Faith in Action Blog | Thomas Aquinas College

Reblogged from Faith in Action Blog | Thomas Aquinas College:

Theologian / ethicist / cultural commentator Dr. Pia de Solenni (’93) has a new column in Headline Bistro about the “strange, weird, and … largely unregulated world of assisted reproductive technologies.” In it she makes an important distinction between “having a child and being a parent,” noting:

“There are many opportunities for people to become parents, either by having their own children naturally or by adopting children desperately in need of a home (and parents). In either case, there may still be situations where people view children as a fancy accessory or possession. The fact that they’re having a child naturally or adopting doesn’t mean that their intentions are necessarily good. But at least the child isn’t being custom ordered like a car or a piece of furniture.”

Dr. de Solenni is also a regular guest on the Catholic Answers Live radio program, and recently defended the Church on NPR.

Warning: long cooking post ahead

So, it's been way too long since I last blasted my cooking exploits up here! I've made apple sauce, apple butter, meatloaf, and oat cakes. As always, I learn a lot when I was in the kitchen.

The apple sauce was very fun and easy. I grated six apples. (Next time I'll just chop them!) I put these in the slow cooker with some ginger, ground cloves, and cinnamon. I also threw in some frozen strawberries and dried apricots, because I had them on hand.



Low heat for four hours made the house smell like autumnal heaven, but there had been little cooking going on. I should've vented the lid so that the whole batch would go to apple butter in that time (which was my original intent).

I put half the mixture in an old pickle jar (clean!!) as applesauce. Then I kept the pot on low overnight, venting the lid by raising it off the pot with two spoons. I didn't mean to, but I woke up in the middle of the night and checked on it. In the morning: scrumptious apple butter.

I also made the meatloaf in the crock pot. Ground beef, an onion, beef bouillon, eggs, a little milk.... I cooked it on high for a little over three hours. The internal temp was good and the outside developed a nice cooked-sausauge color. It was very moist and soft, and it was not easy to take out. Luckily, I'd made a few foil slings underneath it; next time I'll line the whole base of the loaf. I squished it into a large tupperware and it'll last all week. I didn't realize the recipe proportions were probably meant for a larger cooker.

Oat cakes! I've had this recipe on my sidebar for months but haven't tried it yet. It calls for three cups of dry ingredients (half oats, half wheat flour), four cups of wet (half milk, half water), plus a tablespoon each of yeast and salt. First reaction: how weird to put yeast in a batter (it's going to be flat anyway!); second reaction: that's really salty!

Being a good Catholic, I know how to obey things that don't make sense at first. So, I mixed everything together and poured it into a well-greased frying pan.

UTTER FAILURE. I made two fail-cakes (this is when I discovered how salty they were). I decided that, since the recipe wasn't speaking ex cathedra, I needed a different plan.

Experiment: I oiled and floured a baking pan.
Result: better, but not perfect. They were a little underdone on the bottom. Also, it was time-consuming to cut the sheet into slice-of-bread-sized pieces.
Solution: tent with foil. 
Solution: separate with foil during baking.

Second batch: better, but still imperfect. The sheets were easier to separate, though I forgot to tent and therefore bottoms were still a little soft.

I froze the oat cakes for the upcoming weeks' sandwich bread. Time will tell if this is a better method than bread. Things I already like: 

1. I won't have to slice these in the morning when you're in a hurry.
2. They're thinner than bread slices.
3. They cook faster.
4. They're all the same size.
5. They won't mold in the freezer.
6. I won't need an icepack to keep my cheese cool.

Iconography

Our Lady of Częstochowa

I love icons: I have a diptych in my study carrel at school, and a Russian nicopeia in my bedroom. I've often wanted to write icons, especially when I am reading about a favorite saint. However,  I'm woefully ignorant, so I am reading about iconography on my weekend off. (I had an exam last Friday and won't have another one for two weeks!)

I found rich quotes from the Catholic Encyclopedia and an insightful interview with iconographer Marek Czarnecki. I was most impressed with two points: the powerful, subtle way icons teach and the remarkable mentality of iconcographers.

First point: icons are designed to teach through every detail. Czarnecki had this to say:

We can compare an icon to a carefully constructed poem. Indeed, this is why we call it icon ‘writing’ instead of ‘painting.’ Every ‘word’ or element of it fits very concisely and precisely to contribute to the overall meaning and integrity of the whole.

He called iconography an "eternal language," providing a way to depict the Church's saints until the end of time. "Iconography is called, rightly so, a liturgical art. Just like a priest has a rite for saying Mass, so we also have our guidelines...the consensus and example of tradition." He also informed me about the importance of icons in our human lives:

In the eighth century, an ecumenical council was convened. At that time, St. John of Damascus determined that icons were not an ‘option,’ but rather a necessity in explaining the Incarnation of Christ. To not have icons would be a denial of the Incarnation itself.

It reminds me of the importance of the beauty of architecture, which I realized when TAC dedicated the Chapel my sophomore year. It was designed to be a church that teaches, so that the marbles used and the positions of the materials impressed on TACers truths of the faith. In the same way, shapes and colors on the wood of an icon impress us with truths. I've seen that the richest lessons are the ones I learn gradually and gently, unfolding day by day. The icons in my life do this.

Indirect Sterilization

The genetics lecturer yesterday had dozens of case studies. Here's one, which mainly surprised me because of the polled response she received from the audience. (Because of a technical difficulty, the audience excluded me and everyone at my site; only the remote sites to which the talk was teleconferenced were able to vote.)

Mrs. _____ has a family history of breast cancer. She wants a TAH/BSO [total abdominal hysterectomy and removal of both ovaries] for prevention. You offered her genetic counseling and genetic testing which she declined. Do you comply with her request?

1. Yes
2. No
3. Maybe

As soon as the question appeared, I snorted a quiet "no" to myself. This is indirect sterilization: a procedure resulting in loss of fertility (direct sterilization is a procedure that brings about the loss of fertility as its only purpose.) Then the results appeared:

1. Yes - 47%
2. No - 17%
3. Maybe - 36%

I was shocked that the largest group of my peers would remove this woman's healthy generative organs. Since this poll was on my mind, I looked up the relevant Church teaching.

Autonomy (again!)

There was a fascinating (read "scandalizing") lecture yesterday in Med Ethics. A geneticist spoke in very distracted fashion about the ethics of her science. I was mostly studying embryology during this (and emailing the minutes of the CMA-SS meeting), so I happily didn't have much of an occasion to get angry. However, the members of my small group all came in frustrated with the disorganization and opinions expressed. I did pay enough attention to catch some highlights for you:

...you may have your own moral beliefs, and that's fine, but you have a duty to refer the patients to get complete care.

Context: the patient wants contraceptives or abortion, and those desires are "complete care." The lecturer then continued, saying that she provides what she calls "non-directive counseling," that is, she "will talk about termination" with patients. Still speaking decisions regarding abortion and contraception, she said:

It is not your decision to make, it is the patient's decision to make.
...[W]e make those decisions [the decision not to counsel abortion or contraception] based on our own experience, our religious beliefs, and a number of other things; but patients make those decisions that same way we do, so their decisions may be different than yours.

Apparently, the patient and I can't arrive at the same answer, because we have two impossibly different collections of rules to follow.

But people don't make decisions by consulting a slab of mental commandments and tabulating the dilemmas they create when they intersect! We make decisions based on what is the good we see and the habits we have. I could go on a long rant about principlism, but now is not the time; in fact, now is the time to study for Friday's test. But principlism as an explanation for human behavior fails. The truth is, we act according to the goods and habits described by virtue ethics (Aristotle was right).

There was more to be said about this lecture, but I'll split up the material into two posts.

ACOG Patient Information

Last post, I linked some of ACOG's literature for providers. Now, I'll examine some of their literature for patients. I received five patient-information pamphlets when I became a member (yes, I am a member, but I also joined AAPLOG). ACOG sells these pamphlets to OB/GYNs in private practice. From their list of literature, I chose these five to receive:

1. Birth Control Pills
2. Emergency Contraception
3. Human Papillomavirus Infection
4. HIV and Women
5. How to Prevent Sexually Transmitted Diseases

(I purposefully chose the hot-button issues because I expect that when "reproductive rights" are not involved, ACOG's recommendations are medically sound.) Let's just look at Emergency Contraception (EC).

ACOG Conference

I readily talked about CMA. Now I have to drag myself into talking about ACOG. The American Congress of Obstetricians and Gynecologists does not send me into raptures like the CMA does. In fact, ACOG's opinions are influenced by politicians and advocate a very sad agenda for women (abortion, contraception, selective reduction, etc).

I went to an ACOG conference last Saturday. I swept past several contraceptive companies and IVF providers, and dodged the free demos of IUDs that were being given out to the medical students.  Even so, most of the booths were encouraging: a new women's hospital was opening, a cord-blood bank was giving out stuff, and a lab company was showing off their pap-smear swabs right across from a da Vinci robot (which I got to play with!!!). I think this is because my district of ACOG is rather conservative.

Nationally speaking, ACOG seems very misled morally. Take a look at Committee Opinion 385, drafted in 2007 and reaffirmed last year. Other interesting ACOG opinions:

• Understanding and Using the U.S. Medical Eligibility Criteria for Contraceptive Use
• Forming a Just Health Care System
• The Obstetric-Gynecologic Hospitalist
• Increasing Use of Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy 
• Menstrual Manipulation for Adolescents with Disabilities 
• Induced Abortion and Breast Cancer Risk 
• Abortion Access and Training 
• Misoprostol for Postabortion Care 
• Hormone Therapy and Heart Disease 
• End-of-Life Decision Making 
• Surgery and Patient Choice

All these links provide access to PDFs that open in this window; these documents belong to ACOG but are available online. I'd like to discuss some of these here in the future (the funnest posts I write are the ones where I dip into my philosophy background—closely seconded by the food posts). However, right now genetics beckons.

CMA plug

The Catholic Medical Association (CMA) is an excellent group: its theology is orthodox and its priorities are straight. I've been to one of their conferences before, and I was floored: solid philosophy, wholesome theology, strong science, daily Mass and confessions, relics of St. Gianna Molla, exposition of the Blessed Sacrament...I could go on. It has a Students Section (CMA-SS), and a student wrote a reflection on this year's conference:

This year’s national conference could not have come at a better time in my medical school career, a time when I am nervous about choosing my specialty and honestly struggling to balance my work responsibilities with the time needed to lead a fulfilling, God-centered life. I feel like God placed this 3 days of conference right where I needed them to re-center my purpose in medicine and to rededicate myself to a life centered around Christ. I once read that it is the most important things in life that we need reminded of most often. This conference was my reminder.

Continue Reading A Reflection on 2011 CMA Conference

Brian B., another student of CMA-SS blogs at The Catholic Medical Student. He is very articulate and writes longer, more focused pieces than I do. I highly recommend his work.

I am becoming a leader in my school's chapter of CMA-SS, so I'm thinking a lot about the CMA lately. I hope I can be a good leader; there are some lukewarm Catholics among my classmates, and I would love to aid Christ in seizing their souls.

Relativism and Autonomy

I want your opinion:

A 48 year-old black women has developed stage III non-Hodgkin's lymphoma and needs combination chemotherapy for treatment. Without therapy she has no hope of survival beyond a few weeks or months. With therapy she has an 80% chance of complete remission. She understands this entirely, but insists that she simply does not want the therapy. There is no evidence of depression.

Which of the following is the most appropriate action?

1. Honor the patient's wishes
2. Ask the family for their opinion
3. Offer radiotherapy instead
4. Psychiatric evaluation
5. Seek a court appointed guardian
6. Risk management evaluation

This was a question on our Medical Ethics midterm. The correct answer was (A) because the end-of-life lecture heavily emphasized autonomy. (Because I know how to jump through hoops, I knew the answer they wanted, but I chose (C) in defiance. None of the other answers make sense; the patient is competent.)

But (A) does not make sense, given the information provided. The principle of autonomy does not allow a physician to lay aside his duty (rather, it binds him to respect the dignity of his patient as equal to his own). Choice (A) does not respect this patient; it betrays her.

The real answer is neither (A) nor (C). The real answer is: sit down with the patient; find out why she does not want this treatment. Her risk-to-benefit ratio is so low! What is she afraid of, or what does she believe about this treatment? And how can I help allay help her make the right choice?

Our Ethics class has operated from the very first lecture on the premise that there are no right answers. As a result, there is no "right choice" for a patient to make in a given situation. There is only the patient's desires and the doctor's opinion. In a world where there are no right answers, (A) makes sense. Ironic that I got the answer wrong in this world of relativism.

I'm contacting the course administrator about the question; we'll see what happens. (The grade does not matter, but the truth does.)

Healthcare disparities

Finally! A good lecture in Medical Humanities. Most of our lecturers make three mistakes:

1. They openly lean left. This is pedagogical.
2. They do not defend their conclusions. This is a cross for the TACer (and any intellect).
3. They employ heavy filler in their presentations (this hurts the medical student soul; we're constantly thinking, "is this a good use of time?? I need to study G-coupled protein receptors!!").

Today, we had a woman who made none of these mistakes. She gave a stimulating lecture, had strong ethos to support her position, and reached beyond politics and academia for the good of patients. Some highlights:

• people do not need to look the same to treat each other without unjust disparity (she was asked before the lecture whether, if the racial distribution of doctors matched the racial distribution of patients, healthcare disparities would disappear)

Living wills and healthcare proxy

Our professors have asked us half a dozen times: "who in here has a living will?" Very few hands go up, and the professor berates us for being young and shortsighted. Every time we're asked, I diligently make a mental note: "I'm going to go home and do that...it's a good idea and I should set an example...." But every time, I forget! (So I still haven't raised my hand.)

Tonight (after the last exam of the first block) I had lots of time, so I looked up advanced directives. Three seconds of research tells me this: "Many Catholic bishops and moralists consider this [living will without healthcare proxy] an unsatisfactory approach, as it does not provide for unforeseen circumstances" (NCBC, ETWN; this page goes into good detail about artificial nutrition and hydration and "extraordinary means").

For reference, here is is a purely Catholic and legally sound healthcare proxy form (designating decision-making authority to another person in the case that you are incapacitated and expressing desires in those cases). It explains very carefully that

the statutory definitions are not always consistent with Catholic moral teaching. For example, the definition of “life-sustaining treatment” under Texas law conflicts with Catholic teaching because the Church considers food and water, even “artificial nutrition and hydration,” as ordinary care, not a “life-sustaining treatment.”

It makes general provisions in accord with Catholic teaching before offering the typical curt "I do wish" or "I do not wish" option.

Please note: these differ according to state. Search for "Catholic advance directive" and your state.

My Companions

Here are the blessed whom I love (hover the cursor over each image for a quote, where available).