How do institutionalized religions solve moral ambiguities around controversial medical innovations and public health issues? Most religions have moral guidelines about what can and cannot be done to people’s bodies, but these guidelines are not always straightforward and, when faced with certain scientific advances, can come into contradiction with other doctrinal principles. I address this theoretical puzzle through the empirical case of the Spanish Catholic Church’s discourse on organ donation and transplantation during the second half of the twentieth century. Drawing on an interpretive analysis of official statements by the Spanish Catholic Church, and of the media coverage of the religious debate over organ donation and transplantation in Spain from 1954 onwards, I show that the first experiments in organ transplantation faced the Church with a contradiction between its altruistic teachings and its beliefs in the sacredness of human life. Faced with an interpretive dilemma, the Church produced a context-specific version of its official doctrine friendly to organ donation and transplantation. It did so by activating its altruistic elements and suppressing sacralized meanings of the body, thus aligning organ donation with Catholic values of generosity and fraternal love. My study theorizes this moral alignment as a semantic overlap realized through historically situated institutional discourse. Additionally, it incorporates 24 primary and secondary sources on comparative cases to propose three facilitating factors that enabled and encouraged the Spanish Catholic Church to embrace a controversial medical practice.

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More than 30 years have passed since the first HIV-specific criminal laws were enacted, generally making it a crime for people living with HIV to have sex with another person without disclosing their HIV-status. This study examines the tensions between medicine and criminal justice discourses in the application of laws governing a once terminal disease that medicine has transformed, over the past three decades, into a manageable condition. Has medical progress affected courtroom discussion? To answer this question, the authors analyze court transcripts from nine criminal HIV nondisclosure jury trials between 1994 and 2015 in Michigan, Tennessee, and Missouri. The analysis focuses on how shifting medical discourses of risk influence the way prosecutors and counsels construct notions of individual responsibility and, thus, culpability for HIV exposure. The authors argue that antiretroviral therapy and sophisticated clinical testing technologies have led to increasingly medicalized notions of criminal responsibility that they term ‘molecular responsibility.’ Over time, arguments over the defendant’s responsibility shift from the realm of morality to incorporate the defendant’s capacity and willingness to medically control the microbiological dimension of their condition.