By JOHN L. ALLEN JR.

In the court of public opinion, Roman Catholicism usually looms as the great “Doctor No” of bioethical debate. From abortion to birth control, from homosexuality to embryonic stem-cell research, the wearily familiar pattern is for officialdom to strike a restrictive position, leading critics to clamor for greater tolerance.

Less well-known, however, is the recent emergence of another cluster of bioethical issues where the exact opposite is the case -- the official Catholic position is approving, so the strongest challenge to church teaching, both inside Catholicism and out, comes from those demanding a tougher line.

Consider the following examples:

• In late September, the bishops of Connecticut announced that Catholic hospitals in the state may participate in an emergency contraception plan for rape victims, drawing howls of protest from pro-life groups. One person said bluntly, “The devil won in Connecticut.” The bishops’ position, however, builds on a well-established codicil of church teaching that because sexual assault is not part of the unifying and life-giving functions of marriage, its victims should be able to defend themselves against unwanted conception. (That logic ends, however, when a new life has been conceived, in which case the traditional ban on abortion stands.)
• Three times, twice in the 1980s and again in 2006, the Vatican has signaled its acceptance of so-called “brain death,” meaning reliance on the absence of brain activity to define death. That standard is essential to organ transplantation, since it allows the removal of organs while the donor is still circulating blood. The stance has come over the objections of an influential subset of pro-life Catholics, including bishops, philosophers, theologians and physicians, who believe that “brain death” is a macabre case of the ends justifying the means, redefining living human beings as cadavers in order to plunder their bodies.
• Senior Vatican officials have also signaled basic approval of genetically modified organisms, or GMOs, meaning crops that have been engineered with some specific trait, usually to increase yields or boost pesticide resistance. While these Vatican officials believe that GMOs could be an important tool in the fight against hunger, critics have accused the church of being bought off by massive agribusiness interests and neglecting the potential health risks of GMOs as well as their impact on traditional farm economies. Touting GMOs as a solution to hunger, these critics insist, ignores far more basic problems of social justice.

Looking ahead, it’s an open question whether these instances of the church saying “aye,” even if in a cautious and qualified manner, will prove as durable as its nays. As John Paul II noted in his 1993 encyclical Veritatis Splendor, a negative rests on a more secure foundation, since it involves a moral absolute that obliges “always and under all circumstances.” An affirmation usually involves a prudential judgment facing a given set of circumstances -- and as those circumstances evolve, so can the response.

In light of widespread apprehension about a creeping “culture of death,” bishops and theologians alike are feeling mounting pressure to tighten the church’s positions. The drama in Catholic bioethics might be phrased this way: Will the church be able to find ways on at least some fronts to say yes, in a time when it’s often politically and theologically easier to “just say no”?

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The response of the Connecticut bishops on emergency contraception led to withering criticism in Catholic pro-life circles. An Oct. 4 letter from the Catholic Media Coalition, signed by two dozen members of the Virginia-based group, called on the bishops to rescind their position. Mary Ann Kreitzer, the group’s president, said the Connecticut plan “turns the womb into a hostile environment.”

Yet in terms of church teaching, allowing victims of sexual assault to defend themselves against pregnancy is hardly a novelty.

In the early 1960s, for example, during a period of civil war in what was then the Belgian Congo, religious women were targeted for rape by various paramilitary groups. According to Redemptorist Fr. Brian Johnstone of the Catholic University of America, the Vatican’s Holy Office (forerunner to today’s Congregation for the Doctrine of the Faith) gave permission for the nuns to use contraceptives. “It was seen as a protection against pregnancy arising from unwanted, unfree sexual intercourse,” Johnstone said.

That has remained the official position. In 2003, for example, the Massachusetts legislature debated a bill mandating that rape victims have access to contraceptives. The state’s bishops sanctioned the measure, though specifying that the contraceptives must work to prevent pregnancy rather than to induce abortion.

The victim, the bishops said, “is not obliged when raped, as would be the case in consensual relations, to accommodate the natural potential for conception. The forced introduction of sperm is an act of aggression she may resist even through means that prevent the creation of new life.” Thus contraception, especially if delivered within 24 hours after the rape, can be justified.

That permission, they emphasized, does not apply when conception has already occurred. “A human life conceived by rape is not an act of aggression, but a new person innocent of any wrongdoing,” they said.

The Connecticut case is murkier, many observers say, because the state law that took effect Oct. 1 does not require an ovulation test to determine if a new life is present, does not provide an exemption for conscientious objection for medical personnel, and relies on the “Plan B” dose of birth control pills that some critics consider a form of “chemical abortion.” Church spokespersons have indicated that the bishops still consider the law “flawed.”

“If it becomes clear that Plan B pills would lead to an early chemical abortion in some instances, this matter would have to be reopened,” their statement said.

Nonetheless, the moral principle that pregnancy cannot be coerced seems well-established. The Ethical and Religious Directives of the U.S. bishops state that a woman “who has been raped should be able to defend herself against a potential conception from the sexual assault.”

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Organ transplants didn’t become feasible until the 20th century, making their swift embrace by Catholic officialdom fairly remarkable. As early as 1956, Pope Pius XII said organ donation “should not be condemned, but positively justified.” In a 2000 address, John Paul called organ donation “a genuine act of love.” In perhaps the ultimate sign of approval, Pope Benedict XVI himself carries an organ donation card. (Given his age, it’s unlikely he would be considered a suitable donor, but it’s still a striking bit of symbolism.)

Despite this seemingly unambiguous position, an undercurrent of discontent has long circulated.

In the wake of John Paul’s 2000 address, Catholic figures of some importance, including Bishops Fabian Bruskewitz of Lincoln, Neb., and Robert Vasa of Baker, Ore., along with noted Catholic philosopher Josef Seifert, published an essay arguing that transplant procedures amount to death at the hands of doctors. They directed special criticism at the concept of “brain death,” arguing that it redefines living human beings, albeit gravely ill, as dead, in order to harvest their organs.

Traditionally, telling the difference between a cadaver and a living person did not require specialized medical expertise. With the development of ventilators and other techniques to mechanically prolong the operation of lungs and hearts, however, pressure grew for another way of establishing death. Thus in 1968 the “Harvard Criteria” were published, relying on the complete cessation of brain activity to define death. Since that time these criteria have become standard practice.

“Every Catholic hospital I know uses the brain death protocol,” said Jesuit Fr. Peter Clark, director of the Institute of Bioethics at St. Joseph’s University in Philadelphia.

That fact doesn’t sit well with critics such as Peter Byrne, a physician specializing in neonatal medicine and past president of the Catholic Medical Association.

“If you wait until somebody is truly dead, you can’t take their organs,” Byrne told NCR. “To get around this, a committee decided to translate irreversible comas into brain death.” As a result, Byrne insisted, “the vast majority of transplant cases involve the removal of organs from living human beings.”

Critics such as Byrne insist that despite high-minded rhetoric about the “gift of life,” organ transplantation devalues the lives of terminally ill people, treating them as little more than organ and tissue banks.

Despite the fact that the Pontifical Academy of Science endorsed the absence of neurological activity as “the true criterion of death” in 1985 and again in 1989, and that John Paul II himself endorsed it in his 2000 address, the Vatican nevertheless organized conferences in 2005 and 2006 to debate the issue.

For now, however, the consensus in favor of brain death, and thus in favor of organ transplantation, seems secure. The 2006 Vatican gathering ended with a nine-page statement titled “Why the Concept of Brain Death Is Valid as a Definition of Death,” signed by Cardinal Georges Cottier, then-theologian of the papal household; Cardinal Alfonso Lopez Trujillo, president of the Pontifical Council for the Family; retired Cardinal Carlo Maria Martini of Milan, Italy; and Bishop Elio Sgreccia, president of the Pontifical Academy for Life.

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While Catholicism has never taken an official position on genetically modified organisms, or GMOs, the clear drift of Vatican thinking seems favorable.

In a 2001 document, the Pontifical Academy for the Sciences concluded: “Rapid growth in world population requires the development of new technologies to feed people adequately. ... The genetic modification of food plants can help meet this challenge.”

Cardinal Renato Martino, president of the Pontifical Council for Justice and Peace, lived for 16 years in New York as the Vatican’s representative to the United Nations, and came away positively disposed to GMOs. “I ate everything that was offered to me, including genetically modified products,” he said during an August 2003 press conference. “They had no effect on my health. This controversy is more political than scientific.”

In this case, opposition comes less from pro-life forces than Catholics concerned with social justice.

In 2002, the Catholic bishops of South Africa declared, “It is morally irresponsible to produce and market genetically modified food.” In 2003, 14 Brazilian bishops put out a declaration in which they condemned the cultivation and consumption of GMOs, citing three risks: health consequences, including increased allergies, resistance to antibiotics, and an increase in toxic substances; environmental consequences, including erosion of biodiversity; and damage to the sovereignty of Brazil, “as a result of the loss of control of seeds and living things through patents that become the exclusive property of multinational groups interested only in commercial ends.”

In 2004, an international coalition of Catholic nongovernmental organizations published a joint statement that concluded: “GMO crops do not address the root causes of hunger, including lack of access to land, water, energy, affordable credit, local markets and infrastructures. Greater investment in agriculture and rural development, land reform, more participatory decision-making within institutions, and fairer rules governing agricultural trade and regulations on corporations are some of the key changes needed in order to address these complex causes of hunger.”

Holy Cross Br. David Andrews, executive director of the National Catholic Rural Life Conference in the United States, was blunt in a 2004 statement.

“Surely among the structures of sin in the world today are agro-food corporations that steer the goods of the earth toward themselves solely for profit,” he said. “If one thinks that the focus of these multinational corporations and their supporters is to cure world hunger, then one is among the most naive on the planet.”

In essence, Andrews charged that the Pontifical Academy of Science has been bought off by American biotech interests. “It reminds me of many state-sponsored universities in the United States which take funds from biotechnology companies and lose their scientific critical culture for one of uncritical endorsement of the agenda of the companies that fund their research,” he said.

Here too, however, the basically positive stance of church officials seems intact. Following a 2003 conference on genetically modified organisms sponsored by Martino, most participants came away with the impression that the Vatican’s stance will remain a “yellow light”: proceed with caution.

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While it’s virtually unimaginable that the church will change its position on such bedrock moral absolutes as opposition to abortion, revisiting its permissive stances on other matters, in the eyes of most experts, is more within the realm of the possible.

Perhaps as social concern over a slippery slope towards euthanasia intensifies, church leaders will tighten their positions on contraception for rape victims, or on transplants, as some believe has already been the case with Catholic teaching about withdrawal of food and water for patients in a persistent vegetative state. As the Global South becomes an increasingly important force in the church, today representing two-thirds of the world’s 1.1 billion Catholics, anti-GMO pressures may drive the Vatican toward a more negative view.

In the meantime, however, these cases underscore two basic points.

First, they offer a reminder that, stereotypes associated with the Galileo case notwithstanding, Catholicism through the centuries has often been a patron of the sciences. The founder of modern genetics, Gregor Mendel, was an Augustinian monk. No less a secular oracle than Alfred North Whitehead, in a 1925 lecture at Harvard, observed that modern science arose in Europe due to “faith in the possibility of science ... derivative from medieval theology.”

Second, they illustrate how new medical and technological possibilities are straining the church’s capacity to keep pace. In that regard, some experts believe church leaders deserve credit for trying to make careful distinctions.

“My experience of working with the bishops is that they’re making an enormous effort to educate themselves on highly complicated issues where most of them quite frankly are not experts,” said Mercy Sr. Patricia Talon of the Catholic Health Association.

Given the political intensity of bioethical debate and the complexity of the subject matter, the learning curve to which Talon refers will only grow steeper.

John L. Allen Jr. is NCR senior correspondent. His e-mail address is jallen@ncronline.org

National Catholic Reporter, November 16, 2007