{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:51:29Z","timestamp":1791611489187,"version":"4.3.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Linacre Q"],"abstract":"<jats:p>Catholic healthcare institutions worldwide are under increasing pressure to participate in euthanasia\u2014often through forced implementation rather than chosen partnership, creating ethical challenges in balancing institutional conscience and theological integrity with their obligations to serve the broader public. This paper develops an interdisciplinary spatial ethics framework of healthcare space grounded in epistemology, environmental psychology, and Catholic moral theology; it examines three spatial dimensions\u2014operational, missional, and moral\u2014and Catholic social teaching principles of subsidiarity, preferential option for the vulnerable, and human dignity. The framework is applied to a paradigm case: a government-mandated euthanasia clinic structurally embedded within a Catholic hospital's interior hallway, its mural extending into the hallway and creating a single spatial aesthetic continuum between the contested practice and the Catholic healthcare space. Spatial analysis reveals not merely proximity, but the absence of any institutionally produced boundary\u2014operational, missional, and moral\u2014between Catholic space and the euthanasia act. This paper argues that the provision of facilities for grave evil cannot be assessed apart from spatial-moral effect, and the spatial-moral effects of architectural integration remain subject to cooperation analysis even under conditions of imposed configuration where institutional capacity for spatial remediation persists. The clinic's architectural integration and spatial arrangements constitute proximate mediate material cooperation and render proportionate reason structurally unavailable. Beyond cooperation, the spatial arrangement creates three further harms: scandal erodes trust in Catholic healthcare; stakeholder exclusion from design decisions undermines subsidiarity; and vulnerable populations experience environmental pressure through repeated exposure and architectural normalization within spaces intended for sanctity of life. This case study demonstrates the need for globally applicable evaluation frameworks equipping Catholic healthcare institutions to assess facility proposals, protect vulnerable populations, and preserve institutional conscience through architectural and spatial integrity.<\/jats:p>","DOI":"10.1177\/00243639261490177","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:31:44Z","timestamp":1791455504000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatial Ethics of an Imposed Euthanasia Clinic Within a Catholic Hospital Space"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7981-2869","authenticated-orcid":false,"given":"Yuriko","family":"Ryan","sequence":"first","affiliation":[{"name":"Independent Scholar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0749-5978(91)90020-T"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hast.1353"},{"key":"e_1_3_4_4_1","unstructured":"Aquinas Thomas. 1920. Summa Theologiae. 2nd and Revised Edition. Translated by the Fathers of the English Dominican Province. New York: Benziger Brothers. 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