Linacre Quarterly最新文献

{"title":"Faith as a Moral Determinant of Health: Toward a Population Health Paradigm Shift.","authors":"Izaskun M Iglesias, Eduardo Smith Singares","doi":"10.1177/00243639261450681","DOIUrl":"https://doi.org/10.1177/00243639261450681","url":null,"abstract":"<p><p>Social determinants of health (SDH) such as income, housing, education, and access to care are widely acknowledged as critical drivers of population health. However, they do not arise independently or randomly; instead, they are shaped by upstream societal decisions, institutional priorities, and ethical commitments, which Berwick has termed moral determinants of health (MDH). The central thesis of this essay is that faith (articulated through Christian doctrine and Catholic social teaching) operates independently as a robust moral determinant of health. Historical evidence demonstrates that faith is a catalytic force that motivates structural change, sustains long-term commitment to justice, and mobilizes resources to transform the social conditions in which health and disease emerge. Faith-inspired institutions deliver significant portions of all global healthcare, advocate for policies that prioritize people experiencing poverty, and address the root causes of inequity. When guided by the Holy Spirit, such actions become not merely social work but a visible manifestation of the Kingdom of God. Recognizing faith as one of the MDH reframes public health as a moral project and calls for policies that integrate faith-based motivations and institutions into health systems. In this way, addressing SDH becomes both a public health imperative and a theological mission.</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261450681"},"PeriodicalIF":0.5,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the Physician Becomes the Patient: Suffering, Surrender, and the Formation of a Catholic Medical Vocation.","authors":"Siegfredo R Paloyo, Ferri P David-Paloyo","doi":"10.1177/00243639261450689","DOIUrl":"https://doi.org/10.1177/00243639261450689","url":null,"abstract":"<p><p>This essay examines the theological and vocational implications of a physician's experience of serious illness through the lens of Catholic anthropology and sacramental theology. When a practicing transplant surgeon unexpectedly underwent emergency open heart surgery for acute aortic dissection, the transition from healer to patient precipitated an existential reorientation. Drawing upon St. Augustine's understanding of human dependence upon grace, the Catechism's teaching on divine sustenance, and St. John Paul II's theology of redemptive suffering in <i>Salvifici Doloris</i>, this reflection explores how acute vulnerability disrupts professional identity while deepening it. Two devotional texts-<i>Lead Me, Lord</i> and <i>Anima Christi</i>-serve as interpretive anchors, illuminating the movement from disorientation to surrender and from autonomy to dependent agency. The essay argues that serious illness can purify and reform medical vocation by exposing the illusion of mastery and situating clinical practice within the primacy of grace. Rather than erasing professional identity, the experience of suffering may configure the physician more deeply to Christ and foster a more integrated understanding of healing as cooperation with divine providence. In this convergence of medicine and theology, vulnerability becomes not a negation of vocation but its refinement.</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261450689"},"PeriodicalIF":0.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Forgotten Encyclical: Why <i>Evangelium Vitae</i> Still Matters.","authors":"Richard A Spinello","doi":"10.1177/00243639261452383","DOIUrl":"https://doi.org/10.1177/00243639261452383","url":null,"abstract":"","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261452383"},"PeriodicalIF":0.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Parental Nutrition as a Proportionate Means of Conserving Life.","authors":"Michael Bernhardt","doi":"10.1177/00243639261450677","DOIUrl":"https://doi.org/10.1177/00243639261450677","url":null,"abstract":"<p><p>The seventh edition of the Ethical and Religious Directives for Catholic Health Care Services states, \"In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally.\" Most of the discussions around medically assisted nutrition and hydration have focused on enteral nutrition. The present article aims to argue that the obligation to provide nutrition and hydration, in principle, extends to providing parenteral nutrition for patients who cannot take in food through their intestines so long as the intervention does not constitute a grave burden, does not entail excessive expense, and provides a reasonable hope of efficacy. There are several medical conditions in which either short- or long-term total parenteral nutrition (TPN) is required and is accepted as the standard of care. The inability to tolerate nutrition enterally should not be either a death sentence or a condonation of passive euthanasia via dehydration and starvation if death is not imminent. Fr. Tadeusz Pacholczyk, in discussing death and feeding tubes stated that, \"Our death, in other words, should result from the progress of a pathological condition, not from a lack of food or water if it could have been readily and effectively offered to provide comfort and support to a patient.\" Proceeding with TPN is a proportionate method of assisted nutrition and hydration that has the potential to aid in the prolongation of life worth living, as well as preventing unnecessary death via dehydration and starvation.</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261450677"},"PeriodicalIF":0.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Of Fasts and Feasts: Catholic Ethics and the Right Use of GLP-1 Agonists for Weight Loss.","authors":"Annemarie Y A Starr","doi":"10.1177/00243639261450700","DOIUrl":"https://doi.org/10.1177/00243639261450700","url":null,"abstract":"<p><p>Can Catholics ethically use GLP-1 agonists to pursue the goal of weight loss? I argue that the goal of maintaining a healthy weight should serve the further ends of caring for the good gift of one's own body and pursuing the virtuous beatitude which befits the human person. Drawing from Thomas Aquinas, I argue that temperance is an integral part of human flourishing. I apply the work of other Catholic ethicists on analogous behavior-modifying drugs to consider whether GLP-1 agonists facilitate or thwart the development of temperance. I conclude that the drug may contribute to insensibility (the opposite of temperance) and undermine the moral agent's development of a Eucharistic disposition toward the gift of food. Finally, I argue that GLP-1 agonists must not be regarded as a fix-all solution when the greatest share of America's obesity crisis is borne by the poor and marginalized. Rather, Catholics must recognize and reform underlying unjust socioeconomic structures, such as food deserts, and the American culture of food consumerism, which make it more difficult for disadvantaged communities to exercise responsible stewardship of their bodies.</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261450700"},"PeriodicalIF":0.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomy and the Value of Human Life in Christian Bioethics: A Critique of Functional Moral Reasoning.","authors":"Jay J Oh","doi":"10.1177/00243639261450692","DOIUrl":"https://doi.org/10.1177/00243639261450692","url":null,"abstract":"<p><p>Contemporary bioethics treats autonomy as the governing principle in decisions involving euthanasia, abortion, and end-of-life care. Yet the operative moral reasoning in these debates frequently depends not on autonomy but on implicit judgments about the value of human life based on functional capacity, suffering, or perceived quality of life. This paper identifies and analyzes this conceptual inconsistency. It argues that functional valuations of life, not autonomy, are doing the decisive moral work in contemporary clinical ethics, and that this hidden reliance on conditional assessments of human worth creates an unstable foundation for protecting vulnerable persons. Drawing on the Christian theological tradition, particularly the doctrine of the imago Dei, Augustinian and Thomistic moral anthropology, and the work of Edmund D. Pellegrino, the paper proposes an alternative framework in which human dignity is intrinsic and inviolable, and autonomy is understood not as sovereign self-determination, but as responsible moral stewardship exercised within the created order. Three case studies in euthanasia, abortion, and advance care planning illustrate the practical consequences of this reorientation. The paper concludes with implications for clinical ethics consultation, institutional policy, and the role of Christian bioethics in pluralistic healthcare discourse.</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261450692"},"PeriodicalIF":0.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unity of Man.","authors":"Daniel A Dansak","doi":"10.1177/00243639261452417","DOIUrl":"https://doi.org/10.1177/00243639261452417","url":null,"abstract":"","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261452417"},"PeriodicalIF":0.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Survival First to Dignity First in Reproductive Medicine.","authors":"Steven Umbrello","doi":"10.1177/00243639261450686","DOIUrl":"https://doi.org/10.1177/00243639261450686","url":null,"abstract":"","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261450686"},"PeriodicalIF":0.5,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Searching for a Well on the Antepartum Service.","authors":"Ellery Sarosi, Luke A Gatta, Warren Kinghorn","doi":"10.1177/00243639261435862","DOIUrl":"https://doi.org/10.1177/00243639261435862","url":null,"abstract":"<p><p>Women admitted to inpatient antepartum services are often navigating unexpected obstetric complications. Their tenuous circumstances may persist for days, weeks, or even months, and at times result in extended inpatient stays. Within these admissions, the weight of uncertain maternal-fetal outcomes disrupts any constancy found in the daily routines of rounding, monitoring, and intervention. What does it look like for clinicians to accompany patients amid such uncertainty? Uncertainty and vulnerability also characterized the encounter between Jesus and the Samaritan woman at Jacob's well (John 4:1-42). But in their encounter, the woman found herself known and heard, Jesus revealed himself as Israel's Messiah, and the woman became an evangelist and disciple in her community. Their encounter was characterized by vulnerable truthfulness, respect, and reverence for the other's story, and treating each other as ends rather than as means. Intertwining theological reflection on the story of the Samaritan woman at the well with narration of selected experiences of women admitted to the antepartum service, the authors explore how the transformative encounter of the Samaritan woman and Jesus might inform care of women on modern-day antepartum services. The encounter at the well can encourage clinicians to embrace \"well person care,\" a model of care focused on vulnerability, truthfulness, and respect that seeks to care not only for patients' immediate medical needs but also addresses the \"thirst behind the thirst.\"</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261435862"},"PeriodicalIF":0.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Medical Trainee Perspectives on the Ethical and Religious Directives: Single University Experience.","authors":"Alexandra Mauritsen, Hannah Fleming, John Sweeney, Alexa Mistichelli, Kevin FitzGerald","doi":"10.1177/00243639261429396","DOIUrl":"10.1177/00243639261429396","url":null,"abstract":"<p><strong>Background: </strong>The Ethical and Religious Directives (ERDs) guide the delivery of health care in Catholic hospitals across the United States.</p><p><strong>Purpose: </strong>This study seeks to understand the perceptions and experiences of medical trainees in a Catholic health care system on key ethical issues pertaining to the ERDs.</p><p><strong>Methods: </strong>Medical students from a Jesuit Catholic university were recruited via email to complete a self-administered online survey on seven contemporary ethical issues: Catholic Healthcare Systems as Safety Nets; Contraception and Sexually Transmitted Infection (STI) Prevention; Gender-Affirming Care; Fertility; Maternal Endangerment and Pregnancy Termination; Elderly Care; and Brain Death and Organ Donation. Each student ranked the seven issues in order of priority and responded to further questions for the top three issues ranked. Free responses were analyzed with reflexive thematic analysis with an interpretivist approach.</p><p><strong>Results: </strong>Forty respondents (40/972; 4.12%) completed the entire survey. Maternal endangerment was the most commonly selected issue (N = 37). A statistically significant association was identified between religion (observance and self-identification) and the selection of Contraception and STI Prevention (p = 1.0 × 10^-4; p = 0.011, respectively). In qualitative analysis, concern for patient welfare, navigation of value conflicts, and expression of uncertainty emerged across themes.</p><p><strong>Conclusion: </strong>The findings of this study suggest that medical students' ethical reasoning and experiences may be in tension with the ERDs. Recommendations include promotion of familiarity and alignment with the ERDs through the exploration of specific scenarios and exposure to ERD-coherent practices throughout medical training.</p><p><strong>Non-technical summary: </strong>Medical students from a Jesuit Catholic university were surveyed for their opinions on seven contemporary issues related to the Ethical and Religious Directives, which guide Catholic healthcare provision in the United States. The issue of Maternal Endangerment and Pregnancy Termination was the most commonly chosen topic. An association between religion and selection of the topic of Contraception was detected. Free responses across topics demonstrated concern for patient welfare, navigation of value conflicts, and expressions of uncertainty.</p><p><strong>Short summary: </strong>Medical students from a Jesuit Catholic university were surveyed for their opinions on the Ethical and Religious Directives.</p>","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639261429396"},"PeriodicalIF":0.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}