Manual of Catholic Medical Ethics

on-line edition as of 2023 edited by Willem J. cardinal Eijk, MD PhD STL, Lambert J.M. Hendriks, PhD STD and prof FransJ. van Ittersum, MD PhD MSc

Ⓒ Katholieke Stichting Medische Ethiek 2014 - 2024

Preface to on-line texts (as of 2023)

After the introduction of the first edition in 2014, the Manual of Catholic Medical Ethics has found its way to many interested parties: medics, moral theologians, priest students and other students, among others. It is in use as a study book and reference work. The printed version from 2014 is still remarkably up-to-date. In a span of 9-10 years, there have been some developments in biology and medicine that are not discussed in the book. As these can be overlooked for the time being, these new developments are published on this website as supplements to the Manual of Catholic Medical Ethics (2014 version) edited by W.J. cardinal Eijk, MD PhD STL L.J.M. Hendriks, PhD, STD, and Prof F.J. van Ittersum, MD PhD MSc. These additional texts will be provided with a publication date.

The editors

February, 2023

Preface to the English Edition (2014)

Contemporary popular opinion, influenced by the expressed opinions of many leading members of the Enlightenment, would have us believe, unfairly, that religion was an obstacle to the project of modern science, and that the mediaeval period was a particularly egregious example of religion’s hostility to science. In fact the connections between the practice of medicine, natural philosophy, and the JudeoChristian Tradition are of longstanding. From the early Hebrew laws on what food could not be eaten (a primary healthcare requirement), to the strong promotion of the Hippocratic Oath by early Christians, the provision of hospices for the sick and dying from the 11th century, and onwards into the contemporary age, the Christian religion and provision of healthcare have been inextricably intertwined.

Perhaps the fairest description of the relationship between Christianity and natural philosophy in the Middle Ages was one of “creative tension” (James Hannan, God’s Philosophers. Icon Books, 2009). While there certainly were some restricting rules applied by the Church where the pursuit of the natural sciences was concerned, the fact is that there were very significant advances in science and technology in the mediaeval period thanks in large part to the scholars active in the religious tertiary foundations of the time. These advances provided the platform for major developments from the 17th century onwards.

From about the middle of the 19th century, mankind has witnessed a revolution in the development of medical science and with it the practice of medicine. The Catholic Church contributed greatly to this revolution in its ongoing provision of hospitals, medical schools and research facilities. The Catholic Church’s engagement with medical science and medical care has always been based upon her conviction that truth is indivisible, that there can be no opposition between the truths of revealed religion and the truths discovered in the sciences, and that Christians are committed to the care of the sick and dying (cf Matthew 25:36).

But today, in an increasingly secularist environment, the contribution of the Catholic Church to ethical reflection on medical and scientific developments is often marginalised as having no place in the public square because it is based upon “religion”, and therefore not open to reason.

This Manual of Catholic Medical Ethics is a timely reminder of the reasonableness of the Catholic moral tradition, of its openness to the truth where the scientific facts of the matter are concerned, and of its overriding concern for the good of human persons living in a human community.

In English-speaking countries public debate on medical-ethical issues is often characterised by the underlying assumption that facts can be reported and interpreted as facts in a completely objective way, unhindered by the prejudices of the religious mind. But as Bishop Anthony Fisher has reminded us (Fisher 1991, 204): “The simplistic dichotomy between fact and interpretation, objectivity and subjectivity, is illusory.” Bishop Fisher cites, with approval, the moral philosopher Alasdair MacIntyre (1985, 79):

‘Fact’ is in modern culture a folk-concept with an aristocratic ancestry. When Lord Chancellor Bacon as part of the propaganda for his astonishing and idiosyncratic amalgam of past Platonism and future empiricism enjoined his followers to abjure speculation and collect facts, he was immediately understood by such as John Aubrey to have identified facts as collectors’ items, to be gathered in with the same kind of enthusiasm that at other times has informed the collection of Spode china or the numbers of railway engines. The other early members of the Royal Society recognized very clearly that, whatever Aubrey was doing, it was not natural science as the rest of them understood it; but they did not recognize that on the whole it was he rather than they who was being faithful to the letter of Bacon’s inductivism.

Aubrey’s error was of course not only to suppose that the natural scientist is a kind of magpie; it was also to suppose that the observer can confront a fact face-to-face without any theoretical interpretation interposing itself. [Emphasis added]

Bishop Fisher adds (1991, 203-204):

Among important critics of the assumptions operative in the sciences have been Polanyi, Kuhn, Lakatos, Hanson and Feyerabend. They have exposed some of the assumptions behind naive inductivism and the positivist distinctions between fact and interpretation, neutral objective science and committed subjective metaphysics and religion.

The reality is that facts and the use of facts are always received by human persons and interpreted through the prism of whatever philosophical framework a person may bring to bear on the subject, including of course philosophical assumptions of which the person may himself be unaware and which remain undeclared. Bioethics scholars generally, though, do declare their adherence to one or other competing moral philosophies so that their conclusions may be evaluated in terms of those philosophical positions.

In this Manual, the authors not only clearly articulate the theological and philosophical position which is adopted throughout the book, they also examine and defend this approach in dialectical relationship with other philosophical ways of doing ethics. Scholars and students who want to understand better the foundations of the Catholic Church’s fundamental moral position will be greatly rewarded by the contributions of Cardinal W.J. Eijk in his Introduction to the book as a whole, and also in Chapter 1 which follows. Cardinal Eijk brings to bear on the subject material his medical qualifications (gained before he entered the priesthood) and his doctoral qualification in philosophy and theology.

The scope of medical ethical issues covered in this Manual is breathtaking with the eight contributors representing a very wide range of professional expertise. The detailed scientific material presented is impressive in its range and depth and provides a sound basis for ethical reflection.

This English edition of the Manual of Catholic Medical Ethics reveals the high level of sophistication of bioethical reflection in the Netherlands. The authors understand that bioethics debates take place at both the local and international levels, and rightly underscore the vital importance of the Catholic contribution to those debates.

This is an important book for all nations. That it is now available in English should secure it a place in faculties and universities across the globe, and a place in the libraries of all who want to understand better the crucial intellectual and cultural contribution of the Catholic Church to bioethics.

The Rev Dr John I. Fleming BA, ThL (Hons), PhD
Sessional Faculty, John Paul II Institute for Marriage and the Family (Melbourne, Victoria, Australia) Corresponding Member of the Pontifical Academy for Life.


In 2008, the Board of Directors of the Foundation for Medical Ethics (Stichting Medische Ethiek, in the Netherlands issued a manual of Catholic medical ethics entitled, Handboek Katholieke Medische Ethiek, published by the Publishing Company Parthenon in December 2010.

Since a work in the Dutch language is only accessible to a rather limited public, it was subsequently decided to adapt the manual for use by English-speaking readers. The present edition of the Manual of Catholic Medical Ethics is the result.

The term “Catholic” in the title is significant, because it is the intent of the present book to present the Catholic teaching on medical ethical issues in an unabridged, clear, and, above all, also a wellargued manner.

Members of the Board of Directors of the Foundation of Medical Ethics and others contributed to the present Manual, which took form under the leadership of His Eminence Cardinal Willem J. Eijk, M.D., Ph.D., S.T.L., Archbishop of Utrecht, the Netherlands.

For the translation into English, the authors are indebted to Sister M. Regina van den Berg, F.S.G.M., and to Dr. Janthony Raymakers who put much effort into the translation and adaptation of the Dutch text. Moreover the authors want to express their gratitude for the important contribution of Fr. Dr. John I. Fleming, who carefully read the entire manuscript and offered a great number of useful suggestions for correction and adaptation to an English-speaking readership.

In the arrangement of the book, much attention is given to the explanation of the general principles of medical ethics, based on a Catholic view of man. In line with Catholic tradition, philosophical as well as theological argumentation is used throughout. With regard to philosophical argumentation, Thomistic philosophy is taken as point of departure. These explanations are then followed by a discussion of different issues, which are arranged according to the phases of human life in which they occur: developing life, transmission of life, therapeutic and non-therapeutic care, and care for the dying. The book concludes with a discussion of some social aspects of health care and a new translation of the Hippocratic Oath with a commentary. Throughout the book, an effort has been made to include contemporary developments in health care. An ample bibliography makes available all the sources, and an elaborate index allows for use of the book as a reference.

We hope that this book may be of help to medical professionals and other professionals in healthcare, to pastoral care workers, and to those who simply interested in understanding the difficult issues we encounter nowadays in the field of clinical medicine and in biomedical research. At the same time, we hope that the readers will be inspired by the Catholic vision of health care, which finds its ultimate example in the person of Jesus Christ and in His loving care for every human being without limit or boundary.

We hope that this book will of use to many readers.

The Editors
Spring 2014