S. 22. For example, K.H. Rothenberg, "Gestational Surrogacy and the Health Care Provider: Put Part of the 'IVF Genie' Back into the Bottle," Law, Medicine and Health Care 18 (1990), n Callahan, Surrogate Motherhood: A Bad Idea, N.Y Times, Jan. 20, 1987, at Id.

9 1992] CATHOLIC PERSPECTIVE 1625 subject "Surrogate Motherhood: a Still-born Idea." '25 One response to this presentation might well be: How is this a Catholic perspective? What makes it Catholic? Could not any humanist espouse a similar analysis? Such questions reflect a misunderstanding about the nature of moral reflection in the Catholic community. This reflection has never yielded to the sometimes comforting enticements of sectarianism, as if "Catholic" contained an implied reference to a secretum arcani in the moral sphere. It is here that I return to the criterion of the person integrally and adequately considered. If that is truly the appropriate criterion, as I believe it is, then whatever will throw light on the impact of the reproductive technologies on the well-being of persons is necessarily part of human reflection on the matter. The Catholic church, with its centuries-old tradition of natural law in moral matters, is quite comfortable with Aguinas' saying that "we offend God only in so far as we offend our own good." '26 If surrogate motherhood offends - on balance - our own good as persons, then Catholics would reject it. I believe they should. 25. Richard A. McCormick, S.J., "Surrogate Motherhood: A Stillborn Idea," Second Opinion, v. 5, at (1987). 26. Summa contra gentiles 3, 122.

10 1626 CREIGHTON LAW REVIEW [Vol. 25 CURRICULUM VITAE RICHARD ARTHUR MCCORMICK, S.J. Born October 3, 1922, Toledo, Ohio. Entered Society of Jesus in Received B.A. (1945) and M.A. (1950) from Loyola University, Chicago; S.T.D. (doctorate in theology) from the Gregorian University, Rome, Ordained to priesthood in Presently John A. O'Brien Professor of Christian Ethics, University of Notre Dame. Previously ( ) he was Rose F. Kennedy Professor of Christian Ethics of the Kennedy Institute of Ethics, Georgetown University, Washington,, D.C., and Research Associate at the Woodstock Theological Center (D.C.). From 1957 to 1973, Professor of Moral Theology, Jesuit School of Theology in Chicago. Lectures frequently throughout the country on Christian morality. Father McCormick is the author of Ambiguity in Moral (hoice (Marquette University, 1973); Doing Evil to Achieve Good (with the late Paul Ramsey, Loyola University Press, 1978); How Brave a New World? (Doubleday, 1981); Notes on Moral Theology, 1965 through 1980 (with Index, University Press of America, Lanham, Maryland, 1980); Readings in Moral Theology 1. Moral Norms and Catholic Tradition (ed., with Charles E. Curran, 1979); Readings in Moral Theology II: The Distinctiveness of Christian Ethics (ed., with Charles E. Curran, 1980); Readings in Moral Theology III: Morality and Authority (ed., with Charles E. Curran, 1981); Readings in Moral Theology IV. The Use of Scripture in Moral Theology (1982); Readings in Moral Theology V: Official Catholic Social Teaching (1986); Readings in Moral Theology VI: Dissent in the Church (1988); Readings in Moral Theology VII The Natural Law (1991); Notes on Moral Theology (University Press of America, Lanham, Maryland, 1984); Health and Medicine in the Catholic Tradition (Crossroad/ Continuum Publishing Co., New York, 1984); The Critical Calling: Moral Dilemmas Since Vatican 11 (1989). He is a regular contributor to journals such as Christianity and Crisis, New Catholic World, Hospital Progress, America, Commonweal, Concilium, Cross Currents, Etudes, Theological Studies, Review for Religious, Catholic Mind, Linacre Quarterly, Journal of the American Medical Association, Hastings Report, Perspectives in Biology and Medicine, Journal of Medicine and Philosophy, Contemporary OB/GYN, "Notes on Moral Theology" since 1965 (Theological Studies). He has written for Sports Illustrated, the New York Times, and the Washington Post. He has contributed chapters to many books such as Norm and Context in Christian Ethics, The Future of Ethics and Moral Theology, All Things to All Men, Judaism and the Christian Seminary Curriculum, The Problem of Population, Proceedings of the Conference on

11 1992] CATHOLIC PERSPECTIVE 1627 Teaching of Medical Ethics, Love and Society, An American Catholic Catechism, Ministering to the Divorced Catholic, Personal Values in Public Policy, etc. Father McCormick is a past president of the Catholic Theological Society of America; past member of the Board of Directors of the American Society of Christian Ethics; past member of the Board of Trustees of the University of Detroit and of Fairfield University; member of the Catholic Commission on Intellectual and Cultural Affairs; past member of the Board of Directors and Treasurer of the Churches' Center for Theology and Public Policy; past member of the Ethics Advisory Board, Department of Health, Education and Welfare; Fellow of the Institute of Society, Ethics and the Life Sciences (Hastings Center); past associate editor of America magazine; editorial advisor for Theology Digest and Hospital Progress; member of the Editorial Board of the Journal of Religious Ethics; member of the Editorial Board of Fetal Medicine; member of the Editorial Board of the Journal of Contemporary Health Law and Policy; member of the Special Bioethics Committee, American Hospital Association; member of the Bioethics Committee of the National Hospice Organization and the Catholic Health Association; member of the Ethics Committee of the American Fertility Society. Cited in the New York Times,'Washington Post, Wall Street Journal, Time, Newsweek, U.S. News and World Report, Parade, etc. Appearances: Today, Nightline, Meet the Press, etc. In 1969 Father McCormick was awarded the Cardinal Spellman Award by the Catholic Theological Society of America as "Outstanding Theologian of the Year." In 1988 he was given the Henry Knowles Beecher award from the Hastings Center for "lifetime contributions to ethics and the life sciences." Honorary Degrees: University of Scranton, Pennsylvania (1975) Wheeling College, Wheeling, West Virginia (1976) Jesuit School of Theology, Berkeley, California (1982) Siena College (1985) University of Louvain (1986) Holy Cross College (1986) Seattle University (1987) Fordham University (1988) Xavier University (1988) Loyola University of Chicago (1989) University of San Francisco (1989) Georgetown University (1990) Catholic Theological Union, Chicago (1991)

12 1628 CREIGHTON LAW REVIEW [Vol. 25 In 1990 he was elected to membership in the prestigious American Academy of Arts and Sciences. His father, the late Dr. Edward J. McCormick, was president of the American Medical Association.

13 1992] CATHOLIC PERSPECTIVE 1629 Fr. Richard A. McCormick, S.J. Partial Bibliography Listing Fr. Richard A. McCormick, S.J. has an extensive bibliography starting from Due to space limitations, the bibliography included here is only a partial listing of works dating from 1975 through "H.V. in Perspective," The Tablet (London: The Tablet Publishing Co., Ltd., (February 8, 1975) ; "Notes on Moral Theology: April-September, 1974," Theological Studies 36 (March, 1975) ; "Life-Saving and Life-Taking: A Comment," Linacre Quarterly 42 (May, 1975) ; "Fetal Research, Morality, and Public Policy," The Hastings Center Report 5 (June, 1975) 26-31; _-, and Walters, Loroy, "Fetal Research and Public Policy," America 132 (June 21, 1975) ; "The Social Responsibility of the Christian," The Australian Catholic Record 52 (July, 1975) [Digested in Theology Digest 24 (Spring, 1976) ]; "Life/Death Decisions: An Interview with Moral Theologian Fr. Richard McCormick, S.J.," St. Anthony Messenger 83 (August, 1975) 33-35; "A Proposal for 'Quality of Life' Criteria for Sustaining Life," Hospital Progress 56 (September, 1975) 76-79; "Transplantation of Organs: A Commentary on Paul Ramsey," Theological Studies 36 (September, 1975) ; "Indissolubility and the Right to the Eucharist: Separate Issues of One?" Cannon Law Society of America Proceeding of the 37th Annual Convention (October 6-9, 1975) 26-37; "Divorce and Remarriage," Catholic Mind 73 (November, 1975) [Reprinted as "Scheidung und Wiederverheiratung," Theologie der Gegenwart 18 #4 (1975) ]; "The Karen Ann Quinlan Case: Editorial," Journal of American Medical Association 234 (December 8, 1975) 1057; "Experimentation on the Fetus: Policy Proposals," Appendix: Research on the Fetus (Washington, D.C.: U.S. Department of Health, Education, and Welfare Publication, 1975) ; "The Insights of the Judeo-Christian Tradition and the Development of an Ethical Code," Human Rights and Psychological Research: A Debate on Psychology and Ethics, ed. Eugene Kennedy (New York: Thomas Y. Crowell, 1975) "Sexual Ethics - An Opinion," National Catholic Reporter 12 (January 30, 1976) 9; "Notes on Moral Theology: April-September, 1975," Theological Studies 37 (March, 1976) ; "The Preservation of Life," Linacre Quarterly 43 (May, 1976) ; "Experimental Subjects: Who Should They Be?" Journal of the American Medical Association 235 (May 17, 1976) 2197; "The So-

14 1630 CREIGHTON LAW REVIEW [Vol cial Responsibility of the Christian," Theology Digest 24 (Spring, 1976) 11-14; "When the Neonate is Defective," Contemporary Ob/ Gyn 7 (June, 1976) 90, 92, 95-96, 99, 103, 107, 109, ; "The Moral Right of Privacy," Hospital Progress 57 (August, 1976) 38-42; "Sterilization and Theological Method," Theological Studies 37 (September, 1977) ; "Experimentation in Children: Sharing in Sociality," Hastings Center Report 6 (December, 1976) 41-46; "The Principal of the Double Effect," Concilium 120 (December, 1976), ; "Romische Erklarung zur Sexualethik," Theologie der Gegenwart 19 #2 (1976) 72-76; "Morality of War," New Catholic Encyclopedia 14 (1976) ; "Maker of Heaven and Earth," Christian Theology: A Case Method Approach, eds., Robert A. Evans and Thomas E. Parker (New York: Harper & Row, 1976) and Hellegers, Andre E., "Legislation and the Living Will," America 136 (March 12, 1977) ; "Notes on Moral Theology: 1976," Theological Studies 38 (March, 1977)57-114; "'Sleeper' on DNA," National Catholic Reporter (July 15, 1977) 9; "Man's Moral Responsibility for Health," Catholic Hospital 5 (July-August, 1977) 6-9; McCormick, Richard A., S.J., et., "A C & C Symposium: Paying for Abortion: Is the Court Wrong?" Christianity and Crisis 37 (September 19, 1977) ; "Christianity and Morality," Catholic Mind 75 (October, 1977) 17-29; "Sterilisation und Theologisch Methode," Theologie der Gegenwart 20 (1977) "The Quality of Life, the Sanctity of Life," Hastings Center Report 8 (February, 1978) 30-36; "Notes on Moral Theology: 1977," Theological Studies 39 (March, 1978) ; "Abortion: Rules for Debate," America 139 (July 15-22, 1978) 26-30; "Life in the Test Tube," New York Times (August 8, 1978); "Unanswered Questions on Test Tube Life," with Andre Hellegers, America 139 (August 12-19, 1978) 74-78; "Some Neglected Aspects of Responsibility for Health," Perspectives in Biology and Medicine 22 (1978) 31-43; "Moral Norms and Their Meaning," Lectureship (Mt. Angel Seminary, 1978) 31-47; "The Contemporary Moral Magisterium," Lectureship (Mt. Angel Seminary, 1978) 48-60; McCormick, Richard A., S.J., and Ramsey, Paul, eds., Doing Evil to Achieve Good. Moral Choice in Conflict Situations (Chicago: Loyola University Press, 1978) "Abortion: A Changing Morality and Policy," Hospital Progress 60

15 1992] CATHOLIC PERSPECTIVE 1631 (February, 1979) 36-44; "Bioethical Issues and the Moral Matrix of U.S. Health Care," Hospital Progress 60 (May, 1979) 42-45; Readings in Moral Theology No. 1: Moral Norms and Catholic Tradition, ed. with Charles E. Curran (Mahwah: Paulist Press, 1979); "Notes on Moral Theology," Theological Studies 40 (1979) "Restatement on Tubal Ligation Confuses Policy with Normative Ethics," Hospital Progress 61 (September, 1980) 40; "The Fox Case," Journal of the American Medical Association 244 (November 14, 1980) ; Readings in Moral Theology No. 2: The Distinctiveness of Christian Ethics, ed. with Charles E. Curran (Mahwah: Paulist Press, 1980); "Sterilization: The Dilemma of Catholic Hospitals," with Corrine Bayley, America 143 (1980) ; Notes on Moral Theology: 1965 through 1980 (Lanham, Maryland: University Press of America, 1980); "The Preservation of Life and Self-determination," Theological Studies 41 (1980) ; "Neural Tube Defects," Maternal Serum Alpha- Fetoprotein: Issues in the Prenatal Screening and Diagnosis of Neural Tube Defects, eds. Barbara Gastel, et. al., (Washington, D.C.: Government Printing Office, 1980) "No Short Cuts to Making Public Policy on Abortion," Washington Star (March 23, 1981); "Marriage, Morality and Sex-Change Surgery: Four Traditions in Case Ethics," Hastings Center Report 11 (August, 1981) 10-11; "The Fifth Synod of Bishops," Catholic Mind 79 (September, 1981) 46-57; "The Ethics of In Utero Surgery," with William Barclay, et. al., Journal of the American Medical Association 246 (October 2, 1981) ; "Guidelines for the Treatment of the Mentally Retarded," Catholic Mind 79 (November, 1981) 44-51; "Theology as a Dangerous Discipline," Georgetown Graduate Review 1 (1981) 2-3; How Brave a New World? Dilemma in Bioethics (Garden City: Doubleday, 1981); Readings in Moral Theology No. 3: Morality and the Magisterium, ed. with Charles E. Curran (Mahwah: Paulist Press, 1981); "Notes on Moral Theology," Theological Studies 42 (1981) ; "Kernenergie und Kernwaffen," Theologie der Gegenwart 24 (1981) ; "Scheidung und Wiederverheiratung als pastorales Problem," Theologie der Gegenwart 24 (1981) 21-32; "Living-Will Legislation, Reconsidered," America 145 (1981) "Infant Doe: Where to Draw the Line," Washington Post (July 27, 1982) A 15; "Les sions intensifs aux nouveau-nes handicapes,"

16 1632 CREIGHTON LAW REVIEW [Vol. 25 Etudes (November, 1982) ; "Ethical Questions: A Look at the Issues," Contemporary Ob/Gyn 20 (November, 1982) ; " : Value Impacts of a Decade," Hospital Progress 63 (December, 1982) 38-41; "Pastoral Guidelines for Facing the Ambiguous Eighties," The Future of Ministry (Milwaukee: St. Francis Seminary, 1982) 41-44; "Neuere Uberlegungen zur Unveranderlichkeit sittlicher Normen," Sittliche Normen, ed. Walter Kerber, S.J., (Dusseldorf: Patmos, 1982) 46-57; "Notes on Moral Theology," Theological Studies 43 (1982) ; "Theology and Biomedical Ethics," Eglise et theologie 13 (1982) ; "Theological Dimensions of Bioethics," Logos 3 (1982) 25-46; Readings in Moral Theology No. 3: The Magisterium and Morality, ed. with Charles E. Curran (Mahwah: Paulist Press, 1982) "Notes on Moral Theology," Theological Studies 44 (1983) ; "Bioethics in the Public Forum," Milbank Memorial Fund Quarterly 61 (1983) ; "Saving Defective Infants: Options for Life or Death," with John Paris, S.J., America 148 (1983) ; "Nuclear Deterrence and the Problem of Intention: A Review of the Positions," Catholics and Nuclear War, ed. Philip Murnion (New York: Crossroad, 1983) ; 1984 Readings in Moral Theology No. 4: The Use of Scripture in Moral Theology, ed. with Charles E. Curran (Mahwah: Paulist Press, 1984); Health and Medicine in the Catholic Tradition (New York: Crossroad, 1984); "Notes on Moral Theology," Theological Studies 45 (1984) ; "The Chill Factor: Recent Roman Interventions," America 150 (1984) ; Notes on Moral Theology: 1981 through 1984 (Lanham, Maryland: University Press of America, 1984); "Medicaid and Abortion," Theological Studies 45 (1984) "Was There Any Real Hope for Babe Fae?" Hastings Center Report 15 (February, 1985) 12-13; "Genetic Technology and Our Common Future," America 152 (1985) ; "Caring or Starving? The Case of Claire Conroy," America 152 (1985) ; "Theology and Bioethics: Christian Foundations," Theology and Bioethics, ed. Earl Shelp (Dordrecht: Reidel, 1985) ; "Moral Argument in Christian Ethics," Journal of Contemporary Health Law and Policy 1 (1985) 3-23; "Notes on Moral Theology: Moral Norms - An Update," Theological Studies 46 (1985) 50-64; "Therapy or Tempering? The Ethics of Reproductive Technology," America 153 (1985) ; "Gustapon's God: Who? What?

17 1992] CATHOLIC PERSPECTIVE 1633 Where? (etc.)." Journal of Religious Ethics 13 (1985) 53-70; "The Past, Present, and Future of Moral Theology," Proceedings of 1984 Theological Symposium (Villanova University, 1985) "The Magisterium," Authority, Community and Conflict, ed. Madonna Kolbenschlag (Kansas City: Sheed and Ward, 1986) 34-37; "Gaudium et Spes and the Bioethical Signs of the Times," Questions of Special Urgency (Washington: Georgetown University Press, 1986) 79-95; "Health and Medicine in the Catholic Tradition," Ephemerides Theologicae Lovanienses 62 (1986) ; "Symposium: Bioethical Issues in Organ Transplantation," Southern Medical Journal 79 (1986) ; "The Best Interests of the Baby," Second Opinion 2 (1986) 18-25; "Biomedical Advances and the Catholic Perspective," Contemporary Ethical Issues in the Jewish and Christian Traditions, ed. Frederick Greenspan (Hoboken: Ktav Publishing House, 1986) 30-52; "The Search for Trust in the Catholic Context," America 155 (1986) ; "L'Affaire Curran," America 155 (1986) ; Readings in Moral Theology No. 5: Official Catholic Social Teaching, ed. with Charles E. Curran (Mahwah: Paulist Press, 1986); "Notes on Moral Theology," Theological Studies 47 (1986) 69-88; "Bishops as Teachers and Jesuits as Listeners," Studies in the Spirituality of Jesuits 18 (1986) 1-22; "Finality," "Double Effect," "Magisterium," Dictionary of Christian Ethics, eds. James Childress and John Macquarrie (Philadelphia: Westminister, 1986) "Ethics of Reproductive Technology: AFS Recommendation, Dissent," Health Progress 68 (March, 1987) 33-37; "Document is Unpersuasive," Health Progress 68 (July/August, 1987) 53-55; "Notes on Moral Theology: Dissent in Moral Theology and its Implications," Theological Studies 48 (1987) ; "Surrogate Motherhood: A Stillborn Idea," Second Opinion 5 (1987) ; "Self- Assessment and Self-Indictment," Religious Studies Review 13 (1987) 37-39; "The Vatican Document on Bioethics," America 156 (1987) 24-28; "The Vatican Document on Bioethics: A Response," America 156 (1987) ; "The Catholic Tradition on the Use of Nutrition and Fluids," with John Paris, S.J., America 156 (1987) ; "Begotten, Not Made," Notre Dame Magazine 15 (1987) "Bishops' AIDS Letter 'Splendid' Theology," National Catholic Reporter 24 (January 22, 1988) 1, 5-6; "The Future of Chaplaincy: Bioethical Problems that Shape Ministry," Charting the Future

18 1634 CREIGHTON LAW REVIEW [Vol. 25 of Pastoral Care (Special Publications of National Association of Catholic Chaplains, v. 4, Summer, 1988) 24-39; "Searching for the Consistent Ethic of Life," Personalist Morals, ed. J.A. Selling (Leuven University Press, 1988) ; "A Moral Magisterium in Ecumenical Perspective?" Studies in Christian Ethics 1 (1988) 20-29; "The Importance of Naturalness and Conjugal Gametes," In Vitro Fertilization and Other Assisted Reproduction (Annals of the New York Academy of Sciences, v. 541) (1988) ; "AIDS: The Shape of the Ethical Challenge," America 158 (1988) ; "The Shape of Moral Evasion in Catholicism," America 159 (1988) ; Readings in Moral Theology No. 6: Dissent in the Church, ed. with Charles E. Curran (Mahwah: Paulist Press, (1988); "The Cost-Factor in Health Care," Notre Dame Journal of Law, Ethics and Public Policy 3 (1988) "Abortion: The Unexplored Middle Ground," Second Opinion 10 March, 1989) 41-50; "Theology and Bioethics," Hastings Center Report 19 (March/April, 1989) 5-10; The Critical Calling: Moral Dilemmas Since Vatican II (Washington: Georgetown University Press, 1989); "Moral Theology : An Overview," Theological Studies 50 (1989) 3-24; "Pluralism Within the Church," Catholic Perspectives on Medical Morals, eds. Edmund D. Pellegrino, John P. Langan, John Collins Harvey (Dordrecht: Kluwer Academic Publishers, 1989) ; "Moral Theology in the Year 2000: Reverie or Reality," (Regina: Campion College, The Nash Lecture, privately printed.); "Foreword," Why You Can Disagree and Remain a Faithful Catholic, by Philip S. Kaufman (Bloomington: Meyer-Stone Books, 1989) xi-xii; "Sterilization: The Dilemma of Catholic Hospitals," History and Conscience, eds. R. Gallagher and Brendan McConvery (Southampton: Camelot Press, 1989)

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