Peace to you, brothers and sisters. As we reflect on the Season of Creation, let us call to mind our recent history. The COVID-19 pandemic, political turmoil, war, unaddressed global poverty, the backsliding of climate initiatives, deepening inequality, the deliberate inflaming of racial and ethnic strife, the accelerating concentration of power driven by artificial intelligence, and rising assaults on human dignity—especially against those who are marginalized and “othered”—all cry out for a new (or perhaps a very old) practical wisdom. Some eight hundred years ago, the lives and witness of Saint Francis of Assisi and his followers offered a prescient critique of the very crises we now face. Secular “bioethics is the systematic study of the moral dimensions—including moral vision, decisions, conduct, and policies—of the life sciences and health care, employing a variety of ethical methodologies in an interdisciplinary setting.”[1] I honor that tradition, and I work within it. But I write, teach, and practice as an African American Franciscan bioethicist—a clinical ethicist at the bedside and a Catholic voice for a wounded world. It is precisely this perspective, I believe, that our moment requires.
Too often, despite the complexities of contextual challenges in clinical care, Catholic bioethics scholarship has trained its gaze narrowly on questions at the very beginning and the very end of life, while leaving the long middle—access, justice, equity, climate change, the political determinants of health, eco-social trauma, and structural violence—almost entirely unexamined.[2][3][4] What follows is my attempt to sketch the contours of a Franciscan bioethics: one grounded in the mysticism of Saint Clare of Assisi and Saint Bonaventure, the interdisciplinary and homiletic genius of Saint Anthony of Padua—whose name I will take when I am fully professed—and the pastoral theology of the late Pope Francis, a Jesuit with a Franciscan heart. I offer it, too, in order to carry forward the legacy of the late Jacquineau Azetsop of Cameroon, a Jesuit social bioethicist who took structural violence seriously. I pray for a double portion of his spirit.
Consider that roughly sixty percent of the world’s people carry a history of adverse childhood experiences (ACEs).[5] At their root, these wounds are ruptures in relationship—and such ruptures occur at every level: individual, family, community, state, nation, globe, and planet. When they are inflicted indirectly, through impoverishing systems and practices, we name it structural violence: physical, economic, political, and cultural.[6]
Without love, wounded people wound others as surely as an infectious disease spreads—not only in the present, but across future generations through epigenetics.[7] Trauma is a biopsychosocial-economic-spiritual wound, and it drives excess morbidity and mortality.[8][9] Those who carry four or more ACEs can lose up to twenty years of life to illness and premature death.[10] Truly, “the wages of sin is [literally] death, but the gift of God is eternal life in Jesus our Lord” (Rom 6:23). The Law of Moses grew ever more intricate as societies changed and divine precepts had to be applied to new human needs, all of it resting on rational interpretation. But here lies the difficulty: the prefrontal cortex—the seat of reason, logic, and decision-making—goes offline when a person is triggered by trauma.[11] Trauma can therefore stunt the growth of virtue and disable our very capacity to apply moral principles rationally.[12]
Jesus met trauma with love, and in doing so gave us the antidote to our biopsychosocial-economic-spiritual wounds: to love God and to love our neighbor. This was not only his proclamation; it was the very ground of his healing and his Resurrection. Even when we unwittingly sought to traumatize God himself—when, by our will to power over the Only Begotten Son, we brutally executed Love as an enemy of the state while his Father and mother looked on—still God held us in his merciful hands. Love cannot be contained because it is the generative ground of our being and the very source of resurrection and recovery.
And the science agrees. Research in interpersonal neurobiology shows that love, offered through healthy relationships, can heal the mind and body—and can even make us wiser.[13] As Judith Herman writes, “Recovery can take place only within the context of relationships; it cannot occur in isolation.”[14] This is why good clinical ethics matters. In a well-run ethics consultation—what we often call a “family meeting”—the ethicist must remain attentive to asymmetries of power, lest we violate the very principles of beneficence, non-maleficence, autonomy, and justice we are called to protect, and so inflict fresh trauma.[15][16] This unconditional positive regard for the other, joined to trauma-informed care, creates the conditions in which even the most complex and seemingly intractable ethical and relational dilemmas can find principled resolution.[17][18] Just as Saint Francis built bridges with those who were othered (including creation), Franciscan bioethicists become peacemakers who advance the Kingdom of God’s palliative love.[19]
To reach the universal fraternity at the heart of the Franciscan charism, we will need many such meetings—interpersonal, communal, civic, national, and global—each of them trauma-informed, each of them schooling us in an ethos of love.[20] Only then can we tend our collective stigmata and be raised into universal kinship, into the very life of the Triune God who is love itself (1 John 4:7–21). Only then can we care for our common home, together. May Love and Life be all in all for eternity.
Peace and All Good.
References
Azetsop, Jacquineau. Structural Violence, Population Health and Health Equity: Preferential Option for the Poor and the Bioethics Health Equity in Sub-Sharan Africa. VDM Verlag Dr. Muller Aktiengesellschaft & Co. KG, 2010.
Brown, David W, Robert F Anda, Henning Tiemeier, et al. “Adverse Childhood Experiences and the Risk of Premature Mortality.” American Journal of Preventive Medicine 37, no. 5 (2009): 389–96.
Burke Harris, Nadine. The Deepest Well : Healing the Long-Term Effects of Childhood Adversity. Houghton Mifflin Harcourt, 2018.
Cahill, Lisa Sowle. “Foreword.” In Catholic Bioethics and Social Justice: The Praxis of Us Health Care in a Globalized World. Liturgical Press Academic, 2018.
Carbajo-Núñez, Martín. The Universal Fraternity. Tau Publishing, 2023.
Dubler, Nancy Neveloff, and Carol B Liebman. Bioethics Mediation: A Guide to Shaping Shared
Solutions. Vanderbilt University Press, 2011.
Englebert, Omer. St. Francis of Assisi: A Biography. Franciscan Media, 1965.
Farber, Barry A, and Erin M Doolin. “Positive Regard.” Psychotherapy 48, no. 1 (2011): 58.
Fiester, Autumn. “TIEC, Trauma Capacity, and the Moral Priority of Surrogate Decision Makers in Futility Disputes.” The Journal of Clinical Ethics 36, no. 1 (2025): 40–51.
Fisher, Anthony. “The Vocation of the Healthcare Ethicist.” Health Care Ethics USA, no. Spring (2021): 7–21.
Herman, Judith Lewis. Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror. Hachette UK, 2015.
Jonsen, Albert R. The Birth of Bioethics. Oxford University Press, 1998.
Lanphier, Elizabeth, and Uchenna E Anani. “Trauma Informed Ethics Consultation.” The American Journal of Bioethics22, no. 5 (2022): 45–57.
Lysaught, M Therese, and Cory D Mitchell. “Vicious Trauma.” Journal of the Society of Christian Ethics 42, no. 1 (2022): 75–100.
Madigan, Sheri, Audrey-Ann Deneault, Nicole Racine, et al. “Adverse Childhood Experiences: A Meta-Analysis of Prevalence and Moderators among Half a Million Adults in 206 Studies.” World Psychiatry 22, no. 3 (2023): 463–71. https://doi.org/https://doi.org/10.1002/wps.21122.
Siegel, Daniel J, and Marion F Solomon. Healing Trauma: Attachment, Mind, Body and Brain. WW Norton & Company, 2013.
Torres-Deas, Lucille M, Monica L Lypson, and Christina M Puchalski. “Integrating Health Justice into the Biopsychosocial-Spiritual Model to Promote Well-Being.” BMJ Leader 7, no. Suppl 2 (2023): e000785.
Yehuda, Rachel, and Amy Lehrner. “Intergenerational Transmission of Trauma Effects: Putative Role of Epigenetic Mechanisms.” World Psychiatry 17, no. 3 (2018): 243–57.
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[1]Albert R. Jonsen, The Birth of Bioethics (Oxford University Press, 1998), vii.
[2]Lisa Sowle Cahill, “Foreword,” in Catholic Bioethics and Social Justice: The Praxis of Us Health Care in a Globalized World, ed. Lysaught and McCarthy (Liturgical Press Academic, 2018).
[3]Anthony Fisher, “The Vocation of the Healthcare Ethicist,” Health Care Ethics USA, no. Spring (2021).
[4]Jacquineau Azetsop, Structural Violence, Population Health and Health Equity: Preferential Option for the Poor and the Bioethics Health Equity in Sub-Sharan Africa (VDM Verlag Dr. Muller Aktiengesellschaft & Co. KG, 2010).
[5]Sheri Madigan et al., “Adverse Childhood Experiences: A Meta-Analysis of Prevalence and Moderators among Half a Million Adults in 206 Studies,” World Psychiatry 22, no. 3 (2023), https://doi.org/https://doi.org/10.1002/wps.21122.
[6]Azetsop, Structural Violence, Population Health and Health Equity: Preferential Option for the Poor and the Bioethics Health Equity in Sub-Sharan Africa.
[7]Rachel Yehuda and Amy Lehrner, “Intergenerational Transmission of Trauma Effects: Putative Role of Epigenetic Mechanisms,” World Psychiatry 17, no. 3 (2018).
[8]Nadine Burke Harris, The Deepest Well : Healing the Long-Term Effects of Childhood Adversity (Houghton Mifflin Harcourt, 2018).
[9]Lucille M Torres-Deas et al., “Integrating Health Justice into the Biopsychosocial-Spiritual Model to Promote Well-Being,” BMJ Leader 7, no. Suppl 2 (2023).
[10]David W Brown et al., “Adverse Childhood Experiences and the Risk of Premature Mortality,” American journal of preventive medicine 37, no. 5 (2009).
[11]Burke Harris, The Deepest Well : Healing the Long-Term Effects of Childhood Adversity.
[12]M Therese Lysaught and Cory D Mitchell, “Vicious Trauma,” Journal of the Society of Christian Ethics 42, no. 1 (2022).
[13]Daniel J Siegel and Marion F Solomon, Healing Trauma: Attachment, Mind, Body and Brain (WW Norton & Company, 2013).
[14]Judith Lewis Herman, Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror(Hachette UK, 2015), 191.
[15]Elizabeth Lanphier and Uchenna E Anani, “Trauma Informed Ethics Consultation,” The American Journal of Bioethics 22, no. 5 (2022).
[16]Autumn Fiester, “TIEC, Trauma Capacity, and the Moral Priority of Surrogate Decision Makers in Futility Disputes,” The Journal of Clinical Ethics 36, no. 1 (2025).
[17] Barry A Farber and Erin M Doolin, “Positive Regard,” Psychotherapy 48, no. 1 (2011).
[18] Nancy Neveloff Dubler and Carol B Liebman, Bioethics Mediation: A Guide to Shaping Shared Solutions(Vanderbilt University Press, 2011).
[19] Omer Englebert, St. Francis of Assisi: A Biography (Franciscan Media, 1965).
[20] Martín Carbajo-Núñez, The Universal Fraternity (Tau Publishing, 2023).