For much of my adult life the term “cafeteria Catholic” has been invoked as something of a slur against those who allegedly “pick and choose” what Catholic teachings they will observe to suit their tastes. I believe the term is a straw man which overlooks several critical points:  No one is without sin, and we all select choices compatible to our own lights, contrary to Church and Gospel. In other words, all of us without exception live our moral lives like cruisers at the ship’s smorgasbord; show me an instance of someone who does not.  Moral purists overlook the considerable body of Church history and tradition—particularly from the medieval era—that moral choice making is a complex and, in many ways, still poorly understood process. See this essay from Stanford University on new interest in medieval mental operations.  The Church has always provided a forum for discernment of individual moral decision making, as in the 1970’s on the matter of birth control, in the confessional. It was only in the 1930’s that confessors were instructed to interrogate married persons on matters of contraception.  Even under the guidance of the Holy Spirit, the Church has had to consistently review its moral directives in the light of deeper discernment, as with Pope Francis’ revision of Catechism Code 2267 on the inadmissibility of capital punishment.
With all of this in mind, I do not envy the job of catechists who are attempting to convey the teachings of the Church to young people and adults, nor any Catholic who is attempting to make moral decisions or engage in meaningful conversations with family and friends who are trying to decipher the Catholic moral way. Catholic morality certainly holds absolutes, but its greatest moral teaching is the love of God and neighbor. Unfortunately, we have something of a new phenomenon to behold, a collection of bishops in the United States who claim, for all practical purposes, to be more Catholic than the pope and to hold their charges to a higher standard of conduct than the official Vatican guides prudently advise.
The specific issue in question is the Covid vaccine and its relation to biological strains of aborted fetuses from the 1970’s and 1980’s employed in the development. Although my graduate specialty in the early 1970’s was moral theology, there have been so many scientific advances in the past half century that I am in the same position as most of my Catholic fellows today: dependent upon the information of honest, peer reviewed science and the Church’s moral guidance as processed by the Vatican’s Congregation of the Doctrine of the Faith.
During the reign of Pope Benedict XVI, on September 8, 2008, the above cited Congregation issued a teaching entitled Dignitatis Personae, “The Instruction on Certain Bioethical Questions,” an ethical directive covering a wide range of new medical research and practices, including the development of new vaccines. The Congregation took note of the practice of using strains from fetal tissue to develop new treatments and, not surprisingly, condemned the practice of harming or aborting an unborn child for the purpose of extracting tissue or other organs for research purposes. But then, in para 35, the Congregation writes this: “Grave reasons may be morally proportionate to justify the use of such “biological material”. Thus, for example, danger to the health of children could permit parents to use a vaccine which was developed using cell lines of illicit origin, while keeping in mind that everyone has the duty to make known their disagreement and to ask that their healthcare system make other types of vaccines available. Moreover, in organizations where cell lines of illicit origin are being utilized, the responsibility of those who make the decision to use them is not the same as that of those who have no voice in such a decision.”
There are two critical “take-aways” from this 2008 directive. First, the Congregation states that moral responsibility lies with those who made the original decision years ago to use aborted fetus cells for medical research; the guilt does not extend to those “who have no voice in such a decision,” i.e., those of us decades later who need the vaccine to protect not just ourselves but the most vulnerable members of society, the elderly, the ill, and the young. In the technical terms of moral theology, the question is direct versus remote participation or causality. Certainly, we can and should study the issue and “make known [our] disagreements and ask that [our] healthcare system make other types of vaccines available,” as Dignitatis Personae exhorts. Unfortunately, the urgency of a pandemic does not give us this luxury in the cases of the three vaccines developed to combat Covid-19.
The second “take away” is the long tradition of Catholic practice in matters of moral decision making of recognizing that in certain circumstances there is no perfect choice. Put simply, we are sometimes faced with choosing the lesser of two evils from the vantage point of Catholic moral teachings. A textbook case is a pregnant mother suffering from an invasive cancer in the reproductive system. Surgical removal of the cancer may necessitate removal of the fetus. The moral choices open to the mother are the unfortunate termination of her pregnancy, on the one hand, or permitting the cancer to metastasize further and eventually take her life. In such moral dilemmas, the choice is between two morally challenged outcomes. For centuries, dating to medieval theology, the virtue of prudence has been invoked to determine which option is the wiser in view of available data.
On December 14, 2020, the United States Conference of Catholic Bishops issued a pastoral directive calling upon Catholics to be vaccinated against Covid-19, stating that “being vaccinated safely against COVID-19 should be considered an act of love of our neighbor and part of our moral responsibility for the common good." At that time, the Pfizer and Moderna vaccines were being distributed for use in the United States. The Astra-Zeneca vaccine was also ready for use in England, and there was some question that this vaccine was more “morally compromised” because of greater dependence upon strains of fetal cells in its testing. In a directive that can be easily applied to the newer Johnson & Johnson vaccine as well, the bishops wrote: "It may turn out, however, that one does not really have a choice of vaccine, at least, not without a lengthy delay in immunization that may have serious consequences for one's health and the health of others. In such a case ... it would be permissible to accept the AstraZeneca vaccine."
On January 11, 2021 Pope Francis, who himself was vaccinated, spoke of the process as a “moral obligation” and authorized immunization of all employees of the Vatican. One would have supposed that by this point it would be clear that a Catholic could be [and probably should be] vaccinated with a clear conscience. But on March 2 the USCCB felt compelled to issue a new clarification: “…if one can choose among equally safe and effective COVID-19 vaccines, the vaccine with the least connection to abortion-derived cell lines should be chosen. Therefore, if one has the ability to choose a vaccine, Pfizer or Moderna's vaccines should be chosen over Johnson & Johnson's.”
Rather remarkably, also on March 2, the Diocese of Bismarck, North Dakota, issued this statement: “The recently approved (FDA 2-27-2021) vaccine produced by Janssen/Johnson & Johnson used abortion-derived cell lines in the design, development, production and lab testing. This Janssen/Johnson & Johnson vaccine is morally compromised and therefore unacceptable for any Catholic physician or health care worker to dispense and for any Catholic to receive due to its direct connection to the intrinsically evil act of abortion. No one should use or receive this vaccine but there is no justification for any Catholic to do so. Two morally acceptable vaccines are available and may be used. As always, no one is bound to receive this vaccine, but it remains an individual and informed decision.” The St. Louis and New Orleans archdioceses have counseled Catholics to avoid the Johnson & Johnson vaccine.
If you have ever wondered about that saying, “more Catholic than the pope,” you have a good example here. Those of us who love the Church and minister in its name have a right to be troubled when maverick bishops issue directives which deviate from universal Church guidance, not to mention the Church’s tradition of thoughtful prudence. Certainly, one factor here has been the U.S. bishops’ longstanding policy of making abortion the preeminent moral concern in its public policy statements, including election guidance. Another is a palpable discomfort of a good number of American bishops with Pope Francis himself, whose moral vision of social justice is considerably broader than that of traditionalists in the United States. For whatever reasons, these bishops feel empowered to exercise more restrictive rulings than the Vatican itself.
Jesus expressed himself clearly enough about the challenges of living a moral life; it is hard enough without creating more obstacles: “They tie up heavy burdens hard to carry and lay them on people's shoulders, but they will not lift a finger to move them.” This being the first anniversary of the pandemic in the United States, it is worth pausing to reflect upon the many who have died, suffered, lost their livelihoods, their schooling, their family bonds, and even their access to the Eucharist. The discovery of vaccines in a record short time which promise alleviation of such suffering ought to be seen as a gift from God. I am saddened that some churchmen cannot see this medical intervention in that light. If any vaccine facilitates a single person’s reunion to reception of the Eucharist, a prudent judgment will render it wise.