Raise your tiny hand, Divine Child,
and bless these young friends of yours,
bless the children of all the earth.
— Pope St. John Paul II, Letter to Children in the Year of Families (1994)
We joyfully present this special issue of The Linacre Quarterly to our readers, an issue devoted entirely to medical, ethical, and spiritual issues in the field of pediatrics. Children are a particularly vulnerable population principally because of their inherent dependency on others. They are growing in their physical, emotional, psychological, cognitive, and spiritual capacities, while still retaining the ineffable and immutable dignity with which they were created from the very moment of their conception.
A reflection on the nature of the child tells us much about the nature of the human person. As Pope St. John Paul II was fond of pointing out, part of the beauty of being human is the interdependency or integration of one with another. Hence, children in a special way, remind us that dependency, vulnerability, and our growth as a result are elements of the human condition not to be eschewed but to be embraced.
This notion—that one can be dependent on another and yet still be sacred and inviolable—is almost a revolutionary concept in the twenty-first century. How disheartening that this should be so! And yet, assaults on the lives and dignity of children, the very ones of whom our Lord said, “for to such belongs the Kingdom of God” (Mt 10:14) are spreading at an alarming rate.
The issue begins with an impassioned editorial by Dr. Bill Williams and Dr. Peter Colosi, calling for a new Bill of Rights for Children, and in doing so, outlining the manifold challenges facing children today. Many groups in our society have been demanding their rights, but few have thought of advancing the rights of children. A just society should give the rights of these weaker members precedence over the rights of those who control the political power. The precepts put forth in this editorial are proposed as a starting point to begin a discussion on drafting a Bill of Rights for Children.
Dr. Jay Bringman leads off the discussion in the field of perinatal ethics: should a Catholic healthcare provider, without certainty of a pregnant patient's plans, be willing to perform invasive prenatal testing when a genetic abnormality might risk a termination of the fetus? Dr. Bringman traces the history of prenatal testing, including the American College of Obstetrics and Gynecology's recommendation that such testing ought to be universally offered. He then inspects very carefully the more nuanced Church teaching from many facets: Magisterial teaching (Donum vitae and Dignitatis personae), the Ethical and Religious Directives, and the work of prominent Catholic bioethicists. Dr. Bringman's work brings new clarity: in the face of decisional uncertainty by the patient, one benefit of prenatal testing can be the simple presence of the Catholic physician who orders it.
Dr. Michele Schumacher next tackles the philosophical underpinnings of the continued destabilization of the traditional family structure. She argues that not only has the content of words such as “marriage” been altered by positivist anthropology—but so also “human rights” and “human dignity”—becoming devoid of any metaphysical or divine character, and instead assuming a wholly subjective and relativistic nature. Thus, the personalistic norm (articulated beautifully by Pope St. John Paul II), which has underpinned marriage and is so crucial to the ideal development of children, has become simply personal preference. Dr. Schumacher, by contrasting Christian personalism with modern utilitarianism, ultimately suggests that a reflection on the social dimension of marriage and an acknowledgment of its truth can be the antidote for the problems of the breakdown of the family.
Next, Fr. Earl Fernandes, bioethicist and theologian, and his brother, Dr. Ashley K. Fernandes, bioethicist and pediatrician, bring to the forefront a topic often ignored, even within Catholic circles—that of sexuality in the child or adolescent with cognitive disabilities. The secular world, as it is, will treat sexuality in children with severe disabilities as a problem to be solved—and reflexively seek solutions from the mundane (contraception and sterilization) to the radical (the “Ashley Treatment”). The Fernandes brothers argue that a Catholic conception of dignity, rooted in a Christian philosophical anthropology, can provide the framework for practical advances in the care and education of these children. By focusing on the “covenantal encounter” between physician, parent, and patient, they argue that Catholic theologians and medical educators have a special duty to follow their principles into practice: by improving medical and seminary education, advocating in society for the rights and humanity of the disabled, and protecting the disabled child's dignity in every day clinical practice.
This special issue also contains a case report. This case by two medical students, “Catholicizes” Jonsen and Siegler's “Four-Box Method” of ethical analysis in a case of two adolescent girls being forced to use contraception.
Finally, we invite our readers to peruse the American College of Pediatrics’s position statements on “Abstinence Education,” “The Impact of Family Structure on the Health of Children—Effects of Divorce,” and “Neonatal Euthanasia: The Groningen Protocol.” These were reprinted with permission of the ACPeds in this edition. Finally there is a book review by authors Amy Kuebelbeck and Dr. Deborah Davis on Gift of Time, which ends where we began, with perinatal ethics.
We began this brief introduction with the word “joyfully,” for despite the current threats to the welfare of the children, we know that by our daily work in medicine we can bring hope to children, and through them, to the whole world. We know that if we, through the unceasing work of the Catholic Medical Association, can change minds and hearts and make our communities more child-like, then hope can in some small way be rekindled—a hope which spreads, a hope which never dies, a hope of which the Psalmist writes, “For you, O Lord, are my hope, my trust, O Lord, from my youth” (Ps 71:5).
Additional information
Notes on contributors
Ashley K. Fernandes
Ashley K. Fernandes, M.D., Ph.D., is Associate Professor of Pediatrics and Associate Director of the Center for Bioethics and Medical Humanities at The Ohio State University and Nationwide Children's Hospital, Columbus, OH, USA. His email address is [email protected].
Thomas Bender
Thomas Bender, M.D., is Assistant Professor in the Division of Neonatal-Perinatal Medicine at Saint Louis University School of Medicine, St. Louis, MO, USA. His email address is [email protected].