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 MEDICAL CARE AT THE END OF LIFE: A Catholic Perspective, by
David F. Kelly. Georgetown University
Press. 192 pp. $16.95.
Reviewed by MARK WILKINS, a teacher of
religion at St. Xavier High School in
Cincinnati and a college adjunct lecturer
in health-care ethics.
THIS IS A RARE perspective on healthcare
issues. David Kelly, who has
worked as a chaplain in hospitals
and nursing homes
and on their ethics boards,
has also taught at Duquesne
University. His book is a
practical guide for thinking
about decisions that more
and more people face every
day.
Kelly draws on the long
history of medical ethics in
the Roman Catholic tradition,
as well as contemporary
American law and
public policy. He also focuses on formal
papal statements and current events.
This is not a lengthy book, but is in
no way superficial. There is a lot packed
into the 192 pages and eight chapters.
Chapters 1 through 5 develop what
Kelly calls the “American consensus”
on forgoing treatment. First, since the
1990s, Kelly says, there is a greater sense
that not all treatments that prolong
biological life are beneficial to the
patient. In the Catholic context, this
has been debated as the difference
between “ordinary” and “extraordinary”
means.
Second, he argues, there is a moral
difference between killing someone
and allowing a terminally ill patient
to die. Active euthanasia and termination
of futile medical treatments
are not in the same moral order. Decisions
to forgo treatment can be
changed if conditions warrant reassessment,
but active euthanasia or
physician-assisted suicide is a definitive
and final choice.
Kelly points out that in the U.S. legal
system these two insights have combined
to produce the legal concepts of
autonomy, privacy and liberty. Taken as
a whole, these are the foundation for
the current consensus, which would
have been impossible had the first two
pillars not already been developed in
Catholic moral theology.
The “ordinary” versus “extraordinary”
distinction has its
roots in the 16th century,
with the discussion furthered
in the 18th century
by St. Alphonsus Liguori.
This point was emphasized
by the teaching of Pope
Pius XII in the 1950s. Kelly
stresses that this is a
moral—rather than a medical—distinction based on
the Catholic understanding
of the meaning of human
life. Some of his distinctions
will surprise the casual observer, but
not the thoughtful reader.
Chapters 6 through 8 cover feeding
tubes, euthanasia and physician-assisted
suicide, then medical futility.
Each of these issues covers a specific
application of the general principles
presented in the first five chapters. The
author combines legal precedents, personal
experiences and specific cases to
build his arguments. He doesn’t quibble
over minor points or oversimplify
dissenting views.
The very best sections in the book
are the ones that he devotes to Terri
Schiavo’s case and Pope John Paul II’s
allocution on hydration and nutrition.
Both deal with whether hydration and
nutrition are morally ordinary treatment
for patients in a persistent or permanent
vegetative state (PVS).
Kelly writes: “To claim that treatment
can be morally extraordinary
only when the person’s death is imminent,
regardless of whether the treatment
is given, is to give biological life
itself an absolute value that supercedes
all other values.”
He finishes by stating that this is a
move toward vitalism that would undercut
and even eliminate the centuries-old
Catholic distinction between ordinary
and extraordinary means. This
chapter alone is worth the price of the
purchase.
My only suggestion to the author
would be to add a concluding chapter
to give an overview and synthesis of all
the points he has covered. The book
just seems to end.
On the positive side, there is much to
recommend this book. It is probably
accessible for most readers who keep
up with current events. Interestingly,
Kelly asserts that Catholic medical
ethics is ahead (in many cases) of recent
legal and policy debates. The
Church has been discussing these issues
for hundreds of years. Only the specifics
of each case change as the technology
changes.
His handling of the Terri Schiavo
case is an excellent example of the
nuance and perspective that both his
experience and scholarship bring. Too
often these books are written by well-intentioned
authors who are either
scholars or health-care professionals.
Kelly has the advantage of being both.
He has written a book that should get
a wide audience among laypeople and
professionals alike. Maybe they should
talk to each other afterward.
You can order MEDICAL CARE AT THE END OF LIFE: A Catholic Perspective from St.
Francis Bookshop.
THE LAST WEEK: A Day-by-Day Account of Jesus' Final Week in Jerusalem, by Marcus J. Borg and
John Dominic Crossan. HarperSanFrancisco. 240 pp. Hardover, $21.95,
U.S./$28.95, Canada; paperback,
$13.95. (Also available in large-print
paperback for $21.95 and as an audio
CD for $32.95.)
Reviewed by JORIS HEISE, the author of
Hosannas of an Ordinary Life (Authorhouse)
and Literature: Discovering Ourselves
Through Great Books (American
Press). He lives in Waynesville, Illinois,
with his wife.
THIS BOOK OFFERS a prayerful guide
through the last week of Jesus’ life, as
Mark’s Gospel tells it. Acknowledging
the Catholic understanding
of inerrancy and inspiration,
the authors insist that,
for Mark’s Gospel, the writer
selected and arranged
events to show what faith
in Jesus means. Mark’s readers
see Jesus’ last week less
as disconnected memories
and more as a coherent
parable designed to bolster
their faith.
The authors were both
fellows in the Jesus Seminar.
Marcus J. Borg is Hundere Distinguished
Professor of Religion and
Culture at Oregon State University. He
is also president of the Anglican Association
of Biblical Scholars and a regular
columnist for Beliefnet.com. John
Dominic Crossan, a Catholic, is a professor
emeritus in religious studies at
DePaul University in Chicago.
Borg and Crossan note that Mark’s
Gospel frames Holy Week in terms of
time: “In the morning,” “When it was
evening” and so on. The two authors
make it clear that, no matter what the
factuality, this Gospel “frames” moments
to correspond to one another,
and indicates prophetic acts by comparing
befores and afters, this event
with that one.
Mark’s Gospel, for example, contrasts
Jesus’ Kingdom with human “domination
systems,” such as that of Rome.
Domination systems use military, political,
social and economic means to
control people. This Gospel contrasts
the “way” of Jesus with how Rome and
its Jewish collaborators oppressed people.
The authors ask us, for example, to
consider Palm Sunday. Pontius Pilate’s
entrance into Jerusalem for Passover is
not mentioned in the Bible. Mark’s
readers, however, would compare Jesus’
modest entrance into Jerusalem with
that of the Roman procurator. Jesus
rides humbly while the oppressor
parades triumphantly. Followers of
Jesus should reject Rome’s domination
system and any Jewish accomplices.
That domination system brought
Jesus to his cross. His resurrection, however,
shows that it is Jesus who is the
true Lord, the real Son of God, not the
Roman emperor.
A second feature of Jesus’
last week in Mark’s Gospel
emphasizes how much
Jesus’ closest followers
misunderstood him. The
Gospel singles out the failures
of Peter, John and
James (Jesus’ inner circle).
Mary Magdalene, Mary
(the mother of James and
Joses), Salome and “many
other women,” on the contrary,
follow Jesus on his
way of the cross and to his grave.
Because of their loyalty, it is these
women who first see him risen.
This book also argues for us to reconsider
the belief that Jesus redeemed
us by substitution. According to this
theological misconception, Jesus substituted
for us like a sacrificial lamb.
God demanded payment for sin, and,
in place of us, Jesus accepted the
wrath of God directed at human sinfulness.
His innocence substituted for our
guilt.
This whole notion is absent from
Mark’s Gospel. Instead, it emphasizes
our participation in Jesus’ suffering;
we are redeemed by sharing his passion
to confront the abuse of political
power. Jesus fought injustice passionately
and was martyred by legitimate,
though unjust, authorities. By partnering
with him now in courageous
passion for God’s justice in this world,
we come to share his ongoing Resurrection.
Presenting the “harrowing of hell,” “apocalyptic eschatology” and the conflicting
accounts of Jesus’ resurrection, the authors bog down in theology.
Nonetheless, readers can see clearly the
approach they are offering—that this
Gospel uses parabolic, or mythic, language
to tell meaningful truth.
The value of this book is that
Borg and Crossan offer us a view of
Mark’s Gospel as parable rather than as
history. Like Jesus himself, Mark’s
Gospel uses parabolic language to
teach. “Parable[s],” the authors write on
page 193, “independently of historical
factuality, can be profoundly true.
Indeed, it may be that the most important
truths can be expressed only in
parable.”
Centuries ago, humanists of the
Enlightenment convinced even religious
people that truth is limited to scientifically
provable facts; that is not how
Jesus taught people his Way. The most
profound truths come to us in stories
that cannot easily fit into facts or analysis.
It should be no surprise to find out
that Mark’s Gospel sees the last week
of Jesus’ life not as facts but as truth
told in structured, meaningful parables.
You can order THE LAST WEEK: A Day-by-Day Account of Jesus' Final Week in Jerusalem from St.
Francis Bookshop.
THE COLLEGEVILLE CHURCH HISTORY TIME-LINE, by
Joseph F. Kelly. Liturgical Press.
24 pp., plus a six-page foldout
time-line. $12.95.
THE CATHOLIC CHURCH IN HISTORY: Legend and Reality, by Keith D. Lewis. The Crossroad
Publishing Company. 183
pp. $19.95.
KEY MOMENTS IN CHURCH HISTORY: A Concise Introduction to the Catholic Church, by Mitch
Finley. Rowman & Littlefield. 195
pp. $17.95.
Reviewed by PAT McCLOSKEY, O.F.M.,
editor of this publication and a lifelong student
of history, especially Church history.
CATHOLIC BOOKSTORES these days
give more shelf space to Church history
than they did a few years ago. The success
of The Da Vinci Code book and
movie has caused some people to learn
more about their Church’s story.
Anyone seeking a
short overview of the
history of the Catholic
Church should
find Kelly’s book extremely
helpful. Chair
of the religious studies
department at
John Carroll University
in Cleveland, he
devotes a single page
to each century (except
the 21st, which
gets two pages), explaining each era’s
principal challenges and developments.
Ten maps, plus 28 photos or drawings,
strongly reinforce the text. The
foldout time-line lists significant people,
missions, Church councils, books,
organizations or buildings, political or
cultural events, plus conflicts.
In the second book, instead of trying
to cover all of Church history, Lewis
concentrates on seven “hot button”
topics: the rise of Islam, the Crusades,
the Spanish Inquisition, Martin Luther,
16th-century colonization, Galileo, plus
Pius XII and the Nazis.
A professor of Church history at St.
John’s Seminary in Camarillo, California,
Lewis strives to “help the reader to
a clearer understanding of how objectively
to place the topic within the
larger context of Roman Catholicism.”
People who mistakenly assume that
they know these seven topics well may
be surprised at what they learn from
this book. Every chapter contains
surprises. For example, prior to his
flight from Mecca to Medina in 622
A.D., Muhammad emphasized the
importance of Moses; later he stressed
Abraham. Before the Crusaders captured
Jerusalem in 1099, approximately
half that city’s population was Christian.
The Spanish Inquisition was a network
of regional tribunals but not a
single organization. Jesuit missionaries
initially enjoyed greater freedom in
lands colonized by the Portuguese than
in areas under Spanish control.
By 1932, the German bishops collectively
endorsed a ban on joining the
Nazis—though some bishops dissented.
According to Donald Dietrich, between
1870 and 1894, approximately one third of the anti-Semitic literature was
written by French priests.
What Lewis does, he does well. I was
surprised that his chapter on Martin
Luther made no reference to the 1999
Catholic-Lutheran declaration on justification,
which had been a key issue
during the Reformation.
This volume includes 10 pages of
Endnotes and a six-page Index.
The Finley volume is the third edition
of this text. In the Introduction, he
writes, “One of the most important
lessons a volume such as this can offer
is that change in the Church is not
only nothing to fear but is necessary for
the Church to remain faithful to its
true identity.”
Many of Finley’s 30 books have been
reviewed in these pages. He tells this
story well in 11 chapters. His 10 pages
of Endnotes show that he has read
widely, especially the works of Thomas
Bokenkotter, John Dwyer, Roger Aubert
and Hubert Jedin. He has also consulted
Anthony Gilles, whose books
have been published by St. Anthony
Messenger Press. Finley has a master’s
in theology from Marquette University.
There are, however, several mistakes
that should be corrected in a future
edition: Cicero wasn’t a Greek philosopher
but a Roman statesman; it was
Pella in Jordan and not northern
Greece that was the refuge for Jerusalem
Christians in 70 A.D.; an incorrect date
for the First Crusade is given; the terms
Cistercian and Trappist are not interchangeable;
Pope Gregory IX was not
alive at the time of one reference; the
Council of Trent did not issue the
Roman Missal (although it set this in
motion); and the title of Vatican I’s
document about papal infallibility is
given incorrectly.
I was quite surprised that St. Benedict
of Nursia is not mentioned in Finley’s
volume, which gives very little attention
to monasticism. Finley, a husband
and father, apparently finds U.S.
parishes to be more anti-family than I
have observed.
Librarians will appreciate this volume’s
nine-page Index.
Studying Church history can be frustrating,
but this subject is never dull
with guides such as Kelly, Lewis and
Finley.
You can order THE COLLEGEVILLE CHURCH HISTORY TIME-LINE, THE CATHOLIC CHURCH IN HISTORY: Legend and Reality and KEY MOMENTS IN CHURCH HISTORY: A Concise Introduction to the Catholic Church from St. Francis Bookshop.
CONSPIRACY AND IMPRISONMENT, 1940-1945, Dietrich Bonhoeffer Works, Volume 16, edited by Mark S.
Brocker and translated by Lisa E.
Dahill & Douglas W. Stott. Fortress
Press. 882 pp. $60.
Reviewed by HILARION KISTNER, O.F.M.,
editor of Homily Helps, published by St.
Anthony Messenger Press.
IN MANY WAYS this is a terrific book.
Top-notch scholarship, it documents
the last six years of Dietrich Bonhoeffer’s
life and the experiences of the Confessing
Church (Protestant groups who confessed
the gospel and resisted the Nazi
government). Historians will find it a
gold mine of material for understanding
many important events of 1940-1945 in
Germany.
But this is a complicated book. There
are so many names, dates, German
institutions and offices mentioned, and
so many footnotes and cross references that it is easy to get confused.
The “Editor’s Introduction to the
English Edition,” however, provides
helpful background for following the
course of events. Later in the book there
is an “Editors’ [there are three editors for
the German edition] Afterword
to the German Edition” that
helps to complete the picture.
My recommendation
to those brave enough to
undertake the monumental
task of reading this book is
to read the Introduction and
Afterword first.
The book has three parts.
Part 1 is “Letters and Documents,”
which contains
mostly letters by Bonhoeffer
to family, friends, fellow
ministers in Germany and elsewhere.
They reveal an affectionate human
being, a zealous pastor and a hopeful
ecumenist, a lover of classical music
and a man who loves his country but
must plot against its evil government.
Bonhoeffer was also a man in love.
He became engaged to Maria von
Wedemeyer, but was imprisoned before
he could marry her. His letters to her
are restrained but indicative of a loving
and caring heart.
Part 1 ends with various letters and
documents connected with the imprisonment
and indictment
of Bonhoeffer and
some of his friends. The
final piece is a letter from a
friend of Bonhoeffer informing
another friend of
Bonhoeffer’s execution,
which took place in Flossenbürg
on April 9, 1945.
Part 2, “Essays and
Notes,” and Part 3, “Sermons
and Meditations,”
are short, but give us a taste
of Bonhoeffer’s theology
and spirituality.
Yes, this book is difficult. Yet one
feature of this book was especially helpful
and even fascinating, namely,
the “Index of Names.” There are 76
pages of names. Repeatedly, I found
myself checking names that appear in
Bonhoeffer’s letters. Gradually, I got to
know a number of Bonhoeffer’s friends
and acquaintances who were especially
involved in his life. They became
quite real. It was sad to find some of
them executed before the end of the
war. It was also consoling to find that
some escaped the horrible death he
suffered.
The book prompts some questions:
How much did Bonhoeffer struggle in
conscience while conspiring to put an
end to Hitler? How was he able to concentrate
on theology in such precarious
circumstances? (It was during this difficult
time that he worked on his
Ethics.) Was it his prayer life that sustained
him?
Such questions may lead us to ask
questions of ourselves: What would we
have done in his place? How would
we act in such precarious circumstances?
And the more pertinent and
impertinent question: What are we
doing to resist and counteract the evils
of our time—and in our hearts?
This book may not be a book for all,
but it prompts us to appreciate a man
whom many consider a martyr for
Christ. His life and death may also
inspire the reader to a greater love of
the gospel.
You can order CONSPIRACY AND IMPRISONMENT, 1940-1945, Dietrich Bonhoeffer Works, Volume 16 from St. Francis Bookshop.
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