To: (Multiple email addresses may be specified by separating them with a comma)
Bioethicist Father Tad Pacholczyk speaks about end-of- life issues.
BY Joel Davidson
Father Tad Pacholczyk serves as director
of education for the National Catholic Bioethics Center in Philadelphia.
Father Pacholczyk (pronounced
pa-HOLE-check) was ordained a priest for the Diocese of Falls River, Mass., in
1999. After earning a Ph.D. in neuroscience from Yale, he did postdoctoral
research at Massachusetts General Hospital/Harvard Medical School. He also
studied theology and bioethics in Rome.
He travels and speaks extensively on
the ethical implications of embryonic stem-cell research, human cloning,
end-of-life issues and in vitro fertilization.
As the nation geared up for an
overhaul of its health-care system, Father Pacholczyk spoke with Register
correspondent Joel Davidson.
In his March letter to the
bishops of the world, Pope Benedict XVI said: “With the dimming of the light
which comes from God, humanity is losing its bearings, with increasingly
evident destructive effects.” Do you see this phenomenon in the area of
If you look at the history of
bioethics, the whole field has remarkably religious roots. Religious men —
Catholics and Protestants in particular — were involved in founding the
discipline. As this dimming occurs, which the Pope describes, those working in
bioethics are looking for other points of reference, and they are trying to
establish a secular bioethics — one which almost defines itself in
contraposition to traditional ethics and bioethics, which have been invoked
when complex questions arise. That is a new phenomenon in the last 15 to 20
years, but one that is becoming a stronger and stronger force.
We are now witnessing a certain
arbitrariness that ends up characterizing the entire field of bioethics. We do
not have a common language as we used to. This is a problem in society in
general. This loss of a common language includes an overt attempt to exclude
religion from the public square. As people accede to that move, you end up in
these places that the Pope describes as a dimming. It is a fearful place,
When the religious and moral
perspective is excluded from bioethics, it seems that a very important piece of
information is missing, especially when someone is struggling to make a morally
sound decision about medical care, either for himself or a loved one.
Absolutely. In other words, people
struggle to gain their bearings when they are only given purely medical
information and the moral framework that might illuminate the best path for
them is not provided.
You’ve said that a false
autonomy increasingly affects bioethical decisions.
Autonomy is something that has
become exaggerated in our society to the point that the exercise of autonomy is
almost considered the definition of what is right — if you choose it, it must
be right. But that is a completely untenable position in the final analysis. A
proper understanding of autonomy means that a person chooses freely from among
moral options. Insofar as that occurs, then autonomy becomes a very active and
important dimension to health-care decisions.
In your work, you sometimes
address ethics boards at Catholic hospitals. What do you say about how Catholic
hospitals should approach the issue of autonomy?
Catholic hospitals have a duty to
respect a patient’s genuine autonomy, but this never extends to the point of
allowing a patient to do something that runs contrary to the moral law — to the
good of the person.
This is an eminently reasonable
position. It is the recognition that there are some human choices that are
harmful and unreasonable. When you enter a relationship with a health-care
institution, there is a kind of covenant that you enter into with those who
care for you. This implies a need for communication, for honesty, for real
moral information to be made available so that decisions are informed.
How can the average Catholic be
assured that he or his loved ones receive care that is in accord with Catholic
Part of the challenge is to be
involved. If you bring Mom or Dad to the nursing home and then don’t see them
for the next six months, there may not be many opportunities for you to get a
sense of how things are proceeding. I think the ministry of presence — being
there with our loved ones — really opens up an awareness of how issues are
handled. Some of this will come through dialogue with doctors and nurses.
A person may not be up to doing a
lot of extracurricular reading on (bioethics), but they may still have enough
Catholic formation to sense when they are dealing with an individual physician
or a nurse who may have an ideological slant that appears troubling. We need to
be aware of this, and there may be occasions to raise questions with hospital
staff when these concerns appear. It is important to be present so you are
aware when those concerns appear.
It seems that end-of-life
questions are ultimately about how we should approach death. You have said that
graces come in the dying process. What did you mean?
graces of dying well are enormous, because there is a possibility for real
closure and transition for everybody. For the person who dies, it is the
transition into the next life. But for those who are left behind, they can feel
that they did things as best they could; they did them well; they were present.
Yes, it may be hard and there may be suffering, but there can also be moments
of healing and moments of seeing into the person who is about to leave, things
that they may have never seen before. Those moments are a part of the human
certainly will be some tensions and pain, but I am convinced that the Lord is
in the details, and he knows all of this. The particular trajectory of each of
our deaths, like our lives, is in the Lord’s hands, and he fine-tunes many of
those details for the benefit of those around us who are perhaps approaching
death for the first time or really struggling with it. This is the mystery of
grace at work. The Holy Spirit is ever present in our hospitals and in our
Joel Davidson writes