surrogacy: a catholic perspective - semantic scholar · tinguish surrogate gestational mothers from...

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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 theCatholic perspective. I do this not because there is not an officialCatholic perspective. There is. It is presented briefly in Donum vi-tae ("Instruction on Respect for Human Life in its Origin and on theDignity of Procreation").' Rather, I do it because the theologian'stask is not simply to repeat official formulations, but to assimilatethem critically so that the very assimilative effort contributes to thepurification of these formulations. To say anything else would be towrap these formulations in a non-historical immobility that is untrueto reality.

Second, "a Catholic perspective" means to underline the fact thatthe perspective is not merely presented by a Catholic, but is one thatattempts to draw on the riches and worldview identified with an his-torical believing community. As we say in theological shorthand,"reason informed by faith." This is not to suggest that all Catholicswill or must share these analyses and conclusions. Nor is it to sug-gest that non-Catholics will not or cannot share them. It simplymeans that "Christ . . .through his life, death and resurrection hasgiven a new meaning to human existence,"2 and that this meaningwill shape our consciousness as we deliberate together about what ismorally appropriate human conduct.

A sound Catholic methodology will begin by stating its criterionof judgment when dealing with new technologies. Vatican II is ofgreat help here. Dealing with marital morality, it stated that the"moral aspect of any procedure . . .must be determined by objectivestandards which are based on the nature of the person and the per-son's acts."3 The official commentary on this wording noted twothings: that in the expression there is formulated a general principlethat applies to all human actions, and that the choice of this expres-sion 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 ChristianEthics at the University of Notre Dame. A curriculum vitae of the author and a par-tial bibliography are included at the end of the essay.

1. Instruction on Respect for Human Life in its Origin and on the Dignity ofProcreation (Vatican City: Vatican Polyglot Press, 1987).

2. Declaration on Euthanasia (Vatican City: Vatican Polyglot Press, 1980), 4; seealso Origins 10 (1980), 154-57.

3. Documents of Vatican II, ed. Walter Abbott, S.J., (New York: America, 1966),256.

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to the human person integrally and adequately considered."'4

I fully accept this criterion. Indeed, I take responsibility for itsuse in the American Fertility Society's Ethical Considerations of theNew Reproductive Technologies.5 That document stated:

'Integrally and adequately' refers to the sum of dimensionsof the person that constitute human well-being: bodilyhealth; intellectual and spiritual well-being, which includesthe freedom to form one's own convictions on importantmoral and religious questions; and social well-being in all itsforms: familial, economic, political, international and reli-gious. Actions (policies, laws, omissions, exceptions) that un-dermine the human person, integrally and adequatelyconsidered, are morally wrong. Actions that are judged to bepromotive and supportive of the human person in the sum ofhis or her essential dimensions are morally right.6

The document notes of this criterion that "in principle it calls foran inductive approach based on experience and reflection." I notehere that Donum vitae reproduced this personal criterion. Repeat-edly it refers to the integral good of the human person, or some suchphrase. In this sense it is one with Vatican II. One may legitimatelyquestion, however, whether Donum vitae actually uses this criterionwhen it draws concrete conclusions about reproductive technologies.

Now let us turn to surrogacy. At the very outset we should dis-tinguish surrogate gestational mothers from surrogate mothers. Asurrogate gestational mother provides the gestational but not the ge-netic component for reproduction. A surrogate mother provides boththe female genetic component and the gestational component. Oncethis distinction has been made it may be temporarily shelved becausemost of the ethical pros and cons apply quite similarly to both formsof surrogacy. One can see this by reviewing the American FertilitySociety's document on surrogacy.

There are at least two general approaches to our subject that canbe identified. The first views surrogacy under the rubric of the use ofthird parties in genere, as but a single example of a general practice.The second views surrogacy in specie and underlines the advantagesand 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: Ex-pensio modorum partis secundae (Rome: Typ. pol. Vat., 1965) 37-38.

5. Fertility and Sterility, vol. 53, n.6, 1 S (Supp. 2 1990).6. Cf id.

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CATHOLIC PERSPECTIVE

procedures are possible: donated sperm, donated ovum, donated em-bryo, donated uterus, or combinations of these. Most discussionshave centered around donated sperm (AID-artifical insemination bydonor) 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 participa-tion in reproductive technologies.

The most thoughtful and stimulating recent study on AID is thatof Paul Lauritzen.7 Lauritzen examines some contemporary workson AID. One is by Lisa Sowle Cahill.8 Cahill rejects third party par-ticipation in reproductive technologies because they separate geneticand social parenthood. There are moral responsibilities that are di-rectly contingent on genetic connection. They are inalienable andcannot be completely transferred to others. Thus, in Lauritzen'swords:

Thus it could never be morally acceptable to create a childwith the intention of separating genetic and socialparenthood, for to do so would require an individual to cre-ate a set of moral obligations he or she had no intention ofdischarging.9

For Cahill, the responsibilities of parenthood do not root entirelyin human choice. They root also in biological genetic connections.For this reason, "biological relationships can and should exercisesome constraints upon freedom to choose (or not to choose) the pa-rental relation."' 0 And for Cahill, biological restraints restrict thefreedom to choose AID and surrogate motherhood.

Lauritzen criticizes this view on the ground that it assumes thatto separate genetic and social parenthood is to abandon all con-straints on reproductive choice. As he says:

Yet in disagreeing with Cahill about the normative ideal, Iam not abandoning all restraints on reproductive choice.Rather I am simply drawing the line of acceptable choice ata different place."

What is not clear to me in Lauritzen's fine study is where he isdrawing the line and above all why. The major ethical obstacles hesees to the responsibility of parenthood in AID are secrecy (deceptionat 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 57-75. For responses to Lauritzen, see Second Opinion,January 1992, at 95-107.

8. Lisa Sowle Cahill, "The Ethics of Surrogate Motherhood: Biology, Freedomand Moral Obligations," Law, Medicine and Health Care 16, 65-71 (1988).

9. Lauritzen, supra note 7, at 64.

10. Cahill, supra note 8, at 65.11. Lauritzen, supra note 7, at'65.

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asymmetry. When dealing with secrecy, he cites the work of Baranand Pannor:

For most of the men we interviewed, the choice of donor in-semination had been an acute response to the pain they wereexperiencing. They never permitted themselves the timeand opportunity to explore their feelings about the devastat-ing ego blow. They prevented themselves from becomingcomfortable with and accepting of their handicap. Instead,they cast the handicap in concrete, and their feelings of inad-equacy were continuously reinforced by visual proof: theirdonor off-spring.

With this enormous deficit in place, the relationship be-tween the husband and wife had to be realigned. The hus-band became weaker and more passive; the wife becamestronger and more powerful. The wife was the real motherof the children, and this message, although never spoken,was clearly given to the husband in many ways. The hus-band could be devoted and caring toward the children, while,at the same time, recognizing the difference between his pa-rental role and his wife's. 12

Lauritzen seems to treat this scenario as a problem of secrecyand therefore one that could be dispersed by candid revelation anddiscussion. Actually, I believe it will be seen by many as an intrinsicproblem and as inseparable from AID itself whether secrecy is thereor not. Whatever the case, if secrecy and asymmetry are the two ob-stacles to responsible parenthood in using AID, and if both can beovercome, it is not clear where and why Lauritzen would "draw theline of acceptable choice."

This exchange between Cahill (emphasizing the basic importanceof genetic connections) and Lauritzen (emphasizing the superior im-portance of the parenting function) is a kind of symbol of the waythe ethical discussion is conducted.

For instance, Donum vitae regards the use of third party ga-metes as "a violation of the reciprocal commitment of the spousesand a grave lack in regard to that essential property of marriagewhich is its unity."1 3

How is this unity to be understood? There are at least two pos-sibilities. The first is at root nonconsequentialist in character. It ap-peals to the nature of marriage - or at least that is how I readDonum vitae's presentation of the argument. After noting that the

12. A. Baran and R. Pannor, Lethal Secrets: The Shocking Consequences and Un-solved Problems of Artificial Insemination (New York: Warner Books, 1989), 51.

13. Cf. note 1, at 24. Instruction on Respect for Human Life in its Origin and onthe Dignity of Procreation 24 (1987).

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child must be the fruit and sign of the mutual self-giving of thespouses, of their love and fidelity, it states: "The fidelity of thespouses in the unity of marriage involves reciprocal respect of theirright to become a father and a mother only through each other."'1 4 Acertain notion of marriage as exclusive at all levels seems to under-gird that statement, though I admit that if one pushes hard enough(e.g., "Why must unity be so understood?") one gets to consequential-ist considerations.

The second possibility is that of Lauritzen. AID introduces lifeexperiences that cannot be fully shared and "this lack of mutualitymay interfere with the couple's ability to care for and to love thechild that is created."' 15 But is this disunity an overwhelming obsta-cle? Lauritzen thinks not.

At this point, I would like to introduce a consideration I haverarely heard discussed. It will be recalled that Donum vitae rejectedany reproductive technology that is a substitute for sexual inter-course. My own experience with couples who have undergone IVFand ET (in vitro fertilization with embryo transfer) is that they donot regard these procedures as a substitute for sexual intimacy, butas a kind of technological continuation or extension of it. Now if thatis indeed the case, then we must ask: Is it appropriate for third par-ties to be involved in such continuation?

Let me summarize here. There are two key issues on whichthere is likely to continue to be strong disagreement: (1) Does thirdparty involvement (via gametic donation or surrogate gestation) in-fringe on conjugal exclusivity? and (2) Does having a jointly raisedchild justify such infringement? My own answers are yes to the first,no to the second. I hold these positions because I believe the notionof conjugal exclusivity should include the genetic, gestational, andrearing dimensions of parenthood. Separating these dimensions (ex-cept through rescue, as in adoption) too easily contains a subtlediminishment 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 dif-ferent ways. First, it can be argued that third party involvement isitself violative of the marriage covenant independent of any potentialdamaging effects or benefits. This is the thrust of Lisa Cahill's analy-sis, as well as that of Pius XII. The view might be argued in purelyethical terms (Cahill) or in religious terms. An example of the latteris the distinguished Paul Ramsey. He writes: "To put radically asun-der what God joined together in parenthood when He made love pro-

14. Id.. supra note 7, at 23.15. Lauritzen, 72.

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creative, to procreate from beyond the sphere of love.., or to positacts of sexual love beyond the sphere of responsible procreation (bydefinition, marriage) means a refusal of the image of God's creationin our own."'16

As I just noted above, there is a simpler way of making thispoint. Many couples regard in vitro fertilization not as a replacementfor their sexual intimacy, but as a kind of continuation or extensionof it. On that view, third party presence (via egg or sperm) is pres-ence 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 mari-tal exclusivity will be a source of harm to the marriage (and marriagein general) and to the prospective child. For instance, the use of do-nor semen means that there is a genetic asymmetry in the relation-ship of husband and wife to the child, with possible damagingpsychological effects. If a surrogate mother is used, then conflictscould arise that damage both the marriage and the surrogate.

William J. Winslade and Judith Wilson Ross recently raisedsome 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 thatwhich is deemed to be health-related data, or all of the otherbiological information about its heritage that most of usvalue? Whose interests, whose preferences, whose needscount here? Born into a society that is already fragmentedby divorce and confused about alternative life styles, moralsand sexual choices, the child may well have serious identityproblems at a later time. Does such a possibility have to beseriously considered by those who want to undertake unu-sual reproductive methods?1 7

The Winslade-Ross essay concludes: "The interests and well-be-ing of the baby-to-be-made seem to be the last issues considered, andsometimes (when physicians promise anonymity to the donor or par-ents require it of the surrogate) seem not to be considered at all. ' ' i s

Another form of this first approach is the assertion that third-party involvement separates procreation from marriage in principle.That opens the door, both by human proclivity and the logic of moraljustification, to a litany of worrisome problems such as single-womeninsemination 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: YaleUniversity Press, 1970) 89.

17. Winslade and Ross, N.Y Times, Feb. 21, 1986, 27.18. Id.

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ject to empirical verification. It must be admitted in all honesty thatthe data are thin at best, often even conjectural. Fears of what mighthappen once marital exclusivity is relaxed are legitimate even if theydo not always lead to clearly established absolute prohibitions. In thepast I have argued that the risks and potential harms involved wouldsupport a safeside moral rule (procreation should be restricted tomarriage at all levels - genetic, gestational, and social) against theslide to abuse. This is a prudential calculus which gives greaterweight 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 tosurrogate motherhood, not surrogate gestation only because the cir-cumstances for this latter are likely to be extremely rare.

First, the individual level. I will simply list here some of theconcerns noted by the American Fertility Society ("AFS"). The AFSreport lists potential harms under these categories: the surrogate,the couple, and the child.19

1. 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 advicethat could help her solve infertility in other ways.-Risk of harassment from surrogate.-Continued involvement of surrogate could harm couple'srelationship.-Financial risk to couple because of uncertain legal status of theprocedure.-Pain if surrogate decides to keep the child.

3. The child.-Child could be physically harmed by a surrogate's geneticdefect.-Surrogate who knows she has no rearing responsibility mightbe careless during pregnancy.-Concerns about child's sense of identity and clarity aboutparenthood.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. 2 1990).

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example) couple to rear a child with a genetic relationship to one ofthem.

Weighing the pros and cons of this procedure, the AFS ethicscommittee concluded that if surrogate motherhood is to be pursued,then it should be "pursued as a clinical experiment." By this thecommittee meant to designate "an innovative procedure that has avery limited or not historical record of whether any success can beachieved. ' 20 Being a member of this committee, I can confidently as-sert that this is about as close as the committee would come to out-right condemnation. Indeed, committee member C. Alvin Paulsenstated his dissent by noting that "the risk/benefit ratio of the surro-gacy procedures does not justify their support. '21

There is one important aspect of surrogate motherhood thatshould be noted: The potential harms are inherent in the procedure.They are not the result of inadequate protocols, etc. This point hasbeen noted by others.22

Now let me turn to the social level. There will naturally besome overlap here with considerations already mentioned. At thetime of the Baby M. case, Daniel Callahan wrote: "We are caught inthe middle of a major social experiment without the faintest ideahow it should be conducted. The case reveals why the attendantproblems are so hard and why surrogate motherhood was probably abad idea from the outset. ' 23 By the "attendant problems," Callahanrefers to the kinds of problems our society would be better off with-out. He refers to three above all. 1) Surrogacy represents yet an-other mode of producing children that is less than desirable, and at atime when we are not underpopulated. 2) We court confusion aboutparentage with the accompanying uncertainty about responsibility forthe welfare of the child. 3) We introduce a cadre of women whoseprime virtue is what we now take to be a vice - "the bearing of achild one does not want and is prepared not to love."'24

These considerations of Callahan's open another issue of socialconcern: The impoverishment of women by their reduction to theirchild-bearing capacity. I find it difficult to see how any surrogacy ar-rangement does not reduce a woman to a means. Considerations likethe 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 andHealth Care 18 (1990), 345-52 n. 38.

23. Callahan, Surrogate Motherhood: A Bad Idea, N.Y Times, Jan. 20, 1987, at 25.24. Id.

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subject "Surrogate Motherhood: a Still-born Idea."'25

One response to this presentation might well be: How is this aCatholic perspective? What makes it Catholic? Could not any hu-manist espouse a similar analysis? Such questions reflect a misun-derstanding about the nature of moral reflection in the Catholiccommunity. This reflection has never yielded to the sometimes com-forting enticements of sectarianism, as if "Catholic" contained an im-plied reference to a secretum arcani in the moral sphere.

It is here that I return to the criterion of the person integrallyand adequately considered. If that is truly the appropriate criterion,as I believe it is, then whatever will throw light on the impact of thereproductive technologies on the well-being of persons is necessarilypart of human reflection on the matter. The Catholic church, withits centuries-old tradition of natural law in moral matters, is quitecomfortable with Aguinas' saying that "we offend God only in so faras we offend our own good."'26 If surrogate motherhood offends - onbalance - our own good as persons, then Catholics would reject it. Ibelieve they should.

25. Richard A. McCormick, S.J., "Surrogate Motherhood: A Stillborn Idea," Sec-ond Opinion, v. 5, at 128-32 (1987).

26. Summa contra gentiles 3, 122.

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CURRICULUM VITAERICHARD ARTHUR MCCORMICK, S.J.

Born October 3, 1922, Toledo, Ohio. Entered Society of Jesus in 1940.Received B.A. (1945) and M.A. (1950) from Loyola University, Chi-cago; S.T.D. (doctorate in theology) from the Gregorian University,Rome, 1957. Ordained to priesthood in 1953.Presently John A. O'Brien Professor of Christian Ethics, Universityof Notre Dame. Previously (1974-1986) he was Rose F. Kennedy Pro-fessor of Christian Ethics of the Kennedy Institute of Ethics, Ge-orgetown University, Washington,, D.C., and Research Associate atthe Woodstock Theological Center (D.C.). From 1957 to 1973, Profes-sor of Moral Theology, Jesuit School of Theology in Chicago. Lec-tures frequently throughout the country on Christian morality.

Father McCormick is the author of Ambiguity in Moral (hoice (Mar-quette University, 1973); Doing Evil to Achieve Good (with the latePaul Ramsey, Loyola University Press, 1978); How Brave a NewWorld? (Doubleday, 1981); Notes on Moral Theology, 1965 through1980 (with Index, University Press of America, Lanham, Maryland,1980); Readings in Moral Theology 1. Moral Norms and Catholic Tra-dition (ed., with Charles E. Curran, 1979); Readings in Moral Theol-ogy II: The Distinctiveness of Christian Ethics (ed., with Charles E.Curran, 1980); Readings in Moral Theology III: Morality and Author-ity (ed., with Charles E. Curran, 1981); Readings in Moral TheologyIV. The Use of Scripture in Moral Theology (1982); Readings inMoral Theology V: Official Catholic Social Teaching (1986); Readingsin Moral Theology VI: Dissent in the Church (1988); Readings inMoral Theology VII The Natural Law (1991); Notes on Moral Theol-ogy 1981-1984 (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 contributorto journals such as Christianity and Crisis, New Catholic World, Hos-pital 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 ofMedicine and Philosophy, Contemporary OB/GYN, "Notes on MoralTheology" since 1965 (Theological Studies). He has written for SportsIllustrated, the New York Times, and the Washington Post.

He has contributed chapters to many books such as Norm and Con-text in Christian Ethics, The Future of Ethics and Moral Theology,All Things to All Men, Judaism and the Christian Seminary Curricu-lum, The Problem of Population, Proceedings of the Conference on

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Teaching of Medical Ethics, Love and Society, An American CatholicCatechism, Ministering to the Divorced Catholic, Personal Values inPublic Policy, etc.

Father McCormick is a past president of the Catholic Theological So-ciety of America; past member of the Board of Directors of theAmerican Society of Christian Ethics; past member of the Board ofTrustees of the University of Detroit and of Fairfield University;member of the Catholic Commission on Intellectual and Cultural Af-fairs; past member of the Board of Directors and Treasurer of theChurches' Center for Theology and Public Policy; past member of theEthics Advisory Board, Department of Health, Education and Wel-fare; Fellow of the Institute of Society, Ethics and the Life Sciences(Hastings Center); past associate editor of America magazine; edito-rial advisor for Theology Digest and Hospital Progress; member of theEditorial Board of the Journal of Religious Ethics; member of theEditorial Board of Fetal Medicine; member of the Editorial Board ofthe Journal of Contemporary Health Law and Policy; member of theSpecial Bioethics Committee, American Hospital Association; mem-ber of the Bioethics Committee of the National Hospice Organizationand the Catholic Health Association; member of the Ethics Commit-tee 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 SpellmanAward by the Catholic Theological Society of America as "Outstand-ing Theologian of the Year." In 1988 he was given the HenryKnowles Beecher award from the Hastings Center for "lifetime con-tributions 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)

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In 1990 he was elected to membership in the prestigious AmericanAcademy of Arts and Sciences.His father, the late Dr. Edward J. McCormick, was president of theAmerican Medical Association.


Fr. Richard A. McCormick, S.J.Partial Bibliography Listing

Fr. Richard A. McCormick, S.J. has an extensive bibliography start-ing from 1952. Due to space limitations, the bibliography includedhere is only a partial listing of works dating from 1975 through 1989.

1975"H.V. in Perspective," The Tablet (London: The Tablet Publishing

Co., Ltd., (February 8, 1975) 126-128; "Notes on Moral Theology:April-September, 1974," Theological Studies 36 (March, 1975) 77-129; "Life-Saving and Life-Taking: A Comment," Linacre Quar-terly 42 (May, 1975) 110-115; "Fetal Research, Morality, and Pub-lic Policy," The Hastings Center Report 5 (June, 1975) 26-31; _-,and Walters, Loroy, "Fetal Research and Public Policy,"America 132 (June 21, 1975) 473-476; "The Social Responsibilityof the Christian," The Australian Catholic Record 52 (July, 1975)253-263. [Digested in Theology Digest 24 (Spring, 1976) 11-14.];"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 Sus-taining Life," Hospital Progress 56 (September, 1975) 76-79;"Transplantation of Organs: A Commentary on Paul Ramsey,"Theological Studies 36 (September, 1975) 503-509; "Indissolubilityand the Right to the Eucharist: Separate Issues of One?" Can-non Law Society of America Proceeding of the 37th Annual Con-vention (October 6-9, 1975) 26-37; "Divorce and Remarriage,"Catholic Mind 73 (November, 1975) 42-57. [Reprinted as"Scheidung und Wiederverheiratung," Theologie der Gegenwart18 #4 (1975) 210-220.]; "The Karen Ann Quinlan Case: Edito-rial," 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. De-partment of Health, Education, and Welfare Publication, 1975) 5-1 - 5-11; "The Insights of the Judeo-Christian Tradition and theDevelopment of an Ethical Code," Human Rights and Psycholog-ical Research: A Debate on Psychology and Ethics, ed. EugeneKennedy (New York: Thomas Y. Crowell, 1975) 23-36.

1976"Sexual Ethics - An Opinion," National Catholic Reporter 12 (Janu-

ary 30, 1976) 9; "Notes on Moral Theology: April-September,1975," Theological Studies 37 (March, 1976) 70-119; "The Preser-vation of Life," Linacre Quarterly 43 (May, 1976) 94-100; "Exper-imental Subjects: Who Should They Be?" Journal of theAmerican Medical Association 235 (May 17, 1976) 2197; "The So-

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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, 111-112; "TheMoral Right of Privacy," Hospital Progress 57 (August, 1976) 38-42; "Sterilization and Theological Method," Theological Studies37 (September, 1977) 471-477; "Experimentation in Children:Sharing in Sociality," Hastings Center Report 6 (December, 1976)41-46; "The Principal of the Double Effect," Concilium 120 (De-cember, 1976), 105-120; "Romische Erklarung zur Sexualethik,"Theologie der Gegenwart 19 #2 (1976) 72-76; "Morality of War,"New Catholic Encyclopedia 14 (1976) 802-807; "Maker of Heavenand Earth," Christian Theology: A Case Method Approach, eds.,Robert A. Evans and Thomas E. Parker (New York: Harper &Row, 1976) 88-93.

1977- and Hellegers, Andre E., "Legislation and the Living Will,"

America 136 (March 12, 1977) 210-213; "Notes on Moral Theol-ogy: 1976," Theological Studies 38 (March, 1977)57-114; "'Sleeper'on DNA," National Catholic Reporter (July 15, 1977) 9; "Man'sMoral Responsibility for Health," Catholic Hospital 5 (July-Au-gust, 1977) 6-9; McCormick, Richard A., S.J., et., "A C & C Sym-posium: Paying for Abortion: Is the Court Wrong?" Christianityand Crisis 37 (September 19, 1977) 202-207; "Christianity andMorality," Catholic Mind 75 (October, 1977) 17-29; "Sterilisationund Theologisch Methode," Theologie der Gegenwart 20 (1977)110-114.

1978"The Quality of Life, the Sanctity of Life," Hastings Center Report 8

(February, 1978) 30-36; "Notes on Moral Theology: 1977," Theo-logical Studies 39 (March, 1978) 76-138; "Abortion: Rules for De-bate," America 139 (July 15-22, 1978) 26-30; "Life in the TestTube," New York Times (August 8, 1978); "Unanswered Ques-tions on Test Tube Life," with Andre Hellegers, America 139(August 12-19, 1978) 74-78; "Some Neglected Aspects of Responsi-bility 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 MoralMagisterium," Lectureship (Mt. Angel Seminary, 1978) 48-60;McCormick, Richard A., S.J., and Ramsey, Paul, eds., Doing Evilto Achieve Good. Moral Choice in Conflict Situations (Chicago:Loyola University Press, 1978).

1979"Abortion: A Changing Morality and Policy," Hospital Progress 60

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(February, 1979) 36-44; "Bioethical Issues and the Moral Matrixof U.S. Health Care," Hospital Progress 60 (May, 1979) 42-45;Readings in Moral Theology No. 1: Moral Norms and CatholicTradition, ed. with Charles E. Curran (Mahwah: Paulist Press,1979); "Notes on Moral Theology," Theological Studies 40 (1979)59-112.

1980"Restatement on Tubal Ligation Confuses Policy with Normative

Ethics," Hospital Progress 61 (September, 1980) 40; "The FoxCase," Journal of the American Medical Association 244 (No-vember 14, 1980) 2165-2166; Readings in Moral Theology No. 2:The Distinctiveness of Christian Ethics, ed. with Charles E. Cur-ran (Mahwah: Paulist Press, 1980); "Sterilization: The Dilemmaof Catholic Hospitals," with Corrine Bayley, America 143 (1980)222-225; Notes on Moral Theology: 1965 through 1980 (Lanham,Maryland: University Press of America, 1980); "The Preserva-tion of Life and Self-determination," Theological Studies 41(1980) 390-396; "Neural Tube Defects," Maternal Serum Alpha-Fetoprotein: Issues in the Prenatal Screening and Diagnosis ofNeural Tube Defects, eds. Barbara Gastel, et. al., (Washington,D.C.: Government Printing Office, 1980) 128-129.

1981"No Short Cuts to Making Public Policy on Abortion," Washington

Star (March 23, 1981); "Marriage, Morality and Sex-Change Sur-gery: Four Traditions in Case Ethics," Hastings Center Report 11(August, 1981) 10-11; "The Fifth Synod of Bishops," CatholicMind 79 (September, 1981) 46-57; "The Ethics of In Utero Sur-gery," with William Barclay, et. al., Journal of the AmericanMedical Association 246 (October 2, 1981) 1550-1555; "Guidelinesfor 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 NewWorld? Dilemma in Bioethics (Garden City: Doubleday, 1981);Readings in Moral Theology No. 3: Morality and the Magiste-rium, ed. with Charles E. Curran (Mahwah: Paulist Press, 1981);"Notes on Moral Theology," Theological Studies 42 (1981) 74-121;"Kernenergie und Kernwaffen," Theologie der Gegenwart 24(1981) 147-156; "Scheidung und Wiederverheiratung als pasto-rales Problem," Theologie der Gegenwart 24 (1981) 21-32; "Liv-ing-Will Legislation, Reconsidered," America 145 (1981) 86-89.

1982"Infant Doe: Where to Draw the Line," Washington Post (July 27,

1982) A 15; "Les sions intensifs aux nouveau-nes handicapes,"

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Etudes (November, 1982) 493-502; "Ethical Questions: A Look atthe Issues," Contemporary Ob/Gyn 20 (November, 1982) 227-232;"1973-1983: Value Impacts of a Decade," Hospital Progress 63(December, 1982) 38-41; "Pastoral Guidelines for Facing the Am-biguous Eighties," The Future of Ministry (Milwaukee: St. Fran-cis Seminary, 1982) 41-44; "Neuere Uberlegungen zurUnveranderlichkeit sittlicher Normen," Sittliche Normen, ed.Walter Kerber, S.J., (Dusseldorf: Patmos, 1982) 46-57; "Notes onMoral Theology," Theological Studies 43 (1982) 69-124; "Theologyand Biomedical Ethics," Eglise et theologie 13 (1982) 311-332;"Theological Dimensions of Bioethics," Logos 3 (1982) 25-46;Readings in Moral Theology No. 3: The Magisterium and Moral-ity, ed. with Charles E. Curran (Mahwah: Paulist Press, 1982).

1983"Notes on Moral Theology," Theological Studies 44 (1983) 71-122;

"Bioethics in the Public Forum," Milbank Memorial Fund Quar-terly 61 (1983) 113-126; "Saving Defective Infants: Options forLife or Death," with John Paris, S.J., America 148 (1983) 313-317;"Nuclear Deterrence and the Problem of Intention: A Review ofthe Positions," Catholics and Nuclear War, ed. Philip Murnion(New York: Crossroad, 1983) 168-182;

1984Readings 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 (NewYork: Crossroad, 1984); "Notes on Moral Theology," TheologicalStudies 45 (1984) 80-138; "The Chill Factor: Recent Roman In-terventions," America 150 (1984) 475-481; Notes on Moral Theol-ogy: 1981 through 1984 (Lanham, Maryland: University Press ofAmerica, 1984); "Medicaid and Abortion," Theological Studies 45(1984) 715-721.

1985"Was There Any Real Hope for Babe Fae?" Hastings Center Report

15 (February, 1985) 12-13; "Genetic Technology and Our Com-mon Future," America 152 (1985) 337-342; "Caring or Starving?The Case of Claire Conroy," America 152 (1985) 269-273; "Theol-ogy and Bioethics: Christian Foundations," Theology andBioethics, ed. Earl Shelp (Dordrecht: Reidel, 1985) 95-114; "MoralArgument in Christian Ethics," Journal of Contemporary HealthLaw and Policy 1 (1985) 3-23; "Notes on Moral Theology: MoralNorms - An Update," Theological Studies 46 (1985) 50-64;"Therapy or Tempering? The Ethics of Reproductive Technol-ogy," America 153 (1985) 396-403; "Gustapon's God: Who? What?

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Where? (etc.)." Journal of Religious Ethics 13 (1985) 53-70; "ThePast, Present, and Future of Moral Theology," Proceedings of1984 Theological Symposium (Villanova University, 1985).

1986"The Magisterium," Authority, Community and Conflict, ed. Ma-

donna Kolbenschlag (Kansas City: Sheed and Ward, 1986) 34-37;"Gaudium et Spes and the Bioethical Signs of the Times," Ques-tions of Special Urgency (Washington: Georgetown UniversityPress, 1986) 79-95; "Health and Medicine in the Catholic Tradi-tion," Ephemerides Theologicae Lovanienses 62 (1986) 207-215;"Symposium: Bioethical Issues in Organ Transplantation,"Southern Medical Journal 79 (1986) 1471-1479; "The Best Inter-ests of the Baby," Second Opinion 2 (1986) 18-25; "BiomedicalAdvances and the Catholic Perspective," Contemporary EthicalIssues in the Jewish and Christian Traditions, ed. FrederickGreenspan (Hoboken: Ktav Publishing House, 1986) 30-52; "TheSearch for Trust in the Catholic Context," America 155 (1986)276-281; "L'Affaire Curran," America 155 (1986) 261-267; Read-ings 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 theSpirituality of Jesuits 18 (1986) 1-22; "Finality," "Double Effect,""Magisterium," Dictionary of Christian Ethics, eds. James Chil-dress and John Macquarrie (Philadelphia: Westminister, 1986).

1987"Ethics of Reproductive Technology: AFS Recommendation, Dis-

sent," Health Progress 68 (March, 1987) 33-37; "Document is Un-persuasive," Health Progress 68 (July/August, 1987) 53-55; "Noteson Moral Theology: Dissent in Moral Theology and its Implica-tions," Theological Studies 48 (1987) 87-105; "Surrogate Mother-hood: A Stillborn Idea," Second Opinion 5 (1987) 128-132; "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) 247-248; "The Catholic Tradition on the Useof Nutrition and Fluids," with John Paris, S.J., America 156(1987) 356-361; "Begotten, Not Made," Notre Dame Magazine 15(1987) 22-25.

1988"Bishops' AIDS Letter 'Splendid' Theology," National Catholic Re-

porter 24 (January 22, 1988) 1, 5-6; "The Future of Chaplaincy:Bioethical Problems that Shape Ministry," Charting the Future

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of Pastoral Care (Special Publications of National Association ofCatholic Chaplains, v. 4, Summer, 1988) 24-39; "Searching for theConsistent Ethic of Life," Personalist Morals, ed. J.A. Selling(Leuven University Press, 1988) 135-146; "A Moral Magisteriumin Ecumenical Perspective?" Studies in Christian Ethics 1 (1988)20-29; "The Importance of Naturalness and Conjugal Gametes,"In Vitro Fertilization and Other Assisted Reproduction (Annalsof the New York Academy of Sciences, v. 541) (1988) 664-667;"AIDS: The Shape of the Ethical Challenge," America 158(1988) 147-154; "The Shape of Moral Evasion in Catholicism,"America 159 (1988) 183-188; 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," NotreDame Journal of Law, Ethics and Public Policy 3 (1988) 161-167.

1989"Abortion: The Unexplored Middle Ground," Second Opinion 10

March, 1989) 41-50; "Theology and Bioethics," Hastings CenterReport 19 (March/April, 1989) 5-10; The Critical Calling: MoralDilemmas Since Vatican II (Washington: Georgetown Univer-sity Press, 1989); "Moral Theology 1940-1989: An Overview,"Theological Studies 50 (1989) 3-24; "Pluralism Within theChurch," Catholic Perspectives on Medical Morals, eds. EdmundD. Pellegrino, John P. Langan, John Collins Harvey (Dordrecht:Kluwer Academic Publishers, 1989) 147-167; "Moral Theology inthe Year 2000: Reverie or Reality," (Regina: Campion College,1989. The Nash Lecture, privately printed.); "Foreword," WhyYou Can Disagree and Remain a Faithful Catholic, by Philip S.Kaufman (Bloomington: Meyer-Stone Books, 1989) xi-xii; "Steril-ization: The Dilemma of Catholic Hospitals," History and Con-science, eds. R. Gallagher and Brendan McConvery(Southampton: Camelot Press, 1989) 105-122.

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GILBERT MEILAENDER