The Catholic Church Views on Genetic Testing: Indications for Genetic Counselors
Rebecca B. Donohue MSN, FNP-BC, AOCN, APNG
Catholic Views on Genetic Services and Testing
Cultural diversity can present many challenges when a provider is planning a genetic counseling session. This diversity can be a result of religious as well as gender, racial, ethnic, and other backgrounds. Patients and their families expect to be treated with respect regardless of the personal religious beliefs of the healthcare professional. Some suggestions made by the counselor may violate the patients’ religious beliefs and make them less receptive to counseling. A basic understanding of the Catholic Church’s views on genetic testing may help avoid this dilemma.
In presenting these views, one must account for the structural differences between Catholicism and the rest of the world’s religions. Catholicism is unique in that it recognizes the pope as the single central teaching authority. Technically, this can be regarded as a hierarchical-magisterial structure. Such is not the case for the most of the world’s denominations, where human authority is more diffusive (W. Curtis Mallet, personal communication).
Moral principles are developed from revelation and reason with the authoritative interpretation of those principles. Conscience is then necessary to apply those principles. The Roman Catholic Church has a tradition of bioethical reasoning expressed in scripture, the writings of the church leaders, contemporary Catholic theologians, and encyclical documents (Markwell and Brown, 2001). Papal encyclical documents that address contemporary issues involved with bioethics are used here to assist with defining the Catholic bioethical principles guiding genetic testing. These encyclical documents include Pope Paul VI’s Humane vitae (1968), and Pope John Paul II’s Evangelium vitae (1995) and Veritatis splendor (1993a). Prior to discussion of these principles it is important to point out that “dissent from official teaching exists in all religious affiliations. Healthcare professionals should be aware of the fact that not all persons adhere to every tenet officially proposed by a particular denomination.”
A basic understanding of the principles that guide Catholic Church decisions may help the genetic counselor anticipate how the proposed interventions may be received by the individual of Catholic faith. The Catholic Church maintains the following viewpoint regarding genetic testing (W. Curtis Mallet, personal communication):
Life begins at conception and ends at natural death.
Intercourse is only moral within marriage.
Direct abortion (i.e., destruction of the embryo or fetus) is unacceptable.
Artificial contraception is unacceptable.
Natural Family Planning and ecological breast feeding are laudable.
The moral value of genetic testing will depend upon the circumstances and intention of the person(s) involved.
Presymptomatic and confirmational diagnosis is generally acceptable.
Informed consent is non-negotiable.
Genetic testing is in itself morally neutral.
The purpose of this chapter is to assist in understanding views of the Catholic Church concerning bioethics and genetic testing through discussion of principles guiding these views. Catholic faith principles described here are built on the framework of moral principles presented by Beauchamp and Childress (2001, 13). A basic understanding of the Catholic principles regarding genetic testing may help determine the best strategies to provide genetic services and ensure a proper informed consent process when counseling persons of the Catholic faith. Although principles are general norms requiring judgment, they are not exact guides that inform us in decision making for each action or circumstance as more detailed rules do (14).
Principles of Catholic Decision Making
Principles guiding the Catholic Church decision making with regard to health, therapeutics, and predisposition testing (inherited genetic susceptibility to a disease that may or may not result in disease development) programs are founded on the basic principle of respect, or reverence, for the dignity of human life, from which other principles arise. The Catholic Church views life as a sacred gift from God that is to be protected and nurtured from the time of conception to death. Respect for personal dignity and support of human life can be maintained through prevention of disease and by seeking out more effective therapies for illnesses (Committee on the Home Missions 1996).
Respect
Respect for persons as seen by the Catholic Church can be further divided into four principles: autonomy, beneficence, nonmaleficence, and justice. In respect of an individual’s autonomy physicians, genetics counselors, and the public should understand that responsible use of genetic testing includes providing informed consent (Schneider 2002). The Catholic Church believes in the informed consent process and that this process must uphold human dignity and sustain human life, while protecting privacy and confidentiality (Middleton and Biegert, 2005; Bayley 2005).
Autonomy
The meaning of autonomy in this context is that an individual cannot be coerced into testing; that they must act autonomously. Some may argue that a person cannot act autonomously within religious organizations that direct personal decisions; that individuals that do not act on their own and submit to the authority of a religious organization loose their autonomy. In response to this Beauchamp and Childress state, “individuals can exercise their autonomy in choosing to accept an institution, tradition, or community that they view as a legitimate source of direction” (2001, 60). Respect for a person’s autonomy requires the healthcare provider to acknowledge their right to hold views and to make choices based on their personal values and beliefs. Although the decision to have genetic testing is autonomous, genetic testing often involves testing of not only the individual but also family members such as parents, siblings, and children. It is important to understand that it is a Catholic tradition to consider future generations as well as living individuals (Committee on the Home Missions 1996). In this regard the genetic counselor should
anticipate that the Catholic individual may wish to have family members involved in the entire decision-making process rather than make genetic testing decisions alone.
anticipate that the Catholic individual may wish to have family members involved in the entire decision-making process rather than make genetic testing decisions alone.
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