What Role does Conscience play
in Medical Ethics?
Presentation to the Association of Catholic Doctors
Dublin, 27 September, 2008
Reproduced with permission
This is the revised version of a paper read to the Association of
Catholic Doctors in Dublin on 27th September 2008. I have
added some reflections towards the end of the paper which are
intended to clarify points made at the start.
In preparation for this talk, I took a look at Dr Deirdre Madden's book,
Medicine, Ethics, and the Law,
which seems to me to be a valuable resource. It is, however, a resource that
needs be read with a critical eye, since the author has a tendency to fudge
the issues, which in this area is extremely dangerous. For example, I noted
with approval her account of the Principle of Double Effect (in the context
of her treatment of euthanasia) and how it was used in civil law in the UK
However, on further reading I was somewhat surprised to note that Madden on
the other hand seemed to approve the way this principle had been
misinterpreted by the UK judge in the famous
Bland case. The learned judge
considered the distinction between the withdrawal of life-sustaining
treatment and taking steps to kill a patient to be illogical (cf. p.532). Of
course, there are times when these two distinct acts practically amount to
the same thing, but there are times when the former quite simply doesn't.
Madden fails to note that important distinction, which is precisely one of
the situations where the principle of double effect can help in making a
I noticed that a similar blurring of distinctions apparently gave rise
to the inclusion of article 24.6 in the
Medical Council's Guide to Ethical
Conduct and Behaviour (Sixth Edition 2004) entitled "The Child in
The Council recognises that termination of pregnancy can occur when
there is real and substantial risk to the life of the mother and subscribes
to the view expressed in Part 2 of the written submission of the Institute
of Obstetricians and Gynaecologists to the All-Party Oireachtas Committee on
the Constitution as contained in its Fifth Progress Report, Appendix IV,
The Medical' Council's Guide claims to subscribe to the views expressed
in Part 2 of the written submission of the Institute of Obstetricians and
Gynaecologists to the All-Party Oireachtas Committee on the Constitution as
contained in its Fifth Progress Report, Appendix IV, page A407. The text is
given in Appendix C:
In current obstetrical practice rare complications can arise where
therapeutic intervention is required at a stage in pregnancy when there will
be little or no prospect for the survival of the baby, due to extreme
immaturity. In these exceptional situations failure to intervene may result
in the death of both mother and baby. We consider that there is a
fundamental difference between abortion carried out with the intention of
taking the life of a baby, for example for social reasons, and the
unavoidable death of the baby resulting from essential treatment to protect
the life of the mother.
This precise, clear text is, it seems to me, to be based on the
principle of double effect. But what is disturbing is that the Medical
Council's Guide clearly permits the same principle to be given a broader
interpretation. What are the implications of this broader interpretation?
We can approach the issues involved by first raising a few practical
Does the new, broader, interpretation mean that in future the
training of obstetricians and gynaecologists must include training in
abortion, in limited circumstances of course?
Will a training centre that refuses to undertake such training be refused
recognition by the Medical Council, since one of their functions is to
oversee professional training of health care officials?
Will a doctor who
refuses to offer such treatment be disciplined for one of the rather vague
reasons given in the Medical Practitioners Act 2007,#57, such as (a)
professional misconduct, or (b) "poor professional performance, or (d) "a
failure to comply with a relevant condition"?
- Will such a doctor be able to claim the right of conscientious
objection, if he or she is truly conscientious, and refuses to refer the
patient to another doctor who will perform it?
A similar question must be
raised with regard to Artificial Insemination by donor and I.V.F., both of
which are intrinsically wrong and which must cause a
grave crisis of conscience for responsible medical personnel - not just
those who are Catholic.
The key question for us at the present is raised by the
Medical Council's Ethical Guide
#2.6, which states: "If a doctor
has a conscientious objection to a course of action this should be explained
and the names of other doctors made available to the patient".
I am informed
on good authority that this "obligation of referral", as I would like to
call it, was already in operation in the UK in 1967. Generally speaking,
advocates of the obligation to refer patients to other doctors who will
perform the morally repugnant action claim that such referral is "universal
practice", thereby putting pressure on the local objectors. Is that the
In response to an attack by pro-abortion groups in America on (what at
the time purported to be) a leaked draft of a proposed federal regulation on
conscience rights of health care providers, the Chairman of the American
Bishops' Committee for Pro-Life Activities, Cardinal Justin Rigali, writing
to Members of Congress made the point:
[I]n November 2007 the Ethics Committee of the American College of
Obstetricians and Gynaecologists [ACOG] issued an opinion stating that
pro-life physicians must do abortion referrals â€“ and ACOG had to be
reminded by the Secretary of Health and Human Services that such coerced
referrals are among the abuses that federal conscience laws have long
been directed against.
It seems the statutory policy is clear and needed, and at the same time
is relatively unknown, misunderstood and unenforced.
Even more pertinent in our context is the recent row
involving the Catholic Pregnancy counselling agency CURA and the Government
Crisis Pregnancy Agency since it hinged on precisely the same issue.
Catholic moral theology
rejects such referral because it would be a kind of material cooperation
that facilitated, albeit indirectly, the act that is objectively wrong in
itself. Thus it would seem that the same type of political pressure
("political" is to be understood in the broad sense of social and cultural)
is being used to force Irish medical personnel to act against their
This pressure, as can be expected, might well sway the majority
of lay members of the Preliminary Proceedings Committee or the Fitness to
Practice Committee should they have to judge a related case, in particular
if they happen to have pro-choice ideological bias. That possibility cannot
be excluded in the near future, since, according to the Medical
Practitioners Act 2007, #17 subsection 1, sub-subsection (n) ii, the
Minister can appoint five persons who "have such qualifications, expertise,
interests, or experiences, as in the
opinion of the Minister, would enable them to make a contribution to the
performance of the Council's functions [my emphasis]." Apart from the broad
scope of such qualifications, there is no way of questioning the "opinion of
the Minister" with regard to the standards the Minister might use to
determine who is qualified to sit on the board.
Appointments are entirely at her or his discretion.
What I find most
upsetting in the Act as a whole is something that Dr Kevin Doran in his
excellent article in The Medical News
also pointed out recently, namely the vast extent of the discretionary and
statutory power given to the Minister in the 2007 Act. Is this but another
incidence of the totalitarian tendency of modern so-called democratic
governments (not only in Ireland) and the attendant mushrooming of anonymous
bureaucracy responsible only to those over them? As civil servants they must
do as they are told by those in charge â€“ or else they lose their job or are
denied rightful promotion. That is considerable pressure.
These question are posed by way of introduction to the core issue I want
to address, namely the nature of conscience. Seen in its most positive
light, it is arguable that, behind the above understanding of conscientious
objection that has now been enshrined in the
Medical Council's Guide to Ethical Conduct and Behaviour, is an
honest failure to understand what conscience actually is.
conscience is assumed to be a purely subjective thing, a personal preference
that is fundamentally irrational and so cannot be "imposed" on others.
Behind that rather common assumption is that post-Enlightenment
philosophical tradition that finally spawned moral relativism, a discourse
on which I am going to spare you today. I would just like to stress the need
for those who reject this false notion of conscience to appreciate that
those who subscribe to a subjective notion of conscience, and so to
relativism in moral matters, are not acting in bad faith.
itself, as it were on its own terms, is based on this subjective notion of
conscience and its attendant moral relativism, which could be summed up
rather coarsely as: "I choose my own moral principles and no one dare impose
their values or principle on me". That is its seductive power. This
generally accepted assumption of modern culture -- together with highly
emotional hard cases introduced by the advocates of moral change to move
people's hearts-- has wrought nothing less than havoc to society in
so-called developed countries.
sincerity of those who hold a subjective view of conscience is not in doubt.
But is it enough? More importantly, what is wrong about that all-pervasive
contemporary understanding of conscience? For the rest of this paper, I will
concentrate on such a misunderstanding in the hope of clarifying what
conscience in fact is. Related to this topic there is a question of no small
significance for Catholics: what is the nature and extent of the binding force
of the Church's authoritative teaching on our conscience? If Catholic
doctors are to appeal to their conscience as Catholics, then they must have
some appreciation of the relationship between conscience and Church
authority â€“ but they also be ready for the consequences, often of a negative
nature, that comes from being true to your conscience.
May I begin
with the sombre reminder of the general tendency of sinful human nature:
lapidary Sickness Unto Death,
Kierkegaard observed that most people "work gradually at eclipsing their
ethical and ethical-religious comprehension." He believed that moral
knowledge is universally distributed, in the form of conscience. However, as
he saw it, conscience has an uphill battle because we all know in our bones
that its directives will clash with what seems to be our immediate
So what do
we do when our moral principles push us toward losing our jobs or our
friends, or just having to put up with people's irritation with us? He
answers, "We allow a little time to elapse, an interim called: 'We shall
look at it tomorrow'." And during that interval our moral knowledge becomes
more and more obscured, until finally we come to our senses and convince
ourselves that the convenient course is the righteous course.
rather bleak picture of human nature is not without a grain of truth. It
reminds us of two undeniable facts: (1) that conscience usually makes
demands on us that will upset us, make
us suffer perhaps, or even cost us
our lives. (2) Many people choose to close the ears of their heart,
preferring present comfort to probable pains should they dare to follow
their conscience. Conscience costs something, perhaps even one's life. St
Thomas More is one of the many martyrs whose obedience to conscience did in
fact cost them their lives. More
recently, and on a much lower level, but still significant, Steven Spielberg
resigned as artistic consultant to the Beijing Olympic Games "saying his conscience
will not let him choreograph an event for a country that has done little to
use its influence to ease the
slaughter in Darfur" (The Guardian, 16.02.08). His decision shook the Chinese government.
The voice of conscience strikes terror into the powers that be, especially
those of a totalitarian bent. Conscience has a real existential primacy in
the political world as well as in civil life (business, professional life,
etc.) â€“ but also in the life of the Church. What roused Spielberg's
conscience? It seems that it was an article by Mia Farrow (in the
New York Times). Conscience generally needs to be roused by an
external voice uttering the truth.
there is more to it than that.
As the German philosopher, Robert Spaemann, once put it, conscience is not
an oracle, rather it is an organ, a spiritual capacity that, like our innate
capacity for language needs to be activated from without. Just as we learn
to speak through interaction with the communities into which we are born, so
too conscience has to be formed by the moral communities we inhabit, above
all the religious community, which for Catholics is the Church, where the
Bishop of Rome as Successor of St Peter enjoys a primacy with regard to her
teaching authority. Blessed John Henry Newman succinctly captures the
intrinsic relationship between conscience and the divinely guided authority
of the Church when teaching faith and morals. In his famous letter to the
Duke of Norfolk replying to Gladstone's attack on the dogma of Papal
Infallibility that had been proclaimed by Vatican I, Newman wrote:
"Certainly, if I am obliged to bring religion into after-dinner toasts,
(which indeed does not seem quite the thing), I shall drink â€“ to the Pope, if
you please, - still, to Conscience first, and to the Pope afterwards."
was most of his later life a firm opponent of the spirit of liberalism and
of Christian subjectivism, as found in the Evangelical movement he once
embraced. Evidently he was not suggesting a clash between conscience and the
Papal teaching authority. According to Ratzinger: "Newman embraced an
interpretation of the papacy, which is only then correctly perceived when it
is viewed together with the primacy of conscience â€“ a primacy not put in
opposition to the primacy of conscience but based on it and guaranteeing
it." Ratzinger adds: "Modern man, who presupposes the opposition of
authority to subjectivity, has difficulty in understanding this."
That, of course, is a understatement. Not only do we moderns have difficulty
in understanding this, we have produced a number of false ideas of
conscience, each based on the denial of objective truth.
false notion is the tendency to reduce conscience to what Ratzinger called
an "excuse mechanism", a kind of rationalization to justify one's actions
which, in fact, are wrong in themselves (and deep down one knows that, even
if one is in denial).
This can lead to the situation where conscience is effectively silenced; we
can refuse to let it cause us disquiet or let it give rise to guilt
feelings, which, of course, is precisely its divinely given task. This is
spiritually and psychologically dangerous. Albert Görres, a German
psychologist, once pointed out once that, like bodily pains which alert us
to illness, feelings of guilt alert us to the fact that something is wrong.
Not to experience any sense of moral guilt â€“ as in the case of many
perpetrators of grave crime
â€“ is to be morally moribund â€“ quite literally a sickness unto death. It
"shows that the feeling of guilt, the capacity to recognize guilt, belongs
essentially to the spiritual make-up of man. This feeling of guilt disturbs
the false calm of conscience and could be called conscience's complaint
against my self-satisfied existence."
Another contemporary misunderstanding is to reduce conscience to a basically
irrational personal preference: what I feel, that is right. And what others
feel, is right for them, provided they do no (obvious) harm to someone else.
Behind this widespread assumption is the modern philosophical denial of any
objectivity in moral issues. It recognizes only one moral imperative: not to
be "judgemental" of others, even in such issues as abortion.
Another, closely related, misunderstanding is put into the mouth of St
Thomas More in Robert Bolt's play, A
Man for All Seasons. To quote Anthony Kenny,
"for the More in Bolt's play,
what matters is not whether the Pope's supremacy is true, but the fact that
More has committed his inmost self to it. As he says to Norfolk, 'What
matters to me is not whether it's true or not, but that I believe it to be
true, or rather not that I believe it but that
I believe it'."
Now, of course, that is precisely
what More would never have said, not only because it has distinct echoes of
Luther's Hier stehe ich, ich kann
nicht anders, but because it is a thoroughly modern concept of
conscience. It is alien to all that More stood, and fell, for, namely
conscience as the sensorium of
transcendence (Eric Voegelin) and so of truth.
Conscience, properly understood, is that which, if we allow ourselves to be
prompted by its deepest dictates, drives us to search for objective truth
(both theoretical and practical). And it enables us to recognize the truth
as truth when we find it â€“ or, if we are truly open, when the truth presents
itself to us in the course of our search for it. And the truth More died for
was the truth about the universal Primacy of the Bishop of Rome in matters
of faith and morals.
More died a
witness to objective truth
(that is the definition of a martyr), and not simply for his personal
subjective conviction. Though our grasp of truth is personal (and so, in a
sense, subjective), truth itself is objective: it is something we discover
or, more precisely, we re-cognize; we ourselves do not devise it. Further,
it is not individualistic. Though intensely personal and particular in its
recognition and expression, truth is by nature universal and communal. This
means not only that truth can be recognized by all (and so is universally
binding) but it creates community, not least through its moral expression in
just laws that are therefore binding in conscience not simply because of
external pressure (as in a police state). In sum, one could say that moral
truth here is that rare thing called common sense -- what to an unprejudiced
mind is reasonable, fair and just. Such is the source of the commonweal, or
common welfare, of a society.
conscience needs to be awakened from outside, as it were, God instituted an
ultimate, universal authority â€“ the conscience of a particular person
exercising his responsibility as the Successor of St Peter â€“ to be the
guarantor of the revealed truth He intended for the salvation of all
humanity. In More's own words, after he had studied the question of "Papal
Supremacy" (to use the now easily misunderstood term), "â€¦it holdeth up all".
There is, therefore, an intrinsic, and not just an accidental, relationship
between More's conscience and the authority of the Bishop of Rome, as he
himself seems to have indicated when, after his judgement, it was "prudent"
for him to break his silence.
In sum, conscience and the Church's teaching authority should not be seen as
in opposition but as interrelated. The question is: how?
It is quite
revealing that the quotation from Bolt's play actually features in some
modern moral theology handbooks, such as that of Richard Gula,
as an example of the primacy of (subjective) conscience â€“ now understood as
the final arbiter as to how we should act.
Indeed some theologians go so far as to claim that an adult should be
capable of choosing what moral principles he or
she might adopt, even if one or other is in opposition to those taught
by the Church's apostolic authority.
The term used for this is "dissent", sometimes even "loyal dissent", a term
from the realm of politics, first given to those courageous men and women in
the Soviet Union and its satellites, such as Osip and Nadezhda Mandelstam,
Andrei Sakharov, and Vaclav Havel, who dared to oppose the totalitarianism
of the State.
summarize, we can say that subjectivity today poses as true conscience â€“ it
claims the authority of conscience â€“ though it is the very antithesis of
what conscience truly is. This truth was captured by Steven Wright in two
"A conscience is what hurts when all
your other parts feel so good."
conscience is usually the sign of a bad memory."
is the role of conscience in medical ethics? Conscience is fundamental to
all ethical behaviour (i.e. the actions of free agents) and thus to the
sub-discipline of medical ethics. Conscience is, in the final analysis,
about our humanity in all its depth and dignity. It is thus the last bulwark
against the inhumanity of those negative forces in the world which threaten
our true wellbeing both personal and communal. Those negative forces come in
many guises, internal (our own frailty) and external. The external forces
(political pressure as defined above) range from more or less subtle
pressures to conform to "what everyone else is doing" to the economic and
political forces that aim to dominate the world ostensibly for the good of
humanity. The misleading term used by the Medical Council to put pressure on
"conscientious objectors" is "universal practice". The term alludes to what
is known as "best practice", namely a medical practice which, having been
subject to rigid tests, has stood test of time.
"Universal practice" is a fuzzy concept. For example, one might ask: what if
the universal practice (in a country, continent, or even the world
community, when it relentlessly promoted by its rich and powerful advocates)
is morally reprehensible, as is the case with abortion? In promoting such
"universal practice", anti-life forces usually conceal their aims behind
some appealing mask, such as human rights (in particular women's rights),
equality, or even alleviation of poverty. The latter are noble causes, but
often used for less noble ends, in particular when they are woven into a
rigid ideology and ultimately frozen in legislation. Whatever the form the
mask takes, it generally betrays one common feature. It poses as the means
necessary to prevent or ameliorate suffering. In addition, each mask appeals
to the most fundamental assumption of modern culture: the absolute nature of
man's freedom to choose. As "pro-choice", it both advocates (and appeals to)
a freedom without limits. This, of course, is a claim to become like God,
i.e. unlimited. It is the original seduction of man.
essentially about those limits which define our common humanity. Conscience
is our innate sense of right and wrong, which can be either developed or
deformed by one's upbringing and immediate environment, namely the
polis (the political, cultural and
economic community in which we live). But even when deformed, conscience can
never be obliterated entirely, and so remains the pre-condition for
repentance and so for recovery of our full humanity. The development of
one's conscience depends on many conditions, but two are essential: help
from outside in the form of knowledge about right and wrong (such as
communal values and legal prescriptions) and help from Above (even when one
may be agnostic about God's existence). Most people are docile to help both
from outside and from Above (even when they seem not to acknowledge God) and
so their sense of right and wrong matures â€“ at least to the extent that they
remain alert to what they observer or hear, are critical of common
assumptions, and, above all, are self-critical. Conscience of its nature is
restless to know the truth.
Humility is its hallmark. Another is moral courage â€“ the readiness to stand
up and be counted, irrespective of the consequences for oneself.
The role of
the Church's teaching authority is to witness to the truth about our human
condition in the light of reason (the wisdom of humanity common to all
authentic Religions) and God's self-revelation in Jesus Christ. Her role is,
in a word, to awaken consciences. Her teaching on ethics in general and
medical ethics in particular is thus of universal significance â€“ and so can
be recognized as such by those men and women of good will in other Religions
or even without any religion. Her sacraments are there to enable those to
follow their conscience and so are struggling to abide by what they know is
the truth, what they know they ought to do but find it difficult, if not at
times almost impossible to do so. This applies today in particular when
health care professions have to deal human life at its most vulnerable. Here
the purpose of medical ethics is to indicate the limits to the kind of
behaviour required to ensure that, in treating patients, no serious harm is
done. For example, the Principle of Double Effect â€“ or more precisely, the
principle of foreseen side-effects â€“ helps medical practitioners at all
levels to distinguish between a necessary medical intervention needed to
save the life of the patient despite the foreseen side-effect that might do
irreparable harm to another person - even death.
"Conscientious objection" is the term
used in the Medical Council's Guide to replace "conscience". In the context
of the Guide, the term "conscientious objection" assumes that conscience is
something subjective, merely a personal preference, i.e. one not binding on
anyone but oneself. Further, "conscientious objection" is a negative term
with a very restricted application. It has its origin in the context of war.
Pacificists who object to war on conscientious grounds cannot and do not
prevent others going to war, though they may publicly protest. By way of
contrast, the Guide insists on what they call "the obligation of referral."
In effect it instructs practitioners who object to certain practices on
conscientious grounds to refer the patient to other medical personal who
they know will provide the same (morally objectionable) "services."
guidelines offend against the common moral perception articulated in another
ethical principle, the principle of co-operation. Put simply, this means
that one cannot co-operate in doing serious harm to another person which you
can foresee will undoubtedly happen. Medical ethics, which is a highly
sophisticated discipline, fine-tunes that moral intuition. The conscience of
a man or woman of integrity urges that person, when facing a moral dilemma
in medical practice, to seek whatever help medical ethics based on objective
(i.e. reasonable) morality can offer. It takes real courage both to seek
that truth and to live it.
+ + +
when I first gave the above talk, the Medical Council Guidelines were
revised and the 7th Edition published in 2009. The section (#10) on
"Conscientious Objection" as been refined,
simplified, and radicalized. It reads:
As a doctor, you must not allow your personal moral standards to influence
your treatment of patients.
If you have a conscientious objection to a course of action, you should
explain this to the patient and make the names of other doctors available to
objection does not absolve you from responsibility to a patient in emergency
revised guideline was adopted by Justice Ryan's Expert Report and found its
way into the Heads of Bill for
the proposed legislation on abortion. The following is an excerpt from my
submission to the Oireachtas Committee:
to the Notes, Head 12 ("Conscientious Objection") is to be understood in
terms of the Medical Council's Guide # 10.2 and #10.3. This, in fact, is
exactly what the Expert Report suggested. It is interesting that the Expert
Report (and following it, Head 12) omitted the introductory statement
(#10.1), which in fact is the key to understanding what the Medical Council
now understands by the term "conscientious objection". The introductory
#10.1 states: "As a doctor, you must not allow your personal moral standards
to influence your treatment of patients."
This extraordinary statement seems
not to have raised an eyebrow when the President of the Medical Council
quoted it in his statement to the Oireachtas Committee. In effect, it
affirms that doctors should ignore their own sense of right and wrong. It
would signal the relegation of morality to the sphere of feelings and the
irrational; in a word, it would amount to the abolition of morality.
Consequently, the term "right to conscientious objection" used by the
Medical Guide (#10.1), the Expert Report (6.9) and now Head 12 of the Bill
implies that conscience is something entirely subjective, merely a personal
preference, and therefore not binding on anyone but oneself. Both the
Medical Guide and the Expert Report thus logically insist on the obligation
of referral. And so the proposed Bill now proposes to write this into the
law of the land.
I rest my
Vincent Twomey svd
In an article "Double effect principle must not be dismissed" (Rite
and Reason, The Irish Times 27 June 2000; revised and reprinted as "The
Principle of Double Effect and Civil Law"
Irish Theological Quarterly, vol. 67, p.32 & p. 54) this writer took
issue with a distinguished Senior Councillor at the time (now
Supreme Court Judge), who had published an article rubbishing the
moral principle that, he claimed, originated in Catholic moral
theology (St Thomas Aquinas) and, on the ground of being "Catholic",
denied its applicability to civil law.
Since they generally offend common moral instinct (often dismissed
as traditional), radical changes in medical practice are often
justified by way of "exceptional circumstances" when first
introduced by means of Guidelines or new ("progressive")
legislation. But then, slowly but surely, the exception become the
norm, since, in a sense, most
medical interventions are exceptional, being particular to
each case. It should be noted that there is a school of modern
Catholic theology (known as "proportionalism") which has adopted as
one of its fundamental principles the principle of justifying
certain actions, otherwise regarded as illicit, because of
"exceptional circumstances". Blessed Pope John Paul II's
encyclical Veritatis Splendor
(1993) shows this kind of theology is seriously mistaken.
The letter is dated 18 July 2008.
It should be added that here, as elsewhere, Catholic moral theology,
when true to the Church's teaching, simply articulates a common
moral instinct, i.e. an instinct which is common to our humanity and
found in all religious traditions. I own the phrase "common moral
instinct" to Fr Seamus Murphy SJ: it is the source of what is known
technically as "natural law".
Since I gave this paper, the present Minister for Health (Mr
O'Reilly) appointed a prominent member of the Irish Planned
Parenthood as head of the HSE.
'Before Teaching Ethics, Stop Kidding Yourself' in
The Chronicle Review 50/24 (20 February 2004) B5.
What follows is indebted to Joseph Cardinal Ratzinger,
On Conscience (Philadelphia/San Francisco: The National Catholic Bioethics
Center/Ignatius Press, 2007); see also D. Vincent Twomey SVD,
Pope Benedict XVI, The
Conscience of Our Age (San Francisco, Ignatius Press, 2007), in
It has to be acknowledged that, in modern Catholic theology, this
quote of Newman has been used to support a subjective notion of
conscience. A reading of the whole "letter" [in fact a book]
â€“ and not just this intentionally provocative quote taken out
of context â€“ makes it
clear to the reader that such an interpretation simply misses the
Joseph Cardinal Ratzinger, On
Conscience (San Francisco, Ignatius Press, 2007), 23.
This all-too-human tendency is exacerbated by the theoretical denial
of any acts that are wrong in themselves, a position held by too
many modern Catholic moral theologians
See Peter Charleton's classic,
Lies in a Mirror An Essay on
Evil and Deceit (Blackrock Co Dublin: Blackhall Publishing,
Ratzinger, On Conscience, op.cit., p.18.
Kenny, Thomas More [Past Masters Series] (Oxford, 1983), p 95.
This would seem to be the way some contemporary moral
theologians also interpret conscience and, as we will see, even
appeal to Bolt's play in support.
Discourse on St Thomas More's Great Matter: Conscience' in Amelia
Irish Moral Discourse. Festschrift for Patrick Hannon (Dublin:
Columba Press, 2006), pp.155-79; reprinted in Enda McDonagh and
Vincent McNamara, An Irish
Reader in Moral Theology: The Legacy of the Last Fifty Years, Volume
I: Foundations (Dublin: Columba Press, 2009), 335-53
More died for both theoretical (or dogmatic) and moral truth - i.e.
both Papal Supremacy (dogmatic truth) and the wrongness of divorce
R.W. Chambers, Thomas More, London 1935 [1948 reprint], p. 196.
Cf. ibid., p. 340
Richard M. Gulla, S.S., Reason
Informed by Faith: Foundations of a Catholic Morality (New
York/Mahwah: Paulist Press, 1989), pp. 123-134, here pp.133-5. Gula
rightly distinguishes between psychology's superego and conscience.
However the distinction is nullified by the fact that he sees the
distinction not one of kind but only of degree (p.129): the superego
is seen as "a primitive but necessary stage on the way to genuine
conscience" (p.128). Gula quotes Vatican II's
Gaudium et Spes #16 in
support of his understanding of conscience without recognizing the
deficiencies of that text: see Joseph Ratzinger's critique of G&S
#16 in his commentary on the text in
Commentary on the Documents of Vatican II, vol 5, Pastoral
Constitution on the Church in the Modern World, edited by Herbert Vorgrimler (London/New York, 1969), pp. 115-63; here
pp.134-6. According to Ratzinger, the treatment of conscience in
Gaudium et Spes is naive.
"I must always do what I believe is right and avoid what I believe
is wrong" (Gula, p.133). This, of course, applies to an erroneous
conscience in good faith - but Gula, like many other moral
theologians, ignores the distinction between genuine conscience
(what is objectively true) and a subjective conscience that is in
error. That erroneous conscience may be due to negligence (by
failing to search for the objective truth or for what the Church's
apostolic authority teaches.
The technical term for the Church's teaching authority is the
Magisterium, a Latin term which, when used in any modern language,
especially English, has, unfortunately, a somewhat authoritarian ring about
grateful to Dr Mary McCaughey for this helpful distinction.